One month old

Miss Adelyn Grace is one month old today! I can't believe it; it seems like it's gone by so fast, but then again that might be because she spent the first two weeks of her life in the hospital. We didn't actually get to bring her home until she was two weeks old so it didn't really feel real until then. These past two weeks have flown by though... Stop going so fast, time!

Adelyn at one month old:

• She had her first check up on December 22nd. She was 8 lbs 6 oz and 22 inches long. Her height puts her in the 94th percentile. She's tall and skinny!
• She's still in newborn diapers and newborn onesies. Even a couple of her newborn outfits are a bit big.
• She's smiling like crazy. It's mostly random but I have gotten her to smile at me a couple times. If I can get her attention and be just the right distance from her face, I can get a smile out of her. 
• She's sleeping ok; she'll wake up usually twice at night to eat, then sleep for a 2-3 hour stretch. Sometimes it takes her a bit to go back to sleep but I'll usually get 6-8 hours of sleep a night in 2-3 hour stretches. It's ok for now but once I go back to work it might get rough. 
• She's generally a very happy baby. She doesn't cry unless she's hungry or needs her diaper changed. If you wait too long for either of those things though, she will shut. down. Like, screaming so hard she gets splotches on her face. 
• For the reason above, we call her our "drama queen." She'll get upset when you change her clothes, or move her when she's comfortable, or bathe her. She has this little tearless wail she'll let out that immediately stops once you've stopped doing what's irritating her. Ken says she takes after me, haha. 
• She'll giggle every so often, though I don't think she knows what she's doing. It's mainly when she's sleeping, she'll let out this little breathy giggle. It's adorable.
• She's eating every 2-3 hours, 3-4 oz a feeding. She's a little sow and sometimes will eat up to 5 oz in one feeding. We'll give her a 3 oz bottle, and she will scream after it's gone until we pop another one in her mouth. She's getting pumped breast milk with formula for supplementation. I just can't produce enough milk for her so she gets breast milk every other feeding. I felt bad about giving her formula at first, but she needs to eat and some breast milk is better than none. 
• We had a few successful times breastfeeding; she'll latch ok and nurse for like 15-20 minutes but I don't know if she's a lazy sucker or just gets frustrated easily, but she ends up screaming for more after every time I nurse her, so we have to give her a bottle then I still have to pump and I get just as much as I would had I not nursed her. So it's just easier to pump and give it to her in a bottle. The bottle nipples flow a bit faster too so I think that may have something to do with it. 
• She doesn't spit up much, thank goodness. She'll give us a good burp with each feeding but there's rarely spit up. And if she does, it's not much. She's a very messy eater though so she usually still ends up with milk all over her after a feeding. 
• She loves her binky. Anytime she's fussy if you pop that binky in her mouth, it calms her right down. It's helpful for when she wakes up in the middle of the night and needs her diaper changed before I can feed her. 
• She usually poops once a day, and boy does she poop. She's only pooped out of her diaper once, but more often than not, I'll go to change her and she's not done and she'll either poop all over her new diaper, her changing pad, or my hands. I've learned that when she's pooped, I have to wait a few minutes for her to finish otherwise I'll have a bigger mess to clean up than if I just waited. 
• Her umbilical cord just fell out a few days ago, so she's been getting sponge baths. She doesn't like them very much, I think because she gets cold. I'll probably continue to give her sponge baths until the stump heals completely. 
• She still has a ton of dirty blonde hair. It hasn't started to fall out yet and I hope it stays that way. It's wild though, I'll brush it down after a bath and within minutes it's sticking up all over the place. 
• I think her eyes are going to be brown. They're still a grayish color but I see hints of brown in them in the right light.
• She loves to cuddle. After a feeding I'll put her on my chest and she'll usually fall right to sleep. 
• She will not keep socks on. I don't know if that's just a baby thing or just an Adelyn thing but within minutes of putting socks on her, she's kicked them off. I try to put them on her at night so her feet stay warm and when I unswaddle her to change her diaper, the socks are just sitting in the blanket.
• She also doesn't like to be completely swaddled. She doesn't like having her arms confined in any way. I think it's from when she was in the hospital and she had the arterial line in her arm. She had it splinted so she couldn't move it and I think that stuck with her. I'll usually swaddle her right underneath her arms so she's warm but has control of her arms. The couple times I've tried swaddling her with her arms inside, she's broken free of it within minutes.
• We've tried tummy time a couple times. She'll tolerate it ok on my chest but when we tried with the Boppy she had a melt down. 
• She's starting to hold her head up. If I lay her on my chest, she'll push herself up with her elbows and look around. She'll hold her head up and look around too if I hold her up on my shoulder. You just have to have your hand behind her head cause she'll get over excited swiveling her head around and she's banged it on my shoulder or chin before and she'll get very upset, lol. 
• She loves looking at lights. If we have her in the kitchen, she will just stare at the track lighting on the ceiling. If I set her down on the bed, she'll turn her head towards the TV and "watch" it. 
• She loves her swing. We haven't tried the bouncer yet. I'm afraid she'll fall out of it, lol. 
• She's a very heavy sleeper. Once she's out, she's out. We'll have visitors over, and she'll get passed around and not wake up once. My brother in law set off the smoke alarm once when he was over and she didn't even flinch. 
• She's currently sleeping in her pack and play next to the bed. Until she sleeps through the night, this is the easiest option since she's so easy to get to. Once she outgrows the napper we're either going to just let her sleep in the playpen part or move her to her crib. Depends on how long she's sleeping at night. 

Here's some pictures of her first couple of weeks home!

Adelyn's NICU Stay

So this may be a bit all over the place; it's hard to remember every detail and what days certain things happened on, so a lot of it is guessing (i.e. when she came off the sedation, when her breathing tube came out, etc.). But everything I could remember is there.

So when Adelyn went into the NICU, we didn't know what to expect. The doctors were telling Ken they'd probably keep her overnight for observation so at first we were optimistic about getting to take her home when I was discharged. I started to pump breast milk for her since I couldn't nurse her and would take it to her in the NICU every two hours or so. I was moved to recovery the day after I had her and shortly after, we got a call that we needed to come down to the NICU so the doctors could talk to us.

They told us she had a lot of meconium in her lungs and she needed a lot of help breathing. She could do it on her own, but she was having a lot of trouble and working really hard so they had her intubated and on 80% oxygen. She was on two separate breathing machines, one I believe was a mechanical ventilator (it used water and I think had slightly humidified air going into her lungs from what my internet research is telling me) and one was the oxygen. There was a possibility she may need a blood transfusion as well (though I don't remember why, I was still pretty out of it). She didn't end up needing it after all, thank goodness. It was heartbreaking to see. They had her on Fentynal to sedate her, so it wasn't really affecting her at all. They also had her on an antibiotic to prevent the meconium from advancing into pneumonia and a nutritional drip (fats and sugars). She had an arterial line in her arm to get blood out of so they didn't have to poke her every time they needed blood from her. She also had two umbilical lines in her belly button, which also helped with getting blood and giving her fluids. They didn't necessarily like the umbilical lines, as they were only good for about a week and they didn't want to have to replace them so they tried inserting a PICC line in her arm, which served the same purpose as the umbilical lines but would last longer. It was a catheter that they would snake up a vein in her arm that would sit close to her heart. They tried it on both arms but her veins kept collapsing so they had to stick with the umbilical lines until she healed a bit more. They couldn't give her any of my breast milk at first as they didn't want to stress her system out too much when she was trying to heal her lungs. They told us that on average, it takes about two weeks for babies with this severity of meconium aspiration to go home, could be longer, could be shorter. But that we were looking at an uphill battle. They never made us feel like she wasn't going to make it or that she was going to get worse, but they also were very blunt in that she was critical and a very sick baby and she had a lot of healing to do. I wasn't going to share pictures of her when she was hooked up to everything, as they're pretty hard to look at, but I decided while writing this I would share a couple just to show how sick she was.

This was the first night in there, when she was still completely sedated. 

I believe this was after they had taken a bit of the sedation off, since her hands are up by her face. She hadn't moved at all when she was completely sedated. You can see how puffy she is and she was a bit jaundiced.

While I was still in the hospital, we went down and visited her every time I needed to take breast milk down to her. She was locked in an isolette and they wouldn't let us even touch her. They wanted the least amount of stimulation as possible so as not to stress her out. The first couple of days were the hardest since all we could really do was look at her.

We got two updates a day when the doctors did their rounds. They were doing x-rays of her lungs during every shift and with each one, her lungs were looking a teeny bit better. But as the meconium broke down, it would create more secretions in her lungs and the tube in her throat would irritate her lungs as well so she had to be suctioned often. It was kind of a two steps forward, one step back kind of situation. As she broke down the meconium, the secretions would irritate her lungs and she had the possibility of developing pneomonia. They were keeping a close eye on the color of the secretions; they wanted them to be clear, and they were coming out a light yellow color, so she had to stay on the antibiotics as a precaution. She was also getting her blood/gas levels checked frequently so make sure she was getting rid of the CO2 in her blood efficiently.

I was discharged the Sunday after she was born. Leaving the hospital without her was one of the hardest things I've ever had to do. I brought myself an outfit to go home in, but I didn't even want to change into it. I went home in pajamas. As I was packing everything, it was just so depressing seeing the blankets I had packed that I was going to wrap her in, the outfits I was going to dress her in, the hand sanitizer I was going to have the guests who came to visit her use...it was all untouched. Ken went to get the car and while I waited for him, I just cried. I cried the whole way home with Ken trying to reassure me she was going to be fine and that we would be back soon to see her. I definitely wasn't expecting an empty carseat in the back of the car.

We ended up visiting her twice a day each day, usually around when the doctors did their rounds, at about 11:00 and 6:00. I was pumping every 2-3 hours and taking her the breast milk for when she was ready to start getting it. At first, we would go down there and stay for an hour or so, as all we could do was look at her in the isolette. As she got better and we could interact with her, we stayed longer, usually 2-3 hours at a time. So we were at the hospital anywhere from 6-7 hours a day. It was rough. I was still super sore from her birth, with the stitches I got and the fact that I was retaining a ridiculous amount of water. When I left the hospital, I weighed exactly what I did before I gave birth from all the fluid I was retaining. My ankles were so swollen I could barely walk. Ken would drop me off at the front of the hospital to park and meet me upstairs since I couldn't even walk across the parking lot. It was awful. I still looked six months pregnant; I had two residents where I work ask, "You haven't had the baby yet?" when I went downstairs and a worker at Port of Subs ask if I was expecting. It wasn't a huge deal to me... I had just given birth three days prior, but really? Give me more than a few days to get back to normal.

A day or so after I was discharged, they decided to start weaning her off the sedation to see how she reacted. They wanted her to start fighting the breathing tube to show she wanted to breathe on her own. It was relieving to see her eyes open, but also tough to see her awake with the tube down her throat. They also decided to start giving her a little bit of breast milk to jump start her digestive system. It was at this point they let us start touching her and changing her diapers. It felt a little better being able to feel her but it was still so sad to see her the way she was. And there was still no holding her, which was tough.

Me changing her diaper.

First picture of the three of us. 

Ken changing her diaper.

This picture brings me to tears every time I look at it. If I had to pick a favorite picture when she was still hooked up to everything this would be it.

With each day, her x-rays were looking better and better, so the doctors decided to take her off the antibiotic and just monitor her closely for infection. At the same time, they weaned her more off the Fentynal so she was much more alert. The entire time, they were slowly weaning her off the oxygen as well, and after a few days, she was down to 30-35% oxygen. They also started giving her Lasix to get the fluid out of her system; she had gained a whole pound since birth from all the fluids she was getting and she looked so puffy. She lost the whole pound within a day so she looked much more normal.

Once they gave her the breast milk, she started making strides, and I am convinced it was because of the milk. The first day getting it (in a feeding tube), she did great. She was getting 10 ml every three hours. By the second day, she wasn't digesting it as fast as they'd like; when they'd pull up on the feeding tube, it would pull up some milk just sitting in her stomach, so they cut back on it a bit. But by a couple days later, she was doing great with it and they were slowly upping how much she was getting.

A few days after they started weaning her off the Fentynal, she was completely awake and was really fighting the breathing tube. This was the hardest thing to see. For the most part, she was ok with it, but every so often she would choke and gag on it which would make me break down into tears every time she did it. The nurses kept reassuring me this was a good sign as she was trying to breathe around the tube and the more she did this, the closer she was to getting it out.

Her isolette sign.

Cute sign one of the nurse made for her isolette. 

So about a week or so after she was born, she was doing so much better. She was off the sedation, off the antibiotics and was down to almost room air so they made a few changes to her recovery. They took out the arterial line, which was such a relief. She hated having it in; they had her arm in a splint so she wouldn't bend her wrist where it was sitting. Plus, we couldn't hold her until that was out as it ran the risk of collapsing her artery if it was disturbed too much. They decided to try the PICC line again since they needed to take out her umbilical lines. They still couldn't get it in her arm, but they were successful in getting it into her leg, so the umbilical lines came out. And she came off the mechanical ventilator, which meant the tube came out of her throat! This was the most exciting part as the tube was what I hated most. Plus the machine was loud and annoying. It was so much quieter in her room after that. She had to stay on a nasal cannula though, since she wasn't used to breathing on her own, just to give her a little bit of help. At first, she was getting a continuous flow of oxygen; it was sort of pushing the air into her nostrils. and they would later wean her down to just a little bit of a flow of oxygen just to help. All of this also meant we could hold her for the first time! Which was amazing. It felt so good after a week to finally get her into my arms. It was still pretty sad though, when she would try to cry, her throat was so irritated from the tube that it was just this hoarse little whisper of a cry. So sad to hear, I wanted to hear her scream. But rest assured, she got her voice back and now has quite the set of lungs on her. :) She did still have the feeding tube in though; they couldn't feed her by mouth until the nasal cannula was out so she didn't risk aspirating more into her lungs.

First night she had the breathing tube out.

We were able to really start taking care of her at this point too. The nurses let us change all her diapers, we were able to dress her in her own onesies and we took her temperature and the nurses help us give her a bath. She wasn't locked in the isloette anymore as she was regulating her body temperature so every time we came to see her, we could walk right up and touch her. At this point, since she was still on a bit of oxygen, we couldn't grab and hold her when we wanted without the help of the nurses since she still had a lot of tubing connected to her.

After a day or so on the oxygen, the nasal cannula was able to come out and she was completely breathing on her own. Which meant she could start getting her feeds by mouth! At this point, I believe she was getting 30 ml every three hours by the feeding tube, so they started her on one mouth feed per shift at first to see how she did with her suck/swallow reflex. The doctors said it would probably be about another five days until she came home; she needed to be taking her feeds completely by mouth before we could take her home and they had to slowly wean her off the feeding tube rather than just taking it out and trying to give her all her feeds by mouth. The tube had to stay in as well so if she didn't finish her mouth feeds, they could give her the rest in the tube. She also had to gain weight before she could come home, so they had to make sure she was getting enough nutrition.

Happy to get the nasal cannula out!

Her first feeding courtesy of daddy. 

With each day that passed at this point, it was all uphill. After the nasal cannula came out, they started weaning her off the fat and sugars she was getting through her PICC line. It took a day or so to wean her down, then she was just on clear fluids. They said after 24 hours on the clear fluids, the PICC line would come out. It actually didn't even take that long; she got the clear fluids one night when we were there, and the PICC line was out the next morning when we went to see her, so she must have done really well that night.

One day when we were there, a nurse brought us a little gift bag and said it was a former NICU mom. This woman's baby was in there almost five years prior and she brought little Christmas presents for all the NICU moms to try to cheer them up every year. It was so touching and seriously brought tears to my eyes.

The doctors decided to let her have feeds by mouth as she wanted them, so she was doing really well with the eating by mouth. They let me try to nurse her a couple days before she went home and she latched like a champ. She did really well with it but since then, it's been hard and she's just been getting pumped milk with some formula for supplementation. Eventually, she was getting 60 ml (2 oz) per feeding by mouth and was doing great so the feeding tube came out. She was finally off everything except her heart/pulse monitors so it was amazing being able to go in there and just be able to pick her up or change her diaper without the nurse's help.

Yay! No more feeding tube!

Poor baby's cheeks were all red from the tape.

She did her carseat test (they have to sit in a carseat for 90 minutes without their heart rate/pulse/oxygen levels changing significantly) and she passed with flying colors. She just slept the whole time. She also got her hearing test, which she passed and a hepatitis shot. The doctors were telling us she'd probably be ready to go home by Friday (the exact day they had quoted us the day she went into the NICU) as long as she gained weight.

During her carseat test.

On the morning of Thursday, December 11th, 13 days after she was born we got the call that she was ready to go home a day earlier than expected! We went down to the hospital and were finally able to dress her in the cute little outfit we had packed for her to go home in.

I still had to be wheeled down to the lobby in a wheelchair, which didn't make sense to me. I was fine, but I guess it's hospital policy when you take your baby home to be taken down in a wheelchair. She did really well on the drive home, she stayed asleep the whole time.

We're very excited to finally have her home. She's been a very good baby; she really only cries when she's hungry or needs her diaper changed. She has her days and nights mixed up so I'm a tired momma but we'll fix that in time. :)

I'll post my baby shower next!