22-11-2009 - Zachary's birth blog - part 4 Zachary keeps fighting

My mood while writing this blog: relieved

Zachary was well known in SCBU by all the staff, even those who were not directly caring for him. Not just because of his large size but because of his outrageous behaviour.

For all you ladies who have followed my blogs throughout this pregnancy know, between us Zach and I have had a lot to deal with before he was even born, he has consistently fought the odds to come into this world and was born fighting with the will to survive.

Zach was forever getting the nurses flying across to his incubator at break neck speed. One of his favourite tricks was stroking his chest with his hands til he found the electrodes monitoring his breathing and heart rate, curling his little chubby fingers round the wires then yanking them off with all his might.....cue nurses pumped with adrenalin ready to perform CPR to be quitely relieved that it was a false alarm.

He pulled his glucose feeding tube out of his stomach doing the same thing and eventually they put a nose feeding tube in for him, he also tried a similar trick with his canula in his hand, so they ended up re-sighting them in his feet where he couldnt reach them.

When he developed jaundice, they put him under a phototherapy light with a plastic tinted shield for his eyes. The shield was like a dome that went over his head and shoulders, but surprise surprise, he didnt like that either! We came down to visit him in SCBU and found the shield lying backwards behind his head, one of the nurses came over and put it back over him properly so we sat down to watch our boy.

No sooner had she turned to walk away he grabbed either side of the shield and pushed it backwards, if he had been wearing raggity purple shorts he would have looked like the Incredible Hulk!

So they tried different approach. They put a special sleep apnea monitor under his mattress and laid him on his front and then put the shield over him. He kept trying to push himself up on his hands, but couldnt remove the shield. PLEASE NOTE: laying your baby to sleep on his/her front is dangerous, and should only be done on the advice of a medical professional with the appropriate safety equipment in place!!!!

One problem solved, but he needed anti-biotics for group b Strep as his infection markers had gone through the roof and he was on meningitis watch, more stuff being pumped into the little mite.

He weight was also starting to drop quite dramatically, so as the glucose drip through the belly button had been removed they decided to start feeding by nose tube. So all my little vials of colostrum I had collected over the previous few days were brought to temperature along with a bottle containing 1 oz of my expressed milk that had just started to come in. I was horrified when they told me for his age and weight I need to be producing 3oz milk per feed, and feed at 2 hour intervals! All of my hours of hard work were not even enough for one meal! So they put it all down the tube and topped it up with formula to the required 3 oz.

I decided to go back up to the ward in search of a good snack and plenty of liquid refreshment so I would have at least something to take down for the next feed.

I felt like Daisy the Cow stuck on my pump for the next hour, and managed another oz which I got nurses to take down for me. After a few days I just managed to get to the required 3 oz when they told me I now needed 4 oz per feed every 2 hours, so I still couldnt quite keep up without having to top up with formula.

It took another day before I was able to produce enough expressed breastmilk to go down his tube without any formula. When he started his rooting reflex, I was then encouraged to try putting him back to the breast, but it was hard work for him and he got tired very easily, so after about 10 minutes they would top him up by tube and put him back in the incubator to rest.

I was determined to breast feed, so I would be up every two hours, on the hour to go down to SCBU change his nappy, put him to the breast, wind him wait for nurse to top him up by tube, hold him upright for 20 minutes then lay him down to sleep while I trotted back upstairs for an hours sleep myself before the next feed.

I was like a zombie, but after about 3 days, he finally got the idea that rooting around wasnt quite enough and he had to suck, they also increased his feed amount to 5oz and spacing to 3 hourly. Feeding by tube was not ideal, as he hated it and managed to pull his nose tube out several times, which meant they had to starve him before they could re-insert it. By this time he was out of high dependency and allowed on the ward for an hour or two for visiting unless he was exhausted, but I was coming to the end of the maximum 10 day stay. As he wasnt feeding properly, he couldnt be discharged but I was viewed as blocking a bed. It was muted that we be separated, with him in SCBU still and with me being sent home and coming back in at feeding times. It was difficult, because living 25 miles away from the hospital I couldnt just pop in to feed him as some of the other mothers did, and breastfeeding aswell was difficult enough.

The criteria for sending Zach home was two consecutive days of weight gain, feeding 4 hourly and established breastfeeding. On the 10th days itself he had a small weight gain, predominantly because of all the tube milk forced into him about an hour before weighing. One of the nurses could see how upset I was at the thought of being separated so she recalculated his milk regime to get us onto 4 hourly feeding that day, which as it turned out was great! I ended up going down with both BB's engorged with milk and a crying baby hungry to latch on. I asked if I could be allowed to have him for visiting time on the ward and she agreed. I was later told that I could keep him on the ward with me overnight aswell and I could feed on demand all night with no tube feeds, as he would be weighed in the morning.

The nurse gave Zach a stern talking to and wished us luck, and that she would be there for the weigh in the morning.

Zach fed beautifully on demand all night long, and the nurse came to escort us to SCBU to be weighed as promised with some trepidation knowing that I would have to be discharged from my ward, and there were no discretionary rooms available on SCBU.

When the nurse put Zach on the scales and showed that he put on almost 2oz, we both hugged each other jumped up and down, I had tears streaming down my face. All the other nurses on duty came in to hear how he had done. The nurse who weighed him said she was worried that he would have lost weight and was ready with a list of reasons to give higher up the line if he hadn't gained. All I could think about was getting my boy home.

Within the hour he was checked over by the Paedatric Consultant and discharged, I had to then tell DH to come with the car chair and get us. After getting some anti-biotics for myself and my paperwork finished off we were on our way home at last!