by on August 9, 2013

If something can be measured in the NICU, it generally is, and it is measured often. Weight, head circumference, urine output, abdominal circumference, heart rate, blood gases, white blood cells, feeds, oxygen saturation. But there are a few important influences that can’t be measured.

Within a short time, the nurses were telling us that “you always know when Audrey wants to be moved”. She was feisty, and they were pleased. Everyone in the NICU knows that temperament makes a difference.

NICU nurses are a special breed. They can’t help but become attached to their charges and their families. When a nurse agrees to be a primary nurse for a baby, that means that they will always care for that baby when they are on duty. This is good for the baby as it allows for continuity of care and issues can be caught sooner. We were incredibly lucky to ¬†have two nurses, Erin and Jinal, take a risk and become Audrey’s primaries almost immediately. A few weeks later, they were joined by Elizabeth.

Initially, Erin was working the day shift and Jinal was working nights. That meant that, when we had to leave, we were leaving her in the care of someone who we knew and trusted. In my mind, they became like substitute moms to her when we weren’t there, and almost a part of our family. Because we got to know them, we felt comfortable asking questions. And there were a lot of questions.

In order to go home, a NICU baby must achieve 3 things. They must be able to hold their body temperature out of the isolette (which happens at about 4lbs), they must be able to breathe on their own, and they must be able to feed and gain weight. Along the way, they can face countless complications.

In her first day, Audrey was doing so well with breathing, that she came off the ventilator and went on to CPAP. It was thrilling that she was doing so well but the CPAP obscured her little face. And she developed “spells”. A preemie’s brain isn’t fully developed yet and sometimes they “forget” to breathe: this is called Apnea of Prematurity or more commonly “spells”. When this happens, their oxygen saturations and their heart rates drop, causing their monitor to beep. That beeping alerts the nurse, who often just has to rub their back or similar to get them to breathe again. But for a parent, hearing and witnessing it the first few times can be terrifying. ¬†They started her on caffeine to help with the spells but she still had a lot.

Audrey had hyperbilirubinemia (jaundice), so she was placed under lights for a day. And her platelets were dropping, a common after effect for babies born out preeclampsia. I started to pump, hoping to provide breastmilk. All things considered, she was doing well, as was I. We were on the part of the rollercoaster that climbs up.

With the CPAP

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