Most Difficult Decision: Baby Number Two After Preemie?

In May of 2014 we had the joy of welcoming a second son into our lives. Though he too was early, he was perfectly healthy at 5lbs 2oz and able to come home right away.

The decision to have another child following our first experience was an incredibly difficulty one. We knew the risks of having another preemie were high, and that we may not be so lucky with the outcome. Because my preterm delivery was unexplained, there was little I could do that would assure I made it to term. But we also knew that even though there was a 30-35% risk of another preterm delivery, there was also a 65-70% chance that everything would be fine. Stats were not entirely compelling to us having lived through every 2-10% chance materializing against us when Elie was first born. If you are the unlucky 2% that's all that matters. We debated for well over a year. People tried to assuage our fear but few had similar experiences. Ultimately we believed strongly that things would be okay, even if he or she came early. Elie was healthy and thriving and we believed the same would be true for our next child. But we accepted that things may not be perfect. We accepted that we may have challenges and that our next child would also arrive early. We didn't expect it, but we accepted that was a risk, and decided to expand our family with all that information in mind.

A prior preterm delivery is one of the strongest predictors of subsequent risk. Because of that, I was referred to a high risk specialist who followed me closely throughout my pregnancy. I had my cervix measured at several times to watch if it was thinning early (it did).  I was prescribed progesterone from 16 weeks on, taking it until I was 34 weeks pregnant. Because i had been fit and exercising throughout my first pregnancy, I avoided anything strenuous and did everything I could to rest my body. We brought in a nanny 1-2 days a week to help me care for my youngest while Ryan was at work. Everything we could do to lighten my load we did.

When I left my 34w appointment I cried. I felt like I had won a lottery. I knew things would be fine from that point on. At 36w4d I started contracting. It was irregular so I stayed home from work the next day and tried to relax. After a long day it ceased and I reluctantly agreed to go for dinner. I started contracting regularly in the car and realized that it was going to happen that night. We called my in laws and asked them to come watch my son. I struggled with leaving him because I knew life as he knew it would change. I hugged him, and with contractions less than 3 minutes apart we drove to the hospital. I delivered 45 minutes after checking in and my beautiful son Noam arrived healthy, without complication. I have a photo of Ryan holding him for the first time and it is the happiest I have ever seen him. We both knew our baby would be fine and the fear and shock we experienced with our first just wasn't relevant.

The decision to have a second child following a very early preemie is an individual one. There is no right answer. I struggled with what to do, and for whom I was making that decision. I felt such responsibility for this new child's life that I didn't want to make any decision without thinking about the impact to them. We were lucky. Both our kids are healthy. Elie has finally caught up and no one would every know he was early. He is bright. He is physically healthy and strong. And my youngest is the same. He may be small but that might also just be genetics.

My sons are incredible, and we are so grateful that we live in a country (and a city) that makes prenatal care a priority. There is no right answer. It is yours to make. Don't let anyone tell you it is an easy choice. For us it was the right choice. Know that it may be the right choice for you too.

Happy Belated Birthday!

It's hard to believe more than a year has passed since Elie arrived so suddenly.  Everything happened  quickly in those early days.  There was a strong urge for him to get to the next milestone that we often found ourselves living in fast forward.  Now at 13 months adjusted (15 1/2) we feel more settled, and confident that he is going to be okay.  So much so that for his first birthday we returned to the NICU to say thank you to all the doctors and nurses.  They could hardly believe how big he was, and how well he was doing.  And just before we were leaving we saw a family new to the NICU. The mother was still in a wheelchair from her section. The nurse escorting them leaned over and told the couple that Elie was a 29 weeker, trying to provide some reassurance to the mother that her baby would also be alright.  And I saw relief on the woman's face; Real relief that things might be okay.  That brief exchange made our visit worth it.

All I wanted to hear in those first few weeks was that he would be okay.  A few close friends gave me that, and even some of the doctors were prepared to say it.  It was what I needed to hear.  And it gave me time to cope with what was happening without being constantly afraid of the unknown.  Everything has turned out okay and he is walking and chatty and the happiest little boy I know.  I couldn't have asked for a more wonderful son. 

We are so grateful for all the help we got, even if all it was sometimes was that reassurance that one day the NICU would feel like a distant memory.  Sending lots of appreciation to the amazing staff at FMC and RGH.

JLL

Canadian NICU Support Foundation: World Prematurity Day at Foothills Medical Centre

Canadian NICU Support Foundation: World Prematurity Day at Foothills Medical Centre: Hi Moms and Dads: If any of you are in Calgary, Alberta, we would love to have you join the Foothills Hospital in recognizing World Prem...

SMILE Cookies in support of NICU

http://www.timhortons.com/ca/en/difference/smile-cookies.html

Alberta babies more likely to be born earlier, smaller

Alberta babies more likely to be born earlier, smaller

Mother's Day Run

Injured boy, 8, dedicates Mother’s Day Run to mom killed in accident (with video)

MOTHER'S DAY RUN

TEAM ELIE WAS AWESOME TODAY, THANK YOU TO ALL OUR FRIENDS AND FAMILY FOR COMING OUT AND RUNNING/WALKING IN SUPPORT.  OVER 14,000 PEOPLE CAME OUT THIS MORNING TO HELP RAISE MONEY FOR THE CALGARY NEONATAL INTENSIVE CARE UNITS.

WE ARE FOREVER GRATEFUL TO THE DOCTORS, NURSES AND ALL THE STAFF WHO HELPED IN THOSE EARLY DAYS.  WE ARE IN AWE OF EVERYTHING YOU GAVE AND THE INCREDIBLE DIFFERENCE YOU HAVE MADE TO OUR LIVES.

THIS WILL NOW BE OUR MOTHER'S DAY TRADITION - A GOOD REMINDER OF LIFE'S BLESSINGS.

Benefits denied! UPDATED

I just found out today Manulife will not cover rental or purchase of breastpump under my benefits plan, notwithstanding that it is considered medically necessary.  Given the length of stay in the hospital, his inability to breastfeed afterwards and his allergy to milk protein, I am appalled that a carrier would deny such expenses.

Stay tuned, lets hope that with a little more investigation the appropriate person intervenes.

UPDATE:

I raised the issue with my Benefits Manager and she agreed to follow up.  She advised me yesterday that my employer has expanded coverage to include pumps under their contract with Manulife.  Not only have they taken steps to ensure my expenses be covered, but any colleague will be able to claim for the cost of a breast pump.  This is such a relief and I am so impressed with how they handled this matter.  THANK YOU MR!

Sportchek Mother's Day Run & Walk 2012

Premature Baby Deaths Preventable

http://www.guardian.co.uk/society/2012/may/02/premature-baby-deaths-preventable-report

15 Million Premature Babies Born Each Year

http://www.cbc.ca/news/health/story/2012/05/02/premature-births.html

Hostage to the Pump - PROS & CONS

For the first 6 weeks of his life, my son received all feeds by nasal tube.  The nurses explained that usually they see babies discharged (provided they meet the other discharge requirements) approximately 5-7 days from the time they are receiving 50% of their feeds by bottle or breast.  It wasn't until he was 35 weeks that we even started to introduce the bottle.  We had focused on feeding him with the bottle because it was easier to measure his intake and he was a very slow gainer.  The biggest issue we had in the last 3 weeks of hospitalization was his slow weight gain.  We tried to get him breastfeeding but we were nervous about how much he was actually removing from the breast and so we stuck mainly to bottle.  After much discussion with the doctors, we agreed to maintain the bottle feeding and only increase breastfeeding one additional daily feed per week.  My father was gravely ill and so I liked the flexibility to travel without my son that pumping gave me.

I struggled with whether there was any downside to continuing exclusive pumping and asked nurses and doctors their opinions. They all told me it did not matter, other than breastfeeding removes milk more efficiently so I may spend more time pumping.  In my case, they were wrong and it did matter.  If I had the choice again, I would have tried harder to breastfeed rather than express my milk.  Here's a point form list of the pros and cons associated with exclusively pumping:

CONS

1. Time: it takes twice as much time to feed my son than if I were breastfeeding. 
2. Difficulty timing pumping and feeding: invariably my son was hungry whenever it came time for me to pump.  Over the last 7 months I have often found myself in the awkward situation of not knowing whether to feed him or pump.  This results in either an unhappy baby or uncomfortable breasts.
3. Drop in Milk Supply: within 6 weeks of my son returning home, I noticed a significant drop in my milk supply.  I believe the inefficiency in pumping and less skin to skin contact are factors that contributed to that drop. Because my supply dropped, I also began to ovulate which resulted in a further drop in supply.  The drop in milk supply has caused so much anxiety it is difficult to put into words.
4. Travel is difficult: I mistakingly thought pumping would give me freedom but it hasn't turned out that way.  The last thing I want to do when I'm on the plane is pump in the bathroom.  It is much easier to breastfeed in your seat - there is no way I am ever pumping at my seat, even under a cover.  The pump is so much more conspicuous than a suckling baby!

PROS

1. Help from others: Other people are able to feed the baby because he/she is bottle fed.  Not only does that lift some of the burden from your shoulders, but it permits other people (fathers, grandparents) to more fully participate in caring for the baby.  It allows others to bond with the child and learn to comfort the baby in a way that is often reserved for the primary caregiver.  
2. Time away: Allows me to be away longer than I would be able to be if I were breastfeeding.  I've made several trips out of province for family matters and my son is able to rely on my frozen reserves during that time.
3. Reserves: I was able to build up a large supply of frozen milk that I rely upon when I'm away or when I want to partake in a few too many glasses of red wine.  
4. Better monitor intake: We are able to monitor precisely what my son's intake is because he takes a bottle and therefore better able to know if he is getting enough milk or going through a growth spurt.     

Ultimately, the decision to exclusively pump or not may not be your decision.  We were warned that it can be difficult to get your baby to breastfeed after being fed via bottle.  There is no question that babies are 'lazier' after receiving milk by tube or bottle and it can take weeks even months to get them breastfeeding.  Whatever you decide to do, recognize that it is not easy and you should be proud of the effort you are making.  Good luck!

Breast milk bank, second in Canada, seeks Calgary donors

Breast milk bank, second in Canada, seeks Calgary donors

Preemie Clothing

It is difficult to find clothing that fits preemies.  The following is a list of the best places to shop in town for small baby clothing:

Edamame Baby on 32 ave SW in Marda Loop
Sears Chinook

There is also an online store that is a good place to check out if you're pumping at home with nothing to do one night while your little one is still in the hospital.  Check out http://www.preemiestore.com/

Australian couple faces $1-million hospital bill after baby born in B.C.

This article helped me do the math on how much was spent on Elie's hospital stay.  We are so grateful!

http://www.theglobeandmail.com/news/national/british-columbia/australian-couple-faces-1-million-hospital-bill-after-baby-born-in-bc/article2383743/

News on Common Antibiotic for Prems

http://www.cbc.ca/news/health/story/2012/03/16/asthma-antibiotics-gut-study.html

BRILLIANT BEGINNINGS

Brilliant Beginnings is a one-stop resource centre for parents, infants, and toddlers (newborn-4 years) in the Calgary area. Their goal is to equip parents with the tools to understand early development and how to optimize this crucial time of learning. 
Brilliant Beginnings' curriculum utilizes a multi-sensory, active-learning approach that is shown to enhance learning in young children. Classes focus on contextual learning (themes), language & literacy, motor, and problem-solving skills all while having tons of fun! 

Brilliant Beginnings also provides a variety of services to support your child's social, emotional, and cognitive development. These include parenting support (in your home), parenting workshops, and public education.


The founder, Melanie Gushnowski, M.Sc has a Masters in Applied Psychology with a major in Human Development and Learning.  I understand Melanie  formerly worked at the early intervention clinic located at Alberta Children's Hospital and has lots of experience with prems.  This is a great resource for those of us who do not qualify for the perinatal early intervention clinic. 






http://brilliantbeginnings.ca/

Interesting...HMF by donated milk

Not available in Canada but maybe one of the best ways to help little ones...

http://thechart.blogs.cnn.com/2011/08/15/fortified-breast-milk-helps-preemies-grow/

TOP 5 RULES TO FOLLOW IN NICU

1. DO NOT COMPARE YOUR BABY TO ANY OF THE OTHER BABIES IN THE NICU
All babies are born under different circumstances and there are so many factors that influence how your baby is progressing.  You do not have all that information and the exercise of comparing your infant to the infant in the next bed who may be gaining weight faster or seeming to be getting better sooner will not be helpful.

In the event that it is your infant who is gaining well or seems so much bigger than the next infant, it is even more important to keep those comments to yourself.  A parent who is watching their infant struggle does not need to hear you confirm their worries.

This happened to us a few times, and it was hurtful to hear someone comment on how small or sick my son looked. These parents most certainly must have assumed I couldn't hear them discussing us with the nurses but I could and it was the last thing we needed in an already stressful situation.

2. DO NOT BRING MORE THAN 2 PEOPLE BEDSIDE
This is tricky.  Of course you want to show your family your baby and it is so tempting to to have your parents of other children in to see your preemie.  This is understandable.  But the NICU has rules, and they ask that you have no more than 2 people bedside during any visit.  You are not the only person who wants to have family visit the baby, every parent in the NICU feels the same. But if everyone disregarded the rules it would be absolute mayhem.  On low flow hours (early in morning or late evening), the units are often quieter and bringing an additional visitor (ie two grandparents + yourself) may be permissible but ask first.  Babies are very sensitive to noise, and 2 or 3 people per bed can amount to a lot of extra talking/noise in the NICU at any given time.  Please be sensitive to the other babies, and families and do not take advantage of these guidelines.

3. PUT ALL BAGS, PURSES, COATS AND FOOD IN A LOCKER
We witnessed a number of women bringing their purses bedside.  I have no doubt that the nurses told them that was unacceptable but since it occurred fairly regularly I will highlight the rule again.  Purses are often put on the floor, then the counter where items that come into contact with your infant are placed. So many germs and bacteria can be transferred this way.  LEAVE YOUR PURSES IN A LOCKER.

4. DO NOT HOG THE BREASTPUMPS
At Rockyview, mothers do not have a separate pumping room and pump milk bedside.  There are a limited amount of pumps and they have to be shared. Once you are done with a pump, clean it and return it to the hallway where you found it.  If the NICU is quiet and you intend on using it again shortly, at the very least clean it and place it in the pod hall so that others can spot it if they need to borrow it quickly in between your pumping sessions.  I heard stories of mothers hiding the pumps in their pods (crazy) and refusing to share, but never experienced it first hand.

5. CLEAN EVERYTHING YOU TOUCH
Once you are done with a chair, breastpump, pillow, scale, wipe it down with cavi wipes.  CONS and other infections may be able to be prevented if people diligently wash their hands and sanitize the items/objects that come into contact with the infants.  Also return all used gowns, clothing and pillow cases to the proper laundry hampers when you are done with them.