The Bell Family Blog: 2014

Adalee's first week was spent in the Neonatal Intensive Care Unit of Shawnee Mission Hospital.

After Adalee's delivery, I had to spend some time in the recovery room before they allowed me to visit her in the NICU. Once I had sufficiently "recovered", they wheeled my hospital bed up to the NICU so I could see Adalee. My epidural was still in place, so I was not able to walk, stand, or even get out of bed to see her. By the time I arrived in the NICU, the nurses had placed a "bubble" over Adalee's head that was pumping in oxygen to keep her levels up. The nurse explained that we were only allowed to lightly touch Adalee's hands or feet. We were encouraged not to rub or stroke her skin because too much touch would cause her to over-stimulate. During the visit, it was obvious that Adalee was working very hard to breathe. Her chest moved up and down very quickly and she kept making a grunting sound. The nurse explained that this was her way of keeping her lungs open so she could breathe.

After spending 15-20 minutes with her, the nurses encouraged me to go to my room to get some rest. This was the hardest part of having a baby in the NICU - not being able to have her in the room with Michael and I. Instead, we were staying on the third floor and Adalee was staying on the fourth floor. It was challenging to balance wanting to be in the NICU with her and needing to get rest for my recovery, but I did the best I could.

First NICU Visit

Later that afternoon, I was finally able to hold Miss Adalee for the first time since being in the recovery room. I remember her looking and feeling so fragile - like I was going to break her if I moved the wrong way. On top of that, she had so many cords attached to her, so it was really hard to even move her from her NICU bed to my arms. Once I had her on my chest, I was in heaven. Everyone talks about the importance of "skin to skin" time after the baby is born - and it is completely true. Despite all of the craziness of the day, I somehow felt at peace while holding Adalee.

Our first family picture! Excuse the tired eyes...

For the first three days, the main focus was improving Adalee's breathing and oxygen levels. After her birth, Adalee's respiratory rate was between 100 and 120. Normal levels for infants are between 40 and 60, so a lot of improvement was needed. With all of Adalee's energy going toward clearing her lungs, she didn't have much energy left for eating or being awake. Thus, they had Adalee hooked up to IV fluids to ensure she was getting some "food" while she slept. Overall, there was not much we could do to help Adalee improve her respiratory rates. We simply had to be patient and wait for things to hopefully get better.

Because Adalee was being fed through her IV, the nurses started me on an intense pumping schedule to help my milk supply come in. Starting the afternoon she was born, I was pumping every two hours for at least 15 minutes, even throughout the night. In the beginning, nothing was more frustrating then pumping constantly and not getting any milk. I remember actually celebrating the first time I pumped one milliliter of milk - it felt like a HUGE accomplishment. After 2 days, my milk supply came in - in full force I might add. I was so anxious to start breastfeeding, but the nurses made me wait. Adalee simply did not have the energy.

December 3rd - Day 2 in the NICU

December 4th was a big day for Miss Adalee. That morning, the nurses allowed me to change her diaper for the first time. While changing a diaper does not seem super important now, at the time, it made me feel like a "normal parent". There was so much that Michael and I were not able to do because we were in the NICU, so being able to do a normal parent task was really nice. Also, in the afternoon of December 4th, Michael was able to hold Adalee for the first time since her delivery. I remember him being really nervous at first, especially with all the cords, but after 10 or so minutes, I thought he wasn't going to ever let her go.

Then, in the evening of December 4th, the nurses finally saw enough improvement with Adalee's oxygen levels that we were able to try breastfeeding for the first time. For something that is supposed to be so natural, it did not come easy at first. We were both trying to learn and figure out how to make it work for us. Plus, Miss Adalee was still super tired and kept falling asleep before really getting any milk. While I wouldn't say our first breastfeeding experience was successful, I was just glad to get started and I knew it would eventually get better, which it did - eventually.

In addition, because her oxygen levels were improving, we also got to help give Adalee her first sponge bath during the early morning of December 5th. While the nurse did most of the washing, Michael and I were able to hold her hands and feet. She had some initial flinches and cries at the beginning of her bath, but then she calmed down. She especially liked when the nurse washed her hair - making lots of "oooohh" faces!

During mid-morning on December 5th, we had a small setback. Miss Adalee's respiratory rate jumped and they had to increase the oxygen that they were providing her again. Luckily, we were able to meet with NICU doctor that morning and talk about Adalee's progress. Because she was still having issues stabilizing her oxygen levels, and because her weight had dropped from 7lbs 2oz to 6lbs 8oz, the doctor recommended putting in a NG feeding tube. The feeding tube would allow the nurses to insert food directly into her stomach, removing her need for continuous flow of nutrients from the IV. The idea was that this would hopefully incentivize her to breastfeed better, which would give her the energy necessary to stabilize her oxygen levels. Michael and I said okay to the NG tube, and within an hour the tube was placed. It was really hard to watch the nurses run a tube through her nose and down to her stomach. You could tell it was not comfortable for Adalee. She kept sneezing and trying to wipe it away with her hands.

On December 6th, just 24 hours after adding the NG feeding tube, Adalee was doing much better! She was eating much better, and her oxygen levels had stabilized for long enough that the doctor felt comfortable removing the additional oxygen all together! We were so excited to have the oxygen tubes finally removed from her nose - we could finally see her whole face again! Unfortunately, because her oxygen tubes had been taped on for days, taking them off wasn't easy. Miss Adalee had red checks where the tape had been and even a little scab where some of her skin had come off.

December 7th, our last full day in the NICU. At this point, it felt like it had been FOREVER since Adalee was born, but really it had been 5 days. At this point, Adalee's oxygen levels were greatly improved and her weight had slightly improved, so the doctor was okay with the NG tube being removed. Adalee actually removed it herself by pulling it out with her hands, but the doctor gave the okay for us not to have to put it back in.

At this point, we were pretty exhausted... :)

Because she was doing so well, we were able to move her from her NICU bed to the normal cradle that the hospital uses for newborns. However, jaundice began to become an issue. Because it took Adalee so long to start eating, a lot of junk had begun to build up inside her body. Her skin started to become more yellow/orange, which was cause for concern. In order for us to be discharged, the doctor needed to see improvement with her bilirubin levels. In order to decrease the bilirubin, Adalee had to lay on a UV light most of the day and night.

We spent our final night at the hospital in the NICU transition room, which is supposed to mimic the feeling of being at home. We actually got to sleep on a pull out couch and had access to a private bathroom - it was wonderful. And the best part - Miss Adalee got to stay in the room with us! She had all of her monitoring cords removed, with the exception of the UV light, and was able to sleep in her hospital cradle next to us! I didn't get much sleep that night, because I jumped up at every noise she made, but it was worth it to have a sense of normalcy.

The morning of December 8th flew by... Around 5:00am, the doctors did another weight check, as well as another blood draw to check her bilirubin levels. It took a while to get the lab results, but we finally got the approval for discharge around 10am. However, leaving was not simple as that. There was a lot of paperwork had to be completed, as well as some final check out procedures, like her hearing screen. A few hours before we were able to leave the NICU, one of the hospital photographers stopped by to take her newborn photos. We almost didn't have her photo taken because we were so exhausted, and still had to pack up all of our things before going home - but I am so glad we did! Her photos were taken right before we had planned on feeding her, so we even got a few shots with her waking up!