Often times through out a NICU stay your preemie may acquire an infection of some kind. The types of infections vary as widely as their symptoms as well as the course of action taken. I remember the first few times the NICU notified me of their suspicions I was terrified and was even more nervous when they gave me a run down of what they would do to identify the infection and the appropriate course of action.

Once the medical staff detected any sort of issue or “symptom” they would quickly jump into action. It usually began with a blood draw that would be sent of for a culture, and would sometimes also include a Spinal Tap as well. If they noticed any type of discharge they would swab the air and send that for a culture as well. Sonograms and/or x-rays could be expected to depending on exactly what was suspected, for example: if there was an area of the body that was swollen or if it was a possible repertory infection they may x-ray their chest, etc.

After that the waiting game began… the waiting for test results. Most often a “positive” would come back on any test rather quickly which meant they could then pursue treatment rapidly. Depending on what exactly the medical team believed the infection was, they would start treatment before that because waiting could causes the infection to get worse.

Something that is important to remember is that you know your baby best. If you notice something different, don’t be afraid to speak up.  You are part of your baby’s care team too and early intervention and detection of an infection is the best treatment. 

Here are some common infections for NICU babies: (check back often, we will add more soon!)

Group B Streptococcal 
Menigitis
MRSA
Osteomyelitis
Sepsis

Dear Cora,

            

The story of the day you were born is a hard story for me to write. I wish I could write something that was filled only with joy, expectation, and love. Those things are all part of your story. But your birth wasn’t only a day of joy, it was also one of the scariest days of my life because I was afraid that I would lose you. Even now, 16 months later, its hard for me to admit that.

The night before you were born, our lives seemed so very normal. Looking back, its bizaar to me that there were no warnings. I went to a meeting at church, came home, and tried to sleep. I woke up a few times that night with what I thought were gas pains. I had experienced that before while I was pregnant so I thought it was normal. By the morning when the gas pains had not gone away, I decided to call the midwives just to make sure things were ok. They made me an appointment for 10:30 that morning. I sent your dad to work and called to make sure your Maw Maw knew I was going in. The whole time I kept reassuring everyone, including myself, that it was not big deal, I was just being extra cautious.

I sat in the waiting room for about 20 minutes before I got to see Theodora, one of the midwives. She hooked me up to a monitor and it quickly became clear that I wasn’t have gas pains, I was having real contractions. So she made arrangements for me to be sent across the street to the hospital where they would stop the contractions. I want you to know that at this point, no one had any idea that you would be born a few hours later. I called your dad and asked him to come up to the hospital to wait with me. He called your Maw Maw for me. The walk from the midwives’ office to the hospital takes about 5 minutes. That’s how long it took for me to go from “we will stop the contractions and send you home on bedrest” to “we need to get some consults in here now!” I was checked into a room at St. Lukes and things began to get scary quickly.

I was hooked up to several monitors and given an IV. Nurses, the midwives, and an OB who I had never seen before kept coming in the room to check me and then walking out for a hushed conversation. The OB examined me quickly, moved to where I could see him and said “we are taking this baby now, we cannot wait.” It was immediately like the world had stopped. I just stared at him thinking that he must be wrong. I was only 27 weeks pregnant. I knew you were not ready for the world yet. But ready or not, you were coming. Your dad walked in the room just after that moment, I was so glad to see him. He was so scared but he tried hard to take care of us instead of himself. The nurses gave him some blue scrubs and wheeled me out of the room to prep me for surgery. He called your Maw Maw, who was on her way to Austin for work, to tell her what was happening. She immediately started calling every single person she could think of. She asked them all to pray for you, and sweet girl I know it made a difference. Then your dad signed a stack of papers-maybe the only time in his life your father signed documents without reading them carefully. I learned all of this later.

I was wheeled into an operating room, moved to a surgical table and given an epidural. After the medicine had started working, your dad was brought into the room and the surgery began. I don’t remember much of the surgery. I was just so scared. You did not cry when you were born. The doctors took you quickly and began to work on you. They helped you breathe with a ventilator, gave you IVs for medication, and wrapped you in saran wrap to help keep you warm. At some point in the middle of all this, Dawn, the midwife who was with us, came to tell me that you were a girl. I remember whispering “her name is Cora.” It was really important to me that you had a name right away, that all the doctors and nurses working on you knew your name. Soon they called your dad over to meet you while I lay on the table still.

Your dad came back to tell me that you were beautiful. There were tears in his eyes when he returned and I knew he was scared. He told me again and again how precious you were. The TCH team was ready to move you to the NICU. They stopped on their way out to give me a minute to meet you before taking you away. I remember touching your itty bitty hand. You were the tiniest thing I’ve ever see. And the most beautiful. I already loved you but in that moment I knew I loved you more than anything else in the world. And I was terrified that something would happen to take you away.

The next few hours are pretty blurry for me. Your Papoo, PePaw, Pastor Kerry, and Beth were the first people to get to the hospital. The rest of your grandparents quickly followed. I remember calling your uncles to tell them that you were here, how beautiful you were, and how tiny. Your dad came back to tell me that you were doing well and settled into your new home in bed A8 of the Purple Pod. He took your grandparents to meet you and they all came to tell me how amazing you were.

Later I learned that when you dad took you to the NICU, the nurses asked him if you had a name and he said “I think its Cora, that’s what her mom said.” He was so overwhelmed. But the nurses made you a special name plate for your isolette.

It was after midnight before I was allowed to see you. I fought hard to be with you my sweet girl. It was all I could think about. So as soon as I was able, your dad pushed my wheelchair to your bedside and I was able to really see you for the first time. You were black and blue, covered in tubes and wire, but already so beautiful and so very strong. You had amazed the doctors already. Within hours of your birth, you were able to breathe well enough on your own to have the ventilator removed. I never saw you with that machine breathing for you. By the time I saw you, you had a CPAP hat and mask helping you breathe but you were fighting to do it yourself. I would learn quickly how determined you were. I truly believe your inner strength helped save your life.

Cora, the day you were born was such a scary, emotional day for me. It will always have those memories. But it was also the day I learned that it is possible to love someone more than you love yourself. I learned that watching your baby fight to live can inspire the kind of love that doesn’t have words. I learned that a tiny 2lb 10oz baby can move people around the world to prayer. And I knew that you would bring more joy and more love to our lives than I ever thought possible. On that day I knew that in making me your mom, God had changed my life forever.

I love you more than words can say and I am so proud to be your mommy. 

A is for apnea, a temporary cessation of breathing.

B is for bradycardia, when the heart rate slows to 80 or less beats per minute.

Most babies in NICU will experience both of these at some point. They can be very frightening, but luckily most babies grow out of them quickly. A/B’s can become a hurdle for preemies leaving NICU because they’ll need to be episode-free for several days before discharge.

In some circumstances you’ll be given an apnea monitor to take home with you. They’re very loud (and sensitive!) so you’ll know by the lights and beeps what your child is experiencing.

Leaving NICU with a monitor.

While in NICU practice not watching the monitors – focus on your child! It’s harder than it sounds because when you hear the alarm you want to see what is happening. Leave the monitors for the nurses and instead focus on your child. You’ll need to see how they are doing and if stimulation is needed. Give your baby a chance to do it themselves as hard as it is to not step in immediately.

Like all preemie things they will grow out of A/B’s. For some it might be a matter of days but for others it might take a few months.

Your baby will be monitored by a team of apnea doctors who will analyze the information recorded on your monitor. At first your baby will probably have to be attached 24/7 but once their stats improve you’ll only have to keep them on it at night. Do not brush off your doctor’s instructions! It will only delay getting them off the monitor.

If your baby is turning colors, having a significant amount of A/B’s per day, and/or requiring stimulation on many occasions please contact your doctor immediately and/or go to the ER.