36 weeker w/ Meconium Aspiration

[lizzylou]

On March 2nd I gave birth to my daughter. I was 36w1d. I had a normal pregnancy except for a two vessel cord. I had several consults with a perinatologist who felt confident that there was no problem with the baby. I have a history of going late (I was induced at 42 weeks) so I still can barely wrap my mind around the fact that she was born at 36w.

I arrived at the hospital at 7:30 pm and the midwife found that I was completely dilated. She broke my water and there was meconium present. Baby was born about 10 minutes later. She came out blue and apgars were 5, 8, 9 (after they gave her oxygen). It was found that she had meconium in her lungs.

Anyway, here we are about to embark on the 7th day in the NICU. She was on a ventilator for about half a day, and after that she had some oxygen through a nasal cannula. She kept pulling that out though and they found that she seemed to tolerate room air well enough. However the past day or so her blood oxygen levels kept falling into an unacceptable range so they hooked the cannula back up with a low flow. 

She's still tachypneic - sometimes breathing as much as 100 times per minute. They tell me that this is no surprise based on an xray of her lungs. They say that she looks very good compared to how her xray looks.

I would really appreciate stories from anyone who has been here before. The doctor warned me that this could be a slow process, but right now I feel like it will never end. I alternate between thoughts of "it's ok, this is not an abnormal problem" and "this is never going to end." I am beginning to feel worn out emotionally. The doctor originally estimated a NICU stay of 7-10 days and I just have little hope that she'll be better by 10 days. 

[BlueSkyDay]

My son is now a happy, healthy 19 month-old, but like your daughter he had a rough start.  After a very healthy pregnancy I gave birth to my son on his due date.  He'd inhaled so much meconium that he had Meconium Aspiration Syndrome and PPHN (persistent pulmonary hypertension in newborn).  He was on a ventilator/oscillator for the first 11 days and was so unstable that I couldn't hold him until he was 8 days old.  Once he was past the scariest part, the neonatologist warned us that the most frustrating part was yet to come.  He said that a baby with that much trauma to the lungs needed time to heal and that learning to eat would be slow.  It was.  My son was released form the hospital after 45 days in the NICU.

Even with a very family-friendly NICU and wonderful doctors and supportive nurses and lactation consultants, our time in the NICU was hard.  Our 45 days seemed to last forever. Even after our son was "out of the woods" the daily NICU routines, the schedules and doctors and nurses, not being in our own home, pumping around the clock, the effort it took to help him learn to nurse all were physically and emotionally exhausting. Our doctors never gave us an estimated "release date," which was a saving grace - I didn't keep getting my hopes up only to have them dashed. In the meantime the NICU had a wonderful "parent navigator" (a former NICU mom herself) to help us figure things out, a social worker, and  a counselor.  Since our time in the NICU they've begun a weekly NICU-parent & nursing support group that I help facilitate because I know how desperately it's needed.   

Another great source of support is NICU parents - see if you can get to know another family going through the NICU - it helps to have someone else who understands the unique world that is the NICU.

Your daughter's meconium aspiration sounds (hopefully) milder than my son's was and I hope that means her recovery is simpler and her NICU stay is shorter.  In the meantime, gather all of the support you can and be sure to ask at the hospital what support is available there.  Our NICU social worker once told me that feeling worn out and worn down under the stress of sleeplessness, post-partum recovery, being worried over a sick baby, etc. meant that I was normal - responding appropriately to all of that stress.  

There was a lot of "two steps forward and one step back."  My son would make progress in one area only to have trouble in another, or even to backslide a bit in something he'd been doing well in.  It helped me to accept that recovery isn't linear.  If, like my son, your daughter is slower to learn to nurse - don't give up!  With lots of lactation support my son finally learned to nurse at 8 weeks old - a week after he'd been discharged.  He then breastfed exclusively for 12 months (his choice!) At 19 months, he's just weaned himself.  

Our time in the NICU now seems as if it were ages ago, and 45 days doesn't seem so long.  I'm grateful everyday that I had a hospital birth instead of the home birth I'd planned, that we had such an amazing team of doctors and nurses who saved his life, and that my little dude now runs and plays and laughs (and cries!) with a powerful, healthy set of lungs.

Best wishes.

[lizzylou]

Thank you SO MUCH for sharing your story! I've had a hard time finding stories of other babies with the same diagnosis. 

Tomorrow we start the process of trying to get her to eat on her own. She has shown barely any interest in breast or bottle thus far.

[BlueSkyDay]

I hope that introducing the breast or bottle goes smoothly for you and your daughter.  It's great that you already have experience parenting and feeding/nursing a baby so you know you can do it.  Since my NICU baby was my first, I really felt sort of bewildered by how hard it was to get him started nursing.  I'd really presumed that I'd just show him the breast and away he'd go.  I also worried that introducing the bottle would decrease his interest in nursing.  One of the LC's finally told me that the single most important factor in getting a baby to nurse was how determined the mother was.  Once I heard that I had a bit less stress - I knew I was determined so it'd happen eventually.  

I did find the process of nursing in the NICU to be a pain.  Unhook baby from all tubes and monitors, transfer baby to scale, record weight, re-hook baby, nurse, unhook baby, weigh, record weight, re-hook baby.  I just wanted to curl up with my baby lying beside me and nurse!  And the all-too-slow increase in what he took by mouth versus what he took by tube was a bit of a roller coaster.  Two steps forward, one step back,  But again, a nurse gently reminded me that my baby wouldn't head off to kindergarten still taking food through a tube.  And of course, she was right.  At 19 months he's now a super-healthy little eater - lots of whole grains and fresh fruits and veggies.  Your daughter will get there at her own pace.

[justKate]

I responded in the other thread but wanted to chime in here too.  There are LOTS of us with these stories, I think they just don't get posted as often.  My DD is 2 years old and I have yet to post her birth story.  Stay strong mama!

[irja]

Hi there!  Just found this thread and am wondering how your little one is doing?  My son was born on Mother's Day 2011, at 1-day shy of 42 weeks, via c-section after four days of induction.  He aspirated meconium at birth and we spent 12 days in the NICU on oxygen (only ever thru a cannula, no ventilator).  We're home now, but still on oxygen and he just turned 7-weeks -- happy and (mostly) healthy at a solid 13-pounds and breastfeeding beautifully.  However, we still have no sure timetable for oxygen weening.  It's truly a game of wait & see.  Though he's only on a 1/4 liter (barely a whiff), it's still emotionally draining to see my baby anything less than 100% healthy and breathing easy.  And, as he gains more control over those little hands, he's getting better and better at pulling that cannula off!  Sigh... I'm so looking forward to having this all behind us, and I know it soon will be!!

Anyway, I'm wondering how recovery is going for you guys?  Hoping all is going great!!  :)

[lizzylou]

irja, my daughter is doing pretty well. No problems with oxygen. Our main problem is feeding - big, huge problems there which led to a g tube. Otherwise we're doing all right.

[irja]

Awesome to hear you're doing well!  G tubes are no fun, but hopefully she'll be off that very soon and eating like the little champion she is  :)

[KarenGordon]

(Sorry Lizzy. I edited this post for personal reasons, I hope your little princess is doing well  ;)  )

"I feel so blessed I have such a little soldier and I like to believe there was a reason for that, but you know how hard it is and how paintful it is for everyone involved.

I hope your little angel is doing great! I gladly found your story on google, thank you for sharing it.

Take care"

Edited by KarenGordon - 9/23/11 at 12:07am

[lizzylou]

Hi Karen, thanks for sharing your story! I am so glad that your little guy pulled through - amazing! 

At the moment my daughter is doing well. But we have a lot of issues to deal with still... food intolerances, oral eating, low muscle tone. I see little improvements every so often but it's tough to stay patient. If I think about it all at once it seems very overwhelming. We have an MRI coming up too - trying to find out the reason for the low muscle tone.

I'll always wonder how the meconium aspiration fits in with the rest of her issues. I mostly think that it was just a very strange coincidence. I was really sick those last few weeks of pregnancy - I had caught croup from my son. I was coughing rather violently and I wonder if that caused her distress? I'll never know I guess. She would have had the other issues even if she hadn't aspirated the meconium.

And yes it helps very much to talk it out! I had very bad PPD for awhile and I think that I still have a bit of PTSD from the whole experience.

[asicsgirl]

Ladies,

Thanks for your stories. My daughter was 41 2/7 weeks csection after 46 hours of labor. I wanted a naturally peaceful birth, but was in transition at 8 cm for 8 long hours. Spiked a fever so got sectioned. My baby was on a vent/ oscillator for 5 days, then ECMO for 5 days. In nicu for 42 long days. Luckily we did alot of kangaroo care and she pulled her ng tube out after a week if being home and has nursed like a champ. Was the hardest time of my life. Weaning off sedation and trying to nurse with all the lines was awful. But my little one is doing great now. I write this to offer hope to those going through this now. 

Jaclie