Jonah's 4 weeks early and in NICU

[PB's Mom]

Jonah was born on April 18th. My water broke around 9am, and I went in for my Dr. appointment. He said "we need to have a baby." So, they walked me over to the hospital (same building) and let me walk around to see if I could get labor going. I was having very mild cramping. About 6pm they decided I needed pitocin to get my contractions going. The contractions kicked in about 8:00, and Jonah was born at 10:26pm...5 lbs, 13oz. I had no epidural or anything else other than the pitocin. It was pretty intense with the induction, but thankfully it wasn't too long. Jonah was having some breathing problems and they took him to the NICU. He had rapid breathing (100-120 BPM) ....normal breathing is 40-60 BPM. (my 2nd child also had rapid breathing -he was totally natural childbirth)...Jonah also needed oxygen. They put in an IV and wouldn't let him take anything by mouth. I began to pump, and told them I didn't want him to have anything other than breast milk. They waited about 36 hours before giving him the breast milk. Then they had to give it to him in a feeding tube that went through his nose and into his stomach. Then he ended up with jaundice and had to go under the lights. He also has a heart murmer (a hole in his heart) and we'll have to follow up with the cardiologist in a couple of months. He was in the NICU for 9 days, and we finally brought him home on Thursday (4-27). He had to be taking all of his feedings by mouth before they would let him go home. He is doing well nursing, but gets tired easily. They fed him by bottle when I wasn't there (they let me stay a total of 6 nights, but then I had to go home.) They also gave him a pacifier, which I'm not crazy about, but I think it helped him learn to suck, when he wasn't able to feed by mouth. I still give him a bottle or 2 a day when he seems too tired to nurse. I want to keep his weight up and his jaundice down!!! He came home on oxygen, but hopefully will be off in a week or two.
Anyone have any comments on how I could have prevented the pictocin or other interventions?? I originally wanted a home birth, but it seems like it all turned out for the best, considering everything that happened. I wish I could have just waited for labor to have started naturally, but they scared me with the possibility of infection if I didn't deliver. They also gave me 2 doses of antibiotics before delivery since they hadn't done the StrepB test yet. Jonah also got 2 days of antibiotics after delivery until his tests came back negative for infection. I just hate the antibiotics. I'll have to start him on some probiotics soon.
Well, that's my story. I'm just glad that we are home now!!

[boscopup]

So sorry you're going through this.

I had a 29 weeker, so he was in the NICU for 4 weeks, and we went through the tube feedings and all that. Are you using a nipple shield when breastfeeding? It makes it a bit easier for the baby, so you might ask an LC or LLL leader to see if they think that would be good in this situation (I'm not either one of those - I just know they pretty much have all preemies use one when bf'ing at my hospital). It's a pain to use, but it got my DS 100% on the breast when he came home. It took about 4 weeks after that to wean off of it (2 weeks to just get the first latch on breast without shield, and then another 2 weeks to get him consistently latching onto it everytime). Yes, the pacifier use in the NICU is actually useful, if they used it during tube feedings only. That's what they did with my DS, to teach him that sucking got his belly full.

The pitocin does sound weird, especially since they were already giving you antibiotics? I had PPROM at 29 weeks, and I didn't deliver for 4 days. They kept me on drugs to keep contractions away, then after pumping me up with steroids (which probably would have been beneficial in your case too), they waited 2 days, then took me off the meds, and I went into labor that night. Definitely do the probiotics for your DS. When I started that, my DS's reflux cleared up!!!

You might check into the NICU/preemie Support thread in the main Birth & Beyond forum. There's lots of moms who have experienced what you're experiencing, and it's so helpful to hear from those who have BTDT!

[PB's Mom]

Thanks Vera,
He is doing great now at breastfeeding. He only gets maybe 1 bottle a day, and only if he's too sleepy to nurse. We will probably not even need to do that for very long.
The pitocin was necessary because after your water breaks they want you to deliver within 24 hours to reduce the chance for infection. I was not contracting (only very mild cramping) so they needed to induce me. I didn't have time for the steriods, since I had only 19 hours left once I got to the Dr. office and then on to the hospital. I think you need 24 hours for the steroids. I only needed 4 hours for the antibiotics.
I'm trying to decide on when to start the probiotics. He doesn't seem to have any issues at all, such as reflux, or fussiness, or bad stools. Everything right now is great. I'd still like to be sure he's got the good stuff in his tummy. The bottle of Baby's Jarro-Dophilus that I have says to wait until they are 1 week old. I don't know if that means I should wait until he's 5 weeks, since he was 4 weeks early. I guess it wouldn't hurt to wait, since he's not having any issues right now.

[boscopup]

Originally Posted by PB's Mom

The pitocin was necessary because after your water breaks they want you to deliver within 24 hours to reduce the chance for infection.

In a normal full term delivery, yes that's standard of care (although still questionable), but in the case of a preemie (like mine), they can give antibiotics and you're ok. My water broke at 29 weeks exactly, I started contractions about 11 hours later, at which point they put me on magnesium sulfate to stop them, then they gave me steroids for 2 days, then let them kick in for 2 days, then finally they took me off the mag and I delivered at 29w4d. So my water was broken for 4 whole days and I did not get any infection, nor did my baby, but I was given antibiotics the whole time. One important thing to note (in case it happens to you again) is that you should keep EVERYTHING (including nurses'/doctors' hands, sterile speculums, and any other device) out of your vagina. That will greatly reduce the risk of infection.

Some women go WEEKS after their water breaks - PPROM can hit any just about any time. I'm on a PROM list that has women whose water broke at 16 weeks and they made it to a safe time to deliver. You just have to be ultra careful about keeping everything out of your vagina. I know I had to fight the nurses on this point, but I'm glad I did.

Anyway, I'm glad breastfeeding is going so well! Sounds like you're doing a great job!!!

[Adensmommy]

Mary so sorry you didnt get the birth you wanted. I am happy to hear you and your little guy are doing ok, he sounds like a little fighter.
Thank you for sharing.

[nurnur]

Congrats on your sweet baby ~ thinking of you and wishing you the best.

The only way I know of not being induced is to JUST SAY NO. They tried the scare tactic on me the first time around when my water broke and no labor and, but this last time around for me I had done my homework and had a great midwife who was there to advocate for me and inform me as well ~ lo and behold just like I thought would happen, my water broke and no labor, and no labor and no labor and no labor ~ finaly 69.5 hours later I was having consistent regular contractions. Now this goes totaly against the medical model because of their fear of infection, but this would be much more common if we actually let womens bodies do the talking. Most midwives would not let you go past 24 hours w/o transporting or even get to 24 hours, but what the research says out there is that it can take upto 72 hours before labor kicks in without problem. No to vag checks and take temp and bp to monitor for any signs of infection. Hell, if they really wanted to just hook you up to antibiotics and wait it out that would at least be better than the pitocin and forcing this baby on out of you before his time. Just my 2 cents. The only way to get what you want in those hospitals is to be armed with information before you go, and be willing to say NO NO NO.

[miriam]

I am glad you are home with your little one.

G-d bless and keep you strong and healthy for your lives together.

What a nice family! Three boys! I love the names you chose.

[mamaverdi]

Strangely enough I have a Jonah whose water started leaking early. Protocol was as mentioned by another poster---no induction, wait, keep everything out of the vagina, and wait. Take temperature, watch for signs of infection, wait for mama to go into labor herself.

Considering he has a heart condition, I am *really* surprised they pushed him to come before he was totally ready.

Watch the mama, not the clock.

mv

[mamacarla]

I am sorry that they led you to believe you had no choice but to be induced with PROM. I had PROM at 34 weeks and they were hoping that I would lay in bed at least another 3 weeks. As it turned out I went into labor about 26 hours later. Most women go into labor 1-3 days after water breaks. They had several women on the antenatal unit waiting for weeks after their water broke though and many were getting drugs to stall labor to let the baby develop more.

I am glad you are home and OK.

Carla

[dace101]

Congratulations!
Welcome to the world, little one!