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Friday, 16 February 2018

The toughest week of our lives: part two

Like writing part one, it has taken me rather a while to get around to this post! Almost another month to be precise. That probably means I am not telling the story in its true form now; as they say, you quickly forget all the finite details... but here goes...

We went home the day after Pippa was born and after my cesarean (day 1). In hindsight this was far too early but I was a midwife and knew what I was doing so felt that I could be at home... I'd be doing the same things at home as I could in hospital right? After the cesarean she was very very mucoussy. Most section babies get mucoussy but she was possibly the worst baby I have ever seen. Because of this she wasn't really feeding very well and whenever she did feed she then vomited back up. Therefore I was trying her at the breast every 3hrs and then expressing and giving her that by syringe. The last good(ish) feed she had on the day we went home was about 7am. usually the wards wouldn't discharge someone when the feeding isn't great but like I said, I'm a midwife and knew the score/what to do etc. Also because I expressed so much antenatally I knew I had plenty of milf for her in the freezer, therefore when I was at home she was actually getting more milk than I was expressing for her in the hospital.

We were discharged at round 2pm and made our way to Jayne's house to pick up the dog on the way home. I was quite adamant that I wanted to introduce the both of them together at home. I didn't want to get Charlie back and the house already smell of this new weird creature. Again, with hindsight, this was our second mistake.

Initially is was nice being home and in my own environment but I soon got stressed about the feeding. It got to about 10pm and she still hadn't been to the breast since that morning and was still being really sick. In the end I rang the postnatal ward and spoke to a lovely, really experienced midwife who advised me to give her a 10ml top up with the intention to make her vomit the mucous out so then hopefully she would want to feed properly; so thats what I did.

1am came and so did the vomit. Loads of it. Darkly blood stained and it absolutely stank! Not normal what so ever!!!! I rang 111 who advised me that we should get her seen at the childrens hospital within an hour. Shit. Scott hadn't slept for god knows how long so was worried about him driving. I had managed to catch an hour just before the vomit happened but there was no way I could have driven.

Well this dilemma was taken out of our hands. I went to let the dog out for a wee before we left and Scott was changing Pippa's nappy when I hear this panicked call from upstairs. Rushing up, I find a very blue, not breathing baby on the changing table with loads more bloody vomit obstructing her nose and mouth. I instantly went into work mode and resuscitated her. At the time it felt like forever but it was probably no longer than a minute or so and she came round well. However because of this there was no way in hell I was putting her in the car and driving ourselves. I was NOT going to resus her again at the side of the road if it happened again. I rang 999 who agreed and sent us an ambulance.

On arrival of the ambulance crew she did her third bloodstained smelly vomit. They hadn't had any experience of such a young baby so I think they were thankful that I was a midwife. All we needed was the ride (and possibly to resus equipment if she went blue again). and they were happy for me to take the lead: fortunately it wasn't needed. When they saw the vomit though they did call ahead to the childrens as they were concerned about it too and they advised us to be blue lighted in. Luckily it was 2 in the morning by then so the roads were clear. I sat on the stretcher strapped in and held Pippa so she was upright. This worked well for me too as I was somewhat cushioned from the very bumpy journey, though to be fair at this point the last thing I was thinking about was myself.

When we got to the Childrens they did a full check on her which was fine and they weighed her too. This was a day earlier than it would usually be done (day 2 rather than day 3) and showed that she has lost 14% of her birth weight!!! Ouch! On day three we would expect babies to loose upto 10% of their birth weight so 14% really isn't good. Yet again, in hindsight it's not surprising as she vomited up more than she was getting in but at the time I felt like I had failed her. Luckily her blood tests showed that she wasn't too badly affected by the weight loss but did show that she had an infection. Because the blood she had vomited was old looking and not bright and fresh, it was believed that it was from me rather than her. They tested my breast milk but I knew it wasn't that as the blood in the vomit was way too much to be from me; specially when I was expressing and my milk was not obviously blood stained. Later on it was assumed that she probably ingested it at the cesarean and it festered in her which caused her infections. This explains why is was so heavily blood stained and why it smelt so bad.

After about 10hrs of observation, they wanted to admit her to the childrens hospital which would have meant I was staying as an outpatient... By this point it was lunchtime, I hadn't slept and had had minimal pain relief. I really needed to be an inpatient too. Unfortunately, once a baby is discharged post birth it is usual protocol to go to the childrens rather than back to the maternity unit which is hence why we ended up there. Because of this you usually then wouldn't get transferred back but I begged and luckily (probably because I am staff), Southmead did have us back.

As we were taken to the childrens by ambulance, our next issue was how to get from the centre of Bristol to Southmead. Luckily we have great friends who were so helpful. Jayne works in the centre so has a permit to park in all the streets. They drove both of their cars in, parked hers in a side street nearby and dropped the keys into Scott so we had transport. Luckily we had thought about the car seat when we left home the night before so had it with us.

We got back to Southmead at about 4pm by which point I felt like utter death, I cried all the way up the corridor to the ward, I was just so thankful to be back. Once we settled in they got the neonatal doctors there to review her, restested her bloods (including a septic screen) and reweighed her. They actually made her weight loss 12.7% so slightly better than at the childrens - probably the difference in scales and she had also had several formula feeds by this point which may also have helped. She started IV antibiotics and a feeding regime to get her back on track. This meant I was trying her at the breast every 3 hours, topping her up with as much formula as we could get in her and I was expressing and giving that too. I was so so thankful that one, I had a single room and two, that Scott could stay with me, I never would have managed it all on my own! I was pretty sleep deprived and emotional too so I don't think I would have coped with him having to leave me. He did pop home to meet Jayne to give her car back and to hand the dog back over to her. Poor Charlie had been on his own all day bar the neighbours popping in a couple times to let him out for a wee. If he hasn't freaked out enough by this new human in his house, he then suffered the stress we did in the middle of the night and then got left all on his own! I felt so awful for him! Luckily he loves staying with Jayne and her dogs so at least I knew he was happy there.

In the first 24 hours of being back in hospital (day 3) her weight went to 10.8%, a fantastic gain. It should have been though as she was absolutely pumped full of formula. So much so that its was impossible to get her to feed from me as she was so full all of the time. Therefore the next task was to get her to feed from me. As absolute luck would have it she got the message and literally woke up and decided to feed from me without much effort. She literally jumped on the boob. She still needed to feed 3 hourly but the plan was not to give her anymore formula providing she did feed. In the next 24hrs (day 4) her weight stayed the same. Although that doesn't sound good, they were happy with that as she had gone from having loads extra to just relying on me. However, in the next 24hrs (day 5) she had to gain else we would have to give her formula again. I hated giving her formula, she was sicky before but she was so so so much worse on the formula. It stinks too which meant she stank all the time. She spat it out a lot and got a rash on her chin. Luckily enough in she gained 30g taking the percentage to 10% exactly. This is considered a fine gain in such a short space of time. Each day she was also having her CRP checked and the same day it came back showing that the infection had resolved enough for her to stop the IV antibiotics.. this meant we could go home again!! These days had been the most stressful of our lives so leaving the hospital where I had 24/7 support was rather scary, specially after what happened the last time we went home. It felt like such a huge responsibility feeding her myself and the stakes were high because she had been so poorly. But we had to leave sometime right? So we did, and it was fine.

Although I knew full well about the baby blues, I never anticipated how bad they could be! Even when we were doing well at home I found myself randomly bursting into tears over absolute nothing. It went on longer than I thought too but then I guess it's such a huge adjustment both physically and mentally and I was being hard on myself. We didn't exactly have an easy start either!! But onwards and upwards, things did get better...

In the next installment I wish to natter on about how complicated the human overthinking brain can make breastfeeding and the wonders of the first few weeks as new parents! Now how long it will take me to get around to writing it, who knows!!

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