A Rough Start… Who Knew Some Babies Need A Tan?
If you read my post last week you know that my second son was born in January. After a rough delivery on Friday morning, we were released on Sunday evening. For a while we weren’t entirely sure if we would be allowed to leave on Sunday because the pediatrician on staff was concerned about my son’s bilirubin levels. What is bilirubin? According to Dr. Google, bilirubin is an “orange-yellow pigment that occurs normally when part of your red blood cells break down.” When bilirubin levels are high, they can cause a yellowish tinge to a baby’s skin (Jaundice) and according to the pediatrician, high levels for a long period of time can cause other health issues including issues with brain development.
My older son also had jaundice and had his bilirubin levels evaluated several times both immediately after birth at the hospital and in the pediatrician’s office shortly after. However, his levels were never high enough to warrant a need for treatment other than just close monitoring. With my new baby though, things were a lot more complicated.
Knowing that the doctor was on the fence about whether or not to discharge my newborn, I actually asked that we NOT be released if they were very concerned but the decision was made to allow us to go home on Sunday night. I was told that I needed to bring my newborn back to the hospital early the next morning for another blood test at the birth center before an appointment at the pediatrician’s office where they would reassess his bilirubin results.
When I dutifully arrived at the birth center the next morning I was told that since it was a weekday, I needed to go down to the hospital lab directly to get the blood drawn for the test. I wasn’t thrilled since I had specifically asked the day before, before we were discharged, and was told that the birth center would be the one to run the test but I went down to the regular lab as directed. Unfortunately the tech at the lab wasn’t used to working with newborns. She stuck both of my newborn sons’ heels several times before telling me that she thought she had enough blood to run the test. My son screamed the whole time and blood was everywhere. To say it was traumatic would be an understatement.
Following the visit to the lab I headed to the pediatrician’s office to get the results of the test. As luck would have it, an “emergency” came up in the office (although no one told me until later) and I had to sit in the patient room with my newborn for over an hour and a half before we were seen only to find out that the lab hadn’t been able to get enough blood to run the test. The pediatrician said we needed to go back to the hospital to have the test rerun. I was beyond upset. I agreed to go only because the office promised me that they would call ahead to the birth center and have them run the test instead of the lab.
A short while later, back at the hospital birth center, a nurse who was skilled at working with newborns drew my son’s blood to run the bilirubin test again. She was appalled upon removing my son’s Band-Aids on his heels to find that he was STILL bleeding. How was the lab unable to get enough blood to run the test if my son was still bleeding hours later?! At least this nurse knew what she was doing and gave my son a bit of sugar water first before sticking him. He didn’t even cry this time. However, I am pretty sure that he had some version of baby PTSD from the first lab visit because it was weeks before he would allow ANYONE to touch his feet without him freaking out. Poor baby.
I was asked not to leave the hospital premises until the test had been rerun and to wait until the pediatrician’s office called to tell me if I could go home or not. My dad (who had driven me) took me down to the hospital cafeteria and we had lunch while we waited for the test results. Over another hour later I finally got the call we were waiting for. The pediatrician’s office said that we could go home. Half an hour later we were finally back home and I was feeding the baby when the pediatrician’s office called me back to say that they made a mistake and I needed to head back to the hospital because my newborn needed to be readmitted to the birth center. His bilirubin levels were too high and they were concerned. I was pretty much an emotional basket case. I was angry, sad, scared, frustrated, and exhausted just to name a few of the emotions running through my head. I felt like we had been given the runaround all day and frankly I was mad that the hospital had discharged us the night before only to put us through this crap the following day. My baby had spent the majority of the day in his carseat driving between the doctor’s office and the hospital. I wanted to hold my baby and relax at home. Instead, I was packing my newborn back into his carseat and preparing to drive him back to the hospital again. I decided to take a quick shower first (self-care) while my husband packed me some food for dinner.
My parents dropped my newborn and I off at the hospital while my husband stayed home to care for our toddler. Back up at the birth center the hospital couldn’t find the proper paperwork required to readmit my son. They thought we were there for another test scheduled for Friday (more on that another time). Paperwork was finally located and my son was readmitted. Thankfully I was allowed to stay overnight with my son. However, the pediatrician’s office had sent a note saying that they thought that my baby should be receiving supplemental formula. On top of everything else this almost sent me over the edge. Luckily I had had the clarity of mind to grab my breast pump before heading to the hospital. I had been able to express milk since being 18 weeks pregnant and I KNEW that I would be able to pump to feed my baby if I couldn’t breastfeed him. Don’t get me wrong, I have nothing against formula or supplementation but I didn’t feel that it was necessary and didn’t appreciate my doctor’s office telling me my son needed it without talking to me first. The nurses at the hospital allowed me to try to pump to feed my son first and were impressed with how much I was already able to pump at only a few days postpartum. I felt proud of myself and my body for being able to provide for my newborn and I also felt empowered in that I fought back for what I wanted and felt was best for my baby. If this had been my first baby I doubt that I would have felt so confident. I am fairly sure that I would have felt bullied into doing whatever they told me to do and my milk supply likely would have suffered.
It was a long night to say the least. The way that high bilirubin levels are treated (and lowered) is for newborn babies to spend a night (up to 24 hours) under “the lights” in what basically amounts to a baby tanning bed. They tapped a tiny paper eye mask over my son’s eyes so he wouldn’t blind himself but otherwise stripped him naked except for his diaper. I was only allowed to remove him from the lights for 30 minutes or less every few hours. After every feed I pumped and then bottle fed him whatever I could pump afterwards while he was still under the lights. I was instructed to feed him as much as possible to facilitate the flush of bilirubin from his body. I got very little sleep that night. Besides pumping a lot (which probably contributed to my oversupply issues – more on this later) I struggled to keep my son calm and happy. He wanted to be held and it was so hard not to scoop him up and cuddle him. I also struggled to keep his eye mask on him so he wouldn’t blind himself. He hated wearing it and every time I would drift off to sleep or go to the bathroom he would rip it off. After a while I begged the nurses for help because I was so exhausted and super emotional. Thank goodness the nursing staff at our hospital is pretty great. They helped me make it through. The next day (while we waited for my sons’ bilirubin levels to be retested again) one of my friends who is a nurse at the hospital convinced me to allow her to take him to the special care nursery and take care of him for a bit so I could take a nap. I was hesitant to let her take him but she was right in that I really needed the rest if I was going to care for him the best that I could. I am thankful that she did this for me. I was a mess!
On Tuesday night after dinner, the pediatrician on staff finally got my sons’ new test results back and cleared him to go home. I felt relieved, happy, but also drained. I felt as though my son had a rough start but we were on our way and I was proud of myself for advocating for what was best for my son and myself. Although I felt exhausted I also felt strong – like super mama. My son is two months old now and while some days are tough to say the least – I know I can do this. I’m grateful to my friends, amazing nurses, and IBCLC for remind me on the hard days that I’m still rocking this job of being a mama – the best but hardest job I’ve ever had.
A couple of weeks after we brought baby home