I have been wanting to pen this down for the longest time but never really gotten down to doing it. So what is my motivation for writing an account of how my 2 year-old boy, who was born 9+ weeks early, is growing? To encourage the doctors and nurses who took care of him during his stay at the neonatal intensive care unit (NICU), to encourage mums who have premature babies and finally, as a reminder to my little one how God has been good to him.
Note: Each premature baby’s (preemie) growth is different and my little one’s growth is unique to him. Some may be ridden with a whole host of health and developmental issues whereas some grow up to be perfectly healthy adults. Even at the age of 2, it is still too early to tell how he will be when he grows up.
The unexpected arrival
“Dear, we need to go to the hospital”
Took a quick shower and a slice of bread. It’s 4am. You never know when your next meal… or bath will be.
“6-7cm dilated. Baby is in a footling-breeched presentation.. .multiple-fibroids. We need to stop the contractions and do an emergency C-section. When was your last meal?”
Hmmm… I thought eating before coming was a smart thing to do.
“We can’t put you under GA then. It will be a spinal block for you”
“Good grief! This is not something you like to be woken up with at 5am! Looks like we’ll have to go ahead with the emergency C-section”
“Ok all’s ready.. let me do a last scan… let’s see… The fibroids are not in the way. Would you like to try natural delivery?”
“Why not. I’ve got nothing to lose. If it doesn’t work just revert to C-section”
How the ?!?! am I supposed to push when I can’t feel half of my body?? Ok. Never mind. Just try to imagine where my abs are and PUSH really hard. Pushpushpush…breathe…pushpushpush…breathe…
”You are doing well! Continue pushing!”
“Ooooo! I can see the little feet!”
?!?!?! from the head of the bed.
Thank God for trying to be smart and eat first! I would never be able to do this under GA!
Are babies born 9+ weeks early supposed to be able to cry?!?
“How’s my baby?”
To those unfamiliar with the birthing process, this account is something of a miracle. Most gynecologists would not consider proceeding with a normal delivery for a footling breeched baby due to the high risks of complications, unless he/she is very experienced. I was very fortunate to have an experienced gynae to deliver my baby. If she had proceeded with a C-section, I would have had a much longer recovery time and potentially lost a lot more blood due to my multiple fibroids. Really thankful to God how things turned out! As a doctor assisting my gynae told my hubby to inform him of the safe arrival, “This was the best possible outcome that could have happened.”
The stay at NICU
Born at 30 weeks 5 days and weighing 1.65kg, my little preemie had his first “hostel” stay at the hospital’s NICU for about 1.5 months. After the news got around about his unexpected arrival, hubby and I received lots of support from our church friends in terms of prayer and financial support. I was so relieved about how well the delivery went and how God provided for us when we were not ready with friends who were so loving and generous that I had no room to be fearful of the future. Even after reading the whole host of short term and long term medical complications that a preemie can develop, I could only trust God to take care of my baby as He had done before. The comforting words of Romans 8:28-29 kept me going with a deep sense of peace during the uncertain days with the certainty that God’s Word provides…
28 And we know that for those who love God all things work together for good, for those who are called according to his purpose. 29 For those whom he foreknew he also predestined to be conformed to the image of his Son, in order that he might be the firstborn among many brothers.
I was sure God let this preemie come into the world for a purpose… in order for me to be more Christ-like and for His glory. So the question of “Why did this have to happen?” did not dwell in my mind.
Thankfully, baby’s stay in the NICU had been a rather uneventful one. He needed the ventilator for only one day and had no problems maintaining body temperature. There were no recorded episodes of apnea or abnormal heart activity. He had Patent Ductus Arteriosus (PDA) but was resolved with drugs. He also had unexplained high blood pressure but resolved on its own with time. We only had an “emergency” call from a nurse telling us that our baby had indigestion from taking infant formula and can only take breast milk. (They had run out of my breast milk and fed him infant formula. Thank God for providing me with abundant milk supply!)
His long hospital stay was mainly for him to gain enough weight, learn how to drink milk from bottle and/or breast and for the doctors to monitor his blood pressure. He needed to be fed from a tube which was placed through his nostril or mouth that led to his stomach for about 5 weeks before he was awake or interested enough to attempt bottle/breast feeding. It was really tough to nurse a baby that small and sleepy but I was fortunate to be supported by a good team of nurses and lactation consultants.
During the first few weeks, hubby and I visited him once every two days to deliver the pumped breast milk. When his condition was stable for some time, we carried him for short periods and just spent time cuddling, talking or singing softly to him. During the final 2 weeks of hospital stay, I visited him daily and did Kangaroo care with him while attempting to breastfeed.
Finally on Christmas Eve, we brought home the best Christmas present for that year — a little bundle of joy, all 2kg of him.
The early months out of hospital
One of the first few things to know about bringing up a preemie is to know that his physical and mental growth is based on his corrected age (the age a premature baby would be if he/she had been born on their due date) and not his actual age (the age of a baby based on his/her birthday). So having a preemie is not a time for me as a parent to be kan-cheong* about his development as compared to his peers. And to add to this “pressure”, he is a year-end baby. This would mean that when he enters school, he would be way behind his classmates born in January in terms of size, physical, mental and social capabilities. What would mums do in my circumstances? Worry? Push the child extra hard? Since the baby’s growth and circumstances are not within my control, I am forced once again to trust God and remember not to compare my preemie with other kids, take it one step at a time, one day at a time, knowing that my heavenly Father takes care of all of us so I do not have to worry. But I must admit that the temptation to compare and be anxious is always lying in wait to pounce on my mind if I am not watchful. Prayerfully, God will help me to keep my eyes on Him and not give in to fear.
The first challenge that I faced when we brought our little preemie back home was feeding him. He was extremely sleepy (I had to keep him awake very often by using an ice cube to touch his body parts. Even then, it fails sometimes) and nursed with weak sucks. Since he had problems digesting infant formula and I had enough breast milk for him, “forcing” him to learn how to breastfeed properly was the way to go. Pumping milk out and feeding him from a bottle was out of the question for me as I had a 2-year old toddler to take care of at the same time and having to pump milk, feed baby, wash and sterilize bottles and pumping equipment for all feeds meant that I had little time left for the toddler (needless to say, I probably would not have time to cook or do housework). As a result, his weight gain was slow for the first few weeks but by God’s grace, it gradually picked up in the weeks and months that followed.
Sleep training my little preemie took a longer time than my elder son due to his low birth weight. He could not sleep through the night without a feed until he was about 5.5 months old (at 3.5 months corrected age) when he had gained enough weight. Since I began teaching him how to fall asleep on his own from the time he came home from the hospital, he was able to settle down to sleep most of the time when I put him in his crib from an actual age of about 4 months. (More on sleep training in my next post…) Being a preemie meant that he was at higher risk for SIDS (sudden infant death syndrome) and might be more prone to reflux. We bought a sleeper for him so he could sleep at an incline and the positioners made sure that he could not flip onto his front by accident for the first few months.
Although baby’s high blood pressure resolved on it’s own, another issue cropped up in the next couple of months. When he was able to focus on moving objects and move his head to follow it with his eyes, I noticed that he could turn his head to the left all the way but not to the right. Thankfully by God’s grace again, this problem resolved within a couple of months after I followed the pediatrician’s advice to do certain exercises with him on a daily basis. I was also really relieved and thankful that he did not develop any life-threatening health issues like heart or lung problems.
When my preemie was able to nurse well, we started to bring him out of the house. We often get curious stares from people as they looked at the little bundle in my sling. Some would ask “How old is he?” and when I said (for e.g.) “5 months old”, they would do a double take and give a puzzled stare at the newborn-looking infant. I would smile (and wished I had this answer recorded so I could play back when necessary) and say “He’s born 2 months early so he looks very small for his age.” His physical growth was off the charts even for his corrected age during the first month back home. He gradually climbed up the charts to be within the 3rd percentile for height and weight during the first year and a half and is currently at the 10th percentile at the age of 2.
Although the early days were really tiring and hard, it was a joy to watch him reach every milestone. His first smile, his first laughter, his first flip etc…He had always been slow in his gross motor development (late sitter, crawler and walker), but his social, mental and fine motor skills developed at a pace that the pediatrician couldn’t be happier with. As I look back, God has indeed been faithful in taking care of him and I didn’t have to be anxious 🙂
Now at two…
So now at 2 years and 3 months old (actual age), he is just like any other toddler with an innate curiously for things around him and can’t resist exploring things with his hands. He is a fan of Thomas and friends, is cheeky and is a bottomless pit for good food. He remembers stories that were read to him, songs that were sung and words/characters that were taught to him. To date, he can read numbers from 0-20, all the alphabets (upper and lowercase), over 100 English words and over 50 Chinese characters. He is probably mainly limited by my pace of teaching him since he has an older sibling that I have to take care of too. Although he is out of the woods, there could be further health/ developmental issues that will only be more apparent in the future (e.g. eye problems, ADHD). But I just have to look at how much he has grown and I can’t help but give praise and thanks to God for His mercy and grace :). It is our prayer that our little preemie, who is given this physical life on earth, will be granted a new spiritual life by believing in Jesus and live this life for God’s glory.
*A Cantonese and Hokkien term meaning nervous, harried or uptight.