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Maverick's Story - and the dangers of bilirubin

When we found out we were pregnant with our second child, we could not have been happier. We were a little surprised that it happened so quick, but we were happy nonetheless. At an early doctors appointment, I remember my maternity doctor telling me that as long as my first pregnancy was normal and without complications, second pregnancies are usually the easiest. Boy, did that turn out to be furthest from the truth! (Well, if you consider just the pregnancy, she was somewhat right, but after the baby was born, we were in for a whole new world of parenting and emotions).

At 32 weeks, I was told our baby was breech. I knew what a breech baby was (meaning, I knew the baby was head up, instead of the normal head down position), but I didn’t know what it meant for the delivery. So I asked. And she said, “well, if he doesn’t turn, you will need a c-section”. My husband and I walked out of the doctor’s office thinking, wow this really sucks. I had a natural (vaginal) birth with our first son, and figured we could or should expect the same for this one. The thought of the recovery from a c-section, with a 20 month old toddler at home just wasn’t something I had even considered this entire pregnancy. I was told that the baby could possibly still turn on his own, and an ultrasound was ordered at 35 weeks, followed by an appointment with an OB. The OB gave us 3 options: The first was to try to have a breech vaginal delivery, but they would only be able to accommodate us at 2 hospitals in the lower mainland – Langley Memorial, or BC Women’s & Children’s. The second option was to try to turn the baby with a method called an ECV (external cephalic version), where an OB attempts to turn the baby by feeling around the outside of your belly (bump) and just pushing on it until it moves. The success rate we were told, was 50%. The last option, was to opt for an elective c-section. The ultrasound had reported that the baby’s head was in the ninetieth percentile and the OB was under the impression that the baby was measuring closer to 39 weeks rather than the 36 weeks that my due date had implied. After a lot of discussion, contemplating, weighing out pros and cons, and taking a couple of days to sleep on it, my husband and I decided that the c-section would be the best option for the family, and the safest for the baby.

On April 6, Maverick was born via c-section. He was a chunky monkey at 9lbs 2oz, and we were told that he most likely would not have turned, given the way his legs were positioned while in the breech position. (His legs, or his knees were pointed outwards almost in a frog-style position). Anyways, he was given a clear bill of health at delivery, and the following day, both myself and our son were discharged from the hospital. Since they don’t normally discharge c-section patients that quickly, we were told to come back in 2 days to see our maternity doctor so she could follow up with Maverick. When we brought Mav in, he had lost a fair amount of weight, more than the normal newborn weight loss, and enough that they were concerned. She had me breastfeed him in the office, and did a pre- and post- feed weight. She was satisfied with the amount that Maverick ate, and sent us on our way, with strict orders to feed him every 2 hours and top up with a bottle, but we were told to come in the following day for another weight check. The next morning we came in, and he had lost weight again. The doctor this time was more concerned about his colour, and jaundice, but it wasn’t anything alarming. She wanted us to continue with the 2 hour feeds, bottle top ups and we were ordered to come back for another check up 2 days later. When we came in this time, he had lost even more weight despite being fed every 2 hours and being topped up with a bottle for the last 5 days – he had now lost 600 grams. He was down to 7lbs. The doctor made a call to the paediatrician working in the maternity ward that day, and he ordered some blood work. We were told to hurry into the hospital (which is located right next door to the maternity clinic), to have the blood work done. Maverick was wearing only a diaper, and here I am running outside with a one-week old baby in just his diaper, I’m hobbling through the pain and discomfort of the stitches from my c-section, and all I can think of is, “wow, it must look like I’m stealing a baby right now”, running through a hospital with a half naked baby! The results came back with Maverick’s bilirubin levels dangerously high, and a phone call from the paediatrician told us we needed to make our way to Langley Memorial Hospital within the hour. Bilirubin can apparently cause permanent brain damage in infants (among other things), so we were lucky that it was caught and treated right away. Who knew jaundice could have such serious effects on a baby? I mean, when you really think about it, I suppose it affects their liver, so it can totally have very serious consequences, but even as a second time mom, I always thought of jaundice as something where your kid just needs some natural sunlight, some vitamin D drops and it’ll go away. Well, I was wrong. Bilirubin occurs when your baby’s organs are unable to get rid of excess bilirubin in the body/blood. Natural sunlight and vitamin D would not have prevented what Maverick went through.

Regardless, Maverick spent the next 18 hours in an incubator under phototherapy lights, where the special lights in the incubator are absorbed by the skin, and excreted out of the body through urine. We couldn’t even take him out to feed him.

Fast forward 18 hours – they finally take Maverick out of the incubator, and test his bilirubin levels. They are now at a more normal level, and they’re happy with the results. Less than 24 hours later, they weigh him, and again, he’s lost weight, despite the constant feedings (every 2 hours) by the nurses measuring out his feeds and making sure he was getting the amount he needed in order to gain weight. When the paediatrician asked what his birth weight was, and I replied with “4140 grams”, she couldn’t believe how much weight he had lost as he was now at 3444 grams. She immediately ordered us to stop all breast and bottle feeds, and he was only to be fed through a nasal-gastric feeding tube (which went down his nose to his stomach). This was how he was fed for the next 2 days. 2 days later, we were allowed to let him take a bottle again, which he was finally able todo, and ate an entire feed in the time he was supposed to.

They suspect the problem with his weight loss was due to the fact that he was taking too long to eat (which makes babies burn a ton of calories), which was making him lose weight. On top of that, the longer he would take to eat, the less time he had to sleep and rest, which led to poor eating habits – you can see the vicious cycle here. The tube feeds allowed him to catch up on his sleep without having to make him work for his food. He literally slept for 48 hours straightwhile he was being tube fed – almost comatose. He was now finally starting to put on 20 grams over each 24 hour period. 4 more days of slowly introducing the bottle back to him, with a couple of tube feeds in between, and we were finally discharged from the hospital.

Free from hospitals at last! We were at Langley Memorial for exactly 7 days. Plus the 2 days from when Maverick was born, and the kid had officially spent more time in a hospital than he had at home. It was nice to finally be reunited with my husband and Linden (our 20 month old toddler at home). By the way, my husband stayed at home and was parenting Linden, trying to keep things as normal and as stable for him as we could while I was in the hospital with Maverick. We would have taken turns, but I had to pump every 2 hours so they could feed Mav, so we just figured it was easier for me to stay in the hospital with him. Our family was now a family of 4 (or 5 if you include Snowy). That first breath of fresh air walking out of the hospital was emotional. Listening to other kids crying in the ward for the last 7 days, not knowing how your infant was doing, watching them poke and prod him with needles taking and testing blood, conducting ultrasounds on his brain, takes a toll on a new mom, or any parent for that matter. But it definitely makes me appreciate everything we have that much more. Makes you even more thankful for your kids and their health, makes you appreciate the fact that we are able to walk out of the hospital with our kids, because you just know, there’s parents and families out there who aren’t so fortunate.

A week later, and although Maverick is still quite lethargic, he’s at least eating on his own for all feeds. We still have to wake him up every 3 hours or he literally won’t even wake up to eat. I’m pumping every 4 hours to be able to offer him the benefits of breastmilk, but its definitely taken a toll on me both physically and emotionally. He is now back up to his birth weight, and almost 2 weeks after being discharged from Langley Memorial, he’s starting to be more alert and awake, is enjoying tummy time, and can even hold his head up on his own, and can lift his legs and hips during tummy time – all things that are a huge accomplishment considering his slow(-ish) start in life.

After going through all this, I can’t say enough good things about the doctors, specialists and nurses we have had the good fortune of meeting. They save lives everyday (and I’m not just referring to our situation, but all the other people we came across in the hospital), they make the hardest days of our lives that much more bearable, tolerable and comfortable. They stay up over night so you can get an extra hour of sleep. They are the most selfless people around, and don’t get the credit they deserve. We are truly grateful and appreciative to have been in the care of the doctors and nurses at Peace Arch Hospital and Langley Memorial Hospital. Who knows what could have happened to baby Maverick if it weren’t for the diligence and care from all the doctors involved. All we know is that we are lucky to not have to think about what could have been.

We are happy to report that Maverick is now healthy, and we are ecstatic to welcome the newest addition to the family! Thanks to everyone who sent us well wishes, and supported us over the last couple of weeks – from other mom bloggers, to followers on social media, to our friends and family. Your support and kind words helped us through some of the happiest, and most stressful times of our lives!

(Above is a before and after picture of Maverick. On the left, is when he was born at 9lbs 2oz, and on the right, he's a week old, at 7lbs 1oz).

Maverick, happy to be at home, sleeping in comfort in his Dock A Tot.

#Bilirubin #Newborn #jaundice #breechbaby #parenting #parenthood

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