Autumn Pennington, Colorado Springs, Colorado

“Don’t touch her like that,” the nurse told me. I removed my hand from stroking my newborn’s hair. Her hand was unavailable due to the IV. “She needs to rest.” I was on the verge of tears already.

It had been a 24-hour labor, almost to the minute. I had been induced due to my baby girl’s small size. My baby Phoenix was diagnosed as IUGR (intrauterine growth restriction/retardation) and SGA (small for gestational age). IUGR happens in 24% of pregnancies worldwide¹. In the United States, it occurs in only 4-7% of all pregnancies with the most common cause being a placental deficiency or a chronic condition on the mother’s part², asthma in my case. The last few weeks had been tense. IUGR required ultrasounds every week, and my doctor and I worried about her not growing properly, as she was barely holding on to the 8th percentile. “It could be genetics, or it could be a placental deficiency. We need to keep watching,” the sonographer would say. Then they would say the same thing the next week. And the next. Until she dropped even lower at 37 weeks.

Phoenix was born in the 1st percentile at 5 lbs, 3 oz. I wanted to hold her and touch her face, but I hadn’t even heard her cry yet. She was in respiratory distress from having the umbilical cord wrapped tightly around her neck. The Labor and Delivery nurse pushed me in my wheelchair to my new postpartum room. She helped me get in bed and introduced me to the new nurse who would take care of me. Then I was alone. I stared into space, not thinking about anything. It seemed surreal. I felt stripped of my baby, like she had been removed rather than born.

When my husband came back to the room, that’s when it really hit me. I cried for a long time, feeling like a failure as a mother. If I was just normal, if I didn’t have asthma, if I did this or didn’t do that, my baby would be with me and I could touch her and breastfeed her. But she needed the help. That much I couldn’t deny. She was on so many monitors and cords. As a nurse, I had seen it before, but this was my child. My baby!

I couldn’t sleep that night. My mind wouldn’t rest. I had to see her again. I shuffled myself to the NICU, pink hospital gown and all. I saw her in the NICU bed, and I started to break down again. I didn’t touch her, just like the nurse said. It hurt so badly. It couldn’t be. “Autumn, is that you?” Catelyn, one of my fellow nurses and good friends, saw me in there. “I saw the name on the board and wondered if that was you.” She saw my tear-streaked face, my attempts to hide the tears. “Are you okay? How’s she doing?” She came into the room to see my little girl as I told her why Phoenix was there. “She’s so beautiful. Have you been able to hold her yet?” The idea made my heart jump with excitement and fear. What if I messed something up? What if I made her upset because I’m upset? “No, I didn’t think I could. I was told not to touch her earlier.” Catelyn’s eyes widened at this. “I’m not Phoenix’s nurse so I don’t know all the details. Let me find her nurse.”

Soon the nurse for Phoenix came into the room and helped me move Phoenix, with all the wires and tubes, so I could hold her. The nurse was so kind and understanding. Six hours after she was born, I was finally able to hold her skin-to-skin. It felt so natural and I was immediately calmer. It seemed as if all my hormones came into balance, as though I found what I was missing to bring myself back to reality. I had heard the benefits of skin-to-skin but now it was real. I didn’t get my ideal – immediate skin-to skin for an hour³ – but I held my baby. My excitement lasted most of the night. I got to hold her! And I’ll get to hold her again tomorrow!

I was at the NICU early the next morning, speaking to a different nurse. I asked her about Phoenix coming to stay with us and how could I breastfeed her with all the wires. My questions were logistical, rather than emotional. The nurse, however, was taken aback by my questions. “No one told you? You can’t breastfeed her.” It hit me like a brick wall. I had already started pumping/expressing. It had not been much, but it was there. Were they trying to tell me that I didn’t make enough so I couldn’t breastfeed her? I was ready for a fight and the nurse could tell. “She’s too weak. She needs to rest. The doctor said to just put her on the IV for now, to keep her blood sugar up.” This is when I found out why she had respiratory distress: she had transient tachypnea of the newborn (TTN), caused by fluid in the lungs. Most babies who have this are full-term⁴ , yet struggle to breathe. Have you ever tried to eat with your nose plugged? It’s not possible. Until her body got rid of that fluid, it was not going to be possible for me to breastfeed her. That meant it was back to pumping for me and IV fluids for her⁵.

It would be another 24 hours, a total of 32 hours after she was born, before I was able to breastfeed her. By this time, she was so much thinner than she had been. Luckily, she was able to latch with zero issues. Even the lactation consultant was surprised. “Usually they don’t latch well the first time, especially when you have to wait so long.” She looked from Phoenix to me. “You’re doing a great job.” I focused on my baby. My baby loved me no matter what. My baby needed me, the milk I provided, and the cuddles (I needed those just as much as Phoenix did). I owned my motherhood. I learned how to do so many things you don’t think about when you’re pregnant.

Three days after she was born, Phoenix was finally discharged from the NICU. She had lost an entire pound from not eating, weighing just over 4 pounds. The doctors started her on supplemental formula for the extra calories. I heard from many sources that supplementing can be a problem, to not do it, to breastfed only. But my baby needed it right now, and they didn’t know my baby. I became her advocate as well as her mother.

After discharge and to this day, five months later, she is still in the first percentile. “She is small, like her mama!” they say with a laugh. She is still on supplements, but I was able to limit it drastically. She went from having a bottle of formula after every feeding to zero to two per day. I still struggle with low supply. It’s not uncommon for supplementation to be needed with SGA babies, so being down to (the amount of supplementation Phoenix receives) is a huge accomplishment, according to her pediatrician. She is well after her experience, and I’m better for it. I wouldn’t have learned so quickly to speak up for her, and myself, if not for my NICU experience.

References

• 1. www.ncbi.nlm.nih.gov/pmc/articles/PMC3177763/
• 2. www.aafp.org/afp/1998/1015/p1384.html
• 3. news.sanfordhealth.org/childrens/the-importance-of-skin-to-skin-after-delivery-you-should-know/
• 4. www.chop.edu/conditions-diseases/transient-tachypnea-newborn
• 5. www.stanfordchildrens.org/en/topic/default?id=transient-tachypnea-of-the-newborn-90-P02420

Resources

• Breastfeeding Under Special Circumstances: lllusa.org/special-circumstances/
• Kangaroo Care/Skin-to-Skin Contact: www.llli.org/breastfeeding-info/premies-kangaroo-care-skin-skin-contact/
• Low Milk Supply: lllusa.org/low-milk-supply/

Please send your story ideas to Amy at [email protected].

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