Sunday, August 21, 2011

Jennifer & Georgia - An Introduction

Hi, my name is Jennifer and my daughter is Georgia. We’ve had quite the adventure so far that has led to my being an exclusive pumper for her.

I had a relatively easy pregnancy until week 26 when my fundal height was measuring large all of a sudden. After a repeated growth ultrasound, they diagnosed my daughter with duodenal atresia. Basically, she had a blockage in her intestine that would require surgery after birth. It was never seen on any other previous ultrasounds. I was also diagnosed with polyhydramnios because of the amount of amniotic fluid I was carrying around. The main concern was that I was at higher risk for pre-term labor because she was not able to swallow and process the amniotic fluid properly. The other major concern was that duodenal atresia is highly associated with Downs Syndrome. They did an amnio that day and we waited for several days for the results. Thankfully we received word several days later that all her chromosomes came back normal.

The following week, after just moving into our brand new home, I was upstairs in our bedroom when I swore I peed myself. I was livid! All I could think was that I had so much fluid, it was now pressing on my bladder. Turns out, my water was starting to leak. I was 27 weeks pregnant. The next day I was admitted to the high risk pregnancy unit at the hospital and diagnosed with PROM (premature rupture of membranes). Within 24 hours, I went from being considered polyhydramnios (too much fluid) to oligohydramnios (too little fluid). I was at high risk for infection, so I was confined to my bed in the hospital. They immediately started me on the steroids shots and mag sulfate. I had daily monitoring and ultrasounds to monitor my fluid levels. It just kept dropping until there was virtually no amniotic fluid left. However, my daughter was still doing well on the monitor, so the goal was to try and keep her in there until 34 weeks.

Seventeen days later on April 29th and with virtually no fluid left, Georgia’s heart rate showed signs of decelerations during a monitoring session. The next thing we know, I was moved to Labor & Delivery and was being wheeled into the OR for a c-section (she was also breech!). My daughter was born at 29 weeks and 5 days gestation. She weighed 3lbs, 3oz.

Overall, Georgia did great from the start for being a preemie. She was labeled “feisty” by every nurse in the NICU. She was on CPAP for only a few hours before being upgraded to a nasal cannula. She was not allowed to eat/drink anything from the start because of the blockage. She received all of her nutrition from an IV. Originally, the surgeons told us they would wait to operate until she was stronger and gained weight. However, on day four she was transferred to Children’s National Medical Center in Washington DC and had surgery that very night. It was horrible – I had just been discharged home and was not at the hospital when they decided to proceed. Thankfully my husband was there that night and remained by her side the entire time.

Her surgery was a success, but she was not allowed to drink anything until her digestive system “woke up” and started working, which was estimated to take at least 2-3 weeks. Hence, I became a pumping machine! I spent 12-14 hours per day at the NICU at my daughter’s bedside. During the day, I used the Medela Symphony in the pumping room and we rented another for our home at night. I had a massive oversupply from the beginning and worked with the lactation consultants to help battle recurrent clogged ducts. I was lucky I never got mastitis. However, all the pumping on the hospital grade pump destroyed my poor nipples. No one was ever sure if it was thrush or just irritation from the pump, but my nipples turned purple and I got horrible “burns” around them. I was a medical mystery to the entire NICU! I was their lab rat and tried every cream (over the counter and prescription), ointment, and old wive’s tale cure that the NICU staff could come recommend.

It took 25 days for Georgia’s digestive system to start working. We never knew we would pray for poop as hard as we did. “Team Poop” was our family’s motto. Once she pooped, she was started on extremely small amounts (about a teaspoon) of breastmilk through the NG tube in her nose. She didn’t tolerate her feeds well and often puked everything up. It was devastating to watch. My husband and I finally requested that they remove the NG tube and try her on regular feeds by mouth. I argued with the Nurse Practitioners and I think they finally caved because I am a Speech Language Pathologist and knew just as much about suck/swallow coordination as they did. She always took the pacifier like a champ and I was convinced she could take a bottle without an issue. It was the best argument we ever made. Once we started giving her breast milk by bottle, she never looked back! They increased her amounts slowly everyday to make sure she could tolerate it and before we knew it, she was drinking 2oz every 3 hours.

We tried her several times on the breast, but she never was successful. My nipples were just too sore and she was too inpatient. We nicknamed her the “hippo” after the Hungry, Hungry Hippo game. If she didn’t get milk right away, she would scream and cry. I would clench the chairs of the arm in horrible pain as she gnawed at my nipples. Every woman in the room sympathized with me.

Georgia was discharged home after 48 days in the NICU in mid-June. My husband had to roll in our huge tailgating cooler to empty the NICU’s freezers of my pumped milk. Even with a second freezer at home, we were swamped with breast milk. I had close to 1500oz already frozen at home. With the help of the hospital LCs, I donated almost 500oz to the Mother’s Milk Bank. I was so proud to help other babies who needed the milk.

I never intended to be an exclusive pumper, but it works for us. At one point, I was only pumping 4x/day. However, after returning the hospital grade pump and getting my first period since giving birth, my supply definitely took a hit (aka – down to 30oz/day from 50oz/day). So, I’m now back to pumping 6x/day on the Medela Freestyle. I’ve started to rotate through the freezer stash to use some of the older milk from early May. I’m usually able to defrost one bag from the freezer each morning and then replace it with a bag of new milk at the end of the day.

I’ve pumped for almost 15 weeks now. I intend to keep her on breast milk until she is at least 6 months old at the recommendations of the neonatologists and pediatricians. At six months, I’ll re-assess. My next goal after that would be to make it until she is 6 months adjusted, so around 9 months total. We take it day by day around here. Maybe we’ll make it a year – who knows?!?!

My biggest concern is going back to work in November. I took an extended leave to stay home with her since the doctors didn’t want her in daycare until she is at least 6 months old due to her compromised immune system because of being a preemie. I’m not sure how I’ll manage pumping during my crazy work days, but I intend to do my best. She’s worth it!!

Our full story (and it keeps going!)is available on my blog Thanks for the support!!!

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