Friday, June 22, 2012

Back to the Hospital (and more lessons on mommy-instinct).

We were discharged from the hospital on Saturday afternoon.  That day, we came home, put Ruby into her first cloth diaper (yay!), loved on her, and fed her constantly.  My poor, poor nipples.  But that's another story.  =)

That first night was SO HARD.  They don't prepare you for this, but Ruby cried inconsolably the whole night long, unless she was eating.  We were at our wits end.  We ended up doing the very last thing I'd ever considered a possibility in our family: sleeping with her in our bed.  But, ahhhhh, peace!

I didn't mention this before, but while at the hospital, they did a routine bilirubin check on her.  It was borderline high, so they did a blood test.  She was still at the high end, but she passed the test.  On Sunday at home, I thought she kind of looked yellow.  Keith kind of thought so, but we weren't really sure.
All of her clothes were too big.  She was only 6lbs. when we were discharged.
Maybe we should have called the pediatrician.  But we didn't know!  And we didn't know what we didn't know.  Besides, we had an appointment the next day for our post-partum check up.  She seemed fine, so we figured that was the place to ask.

Totally unrelated, but a funny story, my aforementioned nipples were dying.  Girl likes to nurse, and my milk hadn't come in yet, so she was eating all. the. time.  I'd heard of these gel pads, called Soothies, so in desperation, I sent Keith out to get some.  He sent me a frantic text saying, "Target is all out!!!  They don't even have any in the back, what do I do?!?!"  It was pretty funny.  And don't worry, he found some, thank goodness!

Anyway, Monday my milk came in and life got a lot easier!  A full, well-fed baby is a happy baby.  I got Ruby dressed in a cute outfit, and off we went to the hospital for our post-partum check up at 3:30.

The nurse started by doing a scan to check her bilirubin.  The scanner kept getting an error.  She decided we'd weigh her and try again in a bit.  Ruby was put on the scale, and she was down to 5lbs.11oz.  The nurse wasn't too happy about that.  She started talking about supplementing and formula... two things I didn't want to hear.  Especially since things seemed to be going well now that my milk was in.  The nurse gave me two bottles of formula and some tubing for a possible supplemental nursing system, because I did not want to do bottles yet.  She also wanted to do a weighed feed, so I sat in the nursing chair and fed my girl.  

While Ruby was eating, the nurse stepped out to see if she could get a different bili scanner.  I was fighting tears due to a combination of post-partum hormones, and feeling like a breastfeeding failure.  The nurse came back in with another, more experienced nurse (from the get-go, I'd kind of felt like our nurse didn't know what she was doing).  They scanned Ruby once, while looking at how yellow she was.  The other nurse proclaimed that the error code the scanner was giving, was an error because her bilirubin was too high for the machine to read.  Crap.

At this point, they called our pediatrician.  Of course, since Ruby was only 3 days old, we hadn't even had our first appointment yet with the pedi.  So the nurses came to get Keith to give the pedis all our info.  Apparently, the plan was that Ruby would need to go upstairs to the lab to get blood drawn to see what her bili level was, and then we needed to go to the pediatrician so that they could decide how they wanted to treat her. =(  Of course, we'd been assigned the last appointment of the day at the post-partum center, so all of this was done in a big rush.  I was struggling to keep it together.

The good news was, Ruby gained two ounces in just that one feed.  So the nurse proclaimed that we did NOT need to supplement until further notice.  We never have had to, so take that, nurse.

We left, rushed upstairs to a horrifying blood draw (they didn't properly warm her foot, even though I told them it wasn't working, so they had to squeeze the hell out of her to get the blood out, and it was totally awful).  Then we rushed off to the Redmond office of the pedis, because that was the only one that had an appointment for us (5:50pm, the last one of the day).

We got there, met a really nice doctor, and she checked Ruby out.  She said looking at her, she was pretty jaundiced, but the lab hadn't called back with the results.  She told us she was pretty certain Ruby would need treatment.  It would either be bili blankets at home, or she'd have to be hospitalized.  My heart kind of stopped at that.  My new baby might have to be hospitalized already?

The doctor's office was closing for the day, so the doctor sent us off, and told us the on-call night doc would let us know what to do once the lab results were in.  We were still on the way home when we got the call.  Ruby was going back to the hospital.  Her bilirubin level was 21.  Too high for the at-home blankets.  The doctor told us to go home, pack some things, and they'd be waiting for us on the 4th floor at Evergreen.  I hung up and cried.

We did as the doctor told us, but had to make arrangements for Braidy too.  We didn't end up back at the hospital until 9:00pm, but sure enough, they were waiting for us.  

Ruby went right under the bili lights.  

She didn't like it, she wasn't being held!  She cried a lot.  The nurse suggested a pacifier, which I did not want to introduced until at least 3 weeks old when we were into our breastfeeding groove.  Keith was all for it, and the nurse told me to not look at it as a long term thing, but something to get through the next 24 hours.

I'd be lying if I didn't say I wasn't a little bit happy that she spit it out more often than not, but it did help her a little bit.  The other issue I ran into was feeding.  Ruby was only allowed to be out from under the bili lights for 30min every 2 hours.  If she got hungry in between, I wouldn't be able to take her out and nurse her.  The nurse set me up with a pump when I said no formula, and said if I got enough milk, we could go that route.  I didn't want bottles either, so the nurse taught us how to finger feed her with tubing and a syringe.  So it went, every 2 hours around the clock, I'd take her out and we'd weigh her, then feed her for 30min, weigh her again, put her back in, pump, soak the pump parts in my little dishwashing tub, finger-feed her (because she'd always take it, and then be full until next time), clean my pump parts, and then maybe rest until the next time.

The doctors we had there were really great.  After the first night, her levels had gone down, but not enough.  They were also really concerned with how much milk she was getting (because it flushes out the bilirubin), so we were doing weighed feeds around the clock.  Luckily, I had good milk, and she was gaining nicely.  But since her levels weren't as low as they wanted, we ended up having to stay two nights.  

We were finally discharged.  The past two days had been really hard for this first time mom.  Luckily, we'd had great nurses and doctors, and beds to sleep in in Ruby's room.  I never left her for a minute.  We were sent home with instructions to follow up with our pedi for more bili checks.  After about a week of every other day blood draws, Ruby was proclaimed in good health.  Phew.
On the way home from the hospital.  It kills me that she's already outgrown that sleeper she's wearing, and it's too big for her in this picture.

This was the second time in her first week that I wished I'd trusted my instincts.  I knew she looked yellow.  If we had called the pedi, maybe her levels wouldn't have gotten so high?  I guess we'll never know.  But I do know, from now on, when I have a feeling about something, I need to act on it so I'm not kicking myself later.


  1. I stumbled upon this post when I saw that one of your labels said jaundice. I had such a similar situation with my son! He is 8 weeks old now but the day after we got to go home we had to go to our pedi for his first check up and they tested his bilirubin levels. They were at 16 so she wanted to watch him closely. I’m also a first time Mom and my milk hadn’t really come in yet so they said to feed, feed, feed, him to filter it. The next day we went back to the Pedi, had levels checked and they were 18. Pedi thought he may be just at his peak and they would start to go down. My milk still wasn’t in yet and I was starting to freak out. The next day- back to Pedi had levels checked again…(each time they pricked his tiny foot to draw blood, just like Ruby! It was horrible- I cried more than he did.) his levels were at 18.6 UGH the Dr. wanted to put him in the hospital but I just didn’t feel right about it so I asked if it was dangerous to go one more day since my milk still wasn’t in! She said that was fine to go one more day but if it went up we'd have to have a hospital stay. 4 days post partum my milk finally decided to come in and he was finally getting full, went back to Pedi and his levels had gone down to 14! Thank Jesus we didn’t have to go back to the hospital. Just like you said about trusting your instincts… my instincts said he needed one more day to get the bilirubin filtered out and surely enough he did! I can so relate with this post and thank you for sharing. I experienced so much of the same things you did. It was horrible but thank goodness it’s over now!

    1. Hi Katie! I'm sorry you had to go through that experience (isn't it traumatic as a first time mom to have to go through something like that immediately after birth?!?). I'm so glad your little guy is doing better now, though!
      I'm with you on the milk thing. Ruby was so teeny at birth, they told me I'd have to supplement with formula. But my milk had just come in that day! I knew that now that she was getting real milk, she'd start gaining by leaps and bounds, and sure enough, I was right. Mommy-instinct is a powerful thing!