Our happy Hyrum boy is 7 months old now, and as I happened to see some of the pictures the other day of when he was in the NICU, I was reminded that I’d never shared our experience with him being born premature in much detail. I think it would have helped me a lot going into this whole experience if I had read a firsthand account from someone else, so my hope in sharing this is that if you or someone you know is faced with a similar situation, you might know more of what to expect.
Every baby and every experience is different, but I hope I can still provide some insight or thoughts that will be of value.
Note: There are some affiliate links below to products that are mentioned, which means I may get a small commission on any purchases made at no extra cost to you.
Before Birth
My second child was born at 37 weeks, and I’d started having definite labor signs around 36 weeks with that pregnancy. With Hyrum (my third child), I started feeling those same labor signs–intense pressure, cramping, increasing Braxton Hicks, the baby sitting extremely low–at just 24 weeks along. I went and got it checked out by my doctor, but as I had no real risk factors for having a premature baby, they sent me on my way.
The prelabor symptoms came and went on and off, but by 31-1/2 weeks, I was back in the doctor’s office (not by appointment–I just showed up and said I needed to see someone ASAP) due to the prelabor symptoms really starting to pick up again. While there, the on-call doctor hooked me to up a contraction monitor and gave me what’s called a fetal fibronectin test, which is basically a way to kind of predict if you’re likely to go into labor over the next two weeks. If it’s negative, you’re almost certainly not going to. If it’s positive, well, the story gets more complicated, though nothing is for sure.
My test came back negative, but from that point on, I started going in for weekly doctor appointments since my prelabor was basically never letting up by this point. Some appointments, I was a mess–I cried a lot due to the anxiety and stress of not knowing what was going to happen, and everything felt super hard since I was basically on bed rest while still having two other children to care for. Each week, my doctor gave me what I could probably expect if the baby were to come that week as well as what her plan and my plan was. While I still feared the baby coming so early, those weekly appointments were so important because they kept my expectations in check and didn’t let my anxiety get too out of control because the chances of an (eventually) healthy and strong baby with minimal to no lifelong complications were on our side after the 33-week (or so) mark.
At 33 weeks and one day, I went into the hospital to get steroid shots for the baby. They need to be administered 24 hours apart, one in each hip, and they monitor you and the baby throughout. The shot is supposed to help with lung development in the baby, and it’s something that is proven to greatly affect the outcomes of babies that come early (with no negative effects if the baby is full-term, at least according to my doctor). I was also given a medication called nifedipine to take every time the contractions started picking up (specifically, every time they got to be around 15 minutes apart or less) to help slow things down, and I took that multiple times over about the next two-week period.
Since by that point, my prelabor symptoms were basically constant and picked up considerably every time I stood up, I went on pretty strict bed rest from then on, though I had been taking it easy for weeks by that point.
Birth + Delivery
At 35 weeks and 5 days, my contractions went to under 15 minutes apart with no let-up when I took the as-needed medication to try and slow them down. My doctor wasn’t available that day, so we saw the doctor on call, who did a cervical check and confirmed that I was at a 3+ and almost completely effaced. It was a tricky place to be, since some women can stay at that point for two weeks, but with my history, the doctor told me to either go home and take another dose of medication and give it an hour to see if anything changed, or just go straight to the hospital and let them monitor me.
We decided to go home, as our older children were with a neighbor and we wanted to get some more things put together before going in to the hospital. While we waited for my mom to drive up to stay with the kids, I monitored my contractions while eating lunch, and they definitely started coming closer together no matter what I did, so as soon as my mom got to our house, we left for the hospital.
You can find more details about the birth in Hyrum’s birth story, so I’ll just summarize here—all in all, Hyrum’s blood pressure and heart rate were solid throughout the birth, and it was actually the only one of my children’s births that didn’t have complications during the afterbirth, which was a big relief. When Hyrum came out and was screaming at the top of his lungs, I was crying uncontrollably–I had been so worried about his lungs, so I was so relieved to hear that beautiful big cry!
He also was bigger than we could have hoped for at this stage–6 lbs., 12 ounces–and he received an Apgar score of an 8 at one minute, and 9 at five minutes. His oxygen levels were in the mid-90’s, and it seemed that everything was going really, really well with him, especially when he appeared to have a strong latch and suck reflex when I tried to nurse him within that first hour.
NICU + Hospital Stay
While his vitals overall appeared excellent, we did notice a couple hours after birth that Hyrum was really LOUD—he was making constant grunting sounds, and even though he seemed to be nursing well, nothing seemed to help him calm down.
When a nurse from the NICU came to have a look at him and bring him back to the nursery for some testing, she reported that they would have to admit him to the NICU immediately. Apparently all the grunting and noises he was making were signs that his lungs weren’t expanding out as fully as they should, so he would need to be put in there on a machine that would expand his lungs more and then be monitored constantly for temperature, food intake, oxygen levels, etc. The nurse assured us that everything still looked good as far as his vitals went and that many babies born at this age needed help with their lungs, even with me having gotten the steroid shot.
They hooked him up to a CPAP machine and attached the other cords to monitor his vitals. Even though he was sleeping calmly for the first time since birth, nothing quite prepares you to see your tiny infant all hooked up to monitors like that and while I knew he was getting the care he needed and the best help possible, it was still hard for me to feel so helpless.
When you first see your baby in the NICU, the first instinct is fear, the second overwhelm. One thing that really helped me was to ask a lot of questions of the NICU team who were in charge of Hyrum–I asked what every machine and tube was for, I asked about the beeping and what the different sounds, alerts, and blinking lights all meant, and I educated myself on what was considered normal and what warning signs they were watching out for. All of that education helped my anxiety stay in check, since I then (usually) knew what was going on when an alert went off or a different machine started making noises.
Since Hyrum was being fed via tube (and just fed sugar water basically at that point), we were unable to keep up a nursing schedule together. In fact, I couldn’t even hold him for the first day or so he was in there. I was still able to put my hand on his chest and have his little fingers curl around one of mine, but that was about it. That meant that a lot of my time in the hospital was spent hooked up to a breast pump in my own hospital room to try and get my milk supply going, a constant process that somehow managed to keep me constantly busy our entire stay in the hospital. Pump left side. Pump right. Suck up the tiny amount of droplets I’d produced into a tiny syringe, labeled with my name and birthday. Wash the bottles and pump equipment. Go down to the NICU to drop off the offering, to stroke Hyrum’s cheek, to hold him when I was able. Repeat, repeat, repeat.
With the colostrum (that honey-like substance that comes out for a few days after delivery before your milk comes in), I collected what I could in a little bottle, and they took what looked like a giant Q-tip and swabbed it all up on the end of it. Then, once Hyrum started to go off the feeding tube, they would feed it to him “like a lollipop,” as they put it. I produced more colostrum than he was given, but he was at least able to get some of the nutrients from that in the first little while after he was taken off the feeding machine.
Once my milk started to come in at the very end of our stay, they let me try nursing (once I could hold him again), as well as feeding him what I’d already pumped from a bottle. Feeding was the piece that seemed to take the longest–the “milestone” or “goal” that the doctor was wary about before releasing us to go home.
Each day or even each segment of each day, we had “goals” for Hyrum–certain milestones that the NICU team wanted him to reach before we slowly removed all machines and monitoring. He first needed to come off the CPAP machine and oxygen, then regulate his own body temperature, then finally be able to eat sufficiently so that he was gaining (and retaining) his weight.
The thing that many parents learn while their baby is in the NICU is that these milestones and expectations are often a two steps forward, one step back kind of thing. When you’re dealing with tiny humans who have just exploded into a world where they must learn and adapt to everything, nothing is set in stone.
The day after Hyrum was born, my mom brought our two older kids to meet Hyrum for the first time. He was still hooked up to the CPAP machine, and we hadn’t been able to hold him since the few hours right after his birth. Because he’d been acting so agitated upon admission and for the initial hours after, they had him sedated, and he just lay there, sleeping, for basically almost that whole day.
I’m not sure our other kids really knew what to think. Mathias (who was just under 18 months old at the time) was just so relieved to see me again that I don’t think he noticed the baby much. Raven was largely just excited to present him with the present they’d brought for him (and for the presents that were “from the baby” for them). She basically just fed off of our reactions to Hyrum, and since we were calm, she didn’t seem to think anything of it that they couldn’t hold him yet, or that he had tubes everywhere. She still wanted to hold him, of course, but when we told her why she couldn’t, she found plenty else to busy herself with.
We originally thought that we might be able to be discharged from the hospital (both of us) within the timeline that the insurance would cover–roughly 48 hours, or a two-night stay. But when Hyrum kept going back and forth on this hurdle known as eating, our pediatrician was wary of releasing us so soon. What I didn’t know before all this was that the hospital offers a “hotel” to people in our situation, where you basically go and stay in a tiny room at the hospital like you are at a hotel, but without access to nurses or people bringing you food or anything.
We got lucky in our timing, though–Hyrum was doing *just* well enough that the last overnight stay was more of a precaution than anything, so the hospital rigged it so that I could continue to stay in the room I’d been staying at, but with it being booked under Hyrum’s name, and with him receiving care at the “regular” nursery that last night. It was kind of a gentle trial run to see if he would still do as well as we’d hoped he would without the constant access to the amenities of the NICU.
Fortunately, everything went smoothly during the night, and we were cleared for discharge the following morning.
For a sense of timeline, Hyrum was born on a Wednesday around 8:00 p.m. at night, and he was admitted to the NICU that same night just before midnight. He spent all of Thursday and Friday in the NICU, and then Friday night, he spent in the “regular” nursery on the mother/baby floor of the hospital, just so we could be sure he was okay on his own in a place where he could still be somewhat monitored. We were discharged from the hospital Saturday morning.
Discharge From Hospital + First Days at Home
In his final morning at the hospital, Hyrum’s bilirubin levels were tested one last time, and they came back borderline for a preemie. If he had been born at term or full-term, they wouldn’t be considered abnormal, but for his age, they were borderline. As a result, we had to be put into contact with a local group who rented out hospital equipment so we could hook him up to the blue light machine and do phototherapy.
We learned pretty quickly that the whole process was a bit frustrating. The blue light needed to be right on his skin, so we couldn’t wrap him up, which meant that he really wasn’t sleeping that well or wasn’t comfortable. We worried about him being warm enough and tried to wrap the blanket around the plastic sheet-thing that emits the blue light, but the setup was far from ideal.
Thankfully, he only needed to be on the lights for about three days if I remember correctly, and all that was left was to figure out the usual newborn routine of feedings, naps, mixed-up days and nights, etc.
Nursing + Feeding
The biggest challenge of those first couple weeks was feeding. The nurses all said that his latch was excellent, and he seemed to vigorously feed for the first little while and then would fall asleep, so I was assuming that he had gotten enough and was just contentedly sleeping.
However, it became clear at his two week appointment that he was not gaining any weight. He luckily hadn’t lost much either since we left he hospital–only an ounce or two–but he definitely wasn’t back up at his birth weight like he should have been. Our pediatrician recommended that I start pumping and feeding him to ensure that he was actually getting enough because a common issue with premature babies is that nursing literally tires them out, and they’ll fall asleep before they’ve actually gotten enough. The doctor also recommended that we supplement twice a day with Neosure (aff link), which is a formula devised specifically for premature infants to help with growth and brain development.
We had heard about Neosure just after the birth in the hospital from the nutrition specialist, who had all four of her own children born premature in the 35-week range. She said that the two of her kids who were supplemented with that followed a more normal growth pattern and were a similar size as their peers, while the two that she didn’t supplement with it were very small for their age.
We decided to supplement with it for the first two months and then go from there. While we didn’t notice anything with growth (or so we thought) other than that he started gaining weight more like he should (though he was still very small), the formula did seem to make him gassy and uncomfortable and seemed to lead to reflux issues. We decided to take him off of it at two months since I seemed to be pumping plenty of milk and see how he fared.
At the two-month appointment, he was somewhere between the 15th and 25th percentile for all his measurements, and the doctor was fine with us taking him off the Neosure. However, at the four and six-month appointments, he had dropped off the charts for growth almost completely, even when you adjusted his age (thus comparing him to babies a month younger than he was). So we decided to have me just pump his morning and night bottles and then do all the rest of the feedings with Neosure. We haven’t gone back since, but already we can tell a difference in growth. For whatever reason, whether it was that I wasn’t pumping enough or due to the high-calorie formula of the Neosure or whatever, exclusive breastmilk just wasn’t cutting it. (I will note that he was still growing from two to six months, obviously—it was just at a slower rate.)
At seven months old, he currently drinks about 24 ounces per day (combo of breastmilk and formula) and has about 8 ounces of solids (4 oz twice a day).
The First Few Months
Once we were able to return the bilirubin blue lights, we were able to start trying to adjust to life with a preterm baby. Nursing was the biggest hurdle, and once I decided to basically exclusively pump, things overall got better…until they didn’t. As Hyrum got older and the pumping took around 20-25 minutes to complete before he could eat, he got REALLY unhappy (understandably, since he was made to wait so long!). When I decided to mostly just do formula at 6 months, that was a big weight off my shoulders, as he no longer was wailing in the bouncer next to me while I pumped something for him to eat every time.
The other biggest thing was germs.
The nurses and doctors made it absolutely clear that while Hyrum looked like a typical newborn in size and movement and such, his immune system was still underdeveloped and he could absolutely not get sick. This meant we were extremely cautious and strict in the first few months of his life, which meant that we were basically in quarantine for that time, especially because it was the middle of winter (December) and we were concerned about flu and RSV and all the other millions of things that go around then.
And then COVID-19 hit, and EVERYONE was in quarantine.
While it took an adjustment to get used to hardly ever leaving the house for all these months (7+ now!), we’ve made the most of it, and it’s definitely been nice that we haven’t had to deal with ANY of our kids getting sick during this time (with the exception of one random bout of strep that my middle child and I both got in January).
Currently
Other than the fact that he is very small for his age, Hyrum is happy and healthy and a constant source of joy and delight for our whole family. He is hitting all his milestones, is tiny but mighty, and seems to have a strength and tenacity for trying and trying again beyond his age. At seven months, he can sit for quite awhile on his own, is scooting and planking and rolling and starting to try and crawl, is grabbing toys and putting them straight in his mouth, and letting his demands and delights be known with squeals and babbles and coos and little grunts of indignation.
Our journey with Hyrum thus far might have been a bit rockier than with our other two kids when they were babies, but he has been worth every bit of it and more.
***********
If you have any questions, don’t hesitate to reach out and ask! Having a preemie can be a pretty wild ride, so if you need someone to talk to, you can always comment or email me at [email protected].
