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I Didn’t See That Coming

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Many people know by now that Elijah was admitted to the hospital 3 days after he was born for jaundice. I just wanted to share a lot of the story and what was actually going on during that time. There’s a lot that we didn’t share through facebook because at the time it wasn’t that important for others to know, but I hope that this may help some other moms out there who have to face this same battle to be encouraged!

Looking back, the best way I can describe the situation is that “I didn’t see it coming!”. My pregnancy was medically picture-perfect. I mean seriously, there were no issues. I expected that the home birth would be pretty tough, nursing would take some time, but that it would all work out perfectly, the way God designed it, just like my perfect pregnancy. The home birth was a success and in my mind, it was as perfect as it could have been! I was able to start nursing Elijah soon after he was born. There were some issues getting him to latch, but he latched and nursed… at least we thought! The next day (Saturday), he was still doing well by everything we could see. Latching was still a challenge, but he’d eventually get it and nurse. Sunday, we noticed he was starting to get jaundiced. We asked for prayer and were encouraged by people who told us their babies were jaundiced, but it was nothing to be too concerned about. We read online that most babies do get some jaundice after birth and of course we were flooded with advice to stick him in the sun–but it was rainy all weekend so there was no sun! Monday, we went to his pediatrician for his evaluation, day three of being born, and of course she wanted to check his bilirubin levels. We got the phone call that evening that his levels were dangerously high and that Elijah’s care was being transferred to another pediatrician so he could be admitted to the hospital.

When we got to the hospital, they immediately took him and got him under the bili-lights, started an IV to get fluids going, and redrew blood to check his levels. They allowed us to stay in the female on-call doctor’s room while everything was ran. The pediatrician we were admitted under came and introduced herself to us and explained what she was looking for when the blood work came back. She told us that we needed to get his system flushed out, get him pooping to pass bilirubin out of his system, and get his levels down. She also said that there was a chance we would need to transfer to Alexandria’s NICU for an exchange transfusion. Basically what that means is that they would take Elijah’s bilirubin-saturated blood out and replace it with someone’s “clean” blood. I panicked when she said that. So at this point, we sat and waited for the results. I decided to actually pump as long as I could to see how much milk I could get. I was starting to think at this point that maybe Elijah’s poor latching and nursing may be what all of this stemmed from. I pumped for 30 minutes and was horrified when I only had drops of milk from both breasts.

The pediatrician came back about an hour later and told us that his bilirubin levels were at 32. [To give you some perspective, 1-10 is “normal” in babies, 11-19 is high, 20-25 is getting into dangerous ranges.] She immediately started telling us that she had spoken to the NICU in Alexandria and that we needed to transfer there so Elijah could have a blood transfusion. I felt my stomach turn. This did not feel right at all. She had already explained that it was possible he wasn’t getting enough nourishment and I had some hard evidence that she was right! I saw what thirty minutes got me and he wasn’t nursing near that long or with the same amount of force that the pump exerted. I started asking questions about other possible causes of the bilirubin being so high, like a problem with the liver. She said they checked that and it was normal. Another possible cause of jaundice in babies is if the maternal-fetal blood type is different, but his matched mine. So with these ruled out it only left us with him being undernourished or some other explanation that she didn’t even have. I felt that a blood transfusion was jumping the gun on getting his bilirubin down. After all, it appeared that the issue was he wasn’t being nourished so why not try getting him nourishment through formula FIRST before doing a transfusion. I looked to Lance for some kind of indication on what we should do and I could tell he had no idea what to do. So I asked the BIG question: can I sign an AMA form and we try to give him formula, use glycerin suppositories and keep pumping him with IV fluids to get his levels down before we jump to a transfusion? The pediatrician looked horrified and quickly told me that she was not comfortable with that at all and that the NICU said when a baby’s levels get to 30 they automatically do a transfusion. I told her I understood that, but it just seemed apparent to me that the issue was malnourishment; could we try that first and IF his levels didn’t come down to under 30, then we would transfer to Alexandria. Unhappily and very nervously, she agreed and left the room to go get the form for me to sign. She came back shortly with the floor head nurse and I signed the form. She re-explained all of the risks to me to make sure I understood what I was doing.

Now, it was a waiting game again. I knew I had made the right choice. It was ridiculous to take a 3 day old baby and perform a blood transfusion when there was a less-invasive option that we hadn’t even tried. Shoot, it was a completely non-invasive option! I knew I had probably made the pediatrician mad. But I also know my God! I just needed HER to see that God had this completely in His hands and that the decision I made was lead by Him.

An hour passed and her she came with news: Elijah’s levels had dropped 4 points in just an hour, putting him at a 28. She seemed shocked that they had dropped that much that quickly and said we would recheck them in another hour. Praise God! I knew that we were going to be fine, but she still acted like transferring was in the picture so we just kept praying. After another hour, his levels were down to 25. Hallelujah! At this point, we were pretty sure she wasn’t thinking transfer because she left to go home for the night. Lance and I were able to go in and see Elijah and pray over him. It would be 3 hours now before the next set of blood was drawn so we went back to our room to wait. We had many of our closest friends come see us for support and they prayed for us. I’m telling you that the presence of God was all over that room!

At midnight, his levels were down again a few points. This trend continued with his levels dropping little by little. I was able to go in and nurse again starting on Wednesday, but I still hadn’t gotten my milk in. I figured the addition of nursing back into my life as well as the round-the-clock pumping I had been doing would help it come in. Actually, I was completely convinced that my milk would be in that night. Thursday came, no milk, but the encouraging news that we would probably be going home that weekend. (Each day in the hospital was long and grueling, only being able to see my newborn every couple of hours was KILLING me and the whole waiting game was definitely old after the first night there. I don’t want it to sound like everything was easy and happy-go-lucky while we were there because each day was difficult in itself.)

Friday came with a whole new set of obstacles. It was another one of those “I didn’t see that coming” days. Lance and I were sitting in the room waiting for the nurse to come get us to go feed Elijah. We got a knock on the door and when I opened it, there was a lady standing there who was obviously not a nurse. I was surprised and when she introduced herself to me I was horrified. She was a social worker. I knew exactly why she was here. I started praying for God to help me answer her questions. She sat down in a chair across from us and then the questions came, one after the other. They were all addressed to me so I answered each one the best I knew how and with complete honesty. Some of the questions I was asked were, “Why did you choose home birth?” “How much does a home birth cost?” “Did your pediatrician know you were having a home birth?” “I was told home birth was illegal in Louisiana…” “Why did you choose to sign an AMA and not take the doctor’s first choice in care?” And then out of nowhere she looked at Lance and asked, “Did you have any part in any of this?” I had been “ok” with the questions until that one. I didn’t show it, but I was infuriated that she would think I would hold the authority in our house! (Later, I realized that she didn’t know us at all so to assume she knew the way our house was ran was ridiculous of me.) So Lance started talking. She fired questions at him and he answered. She asked Lance what he thought about my decision to sign the AMA and his response I think shocked her a little. He told her, “My mom died when I was 11 and I had to watch her go through multiple blood transfusions and dialysis. I know what she went through and I couldn’t even imagine my 3 day old son going through any of that. I didn’t want him to go through that.” She asked some more questions and then I think was satisfied. She started talking to us like we weren’t enemies. She told Lance that she knew his mom because she worked at the dialysis clinic she was treated at; she said that Mrs. Kitty was a very special lady and she had never met anyone like her before. Then she left.

I broke down when she left. I knew that if I hadn’t had a home birth she wouldn’t have been sent to talk to us. 98% of her questions to me pertained to home birth and she even said at one point that “this is just foreign to us today”. She put the visit off on the doctor, but the doctor had never once acted the least bit concerned. Even the nurses were super and came to get me every time he wanted to eat so I could nurse and would just talk to us. I felt betrayed, like they didn’t trust me anymore, or maybe had never trusted me, and I was scared that they would go as far as to try to take Elijah from us. I was completely unprepared for something like this. Fortunately, I had done all of my research on home birth, etc and had the answers to the questions she was asking me. I never once was left stammering and looking for an answer. Lance told me that I answered everything like I should have and that I had nothing to worry about. I text Alina (my midwife) and told her what had just happened. She told me that it’s not uncommon for a mom that has to transfer during labor or after the birth to the hospital to have a social worker sent in. She also said that every decision I had made thus far for Elijah was exactly what I should have done. I knew she was right. I knew Lance was right. I knew I was right. Once again, I knew that this was not a surprise to God; He knew she would be there and He knew I needed Him while she was.

The rest of the day I was a ball of tears so I spent most of it quiet and in prayer. I started working on Elijah’s birth story to get my mind off of things. Saturday we got the news that we would be going home as soon as they could get a pediatrician in to sign the discharge papers. Hallelujah! We left the hospital with Elijah’s bilirubin levels at a 9. We were able to go to church Sunday which was amazing. It felt like it had been months since I was able to just worship, and the reality was that it had been a week. Monday I had a follow up with Elijah’s actual pediatrician and she was so happy with how he was doing! She didn’t feel it necessary to recheck his levels and told me to come back in a week for a weight/height checkup!

I was still trying to nurse as much as possible, but I didn’t have the milk to keep up with Elijah’s demands so I was having to supplement with bottles as well. By day 14, I still had no milk supply–I was getting 1/2 ounce total from both breasts when I pumped between feedings. My milk supply was not increasing despite everything I was trying (and I tried EVERYTHING) and emotionally I couldn’t handle it anymore. I pumped what I could and just gave that to him in a bottle, but it still killed me that I couldn’t nurse. I called Alina again and she had some good information for me about milk supply, stress, hormones, etc.

So here we are now. Elijah will be 6 weeks old on Friday. I never got my milk; I didn’t see that coming since everything in my pregnancy was perfect. I thought it would be, too. I have a few different reasons on why I think everything happened like it did, which all stemmed from nursing issues. I don’t really feel like I need to share my reasons, but I do have them. I’ve quickly learned that there can be very few assumptions about one aspect of parenting based on the outcome of another part. I know that despite my circumstances and how much I was against formula, I still have a healthy baby boy and I’m grateful that I have a way to feed him (since wet-nurses are basically non-existent today). He is growing like a weed and undoubtedly has a huge part in the Kingdom of God. I’m blessed to be his mother!