All About the NICU

Off to the NICU went our little bundle.

We were blessed with a paed who allowed some skin-to-skin before they swept our little one away.

We were told so many things — that we might be there for a few days, weeks, or even months. Right after birth, I had no idea what was going on or what lay ahead. But I was hoping to be one of those “only a few days” stories.

Shocker — we weren’t.

We spent 4 weeks in the NICU. Our journey was different.

This is not a journey I would wish on anyone. Only a NICU mom will understand that, all of a sudden, you no longer relate to other birth or baby stories. For the first month of M’s life, we had a baby — but our house was empty and quiet.

Our little no-name early bird was a fighter from the start. In her first few weeks of life, she saw more specialists and had more x-rays, blood tests and scans than most of us have in our entire lives.

Week 1

The first week is an easy one — the adrenaline is still pumping, you still hope it’ll be a short stay, and you still have half a baby prep list to complete.

She was on oxygen for a day and under the blue light for most of the week to treat the risk of jaundice. We could hold her, but with all the cables attached to her tiny body, you almost didn’t want to.

We found out we had a healthy but small baby — her main reason for staying was her size.

Later in the week, there were concerns about her digestive tract. She wasn’t passing her meconium on her own. A general surgeon was assigned to assess her. After a few flushes and some monitoring, the concern was resolved.

During this week, she also had a brain sonar, a chest sonar, a visit from a cardiologist, daily blood tests, and some scans — all standard procedure for a preemie.

Her dad had two sayings:

1. “Our journey just started differently.”

2. “She will come home when she is ready and healthy.”

   
   

Week 2

Now we had settled into NICU life — visiting twice a day for a couple of hours. I always felt guilty that we weren’t spending enough time with her, but you can’t sit there all day. We still had things to do and minds to keep busy.

She was growing.

She was still attached to a lot of cables monitoring her heart rate, oxygen saturation, and respiratory rate — which made cuddle time complicated. She hadn’t worn clothes yet and was mostly just in a nappy, swaddled.

On Christmas Day (11 days old), her amazing nurse dressed her in a little Christmas outfit for us.

Week 3

By now, we were pros (in our heads) — we knew all her machines, specialists, procedures, medications, and more. We had NICU friends. This had become our norm.

This is also the week I broke. Three weeks feels like years. I wanted my babs home. I wanted to cuddle and hold her, but she was out of reach.

A part of you has to switch off emotionally just to cope with leaving her in the hospital every night.

This week, we also became very familiar with oxygen saturation and caffeine. Preemies often forget to breathe on their own, so they’re given a baby-equivalent of caffeine to remind them to breathe. When prepping them to go home, they’re weaned off caffeine — and if they go seven days caffeine-free without desaturating, they can be discharged.

M started her caffeine weaning during Week 3. But on Day 4, she had a desat — her oxygen saturation dropped into the 50s. From COVID days, we know this is dangerously low.

We had been so excited — just three days to go! But she needed a large dose of caffeine and oxygen for a day to stabilise her.

We started counting again...day 1.

So, what’s the checklist to go home?

From what we gathered, babs had to:

• Weigh over 2kg

• Be caffeine-free for 7 days

• Be off oxygen and have no desats

• Have no other health concerns

• Be able to drink out of a bottle on their own

  
  

She also got her TB vaccine during this week as part of the prep to go home.

Week 4

We were still here. Still doing this. Now I was numb. There wasn’t much left in the cup — in fact, the cup was gone.

We made it to Day 7, but M was still desaturating — which worried me. How do you take a baby home whose oxygen saturation drops into the 60s? How would we even know? She looked perfectly fine when it happened.

Anxiety hit.

We got to Day 8, and everyone was ready for discharge. But her paed wanted to be cautious. M was still having brief moments of low CO₂. They ran extra checks just to be safe.

She saw the cardiologist again, an ENT, and had all her bloods redone. Everything came back fine. The paed said she’d likely just grow out of the desats.

Dad had a nappy braai, because men always leave things to the last minute.

And then — almost exactly a month after her birth, on 12 January — she was discharged. Hungover dad and all.

Now What?

Apparently, all the normal parent stressors:

• Is she breathing?

• Is she just going to die for no reason?

• Is she going to get sick?

• How do we take care of a baby?

• Is there a manual?

• Are we just parents now?

• When do we sleep?

• When does she sleep?

• Routine?

  
  

Well, one thing did happen within the first few weeks at home — she got sick and was readmitted. PICU, here we come. 5 days admission. Rhinovirus (what is that even?). On oxygen for 3 days. A shaved head for a drip. Chest physio and nebulisers.

But by now, we were veterans of the baby ICU.

And we did it. We caught it early. She came home after 5 days.

So that was it — our NICU stay.

Where we had a baby…but still slept full nights for a month, and I had to convince my brain that all of this was somehow normal.