An IUGR baby: Elsie’s first 24 hours

During my pregnancy, knowing (or pretty much being told) that I was carrying an IUGR baby, I really had no idea what to expect after she arrived. When we were first told to expect delivery at 34 weeks, I knew that special care would be a certainty, but then even after we were able to go longer, to 37 weeks, it was still a possibility. As it is for all babies, I guess. But IUGR babies are not like all other babies. They have not received the same oxygen and nutrients inside that other babies have. For whatever reason. Growth restricted babies may face additional needs at birth.

And yet when Elsie Rose appeared she scored 9 and then 10 on her APGAR tests. She was given to me immediately to hold against my skin, unlike any of her siblings before her. She was a tiny little sleepy thing and aside from regular blood sugar checks, the midwives saw no reason to give her special care at all.

We returned to the Enhanced Recovery ward just after lunch time and Elsie was put into her cot to snooze while we tried to gather our thoughts. It had been a long eight months getting to this point and I remember expressing surprise that she was finally here! As the time neared visiting hours, Ghostwriterdaddy left to get the kids, who crept around our curtain with whispers. The Schoolboy exclaimed brightly that my tummy was thin now (love him!) and that was that. Elsie was part of the family.

It’s when the visitors have gone and the rest of the voices on the ward grow quiet, and the lights dim as the world outside the hospital settles down. That’s when the enormity of what is nestled inside that crib hits you.

There wasn’t much time to really dwell or ponder, since I was on hourly checks (blood pressure, temperature and pulse) for 12 hours and so it was almost 9pm before I was finally ready to try and get out of bed for a shower. I’ll write more about the initial recovery period following a c-section, but lets just say this was not easy. There were tears. Of pain and frustration.

Once showered and dressed and ready to be mum once more, I noticed that Elise was very cool to the touch. The mdwivves agreed and became very concerned about her temperature, which had dipped. She was also retching and choking regularly, uninterested in feeding and generally very lethargic too. I wasn’t too concerned at this point, as I had already been told that babies with low birth weights often struggled to maintain their temperature, and The Toddler had been just the same at birth too. And then the midwives mentioned that Elsie may need a short stay in the special care ward if she wasn’t a able to get (and keep) her temperature up. We wrapped her in extra blankets and popped a (huge) cardi on her, and hoped for the best.

By 7am, and after hourly temperature checks and a 1ml syringe feed, Elsie was taken for a check by a neonatal midwife. The checks were all done on a heated trolley so that she could keep her temperature up.

The special care ward very kindly donated several hats and cardis as the only ones we’d brought with us were far too big. She was placed in a heated bed for a little while and eventually her temperature began to rise. Thank goodness!

And now to tackle the feeding. The midwives explained that Elsie had used all her energy to keep warm through the night, and had none left to latch on and feed from me. She just wasn’t interested and we weren’t able to get her to even open her mouth for a feed. We’d given her a syringe feed at around 1am but it was now almost 9 hours later and she needed to eat. Despite my best efforts, Elsie only managed to latch on for a few seconds and then would either fall asleep, or choke and vomit. The midwives explained that she had lots of mucus that she needed to clear, that a vaginal birth would have helped with. As she was born via c-section her body was struggling to clear the mucus, and this can affect feeding.

At around 11.30, just as Elsie’s first 24 hours in the world rolled around, we were transferred to the post natal ward with the intentions of staying one more night to establish feeding.

Little Eslie Rose, so tiny and so sleepy! And my burning question answered: at 2.5kg Elsie Rose is IUGR.