A premature baby is an infant that is born less than thirty-seven weeks and no more than twenty-three weeks from conception. They can develop a variety of different health issues not only within the short term but long term as well. I didn’t know much about premature birth and the effects that it has on infants or even the causes. However, that all changed on December 15, 2008, when my daughter Carmen Grace Hollywood was born. Carmen weighed a pound and a half at birth. Drowning in thoughts and tears at the hospital, Carmen was given an 8% chance of living. I soon began to educate myself about what a premature baby was, the causes and challenges the parent and child may face.
Carmen was born at twenty-five weeks and was only given an 8% percent chance of living. Her umbilical cord was wrapped around her neck twice, which made her oxygen levels very low. Shortly after she was conceived, she was immediately given oxygen to resuscitate her. At the time of birth, I was not present. I was in my third hour English class when I received the phone call. Immediately got in my car after dealing with conflicts of signing out of school at the school administration office and drove to the hospital. When I arrived at the hospital, I walked into the hospital room feeling scared, and nervous. I had my cousin Dustin with me at the time.
“Where’s the baby?”, I asked.
She replied, “The baby is getting some tests ran and trying to get her oxygen levels together.”
“Is the baby ok?” I asked.
“The nurses will be in shortly to explain to us what is going on,” she replied.
The nurse finally came in ten minutes after I have arrived. She explained to us how sick Carmen was and that she needed special attention. Due to Carmen being born early and the weight that she was born at that she was a high risk for many sicknesses that normal infants don’t develop.
“She will not be coming home with you all”, the nurse said.
I was told by the nurse that my daughter would have to be treated by the Neonatal Intensive Care Unit (NICU) at Saint Francis Medical Center. St. Francis was a good hour and a half north of Caruthersville, Missouri where I resided at that time. Saint Francis treated many different infant illnesses such as premature birth, newborns with infections, babies born with birth defects, babies with breathing difficulties, babies with growth restriction, and maternal health problems.
“In about an hour the hospital's transport should arrive. When they arrive, they will explain more to you both.”
She went on to explain, how much care we would have to provide for our child, such as visiting her often and providing breast milk. The nurse told us that since Carmen was so early, breast milk was a better option for her than regular or syntenic milk. Breast milk was healthier because it had hormones and chemicals that she needed to develop and that it did not contain any bacteria that are common in cow milk.
In research, I found that there are many reasons why women might have an induce or early labor. Some reasons may include placental abruption, placenta previa, premature rupture of membrane, incompetent cervix, maternal toxemia, alcohol, multiple pregnancy, and drug abuse. Any of these could cause preterm birth and would put the child in danger of developing short- and long-term health issues. Studies show that mothers who have back to back births may also have a higher chance of having a preterm infant.
As the nurse took us into the nursery for the first time to see my daughter, it brought tears to my eyes. She was small enough to fit in the palm of my hand. The biggest thing on her body was her head, it was the size of a tennis ball. Her chest was barely moving. Her skin was transparent, exposing all her organs. I had never seen features that small before: hands, feet, nose, ear, etc. About twenty minutes after watching my daughter fight for her life, the hospital had come to take her away. Before the hospital took her away, we had to sign papers, confirming that if she died on the way to NICU we acknowledged that she had a small chance of surviving.
The Saint Francis nurses gave us the contact information we needed to know about Carmen's whereabouts and how to track her progress. St. Francis informed us that they would provide a hotel room, food, and gas when we came up to visit her. As we finished up our conversation with nurses, we said our farewells to our first child as she was placed within an incubator on a cart and they wheeled her out. She also had a feeding tube and oxygen along with her. As I stuck my hand in the incubator to tell her goodbye, she grabbed my hand and gripped it tightly as if to say “Daddy, I’m not going anywhere, I’m going to fight”.
My ex-wife was in the hospital recovering from labor for two days, so we called and checked on my daughter Carmen often. The second night they had her at Saint Francis they told us that she was losing weight. They assured us there was nothing to worry about because female infants have a greater chance of living than male infants.
Thursday, December 18, 2008, was the second time we saw our daughter. This time was in the NICU. The first thing we had to do when we arrived at the NICU was scrub and clean our hands up to our elbows. There were nearly twenty other preemie infants in the NICU. The charge nurse walked us to my daughter’s room where a blue UV light rested upon her incubator. The UV light helped with one of her illnesses named Jaundice. I immediately began questioning the nurse. One question was how much Carmen was eating. I was surprised to hear it took four hours to get her to drink one drop of breast milk. Infant develop the ability to suck is one of the last things an infant develops while in the uterus. The reason is that the sucking and swallowing reflexes are poor or absent. Since it’s the last thing the infant develops, they use a tube that is called a feeding catheter; like an adult’s feeding tube. We spent a total of four hours with our child before returning to the hotel to get some sleep.
As time went by, my ex-wife and I went back and forth to the NICU in Cape to find out that Carmen was getting better. On some of the days we were there, Carmen needed blood transfusions. She was losing blood due to her red blood cell count. About the end of January, all her test results came in. The results read that she was born with a heart murmur, jaundice, urinary tract infection, sleep apnea, bowel movement problems, respiratory distress syndrome, and pneumonia (which developed two additional times while in the hospital). Although sick, she was much healthier than at birth.
National Library of Medicine stated that there are several more possible health issues. Some short-term complications that may occur while the infant is in the hospital may include bleeding in the brain, infections, low blood sugar, bleeding in the lungs, and intestinal inflammation. Some long-term issues may include bronchopulmonary dysplasia (BPD), delayed growth, mental or physical disability, and retinopathy of prematurity.
Bronchopulmonary dysplasia is the development of scar tissue in the lungs. Retinopathy of prematurity is a vascular disorder that affects the retina and could be treated with laser eye surgery or if laser surgery does not work the infant could go blind. According to Neonatal care, Necrotizing Enterocolitis is an acquired gastrointestinal disease. Necrotizing Enterocolitis affects one to three per 1000 live births. The cause remains unclear to health professionals. Necrotizing Enterocolitis effects include stomach issues such as vomiting, bloody stool, and gut necrosis. Some possible treatments are bowel rest, antibiotics, and gastric decompression. A possible long-term effect is growth delay. Center for Disease illustrated a few lifelong problems that could occur: Intellectual disability, cerebral palsy, breathing, and respiratory problems, vision and hearing loss, and feeding and digestive problems.
Some of the treatments for her developmental issues were unknown and some were solvable. The only treatment for the heart murmur was to let the holes close and they gave her steroids through IV. Jaundice, which is yellowish skin, was treated with an Ultra Violet light. The light helped to change her skin back to its normal color. The issues of her urinary tract infection, bowel movement problems, and pneumonia, which she developed more than once while in the hospital, were solved with some strong antibiotics. The sleep apnea she developed had to be treated after they treated her respiratory distress syndrome (RDS). Respiratory distress syndrome was treated with moist oxygen.
After the first month was over, my daughter was on the role to defeat low birth weight. She only had two months left in the hospital. They were two very long months. Going back and forth to the hospital, working, going to school and playing became very hard, difficult and tiring. Every time we would go see Carmen there, we would be informed of another sick baby passing away. We grew attached to some of the infants because we saw them as much as we saw our daughter.
Carmen's heart murmur was closing and needed lower amounts of medicine. Her second month in the hospital was great. They begin to let her out of the incubator and allowed us to hold her. The term that they used was called “Kangaroo Care”. Kangaroo Care was a recent invention to promote mothers holding their preterm infants with skin-to-skin contact. It has been found, in many studies, to increase the amount of sleeping- especially quiet sleep- and decrease crying as compared with periods when the infant is alone in the incubator. The nurses took a picture of me holding her for the second time. I was happy because now I was able to hold her instead of just putting my hand into the incubator to touch her. Her hands and feet were still small, but her belly and head were both getting bigger.
Her last month in the hospital was the best. Not only because it was her last month but was transported from her incubator to an open crib. She was being bottle-fed. I had to take a CPR class and watch nine videos before they discharged her. The classes were too informative to teach in the case we got home, and she stopped breathing, we would know how to get her breathing again. Not only was my daughter coming home I was happy that it was golf season. As the last few weeks were counting down, they performed final tests. The last day she was there I wasn’t present because I had to be in school. She was released on March 27, 2009, which was her actual due date. My ex-wife and daughter traveled back home, and I was very happy she was home.
The hospital sent Carmen home with a heart monitor to keep track of her oxygen level. She was assigned a home care nurse who came out monthly to give her RSV shots. And after three months, Carmen was right on track. I enrolled her in a learning program called Parents as a Teacher. Ginny Vanausdall, her home-based teacher said her IQ was above most kids her age. Carmen crawled, walked, and talked on time.