A family’s adventure with a premature baby – Guest post by Mike Langmaid
I’m happy to share a guest post from Mike Langmaid who works on car seats here at Graco. Knowing that the March of Dimes‘ March for Babies fundraisers are kicking off, I asked Mike to share the story of the early arrival of his daughter. He obliged and shared the intimate details of the rollercoaster ride that his family had bringing a preemie into the world…
I wanted to share a story about my youngest daughter, Mia Erin Langmaid. I am the development manager for US new car seats at Graco Children’s Products, and I’ve worked with infant car seats and premature babies on and off for the last 3 ½ years. I would never in a million years have thought that my wife and I would have a premature baby. Especially since our two older children, Alex (6) and Kylie (4) were both full term, healthy babies.
We were expecting Mia in April 2007 and didn’t initially think anything major was wrong when Claudia (my wife) began having some high blood pressure episodes in January. This had happened at the very end of her pregnancy with Kylie. The high blood pressure persisted, however and her doctors began monitoring her a little more closely. I was literally walking out the office door on my way to the airport to fly to Atlanta for a business trip when Claudia called me and told me she was on her way to the hospital. Once my pulse came down I cancelled my trip and met her at the hospital. Initially, she was diagnosed with preclampsia and told she might have to go on bed rest. They kept her for a couple of days at our local hospital and seemed to be doing better. As a precaution, Claudia was given steroid injections to help the baby’s lungs develop faster in case the doctor needed to induce labor early. Then after five days in the hospital, she called me at work (sounding very alarmed) and told me she was being moved to Lankenau hospital, which is our healthcare system’s NICU for high-risk moms. I jumped in my car and met her at the hospital as soon as I could. When we spoke to the doctor, he told us he might have to induce labor as soon as that night, but he was hoping that with bed rest and some medicine that he could put off delivery for at least a week to allow the steroid injections to work. Then he explained all the possible complications. At this point I was near panic internally, but tried to be as calm on the surface as possible. We were both very overwhelmed, worried for the baby and Claudia both, and still in shock by the suddenness of things.
Fortunately, Claudia was able to make it a full week after the steroid injections, which got the baby through the 30th week. Late that night, the nurses who were monitoring her signs and test results called the doctor in and he told us that he would be delivering the baby in the morning. I could feel the hair on the back of my neck go up when he said that he’d be delivering the baby by C-section because he didn’t like her position. And at this point Claudia was very uncomfortable and the baby was being monitored constantly, so every time the monitor changed I jumped. After we both had a rather sleepless night, Claudia was wheeled into the OR and I changed into a set of scrubs to be with her. I changed quickly and was stuck by myself in the room while the nurses were prepping her. After the longest twenty minutes of my life, the nurse came and got me and the procedure began. I stayed by my wife’s head behind a drape and held her hand and talked to her. I was so nervous I thought I was going to pass out, but I concentrated on talking to Claudia and reassuring her. Before we knew it, we heard a cry and the doctor brought Mia around the drape and showed her to us. Having seen my older two kids as they were born, I was absolutely floored at how small and delicate she was. We were encouraged because she seemed fairly alert and had cried. I breathed a sigh of relief and watched over the curtain as the doctors closed the incision (Claudia still kids me about that).
We were fairly relieved immediately after Mia was born until I got to see her a couple of hours later in the NICU. She was in her incubator and breathing well, with a high oxygen level, but she had a CPAP hose to help her breathe and had lots of wires and tubes attached. That overwhelmed me to the point where I cried for the first time since the adventure began. A few hours later, it was my wife who was overwhelmed by the sight of our tiny girl (2 lb 14 oz, 16.5 inches long) practically covered with hoses. I was better the second time and able to comfort Claudia a bit, but we were still very worried and hanging on every beep, flash, and movement coming from the incubator and all the equipment surrounding it. We spent at least a couple of hours each day with Mia for the six weeks she was in the NICU, and I never did get comfortable with the oxygen sensor. It has an alarm on it that beeps when the baby’s blood O2 gets too low, and you can read the percentage next to it. Right next to it is a pulse monitor that beeps when the baby’s heartbeat gets too low or high. Babies that young get apnea spells and you can tell because the O2 level starts going down and the heartbeat goes down with it. Then the alarm beeps would go to a louder, constant tone and the nurse would come over and rub Mia’s back to wake her up. This would also happen after she ate, because her stomach was getting used to eating way before it normally would have to. Feeding times were wonderful because we got to see her, hold her, and after a few days Claudia could hold her to her skin after feeding (Kangaroo care) which was very nice for the three of us. However, it also brought on frequent apnea spells and they always jolted me a bit.
After two weeks in the hospital, Claudia was released and came home to continue her recovery. Alex and Kylie were overjoyed to have her home, but it was hard for her to be 30 miles away from Mia. To both of us, it felt very odd not to have her in the same building, let alone the same room like we had with our older children. Claudia and I spent the next four weeks making daily and sometimes twice daily trips to the hospital to stay for Mia’s feeding times, when we could do the Kangaroo care for an hour and spend some time with her. Claudia spent a large portion of her day pumping breast milk for Mia which we’d bring down to the hospital with us. There wasn’t a lot of time for her to rest, but my parents (who are retired) stayed with us and helped with the cooking, bottle washing, and keeping Kylie and Alex occupied. The overwhelmed feeling changed at this time to one of constant business, broken up by time with Mia and our families. We got to know the nurses at the NICU very well!
Mia’s main job at this time was to grow and gain weight. She took a couple of weeks to adjust to feeding through a tube, but she started to gain very slowly and was over 3 pounds after a couple of weeks. I felt like a sports fan at this point because there wasn’t much I could do except be with her, talk to her, support Claudia, and pray that she started gaining weight – but I was really pulling for her, trying to ‘will’ her to thrive. Fortunately, she proved to be pretty feisty almost immediately. I was surprised at how much she cried and fussed and wiggled in her incubator, especially when the nurses would turn her on her tummy or change her diaper. The nurses showed us right away how to change her diaper and encouraged us to do it. Claudia seemed fairly comfortable with handling her, but I was so afraid I’d hurt her that I would get shaky handling her. I got better after a couple of weeks of handling her and I was comfortable enough to do Kangaroo care with her myself. For those not familiar with Kangaroo care, this was developed in South America as a way of helping preemies maintain their body temperature. The caregiver holds the baby on their chest against their skin (usually after feeding) and wraps a blanket around the other side. The baby also bonds with Mom and Dad and I believe it helps psychologically for all involved.
Mia spent the last four NICU weeks at Paoli Hospital, which is much closer to our home. We were initially nervous about moving her, but she did fine and at a smaller, less crowded NICU like Paoli, she was less likely to contract a virus like RSV. The move made things a bit less hectic, although there was still the whirlwind of Claudia washing bottles, pumping, holding Mia, spending some time with Alex and Kylie, getting chapped hands from washing before entering the NICU, watching lots of twins and newborns come and go from the NICU, talking to other parents, nurses and doctors, and feeling exhausted. By now Mia was beginning to practice breast feeding, feeding more and more from a bottle, and was so active that she pulled her feeding tube out quite frequently. She was trailing fewer wires and tubes because she’d now been off IV/ PIC lines shortly after arriving at Paoli Hospital, and now only had the apnea, temperature, blood oxygen and heart monitors on. A few days before she left the hospital, she began spending more and more time out of the incubator and could now wear clothes and be held more. She began gaining weight quickly and by the time she was discharged, weighed almost 4 ½ pounds. She met her grandparents, aunts, uncles and siblings, and though she frequently had apnea spells after eating, we became very comfortable handling her.
Mia was now getting ready for discharge, which was exciting but worrying to us. She was gaining weight nicely and eating well, but continued to have apnea episodes especially after eating. The nurses showed us how to use an apnea monitor, coached us on how to recognize apnea and handle it, and brought in a respiratory therapist to test Mia in a car seat. I brought in a Graco Infant Safeseat, and the therapist put her in the seat and set it to the same angle it would be in the car. Mia needed to maintain better than 93% oxygen level for at least a half hour, since our car ride home would be about 15 minutes. She couldn’t do this the first couple of times, so she had to wait day-to-day until she passed the test and had no apnea episodes for 24 hours. After she passed the 3rd car seat test, she stayed an extra day or two because of apnea and finally the doctor cleared her to go home. As a precaution, I got an Angel Ride car bed, which allows the baby to travel lying down and had Claudia sit next to her in the rear seat. The monitor was battery powered so it rode with us in the car and we drove home with a tremendous mixture of emotions — relief, love, hope, worry and excitement.
Mia’s first couple of weeks home was a big adjustment to us; she had to eat small meals frequently to continue her weight gain, so the cycle of feeding intensified somewhat for us. I needed to supplement the heat in our room so we could keep her in a bassinet next to our bed, and it took a while to figure out the apnea monitor. The contacts had to be washed every day, we had to figure out how to reset it after a false alarm (which happened quite frequently when Mia would wiggle around), and it took some practice to get the contacts on her in the right place, with the right amount of tension. It continues to amaze me how well everyone adapted to the new routines, and the most rewarding part of this was that it now finally felt like we could enjoy our new baby because she was home with us.
Fortunately, Mia continued to be feisty and gained weight very steadily. She is now 14 months old, weighs 18 pounds, and no longer has to be tracked with adjusted age (as if she was born 2 ½ months later than she really was). We were able to take her off the monitor after 3 months, and just before Christmas she was sitting up by herself and beginning to crawl. Now she stands holding onto the couch, and laughs, smiles, talks, and flaps her arms and legs when she gets excited (especially when she follows her big brother and sister around). She is a bright, cheerful baby and it’s only when we really look back that we remember her early struggles. Mia’s long term outlook is excellent, and Claudia and I are eternally grateful to the doctors, nurses, our family, friends and co-workers who supported us in every way. In retrospect, it’s clear to us that though we were worried and scared at the time, we were very fortunate and there were no major complications. I don’t remember when I stopped sensing the anxiety and began relaxing, but we are today, a happy and healthy family all together at home, thriving and growing, with a sincere appreciation of how much that means to us.
The March of Dimes is the leading nonprofit organization for pregnancy and baby health. The March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org