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The Story of Baby Noah

Noah is my second child. My first son, Derek, was born 5 years ago at 32 weeks’ gestation. When I became pregnant with Noah, I was considered high-risk from the beginning and was placed on progesterone injections starting at 16 weeks of pregnancy.

Other than having what I thought was ligament pain and the occasional Braxton Hicks contractions, I had no alarming symptoms -- that is, until I began premature labor and bleeding at 22 weeks and 5 days. I was quickly transferred to the closest hospital with a neonatal intensive care unit (NICU), 3 hours away in Bangor, Maine. There I was diagnosed with an incompetent cervix.

My contractions stopped, but I was too far along to be a candidate for a cerclage, or cervical stitch. I was expected to deliver within 24 to 48 hours. I received injections of betamethasone, to help Noah’s lung development, and magnesium, which both stops contractions and is neuroprotective for the baby. I stayed on bed rest for 5 days, until my water broke at 23 weeks and 2 days, and Noah was delivered the following day.

The Beginning of Noah’s Journey

Noah weighed 1 lb 4 oz and was 12 inches long. Miraculously, he did not need to be resuscitated at birth and even gave a weak cry. His first month in the NICU was the hardest – Noah had to have 3 blood transfusions, was on ventilator support, and was diagnosed with stage 1 bilateral brain bleeds, which later extended to stage 2 and a brain bleed on the right side of his brain.

Noah was intubated for most of his first month of life, except for 5 days on CPAP when his lungs were doing well. He was diagnosed with chronic lung disease, and after being taken off the ventilator, he required breathing support until 10 weeks of age. He remained on oxygen until the date he was due to be born. The staff was wonderful and always explained what was going on and the reason behind specific procedures they did. Noah struggled to gain weight, especially in the first month, when he gained only 2 oz above his birth weight. He had reflux, which is common in babies but can interfere with weight gain.

Growth in the NICU

I began pumping my milk just a few hours after Noah’s birth. Having had a preemie before, I knew it wasn’t going to be easy to begin milk production. My body wasn’t expecting to need that milk for another 4 months. I began a strict pumping regimen of every 2 hours during the day and every 3 hours at night.

The nurses also discussed the option of donor milk. Luckily, I was able to produce enough breast milk for Noah, and I have also been able to donate breast milk to help other premature babies in need. Almost immediately after his birth, we were told that because of his extreme prematurity, Noah would need fortification to provide the extra calories he needed to grow. I had never heard of Prolacta before, but the concept of giving a 100% human milk diet to such a fragile baby made perfect sense to me.

Breast milk is made for human babies, so having a fortifier made from human milk seems right. Noah began his fortification with Prolact+4 H2MF®, which gave him 24 calories per fl oz of fortified milk, but he was quickly transitioned to the 28 calorie fortifier because he was having a hard time gaining weight. When he continued to have problems gaining weight, Prolact CR®, a cream product made from 100% human milk, was added to his diet. Noah was the first baby in the NICU to receive Prolact CR, and within 3 days he started to gain weight. After just 2 weeks, he gained a whole pound! By the time he was 2 months old, he weighed 3 lb 2 oz. When Noah was 11 weeks old, he was able to tolerate his first bottle feeding ever!

He took 6 mL, which is considered a successful first feeding. Bottle feeding was hard and tiring, and we worked together for a whole month before he was able to take a full human milk feeding by mouth. The NICU nurses also knew my desire to breastfeed Noah, and we worked on breastfeeding as well as bottle feeding. Noah was in the NICU for 120 days. He was discharged on day 121, just a few days after his actual due date. Noah went home without oxygen, on 100% feedings by mouth, and medication free! He was a whopping 7 lb 6 oz and over 18 inches in length. We even had a graduation march around the NICU for Noah, and he got to wear a graduation cap and gown!

Noah Today

Noah is now 10 months old, or 6 months adjusted age. He weighs just over 14 lb and is 25 inches long. He is developing on track for his adjusted age. He can roll over and sit up while using his hands for support. He loves to laugh and “talk” to us, and he is a happy, healthy baby.

What advice can you offer parents who find themselves in the NICU?

  • Go to rounds as often as you can.
  • Don’t be afraid to ask questions if you have them -- it’s important that you be informed about procedures, medications, and general care.
  • Don’t forget to rest, eat, and drink water! You need to be healthy to be there for your baby.
  • Try and get primary nurses for your baby. Primary nurses are nurses who agree to be your baby’s bedside nurse while they are on duty. They provide continuity of care for your baby and will help you feel more comfortable when you have to be away from your baby for an extended period of time.