A few weeks after Sam's discharge from hospital we had our 'debrief' with my consultant to learn the results of the placental histopathology from Sam's pregnancy. I knew that the news wasn't straightforward when we were introduced to a haematologist who was also attending the meeting. We were also introduced to medical terms that I had never heard before and I remember making a conscious decision to learn more about IUGR and placental insufficiency. The findings showed 'severe maternal vascular undersperfusion, featuring infarcts, accelerating maturation of villi and introplacental haematomas'. My consultant explained to us that this was not normal placental development and was the cause for Samuel's IUGR and premature birth. I was fascinated by the amount of information that could be gleaned from looking at a placenta after delivery! I was desperate to learn more and gain more understanding about what had happened so spent time reading medical journal articles to try and improve my knowledge. Although still somewhat sketchy, I learnt that an 'infarction' is 'an area of dead tissue in the placenta that is due to an obstruction of circulation in the area' the placenta had matured, and begun to die, too early meaning that Samuel wasn't provided with all of the oxygen and nutrients that he should have been provided with. When the placenta was weighed it was found to be very small which was conducive with the other findings and occurrences. It was explained to us that these problems could occur in future pregnancies and as these problems can be caused by thrombaphillias, blood clotting disorders, I had to have a blood test to confirm or rule this out. The results came back a number of weeks later to confirm that there were no found blood abnormalities so I would be given low dose aspirin in future pregnancies, and monitored very closely, to keep me and the baby safe. If there was a recurrence of the problem, or if I developed preeclampsia, the baby would be delivered early by C-Section.
When Sam was 12 weeks old things started to take a turn for the worse. His feeding took a set back and he became more aggravated than he had been. At first I put this down to his immunizations that he'd had a few days previously but when he didn't pick up I began to get concerned. Some friends came down from Harrogate to see me for the day and I was so excited about them meeting Sam for the first time. However, by late afternoon he hadn't taken a single feed properly, had brought up anything he had taken and was very sleepy and floppy. I had to call the doctors to get him an appointment and was thankfully able to get an appointment straight away. I gave my friends the house keys and asked them to post them through the door when they left. The perfect hostess as always! Thank goodness they are good friends who know that that is not my usual behaviour! He was checked over at the doctors and nothing seemed to be wrong with him. The doctor thought he may have reflux and prescribed a feed thickener for him. I picked up the prescription and returned home, relieved that things should start to improve.
Over the course of the next few weeks Sam's feeding continued to deteriorate. I began to feel like I was spending the whole day trying to wrestle bottles down Sam when he obviously didn't want them. He would cry because he was hungry, take a tiny amount of milk and then cry as if he was in pain. He would quite often bring up the whole feed within half an hour of having it. It would take him a good 45 minutes to take this tiny amount so that by the time he was finished he would be so tired that he needed a sleep. He wouldn't have taken enough milk to get him through for long so would then wake up uncomfortable and so the cycle would continue. One night I got ready for bed as John gave Sam his last feed. Things seemed to be going relatively smoothly until I heard John call my name on panicked tones. I went into Sam's room and found them both covered in vomit. I took and cleaned him up whilst John cleaned himself up. We then did our best to clean up the vomit all over the feeding chair. Sam had seemed hungry and had taken his milk but had turn brought up that feed and seemingly the rest of the milk that he had had throughout the day. He was inconsolable.
We returned to the doctors the following day and were prescribed ranitidine, which helps to prevent excess stomach acid from flowing back up the oesophagus, in addition to the feed thickener. He seemed more comfortable but the improvement was short lived.
A week later I attended a mum and baby group with my friends. I was tired and emotional and felt like Sam's dysfunctional feeding was taking over my life. A small group of us sat in a quiet room at the baby group for a baby massage class that we had been taking part in. I loved attending this group. Throughout the session we would be plied with hot coffee and toast and the ladies who ran the group were more than happy to take our babies for a few minutes so that we could have a hot drink or something to eat. My friends and I felt truly cared for at this group. At the end of the baby massage class I gave Sam his milk before he became too sleepy. Surprisingly he did really well with his feed and took a good amount. I was delighted. One of the leaders made me a cup of coffee and brought it to the quiet room so that I could keep Sam still and upright until his feed had settled. I sat for a good half an hour before getting up to go and join the others for lunch. As I walked across the room Sam's whole body went tense and he brought up the whole feed plus, I think, everything from throughout the day. I was covered in vomit, soaking wet and smelly and only had a change of clothes for Sam. The exhaustion took over and I began to cry. Again we returned to the doctors and this time were referred to the hospital to see a specialist. Sam's weight was checked and although he was still very tiny he was gaining weight as a result of our perseverance to keep feeding him. None the less it was obvious that we were struggling and that he was uncomfortable. In addition to the medications he was already on he was prescribed domperidone which helps encourage the stomach to empty before taking more feed - the idea being that it would prevent nausea and vomiting. By this time, however, Sam had begun to associate his bottles with discomfort and had developed a feeding aversion.
Over the next few weeks we spent a fortune trying every bottle, teat and feeding cup that we could find to try and make feeding easier for all over us but Sam continued to fight his feeds. He would scream, wriggle and arch his back yet he was hungry and, as a result, uncomfortable so was very hard to console. I withheld from going out to toddler groups, other that the one that I loved, because I couldn't handle feeding him in front of other mums who I didn't know. John and I spent hours in Starbucks just to find a new environment to feed Sam in. Other than seeing friends who I was comfortable with, and even then I would often make a quick escape to avoid feeding in public, I didn't really see anyone or go anywhere and began to feel isolated. It is through this that I began to trust my 'mummy friends' who were willing to spend time with Sam and I even though we came as a very noisy, stressed and often vomity smelling package!
When the feeding aversion continued we were referred to a dietician. With her support we weaned Sam onto solids and began to see an immediate improvement. Finally he began to be more comfortable and content. He seemed to enjoy his solids, all be it in very small amounts, and very quickly learnt to feed himself and become independent. Things started to look up!
When Sam was 7 months old, I went back to work. I set up my own childminding business and very quickly my places filled up. Not long later a friend, Faye, came on board with me and we offered the childcare together.
...to be continued ...
No comments:
Post a Comment