Any much needed advice from mums of babies born early due to placental insufficiency?

[Millymolliemandy]

Hi,

We had a very worrying appointment with our consultant yesterday at 26 + 5 weeks, where we were told that the placenta is not working properly and we should prepare ourselves for probable early delivery by c-section. We have another scan/doppler in a week.

We did have some pre-warning that this could happen with a very low PAPP A reading at 12 weeks, baby measuring small at 20 weeks, growth and doppler at 23 weeks where baby was still small but placenta working on the high end of the normal range.

I am desperately trying not to worry myself sick and instead prepare ourselves in the best possible way for baby coming quite soon, if the placenta function decreases over the coming weeks.

I wonder if anyone can give me any practical advice about preparing for a prem baby and a c-section. For some reason, the thought of a c-section is making me particularly upset as I had really hoped for as natural a birth as possible, and I am also desperately keen to breastfeed.

Sorry for the long ramble, but would love to hear from anyone who has found themselves in a similar situation.

yes, the constant sterilising, expressing, washing, disinfecting is all coming back to me now...
clabsy, so pleased for you, i think you've got a little fighter on your hands!
wishing you well sixer.

Don't blame you for feeling paranoid about cleanliness - I was just the same; made everyone use hand sanitiser before touching DS2 for the first couple of weeks after he came home. You'll prob be just the same when Charlotte comes home. I had the hands of a crone and they've not recovered yet. Body Shop Hemp hand cream was what all the nurses in SCBU used, I recommend it highly.

Expressing gave me a huge sense of purpose, too. It was the most positive thing I could do for DS2 so I flung myself into it with a vengeance. And even having done it before, the first few days weren't easy so can imagine it's doubly hard for you. Am sure it'll all fall into place for both of you, though.

So how's Charlotte doing now?

And sixer, thinking of you and wishing you a peaceful weekend, a good recovery and looking forward to hearing about your little fighter, too

Hi clabsy, just a quickie about sterilising. I had a steam steriliser which was a huge faff and kept things clean for a limited time. After we moved to a different hospital (which did not have the budget to provide so many expressing kits) we kept our kits in water with sterilising fluid. I figured if it was good enough for hospital it was good enough for home and kept my stuff in a plastic biscuit box with a Milton tablet. It was much easier and it's sterile then until you use it. Might make life a little bit easier for you.

Hope you and your little girl have a good weekend.

And sixer good luck! Have a restful weekend.

Oh yy, Milton is your friend. Still got a big bowl on the go, although it has ruined my lovely wooden worktop...

Milton - is on the shopping list now. UCH advise soapy water and air drying for pumping kits interestingly.
Charlotte still great on the breathing front but has not tolerated her last 2 feeds apparently. You could say she has sicked them up! Trying not to worry I know it's a slow process for feeding. My biggest fear is a stomach infection for some reason, oh and I worry that she will be dropped!!! Totally irrational but had me sobbing at 3am this morning. Lovely to have you here ladies.

DS2 did the same with his first few feeds and I was scared that he'd never ever be able to digest milk and wouldn't put on weight and wouldn't ever get out.

Rationality not my strongest quality at that point, so no middle ground on anything. And I was proved wrong within 24 hours or so, although he was and is quite a sicky baby.

At this early stage, her gut must be even less developed than DS2's but they've started her on the milk really early so must think she's doing well and will be ready soon. Don't know if they mentioned it to you, but the consultant told me that colostrum was not only the easiest thing for DS2 to digest, but would actually repair some of the damage/help develop the gut. So you are doing the best thing possible.

Good news for the day - baby Charlotte now tolerating breast milk nicely but only trophic feeds which I think means not for nutritional purposes. The intention is to prime her guts gently. Also dad had kangaroo care time today and made me very jealous. We did hear that she'd lost 30g since birth and I had to keep check of myself so I didn't cry on the consultants (seems to be a different consultant every day will bean - no Angela yet). I've learnt to stay away when bloods are being taken (heart wrenching) and to close my eyes as she is lifted from incubator to chest ( too precarious) for KC. I promise to cut down on the details as of now! Am hoping that sixer junior is safe and well this time next week and taking up space on this thread. :-)

Nonono, we want details! Glad she's doing well with the breast milk, if anything like DS2 it will be in amounts too tiny to do much good for a while but as you say, gives her insides the general idea.

30g loss could be worse - even at her tiny size, is less than half the 10% that rings alarm bells. And is almost exactly the same proportion that DS2 lost.

How are you feeling? Any luck with expressing?

Agree we want details, the more the better! As I recall consultants were fairly random over a weekend but work weekdays in two weeks bursts so hopefully you will get some consistency next week. Great news about her feeds, trophic feeds are for priming the gut I think and she'll be on full feeds before you know it. Lovely her Daddy got to hold her. I waited 30 days to hold my son and it was flipping hard.

To give a different perspective, weight loss is a normal and positive sign after birth and term babies lose weight. DS could not wee at first and was on so much intravenous medication that he puffed up to about 200g above birth weight, I thought it was great he had grown but the staff had to explain why they were worried about him and now I look back at those pics he looks terrible. Charlotte will pack it back on very soon I'm sure. She sounds amazing. I'm raising a to you all.

All those points are very reassuring - thank you. She has had her feeds increased form every 4 to every 2 hours as a bit of a challenge for her. Blood sugars a bit up and down so they are tinkering with her fluids and insulin. She is weeing and poohing which is great to hear. Expressing is going really well which is a biiiiggggg relief. I can only imagine the horror and heartache it could cause if it was tough. Kangaroo care is lovely - just once a day for now but the side effect of that is I have now developed the "empty arms" feeling people describe :-(
Will bean 30 days must have been awful to wait. I cannot imagine. More news soon and hopefully news from sixer too. X

Can't wait to join you, now. And I'm trying to take in all the stuff about expressing, trophic feeds and all the rest - I've got alot to learn! I hope I'll be able to access the internet in hospital so I'm able to continue to update, and benefit from all your wisdom. Will now attempt to sleep. x

More great news about Charlotte weeing and pooing! It's amazing what makes you happy in NICU. I can recall announcing it on Facebook when DS managed to poo by himself. And brilliant news about expressing. I'm so pleased for you.

Sixer hope everything goes smoothly today. Thinking of you and looking forward to your news.

Sixer, will be thinking of you and sixer junior today. Sending all possible good vibes.

Sixer, thinking of you today. Hope it all goes well. X

Well - Eleanor Beatrix was born at 9.25 this morning. Breathing unaided, pooing (!) and upgraded/ downgraded to special care this afternoon. She weighs 3lb 4, and is in an incubator while she can't maintain her temperature. I am over the moon,though it's tough that I can't be with her. I managed to exress a tiny quantity of colostrum (1 ml), that my partner bore downstairs like the crown jewels, and I think they will try her with that tomorrow. I got 20 mins with her in my nightshirt just an hour ago, which was nerve wracking (she was fussing and her oxygen and heart rate alarms went off) but quite wonderful once she settled. Will start expressing tomorrow in earnest.

Yay! Have been looking for this all day. So pleased for you all. Keep us posted. X

wonderful news sixer, congratulations, sounds like she's doing great. x

Congratulations sixer. Beautiful name! Wow SCBU already is great news. Hope you can spend lots more time with her today.

Hoorah!! What a great weight too. Lots of love

BTW I LOVE her name.

Feeling a really bizarre mix of elation and despair this morning. Elation because I actually feel like a proper mum, being able to comfort Eleanor, and because she was latching on this morning and sucking really well, and despair because there is no reason for me not to be discharged today, and I am really emotional about leaving her. We had thought there was a good chance I'd get a bedroom in the nnu, even for a night or two until my milk comes in, but these are for parents of sicker babies (fair enough) and there are no rooms available privately either. What has upset me irrationally is that we would be loaned a breast pump, but we live too far away (something about the cost of recovery if we didn't bring it back), meanwhile our local hospital won't lend us one because we are no longer booked there! Must just pull myself together ands hire a pump from nct. Clabsyqueen, how are you finding the night-time expressing sessions, and is it a wrench to leave charlotte at the end of each day?

Hi sixer, I totally understand the horror at leaving. We live 10 minutes walk away from UCH so it feels almost as close as being in the building. I go over in the morning til lunch then back after lunch out in the real world and then in the eve the OH goes over but it is so nice to know i could be there quickly. There was talk of moving us to a hospital which is a tube ride from our house but in our borough (she is a westminster baby and UCH is Camden). I COMPLETELY broke down in the NICU!! We are not moving now but but that kind of gives me a clue how you must feel. Sooooo hard. I know as she gets older and is more aware of our presence I am going to find it harder and harder to leave. The only thing to think is that soon she will be home with you 24/7 and will never remember any of this. You can have her strapped to your chest all day!

I also sobbed about the pump as I had spent 4 days trying master the one lent by the hospital and it was hard hard work with my frazzled brain. The idea of getting a new model made me despair and sob on the consultant! It is very easy to rent them - do it now and you'll feel good that you've done something and safe in the knowledge that you don't need to 'hand it in' when you move hospitals.
It's so good that she's latching on and sucking. That's lovely. I can't wait for that challenge. I have heard that there is a skill to this part of the process and that the hospital should be cup feeding instead of bottles to avoid nipple confusion or something. We are up to 1.5ml an hour of milk now! So pleased as in the night time I get about 20ml only. Try to do one about 9pm then 12am then 3am then have a long sleep til 8am ish. This breaks the rule of don't wait more than 4 hours but have just got a record 80ml out so it shows rules are meant to be broken! Keep in touch sixer

Sixer, I made DH take me to Tesco after they finally kicked me out of hospital (I refused to leave so they let me stay an extra day). I couldn't face walking into my house without DS2 .

It was awful, so I do understand. If she's trying to feed and sucking already she must be doing spectacularly well, though and hopefully will be home with you where she belongs, very soon.

Is she still having milk via an NG tube? That's what my SCBU did until DS2 was ready to try bf, and I think part of that reason was to avoid nipple confusion.

Clabsy, sounds like Charlotte's doing brilliantly and so are you - 80ml at a time is brilliant. I did about the same timings as you, and the longer break certainly didn't hurt my supply, either. How is she otherwise (weight, stats etc?).

Baby Charlotte stats: moved to special care today, 2ml an hour feeds, 676g (up from post birth weight loss of 640g phew!). They said as she gets more milk growth should increase. Fingers crossed. Starting to feel more like a mum as I do Nappies and cuddles ( which has the most painful effect on my nipples. Youch! Heard about this but it has to be felt to be believed.) starting to relax a little and trying to settle in for the long haul. Hopefully the news will remain boring for many weeks.