Micropreemies in the NICU--Alyssa's story

Alyssa, like her sisters, underwent PDA ligation surgery within the first couple days of her life and made it through successfully. The girls have a small scar about an inch long underneath their shoulder blade...battle scars from the NICU. Her head ultrasounds were also clear with no indication of bleeding, just like her sisters. It was amazing that the all three girls escaped this complication, being so premature. In her first weeks in the NICU, she did not tolerate her feedings well and often had residuals left in her tummy that she did not digest. She also had some blood in her stool that was monitored closely. Luckily, it cleared and did not mean an infection in her bowel.

Alyssa was always noticeably bigger than her sisters, although she only weighed 5 ounces more than they were born. I guess when you are that small, 5 ounces makes a big difference. She was also born with the biggest cry of the trio, and she definitely let us know if she was unhappy (she still does).

Alyssa 2 days old. She was given oxygen through the CPAP mask in this picture, but went back on the ventilator within a few days. Breathing was way too much work for

her tiny lungs.

9/15/05

Alyssa weighed 2 pounds, 1 ounce. She was the first baby to hit 2 pounds!

10/01/05

This was the first time I held Alyssa. She was taken off the ventilator the next day and I was able to hold her daily from that time.

Just like her sisters, Alyssa suffered from Apnea of Prematurity and Bradychardia (drop in heart rate) episodes. Preemies tend to outgrow this by the gestational age of 34-35 weeks. Because our girls were born so early, the 10 weeks that it took for the girls to learn how to breath on their own seemed like a lifetime. On more than one occasion, we had to watch helplessly as one of the nurses used an oxygen mask or handbag to resuscitate one of the babies who had stopped breathing. When the babies started having a high number of apnea and bradycardia spells, their hematocrit (red blood cell count) was often tested to see if they were becoming anemic, which would mean they needed a blood transfusion. The other worry was infection. Alyssa was started on antibiotics as a precaution more than once in the event an infection was starting, but she never developed anything that was life threatening.

10/30/05

Just like her sisters, Alyssa had to take a picture with dad's football! Alyssa weighed 4 pounds, 14 ounces....a pound heavier than her sisters.

10/24/05

From left to right is Makena, Riley & Alyssa

Mom is in heaven! This was the first time I held all three of my girls at the same time....it was also the first time they were back together since their birth.

Daddy & Alyssa

Alyssa's biggest challenge during her NICU stay was learning to drink from a bottle. At 8 weeks old, we began trying to feed the girls from a bottle once a day. If they were able to take even a few milliliters of milk, we were happy. They needed to practice breathing and swallowing at the same time without choking. This was a huge challenge for Alyssa. She tended to choke often, which would cause her to stop breathing and her heart rate would drop. It takes alot of energy for preemies to recover from an apnea/bradycardia episode. Drinking from a bottle was not a good experience for her. The other challenge for her was that she always became so sleepy and it was hard to keep her awake. In the long run, she developed a MAJOR aversion to bottle feeding and would fight tooth and nail to get the bottle out of her mouth. It often took 45 minutes to an hour to try and get her to drink 2 ounces of milk. Fortunately, Alyssa had a few nurses who cared for her regularly who were very patient and used every trick they had up their sleeve to get her to eat. The way you knew a baby had graduated and earned their bottle feeding diploma was when their gavage tube had been removed. Their were several hopeful attempts to remove the tube so that Alyssa had no option but to take her feeds by the bottle, but more than once the tube had to be reinserted because she wasn't drinking enough by bottle. And Alyssa knew how to throw a fit! The screaming could be heard down the hall. I was always nervous when a nurse who was unfamiliar with her was assigned for one of her shifts. When she finally did make it home, she did much better having the same person (mom) feed her everyday. However, she still liked to CRY like it was nobody's business.

11/19/05

Steve burping Alyssa after a bottle feed. Notice the very sleepy look on her face. I bet she tried to sleep her way through that bottle!

11/30/05 100 days old

Alyssa still has the white feeding tube in her nose. This look of eager anticipation was often the response we'd get when we offered her a bottle.

She weighed 5 pounds, 7 ounces.

Nothing made us happier than seeing the girls snuggled together in one crib. The back of someone's head was often mistaken for a binky!

When the girls were about 10 weeks old, their breathing was more stable and they were able to regulate their own body temperatures. This meant that they were ready to co-bed. Instead of each baby having their own separate crib, they were put together. In the past, co-bedding in hospitals has been somewhat controversial due to the risk of spreading infection, but it has become more commonplace in recent years with the belief that the benefits outweigh the risks. Multiples who co-bed are believed to develop better eating patterns, help regulate each other's breathing, gain weight more quickly and experience less stress overall. Steve and I were thrilled when the babies were moved to one crib. In fact, the babies did know if they were left in the crib by themselves. If Steve and I were each holding a baby and one was left alone in the crib, we would have to roll up blankets and put them on either side to try and fool them. On more than one occasion, the loner in the crib didn't stop fussing until one of her sisters returned. The bond was evident very early.

Grandma (Lola) Quilao visiting with Alyssa.

Uncle Craig visiting with Alyssa.

Christmas evening 2005

Alyssa was all by herself in the NICU. Her sisters were already at home
anxiously awaiting her arrival.

By mid-December, Alyssa had met all other criteria for going home except bottle feeding. She just wasn't taking the amount that the neonatologists/nutritionists wanted her to take by bottle. However, she was still gaining weight and was no longer on oxygen and otherwise healthy. The daily trips back and forth to the hospital were challenging given that her sisters were at home also needing mom and dad's attention. We were anxious for her to join us at home and I (mom) told the doctor's I was ready to bring her home and would take on the challenge of feeding/fighting with her to eat. Alyssa came home on January 6, 2006. She was 137 days old and weighed 8 pounds, 11 ounces.

Pink blanket? Check. Pacifier? Check. Bunny hat? Check. Look of determination in gettin' the heck outta the NICU? Check.