I'm downstairs listening into to every rustle and squeak on the baby monitor; Evelin is getting some rest before Celeste's 1:30 a.m. feeding. This morning (well, it's a little past midnight as I write this, so yesterday morning), Celeste marked the anniversary of her first meeting us. Unfortunately, the celebration took place in the hospital.
Everyone is okay. Celeste is doing great. Evelin is fine. I'm addicted to Diet Coke and very clumsy, but otherwise alright.
On Tuesday, we took Celeste in for her first pediatrician's visit. Everything went well, but because she was a little jaundiced when we left the hospital, they did a heel-stick for a bilirubin test. The level at the hospital on Sunday was 14.2; the Tuesday test was 14.7, which was still within the "we need to watch it" level, but not a serious concern. We were told to come back on Thursday for a follow up heel-stick.
Thursday, before lunch, the doctor called with the results of that morning's test: The levels were too high for the office machine to read. We had to head to the hospital to have the test performed. We went in and, after a longer than expected wait because we were trying to get things done as the pediatrician's office was closed for lunch and the hospital lab was having shifts change and people heading out for lunch. None of that was very comforting for this anxious father.
After the blood was drawn, we headed home to wait for the results. When the doctor finally called, the results were 21.4. We were told to head to the hospital right away and that Celeste would have to be admitted for treatment.
And, as we were heading out to the hospital, my parents called to say that their plane had landed. (They'd flown up to meet their new granddaughter.) While gathering some things to take with us, I filled them in quickly on what was going on. But I neglected to tell them which hospital we were going to. I eventually got back in touch with them (I couldn't use a mobile phone from the pediatrics ward or place a long-distance call to their cells, and I didn't know the phone number of the hotel they were staying in), but it was after visiting hours so they had to wait another day to meet Celeste.
Getting Celeste admitted, fitted with a little headband to protect her eyes, and put under those lights and then being told all we can do is wait was the most terrifying thing I think I've ever gone through. I tried hard not to, but there were tears.
Over the first night, Evelin and I weren't really sure what we needed to be doing except to feed Celeste and to talk to her even if we couldn’t spend much time holding or snuggling her. The nurse did say we could touch her under the lights, so there was a good bit of holding of her little hands and feet at times.
Because jaundice is caused by an excess of bilirubin and bilirubin can be expelled through the body's waste system, the doctor wanted us to feed Celeste every two hours to help ensure that she was excreting enough and to ensure that she stay hydrated under the lights. She also wanted us to supplement the breastfeeding with formula.
Evelin and I had never really talked about formula, but at that moment we both were pretty firm in wanting to avoid giving Celeste something foreign, so we got the doctor to agree to let us try to pump after Celeste breastfed to see how much additional milk we could bank. The goal was to give her at least 30 milliliters of additional food beyond what she'd take in breastfeeding.
Feeding every two hours and trying to pump extra took a serious toll on Evelin, and about six hours later we were facing the option of either using some formula or starting an IV on Celeste. We opted for the formula. The night nurse also intervened on our behalf and we were able to change the feedings to every three hours or so, which helped Evelin's milk supply. For the rest of the hospital stay (and even now, at least until Celeste gets back above her birth weight and/or gets a bit past her original due date), we would give her the breast first, followed by whatever breast milk had been expressed after the previous feeding, plus some formula. And, more often than not, she ate it all.
After that first night, things started to feel better. Celeste was having fairly regular eliminations* and her bilirubin levels were starting to recede slowly. And, later that morning, my parents got to meet her for the first time. Since Celeste could spend a little bit of time away from the lights to be fed, my folks did get a chance to hold her before I ran home with them to pick up some clean clothes for Evelin.
The hospital room was pretty small, so my parents didn't spend their entire visit in the room with Evelin, Celeste, and me. Instead they hung out at our house a bit, helping straighten up some of the mess that quickly accumulates when you have a newborn. My mom also picked some okra and tomatoes from the garden, which were converted into an okra creole and some red pasta gravy. It was really not the visit they'd planned, but it was a big help to us ...
Back at the hospital, Evelin and I had another long day and night, but all the early signs were good. The bilirubin levels were dropping at a respectable rate and they decided to stop taking blood every four hours from Celeste, which was a good thing because I think her heels will be scarred for life after this. Instead, they went to every 12 hours for the heel-sticks.
We were feeling much better about everything and could even joke about the hospital bassinet with the anti-jaundice lights looking like a baby aquarium.
Because nothing can go smoothly, however, this lead to its own problems -- Saturday's 6:00 a.m. blood draw was lost. Or at least that's what we guess happened. The phlebotomist came and took the blood, but the lab never got results up to the doctors. At 9:00 a.m. or so, the resident on duty did a draw, but the sample clotted, necessitating yet another heel-stick around noon. When the results finally came back, the levels were down to around 11, which was excellent.
Next we turned off the lights and had to wait a few more hours to make sure that without the lights the levels did not rebound too much. But without the lights we were able to hold Celeste and my folks were able to have a lot more quality time with her.
Sometime around 6:00 p.m., we got the final blood test results -- 10.8 -- and we were discharged with orders to follow up with the pediatrician on Monday. Our discharge happened at the perfect time for my parents to help us carry everything out to the car before they had to head to the airport for their flight back to Louisiana.
Now Evelin, Celeste, and I are back home with the goal of keeping Celeste out of the hospital for at least an entire week.
* I guess it is a truism: You cannot read a new parent's blog without running into more than a few entries about poop.