“Malia Mei: A Courageous Birth” is a memoir by Michael Moline, a college instructor, loving husband and devoted father, that includes his recollection of the joy, fear, and hardships leading up to and following the unexpected premature birth of his daughter. Jelly Bean Journals is honored to share their story in this multi-part, bi-weekly series.
MALIA MEI: A Courageous Birth
by Michael Moline
As we were departing the Ronald McDonald house, heading to the hospital, Malia’s physician called again. And I knew he would; he told me so last night. But it didn’t make me any less nervous to answer. It had been instilled in my brain that I would only receive a phone call if something drastic happened. Luckily, this was once again not the case. Malia was doing well. She was doing so well, in fact that the physician said today’s goal is to make her a “normal” baby. This meant, remove her antibiotics, remove the order for sedatives, transition from the CPAP to slight oxygen support, and increase her feedings/ decrease IV fluid. Her blood cultures continued to come back negative, her white blood cell count was normalizing, and her lumbar puncture returned with nothing present as well.
We got to the hospital a few minutes later and the nurse reaffirmed all the things the physician had told us. Additionally, Malia would have her bilirubin checked again the next morning, which meant at least one more day of sunbathing in the ultraviolet light.
We each got to hold Malia for an extended period later in the day, Cherry in the afternoon for an hour and me in the evening for about half that (mostly because I became too fidgety and uncomfortable and feared it was interrupting Malia’s rest).
New home, where’s the oxygen?
Professional athletes come to Denver and require extra oxygen to get by. Malia, 5 days old and recovering from likely sepsis in her lungs was officially taken off oxygen support. That’s right; she required less oxygen support than a professional athlete on the sideline in the same city. Specifically, instead of moving from a CPAP to blended oxygen flow, they decided to let her try breathing without any support. And she passed the test with flying colors. She was officially breathing the exact same air as we were, for the being time anyway.
When Cherry and I were first in Denver following the ruptured amniotic sac, we took a tour of the NICU. We were told there were actually 2 NICUs on the floor, serviced by the same doctors, but mostly different support staff. We toured the higher level NICU for the more “at risk” babies (where nearly all babies start). The explanation was “we get them to the other NICU, and they get them home.” Based on her gestational age, Malia should have spent a couple of weeks in each NICU. Following her life threatening event on Monday, I assumed she would spend a heck of a lot more time in the first NICU. But Malia’s strength prevailed and 5 days after birth, she was moved to the advance NICU, the day her gestational age would be 34 weeks. How impressive!
Malia continued to do well. She was off her antibiotics, increasing her feedings/ decreasing her IV fluids, and still breathing normal air without support. Her bilirubin was still a bit high so she had to stay under the ultraviolet light for a few more hours, but that was just about her only issue, and quite minimal as they allowed her to come off later in the day. They planned to recheck her bilirubin in a couple days. Now that she was lacking a lot of health issues, she decided to give me a different kind of issue during her morning cares.
Ariah had peed on me a few times as a baby, but nothing too drastic. She shot some poo at Cherry a couple of times, but left me alone from that end. Not Malia. This was approximately my 6th time changing her diaper ever. I opened the diaper, saw more meconium that I cared to see and started cleaning her bottom. Moments later, Malia decided she had a little more meconium to “discharge.” And where was my hand? About one inch from her little bottom. When the nurse weighed the diaper to check output, I made sure she was aware to add a little more weight to the already heavy diaper.
Monday- Get that thing out of me, give me some tasty treats, and for goodness sake, where are my clothes!?:
Malia reached 3 milestones on the day she turned one week old. First, she was able to have her IV removed. This was important because it made her much more comfortable, easier to take out of the incubator and hold, and most importantly, it meant she was hopefully able to keep her blood sugar and hydration levels where they needed to be with milk only. She was continuing to tolerate the increasing milk levels, so they continued to increase those every other feed.
Her next milestone was her first attempt to bottle feed. She did great! Her prescribed total of milk for the current feeding was 33 ml. She was able to take 4 of those by bottle before becoming too exhausted to continue. It sure doesn’t sound like much, but I could see how much she was working and the nurse told us that was a very nice job for her first time. The other 29 ml was introduced via the feeding tube oriented to go directly into her stomach.
Lastly, we finally put a shirt on Malia! Until this point she had been in a diaper only (Mostly to get the ultraviolet light to her skin). Her shirt was pink and said “beautiful in every way.”
At this point, things were really calming down. Malia was what I called “a regular NICU baby.” If asked a month earlier how I felt about having “a regular NICU baby” I’m sure I would have not liked it one bit. But considering the week prior, I felt pretty darn good about having “a regular NICU baby.”
Malia did have yet another first on this day. Funny how 8 day old babies have a new first all the time. She got to try breast feeding. Cherry felt that she latched well and may have got a little bit of milk on her own. We were warned, however, that it would be a bit of a long process for her to be able to only breast and bottle feed (as opposed to the GI tube). And that was the major goal to attain before getting to go home.
Continuing her pattern of being “a regular NICU baby” Malia had herself yet another easy, status quo day. Her bilirubin was slightly elevated but not enough to go under the light. The plan was to check it again on Friday morning and go from there.
Malia was having slight issues with her weight. She had dropped from her birth weight of 4 pounds, 9 ounces down to 4 pounds, 3 ounces. Wednesday night, she was up to 4 pounds, 4 ounces. The goal was to be back to her birth weight by Monday.
Ronald McDonald House Perks:
In addition to the free housing, nice play areas, and volunteers providing meals, the Ronald McDonald House provided other ways to help their families. They had partnered with recreational establishments in the area to provide free admittance to their facilities. Specifically, families staying at the Ronald McDonald house were able to attend the Denver zoo, aquarium and Museum of Nature and Science free of charge. This was important for Ariah to have these additional activities while she was receiving less attention from Mom and Dad. Grandma was able to take her to these places a couple of times, but on this day, Ariah got special time with Mom and Dad at the museum.
On this day, Malia made no big changes. Her weight remained the same, she stayed in the incubator, awaiting Friday’s bilirubin results and temperature statistics (she had been slightly on the cold side throughout the day). She tried breastfeeding again, with no luck. She did increase her breast milk intake and got to also try a bottle. It seemed the staff was trying to get her to gain some weight and eat on her own as soon as possible so she could go home.
Come back in two weeks to pick up on the next part of Malia Mei: A Courageous Birth.
If you liked this post, take a read through these other Jelly Bean Journals writings: