Third Culture Mothering

Blue Light

True strength is in the soul and the spirit…

Two days after Eelan was born we were not the only ones to notice her yellow skin colour. Dr. Mann, the pediatrician who was on shift during her delivery was already monitoring this. Then her mandatory blood work came in. Like Gaia, she is an A- blood type. I am O+.

Here we are again in the path of blood incompatibility, for more information click here. I knew what would come next…

Eelan’s bilirubin* levels will start going up, causing her to get yellower each day, including her eyes. I will need to feed her as much as possible so her liver can process her bilirubin and her body can get rid of it.  The only way to control the peaking of this letter intolerance is phototherapy, a technique in which a blue light reduces the levels of bilirubin in new born babies. This is done in an incubator where the light is placed over the baby, and this fluorescent rays are absorbed by the skin.  During the process the bilirubin in the baby’s body is changed into another form that can be easily excreted in the stool and urine.

While in this environment babies are undressed so that as much of the skin as possible is exposed to the light. The baby’s eyes are covered to protect the nerve layer at the back of the eye (retina) from the bright light. The bilirubin level is measured at least once a day through blood work. I had to feed and feed Eelan every two hours for straight 15 minutes and then I had 5 minutes to burp her. The limited time was due to the fact that her levels were peaking up and the doctor was starting to get concerned. Thus, he wanted her under the light as much as possible. During this time, the light makes the babies get extremely drowsy and sleepy. 

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Tiny Eelan under the Blue Light

The problems that may occur during this standard form of phototherapy include: skin rashes, dehydration if baby does not receive sufficient fluids when feeding, and difficulty in maintaining the proper body temperature. Eelan did not get a rash, other than a mild heat rash, and this happened because of her difficulty keeping warm. She would get cold easily, as she would be so warm under that light, than once out, she would be so cold.

To put this into perspective, normal bilirubin levels are below 200, Eelan’s levels went up to 480. She was initially supposed to be under the light for 36 hours, but it culminated with her being there for 48 hours.  I was devastated, even though this was my second experience with the blue light. I knew this was under control, and I felt blessed for the efficiency and over sight of Dr. Mann and his stoic demeanor. I just could not help but feel extreme sadness to have to take my tiny baby back to the hospital and leave without her. You see, back in the US when this happened to Gaia, the light was brought into the room, and then once we left, we rented a a fiber-optic blanket which did the same but with less intensity. Now here, those options were not available. She had to go back for two nights. 

The staff at Doha clinic was amazingly empathetic of me. They reassured me I could go at any time to see her and feed. The Philippine nurses were kind and comforting. The Arab nurses were a bit tough on me, or at least my hormones made it look that way, but they cared for Eelan, I could see it in the way they changed her and gently positioned her in the incubator. It’s a matter of culture. I think they could not understand why I kept crying so much if she was there for just two days. Maybe to them it was not a big deal. Then I learned [through conversations with one of the Philippine nurses] that most Arab mothers use the nursery in the hospitals so that babies are well taken care off while they rest after birth. Some would criticize that, but I respect the way some cultures are. So while I was uncomfortable giving my new born to the nursery for 48 hours straight, other mothers felt this was the safest place for their child.

My baby blues lead Bert to consider the option of having me stay at the hospital, that way I felt closer to her. A hallway is indeed, closer that a few blocks driving. I took a room at the hospital on Tuesday November 15, three days after Eelan’s birth. I was back at Doha clinic but this time not as a patient. While I sadly settled in the room I watched Bert sit pensive on the couch. Perhaps in the maze of my despair, I had forgotten about him. I asked how he felt, and with a broken voice and glassy eyes he said something like “I just want this to get over with and have Eelan home”. This is probably the most vulnerable I’ve seen him. In that moment I knew Bert had been a pillar of strength to me while I cried my eyes after we had to take her to the nursery. The silver-lining I concluded, is that our marriage grew stronger during this new phase. Eelan made us stronger.

I went to see my little baby every hour. I fed her while my raw nipples were gaining strength for this second breastfeeding process. In my empty hospital room I pumped, and I pumped. The nurses kept asking for more milk, it was not enough because it was colostrum what I had, and my milk was just starting to come down. In my frustration I was still grateful that at least the increased milk flow would soon come. Eelan needed more fluids. At that point I had two choices: supply her body with an I.V. or formula. I could not stand more needles going into her delicate new skin, her tiny hands, as she was already getting tested once a day for her bilirubin levels. Thus, we had to supplement with a bit of formula. Even though I am against this synthetic form of milk, I had no better choice. At the end of therapy she only had a total of 70 ml (about 3 oz), the rest was my milk. Now the effect of this on me was over production of milk (oversupply). I can live with that, I just need the support of a pump.

The second night I slept at home. Bert and I cuddled as if we were two siblings longing for their mother (for that missing piece). I went to the hospital the last time at 11 pm and would come back at 6 am. This time I was able to leave her plenty of milk. Our home was close to the hospital, but it did not comfort me from coming home to not co- sleeping with my baby and seeing her little bassinet empty. Tears drowned my eyes as I explained to Gaia why her baby sister had to go back to the hospital. I thought about mothers who have babies with terminal illnesses and others who have premie babies. I felt for them, and I felt blessed that these eternal 48 hours would come to an end soon. 

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These amazing ladies  gave the best care to Eelan

Her levels started coming down on the second day… 400, 380. And then on Thursday, November 17 at 7pm Eelan was discharged with a count of 203. Still a bit yellowish skin, and drowsy, my baby looked healthy. We were delighted, it was like having a second birth. Brining her home and seeing Gaia’s bright smile while she kissed her sister, brought all my motherhood strength back. We were together.

We are blessed it was nothing more. The following two weeks we took Eelan to the nursery to check her levels. She continued to be well and healthy, her levels stable as she ate, and ate, and ate. 

 

*Bilirubin is a waste product that remains in the bloodstream after iron is removed from hemoglobin in red blood cells.

Reference: http://www.medicalnewstoday.com/

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1 thought on “Blue Light

  1. Powerful story, Maia. I had no idea you went thru this. These are the things that helps me understand life better. Thanks for sharing it with me (and all your family/friends).

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