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Monday, November 22, 2010

Things they didn't tell me in the NICU--Hypoglycemia "Rebound"

When a baby is born in a hospital, there is a way of doing things. My child was born with extreme hypoglycemia--not really a good way to start a life, but there are worse ways, I guess. A few, anyway.

Mothers have their own ideas about how things ought to go at a birth, and so do perinatal hospital personnel. These can be at odds, but I think that happens more often than is necessary, because childbirth exists in the same black box they keep epilepsy in. There are certainly some real mysteries, but fewer than you might think, it turns out.

A hypoglycemic term baby with a cord abnormality has to stay a little while in the NICU, and it has to down some formula immediately upon hitting the fresh air and having its APGAR recorded. These are not medical mysteries.

As I said, mothers have their own ideas about things. The baby looked fine. FINE!! I wanted to co-sleep, nurse, stare at those little fingers and toes and eyelashes day in and day out. NICU? What the hell!!! Why???

Well, there's a very good reason, as it turns out, but nobody told me what it was.

It seems that term babies with neonatal hypoglycemia (mine, textbook.) will often have a rebound period shortly after birth, during which they will appear fine. FINE!! Often, however, after about 12-24 hours, they will tank, and the effects of the insult will become apparent. This is why your perfectly fine hypoglycemic baby has to stay in the NICU, even over all your protesting. You are still, however, even over all THEIR protesting, free to make a complete pain in the ass of yourself by hanging around your baby day and night. This is what I did, and it was one of the best decisions I have ever made with respect to this child.

The neonatologist, about 11 hours into the game, came over, pronounced him sweet and perfect, and told me not to worry, that he looked perfectly fine (FINE!!), and that we would, in all likelihood be able to bust out of there in a couple of hours.

She must have forgotten about the whole hypoglycemia-rebound-tanking-baby thing because boy was she apparently surprised when he had a spectacular autonomic seizure cluster about an hour later. Two hours after that, he was on a vent, which everyone knows is bad, bad news. She felt horrible, and vowed never to make such a pronouncement to a NICU mom again.

She still didn't tell me about the hypoglycemia-rebound-occipital/autonomic seizure connection. I had to look it up. You can read about it here

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