Help preparing for 34-35 wk preemie?

[tmarie]

I would be grateful for any advice. I just found out that I will likely deliver this week or next due to very low amniotic fluid. It was a total shock--I was having an ultrasound with the peri to follow up on a cord issue, which as it turns out has resolved itself. I'm 34w1d and they almost induced me today. The peri assured me that 34 week babies do very well....but I'm terrified. Six weeks seems so early, and I feel completely unprepared mentally for a preterm birth. I don't know what to expect in terms of the length of NICU stay. Today the baby measured 5lbs10oz. But I know these are just estimates...

Does anyone have any experience with or advice on dealing with a preterm delivery? Any experience with low amniotic fluid?

TIA!

tmarie
dd#1 5/05
dd#2 expected 7/08

[SnuggleBuggles]

((((Hugs)))) I don't have any advice or real info on 34-35 week babies. I am sure all will be well though. :)

Did they put you on bedrest? I have heard that that and sometimes lots of fluids can help buy you some more time when facing low amniotic fluid. Do you know what the measurement was?

I hope little one can stay safely in there a bit longer.

Beth

[nov04]

Sorry you're going through this stress right now.

We had low amniotic fluid readings throughout dd1's pg. but the readings did vary widely and they rely on the skill of the tech. Is it just one reading that their basing their decision on inducing you??? If so, I would definitely ask for another opinion or even a repeat u/s.

I've also heard that 34w babies do well, so if you are faced with that, I would be reassured that things should go very well.

All the best!!!!!

[Drag0nflygirl]

DD was born at 34 weeks. No one really had a good explaination for why. She was 5 pounds at birth and went down to 4.8 before coming back up. She spent 8 days in the NICU before coming home. Yes, it's super stressful, but she's just fine, and your baby will be too.
Do splurge or let someone else splurge on some premie clothing. Your baby will swim in everything else, and you will end up using it for a couple of months.
If you plan to breastfeed you will have to rent a hospital grade pump to stimulate production, and so you can supplement for your baby. Most hospitals have lactation consultants that can tell you where to rent from.
I don't have any real advice other than that. I will share with you that I didn't put DD down for the first 2 months of her life because as far as I was concerned she was supposed to still be inside of me. I wasn't comfortable with a sling yet because she was just so tiny.
We had to go out and buy some of the stuff I had registered for because she was born just a few days before my scheduled shower. On the upside we got to buy girly stuff instead of the gender-neutral things I had registered for. I also bought a mini co-sleeper so I could keep her near.
On the really super shallow upside, even though you're the mom of a newborn, you'll get a full nights sleep (that is if your toddler lets you). Also you'll be too busy to eat because you'll be running back and forth to the hospital all the time - so those extra pounds will melt right off!

[tmarie]

Thanks for the responses! It is such a comfort hearing from other moms.

This was the first time my fluid measured low, but it was also the first u/s I've had in 10 weeks. I saw the peri today and he did three measurements (after the tech measured my fluid at 5), and averaged them at 5.5. He said they like to see over 8, and that if it is under 5, they induce. So it was a very "borderline" call whether or not they should induce me today. Instead he is referring me back to OB's office and letting them make the decision. Before I even returned home from the peri's office, the OB's office had received his report and called me to schedule the followup scans in two days. So they seem to be taking it seriously. I don't even know what to wish for...I would feel so much better if I could carry this baby even one more week, but at the same time I am nervous about risk of infection, etc..., if baby stays put.

I appreciate the stories about 34 week olds doing well. I just want to get my head in shape for this so that I'm not a basket case! I am drinking TONS of water and lying in bed until further notice. :)

[TaChapm]

Jaci was born at 34.5 weeks and never even spent a night in the nursery. She was 6 pounds and perfectly healthy. I did have 2 rounds of steroid shots at 23 weeks to mature her lungs when I went into preterm labor with her and they thought I would deliver really early. I think that probably helped things out but my OB always said that once we got to 32 weeks we would be OK. Are steroid shots an option for you? If so and they are thinking of inducing I would see about getting them over the next 2 days. Apparently they work really fast.

Good Luck and keep us posted. It might be tough but at this point things will likely be fine.

[NewfieNat]

My DS was born at 34 weeks 0 days. He was about the size of a 32 weeker (3 lbs 13 ozs and 16.5 inches) and no one knows why.

The first day he needed an IV for antibiotics (I had a fever in labour and was GPS strep unknown) and also for low blood sugar.

Days 2 through 5-ish went perfect, they were considering sending him home. Then, poof, he needed oxygen. That's the only thing that kept him in the hospital until day 28. No bradys, no apnea, no feeding tube, holding temp, etc.

I'll admit I was in rough shape that month and it took me a long time to get over it.

Now, I think I'd handle it better. I have a better support system, other kids to look after, and know what to expect.

That's my long way of saying, yes, in retrospect, he did well. Be prepared, and you will do just fine!

[sdjeppa]

My son was 34.5 weeks when he was born. I went in for my 34 week check,and ended up in the hospital for Pre-E. Induced the next day, then an emergency C/S 24 hours later. DS was 5 lbs 3 oz, and was in the NICU for 9 days. No real health problems, just needed to eat and grow. I also got steroid shots the day before he ended up being born.

The worst part was going home without him. (I was discharged after 5 days) They did have rooms at the hospital you could pay to stay in, but we lived less than 10 minutes from the hospital, so it was better to sleep in my own bed. I hated leaving him there, though, without me. I also was driving a week after my C/S, only to and from the hospital (DH had a broken collarbone, and couldn't drive. Talk about stressful!) My only advice is, take advantage of any help offered. I have family nearby, and for the couple days before i could drive, they would come pick me/us up and take us to the hospital, 4x a day, or whenever I needed to go up there. They finished the nursery, washed clothes, did everything so we could concentrate on taking care of DS and ourselves.

I also got an Angelcare monitor after he came home. It did wonders for my sanity, and let me sleep a little better. I agree with the preemie clothes too - he lived in those for 2 months. Even the newborn hats were too big.

Good luck - I hope you don't have to go that route, but you will make it, and baby will be fine. (HUGS)

[avd3875]

Joey was born at 34w2d. He was 5lbs 6oz, and 17.25". From the time my water broke, to the time when he was born it was 10 hours, that was with the drugs to slow labor down. A nurse from the NICU came to talk with us while I was in labor. She said that he would likely need to stay until close to his due date. She also said that the lungs usually finish developing at 34w, so we would just have to wait and see if his lungs were working. Everything happened so fast, and we were in such a state of shock it was hard to process it all. As it turned out, he was breathing room air right away. They did put him under the french fry warmer for a few hours, but once he was able to maintain his own body temp he was moved to an open crib. Our pedi said she wanted him to stay at least 5 days. She said that for the first few days he would still be "working off what I had provided" and she wanted to see how he could handle things on his own. Sure enough, on day 4 he started having bradys. Hospital rule, a baby must be brady-free for 7 days before going home. On day 15 we were all set to bring him home. On the way to the hospital the NICU Dr. called and told us DS had booked himself another week at the hospital. We were heart broken. DS spent another 7 days, and was completely brady free. He came home after 22 days in the NICU.

I completely agree with everything the PPs have said about preemie clothes. Joey wore them for many, many months. Let others take care of you - rides to/from the hospital, meals, laundry, etc. You need to be well rested in order to take care of your baby.

The whole experience was surreal. At the time, it felt like we had lived at the hospital for months, but now if feels like he was there for a few hours. I really hope you do not have to do any of this, but if you do, you will be fine.
I wish you the best of luck, and pray that you are able to go full term.

Take care!
BTW, Joey is currently 4.5 years old, 45" and 46lbs. Nobody believes that he was a preemie.

[cono0507]

DS was born at 35 weeks and was 4 pouds 15 ounces.
We had a 2 week NICU stay which involved 3-4 days of breathing difficulty followed by a feeding tube for a week till he learned to take a bottle or breast, and a few days under the bilirubin lights.

Preemie clothes will be nice to have, I agree.

Often preemie babies start out with a feeding tube and then learn to suck, often with a bottle. DS came home from the hospital taking bottles only but learned to breastfeed the following week and went on to be breastfed for a year. If you are interested in breastfeeding, get a lactation consultant and good support to make it happen.

I also used an Angelcare monitor for a long time after he came home. He didn't medically need an apnea monitor or anything, but it made me feel better to have the angelcare one.

ANd I agree it was very very hard to leave the hospital with him still there. I was discharged at day 5 but allowed to continue to stay in my hospital room free of charge until the needed it - I stayed till day 8 and then went home. I was bawling while DH drove us away from the hospital. That's a tough thing to do. Fortunately we were within 10 min from the hospital so I just spent each day there approx 8a-4p, home for dinner, then back again till 9 or 10p. I didnt have other kids at home at the time so I could spend a lot of time there.

Good luck!

[egoldber]

Amy was born at 34 weeks 0 days. :) She was 6 pounds and I had had the steroids, PLUS an amnio for lung maturity, but she still had mild respiratory distress symdrome and spent 12 days in the NICU. So 34/35 weekers are a mixed bag. They can be totally trouble free and go home with mom or have a bit of trouble and spend some time in the NICU.

Like you, we knew ahead of time that Amy would be a preemie and so I did tons of research. I had books lined up. The Sears Premature Baby Book and the LLL Breastfeeding Your Premature Baby pamphlet were very helpful to me. They also gave me something to read in the NICU waiting room LOL!

But whether or not your baby goes to NICU or not, they are more likely to have slight difficulty feeding (bottle or breast) than a full term baby, so be prepared for that. Amy was a slow feeder until she got to about 39 weeks gestation.

They are more likely to have reflux, so think about that, and maybe read up on the signs.

They are also more likely to be jaundiced, so I was prepared for that when Amy had to go under the lights in the NICU.

I would set up an appointment with the NICU/hospital LCs and get their breastfeeding/pumping requirements ahead of time.

[tmarie]

Thank you so much for all of the advice. I have been taking notes! :) It is nice to feel like I have something to do today while I lie here in bed and prepare for a possible delivery tomorrow. Geez....I still can't believe this is happening.

Side note: my peri told me that its "too late" to get the steroid shots, at 34 weeks. It sounds like some of you had them though?

Thank you again!!

tmarie

[egoldber]

They generally don't give them after 34/35 weeks. Baby is less likely to have severe RDS and the shots are not without risks and side effects.

Depending on the steroid, they are given as a series of 2 (24 hours apart) or 4 (each 12 hours apart) and ideally you should have a full 24 hours after the last shot before delivery for the maximum effect.

I had the shots at around 32 weeks.

[kmak]

I had low fluid at 35 wks. I woke up on a Monday morning and my DD wasn't moving, she was a BIG kicker, and my belly felt hard to me. Went to the Dr. and my fluid measured around 6. DD is 2 now, so I don't remember the exact number. She then sent me across the hall to a high risk OB for her to double check the numbers. My OB talked about inducing, but wanted to try to get my levels up first. So, she put me on bed rest and told me to drink, drink, drink. I had about 5 ultrasounds that week to track progress and my fluid level worked it's way back up over the week. So, I might ask the Dr. if you could try to get the levels back up over a few days before inducing.

[SammyeGail]

Hey! (((Hugs))) Its going to be ok : ).

My boys were born at 33.5 weeks due to a quick onset of pre-eclampsia, I was given a 4 hour notice of delivery. It was very sureal, I remember begging the dr. not to, I wanted to make it to 35 weeks, nothing he said phased me until he said 'Samantha, if we don't take the babies right now, you'll die...' (I had alot of fluid in my lungs)

They were 4.8 and 4.10. They were put on the C-Pap for a few hours, then breathed fine on their own. They were just fine, I had the steroid shots for their lungs 4 days before, I hope you've gotten those.

They wanted to keep them 3 days for observation, they fed well and everything. I was in terrible shape, lol. I went up (they were a floor above me) several times a day but couldn't stay long, I would get real dizzy and the NICU is very warm. (I had massive water retention and very high blood pressure) They wouldn't release the boys until I (the mother had to do it) did 3 feedings, both boys, 3 hours apart & diaper changes in a row. DH was not allowed to help. It took me until day 5, the day I was released.

What I do remember is they would fall asleep during feeding. I would have to stroke their cheek or jaw to try to get them stimulated again. Feedings took a long time, lol! We had to set the clock and feed them (wake them up) every 3 hours for about 6 weeks to get their weight up. I was so happy when they started going 4 hours, lol!!

They slept alot and I could tell they really perked up around their due date. by then they were at about 5.5 lbs. (they always stayed close in weight).

At their 6 month well check they were in the 50th percentile and that lifted a huge weight off my shoulders.

I was a mess but my litte guys were just fine. Some hospitals have a policy of keeping preemies until they reach a certain weight (5lbs) so some babies have to stay longer. I was also surprised at how many full term babies were in the NICU, there were 2 in our little corner.

Take LOTS of pics early on. We got so caught up in just trying to survive the feedings, etc., then they weren't tiny anymore. We only have 1 or 2 decent pics of them the week we brought them home.

Best of luck, You all will be ok : ).

Samantha
Noah and Jonas
2.5 years old

[mamaoftwins]

Hugs to you! Your baby is a wonderful estimated weight!!! I'm sorry I have to type quickly b/c my little guys need to go to bed. I delivered my twins at 35wks 1day, after being on bedrest for 11wks. I got the steroid shots at 24wks when I went into labor. They did fantastically. No NICU stay at all. Twin A (4lbs 7oz) came right to our room, and Twin B (5 lbs) went to the Special Care Nursery (step up from the NICU) for 12hrs while they got his blood sugar adjusted and monitored his breathing (I delivered him breech, so he was grunting a bit after that). All 3 of us were home 46hrs after I delivered. I had planned on breastfeeding, but we had to give both formula in a bottle in the hosp and for several days at home until my milk came in fully - their blood sugars had issues (a lot of preemies do b/c they miss those last few wks of weight gain, so they have very little stores to help them out), so we had two choices: give them formula or have them hooked up to IVs and stay in the Special Car Nursery. They did have trouble latching at first (as a lot of preemies do), but got it eventually - getting them to nurse was A LOT of work for me, so if you're planning on breastfeeding, I suggest you see a lactation counselor in the hosp and potentially have one come to your home to help you out. My little guys have had no health issues thus far. And boy, are we thankful for that!

Best of luck to you and the little one!!! We'll say some prayers.

[C99]

DS1 was born at 35 weeks because my water broke (of the slow-leak variety) and I was running a fever. He spent 8 days in the NICU, primarily for jaundice, which was more worrisome because of his size (5 lbs, 12 oz) and because of his prematurity, he was (a) sleep and (b) easily tired. To echo what others have said, it was unexpected and hard, but we all got through it, and DS1 is totally fine at 5-y/o (so far - he isn't in formal school yet). Now, it's really but a distant memory - however, I did need to process some of it out in therapy.

I was on bedrest with DD's pregnancy, from 28 weeks - 34 weeks (until 36 weeks modified), because of what had happened with DS1. However, I never had the steroid shots. I was on a ton of preemie pregnancy groups at the time and the CW then seemed to veer away from the lung steroid shots.

[mom2binsd]

My DS was born via c at 37 weeks and 6 lbs 10 oz...still ended up in the NICU due to premature lungs and was on oxygen for 2 months (we also lived at 4000 feet elevation)....hopefully you will not have to deal with all of that...but they one thing I never knew....all those cute sleepers with zippers can't be used with a baby on oxygen/monitor...you need to be able to slip the wires through the sleeper so snaps up both legs are very useful....as was my bassinet on wheels that was narrow enough to be pushed around my house....good luck as you go into the hospital for delivery!

[mamabelle]

Dd was born at 34 weeks. No explanation why but after 9 hours of fluids and then demerol to try to stop my labor they decided she was coming no matter what and was delivered via vbac after another 10 hours of labor. She was Just over 5 lbs and had about a million people standing there waiting for her from the NICU team. She came out screaming, had a higher apgar score than my full term dd.

She spent 2 days in the nicu because that is standard for unexplained preemie births while they did a full workup for infections and gave her iv abx just in case (since it is usually some sort of infection that causes unexplained premature delivery at this point in an otherwise normal pg) The only issue she had was that she had not developed her sucking reflex yet so feeding was a challenge. I spent a ton of time in the nicu including going down every 2 hours to try to get her to latch on. She did not while we were there but I cup fed her as well and about a week later she started sucking.

She went home on time with me and is really a superstar with no delays or issues at all. We were very lucky but what I have been told by a friend who is a nicu doc is that 34 weeks is a time that there may be ome problems but they are usually not long term problems but in many cases there are no real issues at all.

Good luck to you!

[jerigirl]

My son was 34.5 weeks when he was born. I went in for my 34 week check,and ended up in the hospital for Pre-E. Induced the next day, then an emergency C/S 24 hours later. DS was 5 lbs 3 oz, and was in the NICU for 9 days. No real health problems, just needed to eat and grow. I also got steroid shots the day before he ended up being born.

The worst part was going home without him. (I was discharged after 5 days) They did have rooms at the hospital you could pay to stay in, but we lived less than 10 minutes from the hospital, so it was better to sleep in my own bed. I hated leaving him there, though, without me. I also was driving a week after my C/S, only to and from the hospital (DH had a broken collarbone, and couldn't drive. Talk about stressful!) My only advice is, take advantage of any help offered. I have family nearby, and for the couple days before i could drive, they would come pick me/us up and take us to the hospital, 4x a day, or whenever I needed to go up there. They finished the nursery, washed clothes, did everything so we could concentrate on taking care of DS and ourselves.

I had a very similar situation. DS was born right around 34 wks. He was 6 lbs. He stayed in the "special care nursery" for about 10 days mainly because his suck/swallow reflex was very immature and he wasn't able to eat very well. (babies usually develop that around 34 weeks in utero). He ended up with an NG tube for about 4 days. It is hard to leave them in the hospital after you are discharged but as a PP said, it was nice to be able to go home and get the nursery ready and have a decent nights sleep and ease into things. My delivery caught me totally unprepared so there were still many things to do. If you want to nurse I would definitely contact a lactation consultant for support. With the whole suck/swallow reflex development issue, it might be difficult to get started. I would also get a good pump.

Good luck to you and the baby!

[strollerqueen]

Wow, I can't believe there are so many of us! My water broke right at midnight, when I was just at 34 weeks. In fact I was lying in bed reading this board, lol! I wasn't even sure what had happened.

But it turns out I got very lucky that my regular doctor was out of town. I called and got his partner, who told me to go to the hospital immediately...don't get dressed, don't pack a bag, just go. I felt fine, so I told DH not to worry and I would be back in a couple of hours. Imagine my shock when the doctor checked me at 3AM and said I wasn't leaving the hospital until I delivered the baby!

Like the others said, because I had just hit 34 weeks, they would not do steroids. They did put me on total bedrest, and started pumping me full of antibiotics. They said they were being proactive for Group B Strep. Every time I sat up I would gush, so I learned it was better not to do that. Also like the others said, I drank plenty of water, because your fluid will replenish itself.

The whole time I was in the hospital, I was visited by people giving me doom and gloom scenarios, so be prepared. I wanted to keep the baby in as long as possible, so I negotiated with the doctor, who was Irish, to let me keep him in until St. Patrick's Day, lol! She said they usually want them out right away, due to risk of infection.

And finally,I got lucky because the doctor allowed me to do a VBAC. I had read somewhere that there is actually something chemical or hormonal that happens to baby's lungs as they come through the birth canal, to prepare to breathe on their own. And it's more than just getting the fluid squeezed out of their lungs. So I felt very strongly that he needed to be delivered vaginally.

But my regular doctor came back and wanted to do a C-section, the hospital forbid VBACS, all the nurses told me I was risking my baby's life if I didn't do a C-section, so be prepared for that, too. I am fortunate that my substitute doctor just told everyone she believed that I would have no problem, and that a section wasn't necessary.

To finally end this very long post, my hard labor and pushing lasted less that 30 minutes, and out he was. The whole NICU rescue team was standing by, and grabbed him. After a few minutes they were still standing there whispering amongst each other. My nurse said why are you still here, you are in my way, take the baby to NICU. They told her, we can't, he is too healthy! They said all his tests were stronger than most newborns. They were actually scratching their heads, lol!

So again, I was lucky that I got to take him home right away. He was born just shy of 35 weeks, at 5 pounds two ounces. Now he is close to 12! The only trouble he has had, like the others said, is with BF. The LC told me this is very typical of "near term" preemies, because they don't develop their sucking reflex until 36 weeks. So you see there is a wide range of how it will all play out. But in the end, as with everyone else, you and your baby will be fine. All the best wishes to you!

[annasmom]

Hugs to you!

I know I am late to this, and you have already gotten some great advice, but I just wanted to add that I have a 32 weeker, a 33 weeker and a 36 weeker - all of whom are doing wonderfully.

The best news is, your doctors are on top of the issue. So please take comfort in that.

Best of luck to you, and keep us posted!