Monday, August 26, 2013

The Missing Milk

The day the NICU lost all my frozen breast milk with M was a bad day for the nurses.

The day I discovered the NICU had lost all my milk was an awful day for me.

One day I hope I'm able to offer constructive criticism to the NICU because I'd like to tell them that accidents happen because we are human. But, more accidents happen when the nurses are overloaded. Accidents can be deadly, but they are most egregious when they're preventable and they happen to babies.

Losing breast milk wasn't necessarily deadly to M, but it called into question her care.

This is what happened:

The highest floor in the NICU is for the healthiest babies. Occasionally, nurses trained as well-baby nurses for full-term babies were called to serve on that floor. I realize that adequately staffing for dozens and dozens of babies, all coming and going at their own pace, must be a nightmare. But, our experience was that no matter how well-intentioned and otherwise skilled well-baby nurses were, they were no replacement for NICU nurses. For one, the equipment was a challenge for them. M's nurse one day didn't know how to operate the temperature on her isolette. I walked in to an agitated, red, overheated baby. This was the same baby we were only allowed to handle for short times because we had to fear overstimulating her. I'm pretty sure overheating her did nothing for her. I was by myself at the NICU that day, and I called my husband, crying, "The nurse is frying her!"

I tried to help the nurse with the bed. I had spent hours by M's bedside, but I was no expert on how to program an isolette. My baby's nurse should have been. M had just moved to that floor, and the NICU was at its highest capacity. Ever. As in, they didn't have enough bed spaces for babies. My baby was still tender enough to be in an isolette, and I believe she deserved a nurse who understood how to operate her bed. Nothing like that ever happened with J.

When we moved to the new floor, I carried a plastic hospital bag full of frozen breast milk with me. This milk was from M's earliest days. Bottles and bottles of beautiful, golden colostrum, which my tiny baby desperately needed when we were trying everything to facilitate her growth. So, I carried the milk up myself, but a few minutes later we had to leave the NICU to beat rush hour home. The last time I saw the milk, it was lying on a table waiting for a nurse to put it in the freezer.

The next day I asked M's nurse why bottles of formula were on the table beside her isolette. "Just in case," she said. As she walked off, I called, "Just in case of what?" I was producing more than 40 ounces of milk a day. Every time I was at the hospital, I left a day's worth of milk, and a whole bucket full of frozen milk was in the freezer.

The next day when I arrived at the NICU, the nurse was feeding M a bottle of formula. After all the nights I lost sleep while I was pumping. After all the hours I spent each day attached to that infernal machine. After all the time I listened to that stupid whirring pump, like I was some cow. My eyes felt like they might pop out of my head. Or I might start crying uncontrollably right there. Instead, I tried to solve the problem. "Why are you feeding her formula?" The nurse looked like a deer caught in headlights. "Because she ran out of milk this morning." I felt like crying again. "Why didn't someone tell me?!" She apologized, but I was completely confused. I stumbled on, trying to piece it together. "But, I don't understand. I leave milk everyday. She only eats a few ounces a day, and I produce more than 40. There is milk in the freezer. There's no reason to feed her formula." That's when she told me there wasn't any milk in the freezer. I was incredulous. "Two days ago, when M moved up here, I brought all the bottles of milk up here myself." She checked the freezer again. Another nurse checked the freezer. A nurse checked the freezer downstairs. The charge nurse checked the freezer.

There was no milk. I think my milk sat out, thawed, and was thrown away. I think someone knew it. A whole bag full of labeled bottles doesn't just disappear. I'm sure it was an accident, and I forgave that. What really shook my confidence was that no one told me. All it would have taken was one phone call to identify the problem, and no one had the time to call me.

What if the mistake had involved medicine? Or what if the mistake had been over oxygen? What if she'd had a reaction to the formula? Would someone have told me?

I wasn't so sure anymore. And leaving a baby behind day after day after day requires trust.

During those weeks, there were times when we called the NICU to check on M. No one answered the phone. No one had time to answer the phone. For hours, we'd call, and no one answered. Do you know what that will do to a mother who has to leave her baby behind?

The worst days where when the nurses had four babies. Four preemies with a range of challenges and complications. FOUR. There were six babies in the room. When the nurses had three babies, two nurses were present in the room. When they had four babies, the dynamic totally changed. One nurse was split between two rooms, so when both nurses were preparing bottles or getting supplies or out of the room for some other reason, we'd look up and realize we were in a room with six preemies and no nurse. That's unacceptable. As a parent, that instills no confidence whatsoever. As a nurse, I cannot imagine what that 12-hour shift must be like. It's not fair for anyone.

We spoke with a head nurse who assured us that these problems wouldn't happen again. We did it in a calm and respectful way, but we were adamant. And things did get better. I'm not in healthcare, so I don't know what the answer is. I just know that nurses having four babies in a NICU is awful for everyone involved.

And the missing milk? We never heard from it again. Every time I open our deep freezer and pull out a bag of milk for M, I lament that golden colostrum that probably spoiled in a trash can.

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