{"id":28024,"date":"2019-12-09T12:35:05","date_gmt":"2019-12-09T19:35:05","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=28024"},"modified":"2024-12-24T08:39:40","modified_gmt":"2024-12-24T15:39:40","slug":"special-care-nursery-steamboat","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/special-care-nursery-steamboat\/","title":{"rendered":"“It wasn’t supposed to happen this way:” When a 35-week, 4-pound baby is born fighting"},"content":{"rendered":"
<\/div>
\"This
The McDaniel family – Graham, Mimi, Eddy and Erin. Photo by Meredith Moran Photography<\/a>.<\/figcaption><\/figure>\n

Erin McDaniel\u2019s first and second pregnancies started out the same way.<\/p>\n

\u201cThey were easy, with lots of energy,\u201d she said.<\/p>\n

\u201cSometimes too much energy,\u201d her husband, Graham, countered.<\/p>\n

The pregnancies finished completely different.<\/p>\n

\u201cEddy was born at almost 41 weeks via C-section. Besides being breech, there weren\u2019t any problems \u2013 she was a healthy little girl,\u201d recalls Erin. \u201cWith Mimi, she felt to be in the same breech position as Eddy was. She, however, entered the world at 35 weeks via emergency C-section and spent almost a month in the special care nursery.\u201d<\/p>\n

When it gets real, real fast<\/strong><\/h3>\n

As a freelance videographer<\/a>, Erin\u2019s days are flexible but full, with client meetings, shoots and editing sessions scattered on her calendar.<\/p>\n

\u201cThe weekend before my water broke with Mimi, we filmed a wedding and the day before, I was on a real estate video shoot,\u201d she said. \u201cWe were still working on remodeling projects and the baby\u2019s room. Eddy and I were making cupcakes when my water broke \u2013 she thought my water bottle broke.\u201d<\/p>\n

Erin called UCHealth Women\u2019s Clinic in Steamboat Springs<\/a> at 4:15 p.m. on Sept. 11 and was told to come in. Following an amniotic fluid test to determine that her water had indeed broken and the amniotic sac that surrounded the baby had broken, \u201cit got real, real fast.\u201d<\/p>\n

\u201cWe didn\u2019t pack a bag and had a toddler in tow,\u201d said Graham. \u201cWe didn\u2019t think at that point we were staying for a month.\u201d<\/p>\n

\"This
Dr. Diane Petersen is an OB\/GYN with UCHealth Women’s Clinic in Steamboat Springs and Craig. Photo by UCHealth.<\/figcaption><\/figure>\n

Dr. Diane Petersen<\/a> saw Erin and determined that delivery was imminent.<\/p>\n

\u201cI was concerned about the date being 9\/11 and asked if we could wait until the next day, but Dr. Petersen said water breaks for a reason and the baby wanted to come now.\u201d<\/p>\n

\u201cWith preterm premature rupture of membranes<\/a> (PPROM), large studies have shown that delivery is safer for baby and mother. There is a 15-25% chance of infection with PPROM and also a 2-5% risk of placental abruption, meaning the placenta tears away from the uterine wall,\u201d said Petersen. \u201cAdd in Erin\u2019s history of a previous cesarean section due to breech presentation and the fact that she was having mild uterine contractions, it was clearly time for the baby to be delivered. While delivery at 35 weeks was unexpected, she had grown a healthy baby to 35 weeks, which put the baby at an advantage.\u201d<\/p>\n

\u201cI was still na\u00efve that she was going to be born at 35 weeks,\u201d said Erin. \u201cThere wasn\u2019t the same pomp and circumstance surrounding everything that we felt when Eddy was born.\u201d<\/p>\n

\u201cWe didn\u2019t do research on what it was like to have a preemie, as we never thought she\u2019d come this early,\u201d said Graham.<\/p>\n

Distress at 35 weeks<\/strong><\/h3>\n
\"Graham
Graham and Erin McDaniel snap one last photo as parents of one before the delivery of their second child. Photo courtesy of Erin McDaniel.<\/figcaption><\/figure>\n

Once Erin and Graham were in the operating room and the drape went up at Erin\u2019s chest, the difference in experience between her first delivery and this one were stark.<\/p>\n

\u201cIt was one of the scariest moments of my life,\u201d said Graham \u201cIt had been a few minutes and I could tell from my vantage point something wasn\u2019t going right as Dr. Petersen worked quickly to deliver our daughter.\u201d<\/p>\n

She was born at 7:51 p.m., was 17.75 inches long and weighed 4 pounds, 9 ounces. She was five weeks early.<\/p>\n

\u201cThey didn\u2019t show me the baby right away when she delivered, and that was my first window into this was different than with Eddy,\u201d said Erin. \u201cI knew the doctors had her and kept asking Graham why he wasn\u2019t going to see the baby.\u201d<\/p>\n

\u201cShe was grey. That is a tough visual to get out of your head. And not hearing her cry right away\u2026,\u201d said Graham. \u201cYou could tell she was struggling. The first hour of her life she was put through the ringer, but we had such trust in the doctors and nurses who were taking care of her.\u201d<\/p>\n

\"This
Mimi Elaine McDaniel was born at 7:51 p.m. on Sept. 11, 2019, weighing 4 pounds, 9 ounces and measuring 17.75 inches long. Photo courtesy of Erin McDaniel.<\/figcaption><\/figure>\n

Along with a team of nurses, pediatrician Dana Fitzgerald<\/a> and Allyson Daugherty<\/a>, a neonatal nurse practitioner with Children\u2019s Hospital Colorado<\/a> who cares for newborns in the special care nursery in Steamboat Springs at UCHealth Birth Center<\/a>, worked feverishly to stabilize the baby.<\/p>\n

\u201cRespiratory Distress Syndrome<\/a> is very common in babies who are born prematurely and was one of my main concerns,\u201d said Daugherty. \u201cThis condition is due to a deficiency in a protein called surfactant, which is produced by the cells in the lungs to help reduce surface tension. Surfactant is naturally produced starting at 28-30 weeks\u2019 gestation, but not in abundance until the last several weeks of gestation.\u201d<\/p>\n

When mothers know they are going to deliver prematurely, a steroid shot called betamethasone can be given to help boost the fetus\u2019s surfactant production. But the baby\u2019s arrival was unexpected so there wasn\u2019t time for Erin to receive the steroid shot.<\/p>\n

\u201cAfter the baby was born, we were able to give her surfactant through a breathing tube that went directly into her lungs to help reduce the surface tension to keep her lungs open, allowing her to breath easier,\u201d said Daugherty. \u201cAfter the medication was given, we were immediately able to remove the breathing tube and then use noninvasive modes of respiratory support.\u201d<\/p>\n

While the baby\u2019s respiratory distress began to improve, Graham\u2019s distress continued.<\/p>\n

Feeling helpless<\/strong><\/h3>\n

\u201cIt felt like an episode of ER<\/em>. They\u2019re going to town on a little four-pound baby and there wasn\u2019t a thing I could do,\u201d he said. \u201cI kept thinking how I didn\u2019t want to go home without my wife or my new daughter. I didn\u2019t want to be a single dad. But I knew Erin would be ok because the C-section went well. But this wasn\u2019t how it was all supposed to happen.<\/p>\n

\u201cIt reminded me of how my grandparents went out of life, how they looked when I said goodbye to them \u2013 and this was how my daughter was starting her life,\u201d continued Graham. \u201cYou\u2019re literally helpless and there\u2019s nothing you can do about it.\u201d<\/p>\n

Because the baby was born so early, had the surfactant not worked, the possibility of needing to transfer to a larger facility existed.<\/p>\n

\u201cThat would have been on a whole other level of what ifs,\u201d said Erin.<\/p>\n

\u201cI try to make sure parents understand, as best they are able, what types of infants we can keep here, and which ones we can\u2019t, so they aren\u2019t blindsided if their child needs flown to Denver,\u201d said Fitzgerald. \u201cI was fairly confident she wouldn\u2019t need to fly, but wasn\u2019t 100%. This is a perfect case of why it\u2019s so great we have a partnership with Children\u2019s Hospital Colorado and their neonatal nurse practitioners, because without them and our Level II special care nursery in Steamboat Springs, this little one would been flown to Denver and hospitalized there for weeks, instead of remaining locally at YVMC.\u201d<\/p>\n

Two hours after she was born, Erin finally met her daughter.<\/p>\n

\"In
Erin McDaniel meets her daughter for the first time. Photo courtesy of Erin McDaniel.<\/figcaption><\/figure>\n

\u201cGraham had prepared me about what she was going to look like, with tubes and cords everywhere,\u201d said Erin. \u201cWhen we went together for the first time, we were a family, even though the circumstances were dire. Mom and baby were there.\u201d<\/p>\n

Erin turned on her \u201cstrong mama bear brain,\u201d feeling the need to be strong for both Graham and their daughter.<\/p>\n

\u201cI needed to tell myself it was going to be ok,\u201d she said. \u201cI told her, \u2018I\u2019m your mom and it\u2019s going to be ok.\u2019 I said the words even though I didn\u2019t know if it would be true.\u201d<\/p>\n

More positives than negatives<\/strong><\/h3>\n

Forty-eight hours after she was born, Erin was able to hold her daughter skin-to-skin.<\/p>\n

\u201cIf you moved her wrong, it felt like you would have pulled out one of her lifelines,\u201d she said. \u201cThere were wires from her umbilical cord, leads on her chest, a CPAP mask to help her breathe, the feeding tube.\u201d<\/p>\n

\u201cShe was so small, you could have picked her up with chopsticks,\u201d said Graham.<\/p>\n

With every hour and day that ticked by, Erin and Graham looked for silver linings.<\/p>\n

\u201cWhen the CPAP mask came off and she moved to high-flow oxygen, it was a step forward,\u201d said Erin. \u201cThat let us know her lungs were developing more which was her main struggle. We were making preemie steps.\u201d<\/p>\n

Three steps forward, two steps back \u2013 the \u201cNICU dance.\u201d<\/p>\n

As Erin\u2019s milk began to come in, she had a new focus.<\/p>\n

\"This
This was the view Erin McDaniel had of the world for nearly four weeks while daughter Mimi grew stronger every day in the special care nursery at UCHealth Birth Center in Steamboat Springs.<\/figcaption><\/figure>\n

\u201cPump, eat, sleep. Pump, hold, sing. Every three hours, I pumped like it was my job,\u201d she said. \u201cShe had to eat every three hours, and that was something I was able to do that would help heal her and make her stronger. It gave me hope and a purpose.\u201d<\/p>\n

After nearly a week, Erin and Graham decided on a name \u2013 Mimi Elaine McDaniel.<\/p>\n

\u201cShe\u2019s named after my grandmother, who for most of her life had lymphoma,\u201d said Graham. \u201cShe was a fighter and was always happy even when she was struggling. Mimi was showing us that resiliency, too.\u201d<\/p>\n

Finding strength and support in a new \u201cfamily\u201d<\/strong><\/h3>\n

Mimi grew stronger with each day in the special care nursery. The strength of Erin and Graham\u2019s marriage was also evident.<\/p>\n

\u201cWe leaned on each other more during the time Mimi was in the hospital than we ever have,\u201d said Erin. \u201cIn our 15 years together, this is the hardest thing we\u2019ve ever experienced.\u201d<\/p>\n

\u201cOur baby\u2019s life was on the line, and we had a toddler at home who still needed her mom and dad in her life,\u201d said Graham.<\/p>\n

\"In
Labor and delivery nurse Maria Erz holds Mimi for big sister Eddy to “visit” during her daily trip to UCHealth Yampa Valley Medical Center. Photo courtesy of Erin McDaniel.<\/figcaption><\/figure>\n

Mimi being able to stay in the special care nursery at YVMC, with the oversight of local pediatricians and the neonatal nurse practitioners from Children\u2019s Hospital Colorado, allowed Eddy\u2019s everyday routine to remain largely in place. Graham was able to pick her up from preschool during the week and bring her to the hospital to see where Mimi was \u201cliving in the hospital with the doctors,\u201d as Eddy described it.<\/p>\n

\u201cIt could have been so much harder on Eddy if we had to be in Denver,\u201d said Erin. \u201cIt really helped us heal emotionally and get through those weeks to have access to our home and our pillows.\u201d<\/p>\n

Getting to know the nurses and neonatal practitioners over the weeks provided comfort, too.<\/p>\n

\u201cBeing there for so long, we knew all their names, their kids\u2019 names, what kind of pets they had. They become an extension of your family,\u201d said Erin. \u201cI knew it was ok to run home quick because Faith had her, or she\u2019s with Melissa right now, or Ellen\u2019s on tonight so I know I can get a shower.\u201d<\/p>\n

Home at last<\/strong><\/h3>\n
\"In
Together at last – sisters Mimi and Eddy McDaniel. Photo courtesy of Erin McDaniel.<\/figcaption><\/figure>\n

On Oct. 9, just seven days short of her original due date, Erin and Graham brought Mimi home.<\/p>\n

\u201cMimi went from needing so much help from the doctors and nurses at the hospital just to live, to being home with us as a family,\u201d said Erin. \u201cI had to wait four weeks for the Instagram photos I had envisioned on our bed with my daughters, but it felt so good to finally be home together.\u201d<\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Erin McDaniel\u2019s first and second pregnancies started out the same way. \u201cThey were easy, with lots of energy,\u201d she said. \u201cSometimes too much energy,\u201d her husband, Graham, countered. The pregnancies finished completely different. \u201cEddy was born at almost 41 weeks via C-section. Besides being breech, there weren\u2019t any problems \u2013 she was a healthy little 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