Type 1 and Pregnancy: Our Stay in the NICU

Kelsey Bonilla Health Guide
  • After Mateo's wonderful entry into the world, our joy was interrupted when the doctor announced that his blood sugar was low and he'd have to go to the neonatal intensive care unit for treatment. 


    Low blood sugar is a common delivery complication for babies of diabetics and even for non-diabetic mothers if the baby is particularly large at birth.  They checked his blood upon delivery and it was borderline low at 50 mg/dl (babies have lower blood sugar levels anyway).  At the second check, his blood sugar had dropped to 33 mg/dl.  The explanation for this is that "diabetic babies" have to produce extra insulin in their bodies to handle the extra glucose from mom.  When the glucose stream is cut off at birth, they continue producing that higher level of insulin, resulting in hypoglycemia.

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    Dennis and I weren't too concerned as this is fairly common and we were able to be with Mateo in the NICU within an hour to nurse and cuddle.  The Labor and Delivery unit allowed Dennis and me to stay in the delivery room, right down the hall from the NICU, that first night and postponed my move to the Maternity unit, on another floor, until the next morning, which made it easier to visit throughout the night for feedings.   


    The anxiety set in around midday the second day.  We came back to the NICU after getting a late breakfast in the hospital cafeteria, expecting to hear that Mateo would be able to join me upstairs that afternoon.  Instead, Mateo's nurse explained that there were some other complications they wanted to investigate and diagnose before releasing him.  Basically, they observed that Mateo's oxygen levels would dip occasionally.  A full term baby should be able to maintain oxygen levels of 95-100% at all times, I was told.  Mateo would occasionally drop down to as low as 87% or 88% for no apparent reason.  His oxygen levels would go back up to the desired range without intervention, but they needed to figure out why this was happening before they'd release him.


    I'll try to make this week long story as short as possible... basically, the medical team began investigating various birth complications such as moisture in and around the lungs, a heart valve that may or may not have redirected properly, and then there was a blood test that had an elevated value (of some sort) that could indicate either infection or inflammation.  I was told that these issues could be linked to one another and to the de-sating (the term they used when his oxygen level de-saturated) or they could be isolated issues. 


    Several blood tests, chest x-rays, and an echocardiogram later and Mateo still didn't have a diagnosis.  The doctors opted to start an antibiotic preemptively while we waited the 24 hour, 48 hour, and 72 hour reads of a blood culture.  As each day went by the news was mostly hopeful: blood cultures were all negative for infection; and both the lung moisture and valve redirection issues had resolved themselves.  The doctors decided to continue to course of antibiotics for the full seven days.  Other than that, all we were left with was the oxygenation issue. 


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    Mateo had started off with a high level of oxygen being administered through a nasal cannula (by the way, it was weird to hear words like cannula and bolus used regularly in a context other than my insulin pump!)  They'd slowly tapered off the flow of oxygen until it was "just a puff" to help him with the de-saturation episodes.  So, for the second half of his stay in the NICU, we ran a few trials to see how he handled being off the oxygen.  I sat at his bedside most of the day and night (running home for a few hours of sleep while the nurses gave him pumped breast milk so I could at least have the benefit of rest while my son was hospitalized), and watched the oxygen monitor compulsively. I had a similar emotional reaction to those numbers as I did to my blood glucose levels while pregnant.  In this case, every low made my heart sink while numbers in the high 90s to 100% comforted me.  What a roller coaster ride.


    When Mateo was able to go a full 24 hours without having an episode of de-saturation, the NICU doctors finally discharged him.  When people have asked me why he had to be in the hospital so long, I've given the shorthand reply that "he suffered from the stigma of being a diabetic baby."  In the course of his care, I heard him referred to as a diabetic baby hundreds of times.  It's true that babies of diabetics can have problems with their lungs, heart, and other major organs.  The doctors were undoubtedly extra precautious with Mateo because of my diabetes.  


    During the first full day in the NICU, I was pretty emotional.  Not only was I scared that something was wrong with my baby, but also feeling guilty that I didn't take good enough care of myself during this pregnancy.  Ah, the combination of diabetic guilt and maternal guilt is a killer!  One of the nurses even apologized to me for the medical staff's constant use of the phrase "diabetic baby" because she knew it was adding to my feelings of blame.


    I only allowed myself that one day of pity before redirecting my energy toward bonding with my son and keeping everyone calm and healthy until we could take him home.


    After his discharge he's had a couple appointments with his pediatrician.  Upon explaining this experience to one of the residents he assured me that the medical team was being extra thorough because diabetic babies are at higher risk of having heart defects which can present in a variety of different symptoms.  Also, he mentioned that many babies probably have the kind of de-saturation episodes that Mateo experienced, but since he was being monitored when they occurred, the hospital had to follow certain protocols to rule out more serious issues. 


    Before Mateo was born, my big hope and prayer was that he'd be healthy and able to nurse naturally (after having such issues with Sienna not latching on).  Happily, he is nursing like a champ and very healthy.  I just took it for granted that we'd be able to take him home right away.  When we finally got to take him home, we appreciated the moment so much.   


Published On: February 23, 2011