8 month old Malachi: A Micropreemie’s Story.

“If I could just touch your hand, maybe my soul could breathe”….I place my hand inside the incubator, and for a second our hands meet. Your tiny precious fingers wrap around mine. Such fragility-with visible veins and a moist stickiness about them. Yet, I could hold them for a lifetime. But, within seconds I notice your oxygen levels going down. “He is just agitated,” the nurse replies. Oh, how my inmost being aches just to hold you. Tears begin to flow…”I can’t even touch my baby without causing harm,” I proclaim. “My body has forever failed you.” I sit beside you instead, watching you squirm about…alarms going off. “You aren’t supposed to have to suffer like this. It wasn’t supposed to be this way.” “I will bring some morphine to help him relax,” the nurse states….”he seems to be fighting the ventilator.” I stare at you from behind the plexiglass. My heart wants to burst. “I just want to touch you. I need to feel you. You are mine-yet, I am empty handed.” …I guess I will go pump. …”it’s the only thing I can do for you.”

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I remember this day like it was yesterday. It was a common occurrence for my heart to long to touch and hold my babies…but not being able to because of their fragile state of health. They were holding onto life, and many times I felt as if I was too. I would hold my stomach and mourn. “You are supposed to be inside of me-safe and secure.” It’s not fair! Am I being punished? Could I have prevented this? …All these thoughts of uncertainty and guilt ran through my mind.

Today, I hold Malachi closely-his soft touch and rhythmic breathing eludes a peace and a calmness within me.  One hand on my chest, the other holding my hair so tightly…your face nuzzled within my neck.   I see my tears falling onto his soft skin and think for a moment…”if only my tears could heal you…” I hold his smooth fingers-no longer sticky and translucent, and think of how far we have come. I longed for so long to hold you, now I never want to let you go. Shouldn’t this be enough? Yet, my mind is weary from frustration. Weekly trips to Duke, long appointments filled with tears and vomit. Weekly trips to Rocky Mount for physical therapy. Weight checks, now feeding therapy. Possible surgery in your future. Yes, you are worth every bit of it Malachi. And what we face now can never be as tragic as the battles we once fought. But, I know it’s hard. I’m trying to make your life as “normal” and ” pleasant” as possible. I try to squeeze in as many tickle tummy, patty cakes, and ” the cow goes mooooo” as I can. Your smile is what gets me through each day.  Your smile hits me like a bolt of lightning-and for a second, all my troubles are vanished into the air.

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I must admit, the past month has been like riding a wave onto a crashing shore. On one hand, I am elated in the progression I have seen in Malachi. No, Malachi does not roll over, crawl…nor does he enjoy eating (previous post). But, he is the happiest most joyful little 8 month old (4 months corrected) little boy that you will ever meet. Yes, he still has moments of fussiness like any baby, but BOY does his smile light up a room. He has come so far in Physical Therapy.  Just recently he started lifting up his feet, and trying to touch his little toes.  Malachi has low core muscle tone, and the fact that he can now squeeze his tiny tummy muscles, and hold his legs up is a huge accomplishment for him.  He cannot roll over yet…in fact he hates anything to do with trying to roll.  But, with a little trunk rotation, Malachi can finish the roll.  Sometimes he can roll off his tummy if his hands are placed in the right position, but usually he just props himself up on his forearms and looks around.

We are currently working on trying to get Malachi to pivot for toys, and then we can start learning to belly crawl.  While Malachi has the skill set of a 4 month old (for the most part)…you can tell that he has been out of the womb longer.  He is not mobile, but boy does he always want to be on the go.  You place him on his tummy and he will grunt and move his arms like he is trying to go somewhere.  The physical therapist says…”he is more interested in wanting to crawl than learning to roll…” “He must not have read the baby book on development,” she adds…”and that’s ok!”  I will say that I have seen a great improvement since last month in Malachi’s ability to sit up with limited support.  If you look at a picture of him at 7 months old, and then at 8 months old-you can see that his head control and stability has greatly improved.

Malachi at 7 months old (3 months corrected)...not digging the whole picture taking thing. I think he was trying to eat his shirt.
Malachi at 7 months old (3 months corrected)…not digging the whole picture taking thing. I think he was trying to eat his shirt.
Malachi at 8 months old. Again-not too sure about taking pictures. But isn't that face the cutest? He is supported sitting in this picture. Something he could not do at 7 months.
Malachi at 8 months old. Again-not too sure about taking pictures. But isn’t that face the cutest? He is supported sitting in this picture. Something he could not do at 7 months.

Malachi’s PT always says that he is the most determined little boy. She states: Even if he does struggle in learning to walk, Malachi is going to have “bumps and bruises from trying to walk,” from his incredible resoluteness.  “Why would Malachi struggle in learning to walk?”…you might ask.  Malachi has been diagnosed with mild hypertonia. In other words, due to the brain bleed that he sustained at birth, sometimes his muscles fire and tighten involuntarily.  However, Malachi is such a fighter. He fights like a micropreemie…and that is a strength like no other.

In terms of fine motor skills, Malachi also has completely mastered the whole “grab and put things into your mouth” thing. Toy keys, blankets, fingers, mommy’s hair…you name it…it’s going straight into Malachi’s “mouthy hole,”as we call it. Malachi loves to babble non stop, and he can follow me with his eyes from across the room.  We have a long way to go in meeting each milestone, but Malachi is trying so hard-and that’s all I can ask of him. He will do things when he is ready. Yes, it can be extremely frustrating at times, especially watching him seem so disinterested at times in learning new skills.  But we will get there. “One day at a time,” I tell myself.

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I try to focus on what Malachi can do, rather than what he cannot do. Yes, Malachi struggles…but I am so proud of him and all that he has accomplished thus far. It may not seem like much to you, but in terms of how it could be, it is monumental.   I used to cry as I watched other babies, and even other micropreemies that seemed to be meeting milestones more quickly than Malachi.  I would compare him to other babies his age and get so discouraged.  And then I came across this verse, and I felt it was very relevant to my life.   I wanted to share it with you…

“Then I realized that my heart was bitter, and I was all torn up inside. I was so foolish and ignorant— I must have seemed like a senseless animal to you. Yet I still belong to you; you hold my right hand. You guide me with your counsel, leading me to a glorious destiny. Whom have I in heaven but you? I desire you more than anything on earth. My health may fail, and my spirit may grow weak, but God remains the strength of my heart; he is mine forever.”  (Psalms‬ ‭73:21-26‬ ‭NLT)‬‬

…Even though I fail daily, I still belong to Christ, and he is holding me by the hand through it all. Even when I feel alone, he is there.

For a 23 weeker with a grade 4 brain bleed, Malachi has already blown so many doctors away. He may struggle in some areas, but he also has made leaps and bounds. It is so unfair to Malachi for me to compare him to babies that had such different paths in life.  How can I compare him to a baby that did not fight for his life?  I can’t.

One of Malachi’s Nurse Practitioners wrote to me and said “One of my best memories of Malachi is from the the day we extubated him after surgery and he was “rocking the breathing thing”….I knew that day that your little guy was a fighter and was gonna surprise “medical” people for years to come.”  Her words lifted me up.  I remember reading her words and crying, as it took me back to that very day.  There were so many people that believed in Malachi…even when the statistics were against him.

So what if your baby does not defy all the odds? They are still valuable. Value should not be based on what your child can or cannot do, but rather the joy they bring. Even the parent that cares for the blind child- the child that cannot walk, the child that has limited verbal interactions- they are still valuable. They still bring joy-they still have meaning, and a purpose. So, throw the baby book out the window. Believe in your child. Look for progression, and don’t focus on a time table. Malachi is doing things on “his time” …and while as his mom I want nothing more than to see him live a life of independence and influence. I know that he is already changing me for the better, and that’s a pretty good start.

8 month mommy photo session.
8 month mommy photo session.

So while I work hard in pushing Malachi to maximize his potential, I also need a balance. Time to just snuggle, or to just read a book. Time by the lake to reflect and sing songs. Life is speeding by so quickly, and the last thing I want to do is spend all my time worrying about things that no one can predict. Malachi knows he is loved beyond imagination, he is joyful & exceeding expectations. I’m so proud of you Malachi!

Snuggles with my daddy.
Snuggles with my daddy.
Snuggles with mommy.
Snuggles with mommy.

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Through this journey there have been so many times when I have had to throw my hands in the air and say..” Ok Lord, I don’t understand…but I’m trusting you.” Trusting God in the depths of a storm can be difficult. I know for me it has been hard to trust God after the death of Michael, and watching Malachi go through such immense suffering. When you are deeply wounded, trusting God can be painstakingly exhausting. In your heart you want to give it all to Him, but your crushed spirit is screaming out for answers. You cry out-“why can’t life be easy?” But the problem with an easy life is…it masks your need for Christ. Yes, the past few weeks have been difficult….Malachi is still not gaining weight as he should, vomiting, and refusing to eat at times. But, we have also learned to lean on God for understanding. To trust him, even when we don’t see the bright light in sight.

“Commit everything you do to the LORD. Trust him, and he will help you.” (Psalms‬ ‭37:5‬ ‭NLT)‬‬

So while life is not easy, I am thankful for the struggle. Not because it feels good, but because it is propelling me forward.   Would an easy life be more convenient? Absolutely. But, this is the hand I’ve been dealt. And I know that God does not make mistakes. And so we wait.  We wait for direction, provision, and guidance.

“Be still in the presence of the LORD, and wait patiently for him to act…” (Psalms‬ ‭37:7‬ ‭NL

So how can you pray specifically for Malachi?  Pray for his development, as he strives to meet his milestones.  Pray for healing of his brain, and continued functioning of his shunt.  Pray that he will gain weight this week, and overcome this food aversion.  Pray that if Malachi does have to have surgery for G-tube placement, that it will be void of complications.  Pray that we will make the right decision.  Pray for his muscle tone in his legs, arms, and core.  Complete healing.

People ask me sometimes, “How do you do it? …losing a child, raising a child that is medically complex…I just don’t know how you do it and keep going” or “it takes a special person to raise a child like Malachi.” But does it? Malachi is so easy to love. Sometimes I don’t know how to respond to such remarks. You make it because you have no other choice. A mother that is raising a child with any disability or loss has no other choice but to keep moving forward. You find a way to put one foot before the other. You learn to be happy for the people that never struggle to get pregnant or make it to a term pregnancy. “Rejoice with those that rejoice, mourn with those who mourn” (Romans 12:15, NIV).  You rejoice for the person that may have what you have not, because that is what we are called to do.  I am so thankful for the people that have mourned with me and shared in my sorrow.  When you cry with me, it is as if some of the weight is taken off my chest.  It is as if you are helping me carry the load.

You pray for strength, and push onward- because the alternative is not living. You struggle daily, but you pick up the pieces of your broken life and like shattered glass in a mosaic piece of art…you try to make something beautiful out if it.

I love you Malachi!
I love you Malachi!

Another page to our story…

I throw the bottle onto the floor in frustration. “Why do you not want to eat?” “I don’t understand…” I never thought Malachi would be the preemie that had feeding issues. Malachi always loved to eat. Even with his severe reflux; Malachi would eat until he would vomit, and then eat again. He loved his bottle. He was gaining weight. He was happy. Who knew that a virus could have such lasting effects?

Three weeks ago Malachi suffered an awful GI bug. He wouldn’t eat, he had watery diarrhea every hour or two, and he lost weight. At his lowest he weighed a mere 12 lb 14 oz. We have tried so many things to get our sweet baby to eat…distraction techniques, using different positions, and different bottles…I even resorted to climbing in his crib and letting him watch his mobile while he ate. He pretty much was to the point where he would only eat in his sleep. I sobbed in frustration. Most babies love to eat. How can something so satisfying bring my baby so much pain? We offer him the bottle- he cries and turns his head. The GI doctor brings up the word “tube feeding”…but I cringe at the thought. I don’t want that for my child. I want his life to be as “normal” as possible. “This is just a phase” I tell myself.

We try everything…different formulas, different bottles, different nipple sizes…but nothing seems to be working. After weeks of diarrhea, stool samples, blood work, OT evaluations, and multiple trips to Duke….Malachi finally has been diagnosed with having a food aversion. In other words…he does not want to eat because he now associates eating with pain. He only gained 3 oz this week, which is not enough to continue good growth and development. We are starting treatment by beginning the medication Reglan (to increase bowel motility and stomach emptying) and increasing his reflux medication. We have also changed his formula (trying to change his eating experience). We will be starting outpatient therapy at Duke with a feeding team to try to help Malachi overcome these feeding issues. Feeding issues are VERY common among the micro preemie population. Many preemies often have oral aversions because they required breathing tubes and feeding tubes to survive- which are extremely uncomfortable. Malachi thankfully does not have an oral aversion (he loves putting toys in his mouth and sucking his pacifier or fingers)…he has an aversion to eating. There is a critical time in development between the 3-4 month age in babies where eating is no longer reflexive, and instead children choose to eat. In other words, they eat because they desire to, and not because they have a primitive reflex to suck.

Unfortunately, this is the time when Malachi developed his virus-causing him to associate eating with unpleasant feelings. Now, every time we try to give him the bottle he cries and refuses to drink. Sometimes I spend an hour just trying to get him to eat 3 ounces. Also-he is no longer receiving breastmilk, which not only helped him gain weight, but was much more gentle on his tummy. Unfortunately, with the stress of losing Michael and keeping up with Malachi’s needs, my production of milk quickly dwindled. The doctors at Duke are leaning towards Malachi getting a gastric tube placed to help supplement his calories while he is learning to feed. Basically, he would eat what he wants, and then we would tube feed the rest…all the long while he is receiving therapy from a feeding specialist.

When the doctors first brought up the word gastric tube, I fell apart. I thought…”great, another device that screams ‘my child is different’ …another battle to overcome…another surgery.” But I also want what is best for my child. He needs the nutrition, and I know he is tired of me fighting him to eat. I left the hospital feeling so defeated. I never wanted this for my child. I don’t mind learning to care for a gastric tube, or traveling to Duke for therapy. I can handle it. I’m thinking about the future of Malachi. You know…when I was in the NICU I had a hard time seeing past the day ahead of me. We were fighting for the very life of Malachi, and it was hard to see what a few years down the road would look like- let alone a few days. It was minute by minute. ABG result and vent change to ABG result and vent change. It was surviving surgery, and not developing an infection. It was looking through glass walls and wanting nothing more than my baby to make it to the next day. Today, things are different. I have time to think more about the future- and to be honest-it’s frightening. The unknowns. The questions.

In the NICU you become numb to disappointing news. I remember the day the doctors told me that Malachi’s brain scan was now showing that he had PVL, and how I didn’t even shed a tear. Was I upset? Yes…PVL increases the likelihood for developmental and cognitive delays; but, I was so numb from all the discouraging news I heard on a daily basis, from the passing of Michael, and the emotions I felt as I dreaded Malachi’s upcoming brain surgery- that it didn’t have a great impact on the way I felt. Malachi was alive- and in that moment-that was enough. I tell you all this to say, I almost feel like disappointing news is harder to wrap your head around when you leave the NICU setting. Hearing that my son may need a G-tube hit me like a ton of bricks. It brought back fear and raw emotions. I felt like crying out to God “hasn’t Malachi been through enough?” But then I stopped myself. How selfish of me. God saved Malachi. Malachi is a gift…he is vibrant, and happy. He knows me. He is goofy, joyful, and lights up a room. God has brought him through so much already, and I know we will overcome this too. This is just another page to our story.

Once again, we are reminded that we cannot do this without the strength that comes from Jesus Christ our Lord and Savior. We just cannot make it alone. Also, I am so thankful for the micro preemie mamas I have meet along the way- with their encouraging words and super hero like strength. Yvonne, Lindsey, Leah…just to name a few…you rock! You can’t survive this micro preemie world without faith and fellow micro preemie mama friends who ‘get it’…who truly understand.

So where do we go from here? We pray. Jake and I have gone off to the lake for a few days. No TV, no worries from the world-just time away to spend with our precious boy. Please continue to pray with us for Malachi. Pray that we will make the right decision as his parents about his feeding needs. Continue to pray for his development, brain growth, and muscle tone. I will try to post again soon to let you know how therapy is going, and what Malachi has been up to these days (besides refusing to eat.) He is still such a happy boy, despite all he goes through. I know I tell you all the time- but you are my hero Malachi!

2 Corinthians 4:8 “We are hard pressed on every side; but not crushed; perplexed, but not in despair…”