Rebeca

It has been a busy weekend, with 5 very sick babies - 4 of them being tiny infants in GLA's NICU. For now, let me tell you about one of them. Let me tell you about Rebeca:

I was recovering from my surgery when she arrived. Rebeca was  born around 2 months prematurely, and she weighed a mere 892g (1lb and 15 oz.) She was  barely breathing when she arrived, with a pulse oxygen level of 37% and a falling heart rate. She needed immediate resuscitation and careful post resuscitation care on the night she arrived. Since then, her NICU stay has been anything but smooth. She has been resuscitated no less than seven times. In addition to many of the usual problems that premature babies face, including immature lungs, an immature brain and digestive problems, Rebeca has a chest wall deformity known as Pectus Excavatum, which, is a depression in the sternum, or breast bone. Hers is fairly wide defect, and I suspect it presses on her lungs.  Our poor baby contracted a respiratory virus that caused bronchiolitis, a condition that is often fatal in premature infants and newborns. This was further complicated by pneumonia and by fluid overload (the result of an IV infusion that was not monitored in my absence (officially, I was still out of action).  Rebecca didn't gain weight when she was ill, and as a result, she remains very weak, and is still on CPAP, over two weeks after we admitted her.

Last week, her mother suddenly left the orphanage for several days. Rebeca was producing lots of stomach acid at that point, and did not tolerate the switch to formula feedings very well. I was so relieved to see her mother return on Friday. I greeted her and asked her, please to express some breastmilk right away. The Mothers eyes darkened and she stormed away from me, returning 30 minutes later with a very small volume of milk.

That night, she refused to express at all. Saturday morning, we re-iterated that Rebeca had digestive problems that could be helped by her mother's milk and that could worsen on formula milk. The Haitian nurses and I emphasised that breast milk was recommended for all small babies, and that it was especially important for premature babies, far superior than anything that can be bought in stores anywhere in the world.

The nannies did all the things for this mother than Haitians believe will enhance milk production in lactating women. They made special meals for Rebeca's mother and encouraged her to rest and take care of herself. Still, Rebecca's mother was adamant, she had no milk, and she wasn't prepared to sit for 10 minutes at regular intervals throughout the day to re-establish the excellent supply that she'd had before she went home.

We were exasperated by 7pm that night! Rebeca's mother is in very good health. She is tall by Haitian standards, she is fat and she is eating us out of house and home. We had asked nothing from her, except breast milk for the baby. Did she really want us to give formula, knowing this could compromise her daughter's frail health?

We encouraged, we coaxed, we cajoled, we reasoned, and then came some tough talk.

'She's not my responsibility,' Rebecca's mother exclaimed sullenly. 'You're telling me that because I gave birth to her, I have to produce milk for her? It was God who decided to give her to me!'
'No', we told her. 'You have made choices, now you are a mother.'
But the words were not striking the mark. We were faced with a hostile teenager, with empty eyes, who sneered, and outright refused to express milk for her baby. The milk she said wasn't there. The milk that hit staff members three feet away, whenever she squeezed her nipple.We softened the approach.

'The baby is hungry. Look at her flailing her arms. And because she's crying, her oxygen levels are going down. You've been through a lot to get help for her. We've been through a lot. She's still sick. We know you want her to live. And clearly, the baby has a strong will to live...'

Miss Cammi was cut off abruptly. 'A will to live?' the mother said, spitting the words out of her mouth as though they were something foul.'Well, I don't know why she wants to live! I delivered her in my toilet bucket!'

I was stunned motionless and  defeated. And it wasn't the words, it was they way they were spoken. Not just the fact that the baby was born in a toilet, that happens sometimes. But it was the disregard for this beautiful and precious soul. The tiny life in the incubator, in the corner of the NICU.

I turned to the Haitian staff. Maybe this baby didn't need her mothers milk as badly as we thought. Too much bittterness. Too much hatred and resentment.

Today is Haitian Mothers day. Mothers Day is supposed to be a celebration and  rightly so, because all mothers make sacrifices, and a loving mother is a golden thing. Today, though, i am painfully aware, that motherhood does not come to all women by choice. For some, mothering is a struggle, and the mantle of motherhood, a very heavy burden.

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