It's a boy! Happy Birthday Toler Hartley Smith



Toler Hartley Smith was born on 1/5/11 at 5:00 AM weighing in at 3lbs 6oz with a length of 17 1/4 inches.  As with any preemie birth every day counts and we were very fortunate to get just over 4 full days in utero past the water breaking.  In short Toler is doing very well given his gestational age and size, Emily is ready to put hospital life behind her and take on the world again.                                                                 

The birth story

Our little Tar Heel

Emily had been having sporadic contractions for the past couple nights, these were mostly calmed with a dose of IV fluid and rest.  Last night after turning down just past midnight Emily's contractions came back and by 2:30 AM it was apparent that they were rhythmic and she was in fact going to be giving birth.  Due to a premature birth magnesium is administered to help provide the baby critical final moments in utero during the birth process.  We were lucky enough to administer the magnesium approximately an hour prior to Toler's birth. 

Emily's labor came quick and hard and she was just barely able to receive the epidural.  Once Emily had the epidural things moved rapidly and a call for the birthing doctor was immediate.  With Dad's encouragement and a few intense pushes, Toler was born kicking and screaming at exactly 5:00 AM this morning.  Within 30 seconds the doctor on call for delivery came through the doors, luckily the emergency doctor did a fantastic job coaching these rookies through the process.

A quick clean up, snip of the umbilical cord, and vitals check and we were all done in the birthing room.  Toler and dad were taken to the NICU unit for additional preventative measures while Emily let the remainder of epidural wear off.  In the words of Emily "Once the epidural was administered the rest was easy...".


Toler's health

Toler holding Dad's finger

At just over 30 weeks Toler has several milestones ahead of him prior to his release from the NICU but for

now we could not be happier with the early results.  It was apparent from his immediate crying at birth that the steroids worked!  Toler scored a 9 on the Apgar test (few babies born in Denver get a 10 given the altitude) which was another very positive sign. 

Now that Toler is set up in the intensive NICU he will need to be cared for until the original due date (March 14th) or a couple weeks earlier based on his progression.  Toler is currently set up on the following:

• CPAP (continuous positive airway pressure): used to ensure Toler continues to breath, at 30 weeks preemies sometimes forget to breath even though they do so on their own.  Some respiratory assistance is standard for most 30 week preemies, typically either the CPAP or breathing assistance.  Use of CPAP is a positive sign over full on breathing assistance.  Once stable this will be removed in anywhere from 2-10 days.
• Feeding Tube: while Toler was not feed on his birthday, starting tomorrow he will get fed through a feeding tube up until 34 weeks (Feb) at which time they will begin to administer food through a bottle.  This tube is about the thickness of the smallest electrical wire you've ever handled.
• IV: used to administer antibiotics and sugar water today and also in place for other drug administration as necessary. 

Mom and 'lil Toler

                                                                                

What's next

The thought process is for Toler to spend a couple weeks in the intensive NICU to stabilize breathing and they he will move to the graduate NICU unit for the remainder of his stay at Presbyterian St. Lukes.  The parents and grandparents can visit 24x7 with the exception of the nurse changes, however we really want Toler to eat, sleep, and grow as much as possible.  As such we have a 'care time' of every 4 hours to come to help take his temperature, change his diaper, and hold in our arms, this will move to every 3 hours once Toler is eating on a regular basis.

For the parents this is the second all nighter of the week and are both ready for a long sleep in a comfortable bed.  We will remain in the hospital through Friday (we have moved to room 1117) and then relocate 3 blocks east to the Ronald McDonald House (room 3I) through the remainder of our stay in Denver (anytime between mid February-mid March).

 Pictures

Our little guy

'lil Toler's home

Toler, Mom & Dad