While other new Mums were experiencing sleepless nights, worries about breastfeeding and perhaps battling postnatal mental stresses, our July Mum of the Month was battling all that and more after the birth of her second child.
Taking care of a newborn is already a challenging affair, both physically as well as emotionally. Add on a congenital medical issue and the magnitude of that situation shifts exponentially.
Baby Elizabeth Joy Ong was born with not just one but two holes in her heart. To hear of such a condition in a tiny newborn is somehow more heartbreaking. Her mother, Dr Janice Lam calls her “our Rainbow Baby”.
The Rainbow Baby
Elizabeth, aka Lizzie, was conceived two months after Janice and her husband lost their second baby in April 2019 at 8 weeks. “Our gynae advised us not to wait; that we should just try when we were ready and so we did,” shared Janice. But having recently experienced the loss, she was extra careful during this pregnancy, which turned out to be a difficult one.
“Be it a smidgen of red on my pantyliner or any other little warning sign, I would drop my gynae a text to check if everything is okay,” she confessed. “I was nauseated all the time, vomiting between six to eight times a day in the first trimester! I had to take Diclectin pills to help reduce the vomiting.”
Janice was also concerned about controlling her weight gain. “I lost three kilos in the first trimester but put on a total 17kg overall,” she said. “As I took a long time to lose my baby weight with Jamie, my firstborn, I was more careful about exercising and not eating too much in my later trimesters with Lizzie.”
She took extra care to work out diligently, walking three times a week and doing some prenatal HIIT sessions at home. Janice also prepared for the birth by taking time off way before her due date instead of working all the way up to her delivery date for her firstborn.
Unlike her first birth experience, which was a long and arduous labour, it took Janice literally five pushes for to bring Lizzie out into the world at exactly 3.40pm on 11 March this year! “It seemed like a walk in the park; and that was exactly all I did to naturally induce her birth,” laughed Janice. “Lizzie was also a lot heavier than her brother - weighing 3.45 kg and wanted to latch immediately when she got on my chest - such a greedy girl!”
A precious heart
After the exuberant high of an easy birth, the last thing Janice expected was bad news. “Our very meticulous and thorough Paediatrician picked up a murmur on the second day after Lizzie’s birth and her echocardiography done showed she had both an atrial septal defect (ASD) and a ventricular septal defect (VSD),” said Janice. This information was not detected at her 22-week fetal anomaly scan so this came as a shock to her. “The ASD was considered small but the VSD was considered moderately large.”
Janice and her husband were primed by their Paediatric Cardiologist that Lizzie would most likely need medications at the age of one month to prevent her heart from expanding too much due to fluid overload. She would also probably require open heart surgery to correct the hole when she’s four to six months.
The Hegen Difference
Meanwhile, Janice busied herself with the effort of making sure that little Lizzie was well-fed with a good and steady supply of breast milk. As she is a second-time Mum, she already had some experience in this area before. “I was a lot more prepared about breastfeeding and understood how it was a demand and supply thing. In Lizzie’s case, she latched on immediately after birth and even though I brought my pump to the hospital, I didn’t need it as she fed well and would sleep right after,” she recalled.
Throughout their hospital stay, Lizzie fed like clockwork every two to three hours and produced a steady supply of soiled diapers, evidence of optimum feeding. But things changed around the third or fourth week. Lizzie was bottle fed at night and Janice would direct latch her in the day and each time she would choke and sputter on the bottle at least twice per feed.
This was a real issue as Lizzie was starting to drink massive amounts of milk, about 1.3 litres a day due to a growth spurt. Hence by feeding so often, the choking began to happen as many times. “This worried me especially because of Lizzie’s heart condition which meant that it required a lot more effort for her to feed compared to a normal baby,” Janice explained. “This is due to the mixing of oxygenated and deoxygenated blood in her heart. So, if she were to get a small infection, say an upper respiratory tract infection, it could easily develop into a pneumonia.”
As Lizzie was choking on milk so often, Janice feared that milk was getting into her windpipes. This situation would cause micro-aspirations that could in turn lead to lung infections.
Janice tried her best to find the slowest flow teats from every brand she knew of to help prevent hungry Lizzie from choking. None worked until she was given Hegen’s Extra Slow Flow teats by a friend. It turned out to be the only thing that worked well and Lizzie could happily drink 900ml of milk a day smoothly and safely.
Nothing short of a miracle
To everyone’s immense surprise and joy, Lizzie’s heart condition steadily improved as the weeks and months went by. At her one-month milestone medical check, it was discovered that her ASD was almost closed and her VSD had become smaller (from 5 mm diameter to about 3.5 mm). She did not require any medication and had put on good weight, which was not easy for a baby with a heart condition, as they expend a lot more energy than normal babies due to the mixing of the blood in their heart.
It was at her two-month check that the good news was revealed: her ECG showed that both holes in the heart had completely closed. “Our Paed has said this is nothing short of a miracle,” gushed Janice. “The VSD is known to close spontaneously but only on very rare occurrences and usually happens for smaller sized holes, unlike Lizzie’s. The speed at which closure has happened is also amazing - normally spontaneous closure happens sometime between six months to 1 year of age. Lizzie is only 2 months old!”
Janice attributes this recovery largely to Lizzie’s healthy appetite and being able to feed her well with breastfeeding directly, her oversupply of milk and Lizzie receiving the right teats for safe bottle feeding. “Being able to feed well and sufficient milk intake was paramount to her gaining weight. And this was good because the holes close up mainly due to enlargement of the surrounding heart muscle tissues to close up the hole,” she shared.
As for what the future holds for Lizzie, Janice is hopeful. “Her heart condition is considered to have fully recovered, though there is still a very tiny hole between her two atria - which can be normal in children,” she revealed. “Her cardiologist feels although she would like to follow up first with another heart scan at 6 months, it is most likely the small hole will close up completely and she can participate in normal physical activities when she grows up.”
Who doesn’t love a happy ending? And well-deserved too, Mama! The Hegen team wishes Lizzie and Janice all the best and we’re glad to have played a small role in her road to recovery.