Too Small for My Britches
A life-altering experience can affect us for a lifetime. In my case, this journey began before I was born. It’s been only recently that I have come to realize the impact my birth has had throughout my life. You see, I am a preemie. I am what most would consider a “miracle” baby. I beat the odds. As such, I have had “big britches” to fill ever since my birth … or so I thought.
I was born pre-term; precisely 3 months and four days (27 weeks) prior to my due date. I weighed in at a whopping 2.12 pounds at birth! My mom was required to remain in bed and off her feet during much of the pregnancy. She was hospitalized several months prior to my delivery so she could be monitored in hopes of postponing delivery for as long as possible. However, I had a different agenda and decided to come in with a bang on July 4th, 1957.
I don’t know all the specifics behind my birth. Based on what I’ve been told, I would assume my Mom was suffering from preeclampsia; a condition that affects approximately 5% of pregnant women. According to the medical literature, the exact cause of preeclampsia involves several factors. Experts believe it begins in the placenta — the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta. In women with preeclampsia these blood vessels don’t seem to develop or function properly. They’re narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them.
This lack of blood flow and nutrients may have resulted in my early birth. My early delivery was natural but, unfortunately, not so timely when it came to my physical development and readiness to meet the world. I remained in the hospital in an incubator for three months postpartum while my lungs and the rest of my organs developed more fully. To put this information into perspective, at 27 weeks, I wouldn’t have even known how to suck, swallow and breathe at the same time!
Considering the fact I was born in 1957, I feel very lucky to be here today. My parents told me I was so small I fit in a shoe box. For quite some time, they said I slept in a dresser drawer because the crib was just too big for me. Clothing me was a challenge as nothing fit well. I swam in my cloth diapers.
My twin siblings were several months shy of their fourth birthday when I was born. If four-year-old twins weren’t enough to deal with, the concerns of having a very premature baby most likely caused a significant amount of stress for my parents. At birth, I was placed in an oxygen-enriched incubator to assist in the management of apnea of prematurity. I’ve been told that my Dad passed out when the doctors warned him that his tiny daughter might have been exposed to too much oxygen and could be blind. I am sure there were many more incidents my parents faced as they navigated the setbacks and hurdles of dealing with a preemie and the possibility of me failing to thrive. However, even though the odds weren’t in my favor, I survived and, eventually, I did thrive.
THE PRICE OF SURVIVAL
I believe my response to stress is innately different than others. Studies have shown preemies are genetically imprinted while in the womb and this early exposure to stress can alter their stress response throughout life. It’s also a known fact that children who are born premature have a persistent drive to succeed and often deliver despite the obstacles.
It is also know that children respond and react to their environment and the social expectations placed upon them and develop learned behaviors. Personally, I feel I reacted to my parent’s concern for my well-being during my early developmental years by becoming ‘quite the little fighter.’ After all, I wanted to please and meet my parents’ expectations. Tenacity became my favorite word and my favorite response to stress.
Today, I fit into what is known as the “Extreme Pre-Term Infants (EPI)” category which is defined as babies born before 28 weeks gestation or who have a birth weight of less than 1000g (2lbs, 3oz).
According to statistics, in the 1950s the neonatal death rate was about 20 per 1,000 live births. To put my premature birth and my survival into perspective, here are some 2017 outcome statistics based on babies born before 26 weeks gestation1:
- 22% may develop a severe disability secondary to early birth.
- 24% may develop a moderate disability or special needs from premature birth.
- 34% may develop a mild disability
- only 20% of babies born at 26 weeks gestation or earlier will have no long-term effects from their prematurity.
Research shows that compared to babies born at or after 39 weeks of pregnancy, babies born before 39 weeks are:
- at greater risk of being admitted to the Neonatal Intensive Care Unit (NICU).
- at a 20% greater risk of complications, including breathing, feeding, and temperature problems; sepsis (severe blood infection); and cerebral palsy.
- 5% more likely to have an intellectual or developmental disability.
- at a 50% greater risk for death within the first year of life.
There are studies which show a stressful pregnancy and low birth-weight at delivery can impact the immune response of an individual well into adulthood. Medical studies are finding preemies who reach adulthood are more susceptible to auto-immune related diseases and they have an altered immune function,2 an altered endocrine function, develop primary insulin resistance, and have a lipid profile consistent with the metabolic syndrome.3 Preemies are also known to be more prone to coronary artery disease later in life.4 These findings suggest that in utero exposure to maternal stress and infants born prematurely or having low birth rate may have long-term negative physiological consequences. This information certainly fits me to a tee and may explain, at least in part, many of my current health issues.
Today, I also feel my inherent stress responses may be subconsciously impacting my health in a negative way. As an adult with health issues, perhaps it is high time to realize the need to change how I react to stress and consciously control the physical stresses that are impacting my life. Even though the constant release of excess cortisol and adrenaline may seem to be a normal physiological response to stress; the result of constantly being driven by the need to challenge myself and push beyond my physical capabilities to survive and thrive is no longer an effective method of handling stressors or living well.
You see, it no longer matters what worked for me in the past. I am dealing with the present. I no longer need to be bigger than my britches to survive and thrive. I learned to thrive many years ago and I thank that tiny baby who wouldn’t quit despite all odds. She has served me well. However, life no longer has to be a fight and I no longer need to fill big britches. I simply need to learn to live, work, and play efficiently. From this day forward, I must learn to keep my britches “ON’ each day and not “EXPOSE” myself to unnecessary stress. You see, I no longer have to prove anything and neither do U. It’s time to learn to JUST BE and perhaps I can assist you in this journey!
It’s time to become comfortable in my own skin and not be overly concerned with filling out my britches and taking on more than I can reasonably handle. After all, good things come in small packages! – Barb Casper
“The past can influence who U are. Still, only U determine the final outcome.” – Barb Casper
2 Getting Closer to Myself – Learning to live, love and adapt to life with chronic illness http://gettingclosertomyself.blogspot.com/2008/05/premature-birth-and-autoimmune-diseases.html
3 Cardiometabolic Risk Factors in Young Adults Who Were Born Preterm https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445394/
4 Sullivan, M.C., Mitchell, P.A., Miller, R. J., Winchester, S. B., & Ziegler, J. W. (2011). Cardiopulmonary outcomes in young adults born prematurely with varying birth weights. Pediatric Work Physiology conference, University of Exeter, England
Irving, R. J., Belton, N. R., Elton, R. A., & Walker, B. R. (2000). Adult cardiovascular risk factors in premature babies. Lancet, 355(9221), 2135–2136. doi: 10.1016/s0140-6736(00)02384-9.
Kaijser, M., Bonamy, A. K., Akre, O., Cnattingius, S., Granath, F., Norman, M., et al. (2008). Perinatal risk factors for ischemic heart disease: Disentangling the roles of birth weight and preterm birth. Circulation, 117(3), 405–410. doi: 10.1161/circulationaha.107.710715.
Beckmann, Joanne & Mceniery, Carmel & Cockcroft, John & Marlow, Neil. (2016). LONG-TERM CARDIOVASCULAR CONSEQUENCES OF EXTREME PREMATURITY. Journal of the American College of Cardiology. 67. 1930. 10.1016/S0735-1097(16)31931-3.