Yesterday I was away from little Liam all day. It was my first full day without seeing him at all, which was hard. But Terry was with him, and that was incredibly comforting. In fact, in the Preemies book I checked out from the hospital library, it said that preemies whose Fathers spend more time with them are more likely to be released earlier, to have better respiratory health, and fewer health issues over the next two years of life, even controlling for their initial health and family socioeconomic status. So go Daddy time!
I took the Metra up to Wisconsin for a baby shower my mom and stepmom threw for us. It had always been scheduled for Feb 7th, and although it was more of a birthday party for the little guy (since he decided to crash his own shower) it seemed to make sense to go forward with the shower before it was time for him to come home, when we'll be more restricted.
But it is so so good to be back and see the little man today. We got here for his 10 AM feeding. We tried to breastfeed him again, and although he seemed to get some good latches and whatnot going, when the nurse checked the contents of his tummy it looked like he didn't get much. So we keep trying, he and I together, to learn.
But the other great news is that he is another day free of any Bradys or Apneas. He's doing great on his feeding, so today he's up to 35mL. That means if all goes well tomorrow he will be on "full feeds" of 40mL and they will begin the process of removing the IV from his arm. One less tube attached to him! woohoo!
The nurse told us that he took all three of his night feedings entirely by bottle, which is an awesome improvement. Before he can go home he has to be able to be on full feeds and taking it all by mouth (breast or bottle or a combo of both).
So while we still don't know anything about when he will be going home, everything is moving in the right directions. Yay!
Sunday, February 8, 2009
Saturday, February 7, 2009
Making Progress
So, Liam is still off the oxygen, still off the blue light, and he's starting to make progress eating on his own. They bumped him to 30cc's of milk (about one ounce). Before he leaves he needs to be taking 40cc's by mouth (rather than feeding tube). Today at 10am, he took 15cc's by bottle, the rest by feeding tube. As he figures out the bottle and the breast he'll take more and more...once he's got his feeding sorted out, he'll be almost home!
Lots of hiccups today...it is probably too soon for my solution of a spoonful of sugar (not just for helping medicine go down anymore!)
We'll probably post some more pictures later tonight or tomorrow!
Lots of hiccups today...it is probably too soon for my solution of a spoonful of sugar (not just for helping medicine go down anymore!)
We'll probably post some more pictures later tonight or tomorrow!
Friday, February 6, 2009
Day 7: Goodbye Bradys, Goodbye Giraffe, Hello Burrito!
Today Liam is one week old. That seems pretty amazing. Time has certainly flown by. And today was a great way to celebrate his one weeker: more good news. He was off his respiratory support all day yesterday (the "nasal canula") but they left the white tape that secures the canula to his face just in case he needed it again. Today they decided bye-bye canula, so the tape (what I have been lovingly calling his "milk mustache") is gone.
He hasn't had any long duration Bradys for three days, and he hasnt had even the slightest Brady at all in the last 24 hours. The Preemie book I was reading last night said that sometime between 34 and 35 weeks the Bradys usually go away on their own and go away for good. So fingers crossed that our little man has permenantly left them behind. No matter how much the nurses assure me that bradys are expected for a preemie, I still don't like them. There is something awful about your son's heart rate dropping.
I got another nice surprise when I showed up today: he was no longer in his "giraffe" warming bed. They had it off all day yesterday to check to see if he was maintaining his own temperature, and he did well all day, so today he moved from the giraffe warming bed into a regular ole crib. Holding his temperature in a regular crib is one of the milestones he has to achieve before he can go home, so that's awesome.
So that means also that instead of being all naked w/diaper, he is now wrapped in a too-big shirt (really? why is it so big I wonder, because he's a good size for a preemie) and socks! Cute little fuzzy blue socks. I don't know why I was so smitten with the sight of his little socks, but I suppose it is just another first ("Oh buddy! your first little socks!") for me to gush and adore. I tried to pretend like I wasn't going to be one of those gushy mothers, and who was I kidding? I gush like crazy.
Now that he's not on the warmer we are also trying to swaddle him a little, both to help him maintain his body heat and to comfort him. So I arrived today to find a Liam Burrito. Adorable.
I held him while we fed him by gavage tube at 10, then he slept against me kangaroo care style for the next three hours. Having learned that this requires some endurance on my part, today I had a giant oatmeal breakfast with added protein, and then I ate a yogurt and a high fiber bar right before coming into the NICU. I held him from 10 to 1 (he eats and gets his stats taken every 3 hours), at 1 I changed him and the nurse let me be the one to take his temperature. When I changed him at 10 I hadn't put the diaper on snug enough, so about ten minutes later while holding him skin to skin I was peed on. Worth a good laugh. But when I changed it at 1 I learned from my earlier mistake and snugged it up.
At 1 he was awake and alert enough that we decided to try another nursing session. He's still not a trooper, and couldnt take all his nutrition that way, but each time we try he shows steady progress. So he tries to nurse for a while, I help him as much as possible, and then we feed him by gavage tube while he's at the breast so that he learns to associate suckling with the warm good feeling of being full.
And he's doing great on his feedings. He's up to 25 mL today, and so long as he keeps doing well he'll keep going up by 5 mL until he gets to 40 mL "full feedings" and then we can stop the IV entirely. At that point he'll just have to work on taking all his feedings by mouth (breast or bottle).
He hasn't had any long duration Bradys for three days, and he hasnt had even the slightest Brady at all in the last 24 hours. The Preemie book I was reading last night said that sometime between 34 and 35 weeks the Bradys usually go away on their own and go away for good. So fingers crossed that our little man has permenantly left them behind. No matter how much the nurses assure me that bradys are expected for a preemie, I still don't like them. There is something awful about your son's heart rate dropping.
I got another nice surprise when I showed up today: he was no longer in his "giraffe" warming bed. They had it off all day yesterday to check to see if he was maintaining his own temperature, and he did well all day, so today he moved from the giraffe warming bed into a regular ole crib. Holding his temperature in a regular crib is one of the milestones he has to achieve before he can go home, so that's awesome.
So that means also that instead of being all naked w/diaper, he is now wrapped in a too-big shirt (really? why is it so big I wonder, because he's a good size for a preemie) and socks! Cute little fuzzy blue socks. I don't know why I was so smitten with the sight of his little socks, but I suppose it is just another first ("Oh buddy! your first little socks!") for me to gush and adore. I tried to pretend like I wasn't going to be one of those gushy mothers, and who was I kidding? I gush like crazy.
Now that he's not on the warmer we are also trying to swaddle him a little, both to help him maintain his body heat and to comfort him. So I arrived today to find a Liam Burrito. Adorable.
I held him while we fed him by gavage tube at 10, then he slept against me kangaroo care style for the next three hours. Having learned that this requires some endurance on my part, today I had a giant oatmeal breakfast with added protein, and then I ate a yogurt and a high fiber bar right before coming into the NICU. I held him from 10 to 1 (he eats and gets his stats taken every 3 hours), at 1 I changed him and the nurse let me be the one to take his temperature. When I changed him at 10 I hadn't put the diaper on snug enough, so about ten minutes later while holding him skin to skin I was peed on. Worth a good laugh. But when I changed it at 1 I learned from my earlier mistake and snugged it up.
At 1 he was awake and alert enough that we decided to try another nursing session. He's still not a trooper, and couldnt take all his nutrition that way, but each time we try he shows steady progress. So he tries to nurse for a while, I help him as much as possible, and then we feed him by gavage tube while he's at the breast so that he learns to associate suckling with the warm good feeling of being full.
And he's doing great on his feedings. He's up to 25 mL today, and so long as he keeps doing well he'll keep going up by 5 mL until he gets to 40 mL "full feedings" and then we can stop the IV entirely. At that point he'll just have to work on taking all his feedings by mouth (breast or bottle).
Thursday, February 5, 2009
Hungry Little Dude. Second good day in a row.
So our little man had another pretty darn good day today. He has been steadily increasing in his feeding amount. They started him at 5 mL and now he's up to 20 mL. woohoo! When he gets to 40 mL in a feeding then they take the IV out and he's only on breastmilk. That is, if I can keep pumping enough to stay ahead of his little appetite. He even nursed for a while today before his feeding, and although he's little, he's a little trooper and he's trying.
His bradys (heart rate drops) have been decreasing in number and duration, which is excellent news. He has to go five straight days without any Bradys before he can go home, so we like to see positive progress.
His bilirubin levels yesterday (his first day off phototherapy) were up from 6.6 to 9.6. So we were thinking today he'd have to be back on the lights. But today when they tested his levels it was only 10.3, so the doctors decided to watch and see what the levels do tomorrow. Hopefully our little guy has turned the corner and the levels will start to go down on their own.
In another positive improvement, his next door neighbor was quite a screamer, and that baby went home today so our little man has a slightly more calm environment in which to do the hard work of growing.
And today I did three hours of kangaroo care with him. It was totally amazing. Although it is decidedly less convenient than doing it at home. Because premies can't tolerate too much stimulation, you can't just move them around as much as you like. So once they are settled, you can have them for as long as they do well. But lets say you, for example, are starving and have to pee like crazy? well then you have to decide whether you want more time with your kid, or if you want to answer the call of nature. Because you have to give up one to have the other. So naturally I ignored the rumbly tummy and just kept cuddling our little man.
Yesterday I also checked out a book from the hospital's library on premies. I suppose it is the grad student in me, but knowledge is a soothing thing. And I had been doing all this reading on pregnancy (you know, the kind that goes to 40 weeks) and babies (also the kind that grew to 40 weeks) and breastfeeding (a kid who was 40 weeks developed) and a whole lot of that well intentioned preparation went straight out the window when the rules of the game got changed. So now reading about premies. And the big thing I learned last night was about not over stimulating them. Keeping noise levels low, lights low. Light touches like we are instinctively inclined to give term babies is too much stimulation for premies and upsets them. They find firm, somewhat confining touches comforting, so resting a hand on their rump or head is comforting, stroking is too much.
His bradys (heart rate drops) have been decreasing in number and duration, which is excellent news. He has to go five straight days without any Bradys before he can go home, so we like to see positive progress.
His bilirubin levels yesterday (his first day off phototherapy) were up from 6.6 to 9.6. So we were thinking today he'd have to be back on the lights. But today when they tested his levels it was only 10.3, so the doctors decided to watch and see what the levels do tomorrow. Hopefully our little guy has turned the corner and the levels will start to go down on their own.
In another positive improvement, his next door neighbor was quite a screamer, and that baby went home today so our little man has a slightly more calm environment in which to do the hard work of growing.
And today I did three hours of kangaroo care with him. It was totally amazing. Although it is decidedly less convenient than doing it at home. Because premies can't tolerate too much stimulation, you can't just move them around as much as you like. So once they are settled, you can have them for as long as they do well. But lets say you, for example, are starving and have to pee like crazy? well then you have to decide whether you want more time with your kid, or if you want to answer the call of nature. Because you have to give up one to have the other. So naturally I ignored the rumbly tummy and just kept cuddling our little man.
Yesterday I also checked out a book from the hospital's library on premies. I suppose it is the grad student in me, but knowledge is a soothing thing. And I had been doing all this reading on pregnancy (you know, the kind that goes to 40 weeks) and babies (also the kind that grew to 40 weeks) and breastfeeding (a kid who was 40 weeks developed) and a whole lot of that well intentioned preparation went straight out the window when the rules of the game got changed. So now reading about premies. And the big thing I learned last night was about not over stimulating them. Keeping noise levels low, lights low. Light touches like we are instinctively inclined to give term babies is too much stimulation for premies and upsets them. They find firm, somewhat confining touches comforting, so resting a hand on their rump or head is comforting, stroking is too much.
Liam Day 7!
For now, Liam is off his nasal cannula! So far he's breathing well off the support and we're hopeful that he's off breathing support permanently. In other news, Liam's consumption of breast milk is up again today from 15cc's to 20cc's. Slowly but surely he's getting used to bottle feeding and Erin's making progress getting him used to the breast. We don't know when they'll take out the gavage (feeding tube), but at least he's making progress towards that day. Everyday he gets more and more kangaroo care time, which has served him very well. When he's on our chests, his breathing evens out and his general state of chillness becomes that much more chill. He's awesome.
They just tested his bilirubin level. The results should come back this afternoon. The docs may put him back on the blue light if his jaundice is back on the rise. In many respects, that is the least worrisome intervention. He keeps having the "brady" spells where his heartrate drops (he had two small ones last night), but they seem to be shorter and less frequent. He's working his way out of them slowly but surely. They won't let him out of the hospital until he has five days straight without a brady, so we're keeping our fingers crossed that he is moving out of that phase.
In general, all is well!
They just tested his bilirubin level. The results should come back this afternoon. The docs may put him back on the blue light if his jaundice is back on the rise. In many respects, that is the least worrisome intervention. He keeps having the "brady" spells where his heartrate drops (he had two small ones last night), but they seem to be shorter and less frequent. He's working his way out of them slowly but surely. They won't let him out of the hospital until he has five days straight without a brady, so we're keeping our fingers crossed that he is moving out of that phase.
In general, all is well!
Wednesday, February 4, 2009
A good day in the NICU
Today so far (knock on wood) has been a good day for our little man. He made some good strides forward, and no steps backward (yet today, and hopefully it stays that way). We are still trying to get adjusted to the idea that in the NICU it is normal to expect one step forward, one step backward. That a good day may mean two steps forward and only one back. But today it was slow and steady forward progress.
He is doing super well on his feedings, which is one of the measures they use to assess when he is able to go home. He has to get up to "full feedings" which is 40 mL at a feeding, every three hours. He was on 5 mL per feeding, and now he's up to 10 mL and doing really well with no "residuals" (nothing left over undigested in the tummy when it is time for the next feeding). So if he keeps that up the doctors have said he will more or less go up by 5 mL per day.
Today he had his first ever bottle! Woohoo! He took the whole amount for his feeding by mouth, which is a big accomplishment for the little guy, who until this point has been fed by nasogastric tube (tube straight into his tummy). He will still take feedings by tube so we don't over tax him, but so long as he does well with it, he will keep building up the proportion of feedings he takes by mouth.
The last couple days we have also experimented with little breastfeeding sessions. Nothing major, not as a source of substantial nourishment, but for the little guy to learn how it works. He has done better than expected with it, which makes me hopeful that some day we will be able to transition him to 100% breastfeeding and I can stop all this incessant pumping. But however he eats, we are just happy he's eating.
Still no date fixed for his homecoming. We'd really appreciate it if you didn't ask. As you can imagine, this is a hard subject for us: it is very difficult to live with the uncertainty about something that is so eagerly anticipated. Rest assured that the minute we are given an estimated date for his homecoming, we will broadcast it loud and clear and with total joy.
He is doing super well on his feedings, which is one of the measures they use to assess when he is able to go home. He has to get up to "full feedings" which is 40 mL at a feeding, every three hours. He was on 5 mL per feeding, and now he's up to 10 mL and doing really well with no "residuals" (nothing left over undigested in the tummy when it is time for the next feeding). So if he keeps that up the doctors have said he will more or less go up by 5 mL per day.
Today he had his first ever bottle! Woohoo! He took the whole amount for his feeding by mouth, which is a big accomplishment for the little guy, who until this point has been fed by nasogastric tube (tube straight into his tummy). He will still take feedings by tube so we don't over tax him, but so long as he does well with it, he will keep building up the proportion of feedings he takes by mouth.
The last couple days we have also experimented with little breastfeeding sessions. Nothing major, not as a source of substantial nourishment, but for the little guy to learn how it works. He has done better than expected with it, which makes me hopeful that some day we will be able to transition him to 100% breastfeeding and I can stop all this incessant pumping. But however he eats, we are just happy he's eating.
Still no date fixed for his homecoming. We'd really appreciate it if you didn't ask. As you can imagine, this is a hard subject for us: it is very difficult to live with the uncertainty about something that is so eagerly anticipated. Rest assured that the minute we are given an estimated date for his homecoming, we will broadcast it loud and clear and with total joy.
Liam Day 5!
All,
Liam is doing great. He took his first bottle today and he's starting to figure out this breastfeeding thing (which is all difficult for a pre-term kid...he has to learn to suck, breathe, and swallow all in coordination...it is like conducting a symphony orchestra). He's been off the blue jaundice light for about a day now (though he might go back on) and he's enjoying more and more kangaroo time with me and Erin. When he's on our chests, he is always totally zonked out. It is the best.
Enjoy these photos from yesterday!
Terry
The pacifier as big as a head!
Sleepy...
Flipping the bird!
Bigfoot is found at Prentice Hospital!
Liam is doing great. He took his first bottle today and he's starting to figure out this breastfeeding thing (which is all difficult for a pre-term kid...he has to learn to suck, breathe, and swallow all in coordination...it is like conducting a symphony orchestra). He's been off the blue jaundice light for about a day now (though he might go back on) and he's enjoying more and more kangaroo time with me and Erin. When he's on our chests, he is always totally zonked out. It is the best.
Enjoy these photos from yesterday!
Terry
The pacifier as big as a head!
Sleepy...
Flipping the bird!
Bigfoot is found at Prentice Hospital!
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