Tag: preemie

Baby Emmett, breastfeeding, NICU

NICU day 84

Keeping up with the Hoffmans

Emmett is 12 weeks old today. Hard to believe we’ve been here almost three months.

Today was a pretty good day. Feeds are going much better and he even took a few full feeds via bottle last night! We are averaging around 60 percent orally, and you may remember we need to get to 80 percent over 24 hours to remove the feeding tube (though E tried to get a head start and pulled it out again himself today). The bottle feeds are definitely higher volume than the breast feeds. In fact, if you exclude the breast feeds from his averages, we’re already at 80 percent. This, of course, has me all kinds of hyperanalytical. Should we just focus on bottles for now so we can go home? Or would we ever recover from that if we did? I know babies who were able to figure out how to nurse later, but for many, lack of nursing is the beginning of the end of breastfeeding and once they get used to the relative ease of bottle feeding, it’s hard to go back. Plus, I won’t have the luxury of weighted feeds at home, or lactation consultants just down the hall to help. Can I nurse him at home and be confident he’s getting enough? Am I willing to potentially give up breastfeeding just to go home a few days sooner? Is my own stubbornness in my desire to breastfeed keeping him here longer than necessary? Lots to think about.

I love how he sleeps with his arms up. T used to sleep like this too.
Baby Emmett, breastfeeding, NICU

NICU day 83

Keeping up with the Hoffmans

We had an okay day on the feeding front. After E’s 22 ml feed last night, he was pretty sleepy overnight so they just pushed the full volume through his feeding tube at his midnight and 3 a.m. feeds. At 6 a.m. he looked like he might be ready to go, but then pretty much instantly fell asleep and only got 2 ml from me. At 9 a.m. he was raring to go and took an impressive 44 ml, though, to make up for it! So I know he’s got it in him; it truly does seem to be a stamina issue. His noon and 3 p.m. feeds were 10 and 12 ml, respectively, and much sleepier. I left to pick up T before the 6 p.m. feed, and will stay home tonight. Anxious to find out how he does with bottles tonight.

Interestingly, there appear to be two schools of thought on how to address the sleepy/stamina issue. Our nurse yesterday and the day before had us attempting breast or bottle every other feed, and just gavaging the others to let him rest. Today’s nurse (a different one), said even if he only gets a few ml and falls asleep, the practice is good for developing those muscles, so we nursed every feed. I can see the merits to both approaches, and don’t know what the best way is. I just wish there were some magic bullet so we could figure this out and go home!

Baby Emmett, breastfeeding, NICU

NICU day 82

Keeping up with the Hoffmans

Feeding is going better. Yesterday we were averaging 17 percent via mouth and today we’re up to 34 percent. They started alternating feeds via bottle and feeding tube, and that seemed to strike a good balance between letting him practice and letting him rest. I went into the office today and got to the hospital this evening just in time to feed him at his 8:30 cares, and he took 22 ml via breast, which is about 37 percent of his feed volume. We still have a long way to 80 percent, but it’s good to see things trending upward.

He gained another two ounces tonight and is up to 7 lbs 1.5 ounces. He’s really come a long way.

Baby Emmett, NICU

NICU day 81

Keeping up with the Hoffmans

Well, we didn’t turn the corner on feeding today like I’d hoped. He was pretty sleepy for most of his feeds today so they just fed him through a feeding tube for most of them, though he did take 12 ml from me early this morning, and 35 ml via bottle this evening. The nurse today was talking about the possibility of putting him back on oxygen, which would be really disappointing. He seemed to me he was doing really well with his breathing, but the nurse said he may be working so hard to breathe that he has no energy or stamina to eat. I hate the idea of putting him back on oxygen. I know it’s normal to take steps forward and backward during this process, but that would be a huge step backwards, and would mean we’re even farther from being discharged than I thought. They weren’t going to make any changes today, but would discuss more tomorrow. I just keep hoping he figures it out one of these days.

Weight was up 40 grams tonight, bringing him to 6 lbs 15 oz. Now that he’s the size of a full-term newborn I’m less interested in the weight gain, and more in his feed volume. It’ll be nice to stop obsessing about numbers at some point.

Baby Emmett, breastfeeding, NICU

NICU day 80

Keeping up with the Hoffmans

I spent the night at the hospital last night and got up with E at every cares, attempting to nurse. He did absolutely nothing at 11:30 p.m. and 5:30 a.m., which was disheartening. At 2:30 a.m. I thought he actually did pretty well but when they weighed him afterward he had only taken in a measly 4 ml (his normal feed volume is 60 ml). I almost cried. I’m really starting to get discouraged with this whole feeding thing. He did so well last weekend that they were talking about springing us soon, and now he’s totally regressed.

I left the hospital late morning to meet up with some girlfriends for brunch. I brought T with me so he could play with my friend’s kids at her house. It was a good afternoon with good friends and a needed break from the hospital and feeding issues. After T’s nap, he and I went back to the hospital in time for 5:30 p.m. cares. D met us there with dinner and then took T home so I could stay the night again tonight. At one point during our 5:30 feed I had two lactation consultants hovering over me giving me pointers, occasionally grabbing a boob and helping me reposition. It’s safe to say I’ve lost all sense of modesty (or what I had left after birthing two babies, anyway). The good news is, I think we just may be starting to get our groove back on feeding (knock on all the wood). He ended up taking in 12 ml at 5:30 and 22 ml at 8:30. After the single-digit feedings he’s been having, I’ll take it. Please, please let this be the beginning of figuring it out again.

At one point last night Emmett pulled out his feeding tube. I got a picture of him before the nurse put it back in. Seeing him without the feeding tube made me even more eager to get these feeding isssues resolved. He’s so cute with a naked face! He’s up 54 grams tonight, bringing him to 6 lbs 14 oz.

Baby Emmett, breastfeeding, NICU

NICU day 79

Keeping up with the Hoffmans

Today I had to go into the office, and D wasn’t able to be at the hospital either, so E spent most of the day alone. I got here around 7 this evening and checked in with the nurse to get a report on his day. One big brady/desat (reset that clock by 5 days again), and about 50 percent of his feeds by bottle (not too shabby). Unfortunately when I nursed him tonight he only took in 6 ml, which is just 10 percent. It’s frustrating, to say the least. On the plus side, he’s up to 6 lbs 12 oz.

He was pretty grunty this evening. He’s kind of a grunty baby in general, thanks to the reflux, but tonight he seemed especially uncomfortable. When I picked him up, he would calm down, but as soon as I’d set him down, he’d start up again. He really likes to be held. I can’t wait until he’s wireless and I can walk around or go find a comfortable spot to sit and cuddle him. Because he’s tethered to all the monitors, I can’t take him very far, which means I usually just stand next to his bassinet to hold him.

That’s about it for today. Onto day 80…

Baby Emmett, NICU

NICU day 78

Keeping up with the Hoffmans

Anyone who’s ever been pregnant (to term) will tell you that the ninth month of pregnancy lasts approximately 68475840383758202 years. I’m beginning to think the same is true for that final stretch of NICU life. Since the day Emmett was born, the doctors and nurses have all told us to plan to be here until around his original due date. Sometimes babies go home sooner, sometimes later, but the due date is a pretty average target for a release date when you have a preemie, particularly a really early one. And I think I was okay with that until Sunday when we were teased with the possibility of an early release. Since then E has slipped back into his old ways. Frequent but minor desats, occasional bradys, lack of progress on the eating front. On the bright side, he’s off oxygen still. But it’s looking like these feeding issues will be the final hurdle.

I’m just exhausted and I’ve hit my wall. I know we’re almost done, and he really is doing well. But for some reason I’m having a harder time now than I ever have. I just want him healthy and home so we can begin normal life.

Baby Emmett, breastfeeding, NICU

NICU day 77

Keeping up with the Hoffmans

Today Emmett took a step backward from the great progress he’s been having. He had one brady overnight, which automatically reset our jailbreak clock back to five days. He also had a lot more desats today. They were all quick and not terribly low, and it’s not enough to put him back on oxygen just yet, but they also wouldn’t send us home if he were still doing that. He was also just really sleepy today and not very interested in eating. The nurse said he was probably just really tired from all the progress we’ve made in a short amount of time, and that this rebound effect is very typical of a preemie after making such big strides forward.

So it looks like we’re not as close to going home as we originally thought. He’s still doing really well, considering all he’s been through. But it was a bummer to realize he’s not going home in the next few days like we thought he may be. That said, this rebound could be short-lived and we could see him start trending upwards again very soon. It’s kind of a wait and see game at this point. He’s up to 6 lbs 10 oz now and doesn’t fit in most of his preemie clothes anymore.

Baby Emmett, breastfeeding, NICU

NICU day 76

Keeping up with the Hoffmans

Today was a good day. As I’ve mentioned before, we’ve done two trials off oxygen before, and both times he made it about 12 hours before he got tired and needed it back. I’m happy to report we passed the 12-hour mark. And then the 24-hour mark. And then they removed his tank altogether from his room because it was clear he was rocking it on his own. Yeah!

Feeds were kind of hit and miss today. I nursed him at every feed except the 2:30 a.m. feed, during which I slept and the nurse gave him a bottle. He’s averaging about 60 percent of his feeds by mouth currently. One was as high as 84 percent and one was as low as 24 percent. So we’ve still got some work to do to get to the required 80 percent over 48 hours. He seems to prefer breast over bottle, which as the nurse pointed out, is a nice problem to have. He will take both, though, which has been the goal all along.

We’ve been talking to Theo a lot about E coming home, now that we’re getting closer. I know there will be an adjustment period while he learns how to share us (or maybe we’ve already begun that since D and I have been splitting our time?), but so far he is really excited. His daycare teachers say he’s been talking a lot about “his” baby too. He’s been asking for a few days to go see baby Emmett so I picked him up after school today and brought him back to the hospital. I nursed E while T sat and played a game on the iPad. Aside from the fact we were in a hospital room, it felt really normal, and I got a glimpse of what it might be like on a random afternoon at home with my boys.

This evening they moved us to the pediatric wing, which we have been told is a springboard for going home. The room is nicer and bigger, and is meant for rooming in (we get an actual bed instead of a daybed/cot), as they like parents doing more and nurses less as we get closer to discharge.

He lost half an ounce at his weigh-in tonight, which is a bummer, but not surprising. Over the past two days he’s gone from having most of his food delivered straight to his belly to having to work for every meal. Hoping he keeps getting stronger and more efficient at eating, so we can finally go HOME. Tomorrow we’ll have been here 11 weeks.

Theo helping the nurse move little brother down the hall
Baby Emmett, breastfeeding, NICU

NICU day 75

Keeping up with the Hoffmans

Today Emmett is 37 weeks adjusted, which means he’s officially a full-term baby now. He did pretty well with his bottles last night and today, and this evening he nursed a full feed. He’s averaging about 60 percent of his daily volume orally, and we need to get to 80 percent before the feeding tube comes out and we start the clock for his release. I was able to clarify the other criteria – five days without a major event – and confirmed it started at last event … which was five days ago (!!!), so we are good to go on that front, as long as he continues to behave.

Today was jam packed at work trying to wrap up as much as I can and organizing all of my projects so I can hand them off. It’s hard because I feel like I’m still catching up after being gone those six weeks after E was born, so I’m feeling a little bit panicked about getting everything squared away for a second leave!

I also gave notice at daycare that we will be pulling T while I’m home on leave. We had debated whether to keep him in or not, and I was initially leaning toward keeping him in at least part time. But daycares are germ factories and we will be playing things a little cautious for a while, so we’ll just keep him home. I’m anticipating extreme exhaustion in my future, staying home with a toddler and an infant. Going back to work may very well feel like a vacation!

They removed E’s nasal cannula today around 11:30 a.m. We’ve done this twice before and both times he’s made it about 12 hours before he gets tired of breathing and needs support again. It’s almost 11:30 p.m. now and he’s still doing well. His weight was good too (he’s up to 6 lbs 8.5 oz), which is a good indicator he isn’t having to work too hard. I like seeing more of his face, and with any luck the feeding tube will be next to go!