Friday, December 31, 2010

Ringing in the New Year

With a little Wii fishing....


Day 47, Thursday, December 30

Two steps forward, one step back. They said it could happen but it is really frustrating. I was so hopeful yesterday that we were getting out of here this weekend but after today, that’s not happening.


I started freaking out about all the stuff we need to get done before Tate gets home so I recruited the troops and they were all at my house today with a whole list of things to do. I still have to get to the store though and pick out bottles, nipples and pacifiers. I’ll need to get the calorie supplement and his vitamins too but I am still waiting for the NP to tell me exactly which kinds to buy before I do that. Dr. Samson came by again and said we won’t make New Years but a few days after. So we’re still close, just not as close as I was hoping.

I put Tate back to the breast today with disappointing results. Although his latch and suck is much better than it was last time we tried to breastfeed, he still only took 4 mls. So we still have a lot of work to do on the breastfeeding. The nurse today told me I probably don’t want to be breastfeeding more than once a day until he gets off the calorie supplement. So it will be pretty slow going at first but that will give him plenty of time to figure it out and build us some stamina. Once he’s off the supplement and doing good with one breast feed then we can move up to a second one. She said that I should nurse him and then wait and see how long it was before he gets hungry again. When he gets hungry feed him a bottle, obviously, and use that as a measure as to how much milk he’s getting. When he can go a full 2-3 hours after nursing, then we can add the second one. She also reminded me that I can come to the lactation clinic here as often as I want and they’ll weigh him before and after to see how much he’s getting.

The good news was that although we spent 30 minutes nursing and I was worried he would be too tired for a bottle, Tate took his whole bottle in less than 10 minutes. I was really happy to see that since he doesn’t have his tube in anymore. I don’t want them to have to put it back in. But what I want and what Tate needs turned out to be two different things.

I was surprised he did so good with his noon bottle after nursing but I guess it didn’t hit him till later cause the 3:00 feeding was probably our worst one ever (for me and him anyways). He was really tired and wasn’t really awake. I was thinking we probably shouldn’t do it but really didn’t want to see them put his tube back in so I tried it anyway. I knew better and I’ve been kicking myself ever since. He was barely awake and ended up choking several times. The third time he choked was really bad. His heart rate dropped, he d-sated down to about 50% and was turning blue. I called the nurse over and she took him and held him till he got his pulse ox back up. She didn’t do anything special to him, just held him tight while he recovered. She got him to take the bottle again and gave him back to me but that was it for me. I was in tears and couldn’t have kept feeding him even if he had wanted to. But he was still asleep. So I gave up.

The disappointment with the failed nursing session, the tension of feeding him, the scare of him choking like that, plus the guilt cause I knew in the first place we should have just tubed that feeding - it took me quite a bit to get it back together. The nurse and NP kept checking on me and telling me it was okay. The NP did change Tate’s orders so that he has to eat a minimum amount every 4 hours, not necessarily his full bottle every 3 to see if that would be better for him.

He never took the rest of his 3 pm bottle but he took his full bottle plus some extra at 6 pm for the nurse. Then Jamie fed him at nine and midnight and he was still too tired and stressed so he never took a full bottle. He also had a bad choking episode for Jamie. So finally the nurse said it was time to put his tube back in and let him rest. That’s what I had been hoping for after he didn’t take the full 9:00 feeding. I am hoping they gavage him for both the 3 am and the 6 am feedings before they try a bottle again. He is so wiped out and stressed from us trying to stick a bottle down his throat. My poor baby.

It is SO frustrating to not be able to feed my son a bottle. It should be so easy and it’s not. It’s scary and hard – for both of us. I am glad though that we tried the breastfeeding again before we got home. It would not have been good to have this happen at home. So now we know what’s too much for him. At this point, I am ready to stop the breastfeeding again for two more weeks and try again when he’s bigger and has more energy to burn so I am going to talk to the nurse tomorrow and get her take on it. Surprisingly, he did gain 12 grams today so it wasn’t a loss like I was expecting after the hard day he had.

Day 46, Wednesday, December 29

I am one happy mama today! When I came at noon to feed him his bottle he gobbled it down in less than 10 minutes. And that was his fifth bottle in a row!


To trump yesterday’s nurse telling me to bring his car seat in, today’s nurse had a table full of brochures for me, a video they make you watch before you can take baby home, a can of the fortifier we add to his milk and she sat down and talked to me about going home and what to do when we get there. I have been dreaming of this day and we are now so close!

The NP came by as he was finishing his noon bottle and since he did so well with it she raised his orders from 4-6 a day to 6-8 bottles a day. Last step! Speech said it would be a few days of 6 full bottles before they raised it but she wasn’t able to come today so I guess they made the decision without her. I am sure part of it has to do with how hard our insurance is pushing at this point to get him out of here… He now has to do 2 days in a row of 8 bottles and he’ll be able to go home (assuming he doesn’t lose weight either). It’s even possible that the second day of 8 could coincide with our rooming in. So we are talking a matter of a few days now assuming Tate cooperates with our plan!

I still have so much to do at home to get ready! Most important, I need to get bottles, nipples and a bassinet. Blankets and clothes are washed (although he still won’t fit in most of his clothes). I have to pick out a “coming home” outfit. Get some pacifiers. Figure out what to do with my breast pump. (It hasn’t been working very well so I rented one from the hospital but I have to return it the day he comes home. Otherwise they’ll charge it to my credit card. I’d love to keep it –but it’s a $2000 pump!) Tate’s room is nowhere near ready but it will be awhile before he’s sleeping in there anyways so that’s not a big rush. I’ll be home all the time now so I will be able to get some stuff done around the house…. But whether I’ll have time to do anything…we’ll see.

Tate took 45 mls for me at his 3 pm feeding. Still great but they just raised him from 46 to 48 mls at this feed so not a full bottle. But really good considering that was his 6th bottle in a row! I went to pump shortly after feeding him and when I came back the nurse said he had been fussing a little so she gave him the bottle and he took the last few mls. So that was 6 bottles in a row!

Tate is always waking up about 20 minutes before his assessment time and starting to fuss now. So he must be getting hungrier faster and is realizing it and letting us know. They said that will happen as he gets closer to full term. He’s 37.5 weeks gestation right now so he is considered “full term” even though 40 weeks is a complete gestation period.

I had lots of questions about getting him home so the NP came over to answer them this afternoon. My biggest question is how and when I should start working on breastfeeding with him again. She said now! So tomorrow I will put him to breast for one of his feedings and we’ll see how he does. We’ll give him 15 minutes and then weigh him and see what he took, then try to get him to take the rest from the bottle. She said at home to just start once a day with him and then always offer him a bottle after to make sure he gets enough. I’d prefer to have a scale so I can see what he’s actually getting so I am going to look into getting one. Then as he starts taking more and more I can increase the number of breastfeedings and decrease his bottles.

He still has to have bottles for awhile because we are going to still supplement with 24 calorie fortifier at home. They want us to supplement until he reaches 8 pounds. Here they are using human milk fortifier to supplement with but I can’t purchase that so we’ll have to use a formula brand supplement. Not real excited about having to use formula but if it’s what we have to do…at least it’s going in my breastmilk. It’s actually 22 calorie supplement but since it’s designed to go in water (to make formula) and I’ll be adding it to my breastmilk instead, it will actually be a 24 calorie supplement.

They, of course, told me not to take him out in places where there are big crowds until after cold/flu season is over. So no shopping, church or places like that till May probably. They also told me that we should still limit his holding as much as we can because he needs to grow. Babies grow the most when they are in deep REM sleep and he can’t get into REM when he is being passed from person to person or picked up and moved around. So she said to try to keep as much to the restrictions they had here about holding him as we can. I told her there’s no way I won’t be holding him more than what they let me here, but I’ll definitely be careful about it. She said if I’m laying down watching a movie I can hold him. But I can’t be talking to Jamie at the same time cause that will keep him from REM.

As we were talking she showed me his growth chart. The growth chart charts three different “percentages” – the ‘big’ kids, the ‘average’ kids and the ‘small kids’. We want Tate to at least be in the same percentile with the ‘average’ kids but so far he has always been below the ‘small’ kids. His line on the growth chart just intersected with the “small’ kids line this week so he’s finally catching up and we don’t want to hinder that. So we’ll have to be pretty strict still for awhile about visitors and holding so that he’ll stay healthy and keep gaining weight. She did mention that Tate didn’t have a big drop in weight at the beginning of his life like they usually see and she said that must be because I have “pretty good breastmilk”. As in nutrient rich. She said to keep up with all my prenatals and other vitamins and he should do fine. We also have to keep giving him a daily multi vitamin with iron once he comes home to keep his iron levels up (so he won’t become anemic.)

I talked with our new pediatrician – his nurse actually – and they will do his circumcision at his office and it’s their standard practice to wait at least two weeks (from when he gets out of the NICU) to do it. All I have to do is call and make his first appointment once we know when he’s coming home.

We did have once piece of possible bad news today. Tate failed his hearing test in his right ear. He passed both tests in the left but failed one of the tests in his right ear. At this point they said it’s nothing to be too concerned about because sometimes babies have fluid in their ears that makes them fail the test (Hudson failed his the first time they did them in the hospital) and because he’s a preemie his ears are very tiny so that could play a factor too. He is scheduled for a follow up test in one month so we’ll have that done and then go from there.

The nurse fed Tate his full bottle at his 6 pm feeding and Jamie fed him at both 9 pm and midnight and he took them both! The night nurses were debating on when he’ll be going home and when Jamie left our nurse told him good-bye cause they don’t think we’ll be here next week when she comes back to work! He only gained 11 grams today so it’s obvious that he’s burning a lot of extra calories and working really hard on taking his bottles. It will get better as he gets more used to the bottles but we’ll definitely have to be very careful in the next few weeks to make sure he is gaining properly. I think for my peace of mind I am going to have to get a scale for the house…

At midnight Tate decided to show them that he is really serious about this bottle thing so he went ahead and pulled his feeding tube out. Since he’s doing so good with his bottles the nurse decided not to put it back in! So hopefully it will stay out permanently. Since he did so good today with all his bottles, and because the nurses tonight seem to think we won’t be here next week, I am thinking it might be possible that we will room in this weekend! Maybe even Friday night. It will all depend on how he does tomorrow with his bottles.

Let me out of here!



Wednesday, December 29, 2010

Day 45, Tuesday, December 28

Tate is 6 weeks old today and since he always wants to celebrate somehow, today he took 6 full bottles!

I had my 6 week follow up at the doctor this morning. I have lost another 3.5 pounds. I had a bet going with Jamie that I had gained 5 pounds with all the junk food I’ve been eating so I guess I lost that one. When the doctor came in he asked me “Where’s junior?” I think the confused look on my face made him remember who I was and where “junior’s” at and then he felt bad for asking…

When I got here today the nurse asked me if I had a car seat and said we could bring it in any day. I have been so waiting for them to tell me that because it means we are getting close. She said at this point Tate could put it all together and be up to 8 full bottles in a few days or it could still take another week or two. So she said it was no hurry to bring it in but we could if we wanted to. They won’t do the car seat test till he’s still a little closer to going home. So I’ll probably bring it up in the next few days. She did tell me the brand we have is normally a good one for preemies so hopefully it passes inspection (the straps have to meet certain measurements since he’s smaller than the average baby). Some babies have to actually go home in car beds if they don’t have good body support so to determine if he’s ok for the car seat he has to be able to sit in the car seat for a full hour and half without having any issues (dsats, bradys, apnea). Every baby in the NICU has to pass this test before they can go home.

She also asked if we wanted to have him circumcised here or if our pediatrician would do it. Which brings us to the fact that we have a pediatrician picked out that we think we want to use (I feel more comfortable taking him to a pediatrician for at least the first year over our family doctor just because he is a preemie.) but I haven’t called yet to see if they will take him. She said I should go ahead and get all that lined up and find out about the circumcision. If the doctor does them in his office then we can have it done there but if he won’t do it there then we’d need to get it done here by one of the neonatologists. I think I’d prefer to wait till he is bigger before we have it done so I need to call the doctor and make sure he will do it in his office. First I have to make sure he’ll accept Tate as a patient. But I’m really excited that we are starting to talk about going home stuff….yeah!

Tate will have to go to the pediatrician one week after he gets out of the NICU for a follow up and then it’s up to the pediatrician from there. She said it’s possible they will send home health out to weigh and assess him at first, or we might just have to bring him in to the doctor more often. It will depend on the doctor. Once he gets to 8 pounds we won’t have to worry so much and shouldn’t have to take to the doctor so often, but 8 pounds is kind of the goal to reach to get the all clear of any “preemie” feeding/weight gain issues. 
I am wondering how that will work going home – I know we will want to just hold him constantly but I have a feeling they are going to tell us to try and keep the same routine he has here- which means only holding during feedings and for a few hours total each day so that he doesn’t burn too many calories and keeps gaining weight.

I fed Tate his bottle at noon. I felt really good with this feed. I was reading his cues well and could tell when he was breathing and not. He even started breathing some without prompting the last half of the feed. He did choke once and speech explained it is actually better to leave the bottle in his mouth when he chokes even though my instinct is to pull it out. That’s because if I pull it out he tries to breathe before he’s recovered from the choking versus recovering from the choking before he tries to take another breath. I did that this time and he did recover quicker.

Plus Angela (speech therapist) said I was doing a really good job pacing him and wasn’t pacing him too much. She said to ignore the nurses if they tell us we are pacing too much because based on what she saw, I am doing exactly what Tate needs. That made both of us feel much better because we do feel like the nurses just shove the bottle in his mouth and get him to take the whole thing much quicker. And they tell us they didn’t pace as much as we are but I feel much better taking our time. He did one of his feeds last night in 6 minutes. Like Angela explained, it’s not a race to see who can get him to drink his bottle the quickest; we are trying to do what Tate needs to feel comfortable taking his bottle so that we can do it more and more. So it’s frustrating that we can’t do every feed but if we want to do every feed I would have to start staying overnight to do so. I guess if it’s something we start to feel really strongly about (the way the nurses are feeding him) than that’s something we might have to consider doing.

After his 3 pm feeding I declared that we now officially “get it.” Tate did GREAT at 3. I really feel like I have this figured out now too. He didn’t choke and finished in less than 10 minutes. He was very sleepy towards the end but he pushed through and finished it off. He cuddled with me till 4:45…I wanted to do longer (like always) but since he lost weight yesterday I put him back. Evidently I didn’t need to be worried about his weight gain (or it helped that I put him back) because he gained 118 grams today. Almost 4 ounces. That’s his biggest weight gain ever. He now weighs 5 pounds, 10.3 ounces and is 16 ¾ inches long.

At 9 Tate was so tired he didn’t even wake up for his assessment and diaper change so he tube fed. I was worried he would be too tired at midnight but he woke up and gobbled the whole thing down in less than 10 minutes for Jamie. He then also took full bottles at 3 am and 6 am so that made 6 full bottles for the day (They count from his 9 am feeding through his 6 am feeding for a full day, not midnight to midnight.). Speech told us he would need to do 6 full bottles for a few days before they raised his orders from 4-6 bottles a day to 6-8 a day – the final step! At this point we are estimating we’ll be out of here mid week next week, assuming Tate cooperates with our plan from here on out!

11/21 - 6 days old

 
11/27 - 12 days old

12/4 - 19 days old


12/28 - 43 days old





Tuesday, December 28, 2010

Day 44, Monday, December 27

Speech came again today (Angela hadn’t seen him since last Wednesday.) and decided Tate was ready to move up to medium flow nipple instead of the slow flow. I was telling her about the problem I have been having when I feel like he’s doing good but then he hasn’t drank anything so she checked and said he was collapsing the nipple, which is why he wasn’t getting anything out. She compared it to when we drink a thick milkshake and have to suck really hard on the straw. I mentioned I was the only one having that problem though and she said that could mean I was giving him better cheek/chin support than the others. Hence he was sucking better and harder for me than the others and that’s why he was collapsing the nipple. I’ll go with that because it makes me look better!


Speech let me start feeding him but then we switched to the medium flow nipple right away. I started giving it to him but he choked so she took him and did the rest of his feeding. That was okay by me cause it freaks me out when he chokes. I was already nervous just feeding him and then really nervous when she switched to medium flow. He took the whole bottle for her with no problems and didn’t even stop to burp.

I was really nervous to do his 3 pm feeding but we did it. He choked at the beginning but after that he gobbled it up in less than 10 minutes. The nurse said to make sure to only fill bottle ¼ full at beginning because if he’s really hungry he’ll start sucking really hard and fast and then the milk overwhelms him. This was the first feeding that I felt like I did really well with. The others I haven’t felt as good about but this one I felt like Tate and I worked well together.

I tried to nurse/kangaroo him after his 3 o’clock feeding but all he wanted to do was suck. I didn’t want to wear him out too much so I tried to make him stop but he just kept rooting. His leads for his monitors were loose too so they kept going off so I finally decided to lay him back down. I got his leads back on and him all swaddled and he still wanted to suck! Gave him his paci and he was still awake when I left at 5:15. Those are all good signs that it’s all starting to click with him.

Day 43, Sunday, December 26

Jamie and I slept in till 9:45 this morning. Wow. That felt like so much sleep! I needed to get up at 9 to pump but I knew if I got up I wouldn’t be able to go back to sleep so I let it go a little longer than usual. We had a busy day today because Jamie’s brother and his family got here from Florida and Jamie’s parents came into town.


Before everyone got here Jamie and I went up and I fed Tate his noon bottle and he took the whole thing for me. Had a few episodes where he gagged and took a little bit for him to take a big breath again. He was breathing the whole time (since his monitor never went off I know he’s actually breathing even if it doesn’t look like it) but he hadn’t done what they call “catch up breathing” when he takes a couple big breaths through his mouth and pants a little. I don’t like waiting for that as his face turns red or purple and his eyes start to water. That is why the pacing is so important. If he gets behind it’s scary to wait for him to catch up. After we got over that he did really well and finished the whole bottle for me.

While Jamie was introducing Tate to his Uncle Jeremy they changed his orders to 4-6 bottles a day so Jeremy got to watch Tate have another bottle. Jamie is more confident in the bottle feeding than I am. I still don’t feel comfortable having someone watch because I get too distracted and then he chokes or isn’t breathing. So it will probably be awhile before I invite anyone to come in while I’m feeding.

He took his full bottle for Jamie at 3 pm and then tube fed at 6 pm. Jamie and I came back up and fed him at 9 pm but Tate was totally worn out. I got him to take about half of it before he totally conked out. He was holding his lips shut because he didn’t want anymore.

We’ve definitely noticed that Tate is starting to act more and more like a baby. He rarely cried or even fussed before but the last day or two he’s starting to wake up 20 minutes before feeding time and squirm around. He’s also been crying when we change his diapers and have his clothes off. He’s also starting to root around a lot more. He weighs 5 pounds, 6.5 ounces today.

Jamie’s mom came up to see Tate for a little while tonight too. She thinks Tate looks like Jamie did when he was a baby. We still think he looks like Hudson did – and Hudson looks just like I did when I was young, so we’ll see as Tate fills out more who he really looks like.

Jamie stayed and gave Tate a bath at midnight and tried to feed him another bottle but he was still too tired. He wouldn’t open his mouth at all this time. But overall, Tate took 52% of his feeds by bottle today.  So halfway.  Just got to keep going up, up, up!

Monday, December 27, 2010

Day 42, Saturday, December 25, Christmas Day

After opening presents at home with Hudson we went to my parents for Christmas breakfast and, of course, more presents. Santa brought Hudson a tabletop pool table that is just his size and he absolutely LOVES it. We had to open the rest of his presents we bought him because he just wanted to play with it. He had to take it with him to Papa and Gigi’s and I think we maybe got him to open one or two presents there. All he wanted to do was play pool. “Do you want to play pool with me?” was pretty much the only thing he said all day. He got way too many presents (and we haven’t even had Christmas with Jamie’s family yet!) and I think I might just return everything I bought him. He won’t ever notice since he didn’t open any of them anyways!


Christmas was a sad day at the NICU. Baby Devon passed away this afternoon. He was the 4.5 month old baby that was right next to Tate. The one they had to put on a vent last night. I know he had a lot of medical problems and had about 4-6 weeks before he was going to be able to go home. They had started having volunteers come in to stimulate him during the day because he is up all night and sleeps all day. Last week he started having high blood pressure problems but that’s just what I know from hearing the nurses talk about him. So I don’t know what happened to make him go on the vent last night or why he died today. My sister came up to visit and as I was changing Tate’s diaper Devon must have started crashing. His mom was sitting with him (which is unusual for her to be here so the hospital must have called her)and she started crying really loud. Then they made her scoot back from the bed and closed the drapes around his bed. I could hear that they had bagged him because I could hear them squeezing the bag and then a nurse came around and asked up to step out of the NICU for awhile. Then I knew it was really bad. It states in the NICU rules that they might ask us to step out but that hasn’t ever happened before – and we’ve seen them do quite a few different procedures on different babies.

I left in such a rush I didn’t bring our stuff with us. So we couldn’t leave since we didn’t have the car keys and we couldn’t go down to the cafeteria to get something to eat because we didn’t have any money. So we waited and after about 45 minutes they let us back in. There was an eerie silence the rest of the time we were there. There were a lot of extra nurses there and they were already getting Devon’s place ready for the next baby but no one was talking. It was awkward being in there but we had only been there for 30 minutes before that happened so we didn’t want to leave Tate yet. But we missed his 3 pm feeding since we were outside but the nurse gave him his bottle and he took the full thing. We left after about an hour hoping that it would be different when we got back for the night shift. I figured once the new nurses came on it wouldn’t be as awkward to be there. That’s got to be pretty hard on the nursing staff though. They have spent the last 4.5 months taking care of that little baby and then to all of the sudden have his body fail is pretty sad. Maybe they’re used to it although I don’t know how you can get used to something like that. I cried a little when I came back in and was standing at Tate’s bed watching him sleep. It’s so scary to think what could happen and it’s just another reminder to be grateful that Tate is so healthy.

Tate didn’t take much of his bottle for us when we came back up for his 9 pm feeding. We decided that wasn’t too surprising considering all the activity in the NICU earlier in the day. He was worn out from everything going on around him. I let him nurse while he was getting his tube feeding and he did really good latching on and nursing. I even felt a let down 2 different times. He definitely looked like he was swallowing and actually getting milk. Technically I am not supposed to be giving him milk when we “nurse” but I had pumped an hour before so I didn’t think I would have a let down. I let him suck for 5-10 minutes and then made him stop (even though I didn’t want to!). At midnight when the nurse checked his residuals he had 10 ml. Very unusual for him. They can have 1/3 of their last feeding as residual without it being cause for concern but since Tate usually never has any the nurses were concerned. They were talking about what side he had been laying on and debating what could have caused it when it dawned on me: if he had taken a lot of extra milk when he was nursing then he had more in his stomach to digest, which would explain why he had so much residual. I told the nurses this and they agreed that was probably the cause of it. I don’t think they were upset with me about it happening but I didn’t care either way. I was so excited to realize he actually got a lot of milk while he was nursing. I don’t have any idea how much it was but it must have been at least 10 mls since that was what he still had in his stomach. Even if it was just 10 mls that’s the most he’s ever taken nursing – and I like to think it was even more than that!






Sunday, December 26, 2010

Day 41, Friday, December 24

I had planned on making some Christmas treats for the nurses this morning but those plans quickly changed when Hudson woke up and told me his tummy hurt. He said he still wanted to eat breakfast so I gave him an English muffin and halfway through he threw up all over himself. Great. The flu. Just what we need. On Christmas. So instead of having him help me make some snacks for the nurses (and then exposing all of them to our germs and thereby Tate) we spent the morning just hanging out. I had been in the process of making him an egg for breakfast when he got sick. He begged to eat the egg all morning and I wouldn’t let him. He didn’t have a fever. I finally let him eat some lunch and he devoured it and was fine the rest of the day. So we aren’t real sure what that was about except that he did eat five pieces of baked ham at dinner the night before so maybe that was what upset his tummy.

Since he was not running a fever and was fine the rest of the day we decided to go ahead and go to my family’s Christmas get together Friday night. I was looking forward to it because it was a break in our routine so I was glad we got to go. I wasn’t real sure what Hudson would do with the presents. I thought once we started opening he would be really into it and want to open everyone’s gifts but he was not at all interested in opening presents. Especially not after he got a gator golf game - that was the end of what little participation we had from him. About 9 pm as we were packing up to leave I asked him if his tummy hurt. He said, “No, can I have my eggs now?”

Since I was still the only one that hadn’t gotten Tate to take a full bottle I was determined that today was the day. For my Christmas present Tate was going to drink his full bottle. I prayed all the way to the hospital that this would be the time. We started out a little slow but then it clicked and he took the whole thing. I know I still paced him too much (the nurse said she didn’t pace him near as much this morning as I was doing) and it took us a lot longer than it does the nurses but we did it. We got down to the last 5 ml and Tate was getting really tired so I started begging him for Christmas for mommy to please finish his bottle. He took a few more big swallows and it was gone! Merry Christmas Mommy! I had decided for my other Christmas present that I was going to kangaroo him for as long as I wanted to today. I guess the nurses thought it would be a nice Christmas present for me as well because they let me. After about an hour she stepped in and checked on us but didn’t make me put him back. So I held him till 5:30 and then I had to go pump and head out to my grandma’s for Christmas dinner.

But on top of all that, the doctor gave me a Christmas present too today. He stopped by and said he was impressed at how much Tate had improved in the last few days. Then he said that Tate didn’t make it home for Christmas but maybe he’ll be home in time for New Year’s!

I guess I wore Tate out working on my Christmas present cause he only took about 30 mls for Jamie at his 9 pm feeding. But it was also pretty busy and loud in the NICU tonight because the new baby next to Tate needed more care and the doctors and nurses were working on him (He swallowed meconium at birth and they have him on a ventilator and are clearing his lungs out.) and then the baby on the other side of Tate had to be put back on the ventilator. He is 4.5 months old and still has 4-6 weeks before he can go home. So there was a lot going on and we have definitely noticed that the louder and busier it is in the NICU the more worn out Tate is – even though he just sleeps through it all!

Saturday, December 25, 2010

Day 40, Thursday, December 23

I spend every afternoon up at the hospital with Tate. Which means I don’t ever spend the afternoon (or usually half the morning as well) at home. I would love to have a day that I can just stay home all day. I could get so much stuff done. Work on Tate’s room, catch up on laundry, organize the office, wrap Christmas presents, finish some sewing projects…maybe even cook a meal for my family. But I can’t stand the thought of not seeing Tate for a whole day. So I keep going…however, we did switch up our schedule today which allowed me to spend the entire afternoon at home. All I got accomplished was taking a nap with Hudson which was time well spent. :)

I went up at 9 this morning to meet a new speech therapist. Because the NICU is closed from 7-9 am from rounds they didn’t let me in till 9:15. The speech therapist waited for me and let me feed him while she observed and gave me some pointers. Again the first few minutes I thought he was doing good but when I checked the bottle he had only drank 1 ml. I am definitely doing something wrong for him because no one else is having that problem with him. After the first 15 minutes the speech therapist took him and got him to finish the bottle. She said she had to push him really hard to finish it but she thought if we could have started right at 9 am when he was more alert we would have had an easier time getting him to finish it.

Since I stayed home this afternoon Jamie went up to feed Tate his bottle at 3 pm. Tate took the entire bottle (42 mls) in 10 minutes. And the nurse said he probably paced him too much because Tate was doing a good job on his own with his breathing. They increased his bottlefeeds to 4 times a day already. Halfway there! We still can’t do back to back feedings so that he doesn’t get too tired so we are doing every other one. That means he’s eating at 3 am and 9 am and 3 pm and 9 pm. Jamie and I are able to do the 3 pm and 9 pm feedings but so far we have let the nurses do the other two. We want to be here for every one but the 3 am is not very feasible (so we at least get a little sleep) and the 9 am doesn’t work well since they are usually running late with rounds and they won’t let us in right at 9.

Tate had his picture taken with Santa Claus today. I’ll post the pictures once I get a digital copy of them. They posted the signup for the pictures about two weeks ago – and me, being superstitious, didn’t sign him up in the hopes that if I didn’t sign him up he would be home by now. But as it drew nearer I realized we’d still be here so a few days ago I put his name on the list.

I went up for the 9 pm feeding. This was a big test for me since I was the only one who hadn’t got him to take a bottle yet. The first ten minutes he looked like he was doing good but then still only took a few mls. Nurse took him and got him started and we decided I wasn’t actually putting enough milk in the nipple. So I took him back and put more in and he finished all but 5 ml. (He’s at 42 mls now.). He probably could have done the whole thing if we hadn’t wasted the first ten minutes doing it wrong.

The nurse thought I probably paced him too much because he was doing a really good job with his suck, swallow and breathe. But it’s hard to not stop him and make sure he’s breathing…so I have to get better about watching for his breathing and his cues instead of stopping him every 4-5 sucks. She last saw him Sunday night and said he was like a whole different baby with how well he’s doing on the bottle today!

Friday, December 24, 2010

Merry Christmas! (Our family Christmas letter)

Allow me to introduce myself to those of you – which is most everyone so far – that I haven’t got to meet. I’m Tate Christian Stinemetz. I was born Tuesday, November 16th and weighed 2 pounds, 13 ounces and was 15 inches long. We’ll get to more about me later but first let me update you on everything going on in my family this past year.


There might have been a few things to note in the first part of the year – but it really all starts in April, which is when Mommy and Daddy found out about the exciting news of my upcoming arrival. They decided to keep it a secret till after Hudson’s 2nd birthday – and what a birthday it was. Hudson had a basketball birthday party including a basketball cake and cupcakes and a basketball piñata. It was a lot of fun even if no one knew I was there! Hudson continues to amaze everyone with his vocabulary and speech. Most people can’t believe he’s only two years old when they hear him talk. He also has a great memory and is turning into a funny, rambunctious two year old. He’s very into wrestling these days and I can’t wait to get big enough to jump in there with him and stir up some trouble. He is very excited about being a BIG brother.

After a few weeks they finally started telling people about me. Everyone was convinced I was a girl but I proved them all wrong. Daddy and Hudson were the only ones who thought I was a boy – even Mommy thought I was going to be a girl because she felt a lot better this pregnancy than she did with Hudson. (That’s just because I’m such a good boy - sometimes!)

We had a busy summer. Mommy and Daddy celebrated their 10th wedding anniversary and then Mommy celebrated the BIG 30. Daddy threw her a surprise party and did a good job pulling it off – she was totally surprised. Daddy also celebrated two years of being a small business owner. He likes being his own boss and having the flexibility of setting his own hours. It came in pretty handy when I decided to come into the world a little earlier than expected. In addition to all that, Mommy and Daddy decided to potty train Hudson before I came along so they spent all summer asking Hudson “Do you need to go potty?” I think we all got sick of that phrase but I guess Hudson did really good cause by the end of the summer he was fully potty trained and now he doesn’t even wear a diaper at night. Mommy says that means he’s a big boy and to celebrate Daddy built him a big boy bed. I thought it was about time. I was getting worried as to where I was going to sleep when I got here, but Daddy worked hard and got it built, sanded, painted and set up in Hudson’s room- just a few days before I was born.

The rest of the summer was spent hitting homeruns, driving golf balls in the front yard, scoring soccer goals, shooting free throws, pitching fast balls, punting footballs and doing cannonballs into the pool. Hudson was having so much fun and I was just stuck inside Mommy’s tummy. It wasn’t fair to hear them laughing and playing and not get to join in the fun.

One day I was practicing some of my soccer kicks (can’t let Hudson get too far ahead of me!) and I got myself in a bad position in Mommy’s tummy. Mommy said it’s called breech. She wasn’t too happy about it. She tried all sorts of silly stuff to try and get me to move (like hanging upside down on the ironing board as it was resting against the couch, putting headphones on her tummy to make me move towards the music and even icepacks on my head to try and make me move) but I was stuck in there good. Believe me, if I could have moved, I would have. It wasn’t very comfortable for me or Mommy.

I missed out on all that fun during the summer and then everyone started talking about Thanksgiving and Christmas coming up - all that turkey and mashed potatoes and all the lights and presents. I decided I didn’t want to miss out on anymore of the fun! But let me tell you. So far, it’s been BORING.

I broke Mommy’s water (I was just practicing my punt returns and accidentally kicked the wrong button.) on Saturday night but I guess it wasn’t actually time for me to come out yet. They put her in the hospital and gave her medicine to try and keep me in as long as possible, but three days later I arrived (via a cesarean since I was breech). Thankfully they had time to give Mommy two shots of steroids to help my lungs develop. I came out crying and although I was a little small for my gestational age – little guys are tough! – I haven’t had to have any oxygen or respiratory support which is pretty amazing for a 31 week preemie. Mommy calls me her “little miracle.” Since I was nine weeks early I have to live in this place called the NICU. They won’t let me go home and I haven’t even got to meet Hudson yet. All I’m allowed to do is lie in my bed and sleep so that I can grow bigger and bigger. I’m five weeks old and weigh five pounds now!

At first Mommy and Daddy could only hold me for 30 minutes, 2 times a day. Now they can hold me more than that but not usually more than an hour at a time, 2-3 times a day. I love to snuggle with Mommy but my favorite time of the day is at night when my Daddy comes to see me. Mommy says I’m a Daddy’s boy because I always open my eyes when I hear his voice. Lately they have been waking me up from my naps and sticking all sorts of things in my mouth. Mommy says I’m supposed to eat that way. I didn’t really like it at first until Mommy told me they would take this tube out of my nose once I figured it out, so I’m working on it. I hate this tube in my nose. I keep pulling it out but then those nurses just stick it right back in. The doctors said I can go home once I take all 8 of my feedings from the bottle. I really want to get home to play some basketball with Hudson. He promised to teach me how to shoot a three pointer.

We’ll be celebrating Christmas and New Year’s here in the NICU but I should be able to go home a week or two after that. (They say by my original due date – January 15th.) Mommy, Daddy and Hudson are all really excited for me to come home so we can be a family. But in the meantime, Mommy and Daddy say they are just grateful for God’s blessings (That’s me!) and everyone’s love, prayers and support while I’m here. We are looking forward to a happy and exciting new year and wish you all a very Merry Christmas and a happy 2011!

Love,

Tate


Day 39, Wednesday, December 22

Jamie wanted to watch speech therapy feed Tate too so Hudson spent the night with my mom so that we could get up and go to Tate’s 9 am feeding. Their plan is for speech to feed him once every day, Monday thru Friday, but the time will vary every day. We arranged with her to be there at 9 am. We went up together last night and actually left early (around 11 pm) so that we could get a little more sleep since we had to be up early to be there at 9 am.

We were eating breakfast and getting ready to leave at 8:15 when Tate’s nurse called to tell us that speech couldn’t come at 9 am and would be there at noon instead. Ugh. We could have slept in and got a little extra sleep. But at least they let us know before we drove all the way over there. So instead we used the time to work on one of my many project for Tate’s room. We didn’t get too far with it since we had to go to Lowe’s to buy some materials, but at least we now have what we need so maybe we’ll get to it soon. Problem is it has gotten so cold here lately and all the tools we need are in the garage. Neither of us really want to work on it in our spare time (what little of it there is!).

So we went up at noon to meet speech and she fed Tate again and again he took the whole bottle from her! She did the same things she did yesterday and he drank it right down. She put a paper on Tate’s crib that explains the methods we should be using to feed Tate. The problem is all the nurses have their own methods they use and don’t really pay much attention to the directions she gave. She told us to really watch his tongue placement because he was probably keeping his tongue up and over the nipple (again to protect himself) which is why he’s not actually swallowing any milk those times I have fed him and he hasn’t taken much.

I hung around for the afternoon and kangarooed him at 3 pm. He wasn’t very interested in nursing today. The NP did give some new orders though today. She increased his feed to 42 ml and said it was okay to now do 3 bottle feeds a day but at the nurse’s discretion. So as long as she thinks he has rested well and is alert and ready to try a bottle. I asked her about spacing the feedings, since right now we have to do one every 12 hours and she said not to do them at back to back assessments but at least skip one in between.

Jamie went back up at 9 pm to try it again. He couldn’t even get Tate to take the bottle in his mouth. After 10 minutes of trying the nurse came by and said “let me try.” He proceeded to take the bottle, stick it right in Tate’s mouth (without really waiting for Tate to open for it) but Tate did then take about half the bottle from him. But the nurse never paced him, just let him take half without pulling the milk back out of the bottle or sitting him back up to let him breathe. But he said he was doing fine without pacing and that Tate was putting his tongue up over the nipple to stop the flow when he needed to breathe (which I don’t think we want him to do – sounds like a defense mechanism since we think that's why he didn't take his bottle from me yesterday). Then Jamie tried again and still wasn’t getting anywhere so the nurse took it again, stuck it in and finished off the bottle. So he ate the whole thing in a span of only 10 minutes when it’s always taken the full 30 minutes before. Jamie was pretty frustrated with this because he did everything against what the speech therapist had suggested. When he told me about it I said I wanted to just go back to breastfeeding because then I’m the only one who can do it. It’s very frustrating that each nurse has their own way of doing it and their own opinions about how to do it. We feel like speech knows what they are talking about and should follow their suggestions but then maybe it’s better for Tate to just take it however so that we can get his daily feedings increased. The more feedings we can do the more we can all practice.

Tate gained about 2 ounces today and is now….drum roll, please…..5 pounds, .8 ounces!

Day 38, Tuesday, December 21

Tate had his first session with speech therapy today to assess his bottle feeding. It went really well. I really liked the speech therapist. She explained everything she was doing and why she was doing it. Then after she assessed him she explained the things he was doing that we needed to work on or change. She started by having him suck on her finger so she could see how well he sucked. She said he had a good suck but he keeps his jaw really tight. That could be caused by one of two things: over- developed jaw muscles or because he’s afraid of what might happen and has learned to do that to protect himself. She said it’s easier to fix if it’s a fear reflex than over-developed muscles. After she fed him for a few minutes he relaxed his jaw so she said she was sure it was a fear reflex. He’s probably doing that because he was getting too quick of a milk flow (either from when he was nursing or from the bottle) and he learned to tighten his jaw to protect himself. She also showed another way to hold the bottle, his head, do the cheek push and support his chin. And she showed the sidelying position that we could use to hold him or even a way to hold him in my lap, if it seems to work better for him/me.

Tate did great for her and took the whole bottle! She even got him to burp a few times (She also showed me a few different techniques for burping besides just patting his back.) So that’s two bottles in a row that he has taken. And this one was with NO bradys! Preemies don’t have fat pads in their cheeks which makes it hard for them to hold their suck, hence the reason we have to do the finger hold on their cheeks. She said because they don’t have any molars you can’t hurt them by squeezing and when he’s done he should have creases in his cheeks from the squeezing.

I came away from the session realizing that there is so much more to it than just Tate learning how to do it. Jamie and I have a lot to learn as well. I’d say about 80% of it is all about the way Jamie and I are feeding him vs. just 20% Tate learning how. If we do it correctly, as the speech therapist demonstrated, he’ll do just fine. He’s still learning the suck, swallow, breathe and has to be “reminded” to breathe every 3-4 sucks but the rest of it’s all in how we are doing it. So we have some practicing and learning to do as well. But there’s so much to learn: hold his head, hold his back so you can feel him breathing, squeeze his cheeks, support his chin, get him to root, keep his tongue down, get him latched to the bottle, keep the nipple only half full, stimulate him to suck by moving the nipple across the roof of his mouth or across his tongue, let him suck 4-5 times then tilt him or the bottle up so the bottle empties and wait for him to breathe, watch his facial cues for breathing, listen for him breathing, don’t take the bottle out of his mouth or you have to start all over again….

I was so excited to practice what she showed me so I came up with Jamie for the 9 pm feeding. It didn’t go so well. Although I thought he was doing good after about 10 minutes he had only taken a few mls. I thought he had taken at least 20 by that point because he was sucking really good. Jamie tried then after I did but didn’t have much luck even getting him to take the bottle. It was a frustrating night. They were admitting a new baby in the bed next to Tate at the same time as Tate’s feeding and it was pretty loud, the lights were all on and a lot of doctors and nurses were around. Plus our nurse decided to sit right beside us and offer her advice and talk the entire time. I think it was too much stimulation for Tate. I know it bothers Jamie and I when it’s that loud and busy in there – and having them watch over your shoulder and critique like that makes it pretty stressful.

Tate had his first appointment with the optometrist today and his eyes checked out okay. Preemies can have some eye trouble caused by the high saturation of the oxygen they are on, but since Tate never had to be on oxygen it wasn’t a big concern. But it’s good to know everything looked fine. They had to dilate his eyes for the doctor and then after his exam his eyes were puffy and red so I think they put more stuff in them during the exam. Tate didn’t seem real bothered by that. I was disappointed I didn’t get to see them do the exam. I held him for awhile waiting for the doctor to come by (He was in the NICU examining several babies today.) but finally went to pump and when I came back 20 minutes later the exam was done. So I have a feeling he was waiting for me to leave to do the exam. I wanted to find out how much Tate can actually see at this point. I know full term babies can usually see about 12 inches and see red, black and white the best but I don’t know how much preemies can see. The nurse said it was probably not as much as a full term baby but didn’t know any more than that.

Evidently drinking those bottles is a lot of work because Tate only gained 1 gram today. So no 5 pounder yet.


This little dog showed up in his crib one day.  It's a pacifier holder.  I thought it was just to hold the pacifier so it didn't get lost in the crib till finally one day a nurse had actually done this with it and I realized what its intended use is! 
I hung up some pics of Tate's big brother Hudson in his crib.

Thursday, December 23, 2010

Day 37, Monday, December 20

Well, we might have made some progress today with the bottlefeeding. Tate had another new nurse today and she showed me yet another way to hold the bottle and feed him and this one is easier for me to do than the other way we were shown. The first way requires me to use my right hand to squeeze his cheek with my thumb, the other cheek with my pointer finger, my middle finger under his chin for support and then rest the bottle on top of my hand. That just doesn’t work for me because I have no control of the bottle – either my hands aren’t big enough or it just takes a lot more practice. So this new way allows me more control of the bottle because I use my thumb from my left hand to squeeze one cheek while using the other fingers to support his head and check for breathing (by feeling his back for when he actually takes a breath). Then I can use my right hand for squeezing the other cheek, chin support and holding the bottle. He still only took 10 ml for me though. He just isn’t real interested in latching on to the bottle. Our nurse today asked if anyone had talked to us about having speech therapy work with him. I’d forgotten about it but when we were talking about it last week they had suggested it for his finger feeding. So it hadn’t occurred to me to have them come evaluate his bottle feeding. She said bottle feeding is actually what they primarily work with the babies on. We set up an evaluation for Tate for tomorrow so we’ll see what they tell us.


But then Jamie fed him his second bottle at midnight (Now they are making us wait 12 hours in between feedings to make sure he’s getting enough rest in between. Before we just couldn't do them at back to back feedings.) and he took the whole thing! But he also brady’d twice while doing so. My worry over the brady’s overshadows my joy in him taking his whole bottle. I hate it when he has heart stuff or when he sets the monitors off.  It’s definitely great progress that he took all 40 ml but the brady’s mean he wasn’t breathing and got too overwhelmed. So now we need to take the whole thing without bradys and I’ll be much happier.

Tate weighs 4 pounds, 14.8 ounces today.  He has gained more than 2 pounds since he was born and could even hit 5 pounds by tomorrow if he has a big day. 

Hudson saw my c-section scar today.  He asked me what happened and I told him that was "where they cut my tummy to get Baby Tate out."  He looked at it again and said, "Did you hold still?"  :)

Tuesday, December 21, 2010

Bottlefeeding

Here's a video of Jamie feeding Tate his bottle. Trying to anyways. He was pretty tired and wasn't real interested.
(If you're viewing this from Facebook I think you have to go to my blog to see the video.) www.ourjumpingoffplace.blogspot.com

Day 36, Sunday, December 19

It was a frustrating day for me today. I was really hoping he would just take to the bottle and go, but, like everyone warned us, that’s just not happening. I guess I thought since he had started doing so well at latching and nursing that we were already ahead of the game. But I guess the bottlefeeding is a whole different ball game. I keep reminding myself that it took us a week and half to get to where we are now with the latching and nursing, so it will just take more time. But it’s hard to be patient.


He only took 10 ml at his noon feeding today. We did find out that the nurses yesterday were using a different nipple so I was very hopeful that would make all the difference today, but it didn’t. He didn’t gag like he was yesterday though. We should have been using a slow flow nipple and the one they gave us yesterday wasn’t. Hence the gagging because the milk was going in his mouth too fast. Tate fell asleep pretty quick and we couldn’t get him to wake back up or take the bottle anymore after that 10 ml. We tried burping him and undressing him but he was out. Guess maybe all that sucking he did at midnight did wear him out too much.

At 3 pm I kangarooed him but again, he was pretty tired, so he didn’t nurse for very long before going to sleep. Jamie fed him at 9 pm and he did get him to take 25 ml so that was actually a good feeding, but Jamie didn’t feel like it was because Tate almost brady’d once ( His heart rate dropped pretty low. We call it almost because it didn’t drop low enough to set off the monitor because he was able to recover before he actually had a bradychardia.) and it was a lot of work to get him to keep sucking. But it was 10-15 ml more than what he’s done the last few days, so that is progress.

Tate gained other 65 grams and now weighs 2177 grams or 4 pounds, 12.8 ounces. Getting real close to 5 pounds!

That’s really all I have for today. The nurses and doctors warned us that this is the longest, hardest part and we just have to be patient. So I’m trying. After every feeding I wonder if I should have done something different or pushed him harder to do more. But then I think – he’s a 4 week old preemie. You can’t push. So we wait. And wait, and wait and wait. At least, that’s how it’s felt the last few days.

Monday, December 20, 2010

Day 35, Saturday, December 18

Well, that wasn’t the “click”. Tate had a hard time with both of his bottle feedings today. He took 15 ml at 3 pm and only 9 ml at his 9 pm feeding. He gagged a lot and wasn’t really interested in trying. Jamie thought the nipple on the bottle was a different one than the one we had been using, so that could be part of the problem. We’ll have to check with his new nurse tomorrow. He did burp once for Jamie but so far I haven’t ever got him to burp.


The NP told me I could still do “dry nursing” with him so he can practice his latching and sucking so I did that with him after both feedings today. He did great! At 3 pm he latched right on and started nursing. I only let him nurse for about 5 minutes cause I was worried about wearing him out since he had just worked on taking a bottle. At midnight I kangarooed him again and since he hadn’t had a bottle at that feeding I wasn’t sure what he would do. He only wanted to suck! He has never been like that before and it was encouraging to see. I let him nurse for awhile then thought I shouldn’t wear him out so I switched him to just kangaroo. He would NOT quit rooting around and smacking his lips. So I let him nurse a little more then stopped again. He still wouldn’t stop rooting. Then I got him his pacifier and he sucked on it for the rest of the time I held him. And I held him for 50 minutes! I finally put him back to bed after that cause I was worried that he had been up for too long. That might be the longest he’s ever been awake too. He weighs 4 pounds, 10.5 ounces today.

Tate met his Great Grandma and Grandpa Stinemetz and his Great Uncle Alan today. They were driving home from Jamie’s cousins’ graduation and stopped to see us. Tate slept through the whole thing but did pop an eye open for Grandpa.

Several of my family came over today and started moving furniture around and setting Tate’s nursery up. They moved all the office furniture, paraphernalia and junk downstairs and then set up the crib and the changing table in the old office. Hudson wasn’t real happy about it because he has been telling me that he wants Tate to share his room! He told me again when I was putting him to bed that his bed isn’t supposed to be in the office, he wants it in his room. Too sweet. The only thing in the room is the crib and changing table, and a few clothes hanging in the closet. No decorations or anything yet. But I love going in and just looking at it. Makes it all more real that he will be home. Someday. Soon.




Sunday, December 19, 2010

Day 34, Friday, December 17


Yes, I know. That’s the cutest baby you’ve ever seen. Isn’t he so handsome in his tie?

I saw this idea on a blog a few months ago and decided I wanted to do it for Tate’s first year. I plan on taking a picture of him at every month “birthday” with his necktie on to show how much he’s growing. I found this necktie online and the great thing about it is Daddy and Hudson have matching ones! I already have their Easter outfits! The crazy thing is how small that tie actually is, yet it still looks so huge on him. When they came in the mail I looked at it and thought “well this isn’t going to last very long”. (It’s a size 0-6 months.). Jamie thought the same thing when he saw it. Then we put it on Tate yesterday for his one month birthday – and you can see how huge it is!

Tate took 20 ml from his bottle for me today. When we first started he took right to it and was gobbling it down. Then he choked on some milk. Yes, I freaked out a little. His eyes started watering, his face turned red and it didn’t look like he was breathing. But the nurse assured me he was (the monitor’s weren’t going off). He finally took a big breath. After that I couldn’t get him to take the bottle again. I tried burping him. The nurse tried burping him. Never got him to burp but he was not interested in drinking more milk.

They increased his feedings to 40 ml today. When the NP stopped by to see how he was doing I joked to her that “we were never going to catch up if they kept increasing how much he eats.” She then proceeded to get out a growth chart and show me that Tate is just barely on the charts for his growth (meaning he is really small for his age). So she said that is why she is increasing his feeds so quickly to try to get him to gain weight as quickly as possible. Brain growth is directly related to his body growth so it’s very important that he keeps growing so there’s room for his brain to grow as well. That’s why she’s keeping such a close eye on it. It’s not surprising that he’s so small for his age because he was measuring 3 weeks small when I was pregnant with him. He was only at 28 weeks gestational size when he was born, but I was 31 weeks pregnant. So he has a lot of growing to do to catch up. She did say that once they hit that 1800 grams (4 pounds) they seem to just start growing and growing. And that is exactly what Tate has done this week- he gained 2 oz a day, 2 days in a row and has been gaining an ounce a day the last several days. He gained another ounce today and is at 4 pounds, 9.2 ounces.

When Jamie fed him his bottle at 9 pm he took 35 ml! He just took right to it. He even stopped and burped him – got him to burp and then got him to take the bottle back and eat more. Definitely progress! I’m hoping maybe that was his “click” and he’ll have it all figured out from here on. But I’m guessing that’s probably a little too much to hope for this early. We’ll see how he does tomorrow though.

Saturday, December 18, 2010

Day 33, Thursday, December 16

Tate is 1 month old today! To celebrate his big day he had his first bottle. With a preemie it’s not as simple as just holding him in your arms and giving him a bottle. The nurse demonstrated how to feed him and then let me take over. Instead of cradling him in my arms I have to actually hold him in my lap, straight up. I put one hand behind his head for support and use the other to hold the bottle, support his chin and push in on his cheeks to remind him to suck. (I have yet to master this –that’s a lot to do with one hand!) First, you have to get him to actually take the bottle in his mouth and latch on to it. He likes to push it back out with his tongue at first but he eventually took it. Then once he starts sucking we lean him back and let him take 4-5 sucks. Then we have to sit him back up, let the milk drain back out of the nipple and “remind” Tate to breathe. Once you feel him take a breath you can start getting him interested in the bottle again. Then once he starts sucking you can lean him back again for 4-5 more sucks, and then repeat the whole thing. And we do that till either he drinks the whole bottle (he’s at 38 ml today) or until he gets too tired and won’t take it. Plus burping him in between.

We were both pretty concerned about feeding him the bottle because we watch the nurses feed these other babies and there’s a lot of gagging, choking and bradycardias while they are eating. We definitely don’t want to start the bradys up again and we don’t want him gagging and choking all the time either. It’s really hard for preemies to learn to coordinate how to suck, breathe and swallow. But the nurse told me that one day it will just click for him and he’ll down the whole bottle in 5-10 minutes. But in the meantime, it’s slow going.

Tate took his first bottle like a champ. He took 24 out of the 38 ml before he got too tired. Once I took the bottle out of his mouth to burp him I never could get him to take it again. The nurse thought maybe she could get him to take more after we said he was done. She came over and unswaddled him and tried to wake him up. He was totally zonked out. She put the bottle up to his lips and he sighed and grinned real big. It was pretty cute. But he wouldn’t take any more. But he did really good on his first try. Even the nurse was impressed at how coordinated he was.

Jamie fed Tate his next bottle at his 9 pm feeding but he didn’t do as well as he did earlier. He only took 10 ml before he choked on it and then he wasn’t interested in taking the bottle anymore after that. Can’t blame him! Anything he doesn’t finish from the bottle in 30 minutes (or before if he wears out before that) is then fed through his gavage tube. The nurse practitioner did tell me that I can still do some dry “nursing” with him after he’s finished his bottle, if he’s still awake for it that is. He’ll eat his best in the first 15 minutes which is why we don’t want to wear him out with the nursing before. But that way he can still get a little practice at nursing. Then once we increase the number of feeds we can feed him we’ll do a breastfeed in there somewhere too. But for right now we are just focusing on figuring out the bottle. Once he is consistently taking a full feed by bottle, they’ll increase it to three times a day that we can feed him. And then the more and more he eats, the more feeds we’ll get to give him until one day he is taking all his feeds by bottle or breast and that means he can come home!





Thursday, December 16, 2010

Day 32, Wednesday, December 15

I’m letting go of a dream today. At least loosening my hold anyway. I’m realizing that most of it is about me, not Tate, so I’m letting go. He could care less how he drinks his milk, as long as he gets it. And as long as I keep pumping, he’s still getting the nutritional benefits. And it doesn’t necessarily mean he’ll never breastfeed. We can still work with him on it – and we’ll have plenty of time to focus on it – once he’s home. I realize that breastfeeding is my heart’s desire but right now I have a bigger desire - to get him home. So tomorrow Tate will have a bottle. I’m sure some of you think I’m totally off my rocker (or maybe it’s just the hormones) for making such a big deal about breastfeeding vs. bottle feeding. I breastfed Hudson till he was 21 months old. Breastfeeding is the most natural part of mothering. Your body knows how and what to do and just does it. And you have to remember where I’m coming from after Tate’s birth and the whole c-section thing. You’ve got to give me something….


I spoke with Linda again today and she told me Tate would probably go home 2-3 weeks sooner if we introduce the bottle rather than only breastfeeding and fingerfeeding. She also said we don’t have to give up breastfeeding altogether. We can keep doing breastfeeding at one feed and then bottle at another. Then as he starts taking more milk and we start introducing more feeds we can decide how many are breast or bottle. Tate had one of my favorite nurses today, Phyllis, so I asked her opinion as well. When I asked if she found babies who bottle feed first never take the breast she said she thinks babies figure out where the milk comes from, so no matter which way you feed them, they’ll figure out how to get it. And she mentioned that when Tate goes home he’ll probably still have to have extra calories or protein added to his milk so we’ll have to supplement somehow. Plus I keep reminding myself that two weeks ago I was being told bottle was the only option and I’d accepted that.

Tate didn’t have a great afternoon for me. First of all, he’s congested. The nurse said she thinks it is from reflux and didn’t seem super concerned about it, but of course, I’m concerned. It’s something new and different and it’s making it even harder for him to try and eat since he can’t breathe through his nose. So we tried breastfeeding but didn’t have an easy time with it. He took 2 mls. Then we did finger feed and that went even worse. Maybe part of it was just because he was getting tired but he only took 8 ml and towards the end he gagged a few times and spit the milk out. He’s never done that before. Maybe it’s just from the congestion. They increased his feedings to 38 ml today so he definitely is eating more these last few days. So maybe that is causing some more reflux issues. He isn’t spitting up though. But Jamie thought last night he might be having some reflux just because he seemed uncomfortable. So I guess we just wait and see how the congestion is tomorrow.

When I left at 6 pm I was pretty much decided on starting some bottle feeds and tonight totally affirmed that. Jamie was totally exhausted after work tonight so he let me come back up. I decided to try to breastfeed Tate again since it wasn’t great today and we haven’t ever tried twice in one day. Tate did really good. He latched on a few times and sucked okay in the football hold, which is how I usually hold him since the lactation nurse told me that was the easiest way. He was getting tired of it so I switched him to the cradle hold and he latched right on and sucked and sucked! Definitely the longest he has ever done. So I was really excited to see how much he’d gained. Zero. Zero? How is that possible? I thought he had done so well. The nurse on tonight checked his tube placement before we hooked up the rest of his feeding and she noticed he had a lot of air in his tummy. So he did all that sucking but was just sucking in air, no milk. I know my milk supply isn’t an issue and I felt a let down while he was nursing. But he isn’t sucking strong enough to actually get any milk. So in addition to the hard work of latching and remembering to suck while he’s latched, he also has to suck stronger to drink any milk. All that helped to reaffirm the decision to start bottle feeding.

I got to give Tate another bath tonight. I love being able to take care of him, dress him, change his diaper – even though he has pooped and peed on me every day. I just try to ignore the nurse hovering around and pretend life is normal. It will be someday. Tate gained another 40 grams today and now weighs 4 pounds, 5.9 ounces and is 16 inches long.

Got milk?

We do!  Our new deep freeze came yesterday.  Had to get it because we have run out of room in our freezer and the NICU asked if we could take some of my milk home because their freezer is full too!  They said they have more than enough for the rest of Tate's stay...plus I pump while I'm there and they use the freshest available so they don't actually use that much of the frozen stuff.


Day 31, Tuesday, December 14

Tate is four weeks old today. Our insurance thinks he should be ready to go home by now and has already started pushing the doctors to send him home. I wish he was ready to come home. Do they really think we want to be here?


I came up at noon today and because it fit better with my pumping schedule, I kangarooed Tate for an hour and then breastfed him at his 3 pm feeding. That’s the first time since we started breastfeeding that I held him first and Tate rooted around for the first few minutes. That’s the first time he’s done that! Progress!

Later, Linda, the nurse practitioner, stopped by. When she pulled up the chair to sit down and said “we haven’t talked in a long time” I knew something was up. First she told me that BCBS is starting to push to send him home. She said not to worry about it – it’s just a little push and it’s her job to take care of that stuff. But then she asked what my intentions were with feeding Tate.


 
I had a feeling that this talk was coming. Although we’re making progress, it hasn’t been a lot of progress. Definitely not notable, chartable progress. I can tell he’s latching better and sucking better but all they see is how much milk he drank at each feeding. I thought we’d have another week or so before they broached the subject, but here she was already.

So, of course, I told her I wanted to breastfeed. And then the tears started. She told me not to cry or she would start to cry too. And she did! I told her I cry over everything these days so not to worry about it. She suggested we consider adding bottle feeding instead of just breast and finger feeds so that we can get him home sooner. In her 30 years of experience, she said she’s never seen a preemie go home fully breastfeeding. She said he’s not doing bad at breastfeeding. He’s doing exactly how she’d expect him to do. But bottle feeding is much easier for them because they don’t have to work as hard to latch or suck as hard to get milk. She said it’s totally our decision and if we want to continue with just breast and finger feeds that’s what we’ll do. We can have speech therapy come in and work with us more on his finger feedings to make sure he’s latching and doing everything right. She told me to take a few days and think about it. I told her Jamie and I would talk about it and we’d let her know.

Tate must have been listening in on our conversation because 30 minutes later he took his full feed – 37 ml – by finger feed! I think one time he took 25 but usually it’s around 15 ml. He guzzled the whole thing down –and that was after we tried breastfeeding for 15 minutes. He only took 14 ml from Jamie at 9 pm. We were hoping for a repeat. But that would have been a lot of work on Tate’s part, so not surprising that he was too tired for more than that. He pulled out his feeding tube this evening again. He hasn’t done that in awhile but when Jamie got there for the 9 pm feeding it was out and Tate was lying in a pool of milk. We don’t know how long he’d been like that but the nurses hadn’t noticed it yet. It must have been a lot of hard work today because he only gained 7 grams. But he’s gained 5-6 the last 2 days so he’s doing fine with his weight gain.

Jamie and I have discussed the bottle feeding and it’s basically come down to the fact that breastfeeding is my thing so this is my decision to make. Jamie said he’s fine either way, although he’d rather have Tate home as soon as possible. But he doesn’t want me to say yes just because I feel pushed by the insurance company or the doctors to do so. My biggest concern with introducing the bottle is that he'll then never breastfeed (nipple confusion).  My other concern is whether I can continue to pump for the next year and produce enough milk to satisfy him.  The pumping is already taking its toll - physically and mentally.  Having to do it all the time once he's home will be even harder to do on a 2 hour schedule.  And my goal is to breastfeed until he's at least a year, longer if we can. So I have some thinking and praying to do.




Wednesday, December 15, 2010

Day 30, Monday, December 13

The biggest news today has nothing to do with Tate and all about his new little neighbor in the NICU. Well, more about his mom actually. She is crazy. She came in fighting with the nurses about washing her hands. Since she wasn’t allowed to touch him, she didn’t think she should have to wash her hands. And then it was on and on from there. How she knew more about feeding the baby then the nurse did, the nurse did it all wrong. Couldn’t believe she wasn’t allowed to hold her baby, even touch him. Doesn’t need to pump cause her milk will just come in when it’s ready. Doesn’t know when she’ll be back cause she doesn’t have a ride here. On and on. I had the curtains drawn around Tate’s bed so I was able to listen and laugh – silently – at the whole thing. They finally called one of the doctors and the social worker in to talk to her. So we are praying her little baby gets to go home soon so we can have some peace and quiet – well, as much peace and quiet as you can have when you are surrounded by crying babies!


Tate’s nurse today moved him into another new bed. This one is like a mini crib and I like it SO much better than the other one he was in. Especially with the new neighbor- if things get too rowdy over there I feel like he’s much more secure and safe in this bed than the other.

Tate is now eating 36 ml at every feed. His pulse ox and heart rate have been much better over the last day or two. He’s not d sating very much anymore and although his heart rate still gets high when we are moving him or changing his diaper, if he’s just resting it stays in the 150-160 range. He took 4 ml at the breast today. I was pretty disappointed today because he latched really well and was sucking a lot so I thought he drank a lot more than that. Even the lactation nurse thought it should have been more because we could see him swallowing big. But at least it’s progress. He only took 10 ml at my finger feed but he took 24 ml from Jamie’s finger feed at 9 pm. Today he weighs 4 pounds, 4.2 ounces –another 2 ounce gain!