Our Jumping Off Place: 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!