Do Not Worry
8 months ago
Friday, January 7, 2011
Carver Levi
Congratulations to my brother and his wife (and big sister Callista) on the birth of Carver Levi yesterday. Weighing in at 8 lbs 14 oz - 20 inches - Tate's going to have to watch out for his "little" cousin!
Thursday, January 6, 2011
Day 52, Tuesday, January 4
Everyone needs a day of rest sometimes. Evidently that’s what Tate needed because today he is like a different baby – back to how he was a week ago. All four feedings that Jamie and I did today he was awake beforehand, fussing, crying, rooting and ready to eat! And he stayed awake through the feedings as well. He is seven weeks old today.
The nurse had planned to gavage his 3 pm since we were taking it slow today but Tate was awake and chomping so she made him promise not to make her look bad and he followed through! He took the whole bottle (52 mls) in about 17 minutes. When we started bottle feeding he was only at about 30 mls and the 52 today seems like so much (The NP raises his feeds 1-2 mls every few days depending on his weight gain). The little bottles only hold 60 so they are almost full now so it seems like we are feeding him a lot. I had to pace him the whole time but he did great and had no choking episodes.
He was still sleeping when I left at 6 but we were already planning to gavage that feeding cause we knew he would be worn out after 3 in a row. But he was mad and hungry when Jamie fed him at 9 and midnight and he took the whole bottle.
They gavaged him at 3 and then he took a full bottle at 6 am, so he made his goal of 6 bottles for the day. I am hoping that they will take it slow for the next few days and keep him at 4-6 to let him get used to that, rather than jumping right up to 6-8 like we did last week. But maybe he’s ready for it this time, or maybe our insurance company is pushing pretty hard at this point so they’ll try 6-8 again tomorrow. We’ll see.
The goal for today was 5-6 bottles. He took his 9 am for the nurse and I breastfed/bottled the noon. He took 36 mls at breast today! I am so happy! Yesterday I’m saying he hardly gets any and today he takes more than an ounce. He latched on right away and did really well today. After about 10 minutes he was starting to slow down so I switched him to the other side and he latched right back on and started nursing some more. He was still nursing at the 15 minute mark so we let him go to 20 minutes and then weighed him. I was really hoping he had gotten a lot, because it seemed like he had done really well, but I didn’t want to get my hopes up too much. Of course, the scale isn’t the most accurate, especially when a different nurse weighs at the beginning than the one who weighs at the end – you have to make sure you know exactly how the first nurse weighed – blanket on or off, leads hooked or unhooked, wires on the scale or off, etc. But those things usually make a big difference in weight so we know it’s a mistake. So we went with the 36 mls. Then he just had to take 16 more from the bottle and he gulped it right down.
The nurse had planned to gavage his 3 pm since we were taking it slow today but Tate was awake and chomping so she made him promise not to make her look bad and he followed through! He took the whole bottle (52 mls) in about 17 minutes. When we started bottle feeding he was only at about 30 mls and the 52 today seems like so much (The NP raises his feeds 1-2 mls every few days depending on his weight gain). The little bottles only hold 60 so they are almost full now so it seems like we are feeding him a lot. I had to pace him the whole time but he did great and had no choking episodes.
He was still sleeping when I left at 6 but we were already planning to gavage that feeding cause we knew he would be worn out after 3 in a row. But he was mad and hungry when Jamie fed him at 9 and midnight and he took the whole bottle.
They gavaged him at 3 and then he took a full bottle at 6 am, so he made his goal of 6 bottles for the day. I am hoping that they will take it slow for the next few days and keep him at 4-6 to let him get used to that, rather than jumping right up to 6-8 like we did last week. But maybe he’s ready for it this time, or maybe our insurance company is pushing pretty hard at this point so they’ll try 6-8 again tomorrow. We’ll see.
Day 51, Monday, January 3
When I called this morning to see how Tate did overnight she said Tate only took 3 full bottles yesterday. So because of that the NP changed his orders to 4-6 bottles a day instead of 6-8. He hasn’t done more than 6 in a few days anyway. So today the plan is to only do 4 bottles and gavage every other one and see how he does.
Since they were gavaging the noon feeding I decided to wait and have Jamie come up with me so we could talk to someone about what’s going on. I was hoping we could talk to speech about the nipple issue and see what she thought of how he ate today. But she never came today for some reason, so maybe tomorrow. We came up about 2 pm and spoke to his nurse about everything. She was his nurse last Wednesday when he took the 8 so she was surprised to see us still here and hear that he only took 3 bottles yesterday. So we talked to her about all the issues and she said she definitely thought we had switched things up way too much yesterday with the nipples and introducing new bottles. We were in total agreement with that so we went back to using the same medium flow nipple that speech told us to use last week and the hospital bottles instead of the Playtex ones we bought. She said we’ll switch to the Playtex ones once we get him back up to 8 bottles and a day or two before going home.
We asked her about the fact that he seems to always take a full bottle for the nurses but we are the ones having the failures (of the 3 he took yesterday - all 3 of those the nurses fed him). She said the most important thing to do for him is chin and cheek support. We do that a lot better than some of the nurses. We have watched some of them feed and they don’t do it at all. So I really think the issue is how tired he has been, not something we are doing wrong. But it is still really frustrating.
Last we asked her about the breastfeeding and if she thought we should discontinue that, if that was the cause of all these problems. She was a little more wishy-washy (than the others have been) about whether it could be the cause but she encouraged us to keep doing it just once a day, for 10-15 minutes, max. But it’s really up to us. Obviously if we only did bottles we’d get out of here quicker but my concern with waiting on breastfeeding till we get home is if he does this same thing when we introduce breastfeeding again at home. We don’t want him at home not eating and then have to be readmitted with a “failure to thrive” label. So I’d rather keep it up the once a day and get him accustomed to that now while we’re here.
I went ahead with the breastfeeding at his 3 pm feeding. We limited him to 15 minutes and he only took 2 mls. So at this point besides burning some extra calories he’s not really doing anything with the breastfeeding. So it’s not much different than just letting him do the dry nursing we have been doing all along. So I’ve decided to keep with it once a day. I am really hoping once he gets past full term (40 weeks) and bigger than 8 pounds that he’ll start doing better at breastfeeding. I am NOT giving up on it. But I’m realizing more and more how much more work it is for him and how long it will take us to get switched over to fully breastfeeding, if ever. And it makes it more obvious that we’d be nowhere near this close to going home if we had kept with exclusive breastfeeding. We’ve been doing bottles for 2.5 weeks now and sometimes he’s not getting any more milk from the breast than he was before. He has improved on his latch and sucking though.
Tate finally took a full bottle for me after we breastfed. He hasn’t taken a full bottle for me since last Wednesday, I think. So maybe the rest he’s getting today is helping. He took the full bottle in about 10 minutes but still needed pacing the whole time. He choked once but not as bad as he has before. The nurse watched and said I was pacing him just like she would and doing everything right. So I do really think the issue was just how tired he’s been the last few days cause I didn’t feed him any differently today than I have been trying to all along.
He took his full bottle at 9 for Jamie too and another full at 3 am so he took 4 full today. And we hit that 6 pound mark today - 6 pounds, 0.8 ounces! He is actually starting to fill out his preemie clothes. Lengthwise especially. He’s 17.5 inches now. Everything is still too big on him but his feet actually stay in the ‘footsies’ on a few of his outfits. Several of the nurses that we haven’t had in a while have been stopping in the last few days and can’t get over how big he has gotten. He’s looking more and more like big brother Hudson every day!
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| I guess he wanted everyone to leave him alone and turn out the lights! |
Tuesday, January 4, 2011
Day 50, Sunday, January 2
Tate took 6 straight bottles from 6 pm to 9 am last night! Progress but of the 6 Jamie fed him 2 and I fed him zero. So the nurses are doing better than we are, me especially. I came up to breastfeed at noon but because he’d had 6 in a row we had to gavage him instead. The nurse told me that the night nurse switched him back to the slow flow nipple because he was having so many choking problems. I wasn’t real happy to hear that since it was speech who told us he was ready for the faster ones and I don’t feel like the nurses listen to anything speech says, but I’m all for not having the choking episodes. She said he was still choking some with the slow flow but he was able to recover much faster with the slower flow nipple.
I put him to breast at 3 and he took 20. That’s better than yesterday so more progress. He was awake and alert, chewing on his hands so that was a much better start than yesterday. But by the time we got to the bottle he was pretty tired. He took another 20 mls for me from the bottle and she pushed the last 10 in his tube. (When it’s not very much they just push the milk into his tube with a syringe instead of hooking it up to the pump.)
He woke up at 5:45 so we started his bottle early so I could do it. He did okay. Took about 15 mls for me in the few minutes we had to work on it. The nurse took over and fed the rest (they close the NICU from 6-8 every evening for shift change so I had to leave.). She went back to the faster flow nipple cause she wasn’t convinced the slow one was that great at his 3 pm feeding. But today milk was dribbling out the sides of his mouth and he’s never had that happen before. Maybe we are just confusing him by switching the nipples back and forth. I don’t know. I watched her feed him for a little bit and she wasn’t giving him any chin/cheek support. She was pacing him but she was pacing him by pulling the bottle up instead of holding Tate and the bottle back and then bringing them both up together like speech showed us to do. I went to the store today and bought bottles the nurse recommended and both slow and fast nipples to go with them. She wants us to start using those and maybe we’ll have better luck. They want us to use the kind we’ll have at home for awhile to get used to them and make sure we don’t have any problems with them. Speech should be back tomorrow so hopefully I’ll get a chance to talk to them and get their opinion on everything that’s been going on.
Jamie went back up for the evening shift and he tried using the new bottles with the slow nipple. Tate only took half. He tried again at midnight and Tate still didn’t finish it. They gavaged him at 3 am and he took bottle for nurse at 6. He only did 3 full bottles today. He seems very disorganized while he’s trying to eat. I think we are just confusing him with all the changes we are trying to make and pushing him too hard. Plus I think the bad chokes he had scared him so we are going to have to work back up to where we were before.
Tate weighs 5 pounds, 14 ounces today. More than three pounds over his birth weight now and so close to being a 6 pounder!
Another baby died today. This baby was in the other pod from Tate so I don’t know much about him. I had talked to the mom a few times when I saw her in the lactation room. She had twin boys. Since he was in the other pod they didn’t make visitors leave from Tate’s pod when it happened but I was in the lactation room (pumping) and the mom came in. The lactation room has 3 curtained areas and I was in one pumping when she came in crying. Immediately someone else came in and asked her if there was anything they could do for her. Then they both started crying and talking about planning the funeral and how unfair it was, that they never got to celebrate his birth and now he was gone, etc. It was awful to be sitting right there next to them listening. I packed up my pumping ‘gear’ and left so that they could have some privacy. I came back in and stood at Tate’s bed just looking at him and said a prayer for the family and for Tate. We are so blessed that Tate is so healthy. No matter how frustrating this whole bottle feeding is, I keep having to remind myself how much worse it could be and that this is trivial compared to what could be.
I put him to breast at 3 and he took 20. That’s better than yesterday so more progress. He was awake and alert, chewing on his hands so that was a much better start than yesterday. But by the time we got to the bottle he was pretty tired. He took another 20 mls for me from the bottle and she pushed the last 10 in his tube. (When it’s not very much they just push the milk into his tube with a syringe instead of hooking it up to the pump.)
He woke up at 5:45 so we started his bottle early so I could do it. He did okay. Took about 15 mls for me in the few minutes we had to work on it. The nurse took over and fed the rest (they close the NICU from 6-8 every evening for shift change so I had to leave.). She went back to the faster flow nipple cause she wasn’t convinced the slow one was that great at his 3 pm feeding. But today milk was dribbling out the sides of his mouth and he’s never had that happen before. Maybe we are just confusing him by switching the nipples back and forth. I don’t know. I watched her feed him for a little bit and she wasn’t giving him any chin/cheek support. She was pacing him but she was pacing him by pulling the bottle up instead of holding Tate and the bottle back and then bringing them both up together like speech showed us to do. I went to the store today and bought bottles the nurse recommended and both slow and fast nipples to go with them. She wants us to start using those and maybe we’ll have better luck. They want us to use the kind we’ll have at home for awhile to get used to them and make sure we don’t have any problems with them. Speech should be back tomorrow so hopefully I’ll get a chance to talk to them and get their opinion on everything that’s been going on.
Jamie went back up for the evening shift and he tried using the new bottles with the slow nipple. Tate only took half. He tried again at midnight and Tate still didn’t finish it. They gavaged him at 3 am and he took bottle for nurse at 6. He only did 3 full bottles today. He seems very disorganized while he’s trying to eat. I think we are just confusing him with all the changes we are trying to make and pushing him too hard. Plus I think the bad chokes he had scared him so we are going to have to work back up to where we were before.
Tate weighs 5 pounds, 14 ounces today. More than three pounds over his birth weight now and so close to being a 6 pounder!
Another baby died today. This baby was in the other pod from Tate so I don’t know much about him. I had talked to the mom a few times when I saw her in the lactation room. She had twin boys. Since he was in the other pod they didn’t make visitors leave from Tate’s pod when it happened but I was in the lactation room (pumping) and the mom came in. The lactation room has 3 curtained areas and I was in one pumping when she came in crying. Immediately someone else came in and asked her if there was anything they could do for her. Then they both started crying and talking about planning the funeral and how unfair it was, that they never got to celebrate his birth and now he was gone, etc. It was awful to be sitting right there next to them listening. I packed up my pumping ‘gear’ and left so that they could have some privacy. I came back in and stood at Tate’s bed just looking at him and said a prayer for the family and for Tate. We are so blessed that Tate is so healthy. No matter how frustrating this whole bottle feeding is, I keep having to remind myself how much worse it could be and that this is trivial compared to what could be.
Day 49, Saturday, January 1
When I was little I always had a pet hamster. Ben, Peaches and Oreo are the names of the ones I remember but I think there were probably a few others in there too. The poor things just slept in their cages all the time except for whenever Mom made us clean their cages out. The only form of exercise they had was one of those wheels that they could run on. I remember lying in bed and listening to the hamster run and run at night on that squeaky wheel. I feel like one of those hamsters right now. Running and running and getting nowhere. We are constantly going back and forth from the hospital, never time for much rest, yet here we are going around in circles with this bottle thing. I am so tired. I am so frustrated.
Tate was too tired today to eat. That’s really what it came down to. He took his bottle at nine for the nurse no problem. Our plan was to bottle his noon and then breastfeed at his 3 but at noon he hardly stirred for his assessment. The nurse gave me the bottle and said go for it, but there was no way I was forcing it in when he was tired. I did that a few days ago with bad results so I was not going to try again. I fiddled around a little trying to get him to take the bottle but he never did. One of the nurses came over and stuck it right in and then gave him back to me. I unwrapped him and got him to wake up a little and he took about 35 for me before he went back to sleep. Finally one of the nurses looked over and said he was too tired to keep trying. So we gavaged the rest.
Then at three it took me 15 minutes to get him to wake up to even try to latch and then another 15 minutes to get him to latch on. So we were already 15 minutes over our time allotment for breast feeding. He then latched on and nursed for another 10 minutes but he only took 10 mls. Then he was too tired to do much with his bottle so we ended up gavaging most of it.
Normally we have Hudson spend the night with my parents and we both go up on Saturday nights but I was too frustrated to go back up tonight. Jamie went and, of course, Tate took both his full bottles at 9 and 12, plus he took the one at 6 pm for the nurse. Maybe I am the problem. Do I just need to shove it in and make him take it? Speech said not to. She said if he is too tired or just doesn’t want it to not force it. Otherwise we’ll cause nipple aversion and be even worse off. We have to gain his trust. He can’t be scared of it either. I feel like that is part of the problem after he choked the other day, plus every nurse feeds him differently. He’s never sure what he’s going to get and he’s starting to not trust us. So how do we regain his trust and get going again? I have no idea.
One piece of good news though is that he is gaining weight again. He’s gone a couple days just gaining a few grams and even though they took him off the extra protein in his milk, he still gained today. Tate is up to 5 pounds and 12 ounces today.
Tate was too tired today to eat. That’s really what it came down to. He took his bottle at nine for the nurse no problem. Our plan was to bottle his noon and then breastfeed at his 3 but at noon he hardly stirred for his assessment. The nurse gave me the bottle and said go for it, but there was no way I was forcing it in when he was tired. I did that a few days ago with bad results so I was not going to try again. I fiddled around a little trying to get him to take the bottle but he never did. One of the nurses came over and stuck it right in and then gave him back to me. I unwrapped him and got him to wake up a little and he took about 35 for me before he went back to sleep. Finally one of the nurses looked over and said he was too tired to keep trying. So we gavaged the rest.
Then at three it took me 15 minutes to get him to wake up to even try to latch and then another 15 minutes to get him to latch on. So we were already 15 minutes over our time allotment for breast feeding. He then latched on and nursed for another 10 minutes but he only took 10 mls. Then he was too tired to do much with his bottle so we ended up gavaging most of it.
Normally we have Hudson spend the night with my parents and we both go up on Saturday nights but I was too frustrated to go back up tonight. Jamie went and, of course, Tate took both his full bottles at 9 and 12, plus he took the one at 6 pm for the nurse. Maybe I am the problem. Do I just need to shove it in and make him take it? Speech said not to. She said if he is too tired or just doesn’t want it to not force it. Otherwise we’ll cause nipple aversion and be even worse off. We have to gain his trust. He can’t be scared of it either. I feel like that is part of the problem after he choked the other day, plus every nurse feeds him differently. He’s never sure what he’s going to get and he’s starting to not trust us. So how do we regain his trust and get going again? I have no idea.
One piece of good news though is that he is gaining weight again. He’s gone a couple days just gaining a few grams and even though they took him off the extra protein in his milk, he still gained today. Tate is up to 5 pounds and 12 ounces today.
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| At least someone is getting some use out of the bassinet.... |
Sunday, January 2, 2011
Day 48, Friday, December 31
We took a step back today and slowed down. I called the nurse and spoke with her first thing this morning to see how he did during the night. He slept all night long. The nurse gavaged his feed at 4 am since he didn’t wake up for his 3 am feeding and then he slept till 8 am. He woke up mad and hungry. So she fed him a bottle and he took full feed plus some extra. She gave him extra so that he would hopefully sleep till noon to get him back on his three hour schedule. That worked because when I got there at 11:45 he was just waking up and he was mad, soaking wet and hungry.
PT was just getting ready to do his evaluation so I watched while she did that. They just test reflexes and muscle tone. She did tell me he doesn’t have full range of motion in his neck to his left side so she showed me how to stretch his neck so we can work on that. She said to stretch him at every diaper change. She also pointed out that his head is starting to get flat on the right side so we need to make sure he is sleeping more on his left side. He always sleeps on his right side (probably because of his decreased range of motion to the left) and his little ear is always all crumpled up when he wakes up. So that’s something we need to pay close attention to and make sure it gets better. As long as he still has his soft spot on the top of his head his head shape can keep changing.
I asked the nurse if we should delay breastfeeding for a little longer since he had such a hard time with it yesterday and was so tired. She said she doesn’t think it was the breastfeeding itself that wore him out so much as it was the 8 bottles he took the day before. She thinks he’ll be a good breastfeeding baby and that we should continue with the one a day. She said we don’t want to wait too long to start introducing it again or he will get to used to how fast the milk flow is in a bottle and get frustrated with the slower milk flow at breast. So at her urging I decided to do it again today and see how he did. However we decided to limit him to just 15 minutes at the breast and then gavage the next feeding so that he could rest. I felt better about this plan and decided to at least give it another try today.
He took 24 mls – the most (by far) he has ever done at breast! He then took the rest by bottle. He had his 6 pm feeding gavaged and then took the bottle at 9 pm and midnight for Jamie. He also took his 3 am and 6 am bottles but was pretty tired the nurses said. He is still choking at least once a feeding usually which leads to a bradycardia. He can’t come home until he hasn’t had a brady for at least 5 days but I guess they don’t count bradys that happen while he’s eating. So the last brady he had, unrelated to feeding, was 12/28. So assuming he doesn’t have another brady and starts taking all his bottles he could come home on 1/3. But that’s all depending on the bottles really. His bradys are not a real concern because he doesn’t have them very often, but since we have slowed back down on the bottles I doubt we’ll be home that quick. Tate continues to gain weight but not as quickly as what he was before. He weighs 5 pounds, 11 ounces today. He has to average an ounce a day and he’s been gaining just a few grams the last few days, but hopefully he’ll start gaining more again since we are slowing back down. So everything has to balance out - the bradys, the bottles and the weight gain before we are going anywhere.
We had planned a special evening with Hudson as our last family of 3 outing for tonight but that didn’t end up happening. We were going to take him to the movies for the very first time but the movie started at 5 pm and Hudson didn’t wake up from his nap till 5:30. Jamie tried to get him up but he was not having it. So we cancelled those plans but, unfortunately, it looks like we'll still have another week or so for our last "family of 3" outing. Disappointing since just two days ago I thought we might be rooming in tonight. We ended up having a delicious dinner (prepared by my sister and mother) with my family. Then Jamie headed up to the hospital and Hudson and I went home to bed. I managed to stay awake long enough to send Jamie a text wishing him a happy new year at midnight and then I went to bed. So we didn’t do anything fun and fancy to ring in 2011 but we’ll have our “party” when Tate comes home.
PT was just getting ready to do his evaluation so I watched while she did that. They just test reflexes and muscle tone. She did tell me he doesn’t have full range of motion in his neck to his left side so she showed me how to stretch his neck so we can work on that. She said to stretch him at every diaper change. She also pointed out that his head is starting to get flat on the right side so we need to make sure he is sleeping more on his left side. He always sleeps on his right side (probably because of his decreased range of motion to the left) and his little ear is always all crumpled up when he wakes up. So that’s something we need to pay close attention to and make sure it gets better. As long as he still has his soft spot on the top of his head his head shape can keep changing.
I asked the nurse if we should delay breastfeeding for a little longer since he had such a hard time with it yesterday and was so tired. She said she doesn’t think it was the breastfeeding itself that wore him out so much as it was the 8 bottles he took the day before. She thinks he’ll be a good breastfeeding baby and that we should continue with the one a day. She said we don’t want to wait too long to start introducing it again or he will get to used to how fast the milk flow is in a bottle and get frustrated with the slower milk flow at breast. So at her urging I decided to do it again today and see how he did. However we decided to limit him to just 15 minutes at the breast and then gavage the next feeding so that he could rest. I felt better about this plan and decided to at least give it another try today.
He took 24 mls – the most (by far) he has ever done at breast! He then took the rest by bottle. He had his 6 pm feeding gavaged and then took the bottle at 9 pm and midnight for Jamie. He also took his 3 am and 6 am bottles but was pretty tired the nurses said. He is still choking at least once a feeding usually which leads to a bradycardia. He can’t come home until he hasn’t had a brady for at least 5 days but I guess they don’t count bradys that happen while he’s eating. So the last brady he had, unrelated to feeding, was 12/28. So assuming he doesn’t have another brady and starts taking all his bottles he could come home on 1/3. But that’s all depending on the bottles really. His bradys are not a real concern because he doesn’t have them very often, but since we have slowed back down on the bottles I doubt we’ll be home that quick. Tate continues to gain weight but not as quickly as what he was before. He weighs 5 pounds, 11 ounces today. He has to average an ounce a day and he’s been gaining just a few grams the last few days, but hopefully he’ll start gaining more again since we are slowing back down. So everything has to balance out - the bradys, the bottles and the weight gain before we are going anywhere.
We had planned a special evening with Hudson as our last family of 3 outing for tonight but that didn’t end up happening. We were going to take him to the movies for the very first time but the movie started at 5 pm and Hudson didn’t wake up from his nap till 5:30. Jamie tried to get him up but he was not having it. So we cancelled those plans but, unfortunately, it looks like we'll still have another week or so for our last "family of 3" outing. Disappointing since just two days ago I thought we might be rooming in tonight. We ended up having a delicious dinner (prepared by my sister and mother) with my family. Then Jamie headed up to the hospital and Hudson and I went home to bed. I managed to stay awake long enough to send Jamie a text wishing him a happy new year at midnight and then I went to bed. So we didn’t do anything fun and fancy to ring in 2011 but we’ll have our “party” when Tate comes home.
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