Sunday, November 30, 2014

NICU Day 71

I had a good visit with Baby Girl today.  She took two bottles and breastfed twice.  It is all very exhausting, but I think she's building her endurance. It was really hard to leave her tonight.  The NICU is very full and the nurses are all a bit stretched thin.

I heard the nurses talking about calling Now I Lay Me Down To Sleep and I saw lots of people crying :(  I don't know who lost a baby, but someone did and it is very sad.  It was hard thinking about that possibility and the reality that that mom must be living right now.



Length: 42.1 cm (+2 cm)
Head Circumference: 30.2 (+.2 cm)

Weight: 2355 grams -5 grams (5 lbs 40z)
Milk: 1215 (40.5 oz)
Feeds: 52 ml 6 unfortified, 2 fortified to 24 calories pushed over 30 min
Nursed: 2 nursing sessions out of 3 total attempts
Tri-Vi-Sol .5 ml
Day Nurse: Sarah
Night Nurse: Michelle

Saturday, November 29, 2014

NICU Day 70

Baby Girl reached 35 weeks gestation today.  I went to the hospital with the intention of feeding her twice, however, we realized that she is just too tired if I do two back to back feedings, so I'll need to talk to the doctor about that tomorrow.  Baby Girl continues to have roller coaster desats where she goes from the 90s to the 70s or lower over and over again.  I'd like to know if there is a pattern to the behavior.  Earlier I thought it was an hour after I started holding her, then I thought maybe it was related to her eating, I just don't know.  I suspect we may stay on a monitor even after we come home.  The most disconcerting part is she doesn't LOOK like her sats are low.  She's all pink even when she's registering in the 60s, which is very disconcerting.

Look at the neat picture Google made for me:



Weight: 2350 grams 50 grams (5 lbs 3 oz)
Milk: 1070 (35.7 oz)
Feeds: 52 ml (2 of which are fortified to 24 calories_ pushed over 30 min
Nursed: 1 time 25 minutes each
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Carrie
Night Nurse: Alisha

Friday, November 28, 2014

NICU Day 69

I got to the hospital at 11 today.  On the way there, I spoke with her doctor who informed me that she's now on 6 unfortified feeds a day.  This means I could potentially breastfeed 6 times a day.  I did breastfeed 4 times today.  The rule is that if she nurses for 8-10 minutes, they consider it a full feeding and they do not supplement.  4-5 minutes means they will supplement 1/2 a feeding.  I find it so hard when they ask if they should supplement. On one hand, I'm trying to trust her to eat what she needs to eat, though she could be too tired and not get that done and need the supplement.  On the other hand, if she did eat enough and I have them supplement her with full or half, I could be setting her up for pain or even vomiting.  I really want my Medela Baby Weigh scale back.  It is designed to detect the weight change from before and after feeding and tell you how much milk the baby ate. I'm going to ask about it tomorrow.

At this point, I pretty much need to spend as much time as possible at the hospital. This creates something of a conundrum, since we still have lots to do to get the house ready for her.  Everything is crazy!  Hopefully the uncertainty will decrease soon. I'm sad she lost weight today.



Weight: 2310 grams -10 grams (5 lbs 1 oz)
Milk: 1045 (34.8 oz)
Feeds: 49 ml (2 of which are fortified to 24 calories_ pushed over 30 min
Nursed: 4 times 15-25 minutes each time
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Sarah
Night Nurse: Alisha

Thursday, November 27, 2014

NICU Day 68

Baby Girl had a great day today.  I talked with the doctor about my suspicions that the new human milk fortifier was causing her issues in the rear.  The doctor said we could change to a formula called neosure now, rather than waiting until we go home to decide to keep the liquid fortifier or change to the powder.  So we made that change and I'm hoping to see her rear heal very soon.

Baby Girl is at 4 unfortified feeds a day.   Her weight gain was very small today, but only half her feeds were at the new 49 ml volume.  We'll see what the doctors say today regarding her very modest weight gain.

Baby Girl was having a LOT Of alarms overnight and into the morning.  She started alarming a LOT after the first time I fed her.  The nurse and I were very perplexed by the numbers compared to how she looked.  After holding her upright and checking her probe, we finally changed the probe, even though it looked fine.  Her sats immediately improved and looked a lot better, so we believe it may have been defective.  We'll see which of the alarms they hold against her of the 11 that she had that morning.

I left the hospital and came home to enjoy a delicious Thanksgiving meal with The Husband's parents.  We forewent a large gathering to help ensure we stayed healthy this holiday season.  I REALLY missed baby girl this evening.  I hope she comes home soon.  I did some Black Friday online shopping at Carters and found a fantastic clothing collection in Navy and Grey for baby girl.  I bought quite and found an additional 30% of coupon code!



Weight: 2320 grams 5 grams (5 lbs 1 oz)
Milk: 1045 (34.8 oz)
Feeds: 49 ml fortified to 24 calories pushed over 30 min
Nursed: once for more than 30 minutes
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Kelly
Night Nurse: Natalie

Wednesday, November 26, 2014

NICU Day 67

Baby Girl had a good day. I tried to feed her twice, but she was too tired the second time. Lesson learned, wait until she is angry to try and feed her.

She seemed to have a lot of alarms, possibly because they had oxygen on her butt to help heal it, which kept her on her stomach a lot. Poor baby.  The contraption they used was very amusing, I took pictures.  Note the Styrofoam cup with the oxygen tube coming out of it in the vicinity of her nether regions.  We are high tech!



Weight: 2315 grams 35 grams (5 lbs 1 oz)
Milk: 1045 (34.8 oz)
Feeds: 45 ml fortified to 24 calories pushed over 30 min
Nursed: once for more than 30 minutes
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Sarah
Night Nurse: Natalie

Tuesday, November 25, 2014

NICU Day 66

Baby Girl is back off nasal cannula and was free to start nursing again. I fed her at the 5:30 and 8:30 feedings this evening, it went very well!  She did lose a bit of weight, we'll see what the doctor says tomorrow on that one.  I assume we need to bump up the amount she's eating.  I really miss my Baby Weigh scale from Medela, it told me exactly how much Charlie ate when he breastfed.  It is a crutch and I shouldn't use it again (unless medically needed again)... but I miss it anyway.

Baby Girl's butt is still broken down and looking very painful, I still blame the new fortifier.  We're doing as much air time as we can in the hopes that it will heal up.  We may need to go to blowing oxygen on it, but she really hates that, so I'm hoping it will get better without that.

After her last feeding, we cuddled for a bit and her O2 sats were at 100% without any respiratory support for the first time I've seen... These monitors can make you crazy, but it will be hard to leave them behind.




Weight: 2270 grams -25 grams (5 lbs)
Milk: 1045 (34.8 oz)
Feeds: 45 ml fortified to 24 calories pushed over 30 min
Nursed: twice for more than 30 minutes each time
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Rhonda (Congratulations on your new job, but you will be missed!)
Night Nurse: Natalie

Monday, November 24, 2014

NICU Day 65

Baby Girl had a bit of a setback after getting her 2 month shots.  She's back on low flow oxygen to help her while she gets past the first 48 hours or so after her vaccinations.  We couldn't nurse today, but we had a good cuddle.  She's also still got a very painful, red bum.  They aired it out a bit and blew oxygen on it for a while.  It started after they changed fortifier, so I wonder if that is related.  When I left, Baby Girl was getting some more air time.  She scooted across the bassinet to the top while on her belly, she's mighty!

I'm starting to worry about her being left to cry in her bassinet.  There is one nurse to 4 babies, she can't be there for all of them at once.

I thought it was pretty cool that our nurse's middle name is the same as Baby Girl's and she also received it the same way our baby girl received her middle name.



Weight: 2295 grams +25 grams (5.1 lbs)
Milk: 1175 (39 oz)
Feeds: 45 ml fortified to 24 calories pushed over 30 min
Nursed: on hold for a day
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Linsie
Night Nurse: Sarah

Sunday, November 23, 2014

NICU Day 64

I left the house around 10:45 to go see baby girl today.  I arrived just in time to do cares.  First, I took her temp, which, on the second attempt was warm enough at 36.4 (36.3 is the minimum).   Next, I started to change her diaper.  She had an enormous bowel movement (seriously, girls are way harder to clean up than boys!).  As I cleaned her up, I noticed blood on the wipe :(  The spot of breakdown she had has gotten worse.  Poor baby is very sad.  We're using a special compounded ointment that the hospital makes that will hopefully help.  We also are having her sleep on her belly without a diaper on.  Hopefully some quality open air time will help her rear.  Getting air time and keeping her warm has been an interesting.  Warmed blankets are awesome!  Lori reminded me we can use our dryer to make our own. Pro Tip: apparently microwaves catch blankets on fire.

She was VERY ready to eat after cares.  We settled in to nurse and once she got organized she nursed for about 28 minutes.   It was very cool!  I did talk to lactation about her tendency to "click" during letdown. We're thinking it is either a latch issue or a letdown issue.  After she got done eating, we cuddled up for about an hour then I let her sleep in her bassinet for the remaining 45 minutes before her next round of cares.

Baby Girl had to get her shots during this care round.  The shots were overstimulating and caused her to shut down.  I cuddled her and we spent a couple of hours doing Kangaroo Care after the shots.  I did try and let her nurse one more time, but she was still shut down from the shots.  I didn't want to stress either of us out, so we decided to give her a tube feeding instead and I pumped.



Length: 40.5 cm (+1 cm) = 15.94 inches
Head Circumference: 30.4 (+.7 cm) = 11.96 inches

Weight: 2270 grams +85 grams (5 lbs)
Milk: 1305 (43.5 oz)
Feeds: 43 ml fortified to 24 calories pushed over 30 min
Nursed: 1 nursing session, 28 minutes
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Linsie
Night Nurse: Sarah

Saturday, November 22, 2014

NICU Day 63

Baby Girl is at 34 weeks gestation today.  Charlie woke up with a fever, so I'm trying to be extra careful.   I did go see her, but I showered right before I left and walked out the door without even sitting down to put my shoes on.  Trying to balance between my fear of getting her sick and her need to have her family with her is very hard.  Baby Girl nursed today for over 20 minutes.  We didn't give her feed that time.  Since she gained weight, apparently she had enough that feeding to cover.

Baby Girl has graduated to a bassinet.  She's maintaining her temperature and doing well.  Now that she's in the bassinet, she must sleep on her back without the incline.  She snuggled up under an awesome blanket from the JEDI crew... THANK YOU!!



Weight: 2185 grams +55 gram change (4lbs 13 oz)
Milk: 1165 (38.83 oz)
Feeds: 43 ml fortified to 24 calories pushed over 30 min, or breastfeed more than 10 minutes
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Day Nurse: Lori
Night Nurse: Kathy

Friday, November 21, 2014

NICU Day 62

Baby Girl decided she was done with nasal cannula today, so she removed hers. They decided to let her try without it for a while and she's about the same as she was with it on, so far.  We shall see how she does.  I did get to feed her again today and Baby Girl likes to EAT.  Daddy cuddled her for an hour or so as well.  I like the new NICU area, it is lots quieter and very peaceful.



Weight: 2130 grams 0 gram change (4lbs 11 oz)
Milk: 1240 (41 oz)
Feeds: 40 ml fortified to 24 calories pushed over 30 min, or breastfeed more than 10 minutes
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Low Flow 21% oxygen, 1 Liters
Day Nurse: Lori
Night Nurse: My

Thursday, November 20, 2014

NICU Day 61

Baby Girl had a very busy day today.  First, she had her eye exam this morning.  Everything still looked good, so they are going to let her go 2 weeks before her next check.  Next, I came to see her and we tried to nurse a bit.  She latched for a few seconds at a time, but she was so exhausted from her eye exam, that she really slept through everything.  I also had an appointment for another massage lesson, so we did that as well.  The massage went well and I think it went a long way to making her feel better after the super stressful eye exam.  Because Baby Girl has to have her eyes dilated before they can do the exam, we keep things very dark and quiet on eye exam day.  Today's picture reflects these facts.

Then, this afternoon I got a call from Lori, Baby Girl's primary nurse and one of my favorite people :)  She was very careful to start with telling me Baby Girl was fine, then went on to explain the reason for her call. Baby Girl is doing so well and they have so many babies, that they decided to move her to their step down NICU.  She's going to be in the new NICU room with 3 other babies.  That NICU is much quieter.  There are far fewer alarms, dings and bells, which will be good.  We'll continue to work on feeding and growing.  I look forward to seeing her new space tomorrow.



Weight: 2130 grams -10 grams (4lbs 11 oz)
Milk: 1200 (40 oz)
Feeds: 40 ml fortified to 24 calories pushed over 30 min,
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Low Flow 21% oxygen, 1 Liters
Day Nurse: Lori
Night Nurse: Sherry

Wednesday, November 19, 2014

NICU Day 60

Dr. Caldwell called this morning around 10:15 and started talking about things like "Home feeding schedules".  They took her off of the liquid protein because she's gaining weight at a good pace.  If she continues to have minimal alarms, they will also be taking her off the caffeine sometime around Saturday.  I asked if I'd be able to nurse then as well and she said I could nurse now if I wanted to.  So, I decided to go to the hospital over lunch.  I arrived a few minutes late for the 11:30 feeding and Baby Girl was very ready for food.  As soon as we laid her on the pillow in my lap, she latched on and began nursing.  I had pumped just before I left the office to give her a slower flow, she didn't seem to appreciate that very much.  I worked to help her get a faster flow and she nursed well.  Lori was pleased, as was I.  Right now, we'll nurse once a day, hopefully that will increase to twice a day soon.  Kangaroo care remains very important, so we're trying to balance the two.



Weight: 2140 grams +50 grams (4lbs 11 oz)
Milk: 1215 (40.5 oz)
Feeds: 40 ml fortified to 24 calories pushed over 30 min,
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Low Flow 21% oxygen, 1 Liters
Day Nurse: Lori
Night Nurse: Alisha

Tuesday, November 18, 2014

NICU Day 59

Daddy thought he was going to get to see Baby Girl today, but a tragic toe injury prevented the visit.  I did go see and cuddle Baby Girl and we had a very good visit.  She's now on 1 liter, low flow, which means we may try breastfeeding very soon.  I'm excited and nervous.



Weight: 2090 grams +20 grams (4lbs 10 oz)
Milk: 1060 (35.33 oz)
Feeds: 39 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Low Flow 21% oxygen, 1 Liters
Day Nurse: Rachel B!!
Night Nurse: Brittany

NICU Day 58 (And the missing 57)

I had a great visit with Baby Girl today, we cuddled for a bit and I gave her more fresh milk.  She's still on High Flow, 2 liters, they may start weaning her down soon.  If they do, when she gets to one liter, she can try breastfeeding.  She'll also have to get her first round of shots.



Day 57 - Weight: 2010 grams +70 grams (4lbs 7 oz)
Day 58 - Weight: 2070 grams +60 grams (4lbs 9 oz)
Milk: 1060 (35.33 oz)
Feeds: 34 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
High Flow 21% oxygen, 2 Liters
Day Nurse: Rachel B!!
Night Nurse: Stephanie

Sunday, November 16, 2014

NICU Day 56

We tried to do another massage today, but Baby Girl wasn't really feeling it.  After she spit up, I decided to just hold her and keep her more upright under the assumption that we might be experiencing a bit of reflux.  She went back on high flow today, we'll see how she is by morning.  She's looked good so far.  One Brady earlier in the evening, but it was self resolved.



Length: 39.5 cm (+1 cm) = 15.55 inches
Head Circumference: 29.7 (+1.7 cm) = 11.60 inches

Weight: 1930 grams +10 grams (4lbs 6 oz)
Milk: 1155 (38.5 oz)
Feeds: 34 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
High Flow 21% oxygen, 2 Liters
Day Nurse: Michelle
Night Nurse: Stephanie

Saturday, November 15, 2014

NICU Day 55

Husband and I went to see Baby Girl together today.  C4 stayed with Mimi and Papa, I'm sure he's having a blast.  While we were at the hospital, I gave Baby Girl a massage and then she cuddled with her daddy for over an hour.

Her respiratory rate was a little high today, so they didn't wean her down further on her CPAP.  Maybe she'll have settled by tomorrow, we'll have to see.

She did gain quite a bit of weight today (3.3 oz).  I expressed some concern, but her nurse assured me it isn't a totally worrisome weight gain.  She said she didn't look super puffy, she just looked like a bit of a chunk.  She got some oral stim with her 8:30 feeding (drops of breastmilk around her binky) and she loved it.  Her nurse and I agreed she'd probably be quite the eater once she's set free.



Weight: 1920 grams +100 grams (4lbs 5 oz)
Milk: 1210 (40.33 oz)
Feeds: 34 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21% oxygen, PEEP 4
Day Nurse: Michelle
Night Nurse: Stephanie

Friday, November 14, 2014

NICU Day 54

I had a meeting that sent me to see Baby Girl a bit late today.  When I arrived, I found we had Rachel today.  Rachel, like Lori tends to push me a bit. So, I picked Baby Girl up out of her isolette today for cuddles.  We had a great cuddle, Baby Girl was apparently very relaxed and "moved" by our cuddle.

Baby Girl is having a tiny bit of skin break down on her nether regions, so, when I put her back I got to change that enormous diaper.  As soon as I started changing her, enormous grew to gigantic as she fountained out even more poop.  So, we switched to a second clean diaper... which she immediately started peeing in.  At this point, we gave up as her official care time was only an hour away and she needed to get back to resting.

Dr. Dang weaned Baby Girl down to a PEEP of 4 this afternoon and increased her feeds to 34.  If she tolerates the decreased support over night, they will be trying high flow again tomorrow.  Baby Girl has had far fewer alarms this last week and a lot more time on 21% oxygen, so I'm hopeful.



Weight: 1820 grams +60 grams (4lbs 2 oz)
Milk: 1210 (40.33 oz)
Feeds: 34 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21% oxygen, PEEP 4
Day Nurse: Michelle
Night Nurse: Erin


Thursday, November 13, 2014

NICU Day 53

Baby Girl had her second eye exam today.  I got a better definition of where she is on her ROP (Retinopathy of Prematurity) She is currently stage 1 zone 2.  Which, as they said before, is "expected for her gestational age".  I was late getting out of work this afternoon, but we did have a cuddle after her 5:30 feeding.  Baby Girl LOVES dinner time :) We have high hopes for her eating habits.

She was on room air most of today, except for one patch on her back where she bounced up to 25% then weaned right back down.  They will probably try high flow again tomorrow or Saturday.  Given she had an eye exam today, this was not the day to try something new.



Weight: 1820 grams +10 grams (4lbs)
Milk: 1210 (40.33 oz)
Feeds: 31 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21% oxygen, Peep 5
Day Nurse: Michelle
Night Nurse: Erin

Wednesday, November 12, 2014

NICU Day 52

The Nurse Practitioner who called today said Baby Girl continues to do great!  The CBC they ran showed her Hematocrit had increased, which shows that Baby Girl is making her own red blood cells fast enough to stay ahead without needing a blood transfusion!  She's also stayed almost entirely on 21% oxygen excluding a couple of brief bumps to about 24% when she was on her back, or out getting her first massage.  Yes, that's right, I'm learning baby massage and she LOVES it!  She is also VERY interested in eating.  Typically she starts fussing 20 minutes or so before her scheduled eating time at which point she really loves to have her pacifier, she's very ready for food.


Weight: 1810 grams +60 grams (4lbs)
Milk: 1155 (38.5 oz)
Feeds: 31 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21% oxygen, Peep 5
Day Nurse: Michelle
Night Nurse: Erin

Tuesday, November 11, 2014

NICU Day 51

I didn't get to see Baby Girl for long today.  I had to run to a doctor's appointment and apparently, The Husband is supposed to get to hold the baby sometimes too... He did go hold her tonight for about an hour.  When he came home he expressed his enjoyment of the "good drugs" the baby provides (oxytocin is awesome).



Lab: Complete Blood Count (checking for anemia)

Weight: 1750 grams +20 grams (3lbs 14 oz)
Milk: 1262 (42 oz)
Feeds: 31 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21% oxygen, Peep 5
Day Nurse: Liz
Night Nurse: Erin

Monday, November 10, 2014

NICU Day 50

Baby Girl is 7 weeks old today (32 weeks, day 3 gestational age) and she is still in eat and grow mode.  She's doing very well as far as her oxygen needs go.  Today when I came in, she was on 21% oxygen (room air, what we all breathe every day) and she was high satting (her sats were above 96%). When I flipped her onto her back to change her diaper, I found her nasal cannula was only in one nostril.  So, that was pretty good. She would have probably tired of it eventually, but it is still impressive.

Today's outfit was SUPER cute... there were ruffles.. on her butt.  And the little feet had cloth mary janes on them.  It was adorable!



Weight: 1730 grams +30 grams (3lbs 13 oz)
Milk: 1115 (37.2 oz)
Feeds: 31 ml fortified to 24 calories pushed over 30 min,
1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-25% oxygen, Peep 5
Day Nurse: Liz
Night Nurse: Lindsey

Sunday, November 9, 2014

NICU Day 49

Baby Girl wasn't quite ready to be off CPAP yet.  She started having more desats, so they took her off high flow and put her back on CPAP at about 6 this morning.  They will try high flow again in about 5-7 days.

Baby Girl and I had a great visit today, we snuggled and napped for about an hour and a half.  I think we should have put her back at about an hour and fifteen minutes, she got a bit over stimulated.  Liz says she's done well this evening though, no major desats or alarms.

Sunday's Measurements:

Length: 38.5cm / 15.15 inches (+2 cm)
Head Circumference: 28 cm / 11 inches (+1.2 cm)

Weight: 1700 grams +80 grams (3lbs 12 oz)
Milk: 1195 (39.7 oz)
Feeds: 27 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Day Nurse: Liz
Night Nurse: Lindsey

Saturday, November 8, 2014

NICU Day 48

Baby Girl turned 32 weeks today. In honor of this momentous event the doctor decided to shift her from CPAP to High Flow Oxygen.  The Respiratory Therapist came in while I was holding her and asked if I wanted it shifted now, or if I wanted to wait until after I was done holding her.  I opted to have her off CPAP while I held her.  This worked out very well.  We cuddled for about an hour and a half today and she maintained her sats very well at 23% oxygen.  She removed her nasal cannula several times.  I noticed because she occluded it with her nose, otherwise, I wouldn't have, her sats did not waver when she removed them.  This seems like a pretty good sign.  She did have one Brady while I was holding her.  If I drift toward sleep, she sometimes tries to sneak down for a drink, even though she's really not ready for that.  When she wriggles down, she ends up in a bad position and it causes her to desat/brady. Not a fun way to wake up.

We did start talking about practice breastfeeding and actual breastfeeding today.  When Baby Girl gets down to 1 liter on her oxygen, we can begin practice breastfeeding.  If she doesn't achieve that before 34 weeks, at 34 weeks we can start trying to breastfeed for nutrition.  Lactation will be supporting us through this endeavor.

In other news, C4 (finally picked a real nick name for him) is on week 3 of potty training himself. He has a couple of accidents during the week, but usually does a pretty good job getting to the potty.  I'm glad he decided he was ready for underwear.  We haven't had the same luck with poop as we had with pee, he'd pretty much gone in his pants every time... until today.  Early this afternoon, he walked up to The Husband and said "come see what I did".  Then, The Husband called me to come see what C4 did... he finally pooped in the potty!  No idea if this will last, but he figured it out this time and he was VERY proud of himself!

Weight: 1620 grams -10 grams (3lbs 9oz) - had a Huge, Huge, Huge diaper just before weigh in
Milk: 1182 (39.4 oz)
Feeds: 27 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
Hi Flow, 21%-30% oxygen, 2 liters
Day Nurse: Corree
Night Nurse: Sherrie

Friday, November 7, 2014

NICU Day 47

Baby Girl had another day of eating and growing on day 47.  She gained 20 grams and didn't have many As and Bs.  The NICU in general was pretty stressed again yesterday with 5 new babies coming in.  We had a neighbor again for a little while, but they were able to get a room cleared out so he could be with his twin instead of in with us.  Listening to an admitting process was interesting.  We had a good cuddle and Baby Girl stayed at 21% oxygen the whole time.  I'm learning that she wriggles into a position that compromises her airway, so I'm getting better about catching on and adjusting her position.


Weight: 1630 grams +20 grams (3lbs 9oz)
Milk: 1141 (38.33 oz)
Feeds: 27 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Day Nurse: Stephanie
Night Nurse: Kimberli


Thursday, November 6, 2014

NICU Day 45 & 46

Sleep deprivation is taking its toll.  I didn't finish my post yesterday.  So I combined it with today's, fell asleep before I finished it and here we are.

We're really in something of a holding pattern for the next few days.  We're waiting until she hits 32 weeks gestation and then they will try weaning her down off her CPAP. Once she is off CPAP, we can try "practice nursing".  Practice nursing is when she nurses after I've pumped so she won't get very much milk.

Yesterday when I arrived, Children's Mercy Critical Care Transport was picking up a very sick baby for transport to their higher level NICU.  The loved ones were crying, it was very sad, I cried for them a bit.  I assured them CMH was a wonderful place with wonderful people, they thanked me, but I'm sure this isn't something they ever wanted to do or know about.

They moved our neighbor to another hospital today because they needed more beds at our hospital, things are crazy busy right now.  I believe they had at least 5 new admits today.  I met a mom who had triplets last week, that sounds exhausting.

Baby Girl had her first ROP (Retinopathy of Prematurity) eye exam on the 6th.  She'll have them every Thursday.  Her eyes looked "good for her gestational age".  She has an 80% chance of developing ROP to some degree given her weight and age at birth.

Baby Girl got an amazing sweater and a couple of hats from an amazing person.  They were crafted with great care and skill and I think she looked adorable in them.


November 5:

Weight: 1550 grams +50 grams (3lbs 5oz)
Milk: 1030 (34.33 oz)
Feeds: 27 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Day Nurse: Lindsey
Night Nurse: Megan

November 6:

Weight: 1610 grams +60 grams (3lbs 9oz)
Milk: 1150 (38.33 oz)
Feeds: 28 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Day Nurse: Lindsey
Night Nurse: Kimberli

Tuesday, November 4, 2014

NICU Day 44

Another quiet day of feeding and growing.  We had a great visit and cuddle.  Baby Girl is very sure when it is time to eat and she announces it very clearly if anyone is late.  She gets bigger every day.  Her isolette temperature is now 28C which means she can graduate to a crib as soon as she's ready to come of CPAP.  We will trial being off CPAP once she reaches 32 weeks gestation (which happens on Saturday).

All of the labs they did looked great.  Caffeine was increased to account for her weight gain.

Weight: 1500 grams +40 grams (3lbs 5oz)
Milk: 1175 (39 oz)
Feeds: 27 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Day Nurse: Lindsey
Night Nurse: Megan

Monday, November 3, 2014

NICU Day 43

Baby Girl continues to feed and grow.  It was Daddy's turn for skin to skin time and they had a good cuddle.  Baby Girl apparently spent some time grabbing his chest hair.

C seems to be running a low grade fever at around 99 degrees.  We'll see how he's feeling in the morning.

I didn't hear from anyone for an update today, I'll follow up if I don't get one tomorrow.
Labs tonight: Blood Gas, Nutrition Panel and CBC

Weight: 1460 grams +40 grams (3lbs 2oz)
Milk: 1170 (39 oz)
Feeds: 27 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Day Nurse: Rhonda
Night Nurse: Megan

Sunday, November 2, 2014

NICU Day 42

Baby Girl continues to do amazingly well.  Today in awesome, when Baby Girl snuggled down onto my chest for her 2:30 feeding, she immediately started rooting for food.  I'm so excited to have her show interest in breastfeeding (and for that matter eating by mouth at all).  She tasted some breast milk from a 1 ml syringe and sucked on her pacifier while taking her feed. 

Dr Caldwell called with updates
  • Adjusted feed up to 27 due to weight gain
  • Blood gas looked great. Giving her one more week on CPAP and then trying to shift to nasal cannula, if she agrees with that plan, that will head is toward practice nursing in a couple weeks...

Sunday's Measurements: 

Length: 36.5cm / 14.5 inches (+2.3cm) 
Head Circumference: 26.8 cm / 10.5ish inches (+1.5 cm)

Weight: 1420 grams +40 grams (3lbs 2oz)
Milk: 1191 (39.7 oz)
Feeds: 27 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Day Nurse: Rachel B
Night Nurse: Lauren

Saturday, November 1, 2014

NICU Day 41

I went to see Baby Girl around 1:30 today, which meant I had time to do 2:30 cares and then hold her.  The doctor looked at her while we were there and suggested that her OG tube should be change to an NG tube now that she's on CPAP.  Rachel B and I decided to go ahead and change the tube out even though the OG was good until Nov 9th.  The thought was that if we change it now the neobar that was stuck to her face would be gone.  It would be easier for her to suck her pacifier and her fingers and there would be less stuff on her face allowing her to be generally more comfortable.

That delayed when I held her until 3 and had her a lot more stimulated by the time I was holding her.  We snuggled for quite some time and I fell into a very restful oxytocin nap.  At about the hour mark, Baby Girl as usual marked the time with a desat.  I was comfortable asleep and suddenly she just stopped breathing.  I startled awake and looked at the monitors just in time to see them begin registering the desat, then the alarms started.  I can still viscerally recall the fear that gripped me as I felt her stop moving and woke up.  I didn't wait to see if the desat self resolved, I rubbed her back until her numbers came back up.

Baby Girl looks so much bigger than the last time we took a picture like this:


Weight: 1380 grams (back up those
30 grams) - 3 lb 1 oz
Milk: 1120 (37.3 oz)
Feeds: 24 ml fortified to 24 calories pushed over 30 min, 1 ml protein x 8/day (every feeding)
Iron supplement 1 ml
Tri-Vi-Sol .5 ml twice a day
CPAP 21%-30% oxygen, Peep 5
Blood gas tonight
Day Nurse: Rachel B
Night Nurse: Lauren