It Didn't Go Quite As Well As We Had Hoped...

...but we are still headed in the right direction.  By yesterday afternoon Malia was so tired that she barely even opened her eyes when I went to feed her.  She still ate well, but she was so sleepy that if we had kept it up she would probably have started to lose ground.  So we backed up half a step and went back to breastfeeding two feedings and giving her a break on the third.  Instead of tube feeding, the pediatrician opted to try bottle feeding for the third feeding.  It is easier than nursing so she still gets a bit of a break, but it isn't completely backtracking.  That pattern has worked well today.  Malia is still feeding well and although she is still pretty sleepy, she is not as completely worn out as she was yesterday afternoon.  Her weight was up five grams this morning which is a miniscule amount, but still a step in the right direction.  Yesterday her blood oxygen kept dropping so she is on oxygen today, but the pediatrician is not overly worried about that.  He said it is very common for premature babies and just getting a bit older will resolve it.  He did run some blood tests just take make sure he wasn't missing anything, but all the blood work came back just fine.  And he tells us that being on oxygen won't keep Malia from going home.  If she still needs it by the time she is ready to leave, we would just take a portable oxygen tank home with us.

So we're not as close to going home as I would like, but we are still baby stepping towards the door.

I Can See a Light In the Distance...

Today is day nine in the hospital.  Malia did really well yesterday.  She was feeding well, waking on her own several times, was easily roused other times and had several good periods of wakefulness.  This morning she has gained a bit more weight (about another ounce).  So today we are doing a trial run: all regular feedings and no tube feeds.  This evening we will reassess and see if she feeds well all day without getting too tired out.  And then we'll see if she grows again.  My fingers are crossed.

"She belongs to me, you know."

Although none of us were prepared to have Malia arrive quite this early, the boys were pretty excited (and surprised) when they woke up and Kev's mother told them where Kev and I were.  Last Monday evening before low blood sugars necessitated an IV, Malia was able to come to my room for awhile.  Matthew and Nathan both wanted to hold her repeatedly.  Every time she was passed from one person to the next, Matthew would put his hands under her to "help" get her to the next person.  He wanted to hold her all by himself and we had to explain how carefully we need to hold her and that he will need help for awhile.  At one point, Matthew announced to everyone in the room, "She belongs to me, you know."  I guess I don't have to worry about whether or not they like her.

 

Nathan and Matthew have been so excited about having a baby and now she is here and they aren't allowed to see her.  It has been pretty hard on them.  They keep asking when they get to see her.  We tell them they will see her when she comes home but we don't know when that will be.  I wish we had a better answer for them.

Every Little Bit Counts

Yesterday an early intervention feeding specialist (I know, a huge title for a lady who has studied infant development and feeding problems) met with us to see how Malia is eating and to offer recommendations.  She says Malia has good feeding skills, that she is just struggling because of her age.  Malia's gestational age is 35 weeks and apparently that is the "sleepy" stage.  So the specialist has suggested that we do two traditional feedings and then one tube feeding to give Malia a chance to rest a bit more.  We started that routine last night and the last three regular feedings have gone well.  This morning her weight is up about 2 and a half ounces.  I know it isn't much, but each gain (no matter how small) is a step in the right direction.  The specialist says the excessive sleepiness generally passes once the babies hit 36 weeks gestational age so hopefully in a few more days Malia will begin to wake a bit more.

Why Would You Do That?!

This morning just before Malia’s 6 a.m. feeding, her nurse called me and told me that Malia’s stats were all over the place, that she had lost weight, that she was super sleepy and hard to rouse and that they were going to skip her feeding and just do a tube feed.  I, or course, got all stressed out.  What mother wouldn’t?  It seemed that my baby had taken a sudden turn for the worse.  So as soon as I was able, I walked down to the nursery to get some more info.  By then there had been a shift change and Malia had a new nurse, one that has spent the day with her before.  When I asked how she was, the nurse informed me that she was doing good.  Yes they tube fed her this morning, but it was because she was pretty sleepy (which is totally normal for a 34 weeker) and about an hour after her feeding she roused and had a good fuss session.  Her temperature was just fine and her blood oxygen had dropped for just a few minutes so they just did a bit of blow by oxygen and then she was back to normal.  She had lost a bit of weight, but it was less than she had put on the day before.  Essentially, things were pretty much the same as they were, no major changes.  We think Malia was just a bit more tuckered out because of all the good feeding and alert time she had yesterday.

So let me ask you: why in the world would you call a mother, rouse her from sleep and tell her that her baby was not doing well if there was nothing to be alarmed about?!    I mean, it doesn’t take much to make the mother of a five day old preemie baby panic.  Not only is there the standard worry that happens in any situation where your child is threatened, but there are a boatload of hormones still all whacked up as well.  And you would think that a nursery nurse would know that.  But obviously that is not always the case.  So I’ll take a big breath and keep on moving forward…

Yes, I Actually Chose to Stay Here

Our hospital has a program that allows mothers to stay in their room free of charge if they have a baby in the level 2 nursery and either live more than thirty minutes away or are breastfeeding the baby.  It is based on whether or not there is space, of course, but as of right now there are numerous empty rooms so I've opted to stay here at the hospital for a few more days so I can continue to nurse Malia.  I am no longer a patient so I can come and go as I please which means that in between feedings I was able to go home a couple of times which I think was good for the boys.  They are doing fine, but it has been a rather stressful week for everyone and having me home for dinner gave them (and me) just a bit of normalcy.

As for Malia, in between her improved feedings and tube feedings, she put on a bit of weight overnight.  It's only about an ounce and a half, but for such a little thing that is pretty significant.  Today she has been feeding well enough that they are only tube feeding her if she doesn't nurse for long enough.  This evening she was actually hungry enough and alert enough that she got mad when I didn't feed her fast enough.  So it was a good day.  Hopefully a few more days like today will get her to the point where we can take her home.

It Is As They Said It Would Be

After Malia was born, the doctors and nurses told us that progress would be one of those "one step forward, two steps backwards" deals.  And they were right.  After doing so well yesterday morning, Malia began to have trouble maintaining her body temperature again so she went back under the heat lamps.  Her blood sugar was better with the IV in, but she still wasn't feeding well so yesterday afternoon the pediatrician opted to taper off the IV fluids and place a feeding tube instead.  So now she feeds as much by mouth as she can before she gets too sleepy and then gets the rest through the tube.  So that would be the two steps back part.  After having enough to eat a few times, she is more alert when she is hungry which facilitates better feeding.  And getting enough nutrition means she is back to maintaining her body temperature.  So our current game plan is to keep feeding by mouth and by tube until Malia is feeding well enough on her own to be able to take the tube out.  I will be discharged tomorrow, but obviously she is not ready to go home yet.  We don't know when that will be.  Taking things one day at a time is part of the game as well.

Life Doesn't Always Turn Out the Way You Expect

I like my life to be organized, planned, predicable even.  So even though all the c-sections are not exactly fun, being able to pick a birthday and plan every detail in advance seriously appeals to me.  But life doesn't feel inclined to go along with all my plans and this week has turned out to be the biggest deviation from my plans to date.

My c-section was scheduled for September 22.  It has been on the calendar for several months already and we were just beginning to get the details set up.  But my water broke early on Monday morning so instead of Malia's birthday being September 22, she was born on August 22.  She was five and a half weeks early which was giving me pretty big panic attacks as we were being prepped for surgery and waiting for the doctor to arrive.  Malia arrived at 1:37 p.m. and she weighed in at 5 pounds 6 ounces and 18.5 inches long.  She is actually pretty big for a 34 weeker (although she is tiny for our family), so that definitely works in her favor.  She was breathing well on her own from the very beginning, the only respiratory concern being that she was breathing a bit fast on Monday.  That problem resolved quickly, thankfully, since that was one of my biggest concerns.  She has had trouble maintaining her body temperature so she has spent most of her time in the nursery under the heat lamps.  She seems to be doing better that way this morning and once she actually gains some body fat that problem should cease to be a concern.  Our big focus right now is getting her to eat enough.  Her weight is down to 5 pounds 0.6 ounces today.  She is burning extra calories in order to maintain her body temperature, but she is early enough that she is very sleepy and doesn't always feed well.  Her blood glucose was so low yesterday that they had to put her on an IV to get her sugars up.  Today they will begin to gradually decrease the amount of IV fluid she receives and hope her glucose level doesn't drop too far.  We don't know yet when she will come home.  We are just taking things one day at a time. 

As for me, everyone here has listened and responded well to all my concerns and as a result my recovery has gone very well.  I wasn't sick at all and besides a huge lack of sleep and worry about Malia, I feel pretty darn good which means I can put all my focus on getting Malia to where she needs to be. 

(The ultrasound was right about the hair.)