Week 3 in the NICU

Saturday, May 5th:  To celebrate Cinco de Mayo Gordon and I went to Pappasitos for lunch.  YUM.  No margaritas for us this year.  I'm hoping to have an El Tiempo margarita very soon though!!  Two years ago today Gordon and I moved into our first home!  My oh my how things have changed in the last twenty four months. 
William did a great job eating today and seemed much more alert after his evening bottle. 
9am = 29 cc
6 pm = 30 cc
Weight = 4lb 4 oz

Wide awake after his bath

Sunday, May 6th:  We let daddy sleep in today while we did our normal morning routine.  After he finished his morning bottle I went home and picked Gordon up and we went and had a late breakfast at Barnaby's.  Since William did so well eating yesterday they decided he could have 3 bottles and went up from 36cc to 38cc.  He finished ALL three of his bottles (9am, 6pm, and midnight).  WAY TO GO BABY BOY!
Weight = 4lb 4.4oz

Monday, May 7th:  Dr. Hankins said we could give William a bottle at every feeding (if he acted interested) since he'd done so well with the three bottles.  The amount of milk he didn't finish at each feeding was given to him through his tube afterwards.  They increased the amount of milk from 38cc to 41cc and stopped the prolacta (which provided extra calories).  His bottles did contain 24 calories and now only have 20. 

9am = 28 cc
Noon = 30 cc
3pm = 22 cc
6pm = got through tube
9pm = we tried breast feeding and then he got his food through the tube
MN = 30 cc
3am = 41cc

He started desating after he finished eating in the afternoon so we gave the 6pm feeding through the tube.  It seemed like he was just so tired from all the eating and was forgetting to breath enough.  He also has a hard time pacing himself when he's drinking a bottle.  That usually leads to him coughing or gagging which then makes his heart rate drop.  Feeding a preemie can be a bit unnerving! 

Weight = 4lb 7oz
Height = 17 1/4 inches

Tuesday, May 8th:  Gordon and I attended an infant CPR class at lunch time today.  It was different than a CPR class for nurses....simple and clear cut.  They emphasize assessing the baby's breathing frequently and not just looking at their color.  You are more likely to find your baby not breathing but with a pulse versus not breathing and no pulse.  They say you rarely find an infant without a heartbeat (which is comforting).  The instructor said RSV and pneumonia are what you have to watch out for with preemies once they are discharged from the hospital.  She encouraged the parents to have anyone that will be around the baby often to get the Tdap shot since pertussis, or whooping cough, is also a culprit.  I received my shot 2 days after I had William.  Now we have to find a place for Gordon to go and get the shot.
Other than CPR class things were pretty uneventful.  Just working on this bottle thing.  Sucking, swallowing, breathing and not choking takes a lot of work!!

6am = 30 cc
9am = 30 cc
Noon = via tube
3pm = 41 cc
6pm = 37 cc
9pm = 29 cc
MN = 29 cc 
3am = tube
Weight = 4lb 8oz

Last day to sleep on my "gel mattress"

Wednesday, May 9th:  Since William had continued to have some issues with his heart rate and oxygen saturations during feeding time and the hour afterwards I asked if occupational therapy could see him.  I just wanted to make sure he was sucking the way he should and there wasn't anything else we could be doing for him.  She came by during the noon feeding and watched him eat.  She also placed him in different positions to see what he did with his arms and legs.  He passed with flying colors!  She said he's doing everything he should be doing and there is no need for OT to see him.  This is good news!  We have to remember that William is only 35 weeks gestationally so he's not going to do the things a full term baby can do.  Gotta give the guy a break....he should still be inside of me and I should still be on bed rest.  :) 
We always look forward to Wednesday and Saturday bath night.  He loves getting his head washed and I love the way a clean baby smells!  Tonight was an exceptionally big night.  Dr. Arnold from The Little Couple was the doctor on call.  She stopped by at the end of William's bath to introduce herself and to let us know she was on call.  When she saw how happy he was getting his bath she said he was too cute to not film and asked if we would mind.  SO, little William may be on TV.  We will let everyone know if and when the episode airs. 

6am = 41 cc (finished in 15 minutes!)
9am = 31 cc
Noon = 34 cc
3 pm = via tube
6 pm = 41 cc
9 pm = 29 cc
MN = 30 cc
3 am = via tube
Weight = 4 lb 7 oz

My favorite way to sleep!

Thursday, May 10th:  Today was a hard day for Mama Gooding.  William's monitor seemed to be constantly beeping.  His O2 sats kept dropping while he was sleeping and then his heart rate would randomly go up to 200-210.  They think he has reflux so I'm making sure to hold him in an upright position (usually laying on my chest) for at least 30 minutes after he eats.  I had spent the last 4 nights at the hospital so I think a lot of it had to do with being really tired.  He also got a little rash on his neck that they started putting powder on.  Dr. Hankins is no longer on service so we started with a new attending, Dr. Welty, today.  Alison saw Dr. Hankins out at West Campus at a nursing week breakfast and he told everyone that William and I were a good fit.  He teased my boss and said I was an excellent mama and may never come back to work.  haha!  Gordon and I really hope that one day I can work part time.  I can't say I'd want to be a stay at home mom at this point but working part time would be great.   
Along with the nurse I decided that we needed to cut back on how many times William took a bottle.  I felt like he was just too tired.  We would love to go home but we are in NO hurry.  We want to do what's best for him and at this point I think he needs some time.  There's no point in stressing him out and in the end causing more problems.  So, we went from 6 bottles a day to 5. 

6am = 32 cc
9am = via tube
Noon = 36 cc
3 pm = via tube
6pm = 38 cc
9pm = 39 cc (fed by daddy)
MN = via tube
3 am = 41 cc
Weight = 4lb 7oz

Friday, May 11th:  Today was a much better day!  William had very few episodes of bradycardia and desaturations.  When he does have them they improve almost immediately on their own with no intervention needed.  He's also done much better with pacing himself when he eats.  We've also changed how we hold him when he eats.  We now hold him in a side lying position and this seems to be helping with the choking/coughing.  Dr. Welty thinks we'll be going home in the next 10 days.  He said that everything he is doing is normal for a preemie and not to worry or read too much into any of it.  So we will keep doing what we are doing!  Maybe we'll try 6 bottles again sometime this weekend and by Tuesday be up to 7 and then 8 by the end of next week!  Next Friday we have his car seat test at 10:00.  Our car seat is made for babies 5lbs and up.  Hopefully by then he will be close to this.  If he doesn't pass the test in the car seat we have there are a few out there for babies that weigh <5lbs....Babies R Us here we come if that's the case. 

Question: What is the Car Seat Test for Preemies?

Answer: The American Academy of Pediatrics recommends a car seat test, or car seat challenge, for all babies born before 37 weeks gestation. The car seat test makes sure that premature babies are able to sit in a car seat safely, without any episodes of desaturation, apnea, or bradycardia.

6am = via tube

9am = 37 cc

Noon = 38 cc

3pm = via tube

6pm = 41 cc

9pm = 41 cc

MN = via tube

3am = 43 cc

Weight = 4lb 8.5oz

Mom, I don't wanna burp