NICU Diaries: Week 11
Baby is 38 weeks corrected gestational age.
Read about last week: Week 10!
Day 71: Milk Drunk
I worked with a lactation consultant Rachel who helped wake him up, observed his latch, saw how interested he is in milk (not very), and introduced a nipple shield to help him stay latched since he was off and on. She encouraged me that he’s almost there and it just takes time and practice. Since he’s already done a session where he got milk and did well, she is having me do “modified nutritive breastfeeding” where I pump halfway, and leave enough milk in there so that maybe he gets some but doesn’t get overwhelmed by the flow. Our nurse says that now Baby can try once a shift, so I can practice breastfeeding with him once during the day and again at night.
This was his very satisfied face with milk coming out of his mouth after he breastfed. Nurse Kristi calls it “milk drunk” 😆.
Day 72: First Test Weight
I brought the Boppy breastfeeding pillow with me to the hospital and it sure made it more comfortable. We did test weights before and after Baby’s breastfeeding session to see how much he drank, and he had 15mL of milk! It would have been more, but he spit up a bit. I’m so proud of him!
Aunt Adelyn dropped by and held Baby for the first time.
Day 73: Nutritive Breastfeeding
Baby was cueing really well over night so we tried breastfeeding him again today. We didn’t get a test weight before he started latching onto me, so just estimated that he got up to half of his feeding in 15 minutes at the noon session. He didn’t spit up any of it! He was vigorous and continuous.
He loves being active and looking at everything, especially the red animals on his baby mobile. He fought going to sleep so Nurse Katelin (the one who made footprints and handprints for us) put him in the swing. Such a sweet face!
Night was a different story. Baby and I had gotten very comfortable snuggling skin to skin and I even snoozed for a moment. He did not appreciate getting woken up and moved around for Cares, but tolerated it after his diaper change. I breastfed him and he wouldn’t latch or drink much from me, so his test weight had No Change. It’s difficult to accept those results, but I can’t push him if he gives me multiple clues that he’s done.
Aunt Adelyn came to see us after her school. Being with Henry can be so relaxing. I had a hard time getting up this morning so I said lots of prayers, put one foot in front of the other, and was able to take a shower and eat a bowl of cereal and pump before heading to my doctor appointment this morning. I was scared about the IUD placement going wrong or my uterus getting punctured again. Talked with the Nurse Practitioner about counteracting the hormones and it turns out that’s not really an option for me since my breast milk supply might be affected. I left the office cramping, bleeding, and in a little pain; holding my baby made everything all better somehow.
Day 74: Feeding & Breathing Progress
I walked in to find Baby sound asleep being held by a woman named Jessica. It was the first time I got to meet an actual Cuddler, and she was super nice saying how cute Henry is and that he was telling her all kinds of stories.
He got 16mL at his afternoon breastfeeding session, went for less than 10mins after latching. I love seeing his quiet face covered in milk.
He is now on Low flow!!! We can see his cheeks!!!! 😍😍😍
The respiratory therapist showed me Baby’s inhaler and gave me instructions. There’s 2 preventative medicines in it; he gets 2 puffs twice a day (once during day and once during night). While he’s at the hospital, they can give it to him. He’ll likely go home with it for a couple months and then the pediatrician can discontinue it.
Henry was cueing (showing signs of wanting to eat) while I was getting ready to leave, so the nurse practitioner and Nurse Natalie encouraged me to breastfeed him again because “it says twice a day, not specific times” so we did back to back. He took 14mL! Then the lactation consultant gave me good tips on facial exercises to do with him so that he doesn’t fight me at the beginning to latch. We only need one more feeding with at least 5mL in the test weight before they can start bottle feeding him.
Nurse practitioner Anita stopped me on my way out to talk. Henry is getting an echocardiogram tomorrow to get a picture of the structure of his heart. Some nurses heard a heart murmur last night so we want to see if his heart is working too hard to support his lungs, and to make sure it’s developed properly. The team at Primary Children’s was supposed to look at his labs and lung info to give recommendations for BPD chronic lung disease, but they didn’t have room at the discussion. Since the lungs and heart affect each other so much, the respiratory and cardiology departments work in tandem. I’m trying not to be anxious about this new development.
Day 75: Heart Results
They are weaning Baby from the diuretic and the extra minerals. Our breastfeeding test weights were 6mL and 14mL. Baby has done enough to bottle feed, but we’re giving him a few days to practice breastfeeding more. Lactation wasn’t there to guide me so Baby is still fighting me, I’m having a hard time calming him enough to eat well, and latching is kind of tricky. I just really hope I’m not traumatizing him or teaching him bad habits or inadvertently stressing him.
Today was my first day trying a lactation supplement to help with my milk supply. I also took vitamin D recommended for the change in season and lower sunlight. Holding Baby while nursing and also just cuddling or looking at him in his crib has felt so healing for me.
The nurse practitioner explained the BPD and heart stuff to me. Most of it is stuff we’ve already dealt with for the other kids, or mild things we need to follow up on. Henry will need another echocardiogram 3-6 months after discharge, but we talked about the potential concerns and right now it seems like he’s okay. He’s able to be on low flow oxygen with room air, he’s still growing and breastfeeding, so his heart and lungs seem to be doing their jobs, but maybe not as effectively as they could. We also need to be protective of him especially in this first year since respiratory illness is much more devastating to his premature system.
Day 76: The Boss
It’s Saturday so Jer and I went to the hospital together to visit Baby Henry. We got a bunch of chores done in the morning, so I felt a little less stressed having the bare necessities like clean clothes and less piles of stuff.
It wasn’t just my imagination: Henry has started negatively associating being at the breast or having things near his mouth. It’s not uncommon for preemies who have had tubes and things put in their throat to have issues with feeding and fight even through their natural hunger instincts.
Jen our lactation specialist says our priority is “QUALITY over quantity” and a positive breastfeeding experience. These are supposed to be Baby Led and “he is the boss” so we listen to his cues and signs of stopping. He seems to be an “instant gratification boy”, so we put a little milk in his mouth to encourage him. She did more facial exercises with him and put him in a variation of Football on me so he was able to drink 2mL calmly from me. She said we call that a Success because he was happy to do it.
The second breastfeeding session we had to let go of expectations and just try holding him, but even that didn’t work. We had no lactation guidance, but tried to do what she taught us and Baby wasn’t having any of it—not skin-to-skin, no cueing. He seemed irritated and tired and couldn’t get comfortable. Jer tried unsuccessfully to keep him comfy while I pumped.
We both left missing Baby because we didn’t quite get the bonding with him, feeling dejected and confused and scared for what this may be a preview of when he’s home. Maybe Henry just needs a break. The doctor said that what we are asking him is equivalent to us getting on a treadmill to run 3 miles every 3 hours; it’s a lot!
Day 77
Happy 39 weeks, Baby Henry!
We really enjoyed holding Baby today, who was so cute and loved his swing. No breastfeeding because he wasn’t cueing.
Just for today they removed the fortifiers and extra calories from Baby’s feed, and gave him straight Mother’s milk as a reset. Yesterday he seemed irritable and in a lot of discomfort (maybe even pain) from a prolonged cycle of tummy issues with loose stool in every diaper, which may lower his appetite, too. Hopefully his gut and body get a break, and his sore bum has a chance to heal. He will also take a probiotic, and the fortifiers may be changed to one suited for term babies.
Read about next week: Week 12!
Check out more weeks from our NICU journey here.
