mini-conference with NICU doctor

Emily has been in the NICU for 9 weeks now, which is longer than Claire's stay. We wanted to have the doctors explain her situation so we know what to expect instead of guessing based on prior assumptions. The two main factors are her heart, and her feeding skills.

Her heart defect is more severe than Claire's, so it is definitely slowing her growth. But the doctor said that as long as she does continue to grow, that is a good thing. If her growth stopped utterly, then they would have to consider doing the heart surgery now, which is more dangerous the smaller the baby.

Feeding is a combination of instinct and skill, and in a preemie they are lacking in both, so it requires practice and waiting until they "get" it. He said there is often a sudden breakthrough rather than gradual improvement. I think Emily has the skill/instinct already, but seems to get tired or stall out.

The night-shift doctor was very helpful in answering our questions. Coincidently, he was the same doctor that briefed us the night after Emily was born. I filled out a kudos postcard at the hospital in appreciation.

slow nursing

As I mentioned on Sunday Emily is not yet strong enough to get very much milk at the breast. Even with the nursing supplementer which delivers additional milk through a tube taped to the breast she is only getting about 5-10 ml from the supplementer in 20 minutes. Today the nurse on duty had lots of personal experience using the supplementer and gave me some tips about how to tape it and to use both tubes instead of one and to use the large diameter tubes for a faster flow. She got 10 ml in 7 minutes.

more progress

breastfeeding went well yesterday. Emily nursed 4 times (A new record). A Woman from La Leche League met me ay the hospital and saw how Emily was latching and sucking and thinks she is doing well and won't have problems nursing exclusively once she build up her strength and stamina.

Emily took the bottle at noon yesterday for the first time. She was able to take 20 of the 37 mls that she gets. (They gavaged the rest.) She didn't seem to have trouble with the suck swallow breathe pattern at the bottle. I feel less pressure now that she has a way to take feedings by mouth when I'm not there. For now she'll be receiving two bottles every 24hours.

Update Saturday

I just spoke with Jen and Mark on the phone and things seem to be going well. Jen is up and walking a bit already. Leaving her room on the seventh floor to visit Emily on the 8th floor, however, is exhausting and taxing on her recovering body. (Why, oh why, do they keep the postpartum rooms on a separate floor!?)

Emily had a great first night with no "events": her breathing, oxygen saturation, heart rate, and body temperature all stayed steady and strong. Her breathing was mostly unassisted though the pressurized nose feed remains attached for the time being.

Later, unfortunately, the NICU staff had difficulty inserting an IV line yesterday and that stressed Emily out. They had to make several tries and redos stretching over a few hours! As a result, Emily had some "desaturation" episodes, meaning her oxygen levels fell a few times last night.

On the flip side, having the IV set is one step to closer to removing the umbilical line so that Mark and Jen can cuddle with Emily for some mutually needed and desired skin-to-skin "Kangaroo" time. The nurse told Jen that they might be able to remove the belly line latter today. Hopefully, that means Jen can soon implement her idea of setting up her lawn chair in the NICU to relax with her little one against her chest.

The planned baptism had to be rescheduled because of the extended IV procedure and complications that were keeping Emily and the NICU staff occupied. The new plan is to have the sacrament performed tomorrow afternoon.