breastfeeding

Prematurity

Big steps forwards, small steps back

Not much time to update, I want to get back to the hospital.

Yesterday they were on the verge of pulling the ng tube.  He had gone from 36% oral feeding to 76% in just a day or two.  And he was waking up starving before his scheduled feeds.  So they were going to put him on ad lib feeding, which would mean pulling the tube. But the over the course of the day and night they had to gavage (feed through the tube) partial feedings several times.  So we are going to go back to the every three hours schedule, with a minimum of 35ml, and me still weighing him before and after nursing.  But if he wakes up between feeds starving, they will still offer him a bottle, because starving the kid is clearly not good.  I think the amount he takes orally depends partially on the nurse on duty, and how much is going on.  I think some nurses are more willing to try, or have more time to try.  Also, breastfeeding wears him out.  So he is going to be nursing and then I think the plan is to gavage the rest, so he isn’t using too many calories just to eat calories.

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Prematurity

Getting bigger and closer to home

Rowan is continuing to grow and learn to eat.  He has taken a few full feeds by mouth at this point!  This afternoon he had some big bradycardias.  They weren’t long, but his heart rate dropped pretty low.  But for most of those he was eating, so I don’t know if they will hold them against him or not. But he is getting to nurse a couple of times per day.  For days he was transferring 4ml each time.  But the last two days he’s had one session where he has transferred 10!  Happy birthday to me!!!! His total every three hours is 36mls, so it’s still not a huge amount, but it is a start.  I think oral feeding is finally starting to click for him. Big news is that he is now over 1800 grams!  That’s the 4 pound threshold that is so important.  One more criteria checked off of his to-do list! There haven’t been any other major changes over the last few days.  Slight increases in feeds, but otherwise just learning to eat by mouth. He is awake more and more, and his eyes are getting a little more focused each day.  Tomorrow I should get to meet with lactation again to work on feedings.  Right now with the nipple shield he stays latched on really well, but doesn’t transfer as much milk.  Without the shield he gets more milk, but has to work a lot harder to stay latched on.  And we want him to not have to work hard, because that burns calories that he needs. I am also frustrated because I am having to work harder and harder to pump 2oz of milk.  This is still more than he eats, but I do not want my supply to go down.  So I will talk to the LC about that as well.  I was happy today when the nurse told me to freeze milk at home for a while, because they have plenty. Today during rounds they mentioned that his eye exam is scheduled for next Friday.  The doctor wanted to move it to this Friday, in case he has gone home by next Friday.  Now, that in no way means he WILL go home next week, but it’s the first time I’ve heard any discussion about the actual timing of discharge. Here are some pictures from the last few days!

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