Zacky

Brian is working swings today so it is time for my updating Joshua's NICU story. This is short and sweet.

In the NICU they have these pillow things that look like hands, and they are made to have the weight and feel of a hand too. The pillow is called a Zacky. The Zacky is supposed to make the baby sleep better or whatnot. I don't really know if it helped Joshua sleep or not, but we liked to put it on him. He didn't get to bring it home though, so here is our picture of him sleeping with the Zacky.

Feeding Joshua

The feeding of Joshua evolved through his NICU stay but I will put it all in one post.

He started out purely on IV nutrition for about a day, then when I was released from American Fork Hospital and was able to go visit him at UVRMC they had me sign a release form for him to have pasteurized human milk until my milk came in. Within a couple of days he was eating just my milk, but it was all going in through a feeding tube. Sometimes a nurse would give him a taste of milk so he could get used to the taste and like it. We learned not to ask the nurses because other nurses would look at us like we were crazy when we asked. The weird part about the beginning of his feedings is that they needed to know if he was digesting the food or not. So before every feeding they would suck stuff back out of his stomach and if it didn't look too bad they would put it back in, but if it looked nasty they would throw it away. That was not my favorite part.

In preparation for breastfeeding they had me do skin to skin holding with Joshua. Brian also held him skin to skin for bonding purposes. A couple of weeks before he would be old enough (based on gestational age) to try nursing Brian was holding him and Joshua started rooting around looking for something to suck on. The nurses and we decided that we could start him on the nursing path a little early.

The NICU has several lactation consultants to help the mothers learn how to nurse. Nursing a preemie is more difficult because of their size and age. They helped us get correct positioning which is even more crucial with the preemie, and they gave me a nipple shield to let Joshua get a better grip to suck since his mouth was so small. He was so small when we started, my boob was significantly larger than his head. I had imagined nursing to be fairly easy and I would just hold him in the crook of my arm, but it was fairly complicated.

The first part of working on nursing is non-nutritive nursing. This is where I would pump right before I went to visit Joshua so I would be empty, then they would hook up his feeding tube and feed him while he practiced nursing. Well that is what is supposed to happen. That night we had a little bit of a frazzled nurse so by the time I actually got to sit down with Joshua it was quite a while past his original feeding time. Then she forgot to hook him up. Brian and I were confused about exactly what was supposed to happen so we just let him suck for a while. Then she came back and we realized that she thought that he was going to do a nutritive feeding instead. I didn't think he had nursed that much, but when she hooked him up he spit up most of his feeding. That was the only time he spit up in the hospital (he came home and spit up a ton, I don't know what the difference was), so I think he was hungry and actually nursed.

After that he got a little cold and after he recovered we decided to try nutritive feeding. To figure out how much the baby was eating we would weigh him before the feeding and after the feeding, and the weight difference would be how much he ate. A milliliter of milk weighed 1 gram, so the conversion was super easy. The first time I nursed him for real, a full feeding for him was 32 ml, the nurse said to be happy if he got anything, and not to expect anything too far over 10 ml. Well Joshua nursed 30 ml that first time. Totally rocked it.

When the babies started nursing they are only allowed to try twice a day. When they nurse at least 3/4 of a feeding twice a day, then they can try three times a day. Then comes four a day, but with a break in between feedings, then 4 in a row/12 hour, then for 24 hours, then on demand.

It only took Joshua a week to go from 2 a day to 3 a day nursings, then we got stuck. One of the reasons is I didn't cut back my pumpings at all and with 3 added nursings my milk supply went from a lot to out of control. So I started choking the poor baby. He had this thing that if he would choke he wouldn't try to nurse for like a week. It took us like 3 weeks to get over 3 a day. He also ended up being fairly anemic during this time (it is normal for preemies to be anemic), and was borderline needing a blood transfusion, but with the lack of blood he was sleepier and less interested in eating. During the 3 a day, he was also able to start drinking out of a bottle. Brian got to give him the bottle, and even though it was really hard for Joshua at first, he soon was rocking the bottle too.

When he got to four a day he was finally nursing consistently. During this time he was able to come off oxygen except for during feedings. A couple of the nurses got it in their heads that he didn't need oxygen during feedings even though he needed the oxygen turned up every time he was fed. So they wouldn't let him have oxygen while he at, and he choked and went on strike again. I was quite annoyed.

The NICU has a baby feeding guru named Annie. She didn't spend tons of time with us, because even though Joshua was slow moving along, he had some really good nursings, and was obviously capable of doing well, and there were alot of babies with more difficulties. When we got to four a day, she left for vacation for a week, and planned on us being home when she came back. She was surprised to come back from vacation and find us in the same place as we were. She promptly gave Joshua back his oxygen for his feedings and within a week and a half he went off strike and we ended up home.

He went home with blowby oxygen for his feedings, where instead of hooking up a cannula with oxygen for his feedings we just blew oxygen in the general area of his nose and mouth. I would just weave it through my bra when I was nursing, but Brian came up with an ingenious way to blow the oxygen on his face when he fed Joshua the bottle. He just taped the tubing right to the bottle.

That is how feedings went with a preemie. I had no idea how complicated it was, until I had my second and she just nursed without any contraptions. Good thing Joshua was my first.

Joshua's first bath

Okay it actually wasn't his first bath, but it was the first time Brian and I gave him a bath. I actually went in that day to try to nurse him, but he had gotten a cold. Joshua was all stuffy and miserable, so I didn't think it was a good idea to nurse him. Our nurse suggested that we give him a bath instead.

We had not been at the hospital for his bath before. They would always do the baths during the night shift, but the nurses were usually busy during the first feeding of the shift, so we would be gone by the time they would give him a bath.

Joshua loved soaking in the warm water he would be super relaxed.

But he didn't really like getting his hair washed.

It was a lot of fun and it seemed to help him feel a little better.

May 29, 2008-Pooping

This night when when we went to visit Joshua one of us started to change his diaper and he started to poop. So while we were waiting for him to fill his pants we noticed that he was making hilarious faces. We only got pictures at the end, so they are toned down a little bit, but we still thought it was funny.

May 28, 2008

When Brian and I went to visit Joshua this day we were surprised to see his face without obstruction. He had yanked everything out of his face. It was fun to be able to see his face; it was the first time we had seen him without tubing. He was doing okay without the oxygen because he hadn't yanked the tubing out that long ago, so we were able to take a picture before everything got put back in.

Superstitions

I went in for my 6-week post baby check up after Minna was born. I asked if there was a reason I haven't been able to carry a baby to term. The doctor said there was no real way to tell with me. So since the doctor is unable to tell me why I have my babies when I do, I will have to rely on my own superstitions. These are the things I think make me go into labor.

1-Complaining about the uncomfortableness of being pregnant. A couple of weeks before Joshua was born I decided that I had been a good uncomplaining pregnant lady long enough and I was starting to get uncomfortable. So I started to whine a little bit, then Joshua was born. When I was pregnant with Minna I waited quite a while to complain. I felt like I should just be grateful I was pregnant, then around 32-33 weeks I decided I was starting to get big and it was hard to sleep. Well then Minna came shortly after. Brian says the kids don't want to make me uncomfortable so when I say that I am uncomfortable they come. So if I have another baby and I am not complaining, its not because I am comfortable or loving being pregnant, I am just trying to cook the baby long enough. But once I hit 36 weeks I will whine away.

2-Ordering maternity clothes online. I can buy maternity clothes from the store just fine, but when I ordered maternity clothes when I was pregnant he was born before they were even delivered. Then I ordered some maternity clothes when I was pregnant with Minna, I got to wear each shirt one time and then she was born.


3-I will have babies around the same time my friend Bree has her babies. Joshua was born 4 days after her first, and Minna was born 3 days before her second.

So since the doctor has no idea why I have my babies when I do, I have my own superstitions, that I may worry about if we have another one.

Feelings from the last few months about the NICU

I debated in my mind whether to put this post in the current stuff blog, or this blog. I decided that while these feelings happened recently, it made more sense to put it with the other NICU stuff.

These last few months I have been suprisingly sensitive about Joshua being in the NICU. I know part of it is just that time of year, where I can look back and go two years ago my life revolved around pumping and going to the NICU. But I don't remember being this upset about it last year. Little things set me off like shortly after Minna was born I was in the store and a new baby always brings comments especially from pregnant women. Well I was talking to this pregnant woman and I asked her when she was due. She said she was 28 weeks along and she was due in September. She then said that she wished that she didn't have to go through the whole summer being pregnant and wished that her baby was here now. Now I know she didn't mean that she wanted to have a preemie just to not be pregnant, but something about her being exactly how far along I was with Joshua and then saying she wished the baby was here, set me off. I had to leave quickly to keep from saying something which probably would have been not nice.

I think part of it has to do with the birth of Minna. I thought that having a baby, especially a more normal baby would make everything easier on me. Part of it is just comparing what life with Minna is like compared to what life with Joshua being a baby was like. I didn't realize how difficult it was to take care of Joshua as a baby, I just did it. I knew it was more difficult than having a term baby, and I secretly envied the life of people with term babies, but I just did it and thought it was a little harder than normal.

Then I had Minna and I realized the difference. I really noticed it when I realized how easy it was to take Minna somewhere. To go somewhere with Minna I just need a diaper bag with diapers and wipes, a carseat, water for me, and a nursing cover. When Joshua was a baby I needed the diapers and wipes, the binky (not really a big deal, except I forgot it one time, and then it was a big deal), the carseat, and a stroller to haul around the apnea monitor, and the oxygen tank, and either a nipple shield, or a bottle of pumped milk to feed him with.

Then to get Minna to nurse I just need somewhere to sit to get her hooked up, and some water and I am good to go. (Sometimes I am literaly going chasing Joshua around while nursing). With Joshua I had to put on the nipple shield, which was sometimes harder than attaching the baby, weave the oxygen tubing through my clothes so it blew around his face, and then try to get him to nurse. Nursing was a project, but a large part of that came from his enlarged andoids and I also realize that nursing Minna is easier because I have nursed before.

I think that Minna's birth gave me the chance to fully recognize the feelings of stress and worry I had about Joshua. I am grateful that Joshua's preemie experience went realitively well. And this rant has made me feel better. I am glad I finally got around to it.