3 weeks 2 days - Ian is home!

We brought Ian home from the hospital this evening!  Today he reached 36 weeks gestation and it is one month from the day he was due. If you remember, 36 weeks and 2/17 was my long-term goal to make it to while on bedrest. It turned out to be a milestone of a different kind: homecoming!

On Monday, he was circumcised and Tuesday he passed his car seat challenge so the only thing holding him back was continuing to succeed at bottle feeding and going spell-free for 5-7 days or so. Since Thursday, he has been taking all of his feedings by bottle and doing better each day with them. His last spell was around 10 pm last Friday. I got a call from the neonatalogist yesterday afternoon at about 4 o'clock and he said that we could take Ian home today assuming that he tolerated his feedings through this morning and did not have any more spells. He would get his Synagis shot (to help fight against RSV) yesterday afternoon or this morning. I called this morning and Ian was still doing well so we could take him home!

Ryan and I dropped Keira off at a friend's house about 3 pm and we got to the hospital around 3:45 pm.  We spent about 30-40 minutes talking with the nurse regarding his discharge instructions, gathering up his things, and putting him in his carseat (a longer process than I remembered since he is so tiny!).  We picked up Keira a little after 5 pm and got home by 5:30 pm.

Keira was very excited to see Ian in the car and kept talking to him and calling out "Baby Ian." When we got home, she immediately wanted him out of the car seat so she could hold him. She has been talking about holding him and helping me change his diaper all week.  "Me hold Ian. Me help Mommy change Ian's diaper." So I got Ian out of his car seat and brought him and Keira into the family room so that she could hold him. She sat down on the sofa and I put him in her arms and Ryan helped her to hold him. She had the biggest smile on her face! All night she was very interested in what "Baby Ian" was doing (mostly laying in the Pack 'n Play).  When I fed him at 6 pm, she was right next to us the entire time and watching him try to nurse then drink milk from the bottle.  While he was drinking his bottle, she kept trying to hug him (read: crush him!) and give him LOTS of love. I don't think things could have gone better, she seemed so excited to have "Baby Ian" home.

Tomorrow I will take Ian to see the pediatrician while Ryan stays home with Keira during her nap.

A new adventure has officially begun...life as parents of two and big sister to baby Ian. We couldn't be happier to have Ian home!

(Okay, time to go to bed as he will be eating again shortly...I'm tired just thinking about it.)

3 weeks old - Bottle feeding champion

Ian is three weeks old today!

The past week has been a good one for Ian! I was able to visit him on Tuesday, Thursday and Friday, then Ryan and Invisited him on Saturday and Sunday, and again I visited him this morning.

Last night his weight was up to 6 lbs. 12 oz. So he is over one pound up from his birthweight!

I was able to give nursing a go with Ian starting last Tuesday and have attempted it each visit except for yesterday. Each time has gone better than I expected as I really didn't think he would do much, but each time he has been very eager to latch on and has even done some sucking. It will probably be a while before he really receives much of a feeding from the breast but I will keep trying with him.

On Tuesday and Wednesday, Ian continued to improve his bottle feedings. He drank his first full feeding by bottle on Wednesday. On Thursday, he took five if his eight feedings by the bottle. Also that evening, he pulled out his feeding tube ("I don't need no stinking feeding tube!") and the nurse told me that they were not going to replace it unless he did not complete his feedings by bottle. Well, he still doesn't have a feeding tube four days later and has been drinking from the bottle like a champ! He is getting better at drinking from the bottle every day. Today he took the bottle quite well and showed big improvement from just two days ago.

With the increased bottle feedings, Ian has experienced a few spells of bradycardia and O2 desaturations. He had one each on Wed and Thur and two on Fri. All of these were during or after a feeding so he has had a bit of trouble coordinating his sucking, swallowing and breathing. He has not had anymore spells since Friday night so we are hopeful that he has gotten the hang of bottle feeding and will not have anymore so he can come home.

Since he is now doing all feedings by bottle, these spells are the only issue keeping him from coming home. The doctors usually want 5-7 spell-free days. That means he could be released sometime after Wednesday of this week if all continues to go well. Ryan and I of course are not rushing this as we want to make sure Ian is ready to come home.

This afternoon Ian was circumcised and did well during and after the procedure. I brought his car seat to the hospital this morning so that it will be there when the doctor says he is ready to go home. He has to pass the car seat challenge test before he can be discharged (he is put in his car seat for 90 minutes and the nurses monitor that he does not experience any apnea, bradycardia or O2 desats while in the car seat). On Sunday afternoon Ryan and I attended an Infant CPR class that is required before Ian is discharged. It's a good sign that many if the pre-discharge items are being completed or are ready to be completed.

Today Grandma Janet left for home with Grandpa Gary as there was a snowstorm coming through NJ tonight and tomorrow. They were originally not going to leave until tomorrow. They will be back to stay for a week or so once Ian comes home. In the meantime, I am now "back to work" caring for Keira full-time. I should be able to see Ian either during the day when a friend watches Keira or at night when Ryan is home from work. Today I started nesting and cleaned countertops, cabinets and clothes. I'm exhausted now! I must keep in mind that I am only three weeks out from over two months of strict bedrest. I tend to forget that little fact until the evening hours hit and my muscles begin to ache.

Tomorrow I get to take Keira to ballet class which should be fun! Afterward I will drop Keira off at a friend's house and go visit Ian for a little bit. It's harder juggling the two kids already but should hopefully be better once Ian is home (okay then there will be new but good difficulties!). I can't wait until he comes home! 

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2 weeks old - Improved bottle feeding?!?

Ian is two weeks old today!

Due to a huge snowstorm which dumped 20 inches on us over Friday and Saturday, Ryan and I were unable to visit Ian since Thursday night. Thankfully the snowplow plowed our street this morning at about 10 am so I was able to drive to the hospital to visit him this afternoon. I spent several hours with him and got to hold him, change his diaper, take his temperature, feed him a bottle, and just take in his cuteness!

Ian is currently taking a total 50 cc's of breastmilk at each feeding. Until today he continued to show very little interest in bottle feeding so he is only being offered a bottle at every other feeding. Today he did better though: he took 10 cc's at 9:30 am, 29 cc's from me at 3:30 pm, and 15 cc's at the 9:30 pm feeding! The doctor has ordered that he can try breastfeeding 1-2 times each day so tomorrow when I visit, I will meet with the lactation consultant to try breastfeeding him. It will likely take a while to get him to actually do anything, but we will at least be getting started!

Speaking of feeding, he has gained weight very well the past two days. When he was moved to the Intermediate Care Nursery on Wednesday night, Ian lost weight the first few days, but as of tonight is up to 2710 grams which is 5 lbs. 15 oz.

This morning his billirubin level was down to 7.8 which is down from 9.1 two days ago. That is great because as it goes down, he should become less sleepy and more awake during his hands-on time which should hopefully help with increasing his interest in tge bottle.

Before today he just wasn't showing any interest in the bottle and was sleepy in general. Today during my visit, he woke right up when I started changing his diaper. He stretched his arms and legs out and opened his eyes up to see what was going on. While I fed him his bottle, he was quite alert and sucked for about 18 minutes while I fed him. This was much improved from the time I attemped to feed him a bottle last week as he started falling asleep after less than 10 minutes.

I enjoyed my visit with Ian so much today! While holding him, I just enjoyed watching him sleep and talking to him so he heard my voice. He makes all sorts of faces and was smiling a lot while sleeping. I was able to get a couple shots on camera and posted one picture to facebook. He was awake for a long time while I fed him his bottle and even after I put him back into his crib to get the rest of his feeding through the NG tube. As he got to the end of his feeding, he seemed a little restless so I gave him his pacifier and he just sucked and sucked on it and rather quickly fell asleep. I sang him a lullaby then left him to make my way home while it was still light out.

I plan to visit him tomorrow before the next snowstorm hits that afternoon. The forecast is for another 10-20 inches of snow which means we may not get out again until Friday. Not the best winter for us to suddenly get a ton of snow!  

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9 Days Old - Movin' on up!

Ian had a big day today!

Highlights of the day include:

- He was taken off all IV fluids and his IV was removed. Poor baby cried when it was removed, but I was there to comfort him. (He sounds like a chipmunk when he cries)

- Because he is maintaining his body temperature so well, he was moved to an open crib and out of the isolette.

- At two feedings, he drank a little breastmilk from a bottle! One bottle was fed to him by me and I loved it. He only drank about 5 cc's each time, but it is a good first step toward bottle feeding. His respiratory rate is staying mostly in the lower double digits now so he should be getting tries at the bottle more and more now.

- Because his IV was removed and he's in an open crib, he graduated from the NICU into the Intermediate Care Nursery! This means he is considered a Feeder-Grower and only needs to work on learning to bottle feed and breastfeed.

As I said, it was a big day for him! Ryan and I were so happy to see his IV come out as it means the only wires on him now are the NG feeding tube, the leads monitoring his heartrate and respiratory rate, and the Pulse Ox which monitors his O2 saturation level. And having him moved out of the NICU feels good too that he is on his way to coming home soon.

He was wearing his first clothes tonight which is the hospital long-sleeved t-shirts. Tomorrow we can bring him some clothes from home to wear since he no longer has an IV!

Our one concern remains whether he will continue to have apnea spells. He has not had one since Monday night which is good. We will just have to see whether he has anymore.

This morning Ian weighed 2580 grams so he is now only 10 grams below his birthweight.

He is getting 45 cc's at every feeding now and can take 10-15 cc's by mouth if he is up for it. When feeding by bottle, we can try for up to 20 minutes but more than that time period and we are to stop as they don't want him expending too much energy. He took the 5 cc's from me in less than 10 minutes but then fell asleep so he got the remaining 40 cc's via the feeding tube.

His billirubin level was 9.3 this morning which is up a little from yesterday but still within normal levels. If it should getabove normal levels again, then he will have to go back under the lights. Hopefully he will be okay though. 

During tonight's visit, Ryan changed Ian's diaper and took his temperature. His nurse then checked his vitals, removed his IV as it was not working, and then checked his blood sugar. His blood sugar was 80 which was fine so he did not need IV fluids and hence no new IV! I then got to feed him a bottle and hold him for a while. When I was done holding him, it was time for transport up to his new home in the Intermediate Care Nursery. We made sure that he was comfortable in his new home (he slept through the move!) before heading home.

New adventures for me: I have figured out how to pump under a nursing cover while Ryan drives us to or from the hospital. That saves us about 30 minutes since we don't have to wait for me to do that either at home or at the hospital. Now if we can just not get in an accident so I don't have to explain why I'm so exposed to the world! Tonight I was successful at pumping in the car ride home while eating a Frosty, but I don't know that I will try that again!

Last night I changed my pumping schedule to every 3 hours from every 2-1/2 hours. That made a huge difference in just one day! I felt more refreshed when I woke up this morning and just felt better throughout the day not having to "make milk for Ian" so often.

I better head to bed! It is almost time to pump again! Oops...   

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1 week old - Monday Feb 1st!

Ian is one week old today! His gestational age is 33 weeks 5 days. Thankfully, he is doing well thus far in the NICU. The past week has flown by in a bit of a blur.

High points this week: off C-PAP, off nasal cannula, up to 35 cc's every 3 hours via feeding tube and tolerating well, net weight loss of only 3 oz., infection concern gone, off phototherapy lights, maintaining body temperature in isolette on his own.

This morning, Ian weighed 2500 grams which is 5 lbs. 8 oz. (he weighed 2590 at birth or 5 lbs. 11 oz.) He was down to 2450 grams on Saturday morning, but gained weight the past 2 days!

He is now up to 35 cc's of breastmilk every 3 hours through his NG feeding tube. Thirty-five cc's is a little over an ounce. I'm still pumping every 2-1/2 hours and now getting about 33 oz. per damorEau more than he is eating so he has a good supply in the freezer at the NICU since I bring the milk in frozen every day. I'm going to call the NICU lactation consultants tomorrow to see if I need to continue that frequency or if I can back off to every 3 hours as it is very tiring! It currently means pump for 20 minutes then sleep for 2 hours.

By Saturday morning Ian's bloodwork came back looking good so it doesn't look like he has an infection anymore (if he ever did). That means they are discontinuing his IV antibiotics (ampicillin) tomorrow and should also be discontinuing his TPN IV nutrients then as well. That will mean he can be IV free at least for now.  

On Saturday, Ian was taken off the nasal cannula and is still off of it! So he is totally breathing on his own with room air without any help inflating his lungs. His O2 saturation levels have remained at 99-100% and his respiratory rate did not increase by too much so he has stayed off the cannula.

His respiratory rate has been decreasing every day since Thursday which is good. Once it is consistently in the lower double digits, he should be able to start bottle feeding. His nurses have tried it once last night and this morning, but his RR increases and it is too much for him to handle attempting both breathing and sucking from a bottle right now. They will keep trying and see how he does. Eventually it is supposed to click. I'm hoping it will soon!

On Saturday night, they discontinued the bottom phototherapy lights and yesterday they discontinued the top lights. They will continue to check his billirubin leeks so we may see the lights again, bit hebisbhapoy to have them off for now. He doesn't have to wear the sunglasses nowbwhile in his isolette.

Today we found out that he is maintaining his own body temperature within his isolette! The isolette is kept at room temperature and there is no heat being added to help him stay warm. That means he could be moving to a crib in the next week or so.

I'm looming forward to what the next week may bring! It seems as though he has already made a lot of progress thus far. Bottle feeding and breast feeding will likely be the biggest challenges he faces. Hopefully he is up for the challenge and will progress well. I'm hoping his RR will stay in the lower double digits in the next few days so he can move onto that next step with success.

Concerns for now: apnea. He has had five apnea episodes since birth, three of which were in his first two days while on C-PAP. However he also had one on the 28th and one tonight. We are hopeful that he will outgrow these and that they will not occur for much longer. I guess the good thing about tonight's episode was that he did not require stimulation to come out of it, he remembered to breathe again on his own.

Anyway, it's been a great first week! He is becoming more alert every day and is opening his eyes and looking around at the world.

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