Alec-
Alec is doing GREAT!!! He is starting to nipple, which is great! He's taking about half of his feedings from the bottle! Good job buddy! His residuals have been pretty darn good as well. I did ask the doctor why it was not okay for him to have over 4 or 5 cc residual, and now she's saying 20 cc is fine. She said that it is because he's doing GREAT! She explained that residuals don't often mean much, and nurses may get more residual depeding upon the position of the baby, etc. She is so pleased with how he's doing, and isn't worried about his residuals. IF he has SEVERAL large residuals, then she'll worry, but for now she's pleased! Good job buddy!
They have also asked that I start to separate hindmilk from foremilk. For the breastmilk novices, here are some explanations of foremilk vs. hindmilk I found from google:
FOREMILK: When first starting to breastfeed, the first milk the baby receives is called foremilk. It is thin and watery with a light blue tinge. Foremilk is largely water needed to satisfy your baby’s thirst.
HINDMILK: Hind-milk is released after several minutes of nursing. It is similar in texture to cream and has the highest concentration of fat. The hind-milk has a relaxing effect on your baby. Hind-milk helps your baby feel satisfied and gain weight. Feed your baby until you see a sleepy, satisfied look on your baby’s face.
They are trying something DIFFERENT this time around with Alec. They often fortify breastmilk with a human growth fortifier to add calories for preemies, but the last time they did this with Alec, his tummy got upset and he had all the high residuals and feeding intolerance. So, our lactation nurse suggested a more naturalistic approach, by separating foremilk and hindmilk, and giving Alec only the hindmilk, which is high in fat and calories. So, I now pump the first 10 minutes or so (or 1.25 oz or so on each side) and then put a new bottle on and pump the rest, and the rest is the hildmilk for little peanut Alec. We'll see in a few days how it goes for him! We need to beef him up!!!
Tonight, Curt fed him, and he drank something like 35 cc from the BOTTLE (of 41 cc)!!!! What a BIG strong boy!!!! He's doing GREAT!!!!!!!!!!!!!!!!!!!!!!!
OH! And Daddy got to give Alec a bath today! What a TREAT!!!!!! Here are some photos of the event!!!
Daddy and our favorite nurse Julie:
Evan-
Well, our favorite nurse was on this morning with Evan, and she said that he spit up a bit after his morning feeding, out his mouth and his nose. It was all white, so no bile, but it scared her, as this is what happened before his last NEC appearance. She said she called the doctor over and she immediately did a full exam, and took quite a long time with him checking him over. The doctor decided to stop his feeds for two feeds, and resume at 4:30 pm, beginning at 10 cc, and upping by 2 cc every other feed, so going up slower for him. The nurse said that it "is probably just her, because she is a paranoid mother bear" but she said she just gets nervous because this is what happened last time as well. The doctor decided to just take it slow with him. I appreciate this, but of course am disheartened. I just want things to look up for Evan, and for him to take off and do just great! Come ON little buddy! When Julie (nurse) and I changed him, he had a poopie diaper (dark green bile poop from having nothing in his tummy for a week!), and LOTS of gas. He'd toot toot and then push some more poop out, then toot toot, then push more poop out. Julie thought perhaps he had a tummy ache from not eating for a long time and his tummy was sore from having food in there where it hasn't been for a week, and this might have caused his pukies if he was gassy and pushing, etc. Who knows!!!
He has no other symptoms or bad signs. He has no blood in his stool, tummy nice and soft, bowel sounds, stats good. So...he started feeds again tonight at 4:30 pm. So far so good.
The doctor said that Evan is "a bit puffy", which explains his chubbed out look. She said that he needs some more protein, and that the puffiness will likely stick around for a while until he starts eating a bit more. She explained that TPN is not an exact science, that it does it's job, but not as well as food can and will. All the more reason to route for Evan to eat eat eat and tolerate it well!!!! The doctor also said he needs some more protein. Truth be known, I'm worried about his puffiness. I will ask his regular doctor about it tomorrow probably. That puffiness combined with his big weight gain over the past half week has me worried....then again, what doesn't, right ;) Hahahhaah. It's a mom's job!
Needless to say, I'm thinking of Evan all the time...praying for him to take off and tolerate his feeds. I want him home SO badly, AND his brother Alec... Ohhhh how I hope and pray Evan turns the corner and does wonderfully...
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