A bit of a surprise!

Our precious, precocious daughter yanked out her feed tube the other day and rather than put it back in her nurse decided to see how well she did on a 'feed on demand' schedule rather than a timed gravity feed schedule. That just means that every time she acted hungry they bottle-fed her with my breastmilk. Apparently she did well and gained weight at her usual rate, so they decided there was no real reason to keep her around much longer and informed us that she should come home within a few days! She'll likely be home on Saturday or Sunday!

Um ... what? A baby here, living with us? We are master procrastinators and having not expected her to come home for at least another couple of weeks we find ourselves now scrambling to prepare. Some things we'd intended to do won't get done before the weekend, but they're not the important things like having diapers and bottles and all the little things you find yourself needing. Moving furniture? Can wait.

Luckily we have the most important basics at hand like a place for her to sleep, a car seat, clothes and other essentials. Plus, my boobs. She actually managed to latch without using the nipple shield for a few minutes today, but I am still glad I have that thing or I don't think we'd be having so much success. But the fact that she can be sustained through bottle feeds means that the hospital feels she's ready to strike out on her own, and so it's time for us to take over.

More to follow, but we have a lot to do!

Glimpsing the bottom of the well.

I'm so thankful that I told the nurses that it was OK to bottle feed Shaughnessy. Since the night before last I've had a scratchy throat, sinus pain and an on-again, off-again slight fever. It doesn't feel all that serious but the presence of symptoms like this keeps me out of the nursery where my daughter still lives and that makes me very sad. Even worse it keeps me from breastfeeding my girl, but at least she's being bottle-fed which keeps up her practice at suck-and-swallow.

They did make some worried noises about how much breastmilk they have on hand and feel that they're running low. I wouldn't be overly concerned but my milk supply has decided to get less plentiful over the last week and I'm not quite sure why. If it does happen that they find themselves out at some point I'll give them permission to give her formula, but I'm hoping it doesn't come to that. She's never had formula and the sudden switch would probably give her gas for miles, not to mention worse constipation than the poor little bug already has.

Mostly it's a selfish worry, though. She's at what is considered full-term with regards to her gestational age. Drinking formula is pretty much a non-issue at this point. Being able to express milk for her and know that all of her sustenance came directly from me was a major source of comfort for me during the time when there wasn't anything more concrete I could do for her. I couldn't cuddle her, I couldn't comfort her, I couldn't even really touch her much, but by golly I could pump! Even if I hated physically doing it, I was glad to do something so maternal for her.

Now that I can hold her, interact with her and even breastfeed her directly it's not as emotionally necessary, but I'm still a bit freaked out. I didn't have to put much effort into keeping up my milk supply, and suddenly it is betraying me! The nurses at both hospitals were/are very pro-breastmilk and although they're not explicitly anti-formula (and I am decidedly NOT anti-formula) I have overheard disparaging comments about it. I don't want to be disparaged! I'm already paranoid enough about seeming like I'm not a good enough or caring enough parent.

Anyhow, it's just something new for me to freak out about and poke at with my brain. I'm stepping up my pumping/expressing a bit to try to stimulate more milk production but if anything I've seemed to be getting even less as a result. I do not know what this is all about. What up, boobs. I'll have to chat with the lactation consultant at St. Mike's, someone I have not yet met. Reports to follow on whether she is terrifying.

Anus, whatever.

So I've had three good breastfeeding sessions with Essie so far. The last one was today and she drank about 22 cc's altogether which is almost half of a feed. I tried to get her to do it again for her next feed but she was like, "What? I'm tired!" So, no go. Her stamina is not yet enough, I suppose, so I may have to try to nurse her at alternating feeds rather than two in a row for a bit.

We did have a nice visit with her today. The nursing session was cozy and wonderful, of course, and Andrew was there too which was nice because he wasn't for the last two sessions. The breastfeeding might be going well because I gave permission for the nurses to bottle-feed her and that's apparently been going well too, so she's getting lots of practice with suck and swallow. I just want this kid to be able to eat, as I've mentioned, so the fact that it's all going well makes me very happy.

She is getting a bit of a diaper rash, and I've noticed when I change her diaper at St. Mike's that it's always very, very wet. Like, many pees worth of wet. At WCH that didn't seem to happen and she never really came down with a rash at any point. The nurse gave us some zinc cream to use on her to help with it and Andrew changed her.

While we were sitting around he got in a conversation with the nurse about the rash and ... well, he used a lot of proper terms. Stuff like, "When I wiped her anus," and "I noticed she was red around the anus," and "There wasn't really any fecal matter around her anus."

I was sitting there holding our daughter and all I wanted was to holler, "STOP SAYING 'ANUS'!" He went on to say 'feces' and 'anus' and 'fecal matter' a few more times, and I just clenched my teeth and stayed quiet. We went out for dinner during the shift change and over our meal I suggested to him that terms like 'bum bum' and 'poo poo' were just as serviceable.

He disliked the unprofessionalism of such language and pointed out that when the nurse gave us a bath demo she kept saying 'vagina' a lot and it's true; she did. It was all vagina this and vagina that and vagina over here. But still she is a nurse and he's not! He's a dad! I still can't imagine him saying bum bum and poo poo, though. He's far more likely to say 'ass' than 'anus', to be entirely honest.

The big transfer.

On Thursday afternoon I got a call from the charge nurse to tell me that Shaughnessy was going to be transferred that night to the level 2 nursery at St. Michael's hospital. I'd been expecting yet dreading this call for a while so it wasn't much of a surprise. I knew that we weren't supposed to be at WCH any more and it was only serendipity that had kept us there thus far.

The transfer was supposed to happen at 8:30 but the ambulance actually arrived early so she went around 8-ish, I think. I was about to change her diaper and take her temperature and all that stuff when they got there, so instead her night nurse took over and got her ready to go. It was a nurse who hadn't had her before and while she was listening to her chest with the stethoscope Shaughnessy started up her usual grunting and growling. The nurse tried to work around it, but eventually looked at my girl in pretend exasperation and said, 'You sound like a bear!" I loved this, since her growliness is something that I find extremely funny. If my sources are correct she'll outgrow some of this around the time she reaches her due date so I really need to cherish it while I can!

Anyhow, the nurse did get her settled into the transfer incubator out in the hallway where the ambulance attendants were waiting around. When she was done she draped a blanket over the top, saying to us that whenever people see one of these incubators they gawk at it to try to see the baby inside so it was just a bit of privacy. Then we all started off.

When we got to the elevators to go down to the first floor a huge group of people came out into the elevator area. It was a tour showing expectant parents the various floors they'd be visiting or could possibly end up visiting. It looked like they'd just come up from the high risk floor where we'd spent the first month and a half and when they all saw the incubator they looked very solemn indeed. All the moms were hugely pregnant, likely due near the time I'd been or near thereabouts. The back of the incubator wasn't covered by the blanket and we did see lots of the parents peering in trying to get a look at the preemie within. Shaughnessy was wrapped in blankets, wearing a hat, strapped in a head hugger, covered with more blankets over that, strapped down to the floor of the incubator itself and surrounded by rolled up towels so there was nothing to see but fabric.

We eventually got into the elevator and left the group behind but it was just so awkward and funny and strange. For them the reality that our daughter has had to live is what they are hoping against with everything they have, so that brief encounter in the elevator area was serious and scary and sad. For us it was anything but, seeing as how her transfer is just another indicator of how healthy she is and how much progress she's made. I know that if I'd been a part of that group I'd have felt the exact same way and pitied the poor parents walking next to the incubator, but all I felt was grateful that my girl was OK.

I rode up front with the ambulance driver and Andrew took the subway to meet us at St. Mike's. The drive over was pretty awkward because the driver had a sense of humour that I just didn't understand at all, and had a little outburst to himself where he was looking out the window to his left and muttered angrily, "I just don't give a damn!" It was unrelated to anything we'd said and anything going on around us (that I could see) so I just waited out the rest of the ride as best I could. Eeek.

When we arrived and got up to the nursery one of the first people I saw was a mom I'd been getting to know at WCH, so she and I chatted a bit while the nurse got Ms. Essie out of the incubator and handed her off to her new nurse. Then they did a whole inspection of her with the pediatrics fellow checking all of her reflexes and muscles and whatnot. After all that the new nurse dressed her in new clothes, wrapped her up, covered her with a blanket and that was it! Transfer complete!

I'm having a lot of separation anxiety about not being at WCH any more. Yes, the St. Mike's nursery is bigger and fancier and the rocking chairs are nicer and all that jazz, but it's just not WCH with the nurses we know and the familiar surroundings and all that. WCH is a hospital that I have come to have a lot of respect for and I want to give back to it in some way. Also, change sucks and in a weird way I feel very unsettled about Shaughnessy being in a place that I don't know well. It's not sensible since she's about as safe as safe can be living in a hospital nursery with medical professionals all around her, but whatever.

I did get to nurse her again yesterday which was awesome and went even better than the first time. She drank about 12 cc's before getting tired this time. I can see how it will take some time before she's able to subsist just on breastfeeding alone since she really needs to work up her strength in order to get a full feed from nursing. But it's just as wonderful as I thought it would be to be able to sit and look down at my daughter and hold her hand and sing to her while she nurses. She's awake for most of it and she looks at me and we connect. I feel like I'm more than just her friendliest nurse in that moment.

My baby is unreasonably accomplished.

I went into the hospital yesterday so that I could spend Shaughnessy's eight o'clock and eleven o'clock feedings with her. The nurses seem to think that doing the lick and sniff in the half hour before the feed is supposed to start is best, so I wanted to time it right. She was sleepy when I got there, but I changed her diaper and took her temperature before starting the first lick and sniff and she woke up and was nice and perky.

I'm going to start off each session without the nipple shield but then switch to it after a few minutes. I'm not really expecting her to get a good latch yet without it since she still needs to build up some strength, but I also want her to be familiar with me sans silicone barrier.

Her nurse wasn't there when I started, but when she came to check on us she told me that we looked like a textbook illustration of the football position so that was nice. I'd already started with the nipple shield but S-Girl was still kind of fussing around a bit, moving her head back and forth a lot. All of a sudden, though, she latched right on and started sucking. I could tell she was getting some milk because she paused a bit and seemed to be concentrating on how to coordinate this new aspect of sucking, but then swallowed and from there on didn't skip a beat!

The nurse came back and saw that she was sucking and seemed very impressed. We hadn't weighed her first so the nurse decided to see if any milk would come back up the feed tube, and sure enough it did! She also used the stethoscope to verify that there was swallowing going on (since it's hard to tell with her fatty little neck now), which there most definitely was. Through all this little Ms. Essie just sucked away, kind of ignoring all the fuss going on around her. In the end she really only drank about 5 cc's of milk, but she NURSED THAT BREASTMILK, BOOYAH! The nurse was impressed and wrote it in her chart as a mini-feed, not a lick and sniff!

I know. Babies nurse. It's not earth-shattering. But she's a month shy of her due date and seeing my daughter go from a 1000g baby with no body fat to a 2169g+ baby with thunder cheeks who can nurse like it's no big thang, well ... it thrills me. OK?



Phew. After her feed was over and all that excitement faded I cuddled her for a long time and she flaked right out in my lap, snoring her little snores and getting really warm and comfy and content. I had to put her back in her incubator so I could go eat something, but I had a feeling she was going to be a sleepy baby for her next feed and that the second lick and sniff wouldn't happen. I was right, and oh noes the horror instead I had to cuddle my baby girl for another long period of time, what a chore.

Then I came home to sickly Andrew who has been sick and not able to go to the hospital himself, sadness. His parental leave from work cannot come soon enough. Man needs a vacation and this summer looks like it's going to be the best of our lives!

Suckle THIS, smartypants!

Since I'd gone in earlier in the day I called the nursery at around midnight last night to check on Ms. S before going to bed. The call went really well until the end, when things degenerated for me. Here's how it went.

NURSE: She wants to suckle.

ME: Oh, I know. We had a great session with the lactation consultant today. She's really getting it.

NURSE: No, she needs to do it more than that!

ME: Well, I try to do it every day. It doesn't always work out.

NURSE: Every day! More times a day! If you don't she won't nurse later on. She won't know how!

ME: (Getting a bit defensive.) She had an eye exam today. She was too exhausted for more than the once.*

NURSE: Well she really needs to learn this. More times a day!

Now I am all agitated by the thought that due to my negligence my daughter will never really learn to nurse, even though that's bullshit of the highest order and we'd made real progress earlier in the day. I was feeling great about it, really encouraged by the experience and glad that the lactation consultant had helped me out so much and now I am trying to hang on to that and not feel like I'm failing her in some way.

To me the true point is not that she's breastfeeding, even if I've talked a lot about how much I want to be able to do so with her. The truly important thing is that she's getting my breastmilk and the how of it getting inside her is secondary. If she never takes to nursing and we have to bottle-feed her while I continue to pump then that's how it'll be. Ideally I want her to do both so that Andrew can also feed her and so that we can bottle-feed her when it's less convenient to nurse. I am not stuck on her ONLY breastfeeding and nothing else. I think it would be irrational to feel that way, and potentially crazy-making. I don't want to set myself and Shaughnessy up for disappointment and difficulty. I just want to do what works best and makes us both comfortable

I am doing my reading on all this, believe me, and even if it takes time the majority of babies, preemie or otherwise, figure it out and end up doing fine on only nursing, or a combination of both. I wasn't even planning to breastfeed in the first place and had fully expected to formula-feed her with bottles but the fact of her prematurity threw a wrench into those plans. So, this has been a pretty major adjustment of expectations for me and that's probably why I'm pretty flexible about the idea of bottle vs. breast since either is a vehicle for her to drink my breastmilk. She'll be in my arms, alive, not dead due to undiagnosed preeclampsia. I'd rather wake up every day happy about those things than stress out about whether she'll be a perfect breastfeeder!

* The eye exams that the doctors do to check for ROP are very traumatizing and uncomfortable for the babies, so after they have them they're usually very exhausted and out of it for the rest of the day. They tend to sleep more and be more fussy when awake, so things like lick and sniffs aren't usually all that successful.

Ow, my everything!

WELL! I certainly had a day of man-handling. Or ... person-handling, anyhow.

It started off with a visit to the OBGYN for the six-week followup visit. I had a wait of at least an hour and a half, an hour of which was spent half-naked and trying not to fall asleep on the examining table. No kidding; an hour. Maaaan. But when my doctor got in there he was his usual charming self. He looked at my incision and admired it, which is what every medical professional does when they look at it. All, "Oooooh, very nice. It's hardly going to be noticeable!" This is wasted on my non-bikini-wearing self, but I appreciate it nonetheless.

After he got done looking at it he proceeded to PROD MY INNARDS INTO A PULP while checking my uterus and ovaries. Seriously, I was ready to crawl off the table it was so uncomfortable. I'm not talking about the hand in my privates, I'm talking about the one feeling around on the outside. Ow! My incision is pretty (so they say) but it's still a healing wound, people!

Then it was all, "Put on your pants and scram," so I did. I went to the hospital that houses my daughter and spent the afternoon with her. I was intent on this visit because I was supposed to spend some time with the lactation consultant trying to figure out a comfortable position to nurse Shaughnessy in since what I'd been doing hadn't been working for me.

She recommended the football hold, which is where you tuck your baby under your arm like you're a quarterback and nurse her that way instead of having her lay across your lap in front. It was actually really good and comfy right from the start and I was very happy, but then we moved on to trying to get Shaughnessy to latch, which is something she hasn't done yet. The LC watched me for a minute and then said, "May I?" I said yes, of course.

So she grabbed my boob and the back of my daughter's head, squishing my boob into what she referred to as a 'sandwich', and anytime Shaughnessy opened her mouth she jammed the two together. All I could do was laugh because it kind of showed that there isn't a lot of science involved in the nursing concept. Shaughnessy didn't mind at all, although she still wasn't getting the latching concept very well. Baby+boob=eventual nursing if you're persistent, it seems, so I do think it was a valuable lesson. I don't think I was really doing enough to introduce S-Girl to the concept of nipple going in mouth.

We also tried a nipple shield, which is a thin silicone thingie that goes over your nipple. It's closer to the shape of the soother she's been using, so she actually did latch onto it and do the right thing for a while, but she was super-tired and kept falling asleep. All in all, however, it was a success and things are looking good for future breastfeeding, woot woot! I also have a newfound respect and admiration for the lactation consultant, so won't have heart palpitations from now on when I see her. ;)

I had a bad headache by evening so came home to recuperate from that and all the bodily indignities I'd suffered for the day. Becoming a mother really has stripped away a lot of my extraneous dignity, I must say.

I think this song is about me.

OK, one of the weird things about having a premature baby in the hospital is that you are watched and analyzed in a way that parents of full-term, healthy babies are definitely not. When we go in to see our girl our visits get entered in her daily chart and there is a checklist of parental involvement that the nurses have to keep an eye on.

This is for a sensible reason. There are parents who react badly to having a premature baby. They don't know how to relate to this tiny, alarming being. If the baby is especially ill some parents are scared out of their minds and don't know how to deal with it, so end up avoiding the NICU and having to handle their baby. The nurses and doctors need to be aware of this so they can address the situation and help the parents cope.

This hasn't been a problem for us. We go in to see her every day. We gladly change her diapers, hold her, take her temperature, wipe her face and do all the little things we can do for her. Now that she's in level 2 we're encouraged to do even more for her and so far we're loving it.

Because I yam who I yam, though, this is crazy-making for me. I love my baby, I am not afraid to handle her, bathe her, change her, feed her, do all the things for her that as a mother I have to and want to do, but while she's in the hospital this stuff is being monitored and I find it really intimidating. I have this irrational fear that no matter how hard I try, something will be found lacking.

Of course if she'd gone full-term I'd have had her and then been sent home ASAP. There wouldn't be anyone keeping an eye on how many times a day I feed her, how much time I spend with her, what bathing technique I use. I am an overly-private person (in my RL, not so much online, I guess) so this situation pushes all my buttons and I have to work hard to remember that it's not personal.

The nurse who did the bath demo with us the other night said that in a sense the parents of preemies who are first-time parents are lucky to have this extended period of acclimatization. Having the opportunity to learn all the things you've never done before in a setting with professionals who can show you what to do instead of having to figure it out on your own is a luxury. She's totally right. It's my personal oddities that make the 'being monitored' aspect of it difficult for me and I know it. Parents of full-term babies no longer stay in the hospital long enough to experience that kind of nursing care and our nurse said it made her sad.

Do not get me wrong. I am inexpressibly grateful for Shaughnessy's time in the NICU. I have total respect and admiration for WCH and the staff. They have made the scariest time of my life so much easier than it could have been and I will gladly continue to forgo privacy and autonomy in my interactions with my daughter as long as it's in her best interests. If it had to be that way for the rest of her life I'd do it and do it willingly. But the day that she comes home and she's all mine, MINE, MINE! Well; that'll be a really good day. :)

Oh, man.

Right after I posted the hospital called and said Shaughnessy was back down in level 3. She had a bad choke on some spit-up and they think she aspirated some in her lungs. They've put her back on an IV and discontinued her feeds for the moment (I'm not 100% sure why but I'll find out as soon as I go) and thankfully haven't put her back on CPAP. She'd be devastated to have to wear it again.

I'll update late tonight when I get back home.

Update 11:54 p.m.

Well, we went in to see her and when I got there Andrew was already there, having gone straight from work as soon as I called him to let him know what happened. He was giving her hand hugs and helping her keep her soother in and it was really nice to get there and see her being loved up by her dad.

The charge nurse explained things again to me as soon as I came in and reassured me that they thought she was looking OK but that they were going to do x-rays to see what was going on in her lungs. She was also more pale than usual and very sleepy and still since the whole episode had been stressful. We sat with her for a bit and since the shift change was coming up we decided to go out for a bite to eat so that we wouldn't be in the way.

When we got back her colour had improved some but she was still very out of it. Toward ten she was getting pretty upset, though, since she'd missed two feeds by that point and was used to getting them so regularly. Her night nurse said that the doctors would decide on their rounds when she should go back on her feeds and that wasn't coming up for a little bit so I figured we'd come home and I'd call back a bit later to see how she was doing and whether she was back on them. She did calm down after a diaper change and also a change from the position she'd been in for the last few hours so we felt OK about leaving after that.

If things continue to go well and she doesn't take a turn for the worse she could be back in the level 2 nursery by Sunday morning. It can take a few days for lung problems to really worsen, but so far everyone seems to think she's doing OK and will likely recover well.

Tiny little leaps and bounds.

This has been quite a week in the life of Shaughnessy. And her parents. She's started wearing actual clothing now instead of just hanging out in a diaper all the time, and we got to be there while she had a bath on Wednesday. The best thing, though, is that she's moved out of her incubator! That's right; girlfriend sleeps in a crib.

The clothing is all hospital-issue but it's adorable little pajamas that are donated so she wears something different and cute every day. One outfit so far was even a bit small on her teeny preemie self! She just looks so much like a 'real' baby all of a sudden, and in my eyes the clothes make her look even smaller somehow.



The bath was great. She'd already had a few so it wasn't new to her, but the nurses always do a demo bath with the parents before getting us to do it on our own. Shaughnessy enjoys it and didn't make a peep the whole time, even after the bath when they're most likely to cry because of colder air on their damp skin. She just made her usual conversational grunts about everything. The very best part was when her hair dried. It all stuck straight out from her head in this awesome fuzzy halo of cuteness and looked much lighter than it does when it's all stuck down to her scalp. I nearly passed out, she looked so awesome all dressed up and fuzzy-haired.



Her nurse had intended to change out her incubator to a cot that same night but ended up not doing it, so when I went in the next day I found her in her brand new crib, hanging out like a full-term baby. The crib is awesome because it's so much easier to access her and hold her whenever I want to. That's getting more and more usual, too. The nurses are less and less concerned about her ins and outs and pretty much let us decide when we want to hold her or not.



We've done three lick and sniffs now and she's still pretty much just licking and sniffing. Not a lot new to report there, but I'm going to start trying to go in earlier now and hopefully do more of that so she has lots of chances to get used to it.

That's all that's new. I've been feeling really tired this week and finding it hard to get the energy to do much and force myself to get up and go. Not sure what's up with that, but I'll have to get over it with a quickness! We'll be invaded by a baby tyrant soon and I won't have much choice in the matter.

Oh, I added a Flickr badge over in the sidebar where I upload all the pictures of Shaughnessy that I put in my Facebook albums. Anyone can see the pics, so feel free to click on it to admire her cuteness. They go all the way back to her first week, and I'll keep adding whenever I have new ones.

Because the Lactation Consultant still scares me ...

Aaargh I bought a pump. I bought a Medela pump, even, which is the company that makes the hospital grade pump I've been using. I was going to buy one pump in particular but it was just way expensive so when we got to the pump-buying place I saw another cheaper one by the same company and bought it on faith, which is sometimes a bad bad thing but I do think they make good pumps so risked it.

It's a good pump. Really strong suction, lots of milk pumped, and risk of injury if I use it on the highest setting (which I found out the hard way [please don't ask.]) It has an electric setting, a hand pump mechanism and will also use batteries if you're somewhere without access to an outlet. The hand pump works so well that I almost prefer it to the electric, but mostly because it's much quieter. This pump is pretty loud compared to the hospital-grade pumps.

Holy crap, the word 'pump' is just meaningless to me after reading the last couple of paragraphs.

Anyhow, I still intend to hand-express lots and this pump isn't meant to be used for all your pumping. I got it to make sure I get my hind milk outta there for the kid, and also to use if I get mastitis and want to really make sure I empty the girls out. I haven't had any mastitis problems since switching to hand expressing, though, so hopefully that will continue to not be an issue.

Shaughnessy is doing really well. The level 2 nursery is agreeing with her and she's being her usual talkative self. Her nurse last night joked that Shaughnessy almost doesn't need to be hooked up to the monitors since she can tell from the other room what's going on with her based on how much and how loud she's grunting away. It's very true. That girl knows how to express herself.

The CPAP seems to officially be a thing of the past! I was cautious about believing it, but unless she gets sick she won't need it again. If she comes down with an infection or something she might need the help since she'll be weaker and having to put her energy toward fighting it off. Right now, though, she's breathing on her own and doing it well!

She's had two 'lick and sniffs' at this point. That's basically breastfeeding orientation for preemies, where she's put in the breastfeeding position but not expected to do much except hang out there. She's got the rooting reflex down, she knows how to suck (as evidenced by her enjoyment of her soother) but she has to start learning how to put it all together and figure out how to swallow while still breathing as well. So far she's been opening her mouth really, really wide but not actually latching on as a next step. Then she falls asleep. Hee.

I just like the opportunity to hold her even more, but it's encouraging to see that she has the basics and will probably figure it out in a couple of weeks. Preemies usually start to 'get it' by about 35 weeks gestational age and she's nearly there.



Overall I try not to have too many expectations. The fact that she's alive and already asserting her personality is enough to impress the hell out of me.

Rawk

She's not even supposed to be born yet and she's already throwing the horns!

Fatty Fat Fat

Suddenly my baby girl is getting some real meat on her bones! Breast milk must be amazing stuff because that's all she's eating (although they do fortify the pumped stuff at the hospital.) I'm sick AGAIN and haven't been in the NICU for the last few days, but Andrew is taking pictures and really capturing the sudden chubbiness of her cheeks. She's just, just shy of four pounds now. A few more grams to go and she'll have doubled her birth weight!





Craziness. As of today she's in a level 2 NICU! This is big news since it was all riding on her being off the CPAP for good, and after 48 hours with no desats or bradys she's clear. She was supposed to be moving to St. Michael's but they just haven't had the room, so they finally moved her to the level 2 NICU at Women's College. It's for preemies who have a possibility of being downgraded back to level 3. I'm thrilled that she's still at WCH because I really love that hospital and its staff, but I'm also kind of glad because I'm worried she might still need the CPAP after a few more days, like last time, and have to go back to level 3. As soon as a space opens up for her at St. Mike's she's supposed to move, but I'm in no hurry for that.

Anyhow, overall things are good except for me being sick and not able to visit my daughter. It makes me feel so guilty, even if it's the best thing for her right now. Happily she'll be meeting her great-grandpa today. Andrew's grandpa (and much more of his family) is in town for Easter weekend and she'll be meeting a bunch of them. Quick visits, and not everyone can make it who wanted to, but people are finally getting to see her! I want my sisters to come meet her as soon as possible, too. She changes so fast now.

She looks like Shaughnessy most of all.

Shaughnessy's having a pretty good week, overall. She's back off of her CPAP, seemingly for good this time. We were a bit worried that they were cycling her off of it too quickly again, but as I kept reminding both Andrew and myself; a week in the life of a preemie is a pretty significant chunk of time and her lungs have probably strengthened up more than we'd expect.

She's had two eye exams so far to check for ROP and so far both have come up at zero, which is the best result you can get. She is startled by loud sound and is obviously light sensitive so for now I'm not worried about basic sight and hearing. It's too soon to know if they're perfect or anything like that, but it's all encouraging!

What the CPAP news means is that she'll be moving to a different hospital within the week. I called today to check on her and the nurse asked me what hospital we want her moved to since it's imminent. We want either St. Michael's or Mt. Sinai and would prefer the latter since it's even easier to get to, but we'll see. I don't know what the protocol is for these kinds of things and nobody had really mentioned Mt. Sinai to us as a possibility.

ANYHOW, I'm just excited because she's doing so well and getting so big. She's really starting to put on weight and fatten up a bit. She's hardly recognizable as the baby I had five weeks ago. She's not fat yet, by any means, but her cheeks are really filling out, her arms and thighs are starting to get pudgy and she may even have a butt beginning! In all the dreams I had about having a baby during my pregnancy I had a fatty fat little girl, but as one of the nurses said to me she might just be a lean baby naturally when she's reached her 'ideal' weight. She is a lot like her dad.



Speaking of which; I think she looks totally like Andrew. She has his face shape, definitely has light hair and just overall seems to bear a strong resemblance to him. I'd read all about babies looking more like their fathers as an evolutionary safeguard against the father rejecting the child, but I was surprised to read up on it more and discover that apparently the mother will also insist strongly to the father that the child resembles him, even if they're less likely to claim the same thing when he's not around.

Now, I'm ALWAYS telling Andrew how much I think our girl looks like him. I'm disappointed to think that I'm obeying some sort of evolutionary imperative, but I also insist the same thing to anyone else who will listen. I mean, I think she might have my ears and nose and will probably look like a girl and all, but you can SEE the Andrew half of the equation when you look at our daughter. Even the nurses have told me so.



What it boils down to is that no matter who she looks like she's adorable.

She knows what she wants.

Ooooh, girlfriend.

Shaughnessy was in pretty fine form today. When I got to the hospital my mom was already there (because I was late, for shame) and told me that it had taken TWO nurses to get the CPAP back on her little granddaughter after she'd had it off, so mightily did she fight it. And after it was on she smooshed her face against her blankets and knocked it right back off her nose again.

She spent the rest of the day battling her CPAP and her feeding tube. Erin A. came for a quick visit as well and while she was sitting there with me the nurse let me hold Shaughnessy for a bit. Not Kangaroo Care; just cradled in my arms in her head hugger. Well, little miss thang got seriously overwrought about the CPAP at that point and began twisting her head back and forth against the sides until the prongs were out of her nose and the hat part was askew. Then she worked her feeding tube out of the tape on her chin (tape which she'd already ripped free a couple of times) and they had to stop her feed and take the CPAP off, she was such a grouchy, growly mess.

After that, she calmed down and was a lovely little sweetie for the rest of Erin's visit. She (Shaughnessy; not Erin) did spend some time rooting around against the side of her head-hugger hoping to find a boob to nurse on but had no luck since it's a head-hugger and I was also fully clothed. I hate to see her rooting and not be allowed to try to nurse her yet, but they all say it's still too early. So: no nursing. And she pretty much slept and muttered the rest of the time.

When I say she's growly I mean it, though. She makes an awesome crabby little grunty growl noise when she's displeased. It's very particular to her and definitely means she's about to pitch a fit of some sort if what's bugging her isn't taken care of. They've taken to swaddling her pretty tightly in her blankets and head hugger when they want to be entirely sure the CPAP stays on and that does seem to calm her down some, which is understandable. Infants and preemies in particular respond well to swaddling as a calming device. So the growlies can be tempered that way after she realizes she can't move her arms too easily. It's when she's free to move her limbs that she really goes to town.

I held her again before coming home. Mom and Erin had both left and I was waiting for Andrew to arrive when the nurse asked if I wanted to do Kangaroo Care. Of course I did, and Shaughnessy again spent a little while rooting around with her mouth on my chest trying to find a meal. Poor baby. I'm going to point it out to the nurses next time and see if they'll bump up the intro to nursing schedule for her since she's obviously trying to get to the head of the class.

Despite all of the above, she really is a very peaceful baby when she wants to be:

Regarding miracles.

Maysie sent me this article yesterday. I read it and immediately empathized with the feeling behind what the author had written since I am all about stripping away over-sentimentality and coming at things with hard-boiled common sense. Her point was that people often call premature babies 'miracle babies', but that for their parents those tentative months in the NICU feel anything but miraculous, when all kinds of health problems and complications are a part of day to day life.

It's very terrifying. The uncertainty you feel is exhausting even when, like us, you are blessed with a relatively strong and tough baby that has few if any problems that require invasive treatment. You compulsively count the days, adding them into weeks, waiting for them to equal months until that magical term is reached, the time when your baby should have appeared in the world.

We have weeks and weeks left until then. We are still the anxious parents beside the incubator, peering in at our little girl, delighted just to be in her presence. The sheer luxury of having a baby you can pick up and cuddle on a whim is entirely unknown to us. The privilege of holding her is something that is still meted out to us by her nurses, something we ask for and hope that we asked at a convenient time. When it is offered it's a treat.

On the other hand it is difficult not to refer to these little ones as miracles. When we sit by her side or gaze at the other one of us holding her we are impressed by every little thing that she does. Remembering all the time that she is doing things far, far ahead of schedule for her tiny little body constantly amazes us. Since her birth I've felt a brand new desire to push myself, seeing how she has had to push herself and do it with a determination I never expected to see in such a frail little individual.

Perhaps I am romanticizing the situation, ascribing something to her that isn't really there. It could be argued that she's doing well because her body is simply capable of it and that it isn't taking any sort of spark of personality to drive it along. But I see her irritation and anger at the CPAP she has to wear, how she clearly wants it off of her head and tries to pry it off with her hands or scrape it off on the surface of her blankets. Her nurses tell me all the time that she's a funny, charming little baby and that she makes her wishes well-known, nurses that deal with a constantly changing influx of babies and who have seen it all.

She yawns, she hiccups, she holds on to whatever she can grab and grips it for all she's worth. She opens her eyes and peeks out at the world she's in, unaware that all the blurs will someday coalesce into recognizable objects and loving faces. She cries very little, using her voice to squawk in short-term displeasure rather than kvetch for long periods. These are all things that most every baby does, yeah, but she's doing them all uphill in a way that full-term babies don't have to. Even if she's not technically a miracle, I find her to be the most thrilling, life-affirming thing to ever happen to me and it feels just a teeny bit magical. Even for a lover of hard-boiled common sense.

I didn't say 'nipples' once!

So, the battle of the breast pump has been ongoing. The battle is all in my head, really, but I continue to hate pumping like cats hate water. Cats can swim, see, and I can pump. I just don't like it. *hiss*

What I hate about it is the stupid ceremony of it all. Sterilizing the bottles and bits, drying them out, assembling them, hooking up the tubes to the machine, hooking up the machine to the bottles, attaching them to myself, pumping, emptying the bottles into the milk containers, labeling them, rinsing out the bottles and bits and setting them out for later, putting away the tubes and labels and putting away the machine. When you're nursing you just stick the baby on your breast. You don't boil either of them first.

Sigh.

I'd been intending to learn to hand express. I'd read about it a bit and thought it sounded like a good idea in case I ever found myself without a breast pump around and needed to express. After reading about it even more, though, it sounded like something that I could possibly do as a substitute for using the machine. It's supposed to be good for mastitis and also produce more milk than pumping, something I'm interested in because I'm a bit stressed about providing enough milk. So, I've tried it a few times and tonight I was able to hand express instead of pumping altogether!

Woot indeed, because it knocks out a ton of the annoying steps from the pumping ceremony and I can express straight into the collecting containers instead of having to sterilize anything. All I have to have is clean hands and then I label the container and stick it in the fridge. Pretty sweet.

Also I am still nervous about the lactation consultant cornering me in the NICU and asking me all kinds of questions. Yesterday I was sitting beside Shaughnessy's incubator and the LC was helping a mom with nursing her preemie for the first time. I was glad she was otherwise occupied, but when Shaughnessy's nurse noticed the LC she asked me if I had any breastfeeding questions or anything. I was all, "NO, I'M FINE, MY SUPPLY IS FINE, IT'S ALL FINE, THANKS VERY MUCH!"

Instead of taking the hint she went over to the LC, who was finished with the other mom and washing her hands at the sink, and said, "I have a mom over here you might want to chat with and see if she has any questions."

I told Andrew today that when this kind of thing goes down my instincts are all, "Cheese it, it's the Lactation Consultant!" I didn't run away, scramble or flee; I just gritted my teeth and tried to make it quick by being all immediately confident about my milk supply. She went ahead and quizzed me about how many times a day I pump and how much I think I produce each time. I exaggerated a bit, but then she wrote it down! So now my exaggerations are recorded and I could be caught in my exaggerations at a future date. Dang it.

I just don't want to talk about my boobs to people (who don't read this weblog, I guess.) My boobs are private boobs and I will not let my daughter starve! My hope is that Shaughnessy will take to breast feeding fairly easily and I can put this pumping jazz behind us. In the meantime I can at least alternate hand expressing with machine pumping to make it a bit less irritating!

One step back.

Shaughnessy had a bit of a setback this week. When I went in to see her on Monday I thought she looked a bit pale and seemed listless. They set me up with her to do Kangaroo Care and throughout the whole time I held her she kept having little spells where her breathing was too slow or stopped. I'd have to rub her back to remind her to take a breath whenever this happened. This was VERY unlike her, as was her paleness and general lack of energy.

Andrew had arrived while I was holding her and we were told by the nurses that it was possible that she could have an infection of some kind setting in. We were very upset to hear this, of course, since she'd been doing so well up to this point and we honestly aren't used to getting any bad news, just consistent reports of her good progress. So bad news is out of the ordinary, something that not all parents of preemies are lucky enough to experience.

They also mentioned that if it wasn't an infection it could be that she was tiring herself out from being off the CPAP altogether and had hit the wall. They decided to put her on low-flow air, run some bloodwork and see if an infection was the problem, but in the meantime pretty much sent us home to let her rest. It was getting late anyhow so we went, worried and concerned for our little girl.

Thankfully when I talked to her nurse the next day it was good news. There was no sign of any infection, and they'd put her back on the CPAP. Since going back on it she'd had no more breathing interruptions and was getting her colour and energy back. So; in the end even though Shaughnessy thinks she doesn't need to be on the CPAP, she obviously does and her stubbornness will not change that fact. Breathing entirely on her own is still a bit of an effort for her little lungs which is understandable, given that she's not even supposed to be using them yet!

This does mean she's staying in the level 3 NICU until she's breathing on her own but we're just so thankful that there's nothing wrong with her that we're OK with it! The CPAP is at most a bit uncomfortable at times. It doesn't have any adverse effects other than some frustration for her, so I'm grateful to see her with it on rather than her having to fight off an illness!