Monday, January 26, 2015

Owen: One Month

Dear Owen,

Today you are one month old!  It is hard to believe you have already been with us over 4 weeks, but only home for less than one week.

Now that you are home with us, we are getting to know your personality so much more.  You are calm and quiet, and happy to just look around and observe.  Your time in the NICU has made you independent in that you don't need to constantly be held to be happy, and you fall asleep on your own so easily.  I'm sure that will change as you get used to us holding you more often than we were able to at the hospital, but we will gladly hold you as much as you want.

You have always been so strong physically, and like to lift your head up off our shoulder.  You also try to push off with your legs, and even got your little butt in the air while on your stomach in your incubator.  Your name means "little warrior", and that is you to a "t".

Breastfeeding is going exceptionally well for us- you are eager to eat, have a great latch, are a fast eater, and I haven't had any supply issues like I had with your big brother.  We have a freezer full of breastmilk, and I will continue to add to our stockpile.  You do get two bottles each day of a special high calorie/high nutrient formula, but we hope to be able to discontinue that in the next few months.

You absolutely love your bathtime!  You cry when we undress you to get in, and cry when you get out of the bath, but while you are in there, you are so calm and relaxed.  Giving you a bath is one of Mom's favorite activities!

Your big brother loves you so much already, and is very concerned with taking care of you.  He is a great helper, and instantly gets our attention if you start to fuss even a little bit.  He is proud of having a baby brother, and loves to show you off.

Your newborn clothes are still a little big on you, but you don't fit into any preemie clothes, with the exception of onesies.  You have skinny, wrinkly legs, but an adorable round belly.  I'm sure in time you will chunk up quite a bit!  You are now 6 lbs 8 ounces, and 22 inches long.

We are so thankful you are a healthy, strong little boy, who was just too excited to meet us to wait until your due date.  We love you, Owen!

Owen's NICU Story

Within an hour of you being born, the hospital decided to transfer you to Tacoma General's NICU, as they were better suited to care for a baby of your gestation.  The transport team from TG came down to get you, and we said goodbye to you in your tiny incubator before you left.  Daddy followed the specialized ambulance up to the hospital, while I stayed in Olympia, waiting to be discharged.

I started using a breast pump at the hospital right after you were born, and continued pumping every 2-4 hours around the clock until you were discharged 3.5 weeks later.  Luckily, once my milk came in, I had a great supply, and have had more than enough milk for you.  You did receive donor breastmilk for 24 hours while we waited for my milk to come in, and my breastmilk was mixed with a human milk fortifier everyday to provide you with extra calories while in the NICU/ICN.

You needed a CPAP machine to help you breathe for the first 24 hours, but then moved to room air and did just great.  You occasionally had episodes of apnea and minor bradys, but we quickly learned that is to be expected with preemies.

In the NICU, we had a private room.  Every morning, a team of doctors/nurses/other health care professionals would round on all of the babies, so everyone on the team got to hear the same information at the same time.  This was also a great time for us to ask questions!  We got to know all of your nurses very well, and had a few favorites (Danielle, Jorden, and Amanda).  After only 3 days in the NICU, (Wednesday, December 3rd) we were informed you were being transferred to the ICN (Intermediate Care Nursery).  This was because you were one of the bigger and more stables babies in the unit, and more "delicate" babies were coming in that needed the higher level of care you no longer needed.

The ICN provided much less privacy and room than the NICU.  We immediately missed our nurses and space from the NICU, but knew we would just have to settle in and make the best of it.  Either Daddy, I, or both of us spent every single day with you.  We made sure to attend daily rounds, and as many care times as possible (you were on a 7/10/1/4 schedule).  At each care time, we took your temperature, moved your O2 saturation probe to the opposite foot, changed your diaper, and the nurse listened to your heart, lungs, and stomach.  Those were also your designated eating times.

You needed a bili light for several days, which included a pair of "sunglasses" to protect your eyes.  The light made getting you in and out of your incubator/bed more difficult, but we wanted your jaundice to pass as quickly as possible!

You had an NG tube in that allowed your milk to be fed to you directly into your stomach.  We started allowing you to try breastfeeding right away, but it took you until almost your discharge date before you really got it down.  You also started taking a bottle while in the ICN.  Learning how to take all of your daily volumes by mouth was your major goal for discharge, and really the only thing keeping you in the ICN.  On Thursday, December 18th, you finally took 1/3 of your daily volume by mouth, which was a huge accomplishment.  That next day, Friday, neither Dad nor I could be at rounds, due to me being sick and Dad being home with Lane.  Dr. Willham, the neonatologist assigned to you for the majority of your time at TG, called us that afternoon to say that once you took 1/2 of your daily volume by mouth, we could move you to "modified demand" feeding, which meant we waited for your cues of hunger before feeding you, but wouldn't allow you to go more than 4 hours without a feeding.  This was to test out your ability to take enough food in everyday on your own schedule and still gain weight.  Well over that weekend, you hit the 1/2 mark!  So Monday morning at rounds, I brought up moving you to a modified demand schedule, as I truly felt you were ready to try.  Luckily, both the neonatologist (Dr. Golden) and the nurse practitioner (Alta) agreed with me, and gave us the green light for a full demand schedule!  The nurse took your NG tube out, and it was so nice to see your tiny face without any tubes/wires!

So, we spent that afternoon focusing on breastfeeding.   Later that afternoon, our nurse asked if we wanted to "room in" with you that night, because as long as you continued to feed well and gain weight, you would be discharged soon!  So, I got to call Daddy at work, and asked him if he wanted to bring you home in time for Christmas.  I cried and cried as I talked on the phone, as we never expected you to be discharged in time for us to celebrate Christmas as a family at home.

We spent the rest of the day getting plans in place for Molly and Lane, and performing your car seat challenge (which you passed easily), getting your Hep B vaccine, giving you a bath, and moving into the private room in the ICN.  Daddy and I spent two nights rooming in with you, performing all of your care and feedings.  You were finally free from all of the monitors too, and we were free to walk around the room with you without being tethered to any machines!  The first night, you lost 30 grams, and the nurse and doctor told us if you gained ANY weight the second night, we could go home the next day.  We worked really hard at feeding you frequently, and the nurses waited a few extra hours before weighing you to give you as much time as possible to gain weight.  And you did!  You gained 10 grams the second night, and so Christmas Eve morning, we got the green light to take you home.

It took us several trips to the car to get all of our stuff out of the nursery and our Treehouse room, and Daddy had to run to the store to buy a cooler to take all of my frozen breastmilk home.  Walking out of the nursery with you in your carseat was such a strange and exciting moment- no more scrubbing in each day, no more signing in, no more name tags, no more daily doctor exams, no more cafeteria food, and mainly, no more having our family separated.

This experience was one of the most difficult things we have ever faced, and we could not have done it without all of the help and support we received from family and friends.  You are one tiny but tough little boy, and we love how perfectly you fit into our family.  We love you Owen!