We Have a FOUR Pounder!

Quinn has continued to do great! There really is nothing "exciting" happening and the doctors say this is great! This is how we want it to be! Quinn gets weighed every night around midnight- and last night she surpassed the four pound mark! As of today she is 4 lbs .6 ounces!! She is still small, but I can tell she is growing!

                                 

She is up to getting 37 ml of milk every three hours- here is some exciting news- she is breastfeeding twice a day and taking a bottle once a day. She doesn't get her whole feeding yet- it is hard work for a little baby to suck that much! So, whatever she doesn't get they give her through her NG tube. When we started breastfeeding she was getting about 5 ml. Today she took 15!! I'm so happy about this! Todd has been giving her the bottle at night and she has been taking about 15 ml too! The bottle is a little easier, but we are thrilled that she is doing so well breastfeeding too!

                                   

She is starting to be much more alert- especially around her care times. She is growing and learning to eat....exactly what she needs to be doing. Her breathing remains great- we are so thankful for this, and she is staying healthy! 

Speaking of healthy- they offer what are called "lunch and learns" every Thursday for NICU families. These have been great and I have made some news friends! Last week we talked about infection risk. Preemies have immature immune systems just like everything else about them. This means I have to be a little crazy about germs for the first year of her life at least! She shouldn't be in the grocery store, at Target, around anyone with any symptoms of respiratory illness, and in general she can't be passed around like a new term baby.  We have to wash our hands ALL the time, make sure our clothes are clean, and wear masks if we get sick. Harper is going to have to become a little OCD about the hand washing, but better safe than sorry! 

We know a lot of you want to meet her and hold her, so please don't be offended if we say no, or ask you to wash your hands, or ask if you are sick, or ask if you have had the TDAP vaccination. We only want to keep her safe and prevent her from ending up in the hospital again. You can call me crazy, but I will do whatever I can to keep her safe and healthy!

Thank you SO much for all of the continued thoughts and prayers- and meals!! We are so very blessed with great people in our lives!

Up to Speed

Alright, before I get even MORE behind on this, I need to catch up. The last 11 days have been hopeful. While Quinn is very small and has a lot of growing to do, she has been doing exceptionally well in the NICU.

Every day they have continued to up her feeds. By yesterday - Saturday June 22nd - she was at her max feed of 31 ml every three hours. They use a ratio of ml per KG to decide how much food a baby's stomach can handle - as she gains more weight they will continue to increase her feeds. 

On Wednesday June 19th Quinn had been on the CPAP, but with no oxygen - just room air, for about two days, so they decided to put her on high flow oxygen. This is a much smaller nasal cannula and it meant that her feeding tube could be in her nose and not in her mouth. She was much more comfortable and stopped trying to pull it out. The high flow oxygen was two liters of pressure, but again was just room air.

On Thursday June 20th she was doing so well that they took her oxygen out all together. Also, they decided that since her feeds were up to about 24 ml every feeding they would take her TPN away - this meant that she she had no more umbilical IV and no more oxygen cannula - yay! She got a new isolette, and also, we got to move from the level 3 NICU area down to the level 2. Basically, Quinn doesn't need as much attention as when she was first born. All good news for us.

She looks so much more comfortable and holding her is much easier without so many cords! She still has leads on her chest to monitor her heart rate, the pulse oxymeter to measure her oxygen level, and the feeding tube - but STILL less than before!

About this same day they started fortifying her milk with something called Human Milk Fortifier. Apparently breast milk has a range of calories per ml - hopefully mine is on the higher end:) But the fortifier adds more calories to it. 

Quinn has also been getting caffeine. This is a pretty standard thing for preemies. We were warned that Quinn may have what the NICU calls "events." This is when a preemie "forgets" to breath due to an immature brain. The nurses let the babies self-resolve these if the baby is able to. After 10-20 seconds the nurses intervene and stimulate the baby to breathe if needed. Super scary - even though they are normal and expected. Caffeine can stimulate the brain and help avoid these events. Quinn had one self-resolved event on June 15th - THANKFULLY I didn't see it. But that is it! She is breathing like a champ and her oxygen levels remain high! The caffeine could have helped with this...but either way I am glad she hasn't had any.

Today, June 23rd, the Nurse Practitioner came by to say how pleased they are with Quinn's progress. She is up to 3 pounds 9 ounces - she had gotten down to 3 pounds 2 ounces after birth. They are stopping the caffeine because it hasn't been shown in research to be effective after 34 weeks (Quinn is considered 34 weeks and 2 days today). They did warn me that when she starts to nurse for feedings, or even take a bottle she might start having these events because it is hard for a preemie's brain to organize the breathing and eating at the same time. But, she said by the time babies are term they usually have outgrown this.

Yesterday Quinn also started having protein added into her milk, and today, June 23rd, she started getting vitamin D and iron. Tomorrow (or rather the middle of the night tonight), is when they will do her weekly weight and length check and plot her growth curve - they want her to stay on her growth curve or jump up even higher. 

Quinn has been spending her days and nights  sleeping and growing! At her care times we hold her while she gets her feedings, and she tries to nurse twice a day - she is showing tons of interest in this and even had some good sucking and swallowing patterns yesterday. This just takes time and lots of energy for a small baby!

Lots of people have asked about coming to see her or sit with me while I am there, but the NICU has very strict rules about who and how many people are permitted to come and go. I actually appreciate the rules because it reduces the possible infection rate. 

Grandma and Grandpa are able to visit and hold her:)

Todd just got back from the NICU and told me that Quinn is continuing to be feisty and strong. After he put her in her bed on her stomach (yes this is allowed in the NICU because of all the monitors :) and we have to rotate how she lays), she picked her head up and looked around to try and find her pacifier. That's my girl :) She is so sweet, we love her so much, and we know she is where she needs to be for now. 

While this experience is nothing like I planned, I have to remind myself that I still have my baby. I will get to bring her home some day, she is doing well, and for all of that, I am so thankful.

Friday June 14, 2013

I started getting nervous about leaving today. I wouldn't be discharged until Sunday- but it was hard enough not having my baby in my room with me let alone knowing that I had to leave her here at the hospital when I went home.

Quinn was still on the IV TPN, but today (Friday)  she started getting 3 ml of my milk every three hours. She had a feeding tube ( a very small one) down her throat. Until the CPAP comes out they couldn't put it down her  nose. She did not like this tube and pulled it out several times.

They start the feeds so small to make sure the babies can handle digesting the milk- Quinn has done great. Before every feed they check for residual in the stomach. Only one time did she have any residual- they gave it back to her with the next feed and it was gone! Today(June 22) she is up to 31 ml every 3 hours- that is a huge increase!!!

This was exciting for us, and it made me feel like I could do something for my baby. If you knew me when Harper was born, you know that I am a huge advocate of breastfeeding- I love it and I think it is such a special thing to do for your baby.  I know that it will take longer this time- but I am determined to get Quinn exclusively breastfeeding (unless I am away/at work). I am pumping every three hours around the clock. This involves a lot of washing and sterilizing of pump parts and bottles. Thankfully we were able to rent a hospital grade pump. Todd has been a HUGE help with this- it is WAY easier to just nurse the baby- no cleaning or sterilizing involved!! I told Todd I can't imagine how hard and overwhelming the whole pumping situation would be for a first time mom who didn't have experience breastfeeding and or pumping. It is a lot of work. I just set my alarm and think of it as nursing the baby. I am so glad I had a positive experience with breastfeeding before. I don't mean that to sound judgemental in any way toward moms who didn't or don't breastfeed- I believe everyone does the best they can for their child- but for me it was so important and I am determined to make it work again! The NICU is very PRO breastfeeding. In fact, if there are moms who don't want to breastfeed or can't for some reason, they use donor breast milk unless a parent declines. It is just SO good for babies- especially preemies. I will definitely be donating to the human milk bank this time around.... Let's just say that one nurse said I was producing enough for the whole NICU :)

Adding the feeds was big news for us- and they continued to decrease the amount of oxygen she was getting- but she did still have the CPAP for the pressure.  We continued to get to hold her which is the best thing ever- when we are outta here I'm not sure I will ever out her down!!

Harper is so excited to be a big sister! Todd and I think that she thinks it is normal for babies to be in the hospital when they are born. But, she is starting to ask when baby Quinn can come home. I wish I knew the answer too.

Slo tiny and sweet!

She really is longer than the Sophie! Her legs are just swaddled up!

Tiny feet! 

The c-section

I'm writing this on my iPad while I watch the baby sleep... Hopefully I don't make too many mistakes. 

I walked into the OR- along with the team of doctors and nurses who would be working on me AND the baby .  There were a LOT of people. A neonatologist, a respiratory therapist, two NICU nurses, a neonatologist PA. There was my doctor, a nurse midwife, a nurse, a surgical assistant, an anesthesiologist and a nurse anesthetist - maybe even more that I can't remember.  Immediately they had me sit on the table and they started putting the spinal in. Todd was with me since he has seen so many spirals- I was getting very nervous, it was freezing cold, and I was starting to shake.

They laid me down, put the drape up, and immediately started using the hand-held Doppler to listen to the baby"s heart rate.  It was probably 10:08 at this point.  Then I heard the doctor say, "quick prep," and the anesthesiologist starting urgently poking me and asking me what I felt. The baby's heart rate was dropping and the doctor wanted to get the baby out.  Immediately. 

Todd was so calm- especially considering he knew EXACTLY what was going on- he used to scrub in for c-sections at a previous job. It seemed to get very tense and frantic- but honestly I was shaking, and so nervous, and scared- that I could have misinterpreted that.

The next thing I knew I heard the baby screaming- it was such a welcome sound after a day of bad news. Quinn Maxine (after my grandma Dorothy Maxine), was born at 10:15 PM on Wednesday June 12, 2013. They told us she weighed 3 pounds and 6 ounces- two ounces higher than the ultrasound had estimated. She was feisty as ever with Apgar scores of 8 and 9- not bad for being 7 weeks and 2 days early!  As they wheeled her out of the room they stopped and let me look at her, and then Todd went with the baby.

Having a baby pretty much makes you lose all modesty, and I will admit right here- I asked the anesthesiologist to hold my hand. They got me some warm blankets, and the next 45 minutes flew by as I was getting stitched up. I finally stopped shaking as much and was eventually moved to the recovery room where my mom, sister, cousin, and then finally Todd joined me.  Everyone was showing me pictures of my baby as the feeling in my toes slowly returned. Finally, I stopped shaking.

Besides having the fabulous delivery nurse that I loved, my friend Amy who is a scrub tech in the birthing center helped on my surgery as well. After I was considered "recovered"- I guess, Amy and my nurse wheeled my bed into the NICU and I got to see my baby for the first time.

This was at about 12:00 midnight on Thursday morning.  I was so relieved to see my little girl. She didn't have to be intubated, but she did have a little bit of oxygen and pressure blowing into her lungs through a nasal cannula ( called a CPAP). She squeezed my finger- Best.  Feeling. Ever. 

She also was hooked up to a heart rate monitor, a pulse oxymeter, and she had an umbilical IV. These were to monitor her breathing, heart rate and oxygen levels as well as give her fluids and other medicines if needed.

I was still really scared and overwhelmed, but to see that she was alive and breathing was comforting- and I knew she needed to be here- she had told me all day it was time.