2 Weeks +

Hope is growing well and has passed her birth weight! Two days shy of two weeks she just squeaked past her birth weight, and now she’s almost an ounce and a half beyond it. She was two weeks old on Saturday, and she’s 32 weeks corrected.

Full term babies look weirdly huge to me now. I’ve gotten so used to Hope that when my brother, Micah, saw her for the first time on Saturday and said “Wow, she’s so much smaller than she looks in pictures!” I was genuinely surprised. She seems so normal to me after the past two weeks together!

I learned a few days ago that she has had a couple of “spells” that I hadn’t been told about. Am I supposed to ask specifically about that? Now I do. A “spell” is any time one of the three numbers on her monitor dips below normal limits for more than ten seconds. Those three numbers measure her heart rate, her oxygen saturation, and her respiratory rate. Anyway, it’s not a good thing, and not having spells is one of the requirements for going home. She has only had a few, and yesterday’s nurse said she only requires “mild stimulation” to come out of them (I think they just rub her back to remind her to breathe, for example), so I guess if she’s going to have spells at all at least they’re not worse.

Yesterday Hope’s isolette temperature control got switched from “patient control” to “air control.” This is a good step in the process of weaning her down from having her temperature controlled for her toward eventually maintaining it herself. When it was on patient control the nurses would tell the isolette what they wanted her temperature to be and she had a little probe on her that constantly told the machine her temperature. As her temperature fluctuated, the isolette would adjust its air temperature to bring her back up or down to the target temp. Now that her isolette is on air control, the nurses set the air temperature to remain constant and just check her temp under the arm when they feed her every three hours. This helps keep her from suddenly getting cold when the little windows in the isolette are open, and as she begins to maintain her own temperature they will gradually set the air temperature lower and lower until it’s close enough to the whole room’s air temp to be able to move her to an open crib, swaddled. Reaching that final point is an accomplishment she has to achieve in order to go home.

Hope shows lots of feeding cues when she’s awake: rooting around with an open mouth, opening her mouth and moving her tongue when something touches her mouth or cheek, bringing her hands to her mouth, taking and eagerly sucking a pacifier. Because she’s reached 32 weeks corrected and is showing those cues, one of the other nurses in the room (who overheard me talking with an OT about those cues and asking when Hope might be allowed to try non-nutritive sucking at the breast) said Hope is probably ready to try it and suggested we call upstairs to today’s attending physician to ask for an order. Hurray for encouragement to just go ahead and ask the doctor! So our nurse for today went and called, and now we have an order to let Hope do non-nutritive sucking during Kangaroo Care once per day. That means I’ll pump first so that she’s not getting a ton of milk if she does suck at all (since she could likely choke on it if she’s not quite ready to suck, swallow, and breathe all at once), and then I’ll be allowed to put her to breast while I’m holding her skin-to-skin. Yaaaayyy!!!! I’m SO excited to be allowed to try this! I’m sure the doctors have lots of evidence based research saying babies typically can’t coordinate sucking, swallowing, and breathing until 34-35 weeks, but Hope just acts like she knows what she’s supposed to do with all her feeding cues, and I feel like she could learn to nurse earlier than they expect if given the chance to try. I don’t mean that I don’t believe them about the 34 week average for that ability; I don’t expect her to be able to breastfeed today. I just want her to have the chance to get used to being at the breast and suckling a bit to encourage her to want to be there and learn to eat.

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