Cooper is getting really big, getting close to 5 pounds. Brinley is growing steadily, but staying petite :). Cooper has topped out on his feedings for awhile at about 1 1/2 ounce every 3 hours. Brinley has almost caught back up with him and will probably reach the 38ml mark with him tomorrow.
I can't remember what I've updated as far as their progress goes but here's a quick list of all the "assistance" they've had and are now off of:
- Respiratory assistance (nasal cannula, CPAP machines) - have not had breathing assistance since about 4 days old
- IV - they were getting IV fluids (electrolytes, lipids) for additional help - went off those about 3 days ago
- Jaundice lights - went off these after about 1 week
- Extra fortification in their feedings - they've both topped out on their extra calorie fortifications they get in their feedings along with the breastmilk and get 24cal of extra "stuff" every feeding (to make them gain weight quicker and give extra vitamins breastmilk is lacking)
- Body temperature warmers - they've been regulating their body temperature themselves without the isolette being warmed for about 5 days now
So now that they've passed all of these "tests", the last two remaining hurdles are getting them out of the isolettes and into cribs and learning how to feed orally and not through the tube in the noses. Their is a long protocol on getting out of the isolette but they are making steady progress on that and it will probably be sometime next week. This just makes it easier for us to handle them ourselves without the nurses help.
So the big thing is the feeding. After evaluations by numerous different specialties (the neonatologists, the nurse practitioners, speech therapist, physical therapist, occupational therapist, the registered nurses, lactation consultants) we were given the go ahead yesterday to start to try to breastfeed. Babies at this young gestational age just don't have the capacity quite yet to be able to multi-task - suck, breathe, swallow all at the same time - so it's quite a process trying to nurse them. They definitely still get their feedings through their nose tubes for now; they really don't get, and are not expected, to actually fill their bellies by nursing at this point. We try twice a day at set times (11am and 8pm) during their regular feedings. Without going into too many details, they clearly have no idea what they're doing but they like being close to me and getting little tastes of milk. The problem is getting them to stay awake, and not be lazy about how they're getting the milk. So we're just letting them try it out for now, and everybody says that it will just all of a sudden click with them, but probably not for another week at least. Once they get the hang of nursing, we will get them on bottles as well because we really need them to be able to nurse and take a bottle. They will not be able to go home until they can feed orally. This is what usually trips up preemie babies and will give us a great indicator of when we're getting close to going home. They are very very hesitant on giving us a timeframe on when they'll get to come home, but one nurse practitioner told me a few days ago that it'd probably be a week or two, more like two, depending on how the feeding goes.
I'm still pumping breastmilk for them 7 times a day (the middle of the night pumpings are starting to get to me which is why the blog isn't being updated as much and there's not as many pictures!). I'm getting about 4 ounces per pumping now or about 24 ounces a day. They're eating about 16 ounces per day combined so as of now we have about 4 additional days of milk frozen but are hoping for more still as the nursing progresses and I get more supply.
Also, in other news, I had a Dr appointment on Monday and my blood pressure appears to be going back to normal! We were worried I'd be one of the women who get gestational hypertension/pre-eclampsia during pregnancy and the blood pressure stays elevated even after delivering but things are looking up. I'm still taking BP medicine for now, and we will reevaluate at my 6 week follow up appointment with the OB.
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