Thursday, October 6, 2011

Thoughts on the NICU - 4 of 4

If I had a dollar for every time someone asked me when the boys were coming home during their NICU stay, I’d be a rich woman and I wouldn’t have to work anymore.  There were several milestones that the boys had to accomplish before they were able to come home and that’s what I had to continue to tell people.  So for all those that were wondering, here are the NICU milestones in order of our achievement.
  • They had to be able to breathe on their own.  This was accomplished very early on for our little boys.  They were only intubated for a day and then it was a CPap machine for about a week and then it was just a nasal cannula.  The CPap and nasal cannula were not really helping them breathe, it was just allowing more pressure into their lungs to make them stronger.  We were blessed that the boys didn’t have any major lung issues.  It could have been because I was able to get the steroid shots, or it could have just been because they were strong and healthy.  We were thankful!

Nasal Cannula
  • They had to be able to maintain their body temperature.  For the first few days the boys were in an open warming bed.  This was the easiest bed at the time because they were under the jaundice lights.  Once their jaundice cleared, they were moved to the closed isolettes where you put your hands through the holes to touch and feel the babies.  These isolettes were set at a certain temperature and were adjusted down each day, so that they could get used to being in room air temperature.  By a week and a half in the NICU, the boys were boys were moved to a crib which they shared.  This was the best situation while we were there because they were in the same spot in the NICU.  At this point, they were able to maintain their temperature.  Goal accomplished!  They eventually moved us to a private room and separated the boys into their own beds once they were on their way to going home.  A very good feeling.
Open Air Warming bed
Shared Crib
The Private Suite
  • They had to be free of A’s and B’s.  Apnea is a pause in breathing that lasts 15-20 seconds.  Bradycardia is a heart rate less than 100  which can lead to the baby not breathing.  For the first several weeks, bradys were a problem for our little boys.  They would just stop breathing every once in a while and every time that happened the score chart would start over (you had to go 5 days without before going home).  So one of the main questions to ask the nurse each time I went was if they had any bradys that day.  The nurses actually gave them a daily dose of caffeine to help stimulate them to remember to breathe.  Truett overcame this issue faster than Ellis.  He was taken off caffeine on 6/12/11 after being brady free for at least two days.  Ellis continued on caffeine for another day and eventually overcame his bradys.  Another goal accomplished!

  • They had to be able to eat all 8 times a day by either breast or bottle.  This was the hurdle that kept us in the NICU the longest.  When babies are born so early, the sucking mechanism isn’t developed and so it’s a learning process for both baby and mom to learn how to feed these precious little people.  For the first several days, the boys got their nourishment through TPN (Total Parenteral  Nutrition).  The nurses were holding out for my milk to come in and until it did this is how they were fed.  Once it came in, they started feeding with a very small amount (about 7ml) through a syringe that they would just hold up and let gravity  take it to their tummies.  Once they were taking 20mL or more, they began using the gavage system.  They stayed on strict tube feedings for about a week and a half.  They started a trial run on the bottle on 6/1/11, and both boys took very little but did well for a first time.  They weren’t allowed to add a bottle feeding until they were able to complete one feeding.  It took us several days to master this and finally after about a week they moved us up to 2 feedings by bottle.  They stayed at this for about a week and then it was as if the lightbulb went off for the boys.  They moved up their bottles everyday.  We started breastfeeding a week before they came home and they really latched on well.  By 6/21/11, they were taking all their feedings by bottle and the nurses were preparing for us to take the babies home.  We came home 5 days later (6/26/11) after they had had several days of mastering bottle/breastfeeds. 
Truett's first bottle

NG Tube Feeding

Tandem feeding

  • They couldn’t have any other complications.  We were so fortunate that our babies weren’t sick.  They didn’t ever have any complications that so many babies in the NICU do.  Our babies actually were considered feeder/growers because they were not in critical condition.  They were just small and needed to learn to eat.  The nurses talked about how it was always two steps forward, one step back in the NICU, but I never really felt that while we were there.  I felt like the boys made great strides everyday, but it was just a learning process for them.  When we first had the babies, they said that it would be at least three weeks in the NICU, and we ended up with 5 weeks exactly.  Not too bad considering they were 8 weeks early.  

I believe that this about wraps up my thoughts on our NICU experience though I'm sure that I have left out several things.  It's amazing how far we have come in 19 weeks and ultimately we are so thankful for our NICU stay.  Praise God for those NICU doctors and nurses because they took excellent care of Truett and Ellis and they taught us so much in our journey of being new parents.  

Family pic with Truett - 5/21/11
Family Pic with Ellis - 5/21/11


    Miss G said...

    These posts were really neat to read, Alyson and I hope you don't mind but I passed along your blog to a friend expecting twins. Kelly

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