Posted by Michele
Tuesday, October 13, 2009at 11:59 PM
(TCN: Transitional Care Nursery)
Another short post because I am so tired and it is late...
Babies are great in their new home. TCN is so much quieter than the main section of the NICU. And the twins are in such a nice little spot, at the very end. TCN holds a max of 9 babies, so it is a small space, relatively speaking. But with the nursing screen up and the lights low, it feels almost like we are walking out the door!
This morning, we did our first nutritive nursing! It is possible that the babies were taking in breastmilk when we were nursing before, but they werent being weighed before and after to make sure, and it is relatively unlikely that they got a lot, since my nipple is the size of their mouth, so they couldnt really pull in enough nipple and areola to really suck for nutrition. The nurse and I were chatting while the physical therapist was working with Maya. After PT, the therapist said that, in addition to being perfect, Maya was really sucking on her pacifier, so the nurse suggested weighing her pre/post the breast so that we could see how she was doing. The nurse was really sweet and helpful. She noticed that Maya was basically playing with the nipple, even when suckling, because of its size and the size of her mouth, so she offered a nipple shield (a piece of silicone that molds over the nipple and gives the nipple a little thinner of a length so that preemies can get enough of the nipple in their mouth to breastfeed well. She also helped me get Maya in the football hold, which, the first time can make you feel like the baby is going to end up sliding behind you! I nursed for 15 minutes, then she was weighed. She took in 2cc's! (Her feeding right now is 30, so that meant that she was given 28cc's by tube.)
After holding Maya for a bit, I started Bobby's care and then we repeated the nursing scenario with him. He was more than happy to stay asleep so the nurse gave him a little underarm massage to wake him up. It looked like he was having a slower start, but when he was weighed, he showed us that wasnt the case. He took in 6cc's! (His feeding is 34, so that mean he was given 28cc's by tube also.)
At this point, because of the calories that are burned as they are learning to feed, she suggested nursing them once a day for a few days and seeing how their weight gain is. If it continues to be good, then up it to twice a day for a few days (morning/night), then if that is good, add a third. By that point, gulp, she thinks they could be ready to go home!!!
This morning also brought one less cord and monitor! No more pulse ox! (This was the monitor that kept up with their blood oxygenation.) The nurse said that they are both stable enough that they no longer need that monitoring! So, after an exciting morning, we came back in the evening and changed out Maya's bed! She is now in a crib!
They say that moving to TCN makes things go a lot faster and that, once they are "nippling" (taking their food by breast and/or bottle instead of tube), it moves VERY fast. The day nurse said that she expects them to go home soon. They are gaining weight, maintaining a good temperature, breathing well, weaning off their monitors, and are nippling well before the age they are normally even started (they start around 33 1/2 weeks... putting today as the first day that gives them a week's advantage).
We are so proud of them. They continue to amaze us every single day!