Emery and Benton. The third week.

Obviously I meant to get this post up weeks ago but life is crazy right now and any extra time that I have (zero) is spent napping.  This is going to be really wordy and really long.  I didn't mean for it to be but I don't have the energy to split it up into multiple posts.  So word vomit about Emery and Benton's third week coming at ya.  Feel free to graze or skip!  

The third week of life for E and B was spent in Arkansas Children's Hospital.  Benton and I had moved in so Emery could learn how to breastfeed.  

Our setup.  2 bassinets, a rocker and a scale.  

This is where we slept.  The chair folds into a "bed" and the person staying with me slept on the "couch".  

We got there Friday, May 8 in time for Em's 11:00 feeding.  I carried Benton in totally wrapped up and the lady that lets people into the NICU thought I had a broken arm...not that I was carrying a baby under there.  My mother in law and Blakely dropped me off.  I had explained everything to Blakely and she understood but since we didn't know how long I would be there we didn't know when I would see her next.  There were tears...from me, not her.  She was just pretty excited to get to go to Bob's house!  

So happy to have Emery snuggles

I got there at 1030 so we immediately had to get ready to feed her.  The lactation nurse came in to help and also the speech therapist.  I know...I was totally confused as to why we had a speech therapist too.  Basically they are the ones that evaluate the mouth of the baby to make sure they are ready for swallowing/sucking/safe eating.  They brought a scale into the room because we were going to weigh her before and after each feed.  This was the thing that nearly sent me over the edge during the hospital stay.  


There is an equation they have that determines what a "full feeding" is for each baby based on their weight.  This is the amount they need to eat every three hours to grow at the acceptable rate.  Anyway, for Em it was 46 mL at that time.  So we would weigh her before and then after hoping she would weigh at least 46 mL more than before feeding.  (They measure weight in grams.  1 gram is equal to 1 mL)  

Back to that first feeding.  She latched right on and my milk let down immediately.  She swallowed for a minute or two and then promptly fell asleep.  I stimulated her as much as possible and she would barely wake and swallow a little bit more.  She was already worn out within about 7-8 minutes.  We didn't want to wear her out completely so we stopped and weighed her....5 mL.  FIVE.  I should not have gotten my hopes up but oh they were so high.  I was really hoping we would get breastfeeding down over the weekend and go home Monday or Tuesday.  But over the next day it became obvious that wasn't going to happen.  

These were the sheets I used to document her weight before and after each feeding.  

We tried again at the next feeding and she did 12 mL.  Lonnie still hadn't made it as he was coming after work so I was by myself with both babies for the first time ever.  We (the lactation nurse and me) decided that it was best for Emery to eat first because the milk would come the easiest.  Benton had nursing down and he could work for it a little harder if needed so he had to wait for her to eat each time.  At the second feeding I realized how much of a nightmare this could be when no one was with me.  Benton proceeded to scream as soon as Em latched on.  He was starving, of course, because it had been 3 hours since he ate.  The nurse picked him up and tried to comfort him but he was pretty pissed.  All I could think was what if she wasn't in here with me?  He would just have to lay there and scream because it was important for me to make sure Emery latched on well and continued to suck well.  It was stressful and I decided right then that someone HAD TO BE WITH ME.  

Reunited with his baby girl.  He hadn't seen her in a week due to work.  They stayed like this for a looooong time.  

Over the next 2-3 days we had issues with Emery getting a proper latch.  She would do good at first but then switch it up and not want to open wide.  This meant less transfer of milk which meant a lower number on the scale when we were done.  We had started to see an increase in the amount she was taking...12 mL, 20 mL, 18 mL...but this was no where close to a full feeding.  They would give her the difference (my breast milk that I had pumped) through her NG tube while I fed Benton.

I started to get frustrated.  We had started out nursing 4 out of 8 feedings per day.  Since she wasn't taking a whole lot from me and she would get really sleepy each time so we weren't increasing that.  To me that meant we were never going to go home.  

They had to change out her NG tube one day so we FINALLY got a glimpse of her without anything on her face!  My beautiful sweet girl!  

The nurse exchanging the tube was so sweet.  When I started snapping pics of Em without her tube she suggested we put them both together for pictures.  She was so patient.  I really appreciated her doing that.  I know she was busy and needed to get this done but she made sure I didn't feel rushed and got plenty of pictures.  

After the first week I was feeling like this just wasn't going to work.  She would latch on, eat some, de latch, re latch, eat, choke, de latch, fall asleep, blah blah.  It was a struggle every time and I was not liking it but really wanted to do whatever I could to make it work.  I would work with her and it would take 45 minutes to feed her (she wasn't eating that whole time) and then we would weigh her only to get something like 20 mL on the scale.  They would give her the rest via NG tube.  Then I would feed Benton and then pump for 15 minutes.  Every.  Single.  Time.  By the time all of that was done it was almost time to do it all again.  Exhausting really.  And I didn't feel like we were making any progress.  

The lactation nurse came in a few times and said I was doing great and that Emery was doing great.  It just takes time with preemies.  That she was actually doing better than the average preemie.  I heard them but it didn't really sink in.  

Finally one day one of my favorite lactation nurses came in during one of the feedings (I had requested someone to help because I was so frustrated) and she really helped us with the latch situation.  Emery also just kind of got it at that time too.  The problem is that it took 3 hands to do it!  I had to hold Em's head with one hand and then my boob with the other.  Then Lonnie had to press her chin down while I threw her face to the boob.  Previously we hadn't been very forceful with pulling her chin down but they showed us to do it with more pressure and it worked like a charm.  We started getting better numbers...24 mL, 28 mL, 30 mL, 34 mL.  Still not a full feeding but we were getting close and I was so happy just to see some progress.  

After a few days of that she started having trouble choking and forgetting to breathe when she got tired.  Soooo the speech therapist had to come back in and observe feedings.  Em was always attached to a monitor.  When she would choke or hold her breath her heart rate would go down (brady) and her oxygen saturation would drop (de-sat).  These things are obviously not good and put her at high risk for aspiration.  I was watching her like a hawk at every feeding but it would happen so fast.  She would stop sucking and then all the sudden be blueish and the monitor would start dinging.  Crazy stressful.  She only had a couple of "episodes" like that but it was scary and concerning.  They wouldn't let her increase the number of times she ate because of this.  Sooooo we spent a few days in that holding pattern.  I would have to take her off as soon as I noticed her holding her breath or any of the other signs they told me to look for.  All that on and off business would wear her out and therefore the numbers started going down again.

At this point I knew that she had the breastfeeding thing down.  She knew how to latch and she knew how to eat.  It was all about her getting tired and not being able to take the "prescribed" amount (and then choking).  We were consistently getting number in the 30's unless she had issues with choking.  I was ready to feed her more than just 4 times a day.  This was my issue with the numbers game.  Babies don't take the same amount every time they nurse.  Sometimes they eat a lot and other times not as much.  Ya know, just like us!  So, for instance, I would feed her and she would take 30 mL at 11 am.  This would take 30 minutes.   Then I would go out and tell that to the nurse and she would prepare the difference, 16 mL in this case, in a syringe so Emery would have had a full feeding so she would continue to gain weight.  Sometimes it would be an hour after I fed her before she got that last bit through her tube.  I felt like if we just didn't give that to her she would be hungrier at the next feeding and therefore take more from me.  I know they have to have a formula to go by to make sure babies are gaining weight and I was happy to go by the numbers in the beginning.  But like I said, at this point I knew she knew how to nurse.  I felt like if we just pulled that tube out and I fed her when she was hungry we would be just fine.  I was also REALLY tired of being in a hospital and I missed my Blakely.  

Anyway, back to it.  Once Emery "got it" but she was having the choking issues we kind of started seeing a dip in the numbers again.  I asked for the lactation nurse to come in and see if she had any ideas on how to help that.  This was a new one that I hadn't seen before. She came in and saw how I had been doing it.  Right off she added about 4 more pillows to my chair and propped Emery way up high on my chest.  She was even or higher than my boob.  We latched Emery on and she did great.  All because she was in a more comfortable position.  

She looks so small!  

I have never posted a breastfeeding pic but I love these so much!

After about 8 minutes Emery began to slow down.  I mentioned to her that I thought if we put Benton on the other side then Em would pick back up and do better.  I had been telling Lonnie this for days but I wasn't sure if that was ok if he "helped" her.  The lactation nurse said, "let's do it"!  So she helped me get them both on and for the first time ever I fed both of my babies at the same time.  It was awesome.  Lonnie, knowing me so well, took pictures.  

When we weighed her I nearly cried.  She took 46 mL exactly...a full feeding!  That was the first time she had done that and she continued to average a full feeding the rest of the night and the next day (I only tandem nursed about 50% of that time).  Finally, on Sunday, May 17th we got to increase to 6 out of 8 feedings a day being from the breast.

She continued to do well and I was oh so ready to go home.  She was still getting a little tired but I knew if they would just pull that tube out and I could feed her when she was hungry that she would do just fine.

We had a lot of really awesome nurses during our stay.  One in particular had taken care of Emery the first few days she was there.  We found out that her sister actually worked for Lonnie (small world).  She requested to be Em's nurse anytime she was working.  This nurse was our nurse the day after we increased to 6 feedings a day.  That morning when she came in and saw how great we had been doing throughout the night she said she would call the doctor and see about the tube being taken out and moving up to all feedings from the breast.  The doctor said maybe the next day.  Well after 3 more feedings that day she called the doctor again.  She knew I was ready and she had taken care of my baby girl enough to know that she was going to be just fine.  The doctor said to take the tube out..so that meant no more supplementing with my breast milk.  This mama was happy!  I was a little nervous because we had pushed it so much but my mama heart just knew that this was the right thing to do.  My nurse asked the doctor about going home the next day.  The doctor said if she didn't have any "episodes", continued to eat well (still weighing her) and GAINED WEIGHT until the next morning then we could go home.  Happiness.  

Emery did all of those things, so on Tuesday morning, May 19, I was a nervous wreck waiting on the doctor to come and hopefully confirm that we could go home.  The nurse went ahead and did the car seat test (she had to sit in her car seat for an hour and a half hooked up to all her monitors to make sure her heart rate didn't drop) and I had to watch hours and hours of informative (not really) videos.  After the car seat test it was time to eat again but she needed her vitamins first.  She was getting them once a day through her tube.  Since she no longer had her tube they just squirted it in her mouth.  They are super nasty and hurt her tummy.  So then we tried to nurse.  She literally had no interest in eating.  She was so so sleepy.  I weighed her and it was like 12 mL.  I definitely lied and said she took full feeding.  I wasn't about to let one bad feeding stop us from going home.  The doctor came in, checked her over really good and said we could leave.  WHOOP.  I basically begged her.  I told her that we were friends with our pediatrician and I would take her in to get weighed every single day if needed.  We just really needed out of there!  

 These were their coming home outfits that were way too big but I was detrained they would wear them!  

So where was Benton during all of this?  Well my tiny man was just such a trooper.  He had to learn ladies first very early in life.  Emery always got to eat first.  Most of the time I had someone with me (Lonnie, Bob, Jenni) to help soothe him when I was dealing with Emery.  He did get a little spoiled being held so much.  The only thing we had in the room was a bassinet, which he hated, and the boppy pillow.  So yeah, he was held a lot.  He did good except the times that it took her a long time to nurse.  Poor kid was hungry!  Once we started feeding them at the same time it was better.  But it literally took 3-4 hands to get them both latched on properly and to keep them that way so I didn't do it every feeding.

He did sleep in the bassinet most nights but during our stay he started grunting a lot and groaning and I thought he was having some reflux.  I propped his bed up and I would hold him upright after feeding but sometimes I would just have to hold him all night.  Super tiring but I did love the snuggles!

All of the nurses loved seeing him and how well he was doing.  If I heard it once I heard it a hundred times..."you know how lucky you are that he is doing so well?",  "usually it is the boy that has trouble!", "I can't believe he took to nursing so well!"  I knew he was a rock star but I still liked hearing it.  :)

Benton was scheduled to see our pediatrician for a check up the 3rd day we were there.  In the beginning I was hoping we would all be home and that would be our first check up for Emery too.  But no.  I made Lonnie call our doctor and see if we could skip it if we just weighed him in our room.  He said yes and that he just needed to be gaining an ounce a day but 1/2 an ounce was fine since he was a preemie twin and to call him if we thought we had any issues.  We weighed him at the same time every day and he was gaining like a champ.  

The day we got to come home was a glorious day.  I was so ready to sleep in my own bed and to have Blakely play with the babies.  She came up to see us a couple of times.  

Since we were in a separate section of the NICU they would let siblings come and visit but no other children.  She finally got to meet and hold Emery and we had our first (and only...need to get on that!) family of 5 picture taken in our hospital room.  Lonnie had to work the day we came home so Jenni drove us home.  I really meant to get a picture of all of us in front of the house when Lonnie got home from work but we were all just too exhausted!  It was surreal to finally all be under one roof.  And things have been crazy ever since!