Crib - the Sequel

Maggie is off of the IV as of yesterday and is back in a crib. She is maintaining her temperature well and is up to full feeds (43ml). The overnight nurse gave Maggie her first bottle, so she is now working on three feedings by mouth.

She is still immature, so her full sucking reflex isn't fully developed, so it takes her a long time to get started and by the time she gets going feeding she isn't able to take much because she gets worn out. Last night it took her 15 minutes to collect herself and start feeding, once she did get going she took 9ml by bottle.

The nurse today suggested we start occupational therapy, which will help Maggie's oral stimulation before nursing or bottle feeding. Maggie's nurse said baby's typically do well with this stimulation. The bigger she gets and the more developmentally mature she will get the better she will do at her feedings.

We did the technique today and she latched on much faster and was able to go a little longer. We are going to do this for her at each feeding, even if it's a gavage feeding.

Maggie will get her Hep B vaccine today and I was given information about RSV and a special vaccine Maggie will recieve throughout cold and flu season. It's a series of shots she will receive once a month from November through March to help her immune system fight off any type of respiritory infection caused by a common cold during the long cold and flu season.

We learned last night that we will need to do lots of hand washing and hand sanitizing this winter and be very conservative about taking her out of the house. The last thing we want is for her to end up back in the hospital. The fun part will be teaching our 17 mo. old Cece about germs. We'll see how that goes.

Four Weeks!

Maggie is 4 weeks old today (35 weeks 2 days corrected age) and weighs 4lbs 11oz - almost 5 whole pounds! Maggie's doctors are agressively increasing her feeds today so she will be off of the TPN by this evening, meaning no more IV. Woo hoo!

As her volumes rise to full feeds, the nurses will again be adding fortifier to her milk (which adds calories without adding volume) to help her grow. Within the next few days, we also anticipate the nurses/docs will start her on mouth feedings (bottle or breast).

They are also starting to wean her out of the isolette once more. Hopefully she'll be able to maintain her temperature better this time, especially since she's got more meat on her bones to keep her warm.

I asked her doctor today when we're looking at getting Maggie home and she seemed optimistic that we're looking at another two weeks. I'm so excited and hope these next two weeks fly by as fast as the last four have.   

Nursing resumes!

I was able to resume nursing with Maggie yesterday. Today's feedings went well and she took 15ml tonight at 8 p.m. She is still taking Lipids and TPN through IV until she's back up to full feeds. The doctors have OK'd an increase in feeding volume twice a day. She is currently at 20ml and will most likely increase again tomorrow. Maggie was at 37ml last Thursday, before the NEC scare. I hope that she'll be off the IV by the weekend and back to full feedings.

Maggie is still in the isolette and I'm sure that she'll be out of it soon enough. She's been maintaining a higher temperature and now that she's put on some extra weight (she actually is starting to look chubby if you can believe it) she'll stay warmer.

No other news to report. She continues to do what she needs to do - eat, sleep, snuggle, etc. It's hard to believe that she's already 4 weeks old tomorrow. The time sure has flown by.

Negative is Good!

Good news today. Maggie's final test results are negative for NEC. We are so very happy to hear that. Today at 2 p.m., Maggie's feeds resumed, starting with 5ml every 3 hours and slowly increasing in volume. As her feeds increase, they will decrease her TPN and lipids, just like when she was first born. Once her volume increases, we will be able to nurse again. I'm sure she'll be back on track by the end of the week.

No NEC is good NEC

Preliminary test results are negative for NEC, however the doctors are still taking every precaution necessary with Maggie. She has been recieving antibiotics this weekend and is back on TPN and lipids for nutrition. She is back in the isolette, too, since her temperature has been on the cool side since she moved to a crib last week.

Today, Maggie is doing great. Her tummy x-rays look good, her bowel sounds are normal and her abdomen is soft. Tomorrow, they will slowly resume her feeds and will come off the IV nutrition fully in a few days.

This is all good news to us. We are so happy the doctors and nurses are on top of everything with Maggie. Everyone seems optimistic that her final blood tests will come back negative for NEC.

Maggie's weight continues to climb, today she is 4lbs 4oz.

I'll be heading to the hospital in an hour to kangaroo with Maggie and look forward to tomorrow when her feeds resume.

Scary

After last night's bloody stool, the doctors did an X-Ray of Maggie's tummy this morning. The doctors were concerned with what they saw on the x-ray. She hasn't had another bloody stool since last night, but the doctors wanted to rule out the possibility of NEC - Necrotizing Eterocolitis - which would be a very serious problem with her bowels. One of the doctors said that Maggie shows no apparent signs of this since she has been tolerating her feeds well, been stooling well, etc. - but they are taking every precaution to make sure she is OK.

So, Maggie's feeds stopped today and she has an IV again to receive antibiotics and TPN. The doctors have to run a blood culture, we will have preliminary results from the test tomorrow morning and will have final results Sunday morning.

This was discouraging news to me today, since Maggie did such a great job nursing (14ml) and she has been making such great progress over the last three weeks. My visit this afternoon was cut short because they needed to start her IV immediately. I pray that she is OK.

Jeff went to the hospital tonight to kangaroo with Maggie. He didn't get to see her today, as he had to work. Hopefully, we'll have good news in the morning.

Please keep Maggie in your prayers this weekend.

First Bath

Tonight I learned how to give Maggie a bath. She is pretty tiny, so it was nice of the nurse to show me how best to clean her. I need to keep her wrapped up (so she stays warm) while I wash her face and hair, then I can put her in the mini tub and wash her. Pretty simple. Maggie seemed to enjoy her bath. She didn't fuss at all. I took a picture, which I'll have to upload tomorrow.


Tonight, Maggie had some blood in her stool, so the NNP came and checked her out. She has a fissure on her rectum (probably from all of the pooping she's doing), so it wasn't a major concern to the nurse. They will monitor her over the next day or so to make sure she is ok.


Maggie took 6ml tonight during her feeding and was very alert my entire visit. I arrived early for bathtime, then she wanted to visit before we nursed. She did a good job, but got tired quickly. I dressed her back up and we snuggled during her gavage. She was awake for a long time, so we talked and I sang to her. Then she fell asleep and I tucked her in and kissed her goodnight.


Tomorrow we start our passport to home curicculum, which is the next step on our path to bringing Maggie home. Jeff and I get to check off what we want to learn more about before we bring Maggie home. I'll learn more tomorrow about all of the things we need to know/do before Maggie comes home.

Three Weeks / Four Pounds

Maggie is 3 weeks old today and has passed the 4 pound mark. Today she weighed 4 lbs 1 ounce. She seems to be gaining an ounce or two each day, which is great news! It's all about eating and growing!

Maggie had a few record breaking nursing sessions this week (getting 12ml at two different feedings). We determine this by weighing her before and after we nurse to know how much she gets. Then she receives the rest of her feeding via gavage. She now is up to 37ml per feeding (every 3 hours).

Jeff asked when Maggie will start to add bottle feedings to her routine. Right now the nurses said that once Maggie reaches 35 weeks gestation, which is early next week, they will add a bottle feeding once at night along with the two nursing sessions we are currently doing.

35 weeks coincides with the natural stage in a baby's development where they develop the sucking reflex. As long as she does well with those, I think they will gradually start adding more nursing and bottle feedings. This will bring us much closer to bringing her home. We anticipate Maggie to be in the NICU at the very least another two weeks.

The only other new development to report is that Maggie has a diaper rash, so she has a special ointment to take care of it. It's a bit different from regular diaper rash. It's more of a yeast-infection type rash. Maggie was given antibiotics when she was first born, which killed some of the good bacteria that would typically fight off this type of infection. I think that the ointment is working, as she didn't have the same pimples on her skin that I noticed yesterday.

I can't believe the last three weeks have passed so quickly. I looked at the calendar today and it's already Halloween next weekend. I feel like time has literally stood still, but it obviously hasn't. While we still have a little time left before Maggie comes home, I feel like we have so much to do.

Jeff and I will spend much of the weekend getting progress made on Maggie's room, setting up the bassinet in our room, washing baby clothes, etc. We are just so excited for her to come home.

Crib!

The big news of the day is that Maggie is now in a crib! She has been successfully weaned from her isolette and is maintaining her temperature well enough to graduate to an open air crib. Very exciting!

She is bundled up in a onesie, fleece footie jammies, socks, hat, and swaddled in a blanket with another fleece blanket over her. She looks so warm and cozy.

This week, I am making trips to the hospital twice a day to nurse with Maggie. I have worked out a schedule that allows me to be there for her 11 a.m. and 8 p.m. feedings.

Our feeding this morning was a bit of a disaster. I didn't put her diaper on very well before we started, so her diaper managed to fall off and she ended up peeing all over the Boppy pillow. Then she started to spit up.

Tonight's feeding went a little better. I like going to visit at 8 p.m., the nursery is quiet and peaceful. We just talk and I sing to her. She nurses and I hold her during her gavage (tube) feeding. It's just so nice.

Maggie is still only managing to get about 4ml per nursing session. I think in the next week or two things will start to progress as far as feedings go. Babies develop that sucking reflex around 35 weeks gestation. Maggie is now 34 weeks. She shows real interest in nursing - she's always alert when it's time to eat. Plus, she's gaining weight and will only get stronger in the weeks ahead. I look forward to the day she'll be able to get a whole ounce (which is what she gets through gavage at each feeding). I know it will be soon.

Feeder Grower

This weekend Maggie is being weaned off of her isolette and the nurses report that she most likely will be in a crib by Monday. She needs to be able to maintain her temperature today with the isolette set to room temperature. Of course, she is bundled up in a onesie, footie jammies, blankies and a hat. The nurses regularly check Maggie's temperature to make sure she's not too hot or cold. Maintaining temperature is one of the four things she must be able to do before coming home.

Maggie continues to make great progress nursing. She has successfully taken 4 ml at each feeding this weekend. The nurses determine this by weighing her before and after her feeding. Today I will start going to the hospital twice a day to nurse with Maggie. Jeff and I hope to have figured out a good schedule that allows him to return to more regular office hours, but also allows time for him to visit Maggie at the hospital. It's a lot to coordinate, especially with Cece at home.

All in all, Maggie continues to do just great. She just needs to keep growing! In fact, this next stage will be considered "feeder grower" stage. On Saturday, the nurse reported that Maggie gained an entire ounce since Friday. So, she is definitely growing. The nurses add a fortifier to the breastmilk she recieves through her feeding tube. This fortifier helps her bones grow and provides extra calories without adding volume.

We always get the question - "When will Maggie go home?" The doctors/nurses say to plan on her coming home close to her due date (Nov. 29), but she could come home earlier. It all depends on her progress. I'm optimistic that she's going to come home early to mid-November.

Two Weeks Old, Sort of . . .

Maggie is 2 weeks old today (33 weeks 2 days) and Jeff and I are amazed at the progress she has made in these 14 days. Maggie's bilirubin is back down after another day of light therapy (6). The nurses do seem optimistic that she could possibly be done with that.

Since going off of caffeine a few days ago, Maggie has NOT had an apnea spell, which is great news. Maggie's weight also continues to go up (3lbs 9oz today).

Also, the temperature in her isolette continues to go down. This temperature has been slowly going down over the last two weeks, as it approaches room temperature and Maggie is able to tolerate that and stay warm while dressed and swaddled, she will come out of the isolette.

The biggest news of the day is that Maggie has figured out nursing. In just a few short days she has made amazing progress. Today, she successfully coordinated all of the motions - breathe, suck, swallow - without having any sort of spell. She managed to get 4 ml successfully (the nurses are able to measure this by pulling back what's in her tummy through her feeding tube).

This is a real milestone for Maggie. Once she is able to get more than 5 ml successfully, she will start to be weighed before and after nursing to get a better idea of how much milk she got. She actually spent 45 minutes nursing today. She shows so much interest and motivation. It's amazing to me, since she is just so tiny. In the next few days, I will be making trips to the hospital twice a day to nurse with Maggie.

Maggie was very alert during our entire visit, which was so fun. We read her books, got her dressed, sang her songs. We just love her so much. I had a really hard time leaving her today, but I know in a few short days I'll get to spend lots more time with her.

12 Days / 33 Weeks Gestation

At our visit with Maggie yesterday, just a few new things to report. Maggie is now 12 days old (33 weeks gestation). Her weight was up to 1610 grams (she was 1500 when she was born, which equal 3 lbs 5 ounces). The docs also decided to take Maggie of the caffeine, which they were giving her to help reminder her to breathe (to prevent an another apnea spell). They feel that she's doing well enough to not need this anymore.

Maggie's bilirubin level was up again (at 7), but the doctors were going to hold off putting her under the lights again and recheck it in the morning. There may be a possibility she'll have the lights on again today.

We practiced nursing again and Maggie did awesome. She woke up once we got there and was looking at me and Jeff as we changed her diaper and took her temperature. She was alert the entire time we were nursing and she really did a great job. She started to show signs of rooting, did well with her latching, etc. She seems so determined, a trait she gets from her father.

Jeff and I will make our daily visit this afternoon. I feel like our visits are always too short. Hopefully, we'll get to spend more time with her today. Next week I'll finally be able to drive, so I can spend more time with Maggie.

We developed some of our pictures of Maggie for Cece and put them in a photo album for her. She likes to look at the pictures and give her sister kisses. She also points and says Maggie or baby. We can't wait until she can kiss her sister in person

Practicing Nursing

At our visit with Maggie yesterday, we helped her pass another milestone in her development. The nurse encouraged us to try a "non-nutritive feeding" - meaning Maggie got to practice nursing. Since a full feeding would be too much work for her at this time, we did about 5-10 minutes of practice to see how she'd do. Our nurse said Maggie is starting to develop a rooting reflex and does a good job sucking on her pacifier, which is what prompted this practice session.

Maggie latched on right away, which the nurse considered as 100% success. Right now it's important to Maggie to know who her mommy and daddy are (recogize the sound of our voice, the way we smell, etc), and this practice is one way to help her do that. So, as a next step, we are going to practice this during our visits over the next few weeks until she can handle a feeding.

Also during our visit yesterday, Maggie moved to a new nursery. The babes in the NICU move around quite a bit, as they are remodeling the unit. Maggie is now in nursery 3C, we picked out a nice sunny spot by the window for her!

We're so happy that she continues to do so well! I hope that the rest of October goes fast so we can get our Maggie home!

Rock Star!

Maggie is a little rock star! At least, that's what her nurse told me today. I'm very happy to report that Maggie is now up to full feedings (30ml) and no longer needs the TPN and lipids, she is getting all of her nourishment from me! Her IV is also out, so she looks so much more comfortable. Her nurse told me that she's a pooping machine, which sounds gross, but it's really great news - signs that things are working. She eats, sleeps and poops, just like any other baby!

Today she was back under the lights, hopefully for the last time. As her weight goes up and her age goes up, she'll be able to tolerate her bilirubin level (which is around 6 or so right now), which means she most likely won't need any more light therapy.
No more light therapy means that she'll get to wear her cute little preemie clothes.

We hope she continues her great progress. At our visit on Saturday, we did an hour of kangaroo and then I got to dress her up, change her diaper and take her temperature. Her eyes were open and she was alert while I got her dressed. It was the most we have been able to interact with her. She is just a sweetie and was totally chill while we did all those things with her. It is always hard to leave her, but we look forward to our next visit.

 

 

Doing Great!

Maggie is our sweet angel! She continues to do just great. At our visit today, Maggie was back under the lights. It's normal for preemies to be on one day, off another, back on the next.

Maggie's feedings have increased again today to 23ml per feeding. As long as she tolerates her feedings, the doctors will continue to increase how much she gets. This is good because as her feedings increase, her need for TPN (the nourishment she gets through IV) goes down.

We did kangaroo care again today. Maggie had the hiccups, which were so darn cute.

We can't believe how fast this week has passed. If the next few weeks go as fast as this week, she'll be home before we know it.

In the meantime, Jeff is going to start work on the nursery this weekend. Maggie won't be moving into her new room right away, she'll be sleeping in the travelling bassinet in our room. The bassinet is very special to the Christenson family, more than 40 babies have slept in there since Jeff's brother Chris was born (40 years ago - he was the first). It has travelled around among relatives, so Maggie will be joining the long list of babies to have slept in the bassinet. Jeff, his brothers, cousins, Cece and all of Maggie's Christenson cousins have slept in it.

Thanks to everyone for their kind words, thoughts and prayers. We are so blessed.

Bridget, Jeff, Cece and Maggie

Firsts

This afternoon's visit with Maggie was really fun and full of firsts for us. Jeff got to take her temperature and change her diaper! Maggie is no longer under the lights, so she gets to wear clothes. We brought her a few new preemie outfits and we dressed her up. I got to hold Maggie during her feeding, another first. She was just a sweet as could be. She was pretty alert during our visit, which was really cool. She just seems so content.

We talked to the doctors and nurses and have the following to report. Maggie's weight is up, her feedings are increasing to 19 ml every 3 hours, all of her vitals are stable, and the results of the ultrasound were normal. She just continues to do well as she can. We're so proud of her!

We'll keep up this routine for the next few weeks until she starts to show signs/interest in nursing (this typically happens around 35 weeks gestation, she is 32 weeks 2 days today). At that time, I'm sure we'll be spending more time at the hospital.

Kangaroo Care

Doing great!

Maggie continues to do well in the NICU. Yesterday, she was taken off photo therapy, but today she was back under the lights to keep her bilirubin levels stable. She has increased her feedings from 11 ml to 15 ml every 3 hours, which is awesome. Yesterday and today, we continued our kangaroo care with Maggie. Its hard to believe that she's been with us a whole week tomorrow! The doctors did an ultrasound of Maggie this morning (routine for babies born this early) and we hope to have results back from that this evening.

Meanwhile, we're staying busy with Cece. She loves to look at pictures of her sister and give her kisses. She can't wait to finally meet her sister in person.

Discharge

The new normal

I was discharged from the hospital Monday afternoon. Before we left, I did an hour of kanagroo care with Maggie. She is just so perfectly sweet and snuggly, even at her small size. The time was therapeutic for both of us.

Maggie had another bloody stool before we arrived in the NICU yesterday morning, which the doctors were concerned about. Test results came back fast and it was determined the blood in her stool was from me (ingested during delivery), so she is absolutely healthy and the doctors did resume her feedings. She is still receiving breast milk through a feeding tube and the rest of her essential fats/nutrients through IV until her intestines are matured enough to handle feedings. She is now up to 7 ml per feeding (from 4 ml a day or so ago). She is still receiving almost light theraphy to keep her bilirubin levels down. We called to check on her before bed last night and she was doing just great.

Jeff and I will be visiting her in the NICU this afternoon for some more kangaroo care! We'll keep doing this every day for the next few weeks. Around 35/36 weeks gestation babies develop the proper sucking reflex, so once she starts to learn this, her feedings will increase and we'll get to start nursing. I'm sure that will change our routine to me spending more time at the hospital so I can nurse with her. Once she is able to take all of her feedings by mouth (via bottle or breast), consistently gain and keep on weight, and regulate her body temperature, she'll get to go home.

Bridget

More Rest

Another day of rest

Today continued to be a much needed day of restorative rest and recovery for both me and Maggie. I am feeling more and more mobile and got up again to make a visit to the NICU to see her, along with Jeff.

Yesterday we had learned Maggie had some blood in her stool. The doctors were trying to determine if was caused by the delivery or if she has an intestinal issue. She was taken off of her feedings until they knew more. After the x-ray came back today, it turns out she is OK and it is safe to resume feedings. She is being fed breastmilk/formula 4 times daily through a feeder tube the goes in her nose to her stomach. Nurse Kim says Maggie really likes to eat, which is a good sign. I'm doing my best to keep up my end of the deal for her.

Another change in Maggie's condition is that she had an apnea spell today (common for babies born prematurely - this is when the baby stops/forgets to breathe and needs assitance coming out of the spell). Maggie's nurses got her through this episode and have started her on caffeine, which helps limit these spells.
Maggie continues to spend lots of time under the UV lights today, so our visit was short this afternoon. We plan to return this evening to give her "kanagroo" care (this is skin to skin contact) for a while, then she'll go back under the lights.

We'll be going home tomorrow and before we do, Jeff and I are going to work on a little photo project for Maggie. We're going to print out pictures of Cece, Ole, Artie, and us and stick them on her isolette, so she is always surrounded by us (even when we're not here).

As great as it will be to go home, it will be weird to not go home with our new baby girl. However, we know that she'll be with us really soon and that she's in the best place possible with the smartest doctors and nurses taking constant care of her.

Bridget, Jeff, Cece & Maggie

Recovery

Going home on Monday!

After another good day of recovery, I'm finally feeling better to write in the journal! I had a good night's sleep and have been able to manage through the pain today with the help of some lovely drugs and several naps. I've gotten up a few times and walked around. We visited Maggie in the NICU, but didn't get to hold her because she was undergoing light therapy (to get her billirubin levels stable).

The doctor's say that I get to go home on Monday, which will be nice, because I miss our little Cece. She's doing so great this week and has been a good girl for her grandparents.

My folks brought Cece to visit last night and we showed her pictures of Maggie. She kissed each and everyone one! She is too little to visit her in the NICU (siblings have to be 2), so I think the pictures helped her understand what is going on.

The next month is going to be hard on our family, but I think we'll be able to get through it. I just want Maggie to do well and get strong so she can come home with us as soon as she can.

Thanks to everyone for your thoughts and prayers. We certainly feel so blessed to have your support.

Bridget, Jeff, Cece and Maggie

Bridet Feeling Better

Bridget continues to feel better. We both had a good night's rest and Bridget's moving around more and more. She walked to the corner of the wing we're in today (as she did yesterday). The IV came out today, too, which means there's less concern around her hemoglobin levels.

We visisted Maggie this morning. The nurses are concerned with her bilirubin levels so they had her under a bili-light. She looked like she was hanging out at the beach, complete with shades. They were also a bit concerned about a bloody stool she had. The blood could either be from the delivery or from her intestine. If it's from her intestine, that's a more serious issue. However, everything else looks normal so the nurse thought it was more likely that the blood was from the delivery. We'll know more later.