NICU Day 41 (TCN 9)

Babies are porking up! Yay for chubs!!! Maya has developed a little double chin that is absolutely adorable. Just priceless! She is now up to 3lb 14.4oz (who ever would have thought you could be chubby at that weight, LOL, but she is just perfect). Bobby looks thinner although his face is filling out and he's got a little bum; he's 4lb 4.8oz. He nursed tonight without the breast shield and took in 10 before he was weighed, then we gavaged the rest of his feeding while he was on the breast suckling; he also took a full bottle today. Maya took in 4, although she worked so hard and I really feel like, based on my let down, that she had to get more, but so says the scale. I'm just not thinking about it anymore. They can nurse to their hearts' contents and scale be damned.

I talked to the nurse tonight, who is a ICBLC, about should we continue to breastfeed them or just bottle them until they go home. Here is the quandry: they are judged on how much they take in orally. If they take in a full bottle, that increases their percentage for the day; conversely, if they take in only 1 or 2 cc's, that lowers their percentage for the day. With nursing, while some days have been superstars with 22cc's from the breast, other days (with what seems like just as much effort) results in the scale reading 0cc's transferred. This lowers their overall total percentage, of course, and I cant help but wonder "would they have done better with the bottle?" So, I was wondering if we should just bottle them and then work on breast once we get home.

D said no. In addition to saying that most babies dont nipple anything until 34+ weeks, she said that they are really doing great at both breast and bottle and to try not to worry or stress the percentages. She watched me nurse tonight and said that both babies have the right idea and are latching well. Sometimes, even though they suck well, she said that it is possible they arent getting as much suction as they need, but that they will. I noticed an improvement with Bobby tonight sans breast shield. Even though he could only take in my nipple and a tiny bit of areola, he was still able to transfer over a quarter of his feeding. She said this was outstanding and that the practice of actually nursing was the best part. He also continued to nurse once his remainder was tubed. (I tried Maya with no shield, but she couldnt get my entire nipple in her mouth, so I went to the shield and she immediately started sucking and sucking well.) D also recommended not pumping prior to coming to the hospital, so that I could have a more forceful let down. Overall, her opinion was that they are far beyond where they should be and that, while she can understand my fear that they are being held back because they nipple less at the breast than with the bottle, that I shouldnt be frustrated and should just enjoy their breast time and understand that they will get better. So that is what I am attempting to do. I am concerned with the scale numbers and I just have to let that go. It isnt about the number, it's about them having breast time and bonding and feeling safe and loved.

(10/22/09 @ 7am update: Maya took in 22% of her feeds by mouth (breast and bottle) and Bobby took in 52%, for 10/21. Great News for both!!!)

We interviewed our first of two pediatric practices. They seemed okay and we both would feel comfortable using them. They have experience with preemies and twins, will see the babies together, will get them in within 12-24 hours if they are sick, and have an hour each day, every day, when you can call and ask questions with the docs (you can always leave messages and they can return calls any time). The doctors rotate on call and there is always a practice doctor on in the off hours. We liked the personality of the doctor we spoke to. Our second interview is next Tuesday and we will make a choice after that.

As soon as the pumping goes off, I am going to bed. I am so wiped out...