Porbrecito

So many changes. First, the weight check. Cohen is up to 10 lbs! You may be wondering when I will stop reporting Cohen's weight, especially now that he's not a super tiny baby anymore. I don't know. You see, I love checking his weight. It's a weekly affirmation that breastfeeding IS working. It's not always easy. In fact, for me breastfeeding has been hard work. A full time job sometimes. Currently, I'm struggling with supply issues and an infection, but I'm not giving up yet. For me, it's still worth it.

The most exciting thing that has developed is that Cohen has started tracking! Last week, I noticed that he was making some serious eye contact with me while nursing. After one of our 4am feedings I got him to follow me as I moved my head from side to side. He did it again later that morning when we were both more awake and Joel was there to see it too. It is the neatest trick ever! I can tell he is on the verge of smiling too, a real social smile rather than just a reflex. Sometimes I think he is smiling in response to my silliness, but then I think it's just a coincidence. Either way, it's coming soon:^)

In other, not so fun news, Cohen is getting sick. Joel came home with a cold last week which was probably inevitable working at a children's clinic. Yesterday, Cohen was very fussy and I noticed a difference from his usual nasal sounds. Now you can hear the mucous in the back of his throat and he has been spitting up mucous too. Poor baby. Fortunately, he is still eating well and has been less fussy last night and today. Obviously, Cohen got sick a lot sooner than we wanted and a lot sooner that I expected. Right now, I'm hoping and praying that it won't get any worse.

The good thing about Joel working at the children's clinic is that he's bringing home all types of wonderful medical knowledge about kids health and even some behavioral stuff too. This past week Joel has been working with Cohen's pediatrician. He is a great educator to the families he works with and to the medical students that rotate there. We really like him. Joel has a couple more days there and then his pediatric "final" on friday. After that he will have two weeks off!! YAY!

I finished my last paper on monday. I am so glad to have this semester behind me. I wasn't sure how difficult school would be with everything that has happened. But I did it! And now it's OVER! At least for a few weeks anyways.

Cheers to the holidays!

Baby man hands

The countdown to the end of the semester is on. I have two papers, one "quiz," one final, and one journal assignment coming up in the next two weeks. I will be so excited when this semester is over. Joel will have a break soon too, he will have a few weeks off before he starts his family practice rotation in January.

So the turkey was a success! A friend recommended Alton Brown's recipe for brining the turkey. It took a little extra work but made for a good tasting bird. My mom joined us for the big meal and we had a wonderful day.

Cohen was approved for the Synagis shot last week so we went to Children's Hospital for the appointment. Once we got the shot we had to wait in the room for half an hour to make sure that Cohen didn't have a reaction. The nurses were swooning over Cohen and of course I reveled in all the compliments. When we were finished, I thought about breaking into the NICU to show off Growing Cohen, but stopped myself thinking maybe we should wait until a NICU reunion.

Cohen is now up to 8lbs, 4oz and his hands have grown again. They seem to grow first and then his body catches up. It reminds me of Porter when he was a pup. His paws were so big he was practically tripping over them until his body caught up. Cohen's collection of noises are also starting to expand, cooing and talking more often. He has also calmed down during diaper changes. He used to scream tortuously with every diaper change, hungry or not. At one point I thought he might have some kind of pain down there and I had even mentioned it to the pediatrician. But now he just looks around and sometimes lets out some happy noises. Apparently, he is feeling like he might just live through the changing of the diaper and this makes it a more peaceful experience for Joel and I. Happy, peaceful babies are the best!!

Liquid gold

Cohen is three months old today! He is doing great, doing all the usual baby things, mostly eating. Joel says he has his appetite, but I think he gets his insatiable hunger from the both of us. I have talked Joel and the doctor into letting me weigh Cohen on a weekly basis. This past weekend weigh-in put him at 7 lbs, 8 oz. Growin Cohen is also getting a lot stronger, showing more head control and even starting to arch his back. He is also responding more to our voices, which is really neat to watch.

Last week Nancy and Neal came to hang out with us for a few days. They got some quality time in with Cohen, even getting in on some early morning bottle feedings, which I know Joel appreciated. My parents have also been able to spend some time with Cohen lately. My dad and Christy came up this past weekend, while my mom usually comes every other Tuesday to hang out. My good friends Corena and Brian also visited this weekend.

We love having visitors, especially because we don't really take Cohen too many places in hopes we can keep him from getting sick. We have been waiting for the insurance company to approve Synagis for Cohen, a vaccine for RSV (our doc has referred to it as liquid gold). RSV, a common virus during cold and flu season, usually presents as a cold in healthy infants and adults, but for preemies it can be a much bigger deal. Several doctors have told us that if Cohen were to get RSV he would most likely end up back in the hospital. So we are being very vigilant about following doctors orders to protect Cohen from getting sick. So, no letting sick people near the baby, avoiding kids and even passive smoke. Unfortunately, this also means avoiding big crowds, which means that we won't be attending the many Thanksgiving get-togethers we normally do. This has been really tough for me to accept, because I want to share him and show him off to everyone. All in good time I know.

Since we're not going anywhere for Thanksgiving, we thought it would be fun to cook a bird here at home. I've never done this before and am excited to give it a go. Wish me luck:^)

I hope this update finds everyone happy and healthy. Happy Thanksgiving and Good Eats!

Estimated time of arrival

Today was Cohen’s estimated due date or as I sometimes refer to it, his estimated time of arrival. Joel keeps telling me the medical verbage is called estimated date of confinement (edc). I asked why confinement, and he guessed that it was because once baby comes the parents are confined to the house. Either way, it's crazy to think that I would have been 40 weeks pregnant this week.

Yesterday, we went back to the pediatrician for another weight check. He is up to 6 lbs, 8oz. Wow! That’s 13 ounces in 12 days (the doctors like to see growth of half an ounce to an ounce per day). Go Team Cohen! Needless to say the doctor was happy and we don’t have to go back until his four month well check.

Cohen’s growth was no surprise to me as evidenced by his now super-sized hands. The other day Joel and I had both noticed how big they had gotten seemingly overnight. I joked with the doctor that all 13 ounces went to his hands and he recommended that we get him a piano. I was thinking basketball but of course Cohen should have some say in this. He has also outgrown his ‘preemie’ sized clothing. Looking at those little outfits, it’s hard to believe he was ever that small, let alone a 2-lber at birth.

Cohen is now in the midst of a growth spurt and his abundant weight gain confirmed this theory. Now that Cohen is bigger and has the okay from the doctor to go more than three hours between eating, he wants to eat about every hour and a half, at least the past few days anyways. I was waiting for him to become more demanding about eating and my wish has come true (times ten). Thankfully, the increased feedings happen mostly during the day!

Now that we've reached his due date we will look to his corrected age for developmental milestones. His corrected age or adjusted age is based on the expected due date. It's calculated by subtracting the number of weeks he was born early from his chronological age. So, since Cohen was born 12 weeks early and he will be 12 weeks old on Saturday, he'll be zero weeks corrected this week. I know, sounds funny right? I guess that means it will be his 'Corrected Birthday' on Saturday. Hmmm, maybe we should celebrate with cake...and ice cream. Anyway, in four weeks, he'll be four weeks corrected age. So this means that hopefully Cohen will be smiling at us by Christmas!!! (when he's 6 weeks corrected age). Sounds like a Merry Christmas to me:^)

Scrubbed In

Joel, Cohen, and I spent Halloween night handing out candy and watching one of my favorite '80s movies, Silver Bullet. Cohen was a doctor for Halloween.

This past week has been busy for me. I've been writing papers, studying for quizzes and caring for Cohen. Joel has been working hard too. He started his pediatric rotation last week and has been working 12 hour days. Cohen had another doctors appointment to check weight last thursday. He was up four ounces in seven days, so the doctor was content. Each time we go to the doctor and "pass" the weight test we buy more time between doctors visits. So the next time we go will be next week which will be 11 days since our last visit.

It's been so nice out this past week that we were able to take Cohen outside!!! We went for a walk and had a chance to try out the new stroller. It is awesome! Thank you Len & Sammy! We can't wait to take it off road in the future.

Also, I am starting the process of trying to find a nanny/babysitter for next semester while I'm in class. I would like to keep Cohen out of daycare until spring time when flu/RSV season is over and this seems to be the answer. Feel free to contact me if you know anyone who may be interested. We are an equal opportunity employer:^)

Oh yeah, I've been so excited for election day and it's finally here. Voting always feels so good! The night isn't over yet, but it looks like things are headed in a new direction. YAY!!!

Little Blue Eyes

Today Cohen and I ventured out of the house to go to his follow-up eye appointment. The doctor was checking for a condition called retinopathy of prematurity or ROP for short. ROP is when there is abnormal growth of blood vessels of the retina. ROP can cause vision impairment with the most severe cases causing blindness. The treatment for ROP is laser eye surgery.

Cohen had been seen about two weeks ago to check for ROP and there were no signs of it:) The doc said that he didn't see any abnormal growth in Cohen's retina's today either:) but that they also were not fully developed. We will go back after four more weeks so that he can look again. The doc said that ROP develops in about 20% of preemies born around Cohen's gestational age. I also read in his office how preemies also have a higher risk of developing crossed eyes or lazy eye. Oh good, more stuff to look forward to.

To check Cohen's retina, the doc used a small retractor to hold Cohen's eyelids open while the nurse held his hands down. Then the doctor stuck another tool behind his little blue eyes while looking through his magnifying glasses. Watching this was not fun for me and Cohen didn't really like it either. He screamed like I've never heard before, but stopped as soon as it was over. I feel really lucky that we haven't had to have any surgeries thus far.

Cohen goes back to the pediatrician on Thursday to get his weight checked again. I think he's gaining well. His cheecks seem to get fatter everyday. Cohen will be 38weeks gestational age this week! He is starting to be awake a lot more often and I'm excited for him to become more demanding about eating. He definetly wakes up more on his own to eat now than a few weeks ago, but we still have to wake him up once in awhile, which can be difficult sometimes. I am looking forward to him getting a little bigger so that we can go a little longer between feedings. (The doc says we shouldn't go longer than 3 hours between feedings until he gets to 6 lbs). Right now, he's in a nice pattern of cluster feeding during the day, and sleeping longer at night. This is a great pattern and I hope we stay with it.

Also, I put a few new pictures up on the flicker site. The link is on the left side bar of the blog. Enjoy!

2 months and growing

Cohen is two months old today! We marked the event with a return visit to the pediatrician (Cohen had his first visit on Monday). On Monday's visit we weighed Cohen to get a baseline weight on this new scale; he was 5lbs, 5oz. The pediatrician had us come back today for Cohen's two month check up and to reweigh him.

I had been concerned about his weight because he had lost some weight at the hospital as we transitioned from tube feedings (gavages) to only breastfeeding. In fact we were hoping to go home on Friday of last week but on Thursday night's weigh in he had dropped 20 grams and he was being fussier than usual. I became nervous that Cohen was not strong enough to handle eating without the tube; so we didn't go home on Friday. The next night he had lost 80 grams, quite a bit for such a little guy. The doctor and nurses recommended that we stick with the breastfeeding and reassess again the next day. The doctor said that even if Cohen hadn't gained weight by Monday, they would probably send us home and that we may need to fortify the breast milk, which meant that we would have to start using bottles. Of course, I had wanted to wait a bit longer to introduce the bottle so that Cohen wouldn't get too use to eating from them.

Meanwhile, I had many talks with the wonderful nurses about what could be going on and they reassured me that the weight loss was most likely a transition, and they were confidant we would start to gain weight. Sure enough, the next night Cohen had gained 30 grams! Knowing that they would most likely send us home soon anyway after Saturday night's weight gain, we felt more confidant about him being up to the challenge of eating on his own and felt comfortable leaving. So we asked to be discharged on Sunday afternoon.

Today at the big weigh in, Cohen was up two ounces from Monday to 5lbs, 7oz. YAY!!! He's doing it!!! My little gainer! We will go back a week from today to make sure he is still gaining the appropriate weight, but for now we don't have to fortify.

These past few days I have been practicing self control as I had wanted to weigh Cohen on a daily basis. Joel has a scale in the garage that he uses to measure ingredients when he's making beer. I was very tempted to use this scale, but everyone has warned me against becoming too obsessed over taking daily weights. In my defense, Cohen has been weighed at the hospital every night for the past two months. It was such a part of the routine as well as a daily check on his progress that it only seemed natural.

Anyway, Joel was able to hold me back from the scale and, long story short, Cohen is gaining weight again!!!

At the pediatrician today, Cohen also received his first round of vaccinations; four shots in total. Poor little boy. He handled it better than I imagined and didn't cry all that much.

As for home life, we are loving it!!! We spent many hours at the hospital getting to know Cohen and caring for him as much as possible, but being home with him totally different. Now we are now able to care for his every need and that feels great. Watching him grow and develop the last two months has been amazing, even with all the bumps in the road. I am so grateful for the relatively smooth ride we had in the NICU and for all the wonderful care we received. But now, he's all ours!!! We feel so blessed that we get to experience the next chapter as a healthy and happy family.

Cohen is home!!!

We brought Cohen home from the hospital yesterday afternoon! It was a little scary for me the first few hours because I was so use to looking at the heart rate monitor. Cohen is now completely wireless; just baby, and that is a beautiful thing! Lucky us!

We have a thumb sucker

This week Cohen will be 36 weeks gestational age. We have been in the hospital for 7+ weeks so far. The last mile stone we have to meet before we can go home is to master eating. The hospital uses a method called the feeding pathway (you may hear me refer to it as simply the pathway) to slowly wean little ones from tube feeding while increasing their mouth feeding. Cohen is on a three hour feeding schedule, so he eats eight times a day. Currently, he is able to be breastfed four times per day. Once he takes 90% of those four feeds by mouth we move up to breastfeeding five times per day. Once he takes 90% of six feeds we move on to feeding ad lib, meaning he eats on his own schedule. We do ad lib feedings for one or two days to make sure he is gaining weight before we go home.

Because we are breastfeeding there is no way to know exactly how much milk he is getting. We estimate this by the amount of time he spends nursing. If Cohen spends about ten minutes nursing it counts for a "full feed." If not, then the nurse and I decide how much supplemental milk to give him through the tube.

In order to be most successful at feeding time, I watch for Cohen to cue that he's hungry and awake enough to eat. His cues include waking up around feeding time, looking around, and rooting. A week ago he rooted by putting his hands near his mouth as well as making sucking sounds with his mouth. Recently his rooting has become more advanced! He likes to suck on the bottom half of his palm, and now he has discovered his thumb. The video below was from a few days ago right before feeding time.

The doctors and nurses are beginning to estimate when he will be able to come home, and they have started using numbers and days in their estimations, which is something they don't often do. Joel and I are getting very excited to take Cohen out into the world and bring him into our home!

Like my sister Kelsey told me, "hold on, it's going to be a wild ride."