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!
Monday, October 27, 2008
Thursday, October 23, 2008
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.
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.
Monday, October 20, 2008
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!
Monday, October 13, 2008
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."
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."
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