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."