NICU Thoughts

[ricevermicelli]

I am not always very good at spotting the differences between NICU babies and full-term ones.

Miss Hotspur is doing very well, all things considered. She's working on getting back to her birthweight. She worries them by spitting up now and again. (Her big brother was a spitter too - every time they tell me, looking grave, that she spat up, I want to laugh. Or ask if she also sneezed. That was always good for spectacular upchucking from Danger Lad!, and no one worried about him. They keep careful track of how many milliliters she spat out - "about 6", "just a little spit, 2-3 ml", "almost 10 overnight..." I want to pat their heads and assure them that she'll grow out of it, it's just a laundry problem.) She's breathing on her own, and she's been off caffeine for two days now. She's maintaining her body temp. She's getting most of her food by g-tube (up her nose and into her belly), but she does like to nurse when she's got the chance.

The NICU LCs have the following pieces of advice:
- Given my supply, I can probably get away with just getting up to pump once during the night. To which I say, what the hell? Are they recommending that some poor women get up more than once? I understand the importance of establishing and maintaining supply, but for the love of little green apples, pumping 35 ounces a day ought to get me permission to sleep through the bloody night if I can. And I wonder at what point exhaustion begins to counteract the supply-building effects of hooking oneself up to machinery every two to three hours.
- Hotspur will probably only nurse once or twice a day when she comes home. Please understand, Hotspur nurses once or twice a day NOW. When I can only really visit for 3-4 hours at a stretch. If the idea is to transition the baby to feeding entirely from the breast (and I assure you, that is most certainly the idea), why on earth would I limit her access so drastically? I'm home! I can wear her around and let her have at it as much as she wants! I'm happy to give her extra calories, we can use the bottle as much as we need to, but there is no reason I can see why she shouldn't be at the breast as often as I can stand to have her there.

Throw in the limited number of comfy chairs in the NICU, the small number of breast pumps, and the critical undersupply of freezer space, and I'm surprised that anyone leaves that building breast feeding.

Comments

[zathrus.livejournal.com]

Your NICU's LCs are on crack. If you want to point them in the direction of the work coming out of Rush Presbyterian in Chicago, or if you want me to do so, or what have you, feel free. Given the other issues you list, I am also surprised that anyone leaves the building breastfeeding.

Do they have some particular reason for thinking that she will only nurse once or twice a day when she comes home? Do they think this is good?! Are they seriously recommending that you limit access? This paragraph confuses me. Maybe they think you need to express the milk so you can add fortifier before bottle-feeding it to her? It's the only plausible explanation I can think of. (And even then, you know, at some point, she'll be large enough and healthy enough to simply act like a normal baby and tell your body what she needs herself. I personally think you're totally on the right track, and that those LCs desperately need to be brought up to date and into the real world.)

NICUs do tend toward the paranoid, with a strong emphasis on measuring things. Which is completely justified in a one-pound 24-weeker who's losing weight, but is annoying when they can't switch paradigms to deal with a healthy, larger, closer-to-full-term baby. That one, I see both sides of (although I suspect my reaction to it in person would be similar to yours).

Newt

[cutieperson]

i was *just* thinking there hadn't been a recent update and wondering how all was going.
glad to hear she's doing well, all things considered! sorry for the rest of it, which sounds frustrating.

[ceo]

What she said.

[thenotoriousphd.livejournal.com]

We spent a week in the NICU after Sarah was born -- she was full-term and of normal birth weight, but she needed heart surgery and her immediate health was so bad that she had to stay in the hospital. I was lucky that our hospital had really good support for breastfeeding moms. The lactation consultant was really attentive, there were plenty of breast pumps and nice little rooms for pumping, and they seemed to have plenty of freezer space. We were very fortunate.

Breastfeeding is awesome. Hang in there.

[kitmf.livejournal.com]

I see no reason at all why you shouldn't be able to supply all the food she needs when she comes home. That will certainly mean nursing more than twice a day.

My experience is that hospital nurses tend to not really believe in breast milk if they can't measure it. My experience is not recent, but you are not convincing me it's different now.

[steuard.livejournal.com]

I'm glad that the important stuff is going well (and that your basic sanity is making up for the weird advice). I've been thinking of you often, so thanks for taking the time to pass along the news.

[beth_leonard]

Your NICU is insane about breastfeeding only twice a day at home?? What are they thinking? I want to bap them on the head and give them a dose of enlightened modern woman.

--Beth
(Who was lucky enough to have given birth in the hospital rated highest in the state for exclusive breastfeeding rate upon hospital discharge. AND doubly lucky enough to have a friend who is a full-time lactation consultant at said hospital who helped me through some very tricky spots those first few weeks.)

I am pleased

[drwex]

Strange, I know, to say that but I remember the concerns when DL was young and how much different things were for us the second time around. I hear from you the voice of experience and wisdom and I'm confident you know better than they do and will be able to do the right things for Miss Hotspur, too.

It is good to "see"

[taura-g.livejournal.com]

The tone of your posts getting more relaxed and confident ... sounding more like you. That as much as the content makes me feel like everything is going to be fine.

I'm sure that once you get her home, you will be able to do for her whatever seems best.

BTW - I'm adoring the nickname Hotspur...