Tuesday, June 30, 2009

More Moments at the NICU

Mommy and Oliver



Oliver's first burping


Oliver

Oliver peeking up at Daddy:)


Nursing is so much work!


Grandma Marsha holding a grandbaby (Audrey) for the first time


Sweet Gracie, our little porcelain doll


Audrey and Oliver ("Hi Mom!")


Audrey and Oliver's new cribs (they're in there somewhere!)


Gracie and Tutu


Mommy and Oliver



For the past week mommy has been working on nursing Audrey and Oliver each once a day. Audrey is starting to get the hang of it, and Oliver is just our little pro! He nursed the other day for 25 minutes without stopping and ended up transfering (swallowing) 26 ml of milk! A full feed for him is 38 ml, so the nurse only had to give him 12 ml through his feeding tube.

Even though we are tired of visiting our babies at the hospital every day and want nothing more than for them to grow up so we can bring them home, Robert and I realized that we were both having feelings that everything was happening too fast! Audrey and Oliver have been gaining weight rapidly (about 2 oz a day), and the thought that they are just going to keep getting bigger and bigger and never be that small again is kind of sad for us. We've gotten used to their tiny size and being able to hold them certain ways, and it's hard for mommy and daddy to watch them grow up in the NICU. We're definitely looking forward to having them home so we can be with them more often and enjoy them more as they grow and change.

Audrey (our little chunky monkey) is now 4lbs 13oz, and will probably hit the 5lb mark in the next day or two! Oliver is weighing in at 4lbs 6 oz, and Grace is now 3lbs 3oz. Babies used to be able to come home from the NICU when they reached 5lbs, but their ability to leave the hospital is no longer determined by weight. In order for our babies to come home they must:

be gaining weight consistently

be able to maintain their body temperature

be able to eat full feeds by breast or bottle, keep breathing, and gain weight

have gone one week without an apnic spell (not breathing)

So far all of the babies have been gaining weight consistently, and Oliver and Audrey are both in cribs and maintaining their body temperatures, so as soon as they quit having apnic spells (which the nurses tell me often stop around 36 weeks) and can handle full feedings, they will be able to come home! So my main job right now is to get them to eat, eat, eat! We're hoping to have at least one baby home by week 37 (3 more weeks!), and we're thinking that may be Oliver since he's doing so well at eating! Audrey will probably come home second, and it is very likely that little Gracie will come home closer to the babies' actual due date, August 14th, as she started out so tiny and isn't gaining weight quite as rapidly as her siblings.

Overall the babies are doing really well and should make significant progress with feedings over the next few weeks!

Wednesday, June 24, 2009

You're Stinky Bud!!!!

Oliver has been wide awake and very alert more often this past week, so Daddy decided to capture a few moments of it on film. While he was talking to Oliver, his little boy decided to make the moment memorable and give Daddy his first wiff of Oliver poo! And wouldn't you know, he followed it up with a big, happy grin:) You'll also hear why we affectionately call our little boy "Flipper": he likes to make really cute dolphin noises.

Father's Day Weekend

Daddy and Oliver


Oliver fast asleep in Daddy's arms


Audrey


Grandpa Gene and Oliver


Tutu and Audrey


Audrey in Tutu's arms


Daddy and Gracie


Grace


Mommy, Audrey, and Oliver


Audrey (left) and Oliver

Robert's first Father's Day was very special. We stopped by the NICU before church, and found that our sweet babies had made their dad a beautiful Father's Day card (with the help of their nurse, Jen:)) And Jen wanted them to look extra cute for their daddy, so she knit little "kitty hats" for the girls and is working on a hat for Oliver. After church, we had lunch with Grandpa Gene and Tutu (the Hawaiian word for Grandmother), and then we all spent the afternoon at the NICU holding babies! Tutu held Audrey, Grandpa Gene held Oliver, Daddy held Grace, and Mommy got to take lots of pictures!
Updates on the babies:
Audrey hit 4lbs 3oz yesterday (she has been gaining about 2 ounces a day!), and was moved out of her isolette into a big girl bed - a crib.

Oliver was up to 3lbs 14oz yesterday and had his nasal canula (oxygen tube) removed and is now breathing on his own. He loves sucking on his pacifier, but when that's not available he works really hard to get his tiny thumb in his mouth. And he has been nursing at least once a day and just yesterday began transfering milk.

Grace has also been gaining about 2 ounces a day this past week and was at 2lbs 14oz yesterday. She should hit the 3lb mark either today or tomorrow!

Wednesday, June 17, 2009

We really do have multiples!

Two peas in a pod



Mommy, Oliver (front), and Audrey


Do they look alike or what?!


Since the babies are so tiny, and taking them in and out of their isolettes is pretty stressful for them, the nurses prefer that we hold them for several hours at a time. The problem with this, is that while holding one baby, we usually miss the "hands on time" for the other two babies, and therefore usually end up only being able to hold one baby a day. I was feeling pretty guilty about each baby not getting held by mommy or daddy every day, so I decided to spend 8 straight hours at the NICU today so I could hold a different baby at each "hands on time" every three hours.

I started with Audrey, and tried to see if she would nurse. After giving it a good try and wearing herself out, she fell asleep on me. I had been holding her for about an hour when I noticed Oliver was wide awake and wiggling around in his bed. My heart ached to hold him, so I asked their sweet nurse, Cheryl, if I could hold him too! And since he was taken off of oxygen today and is now breathing all on his own, he is much more "transportable", so she was able to bring him over to where I was sitting with Audrey, and for the very first time since they've been born, two of the babies were able to be together again! It was so wonderful holding both of them at the same time. We have so many pictures of them by themselves, it was beginning to feel like we had three non-related babies rather than triplets used to sharing a womb! Grandma Marsha was able to stop by while I was holding them and enjoy seeing two of her grandbabies together and out of their little beds!

After holding Audrey and Oliver for three hours I held my sweet baby Grace. She's up to 2lbs 6oz today, which is how much Oliver weighed when he was born! She still looks pretty tiny next to her big brother and big sister, but she's growing each day and getting cuter by the minute:)

I can't wait to be able to hold all three!

Monday, June 15, 2009

June 15th - One Month Old

Audrey awake (look at those eyes!)


Audrey asleep in mommy's arms

Kangaroo care with Oliver


Oliver (smiling!) on daddy:)


Oliver wide awake and ready to eat!


The little cards the nurse made for Grace
(look how much she's changed in one month!)


Mommy holding Grace


Grace (smiling!) in mommy's arms


Our three little miracles were born one month ago today! And in just one month's time they have made significant progress and look so much bigger to mommy and daddy! Audrey, born at 2lbs 7 oz, is now 3lbs 7 oz. Oliver, born at 2lbs 6oz, is now 3lbs 6oz (I just noticed that in exactly one month, they each gained exactly one pound!), and little Grace, born at 1lb 9oz, is now 2lbs 4 oz! Grace is still the only baby breathing completely on her own (no more oxygen tubes - yay!), while bigger brother and sister are still requiring a tiny bit of assistance. Audrey and Oliver have for the most part made it down to "room air" (the same percentage of oxygen that we breathe), but still need just a tiny amount of airflow to help their little lungs inflate more easily so they don't have to labor as hard to breathe.

Today was an incredibly special day for mommy. I decided to hold Oliver during his afternoon "hands on time" and he looked really awake and alert which is a new development for our normally perpetually drowsy babes. I asked the nurse if I could put him to my breast to see what he would do (premature babies don't normally take interest or tolerate nursing until about 32 - 34 weeks and our babies are just over 31), but to my surprise and delight, as soon as I placed him near me, he latched right on and began sucking vigorously - which startled mommy a bit! He stayed there for 15 minutes and his stats remained good (the reason most babies can't nurse until around 34 weeks is because they haven't developed their "suck-swallow-breathe" reflex and often stop breathing while feeding). Even the nurse couldn't believe how well he was doing! He kept his little eyes open and stared up at his mama and even put both of his tiny little hands on me. It was the most wonderful feeling to hold my son so close after all this time. When he was done he fell asleep on my skin and slept peacefully there for the next two hours.

Happy 1 month birthday, Audrey, Oliver, and Grace! Mommy and Daddy love you so much!

Monday, June 8, 2009

Sweet Babies

Grace
Grace is such a strong little girl! At barely 2lbs, she was the first baby to be completely removed from oxygen and as of today is breathing on her very own! For the past week she has been doing so well that her doctor decided to remove her canula today (the little tubes going into her nostrils) to let her try breathing all by herself - and she's doing great! I did kangaroo care with her for almost two hours today, and while the doctor came in to talk to me Grace opened both of her eyes and lifted her entire head up to turn it to the other side! The doctor couldn't believe that such a tiny little baby could do that ... I think we should start calling her "little muscles" :)



Oliver

Oliver has had a pretty rough week. He started having a lot of apnea spells (when he forgets to breathe) and bradycardia (when his heartbeat slows too much), so the doctors did an ultrasound of his heart and discovered that his open ductus was causing a section of his heart to become enlarged as well as contributing to his other symptoms. His PDA (open ductus) is very common in premature babies, because the ductus normally closes right before babies are born (when their blood needs to start circulating internally rather than being supplied by the placenta). Because our babies were born so early, the ductus did not close on its own. The doctors have given him two rounds of Ibuprofen to try to close it, but since that didn't seem to work, they decided to start him on a round of Indomethacin. Unfortunately, the medication can cause very serious tummy / bowel problems, so Oliver cannot eat during his treatment and has to be back on IV nutrition and fluids. But because he has now been eating for the past 3 weeks, he now knows what it's like to have a full belly, and is going to be very hungry for the next 5-7 days! Thankfully, when the doctor listened to his heart this morning, she couldn't even hear a murmur! So another echo will be performed tomorrow morning, and if all is well (and his ductus has closed), they will be able to stop the medication and let him start eating again!








Audrey

Audrey is doing really well this week! She has had less episodes of apnea and bradycardia (both of which are very common in premature babies of her gestational age). She has actually had the easiest week of all three babies and is only a few grams away from weighing 3 whole pounds! On Saturday night we stopped by the NICU to check on the babies and I was able to hold my daughter like a real baby for the very first time! Rather than holding her "skin to skin" on my chest like we do in kangaroo care, her sweet nurse Jen swaddled her in a blanket and placed her in my arms - it was a feeling I've been waiting to experience since they were born 24 days ago! Both of her eyes were wide open so for the very first time I was able to hold her in my arms and just stare at her beautiful little face. We gazed at each other for about 15 minutes and then she made a weird face... and spit up all over me! Milk came shooting out of both nostrils and her mouth, soaked her entire blanket and managed to shoot all the way into my hair! It was so wonderful to be spit up on by my very own baby... such a special mommy moment.

Thursday, June 4, 2009

An Update and More Baby Pictures!


Oliver and mommy holding hands


Mommy and Oliver


Kangaroo care with Oliver


Daddy's little Vulcan (Oliver) - "Live long and prosper!"


Mommy touching Grace


Daddy changing Gracie's diaper - so tiny!


Baby Grace under the billirubin lights with her cool shades:)


Sweet Oliver


Little Miss Audrey


Tomorrow our babies will be 3 weeks old! Well, technically they'll be 30 weeks... let me explain:) Even though Audrey, Oliver, and Grace decided to make their appearance 3 weeks ago, they technically should still be developing in my womb. And my gestation tomorrow would be 30 weeks, so developmentally, they're still like a baby at 30 weeks in the womb. This little confusing phenomenon is known as their "adjusted age". Developmentally, their age will be based on their due date (August 14th) when they'll be true "newborns". So even though our babies will be 3 months old by then, they'll really be 0 months developmentally. And in November when they're 6 months old, they'll really be 3 months developmentally. This "adjusted age" will continue until they're 2 years old when everything usually evens out and they catch up to their peers.

Robert and I are very excited about their "graduation" into the 30 week bracket. Exciting things should start to happen (like they would have in the womb). Over the next few weeks our babies should begin to develop their breathe-suck-swallow reflex which will allow them to begin nuzzle nursing and learning how to feed at the breast rather than through a tube down their nose into their stomachs. Mommy is really looking forward to that! The physical therapist says it usually starts to happen around 34 weeks, but if the babies show signs that they're ready earlier than that (maybe around 32 weeks) they'll let them start practicing!

More exciting news: Audrey and Oliver are both very close to hitting the 3 lb mark and Grace is nearing 2 lbs! They are all at "full feeds" meaning they're eating enough breast milk every three hours to support their weights, so Audrey and Oliver have been able to get their IV's out and are just being nourished by my milk (with some added calories mixed in to help fatten them up!). Grace still has her line in because she was having some low blood sugar issues, but hopefully that will come out in the next few days. The doctors would like to see them gain about an ounce each day (or a pound every 16 days or so).

Right now our babies' biggest threat is infection. Even true newborns have very minimal immune systems, but babies in the womb have nearly no immune system, which is where our babies should technically be! So what would be a minimal infection in a grown up would become a serious condition for our babies that would either go to their blood (sepsis) or their spinal fluid (meningitis). The nurses wash their hands all the time, but it is still a huge concern as even their own bacteria on their skin can infect them. Please pray specifically that the Lord will protect them from infection, and that the doctors and nurses will be very aware of any first signs of infection should one occur.

Thank you so much for keeping our babies in your prayers. We know that prayer is the most powerful medicine, and we are so thankful that God, the great physician, is taking care of our precious little ones.