Gabrielle has nursed very successfully for the first time today. Jen estimates that she got about 20cc on two separate occassions today. This is a big step that could save Jen significant time and energy in the future. Once Gabrielle tires of nursing she usually takes about another 60cc by bottle at this time. Since the weather was so pleasant this evening, we took the baby for a short walk in Jen's wrap-around cloth carrier . Afterward, I gave the baby a bath. Prior to this, I spent a good portion of my day in my car as I always do on Sundays. As well as commuting round trip to my current site in the NYC environs, I stopped in Morrisville PA to look at apartments. Although not overly impressed by any of the numerous apartments in our price range, we'll probably move to this area in June. I'll commute into Manhattan from the Trenton NJ train station, right across the river.

Gabrielle continues to do well. She will not be weighed again until Monday, but she has been eating like a champ. She is taking about 2 oz every 3 hours. When she first came home she was taking that much every 4 hours, but now she is waking up more frequently. Her cries are getting louder and she is making her wishes known. She loves to be held and complains when she is put down. She is finally fitting into her preemie clothes and I am sure will soon outgrow them. Mom and dad are exhausted from all of the frequent feedings, but are delighted to finally have her home.

Jen took Gabrielle to the pediatrician's office today. As well as giving a couple of vaccines, the staff took careful measurements of the baby that help to quantify her progress. Born at 1 lb 12 oz, she is now 4 lb 2 oz (3hrs after a feeding.) Her length has grown from 13 1/3 inches to 16 inches. Her head circumference has increased from 9 in to 12 1/4 in. With the size and frequency of her feedings, she'll continue to grow rapidly. Although she looks big to us, Gabrielle is still a tiny baby, however. Jen's sister Jessie gave birth to baby Brandon last night at approx 9pm at a weight of 6 lb 12 oz. We're glad to hear that Gabrielle's cousin is doing great.

Gabrielle is doing great. She's eating and sleeping well. She loves to be held. In fact, she frequently expresses her desire to be held. Once snuggled on your chest, she settles immediately. When she's fussing, Jen and I have each independently discovered that she responds well to a mobile...even with her eyes closed. That's right, we're pretty certain that she can hear the mobile's musical tune. In other news, the nurse visited this morning and weighed Gabrielle at 4 lb 1.5 oz. Again, this weight is somewhat inflated since she had just taken almost 2 oz of milk. Previously at the NICU, precise weights were taken nude at about 3hrs after eating, immediately after a diaper change. By the time this blog is being written tonight, however, I think it is safe to say that Gabrielle has crossed the 4 lb mark. She'll be weighed again tomorrow at her first visit to the pediatrician.

We survived our first night alone with the baby. Marcus and I even managed to get a few hours of sleep between feedings. Gabrielle got up every 3 and a half hours to eat. She is a little piggy taking 2 oz at a time. Today during the day she took 60 cc and then woke up an hour later and took 25 more. She will be 4 lbs before we know it. The visiting nurse came today and she weighted 3 lbs 15 oz. She had just eaten 2 oz before the nurse weighed her so that likely adds 2 oz to her weight.
Marcus and I basically spent the day resting and taking turns holding the baby. She still likes to fidget when she is not held. The nurses say this is common with preemies. She settles down immediately when she is picked up. Brie is also getting more vocal. She is pretty impatient when she is hungry. Mommy and daddy cannot change her diaper fast enough.
Today we also went for our first walk. It was a gorgeous day. The walk was brief, but nice to be out of the house.

Gabrielle is Home!

At 50 days old, Gabrielle is home at last. She made the short trip in her car seat at about 2pm today. The cat's not sure what to think of her, and she's generally keeping her distance. Gabrielle has a cardiac and respiratory monitor that has not sounded so far. We're expecting plenty of noisy false alarms, as well as the baby's normal grunting and babbling. In other words, we're not expecting too much sleep tonight. So far, however, the afternoon has been very quiet. The baby has adjusted nicely to her new environment. She's eating well and sleeping soundly. When I gave her a bath late last night and helped to weigh her, she was 3 lb 10.6 oz.

Today was a good day for Brie. She doubled her birth weight and is 3 lbs 8.4 oz. She only had one small episode of dropping her heart rate and the nurse said it was for about 10 seconds. So that is definitely an improvement. They also started her on Zantac today. I think it was to humor me, but I felt like we should try something. I hate seeing her arch her back and the milk come back up through her nose. They are also setting us up for a monitor at home. I think I will feel better having it here. Tomorrow I will spend the night with Gabrielle in the parents room. I will get a taste of getting up with her and feeding her with the nurse just down the hall. Hopefully she will be home by the end of the week.

Today is a brighter day (although it's still raining.) Jen's out of the hospital and Gabrielle may join her in a couple of days. Her last weight was 3 lb 7.2 oz, a miserly increase of only 0.2 oz. When weighed again tonight (or in the wee hours of the morning), I suspect she may exceed 3 lb 8oz. When she reaches 3 lb 8 oz, she will have doubled her birth weight. We don't like her episodic drops in heart rate, however. The doctor attributes them to reflux. The vagus nerve is very close to the esophagus, and stomach reflux can stimulate it. Vagal innervation slows the heart rate. This is apparent when the baby occasionally chokes/coughs when eating, as all babies do. Since NICU babies have cardiac and respiratory monitors, we can see Gabrielle's heart rate drop from 145 to 80 when she has difficulty taking food. Episodes during feeding are not so much of a concern, however. About an hour after eating Gabrielle sometimes has similar episodes, though, caused by acid reflux. The doctor assures us that this problem is common and should go away with time. He also says that antacids, while effective in adults, are typically unhelpful in this situation. We'll have a monitor when the baby comes home, even though we're aware that such home monitors are most effective at treating nervous mothers (and fathers). The good news is that the baby is eating like a champ! With that nasty formula removed, Gabrielle devours 45-50 cc's in 10 minutes at about 4-hr intervals. The nurses generally don't wake her at prescribed times as before, but let her wake on her own when she's hungry (within certain time limits, of course.) I held the baby a couple of times today and escorted Jen around...initially tethered to a wheelchair with IV antibiotics, but later free of inpatient annoyances. Although I had considered going to NJ this morning, I wasn't very comfortable leaving with Jen in the hospital. The obnoxious ice and slush this morning made my decision easier. I was happy to spend the day in Glenside, with frequent trips to the NICU.

Almost immediately after yesterday morning's optimistic posting, the weekend turned sour again. After Jen's late night surgery and brief admittance on Friday, she developed a fever Saturday morning. The OB/GYN surgical group physician instructed her to go to the ER. A mere eight hours after arriving at the hospital, Jen got an antibiotic. After being instructed to dump her milk by the anesthesiologist on Fri (but not by other doctors), Jen sided with caution and complied with the more conservative recommendation. Gabrielle did not like the idea, however. She didn't tolerate the mixture of breast milk and formula but responded with sloppy feedings, smaller consumption, restlessness, lack of sleep, constipation, increased reflux, and greater frequency of her episodic drops in heart rate. She gained no weight. To top it off, she failed her hearing screening for the second time yesterday. It seemed the rain had no end in sight...literally! Torential downpours greeted the optometry students gathering at 7am this morning for the board certification practical examination.

My return to the hospital today finds everyone in higher spirits, albeit still soggy from the weather. After switching back to breast milk, the baby is doing well again. Jen is feeling better. Nanna and Pop Green (Dave and Lee) visited, and Dave will be helping Jen at check-out tomorrow. I'll be in NJ, of course. The baby looks very good tonight. She's taking almost 40cc of breast milk every three hours and sleeping soundly between feedings. After yesterday's foray into formula, Gabrielle is back on her accelerated growth track. We expect Jen to come home tomorrow afternoon with the baby to follow in a few days.

Gabrielle is 3 lb 7.0 oz today. She will probably come home Sunday afternoon, after the final session of my board exam. The doctor said this morning that she'll likely have a heart monitor at home since reflux from feeding causes her heart rate to temporarily drop. We are told that this is a common response occuring when the reflux stimulates the vagus nerve resulting in a slower heart rate. As she grows, this condition should resolve without need for medication. Gabrielle will also have a repeat hearing test before coming home. She did not pass the first hearing test, but the doctor says that this doesn't mean anything definitive. Many babies with normal hearing fail the screening. If Gabrielle does not pass the 2nd administration of the NICU's hearing screening, she'll see an audiologist. Additionally, Jen is recovering from minor surgery today, a procedure linked to the initial C-section. We got back from the hospital at about 1:30am last night, but the late time is linked only to poor scheduling (or disorganization on the staff's part) and not to any emergent situation. She's doing very well, of course, and is looking forward to the baby coming home tomorrow.

No More Feeding Tube

Gabrielle pulled out her feeding tube last night, and the doctors decided not to replace it. She's been doing very well with her bottle feedings. In fact, the doctor told Jen this morning that Gabrielle will likely come home this weekend! Our friend Mike Johnson (very tall guy in my wedding) has already been scheduled to install the car seat and instruct Jen on installation. He's certified in this; there's actually a medical course on this topic! The doctor said the smallest baby he's ever sent home was 3.8 oz, so Gabrielle should be atleast 3.8 before going home. With her average daily gain of approximately 1 oz, she'll be ready very soon. We're very happy about that, to say the least. It will be a busy weekend, however. Jen's spending a part of each day at a continuing education conference on Thurs and Fri to maintain her certification. I'm taking a written examination on Friday and a practical examination on Sunday as the last step of the national board. Since Shelley and maybe Jessica are planning to visit this weekend, Jen just might put them to work helping to clean the house/wipe down all surfaces before the baby arrives!

Writing from Fairlawn NJ, I relay Jen's update on Gabrielle. Yesterday was eventful. Bottle feedings increased from every other feeding to 2 of 3 feedings. The amount increased a couple cc's to 30 cc for each feeding. Also, Gabrielle graduated from her isolette to an open air crib after passing a 24hr body temperature test. Although very pleased with these advances, Jen and all of the parents involved were unhappy when the NICU closed our small room because of a nursing staff shortage. Gabrielle spent yesterday afternoon and last night in a different room with eight other babies where the quarters were a little too close for comfort. With the new busier environment, no isolette to filter the noise, and even a draft overhead, it's not surprising that Gabrielle didn't gain any weight yesterday. She's 3 lb 3.4 oz, unchanged from Monday morning. Thankfully, the NICU re-opened our small room this morning, so Gabrielle and Jen are back in their more comfortable, quieter corner. Additionally, the staff gave Jen some literature on car seats and what to buy (diapers, etc) before the baby comes home. It's getting closer!

Don't be alarmed if there's no posting within the next few days. I may or may not have Internet access in NJ, where I'll be using the computer to study for part III of the national board in optometry.

Happy Easter! Today Brie is 3 lbs 2 oz. She is wearing a cute little ducky outfit. We tried to shrink one of her dresses to put on her for a picture, but it was still too big. She has been doing well with her bottles and hopefully soon can have one at every feeding. She has also been weaning down to room temperature in her isollette. She has to do 24 hours at her current setting and then she can come out to an open crib. They like babies to be 3 lbs 5 oz prior to coming out of the isollette, but she is small for her age so they may try her sooner.

Today we hit the big 3 lbs!!! She has a sign above her bed marking the occasion. She was held most of the day. Today she was held by grammie Smithgall for a few hours during her feeding. She has been doing well with her bottle feedings. Today she took 2 from mommy and is allowed to take one every other feeding. She was very awake today and was looking for more food when her bottle was finished.

Today our little peanut took 2 bottles from mommy. She did pass her isolette test and now can officially wear clothes. I think she likes being bundled up. Most of her clothes are too big, but she will grow into them. Her weight today was 2 lbs 15 oz. Hopefully soon she will hit the big 3 lb mark. Yesterday she had her eye exam. They found that her eyes are immature. Go figure she is premature! Now she will have an eye exam every 2 weeks until they are mature. Tomorrow they may allow her to take a bottle every other feeding. She seems to like to eat from the bottle so hopefully she will tolerate it well.

Today is a big day for Brie. She is weening from the skin setting to air setting in her isollette. If she passes the three hour test she will finally be able to wear clothes. Before I left today she was in a pink outfit. It was so nice to see her in clothes. She is a little under the weight limit for air setting, but she has been very warm for the past few days on the air setting. The nurses said because she is small for her age she is ready. She is 2 lbs 13.5 oz today. She also got an increase in her feedings today to 27 cc.

Today Brie is 2 lbs 13 oz. She continues to gain weight steadily. They increased the amount of her feeds today to 26 cc- soon she will be taking an entire oz at a time. She is going to have an eye exam either tonight or tomorrow night. It is routine for the eye doctor to see them at 4 weeks of age to see how her eyes are developing.