I went to feed Everett and met with the lactation consultant for a bit of reassurance on his nursing. She showed me some great positioning tricks and confirmed that we were headed in the right direction with his nursing.
Things have changed a little (as expected) with his care:
1. he has been placed in an isolette rather than and open warmer as a bili light was prescribed to help him process his excess (his level was 4 - 2 days ago, 9 yesterday and 14 this morning. I am hoping HOPING it has peaked and will now start to go down. He is not critical, but the rise does need to be stopped before it becomes an issue)
2. The staff - including nurses, doctors, nurse practitioners - everyone - has been unbelievably supportive with my breast feeding efforts. The lines of communication are absolutely amazing and I am so comfortable with their care and honestly. I'm sure part of this is because we are familiar with one another already - but they are certainly making every effort to accommodate Everett in NURSING not just getting breast milk. It just means everything to me to have the opportunity to actually nurse as much as he can. I'm more than willing to put the time in - but they are more than willing to allow for such time in between assessments, bathing, caring, medications, taking him in and out of bed, hooking and unhooking monitors, checking temps. This is an obvious priority for all involved. Thank you.
Everett did really well with this nursing session. I limited his time a little - 15 minutes on either side - to allow for more time under his lights in hopes of him processing the excess bilirubin a little faster. He actually seemed very satisfied at the end and didn't want to nipple from the bottle much at all. I try to let him completely empty one side, then follow up with the other and alternate the starting side each time. He needs to get to the "hind milk" which has a slightly different (yellow) color, more fats, proteins and higher caloric value to help him to gain weight and to help him (again) process his higher bilirubin.
He has been placed in an isolette to try to minimize water loss from the lights and warmer. The warmer is on very very low - if at all. He seems to maintain his temperature very well - but with the bili-lights, he needs to be in minimal clothing (diaper only with eye protection of course) so his nurse is checking his temp every half hour for now to make sure he's warm enough. His TPN is at a very low rate and the NP was waiting on the neonatologist's assessment before weaning further. His IV fluids have been continued for now, again, to minimize risk for dehydration because of the bili lights and warmer.
He looks very very good and did have all tape and stickers off with the exception of his basic monitor and temp stickers. He now has little velcro circles on either temple for his "sun glasses" to stick to though. They tried to avoid putting them on, but the gauze wasn't staying put and eye protection trumps adhesive reaction in this case so I'm just left hoping for minimal skin trauma as it is thought that if he can spend as much time as possible in his little "tanning booth" he should be able to "come out" again in a couple of days. (sigh).
I will go back in a couple of hours to feed again. I have been taking pictures, but time seems to really be getting away from me these days and I haven't gotten them up just yet. Exhaustion is setting in a bit and I admittedly got a little weepy seeing Everett in that isolette...I'm sure I'll process all of this a little more each day or week or month...sometimes it'll be that brick on my shoulder, sometimes it'll just whisper in my ear. Don't think for one second that I'm not aware of just how lucky we are to have survived this... with our darling son nursing away, whining about nothing but a little old bili light and a few days in the NICU. I know. We are blessed beyond any sort of question or explanation...(umm- hear that?? I know. I do get it. I don't need any more reminders. Really. Please and thank you.)
Having some lunch a little rest before getting a good snuggle in at 2!