Noah's First Christmas!

We had a great Christmas Day, Noah was spoilt, as predicted, but nothing ridiculous, just nice. We had Nana and Poppy Bill here as well as my brother Colin and his Wife Annie and my two nephews, Matthew and Jeremy. It was a nice day, rainy, so it wasn't hot which is the usual on Christmas Day. Noah was spoiled from Nana as my mum stayed for a few days over Christmas, which I think she enjoyed alot as well as giving us a hand with him.

Noah has been put onto formula now as we started to run low on breast milk in the freezer and so we slowly put him onto the bottle.  He is having a little reflux and bowel problems, we hope it is just him adjusting to the formula. He has gone back to having trouble pooing and he has vomited a few times and belly aches for a long time after a feed. We think he has a little bit of reflux. Sometimes we think he has silent relux as well, because we see him sort of dry heave, then screw up his little fast like he has tasted something really bad, then he cries like he is some pain.

We gave him some brown sugar and water for his pooing pains and that did the trick again! We are trying to feed him as upright as possible and then keep him as upright as possible for half and hour after his feed and letting him drink want he wants often instead of trying to make him have it. He put on 130 grams in the last week so now he is 5 pounds 10 ounces, or 2550 grams!!

We dont seem to be free from some minor ailment of a sort tho. Maybe this is just what all babies go through. He went from constipation to diarrohea and cramping to constipation, vomiting, reflux. To top it all off he had to go on antibiotics because he was exposed to Whopping Cough at the Eye Clinic the other day. He was not in contact with it, but just to be on the safe side they put all the babies on them just in case. He has approx. 40% protection with his first vaccinations and we managed to give him 4 days of antibiotics and that was enough. It had been 13 days since his exposure and he had no symptoms and his side effects were so bad with the upset tummy and diarrohea that we took him off it. He's been alot better for it.

Anyway, we seem to be doing okay with the upright thing at the moment, we'll just have to see what happens. Other than that he has been really really cute in his bouncer. We proped him up a bit so he could just reach the toys, and he has been trying to swipe at them and does it over and over and looks pleased with himself! He is very alert and looking around alot and looking at us and tracking us with his eyes. Which I meant to say have been given a good report from the opthalmologist. His ROP is nearly resolved in one eye and the other eye is Stage 1 Zone 3 so it is resolving as well, which was the best Christmas present ever for all of us!!

Since he's been home...

Well the lovely Noah has been a good boy really. He had his first paediatrician appointment after 10 days home and unfortunately he had only gained 40 grams. The doc wanted kim to stop breastfeeding and put him on formula, mainly so we could measure exactly what he was drinking and make sure he was getting enough. Kim reminded him that we had a deep freezer full of expressed breast milk at home, so he said that was ideal. Bottle feed him the breast milk. After 3 days of doing this he gained 100 grams!

The doctor also found that Noah had an Inguinal Hernia and sent us straight away to a paediatric surgeon. That was on a Friday and on the Monday he was in theatre for 30 mins having an operation. But he came through that without any hiccups and two little cuts on his lower belly about a cm each. He only had a hernia on one side but the surgeon decided to do both sides just in case with all his straining to poo he popped the other side as well.

He really picked up after the operation with his feeding as well so he is now 2430 grams!! Finally broke the 5 pound barrier!!! He is looking so adorable and is just a delight to have around. He is so cute, everyone says so!! At the moment he is having a little trouble bringing up his wind, so we rang the doctor and he is on colic drops every second feed at the moment, started those last night.

Noah is home...finally!

After 72 days in hospital, Noah came home on Tuesday. It has been an absolute delight having him home. He has been waking up between every 3 to 4 hours for a nappy change and a feed but he is really good during the night. Around midnight, 4.15am and 8.30am. During the day he feeds a little closer together, I think to make up for long gaps at night. Plus he might be having a growth spurt. We have had visits, but not too many, we have been visiting, but not too much and we have taken him to our fertility doctor for a show off and he was really lovely and genuinely so happy for us both that after 3 years of infertility treatment we finally have a healthy little baby!! He held the baby and gave us both a cuddle and congratulated us both.

He has come out of the whole experience pretty much unscathed. He has a small hemangioma on his forearm, which will go away in time.  He does have a little bit of Retinopathy of Prematurity, but it is stable at stage II so it will most likely resolve itself without treatment. He is home on only Iron (for Anemia) and Pentavite (Multivitamin).

Before leaving the hospital he had a full blood count, a head ultrasound, an eye test and a hearing test. He was a little anemic, which could have resolved on its own in time, but we decided to go ahead and give him some blood so that he would have enough energy to breastfeed. His head ultrasound was completely normal. He passed his hearing test with flying colours. His eye test revealed that he still has Stage II Zone II ROP, but that the blood vessels are nice and fine and non-tortuous so it will more than likely resolve itself. He has to go back to the hospital Tuesday for another eye check and the Friday after that he has a check up with his paediatrician.

Now I'm going to talk about poo so if you dont want to hear about this, you might want to skip this paragraph. We had to give him a suppository yesterday because he hadn't pooped for about 7 days and he was really uncomfortable straining and pushing to no avail. So we cut a glycerine suppository in half and popped it up there and he is now suitably relieved. Its normal for a breastfed baby to go up to 10 days without a poo, but he is also on iron so maybe that is making him a little more constipated, so we let it go for for 7 days but that was enough.  He was crying straining. We tried giving him cooled boiled water for a couple of days, then the brown sugar and prune juice and apple juice suggestions came, but we think he is too little to experiment with sugars right now. Might throw out his electrolyte balance or something. The suppositories aren't something that you do every few days, it is more a last resort. Hopefully he will have built up some pooing muscles with all that straining over 10 days.

Ok back to the nice stuff. He has had a few visits with his Nana who loves him so much she was upset yesterday that she couldn't hold him because she felt a bit queasy in the tummy, so she sacrificed her cuddles for his sake. We have heaps of photos that have to uploaded. Also need to go to the photo booth and print some hard copies of these photos so we can post them out to everyone and get his photo album sorted. He is so cute in his little clothes. We have two pj's in 000000's but mostly his outfits are 00000's and a little bit big on him, but he will grow into them. But i think he will grow too tall for them before long.

When Kim had the 19 week ultrasound, his arms and legs were measuring 2 to 3 weeks behind (the start of his growth restriction). The sonographer put it down to hereditary shortness on Kim's behalf. But it turns out that he has got big feet and hands and his arms and legs are quite long really. So i don't think this kid is gonna be a short stuff like his mum. Here is a pic of Noah getting cuddles with Nana!

Oh well how ever he turns out, he is going to be absolutely lovely, we are in love totally with our little man and we are enjoying having him home waking us up and taking up every spare moment we have 100%

Nearly there...

Well Noah should be home next week!!! He is now 2030 grams and he is in an open cot, off all monitors, only has an apnoea monitor called a Grasby. He was a little bit anemic and didn't want to feed properly because he was tired all the time so they gave him another blood transfusion so he perks up and has the energy to feed.  He is nice and pink now. He is breastfeeding four times a day now and he will have a final head ultrasound on Monday, another eye scan on Monday and a final blood count to see that he is not anemic still. Then the plan is to room in on Tuesday and Wednesday night at the hospital and then we can go home on Thursday next week!!!

We are so excited. Finally getting our baby home. We have gone and bought nappies and wipes and some more wraps and have washed all his clothes and linen and getting everything set up for him. We are off to the hospital this morning to put in a full day with him today and also tomorrow to get his breastfeeding on track. Four breast feeds during the day and they tube feed him at night for the next few days, then the rooming in for two nights is to make sure he can breast feed 24 hours a day. Packed lunches, long hours, all worth it!!!

Almost home!!

Well its been a while between posts and really not a lot has happened. Noah has graduated from High Dependency to Special Care Unit. Last stop before home. Noah is still wonderful and stable and growing and he is now off all monitors except heart rate and oxygen saturations!!! He is on the same dose of caffiene as he always was so by getting bigger he is growing out of the dose. But he hasn't been having any brady's or apnoeas.  He is now 1720 grams ( or 3 pounds 13 ounces!!) and so he will hopefully be taken out of the isolette into an open cot today!!! They have gradually been turning down the temperature in the isolette to get him used to maintaining his own body temperature and putting little outfits on him and they graded up to 3 hourly feeds yesterday. He is on one breastfeed attempt a day still and it depends on how awake he is and how hungry he is as to whether he is interested. They reckon that now he will have a chance to get hungry he will soon learn where the food is!!

One night i noticed some little lumps under his arms. The doctor was called and they are lymph nodes. So he ordered a blood test which came back fine, but he gave him one dose of Lasix because he was getting a bit puffy. He peed all that extra fluid out and looked much better and started breathing a little less rapidly as well. He also did well on his last eye exam and he will be having another one tomorrow, just to make sure his vision  is developing normally. He had to have a little bag stuck to his little fella yesterday for a urine test. All these tests freak you out but they are just so careful with these little babies at the Mater Mothers its amazing the care they all receive. It's a relief to come home and know that he is being so well looked after.  One of the nurses put him to bed after a cuddle and as she put him in she gave him a little nurse and a kiss on his soft hair  before she put him back. These nurses really love looking after the babies. It must be hard for them with a really sick baby. But they say babies like Noah make the job worthwhile. Seeing a baby that would normally not survive being born at 27 weeks grow into a healthy bub is their reward.

And healthy he is just look at this little chubby cherub!!

Leaps and Bounds...

Noah has had an absolutely great week! He is now 1340 grams (or 2 pounds 15 ounces). He has been more settled in that his heart rate has slowed to the 160's and he is back on the full dose of caffeine. I really think the little hiccup he had was due to anemia and now that he has had that transfusion everything is back to normal.

He has been nuzzling with Kim to learn how to breastfeed and he has latched on a couple of times and given some good sucks. Sometimes he's not interested, but he isn't meant to know what to do at all until he is at 35 weeks and he is still only 33 weeks and 3 days old. In a couple of weeks that part of the brain will mature and he will be searching for the nipple and sucking and swallowing and breathing all at the same time. The nurses say its just amazing how they just switch from not knowing what to do with a nipple to latching on and doing what nature intended.

He sucks his little dummy perfectly, we haven't tried him with a bottle so if we do have any problems at least we can try a bottle with breast milk. Heaven knows we have about 6 months supply in the freezer. Frozen breast milk is better than formula if it comes to that. But i don't think it will. He'll get there. And I don't think it will be too long at all until he does.

Best Laid Plans...

Well it's official. Noah is now 1 kg!!! Yay!!!!!!!! A 1000 grams and we thought we were home and hose when he got to 1 kg. Funny how he was no trouble at all when he was little. This little man has had a few ups and downs the last few days. Firstly his heart rate was sitting in the 190's and often set the heart rate alarm off going above 200 when he squirmed, pushed to poo, during cares, etc.... This was a worry to the nurses so they mentioned it to the doctor on call one evening and they decided do do a full blood count. The bloods came back saying he was a little anemic but otherwise perfect. They let it go and decided to reduce his caffeine.  Heart rate came down a little over a couple of days but not enough. So they did bloods again and his hematocrit levels were lower again so it was time for a transfusion. He got 18 mls of blood and he was really red for a few days. Seems to have settled down now. They'll wait about a week to do bloods again.

His heart rate settled down nicely, only issue is they don't know if it was the blood transfusion or the reduction in caffeine. Now his oxygen saturation levels are lower and he desaturates when he squirms, pushes to poo, during cares, etc... and a couple of bradycardia's are happening now when the weren't before. So they have decided to up the caffeine again. They did a chest x-ray to make sure he wasn't getting chronic lung disease or getting an infection, which he isn't thank god and they got the results to the 4 week head ultrasound and his brain is perfectly normal, no bleeds etc.

So even though we have gotten to the magical 1 kg mark, he has reminded us that there is still a long way to go, like at least another 700 grams before he can come out of the isolette!!  Then he needs to start feeding but Kim's milk supply has halved all of a sudden and she is up every three hours expressing trying to build her supply back up!! She is just a wreck with all the broken sleep!!  Kim has an appointment this Friday to start nuzzle's with the lactation consultant. Hopefully he will like it as much as he likes his dummy and the nuzzling with him will boost Kim's milk supply as well.

I know I planned on making him a home made cake but I didn't get a chance. He put on weight so quick and through all the sleepless nights and working full time and trips back and forth to the hospital, I was just exhausted!! My day starts at 6 am and finishes at 10 pm, in that time we go to the hospital twice and i work full time, but poor Kim has to set the alarm to also get up every three hours to express. She is meant to get a 5 hour break during the night but the lactation consultant told her that until her supply increases she should still get up during the night every three hours.

So I got him a lovely cake from the little passtiserie downstairs from my work. The lovely ladies there wrote "1 kg Noah" on it for me and we shared it around the entire NICU, inviting all the nurses we could find that have looked after Noah since he has been there for the past month!!  Kim cut the cake as i was kangaroo cuddling Noah.

Almost there...

Well today was weigh day again and the goal is 1kg. Once Noah gets to 1kg they will only weigh him every 3rd day instead of every 2nd day. Anyway he has gained another 40 grams so he is now 920 grams! It wont be long now!

The tradition in NICU is for the parents to buy a cake to bring in to celebrate reaching 1 kg. But i'm going to try my hand at making one from scratch myself. Home made is always the best and I can't wait to decorate it! I want to always make Noah's birthday cakes as well! When I was growing up I thought that was the best part of having a birthday!! Watching mum make my cake and then getting to lick the bowl and the spoon and the beaters!

31 Weeks Old / 3 Weeks 3 days Old

I know its a bit confusing, but every Wednesday Noah gets a week older in gestation and every Sunday Noah gets a week older in age. So we keep track of both for now. Note the feeding tube has been put in his nose now. This is because there is no chance really of him having to go back on CPAP and he will need his mouth free to learn how to suck!!

Check out this photo of Noah holding his mama's chin!! It's so cute. He gets more and more coordinated and alert every day!!

Graduation Day!

Well we just got a phone call from the NICU. Noah is doing so well he is being moved from NICU1 down to NICU2!! So our baby is no longer in highest level of NICU!! Yay! Noah looks pretty happy about it too!

Noah was weighed again today and put on another 50 grams!!!!! So he is now 880 grams! If he keeps going at this rate he will be a kilo in less than a week! His feeds have gone up to 12 mls every two hours. We think it has a lot to do with refusing to give the nurses fresh milk and insisting that they defrost all the milk that Kim pumped in the first two weeks. They have it all in the freezer there and there is a sign on the door of the freezer that says that you should give the baby the milk in this order. 1. Colostrum 2. First two weeks of breast milk (whether fresh or frozen as it still has a higher fat content) 3. Fresh breast milk 4. If no fresh breast milk available, then use any frozen breast milk  5. Formula (a last resort).

The nurses are pretty pushy in getting fresh milk off Kim because i think the colostrum is thicker and takes a while to go down the tube, so they have to spend more time feeding him and defrosting milk etc, but she is pretty good at putting her foot down and telling them to defrost the colostrum first. She says that she wont give them fresh milk until the first two weeks worth of milk are used. Luckily she has insisted because it looks as though it is paying off big time. They like to see babies put on 15 to 30 grams every two days. Noah either puts on the maximum or more each and every time!!! But our little man has always been an over achiever!!! Go Noah!!

3 Weeks Old Today!

Well Noah was just a doll all day! There are whispers that he is doing so well that he will be moved out of NICU1 imminently. Will still freak us out when they call just to say that he has moved to another room. It is just so reassuring that he is so well looked after in NICU1 that NICU2 is a little bit scarey.  I know that it means he is doing better and stuff but there is only 1 nurse to 3 babies instead of 1 nurse to 2 babies in there.By the way he put on another 30 grams and so he is now 830 grams!!!!

Visitors...

Nana (my mum) and his Aunty Glenda (my sister) came up for a visit yesterday and had a little cuddle with him. He was wide awake and being all cute. Glenda could not believe how small he was! Mum saw him the day after he was born and although my brothers son was born at 33 weeks, he was still 2000 grams! I don't think she was prepared for our micro-preemie!

Everything is going so well and we are so so so lucky. Spoke to another parent in the tea room and his daughter is still on oxygen and not feeding well at 38 weeks after being born at 27 weeks. She was on CPAP for 9 weeks and they just can't wean her from the little bit of oxygen she is still on and she is only mildly interested in a bottle and not interested in the breast.

Funnily, we had him out for a kangaroo cuddle and he wriggled on my chest so much he got his face first on me and started to lick me with his tongue and then tried to suck on my chest. I said wrong mumma Noah, so Kim and I swapped places but he fell asleep. I don't think we will have too much trouble in that department either!!

He is just doing so well and we are so proud of him and eternally thankful to everyone here and abroad that are praying for him so much. It's working, it is working I believe!

Its the weekend finally!

Now that its the weekend I get to spend more time with the little munchkin! I hate leaving him every morning to go to work! Anyway Noah has put on another 40 grams and is now a whopping 800 grams! I think he put on 20 grams on in each cheek! He has chipmunk cheeks! It looks like he has a marble in his mouth each side! Those little cheeks are so cute. Apparently they are his sucking muscles. Good job we get him to suck on his dummy during his tube feeds to associate sucking with a full tummy!

Brown or Blue??

Look at Noah all bright eyed and bushy tailed!! Its really hard to tell if he has already got brown eyes. They might be really dark blue but we just can't tell! Great news Noah put on another 20 grams  (now 760gms) so now he is past his birth weight and only in 17 days!! They said it would take about 3 weeks! He is off CPAP 24 hours a day now and so all he has left to do until he comes home is grow!! He might be moved from ICU to ICU2 (a step down in care) and thats a good thing! Just waiting for a cot to become available I think. From there, when he reaches a kilo, he will go another step down to Special Care instead of ICU!!! Isn't he just adorable!

On The Up And Up

Great News!!! Noah has put on 40 grams in the past two days since they began fortifier mixed in with his milk which means he is only 10 grams away from his initial birth weight.  What a champion!  They started the first day with only half fortifier so his little stomach could tolerate it and by the second day he was on full fortifier mixed in with his 10 mls every two hour feeds.

Noah had his second head ultrasound done and the results are in .... Completely normal ... no bleeds, no complications.  Our little boy just keeps powering on.

He is off CPAP for six hours twice a day.  The doctor considered keeping him on four hours but decided that he uses way too much energy trying to get the prongs out of his little nose when they are on so better out than in!  Noah in his two weeks and two days is already dictating to one and all what he wants! Go our little man!

2 Weeks Old Today!!!

The Ups: Noah has been very good at learning how to suck his dummy, he has been on full feeds for his size for 24 hrs and this morning his central line came out!!! His temperature is perfect, his blood pressure is fine and his oxygen saturations are really good and he is up to 6 hours off his CPAP now without a worry! 
                                                                                             

The Downs: Last night he was weighed as he is every 2 days. He lost 30 grams so he is back to 700 grams. The doctors and nurses have been asked every question under the sun about why, is this bad, what happened, is he getting sick, etc etc and the stock answer is no. It just happens sometimes. He obviously burned more calories than he ate, even though he is on full feeds. Sometimes the body burns calories developing the organs. There is alot going on in his little body at the moment. His brain, heart, lungs, kidneys, liver etc are all still maturing and that takes energy. So at least that is some consolation. He is developing on the inside! Still we were pretty devastated.                                                                                                                           

The lesson here is to be grateful it isn't anything more serious than a little bit of weight loss. He uses more energy the more time he is off CPAP, but he needs to be weaned from it. Catch 22 situation. He uses more energy having Kangaroo Cuddles, but he needs them to bond to us and there are a load of studies that prove that they do better developmentally if they have them. He uses more energy each time they up his feeds to digest the milk, but he needs to be fed to put on weight. I just think he is at a cross road and this was the changeover from having IV Feeds as well as his milk, to just having milk alone. The good news is that they are going to add a fortifier to his milk which adds calories to his feeds without adding volume. So chubby chub chub, here we come!!!

Photo cuteness!!!

A Weighty Issue...

Great news! Look at his big tummy everyone! Noah has gone up to 7 mls of breast milk every two hours now! They are increasing his feeds every 12 hours by 1 ml.  So this afternoon he will be on 8 mls and tomorrow he will be on 9 mls then 10mls tomorrow afternoon!!!!!!!! That means he will be on full feeds for his size and the central line can come out after he has been on full feeds for 24 hours !!!!!     
                       
When he was born he weighed 750gms. After birth it is completely normal for babies to lose weight and Noah's weight plummeted to only 640gms. That was quite distressing for us to see him grow even smaller.                                                                                                                           

But once he started on his feeds he put on 30gms in two days. They weigh him every two days and the target is to gain 15-30gms. Noah has put on 30gms every two days. So he went from 750gms to 640gms, then to 670gms then to 700gms and now he is 730gms. They said it normally takes about 3 weeks for them to get back to their birth weight and Noah has almost done it in a week!!!                                                                                                                                    

He loves his tucker. They feed him through a little tube that goes into his mouth and right down into his stomach. Before they put the milk through the line they pull back on the syringe to see if there is any undigested milk in his tummy first. There is never any there because he gobbles it all up! He loves his mama's milk!!                                                                                              

They feed him through the tube because premature babies haven't got a good sucking reflex. But I think that Noah will prove them all wrong (as usual) because he has a little dummy and if you hold it in place he sucks that dummy like there is no tomorrow!!

A Star is Born!!

This blog is to record our adventures as parents to our first child Noah. He was much wished and longed for after 3 years of infertility treatment. Noah was born at 27 weeks and 4 days by emergency c-section on Sunday 13th September 2009 due to antepartum haemorrhage. Luckily my partner Kim was already in hospital because she woke up the Tuesday prior with a small bleed. Then they discovered that Noah was small for dates due to placental insufficiency. He was only measuring 24 weeks when we were almost 27 weeks!!! Kim was admitted and put on strict bed rest with a plan to have a doppler scan every 2 days to measure the blood flow through the cord and a growth scan every 2 weeks. Luckily our Dr decided to give her two doses of steroids just in case. We made it to 5 days and she started to bleed profusely so it was off to theatre in a hurry.

Everyone is well, Noah is in NICU but he is a TROOPER!!! 750gms (or 1pound 10 ounces!!!!!!!!) with apgars of 6 at one minute and 9 at five minutes. They intubated him for the first 11 hours of life only to get him settled in NICU and get his umbilical lines in etc, but they didn't need to because he kept wanting to pull out the tube because he was breathing on his own! He was so feisty that they took him off the respirator and put him on Cpap instead. They have never had a baby this young on Cpap alone, so they don't have nasal prongs small enough for him, so they are stretching his little nostrils! He hasn't needed any oxygen since birth!

We are so proud of our LITTLE bundle! Will update when I can, as you can imagine life is hectic at the moment!  Too much time has flown by and Noah is already 11 days old today. He has gone from strength to strength and has had so many graduations I thought I had better write them all down to keep track. Here we go:

• He graduated from Ventilator to CPAP at 11 hours old
• He graduated from TPN (IV Feeds) alone to TPN plus colostrum at 2 days old
• He graduated from 2 hrs to 4 hrs off CPAP twice a day by 5 days 
• He graduated from 0.5 mls of breast milk gradually increasing to 5 mls by 10 days old

When he gets to 10 mls every 2 hours he will be on full feeds for his size and his central line which they feed him the TPN, can come out. That will be a great day indeed because that means he has less chance of getting an infection which is something that us mums in NICU dread. It makes them very sick and they lose weight and their temp's go up and we don't want one of those. Anyhow he is going up one ml every 12 hours at the moment so that means that if he keeps tolerating his feeds he will be on 10 mls in 2 and a half days!!!

Kim is pumping milk like a champion as well, we have already filled up our freezer with milk, so yesterday we went and bought a deep freezer to store all her milk in. The plan is to store the first two weeks worth of milk at the hospital for Noah because the first two weeks is very rich in nutrients and fat and all the lipids that he needs to line his digestive tract etc. Then after that we need to store the rest of the milk here at home and take him a fresh bag of milk everyday. That should be no problem seen as how he is on 60 mls per day at the moment and Kim is pumping approximately 1200 mls per day.

We love our little star so much it hurts and we go up to the hospital twice a day for 3 hours at least. We have spent a whole day there and we were so tired it wasn't funny. The last thing we need is to get sick when we have to be there for our baby, so we are limiting it to the two visits. Today is the first time we will only visit once (will be a big visit i think!) because we are waiting for the delivery of the deep freezer and that could be anytime this morning.

We cannot believe how blonde this little man is!! Kim has dark brown hair and brown eyes and olive skin and the donor is the same but with hazel eyes. Kim was fair when she was little too, but it was a shock to see him so fair, when all along we were expecting a little monkey and we got this golden haired beautiful bundle! He is so cute and all the doctors and nurses don't think we are just being biased because he is ours.... they all agree!