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the eric update - day 63: nine weeks! still no ROP ( yet ). postcards.

yes, indeed, today was eric's nine week birthday and by almost all measures it was a fairly quiet day. he's slowed down on his weight gains and was only up 5 grams over his weight yesterday. the neonatologist has noticed he's not adding weight as quickly and has therefore once again supplemented his breastmilk with fortifier, which adds 4 calories per ounce without adding any substantial volume. those 4 calories make a big difference, so we should probably see eric start to put on weight again in the coming days.

regular readers might remember that eric was due for another exam to determine if he is developing an eye condition known as retinopathy of prematurity. i'm happy to report that there is still no evidence of ROP, which is fastastic news! eric's eye doctor said after his last test that not only was eric not out of the woods - he wasn't even in the woods yet. i think now he can be said to be standing on the edge of the forest and he'll still be at high risk for developing ROP over the next three to four weeks. it's a great sign that he hasn't shown any signs yet, but we still have a few more tests to go before we can confidently state that he won't develop some manifestation of ROP.

we missed the eye doctor during the exam and had to decipher his handwritten notes after he left. somewhat disturbingly, he indicated that there was cloudiness in eric's ocular fluid in both eyes, but none of the staff could say if this was something to be concerned about or if it was a normal developmental stage that would diminish over time. nobody seemed overly concerned with the note, so we'll remain calm until we've had a chance to clarify the issue with the specialist.

and yes - we're still getting postcards!

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9/05/2004 11:56:00 PM 10 comments


Crossing our fingers about the continued positive ROP results. Any hearing tests yet? Have you bought your car seat? You will need it for the tests!

By Blogger Robb, at 9:36 AM  

Happy 9 week birthday, grandson! And, happy two month birthday yesterday too. It looks like you did lots of celebrating. I am very excited to hear that you may be going home soon. (Like Aunt Monica, I have been smiling and crying all at the same time.) Now, Mom and Pops will have to get your room ready. Everyone is so proud that you have grown so much - and you are learning new things every day. I know that you will love finding the new sources of milk - especially Mommy. I am so grateful to see you making such big steps. You are a very special baby. In celebration of such an ominous occasion, I will share some more pictures of Pops (Eric III) when he was about your size. Just visit the "rier" flickr site. Soon, I will show you the pictures of when he came home and saw his big sister for the very first time. I'm looking forward to the day when I can come and visit you in your very own room. I know you are anxious to get there. Love, Gwanmanman Sherry
P.S. Great-nana Rier and Kirk say happy birthday too.

By Anonymous Anonymous, at 2:20 PM  

neat! just to help everyone out, here's the rier flickr site. i think he might bear a striking resemblance to his pops afterall.

thanks for posting the images. amazingly, i haven't seem most of those - not sure where you've been hiding them all these years :-)

By Blogger e3, at 5:07 PM  

nope, we haven't heard (ahem) anything about hearing tests, although my understanding is that it's one of the last tests they do before you leave the nicu.

amusingly, we haven't purchased a car seat and it's funny to think that he might just get home before his baby shower on september 19th (when, presumably, we might get a car sear for a gift).

not that there's an enourmous chance, that he'll be out by the 19th, but odd to think that it might just happen.

By Blogger e3, at 5:11 PM  

Yay little Eric! Have I mentioned that he's a amazing recently? Cuz he is!

I have a question or two about the feedings, and please feel free to say 'Sorry, that's too personal to answer' but why the bottle over the breast for actual nutrition? Is it because they still need to monitor how much he's getting so closely as well as the fortifier stuff? Do they hope he'll be able to drink direct from the 'font'eventually? Is it too soon for Kris to be able to use a supplemental nurser (SNS)?...but I suppose that would trigger her letdown and then you're back to problem #1. I think I may have just answered my own questions :).

Anyhow, WAY TO GO baby boy! Sounds like you folks are in the market for some baby room fixin's! YAY YAY and more YAY!

Emily in Nova Scotia.

By Anonymous Anonymous, at 8:04 AM  

hallo, emily!

nope. not too personal, although it is a controversal topic. although, as you know, eric has been "latching" since before he started taking a bottle he is not and will not receive a majority of his nutrition from breastfeeding for a variety of reasons, including the need for supplemental fortifier to keep up his weight gains.

it's also difficult to know exactly how much milk he's received during breastfeeding. in some nicus , the nurses weigh the baby before and after feeding and extrapolate how much she's received from the weight change, but it's very difficult to know down to the cc how much food has been ingested using this method. this is one of the controversial parts - some would say that our nicu staff are being lazy by not trying to weigh eric before and after feeding. although i wouldn't call it laziness, after seeing for two months how busy the staff are during the day i can see why they might not want the "overhead" of constantly weighing babies throughout the day. you can imagine, with most of the babies on two hour feeding schedules, what an increase in work it would be to be weighing everyone. but i think the real issue is that it's almost impossible to accurately weigh a baby before and after a feeding in a way that would allow you to very precisely calculate how much food was ingested. in theory the preemie scales are very accurate, but in practice they vary for innumerable reasons. and at this stage of the game, one must know exactly how much food has been ingested.

and lastly, there's the time issue. feeding directly from tube takes less time than feeding from a bottle which takes less time than breatfeeding. and while some would think this is another "taking the easy route" issue, it's really not. eric gets fed every two hours and the longer one takes to feed him, the less time he has to digest his food before the next feeding. and less time to digest means more food left in his stomach and intestines which means less room for the next meal.

so, for now, eric will continue latching and getting bottle fed. as he gets bigger and it's less important to know down to the cc how much milk he's received, he will be able to breastfeed for a while ( but not too long, due to the "time to the next feeding issue" ), but they will still give him a "comp" bottle to ensure that he's got enough food in his belly.

hopefully i've answered your question satisfactorily. it is quite a controversial topic and some would say that the reasons i've given are just a bunch of hooey and are meant to obfuscate the fact that the staff are lazy and incompetent. but after seeing them work for two months, and seeing just how much they advocate breastfeeding, i feel pretty confident that their reasoning is sound.

that said, i'm always open to hearing other opinions.

By Blogger e3, at 11:05 AM  

e3, those all sound like perfectly valid reasons to me. I guess I was just wondering if Kris will ultimately be able to actually nurse little Eric from the breast rather than exclsively pumping milk (once the little guy is at home, down the road etc). The constant pumping can get tedious, but it's very definately worth it!

Of course there are alternatives to the bottle esp when actual nursing from the breast is the desired outcome (like tube/finger feeding or cup feeding) but these, as you pointed out, can be more time constraining esp with a preemie. Thank you for pointing out the whole 'time' issues as this isn't something I'd ever thought about. Makes perfect sense tho!

I guess I was just thinking that they'd be able to monitor his intake via a supplemental nurser (the thingy that has a calibrated resevoir and has capilary tubes that attach to the nipple for the babe to suck on. Are you familiar w/ these). But, having given that some thought realized that the pro-longed sucking would trigger Kris's letdown and the little guy would be getting more milk then he bargined for.

So, thanks for clearing all of that up! I really appreciate it!

Emily from Nova Scotia! :)

P.S. I'd just like to point out that I used the phrase 'actual nursing from the breast' unstead of 'breastfeeding' because Kris actually *IS*, in fact, breastfeeding! It's just 2-3 step breastfeeding rather than the traditional 1 step process :D.

By Anonymous Anonymous, at 12:26 PM  

Was just looking at the pics your mom posted of you as a baby. Were you a preemie too?

By Blogger Rena, at 6:32 PM  

yes, i was a micropreemie. i was a 26 weeker waaaaaaaaay back in the dark ages of 1972. i was born a 2 pounds 13 ounces. the family myth is that i did spectacularly well and didn't suffer from any major problems during my own nicu stay. supposedly it's just a coincidence that we were both born so early and not something genetic.

By Blogger e3, at 11:10 AM  

i think supplemental nursers aren't encouraged for the reasons you indicated, emily. it's very common for micropreemies to leave the nicu on feeding mostly from a bottle and occasionally the "normal" way. then again, as some readers can attest, it's not uncommon for a micropreemie to go home still needing to be fed through a tube.

the time issue is a big one, especially now that he's on 36 cc feeds, every three hours. we have exactly 30 minutes to get him to take his food via a bottle. if he doesn't get everything down in that time, then he's "gavaged" ( the term for tube feeding ). again, the strict timing is due to the fact that you want him to have the most amount of time to fully digest the food and after 30 minutes; also, the staff begin to get concerned about how many calories he's burning while bottle feeding after a half an hour.

it's funny to think that the extra calories burned from being out of the isolette can make a big difference.

By Blogger e3, at 11:26 AM  

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