21 hours after being discharged, we had our first pediatrician visit. Thank goodness we live close by! This allowed us to double our experience with infant car seats. We actually made it on time, which caused us both to turn toward each other and ask, "Is that really you?"
The main finding of the visit was that Charlie's weight has been on a flat trajectory over the last 4 days. Down 10 grams one day, then up 10 the next, then down 10 since yesterday. The physicians were happy with how well we had executed the feeding plan, so the conversation turned to finding what else we could do. The conclusion was a duality of increasing energy intake and decreasing expenditure: try to increase supplementation from 45 to 60 cc per feeding, but don't make them work so hard to get it.
The central problem is really that it's hard to get a large serving of food into a late pre-term baby. They don't seem to know how voracious they ought to be in order to properly replace that umbilical cord. They'll start eating vigorously but quickly get tired and disinterested. At the hospital, we learned several tricks to get a tired feeder back into the groove: gentle things like tickling the chin and cheek and foot, and stronger measures to sort of startle them into attention, like checking their diaper and rubbing their backs and stomachs. We would use all such measures to re-ignite little Bruno's and Charlie's interest in their food when they drifted off. The problem is that these measures involve expenditure of the baby's energy.
How do B&C expend energy right now? Mainly on feeding and growing. They do little else (being asleep basically whenever they're not eating). So, given a finite reserve of energy, spending more of it on feeding means less available for growing. Breastfeeding takes a lot of energy. Crying and being cold takes a lot of energy.
So, the advice was to focus on delivering energy economically. Have time at the breast, but limit it. Bottle-feed until baby tires, then let him rest a while. If that means starting again after an hour rather than waiting for "the next feeding" to start, so be it. Thus, our work will get easier and harder: easier per feeding, but harder because it may be happening even more frequently in order to keep that flow going. Nominally, we are giving 8 feedings of 60cc each (about a half liter a day!). But really, we're just continuously administering food whenever they'll take it. I really feel like a parent now.
When we returned, we found a shopping bag hanging from our doorknob. An invisible force of good, having learned that we were home, had deposited some useful breast pump paraphernalia for us. Thank you, Shelby, you are to our morale as a bolster pillow is to tandem feeding!
The main finding of the visit was that Charlie's weight has been on a flat trajectory over the last 4 days. Down 10 grams one day, then up 10 the next, then down 10 since yesterday. The physicians were happy with how well we had executed the feeding plan, so the conversation turned to finding what else we could do. The conclusion was a duality of increasing energy intake and decreasing expenditure: try to increase supplementation from 45 to 60 cc per feeding, but don't make them work so hard to get it.
The central problem is really that it's hard to get a large serving of food into a late pre-term baby. They don't seem to know how voracious they ought to be in order to properly replace that umbilical cord. They'll start eating vigorously but quickly get tired and disinterested. At the hospital, we learned several tricks to get a tired feeder back into the groove: gentle things like tickling the chin and cheek and foot, and stronger measures to sort of startle them into attention, like checking their diaper and rubbing their backs and stomachs. We would use all such measures to re-ignite little Bruno's and Charlie's interest in their food when they drifted off. The problem is that these measures involve expenditure of the baby's energy.
How do B&C expend energy right now? Mainly on feeding and growing. They do little else (being asleep basically whenever they're not eating). So, given a finite reserve of energy, spending more of it on feeding means less available for growing. Breastfeeding takes a lot of energy. Crying and being cold takes a lot of energy.
So, the advice was to focus on delivering energy economically. Have time at the breast, but limit it. Bottle-feed until baby tires, then let him rest a while. If that means starting again after an hour rather than waiting for "the next feeding" to start, so be it. Thus, our work will get easier and harder: easier per feeding, but harder because it may be happening even more frequently in order to keep that flow going. Nominally, we are giving 8 feedings of 60cc each (about a half liter a day!). But really, we're just continuously administering food whenever they'll take it. I really feel like a parent now.
When we returned, we found a shopping bag hanging from our doorknob. An invisible force of good, having learned that we were home, had deposited some useful breast pump paraphernalia for us. Thank you, Shelby, you are to our morale as a bolster pillow is to tandem feeding!
Charlie after last feeding
Oh my gosh, that picture!! Priceless. ( I had a similar situation with Jonathan after he was born - different reason, but all the same, nursing him every hour. It doesn't last long, but more than worth the effort!). You two are my heroes. 💜💜
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