Kaden makes the news again!

We have more breaking news with Mr. Kaden. He has traded in his isolette for a crib. Once he can prove that he is able to maintain his temperature, which he has done well with all day today, he will get to co-bed with his brother. He has turned into such a big boy and has progressing quickly since last week. It is so nice having him in the crib because I can hear his little squeaks while he is sleeping and stare at his cute little face without a barrier between us. The doctor forgot to write the order for co-bedding this morning so I am supposed to remind him when he calls with an update tomorrow. Hopefully the boys will be reunited once again and will get to enjoy each others’ company for the next week or so. I think that once they have the support of one another again they will just take off.
The doctor thinks Braylon may be well enough to get discharged the end of next week but he continues to have brady spells and seems to have had quite a few today. Most of them are related to his reflux or position so they are going to see if placing him on a foam wedge will help. Since his brother may be sharing the same bed he will be sleeping on the wedge too, although he doesn’t need it. I would really be surprised if Braylon gets out next week but you never know with him, he has amazed everyone with his eating skills he could amaze us again.
Both boys have gained weight. Braylon weighed 5lbs 1oz and Kaden weighed 4lbs 1oz. Kaden got to take a shot at breast feeding. He was only allowed to try for a little while but really caught on quick. He took to it very well and he will get to try and feed from a bottle tomorrow. He loved it so much he has begun to root on everything that comes close to his mouth, like his brother did. Braylon still thinks that he should eat every time we wake him, no wonder he is such a little brute. He continues to nipple all of his feeds and now has the tube out of his nose and no longer has anything on his face other than his beautiful eyes, cute little nose, and kissable little lips. Hopefully Kaden will do well enough with his feedings they can remove his tube soon but he still needs the support of the oxygen. We still enjoy his little face too even with his extra attachments.

(I couldn't get a picture of Kaden in his crib today because the battery died to my camera, hopefully tomorrow though)

Breaking News!

Breaking News! Kaden is now in the 4lb club! Here are some pictures of the boys on the scale tonight.

Kaden on the scale weighing in at 4 lbs


Braylon on the scale weighing in at 5 lbs

You may notice the boys are starting to look alike now.

New Arrangement

Well, Braylon continues to have his brady spells which for every day he has a brady will buy him an additional five day stay at Hotel NICU unless the doctors decide to discharge him on a monitor. Since his brother Kaden is getting closer to being in a crib, today’s nurse decided to do a little rearranging in their suite. She got a portable monitor for Braylon and hooked it to Kaden’s boom (the boom holds the monitors and has a power supply) and also moved Braylon’s crib over to Kaden’s side of the room. This way we can hold them together anytime we want, the boys are closer to each other, we don’t have to feel shut out from one baby when we have the curtain closed to other baby’s side of the room, and they are all set up for co-bedding when that day arrives.
Last night Braylon became a member of the 5lb Club. When the doctor called today he said, “Braylon is just a little stud, he has been nippling almost all of his feeds.” I guess this is pretty impressive for a baby his gestational age. He only has to meet a few more requirements to be able to leave the NICU since he has had no trouble maintaining his temperature in his crib and continuing to gain weight. In order to leave he has to not have any apnea or bradycardic spells for five days (unless they are minor spells and will have a monitor), nipple all of his feeds, and pass the car seat test. The majority of his brady spells are related to reflux and/or obstruction (when he gets milk caught in his throat that he can’t swallow or cough up and gags himself, or his head falls too far forward and pinches off his airway), which they are expecting him to outgrow in the next week or so because he will start gaining more muscle control in the weeks to come.
Kaden also gained weight last night. He weighed 3lbs 15oz, just 1 oz shy of the 4lb Club. He will probably weigh 4lbs tonight. Once he reaches 4lbs and maintains it for several days plus maintains his own temperature he will trade in his isolette for a crib, which means he will more than likely be sharing his brother’s crib. Finally! I am thinking this may take place this weekend.
Kaden has also been moved from continuous feeds which run at a slow rate all day long, to bolus feeds which is a feeding given over 1 ½ hours. The doctor said that they may try letting him nipple some of his feedings next week. The occupational therapist have been working with him over the past couple of days and said he has been doing very well with his pacifier and will probably take to breast feeding and bottle feeding very well and they expect him to really take off after that.
This Friday we are all taking infant CPR, which is a requirement if the boys go home on any monitors. The nurse yesterday said to be sure and get it done this week because she is not sure if Braylon will be in the NICU long enough for us to get it in the following week. This would be very exciting but we are not going to get our hopes up because this is the type of thing they have warned us about, just when you think you are about to leave there is always one thing holding you back. We have just been taking it day-by-day and trying not to look too far ahead because we have found that it can get very frustrating otherwise. I keep telling the nurses, “No rush. We will be here until Kaden gets to go home anyways. When he gets closer is when we will be in anxious to get home.” Although we would love to have Braylon discharged, the longer he stays in the NICU the longer he will get to co-bed with his brother and the easier it will be for Bryan and I to visit Kaden. As long he is in the NICU we are able to be with both boys at the same time and not worry about having someone watch Braylon while we are in with Kaden.

Braylon's 5 week picture with his bear


Kaden's 5 week picture with his bear


The view of their new arrangement from the couch (Braylon's crib to the left and Kaden in his isolette to the right)

GOT MILK?!

Picture of the box of milk Bryan took home. The bottles are stacked three high.


So today is the day they finally asked me to take some of the milk home, PLEASE! Apparently the Howland boys’ stash of milk has been taking up lots of space in the NICU freezer. The lactation specialist, officially, asked if I was interested in donating, but I told her, “No, not yet, I want to make sure my boys have enough that we won’t have to buy formula for a while.” (One of our nurses had twins and she said not to donate yet because she went through 2 of the Costco containers of formula a day, which costs approximately $60 dollars per day) Breast milk is good for a year in a deep freeze and that is where we will be storing it. She said that if one year from now I still have plenty of milk left over the milk bank would still be interested in taking it and would pay for all of the screening costs. If I continue to have an abundant milk supply I will most likely become a donor, at Sacred Heart almost all premature babies are given breast milk whether it is from their mother or a milk bank, if the parents allow it, because of it's amazing health benefits. There is a reason they call it "Liquid Gold".

Before Bryan left for Lewiston, our nurse went in to get our box of frozen milk, packed on ice, to take home. When she noticed how much was in the box she asked the nutrition center if they left enough extra supply in case they need to thaw some in the weeks to come, their response was, “Oh yeah, there is a whole ‘nother box in there.”

Bryan took the box home and when I called to make sure he hadn’t forgotten to unload it from the car, he said that he put over 280, 2oz, bottles in the freezer. I did the math and if the majority of the bottles were full that equals over 4 gallons of milk in our freezer alone.

Here an interesting article from the Associated Press that came out the day before our discussion on breast milk vs. formula.

Study: Breast-feeding would save lives, money
By LINDSEY TANNER (AP)

CHICAGO — The lives of nearly 900 babies would be saved each year, along with billions of dollars, if 90 percent of U.S. women fed their babies breast milk only for the first six months of life, a cost analysis says.
Those startling results, published online Monday in the journal Pediatrics, are only an estimate. But several experts who reviewed the analysis said the methods and conclusions seem sound.

"The health care system has got to be aware that breast-feeding makes a profound difference," said Dr. Ruth Lawrence, who heads the American Academy of Pediatrics' breast-feeding section.

The findings suggest that there are hundreds of deaths and many more costly illnesses each year from health problems that breast-feeding may help prevent. These include stomach viruses, ear infections, asthma, juvenile diabetes, Sudden Infant Death Syndrome and even childhood leukemia.

The magnitude of health benefits linked to breast-feeding is vastly underappreciated, said lead author Dr. Melissa Bartick, an internist and instructor at Harvard Medical School. Breast-feeding is sometimes considered a lifestyle choice, but Bartick calls it a public health issue.

Among the benefits: Breast milk contains antibodies that help babies fight infections; it also can affect insulin levels in the blood, which may make breast-fed babies less likely to develop diabetes and obesity.

The analysis studied the prevalence of 10 common childhood illnesses, costs of treating those diseases, including hospitalization, and the level of disease protection other studies have linked with breast-feeding.

The $13 billion in estimated losses due to the low breast-feeding rate includes an economists' calculation partly based on lost potential lifetime wages — $10.56 million per death.

The methods were similar to a widely cited 2001 government report that said $3.6 billion could be saved each year if 50 percent of mothers breast-fed their babies for six months. Medical costs have climbed since then and breast-feeding rates have increased only slightly.

About 43 percent of U.S. mothers do at least some breast-feeding for six months, but only 12 percent follow government guidelines recommending that babies receive only breast milk for six months.

Dr. Larry Gray, a University of Chicago pediatrician, called the analysis compelling
and said it's reasonable to strive for 90 percent compliance.
But he also said mothers who don't breast-feed for six months shouldn't be blamed or made to feel guilty, because their jobs and other demands often make it impossible to do so.

"We'd all love as pediatricians to be able to carry this information into the boardrooms by saying we all gain by small changes at the workplace" that encourage breast-feeding, Gray said.

Bartick said there are some encouraging signs. The government's new health care overhaul requires large employers to provide private places for working mothers to pump breast milk. And under a provision enacted April 1 by the Joint Commission, a hospital accrediting agency, hospitals may be evaluated on their efforts to ensure that newborns are fed only breast milk before they're sent home.

The pediatrics academy says babies should be given a chance to start breast-feeding immediately after birth. Bartick said that often doesn't happen, and at many hospitals newborns are offered formula even when their mothers intend to breast-feed.
"Hospital practices need to change to be more in line with evidence-based care," Bartick said. "We really shouldn't be blaming mothers for this."

On the Net:
• American Academy of Pediatrics: http://www.aap.org
• Government: http://www.womenshealth.gov/breastfeeding/

Copyright © 2010 The Associated Press. All rights reserved.

A Day of Firsts

Happy Easter! Well it was our first Easter as a family, and it was a good one. The boys are doing fantastic, and continue to progress their way closer to home. Braylon and Kaden are both getting so big and chunky. Braylon has some thunder thighs going on, and Kaden is still playing catch up, but he is getting bigger and better. He only comes off his cannula when he needs to, well I guess some of the nurses take him off to give him a break now and then, but most of the time he is on the cannula. He seems to be more awake during his care times and is really starting to root. Last night I was talking to one of the nurses and telling her that she was going to give our kids bad habits. They stick a suction tube up one nostril and some saline up the other side to clean out the buggers. Then when they get done with both sides of their nose they stick the tube in their mouth. For a place that has a lot of germs and people that are trained to handle germs, that doesn’t seem very sanitary to me. So I told her that she was teaching our kids that eating their buggers will be ok, because they are already starting to get used to the taste. They do it in that order because the saline washes down the backs of their throats and they can suck out the excess fluid after they are done with their noses. I would just have two suction tubes, but that’s me. Also, Braylon has been getting into a habit of giving everyone the one-finger salute, and showing his true feelings. I don’t know why he insists on holding that finger up all the time, but I think it’ll cause some problems in the future.
Today was our first family picture. This was a picture that all four of us were in. Ash and I were able to hold Braylon and Kaden at the same time. Earlier today Ashley gave Braylon his first bath and he hated it. The good news was that he didn’t have any monitors or tubes with him during his bath, and Ashley was able to feed him after. He showed Ashley that the faucet wasn’t the only thing that could spray, as he decided to turn his bath into a Braylon fountain and shot it straight up in the air. Well back to our first picture, since we were able to take Braylon off his monitors and cannula for a little while it allowed us to hold the boys at the same time. Kaden was wide awake for this milestone but Braylon wasn’t gonna have any of it as he decided to sleep through the whole thing. So Kaden saw how selfish his big bro was being and that he couldn’t even wake up to say hi. It was pretty cute though as it looked like Kaden was reaching out to touch Braylon, but I think he was stretching out or looking to get a few cheap shots in on his bigger brother while he was zonked out. Braylon stayed awake from one care time to about the other. It means Braylon was up for about 4 to 5 straight hours without sleeping, so it was understandable that he slept while we were holding him and his brother. All in all this was a great day for the Howlands and hopefully we will be able to get some more family photos.

Braylon's Buns

Can't you tell he loves it

Braylon after his bath

Kaden practicing sucking on his bink



First Family Photo

Proud Daddy with his boys

The boys reunited for the first time (you can really tell the 1 lb size difference)

Kaden's point of view

Braylon's point of view

Momma and both boys back together again

Kaden reaching for his brother

Hoping for more days like these

The boys have been looking great. Both are gaining weight. Kaden weighed 3lbs 13oz and Braylon weighed 4lbs 13oz. Although Kaden in only in the 3rd percentile, he is finally starting to gain and maintain his weight. They increased his feeding to 26 calories to help him progress a little quicker.
We have a big eater on our hands. Braylon nippled all but ½ of one of his feedings today and I am pretty sure he broke a NICU record. Yesterday the nurses would give him his whole feeding by gavage (through his tube) even after he had breastfed. I thought that it was strange and thought they might be over feeding him so I asked the night nurse if that was normal. She said, “Oh yeah, they almost always do that with preemies because they can’t get enough from the breast alone, it’s just too much work. I would be amazed if could get a full feeding from breastfeeding at his age. There is just no way.” I told her, “Really? Because it feels like he is getting a lot out.” It wasn’t until they weighed him last night and he had gained a little more weight than they had expected that they started to consider that he might actually be getting a full feeding or even a half feeding from breast. Today the day nurse decided to weigh him before he breastfed and then after he was finished eating. They are able to measure the amount of fluid in their stomach because 1gram on the scale equals 1mL of fluid. She let him eat for a ½ hour and then weighed him. She was so stunned by his weight gain she weighed him twice before she could believe it. He weighed 60 grams more after his feeding, which means he ate a grand total of 60mL, over 1 ½ feedings. His full feeding by bottle or gavage is only 42mL. I wanted to say, “He is a Howland. Haven’t you heard we don’t do anything small? That’s why we got two babies in one shot and look at what a commotion they caused when they were born. And didn’t I mention my milk supply?” (I am able to pump so much they have started to hint about donating some of it, but I keep telling them I’m stock piling it for later, I will need if they both eat like Braylon)
Kaden has been doing excellent on his high flow cannula. The nurses can hardly tell the difference in his respiratory status whether he is on it or the c-pap. The doctor said he can try and stay on it a little longer each time and he only has to use the c-pap when he looks like he needs it. He is starting to fight the c-pap, which the nurses say is great because the more he fights and shows he doesn’t need it the faster the doctors will take it away for good. He made it eight hours by the time we left tonight. I was able to hold him for 2 hours today and we both loved every minute of it. He can finally relax enough to snuggle right in and fall fast asleep. He looks so peaceful now when he is sleeping and actually looks rested. The more rested he looks and the more weight he gains the more he is starting to look like his brother. He is changing more and more each day, just like his brother did several weeks ago when he really started to progress. Kaden is very interested in starting to nipple and likes to burrow his face in my chest and stick his tongue out to lick me or try and suck. Today he left a big puddle of drool on me. He won’t be able to start nipple feeding until he is off c-pap for good and off the continuous feedings. If things go for him like they did his brother it will practically happen overnight. We are hoping that he is finally over the hump.

We Are One Month Old!!!!!

One month ago today, at this very time, I was laying in the operating room with Bryan by my side, waiting for our little miracles to be born.
I can still remember the terror like it was yesterday but yet it feels like a dream. I remember the frightening moment at St. Joes when the labor started again and Dr. Berg came into check me and told me I had to be shipped out. She had asked me if I had a preference and as the tears rolled down my cheek I blurted out the first hospital that came in my head, not knowing anything about either hospital’s NICU and hoping I had made the right choice. I also remember how the meds they gave me to slow the labor made me feel awful and how it felt like forever for the helicopter to arrive. I still get that anxious feeling when I think about arriving at Sacred Heart and knowing that none of my family had arrived yet and I can still hear the helicopter pilot’s voice when he called to tell Bryan that I had arrived safe and sound. I also remember the call I made to Bryan telling him my water had broke but not to panic when deep inside I was the one who was panicking.
Just when I thought I might make it a few more days with our little guys inside me so I could get the extra doses of steroids to help their lungs develop my body decided there was no time to wait and I began to dilate. Dr. Olson came back in the room to check me and it was then that he made the call to get the surgery suite ready and to call in the crew and the neonatologist. Again it felt like a lifetime waiting on the surgery crew as the fear of what was to come continued to build.
I waited in the cold surgery suite while the anesthesiologist gave me the block and they walked Bryan up to the head of my bed. They placed the drape in front of my face and I could hear the doctors and nurses talking as they worked to get Braylon and Kaden out into the world. I could see the nurses scurry from me to the little warmer and another group of nurses scurry from me to the other warmer across the room. They motioned for Bryan to come over and both groups stood around the warmers as I struggled to sneak a peak of the boys, but could only see either a doctor or nurses back. As they wheeled the babies by, one of the nurses noticed me watching and asked her group to stop and said, “Mom just wants a peak.” It was then that I saw one of the babies’ legs sticking straight out. Bryan left with the babies while the doctor and surgery crew sewed me up.
Again it felt like a lifetime as they worked to close my belly and another lifetime as I waited in recovery for the feeling to come back to my legs, asking over and over, “Can I see my babies yet?,” “How much longer until I can see my babies?”, “Can I have something to drink now?” While waiting Bryan brought the camera down from the NICU with pictures of the babies so I could see that they were okay and gave me a little report. From there they wheeled me to my room on post-partum where I had to wait again and finally around 3am Bryan got to wheel me up to see my babies. I remember looking at them with amazement and thinking, I can’t believe you were inside of me and I can’t believe how perfect you are. I instantly fell in love and felt the strongest bond I think I could ever feel.
Today, one month later, the boys have grown so much and yet they are still so small. Braylon is now 4lbs 10oz and Kaden is 3lbs 11oz. Both boys are doing great and continue to make progress and each day is one day closer to going home.
They went from ventilators to c-pap, cannulas, a crib, a bottle, both wearing clothes, and developing their own personalities. Braylon has been getting the hang of taking his feedings from a bottle or breast and by his 9pm care time took 4 feedings by bottle. Kaden has been gaining more and more time on his cannula and will hopefully get rid of the c-pap for good in the next couple of days. He tolerated his cannula for over 7 hours today with little trouble. Both boys had their first eye exams yesterday and both had good reports. Although again it feels like a lifetime, the time spent in the NICU, we have one month already down and hopefully only one more to go.