Sunday, April 11, 2010

Mommy's NICU Birthday

Today’s was Mommy’s 26th birthday and she spent it with us at the NICU. We asked Daddy to have a card waiting for her from us at the RMH and since we aren’t able to walk yet we asked our nurses today to go get Mommy a present. We lay quietly in our crib waiting for Mommy and the rest of our family to arrive and for our nurse to deliver the surprise. Mommy made it to the NICU before our nurse got back from picking up our surprise.
When our nurse got back to our room she handed Mommy a pretty coffee mug with some chocolates and a balloon wishing Mommy a happy birthday from us. Mommy loved it and we think we could see a little tear in her eye. We don’t think she expected it and was really surprised.
After Mommy and Daddy finished with our cares Grandpa and Grandma took Mommy out to birthday dinner at Shogun. We hear that they made a bunch of noise, sang Mommy a song, made her and Daddy dress up, and took their picture. They ate a birthday cake that matched the cookies we had delivered by Grandma to the nurses to help celebrate Mommy’s birthday. The cake looked a little funny though because Angus and Izzy, who we have not met yet, decided they would have a taste too while the cake was in the car. Angus tried to deny it but he had some blue frosting left over on his whiskers. Mommy didn’t mind though, she just laughed.
We are happy we could spend Mommy’s birthday with her. We think she enjoyed having us around. She told us what a great day it was and how thankful she is for everyone who made her feel special on her day.

Mommy and Daddy at Shogun


Our surprise for Mommy




Mommy's sampled birthday cake

Friday, April 9, 2010

Reunited Once Again!!!

The day has finally come that the boys are CO-BEDDING!!!! I walked in this morning and was pleasantly surprised by the sight of both boys in one crib. I can’t even describe the feeling to see them together again and to know that they are side-by-side and have each other even when mommy and daddy are not there. I do feel a little bad for Kaden though because now he gets to bask in the stench of his brother’s dirty diapers. Braylon has some really rank diapers and stinks up the whole room. The smell even creeps its way out of the garbage and lingers in the air. The nurses joke about throwing them in another nurse’s room or even in the other pods as a joke. They say it is from the extra protein they are putting in his bottles, hopefully they decide to get rid of that before sending him home.
Several times today I just stood at the boys’ bedside to see if they noticed each other. They didn’t do anything real exciting but I could see Kaden just staring at his brother and studying his face, as he does with everyone. He seems to be the real observant one. Braylon snuck a few peeks at his brother and watched Kaden a few times until he got distracted by the thought of food. Tonight we experienced a little bit of the twin thing. Kaden was screaming his head off because he wanted his binkie but couldn’t have it until his oxygen level went back up to normal (he has been very attached to his binkie since getting to breastfeed a little yesterday). While Kaden was screaming Braylon was laying there with his eyes open listening intently. After Kaden had carried on for some time Braylon decided he would start some sympathy whining. It started out as kind of soft cry but when he noticed his brother was going to continue carrying on he started whaling. Both boys were going at it and we were all laughing at the sound of their cries together. I thought I had better get my laughs in now because this will not be very funny for long, especially at three in the morning.
Kaden had another first today. He got to try and eat from a bottle. He did very well but was only given the chance to eat 5mL because his oxygen level kept dropping. While he was getting the rest of his feed through his tube he was still having trouble keeping his oxygen level up. The nurse decided that maybe she would try to suck his nose out a little and, sure enough, it was full of boogies. Kaden also got to be held by someone other than mom and dad also. Last night Great-Grandma Cloann got to hold him and today Grandma Brenda got to hold him while Braylon ate.
Braylon has turned into a little comedian. He was having trouble with his monitor today. The nurses were not sure when the guy could come up and fix it so they said to go ahead and start breastfeeding him and the guy would know to knock since the curtain was closed. When the guy arrived Braylon was still working on lunch. I told him I would just cover up and he could come read some of the numbers off the monitor. It was right then that Braylon came unlatched and pulled of the nipple shield (a little device that helps preemies latch on to breastfeed). I couldn’t get the nipple shield and him latched back on without exposing myself so I just held him with his head up on my chest, under the blanket, until the guy was finished. Braylon decided he couldn’t wait and began vigorously moving his head side-to-side, licking my chest causing the blanket to move too and making obnoxious grunting noises. I kept trying to not laugh hysterically at him. The guy said, “Are you sure you have a baby under there and not a teenager.” We all busted out laughing.
Both boys have continued to gain weight and they are consistently staying a pound apart. Braylon weighed 5lbs 2oz and Kaden weighed 4lbs 2oz. We keep hoping that Kaden might start catching up with his brother so he won’t look so little next to him but I am not sure how long it will be with his brother’s hearty appetite.
It looks like Braylon will be staying a while longer in the NICU. He has been having more and more brady spells over the past couple of days. They appear to be more of what they call central apnea/brady spells which means he forgets to breathe at times. They may have to start him back up on the caffeine to help keep him stimulated enough to remember to breathe. He can go home on the caffeine and the monitor but in that case I would just prefer he stay in the NICU with his brother until he either out grows them completely or they both get to go home. I am just planning on not getting to go home until May.

Back together again



Braylon waiting for lunch


Kaden sitting on mommy’s lap waiting for his first bottle


Kaden getting burped


Both boys in their crib


Kaden rooting on mommy’s finger

Thursday, April 8, 2010

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.

Wednesday, April 7, 2010

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)

Tuesday, April 6, 2010

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.

Sunday, April 4, 2010

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