Day 20

Ashwin had another good gain of 82gms - bringing him to a total of 1632gms. The doctor is very happy with his progress and the nurses told her that he seems hungry so they have increased his feeds and the doctor wants to push towards having more suck feeds. He was quite unsettled for a while this morning and then late afternoon - he gets a lot of wind from gulping his suck feeds and seems to be in pain. Of course if I put him on my chest he always sleeps well - it could be because he's upright which helps with wind pain, or it could just be that he prefers sleeping on Mummy. He also slept for a while on Raja who had to put him down in the end so he'd wake for his next feed as he was so happy sleeping on Daddy.

Pictures!

I've finally found time to upload some pictures and have a lot to update. Tuesday night Ashwin was weighed and had only gained 6gms over 2 days (they like to see about 20gms) which was disappointing. I talked with the nurses and we decided to go back to just 2 suck feeds a day. He's been doing very well with the morning feed but when I feed him in the afternoon he's often quite tired so doesn't do as well and the times I don't feel he's had enough I've asked the nurses to top him up with a tube feed. Friday morning we arrived to find during the night he was weighed and had gained 82gms this time over 2 days! Then Friday my Dad visited and got to hold Ash for the first time.



He's very alert for now and the staff are always commenting on how unusual it is and how much they love to see him just looking around taking everything in. We arrived this morning to find they'd removed his last monitors (it's always interesting in the mornings to discover what changes have occured while we're away) so finally we were able to move him about without worrying about leads everywhere. The doctor said she had checked him over thoroughly listening to his heart and chest and was confident he was past the need for the monitors now, though they did take regular checks of his chest today to be sure. For the first time our little man was free of all leads, tubes, and wires and he finally feels more like a normal baby and less fragile.




Because he's been maintaining his temperature so well we also got the go ahead to give him his first bath. He absolutely loved it, looking at us and floating blissfully in the warm water. When I began to lift him out of the water he got upset so I lowered him back in and he settled immediately. As much as he enjoyed it he was then exhausted and slept for most of the day.

The doctor also changed his feeding schedule and he is now on 2 suck feeds followed by a tube feed round the clock. This will take more energy so we're expecting him to have a few smaller weight gains as he adjusts. He's currently 1550gms, so 450gms till we can think about bringing him home.

Day 13

When we got in this morning we found Ash had no nasogastric tube in his nose for feeding - the nurse was waiting for us to arrive so that I could breastfeed Ash. He did really, really well and after a change and a burp had a good sleep and was very settled. As it was approaching time for his next feed I was asking the nurse about putting his tube in when she surprised me by saying as long as he remained settled between feeds she intended for me to continue to breastfeed him throughout the day, and they would put an oralgastric tube in his mouth for his overnight feeds. Apparently if he has a couple of breastfeeds throughout the day and is still settled and gains weight the doctors might allow him to trial moving onto bottle feeds (using the milk I've expressed) for the times I'm not there and he wont need a tube put in for feeds anymore. Once he's on all suck feeds the last milestone to reach before coming home is his weight goal! So the 2nd feed he wasn't as interested and was sleepy, but the last one he did really well again - the whole time I was there today he was fully breastfed and had no tubes and it was so nice to be able to see his beautiful face properly. It was also an exhausting day as once I settled him after each feed I then expressed to keep up my supply. We are well settled in at Bankstown now, I get on well with the staff and we have our own little routine.

Yesterday his Nanna had her first cuddle with Ash - I have some lovely photos of this that I want to put up and I know I promised pictures today but it will have to wait till tomorrow! His Grandad (my Dad) just got back from a trip away and I can't wait to see his reaction to how much Ash has changed since he saw him 9 days ago. Sadly at Bankstown my sister Jody and friend Ains can't see Ash anymore due to a different visiting policy.

Yesterday we spent the morning with Jai and Taj as they really needed some time with us altogether at home. I spent just 2hrs at the hospital in the afternoon - it was really difficult not seeing Ashwin much but at the same time really nice to have that time with Jai and Taj. After me saying Ash wasn't doing so well with feeding he finally had a really good go yesterday. Also I noticed when changing him that he was really hot and they turned down his matress temperature.

Today when we went in we found him in a regular cot! He'd continued to be warm overnight so they'd switched him over and he was having no trouble maintaining his temperature. He had another feed and did so well that they decided to not give him the tube feed that was due at that time and to see if he would be satisfied on what he'd had from me. I was pretty nervous as I've become used to him having his measured, fortified feeds but he was very settled right up till he was due for his next feed which means he must have gotten a decent amount! One of the doctors told me they'd like him to be around 2kg and feeding well before going home so now we know what we're aiming for. He's currently 1462gms. We've also set up his basinette at home as I was finding it quite surreal when I'm at home to believe we've had a baby when there was nothing in our house to indicate it and obviously no baby. We stood looking at it tonight and still find it hard to believe that we'll really have him at home one day soon.

I'll try to put up some more pictures tomorrow - I've been quite tired so not up to it tonight.

Day 11

Ash was doing so well with his feeds that they've moved him to larger feeds (28mls) every 3hrs. He also was very warm in the afternoon so they've turned down the temperature in his matress - if he keeps going like this he'll soon be in a regular open cot. I got a lovely long kangaroo cuddle again and every day he has a go at breastfeeding, though he's not going so well at that now, getting at most 3 or 4 sucks in a row only. He still did get some milk from this as when they aspirated his stomach straight afterwards there was some milk there. At this stage the feeding is more about him practising till he's a little bigger and can feed longer without tiring - and we don't want him to expel too much energy feeding when he needs it all for growing.

We have been amazed and really touched by all the support we've been getting from those around us. We've been provided with a steady stream of delicious meals from my mum, mum's friend, my sister, my friend Ains, and my sisters bible study group - it's such a help not to have to worry about grocery shopping and cooking! We were sent some little gowns with gorgeous fabrics for him to wear in hospital instead of the floral oversized ones and others have been getting tiny clothes for him too. I had snacks and drinks and all sorts of other personal items brought into me when I was in hospital and our neighbours have even been mowing our lawns and taking out our garbage bins for us. My mum has given so much of her time looking after our boys during the day, including school pick-ups and taking them to their regular activities like swimming and dance, plus a whole lot of extra's - parks, the river, and visiting to name a few! She also baths them each night. All this support has made this time so much easier and we are so overwhelmed by the amount of people ready to help and those who care so much about our baby boy.

Brothers

A big day!

Today was a big day! Firstly we got to Liverpool to find Ashwin had been moved to a "hot cot" - an open cot with a heated water matress. He was so content all wrapped up as he loves to be snug. Then the head nurse came around and told us he was going to Bankstown in a couple of hours. People were busy organising all his things and transfer papers, and I was feeling quite excited about making this step till the transport team arrived. He looked so helpless strapped into the transport isolette and I really wanted to just hold him, it was also nervewracking leaving Liverpool where we felt safe and knew all the staff and routines. Arriving at Bankstown was a shock - from a huge room with a zillion monitors beeping and 26 babies to a small, quiet room with just 4 babies (including Ash)!! It was a little scary at first but I can see I'll be able to be even more hands on with him here and I think it'll help with transitioning to home as we'll learn to not rely on all the equipment and monitors and gain confidence caring for him. The best thing about transferring is that Jai and Taj are allowed to visit him here! They were so excited and so sweet with him, holding his hands and watching me change his nappy. I think it's finally real to them and it was nice to finally be all together as a family.

Day 7 & 8

Day 7 Ash was moved again to a spot between the end two bays - there are now only 2 babies between him and the Special Care Nursery room. His long line was removed so the only support he has now is his ng tube. His eyes were tested and we're waiting on the report still. By the evening they scaled him up to full feeds as he was tolerating feeds so well - so he's now on 16mls every 2hrs.

Day 8, today, we got his head ultrasound results and they were all clear, no bleeds at all and no need for any repeat scans. They started fortifying the milk I'd expressed for his feeds to help him gain weight (standard for prems). He was also wearing newborn nappies instead of prem ones. The doctors decided that since he now only needs to learn to feed and grow he can be transferred to the Special Care Nursery at Bankstown Hospital so he can be closer to home. His name is down and will be transferred as soon as he has a place. The professor that was one of those monitoring me during the pregnancy and making decisions about when to deliver Ashwin came to see us and was very happy to see him doing so well as they hadn't been certain if his growth restriction was a placental issue or an issue with him - he also said transferring to Bankstown would be good for Ash as it is a much smaller unit so less chance of infection. We're hoping Jai and Taj will be able to visit him there as they're yet to see their little brother.

Day 6

Ashwin is tolerating his feeds so well they're being increased every 8 hrs now. Raja had his first kangaroo cuddle too. We found he had had a big temperature drop during the night but they thought his nappy had been full and made the bed a little damp which probably explained it. He graduated to a regular small dummy instead of a prem one and also graduated to wearing clothes! They're little hospital gowns but still a big step.

Day 5

By the morning Ashwin was up to 4mls feeds, still increasing every 12 hrs. We tried breastfeeding again at 1.30 and he did well but tired after 5 minutes. The nurse suctioned back up his stomach contents afterwards (they do this regularly before a new feed to check that he's digesting his milk properly and tolerating it before increasing them) and found he'd gotten 2mls of milk! He slept 2 1/2 hrs on me with our kangaroo cuddle today and I even slept a little too. He was weighed and found to have lost only 30gms so was now 1175gms.

Day 4

Ashwin was started on feeds through his ng (nasogastric) tube - 1ml every 2 hrs, to be increased by 1ml every 12 hrs. He also had his first poo! This was exciting because it means his bowel works properly. We had a kangaroo cuddle (skin to skin) for an hour and after lunch he was moved from bay 4 to bay 2, bed number 15. He was out from under the UV lights and at his 4pm cares I changed his nappy for the first time. One of the head nurses syringed some of the milk I'd expressed into his mouth while he was sucking his dummy and he took 2mls so she suggested attempting to feed him to see how he went. This took us by surprise as we thought this step would be a long way off but he fed well on and off for 10 minutes with perfect attachment and oxygen saturation levels of 99-100 (often it's hard for them to feed as they have to coordinate sucking, swallowing and breathing at the same time and their saturation levels can drop). He was very content after feeding and alert, looking around and responding to our voices. Everyone keeps saying what a hungry boy he's going to be and apparently this is quite common for babies that were growth restricted. He then slept for and hour on my chest.

Day 3

I arrived to visit him on day 3 to find he was doing so well they decided to take him off CPAP at 2am. His oxygen saturation levels were looking good though he was working a little hard at breathing so they thought he may end up back on high flow which is a modified version of CPAP to give him a rest. At 4am UV lights were started as he was a little jaundiced. At 5.20pm I got to cuddle him for the first time!! I smelt his head and he had the same sweet newborn smell I remembered from Jai and Taj. During his cares after our cuddle they noticed his left arm with the IV line in was swollen meaning there was a blockage. They decided to put in a long line to an artery to save him having to have canula's done repeatedly and this was done at 8pm. Throughout all of this his oxygen saturation levels stayed good.

Day 2

Ashwin started on lipids at 4.17pm to supplement the IV nutrition. I was up with him at 8pm when they did his cares (clean their face, moisten their lips, and nappy change). We still didn't even know if he had hair as a beanie was put on him as soon as he was born to help maintain his body temperature so when they took off his CPAP to clean his face I finally got to see that he had plenty of dark hair - more than Jai or Taj had at birth! I also got to see his little face properly for the first time and when his nappy was changed saw for myself that he was indeed a boy!! He was mouthing the tube that went in his mouth down to his stomach and very unsettled so the nurse decided to see if he'd take a dummy and he sucked on it immediately and loved it which was a great sign as we weren't sure if he'd have his sucking reflex yet. For the time the CPAP was off for his cares he was breathing well on his own.

Day 1

12-10-11 Ashwin was born at 10.39am weighing 1208gms and 41.5cms long. After a scary few minutes of them working to get him breathing he started crying and didn't stop, so they even brought him over to me for a quick look before taking him upstairs to the NICU. He went onto CPAP Level 5 (positive air pressure to inflate his lungs for him but not breathe for him), had slightly low blood sugars and was given precautionary antibiotics as they weren't sure why he was growth restricted. He was on IV TPN which basically provides all the nutrients he needs. Raja was with him and took photos on his phone and sent them to me so that I could see him. Later that day I was taken up to see him for the first time. The NICU has 5 bays with bay 1 holding the most serious cases. The general rule is that the closer you get to the door (after bay 5 is SCN - Special Care Nursery, then the door) the better you're doing and the closer to going home. He started out in Bay 2.

he's here!

We have a date

Although the ctg went really well and he's very active, the amniotic fluid level has dropped very low and there is a lot more resistance in the cord so they've made the decision to deliver our baby tomorrow. I'll be admitted to hospital tonight and they'll do another ctg followed by one in the morning and then at some point during the day tomorrow I'll have the c-section. We met with a whole bunch of different doctors from different fields today so everyone is ready. The neonatologist in particular was lovely and very positive about outcomes for our baby which really encouraged us. Tomorrow I'll be 33 weeks and 2 days into the pregnancy.

Latest news

I forgot to update what happened on Tuesday. Our original specialist came back from his conference and felt we could push for one more week. We were apprehensive but the doctors were all discussing my case together and he was extremely thorough on the scan checking everything several times to confirm it's the right decision. So we had another scan on Thursday, ctg monitoring today, and Monday we will have ctg monitoring again, doppler scans, meet with a neonatologist to discuss care for our baby, and they will hopefully decide which day to deliver him. If it's later in the week they may consider giving me another steroid shot first. It was difficult at first as we had ourselves psyched up for everything and were worried about something happening to our baby while we waited for them to deliver him but I planned some small things for the boys and I to give myself something else to focus on and have enjoyed the extra family time. I'll update again on Monday. I'll be 33 weeks along tomorrow, which is much further than we expected so definitely a day to celebrate!

The steroids kick in!

The baby has been kicking like mad since yesterday which we were told to expect once the steroids kicked in. Since he was so active we decided to take the boys with us to our hospital appointment for monitoring to get them used to the hospital since we'll be likely spending a lot of time there soon. When they had the monitor on the sound of his heart was so strong and loud in the room the boys jumped up and started dancing to the beat! It was something I wont forget in a long while. Now just to wait till Tuesday when hopefully they'll tell us when our baby boy's birthday will be.

Helpful link for information

For anyone that's interested I found this link which gives a lot of info on outcomes for premature babies and what we might expect. It's hard to know exactly where our baby fits because although he will be 32 weeks gestation he is growth restricted and this comes with it's own complications:

http://www.psn.org.au/images/stories/outcomesprematurebabies.pdf