Just like any other baby

Three weeks at home and over 7 pounds but still a week before his due date. What does that mean? He is just like any full term baby you bring home from the hospital. We've just had a few extra weeks of warm up. And as Miles nears term, he becomes well, less like that sweet little quiet baby we got to know so well. He cries louder, fusses longer, refuses to sleep, and wakes up before the alarm during the night. All this makes it much, much harder to keep to our schedule (thank you for NICU for that!) and reduces our already limited sleep.

This is the first full week Dave has been back at work, leaving me home to care for Miles all day. How hard could that be, really? I should have time to go to the store, organize our finances, put together Miles' baby book, clean the house, and of course, make dinner. And somewhere in there, take a nap to make up for the 4 hours of fractured sleep I get each night.

Ah, you might say, "Welcome to parenthood!" We get it and finally all of those books and pieces of advice make sense. Last night, we watched, The Happiest Baby on the Block, a gift from Susan and Eric West. At the time, they told us of the Five S's and we tried to make sense of it but as they said at the time, watch the DVD after the baby is home and it will be very clear to you. And indeed, they were right. The 5 S's for the record are: Swaddle, Side or Stomach, Shush, Swinging, and Sucking - all meant to mimic the womb environment. After a few days of our previously content baby overcome by screaming, gas, and basic fussiness, he was calm in minutes and slept peacefully during the night, until it was time to feed him. And we had to wake him up!

So, as the week ends, things are looking up. I successfully took Miles to the eye doctor (his eyes are just fine!), visited Day One for a weekly weigh in, and enjoyed a long walk in Golden Gate Park with another new mom I met through Golden Gate Mothers Group, learning the truthfulness of another repeated piece of advice - when all else fails, put him in the car seat!

Still to be done - the cooking, cleaning and organizing.

Holy Sh*t, he's HUGE

In the words of the doctor, we are doing GREAT. So great in fact, she thinks we could write a book of our process. Its that good. And why, you might wonder, are we doing so great at...well, since our last visit to her just 6 days ago, Miles gained 13 ounces bringing him up to a whopping 6 lbs 12 ounces. At this rate, our kid will be well over 8 pounds on his due date, just 2 weeks away. Hard to believe at this point, I should still be pregnant and in my last week of work.

The pictures featured are just one example of what a difference its been - the first taken just a week after Miles was born when he weighed around 3 pounds. The other, on Tuesday at almost 6 pounds, 12 ounces, over double his birth weight.

All of this makes the sleepless nights, endless bottle washing, pumping, feeding, diapering, etc completely worth it. Our boy is thriving...despite that well, he is a just a wee bit constipated. So maybe those extra ounces could be stored up crap. In the NICU when the weight of his stool was charted, he once had one over 1.5 ounces so its reasonable that it could add up to a few days could add up to a few ounces. Fortunately, even this according to the doctor is not cause for concern. Some poor babes even go seven or eight days at a stretch. As long as he is not in pain, its fine though we are encourage to massage his belly and after a few days, stick a vaseline-coated Q-tip up well, you know where...

His progress even made us forget about that incident a few nights ago. His unexplained fussiness, his full-on rooting, his near crawling up my chest made no sense. We contemplated calling the after hours doctor. Hadn't he just been fed? We keep a detailed record of how much he eats, when, when he poops, pees, how he sleeps, fusses, etc. Blame it the lack of sleep but it took us a good 30 minutes before we realized that indeed, we, well, forgot to feed our child. Sure enough, a 4 oz bottle of my finest milk put him to sleep.

Next week, Dave goes back to work so it will be another adjustment but for now, we are glowing in our little guy's growth and again feeling so fortunate for him and his health.

Please just don't call him small

Its been 8 days since we brought Miles home. Eight days for him to find his voice, put on a half of pound and for us to figure out our own schedule, absent the hospital regulations. Everyone has an opinion - everyone that has kids, that is - and each time, I need to remind someone that Miles is not like any other baby. He is still just 37 weeks old, or minus 3 weeks corrected, and if all had gone as it should, I would be bitching about how big and fat I was.

The same rules that apply to term babies dont apply to preemies. My sister reprimands me for counting the ounces he drinks - she thinks the hospital brainwashed me and he need to be exclusively breastfeeding. He also needs to gain weight. More than one person has noted how small he is. I feel like a broken record saying, "He's huge to us!" with a big smile on my face.

Miles has grown quickly to not only enjoy but to demand, his cuddle time. Put him down early and his previously not so shrill cry pierces through the house, quieted as soon as his head is comfortably on mom or dad's chest and little hands grip for dear life. This is usually in the middle of the night and I have taken to hold him on my chest in bed, working hard to stay awake. Most people would say that babies need to learn to cry it out some but again this is where preemies differ. For the first six weeks of his life, touch was more often than not associated with a nurse who handled him as a job not love. Touch meant shots, cold wipes, temperature taken, monitors moved, tubes inserted in his throat and only once or twice a day, the warmth of me or Dave. So for now, on doctors orders and at least until he is term, we have carte blanche to cuddle, coo and love him as much as we can, crying or not.

And as you can tell from the pictures, there is a lot to cuddle and coo at. With every ounce, he comes into his own even more, becoming more delicious and sweet.

Where does the day go?

Really how hard can it be to care for 5 (almost 6 pound) little infant? How much gear is really necessary? How can it possible wipe out two professional, in-shape and somewhat logical adults? Welcome to Miles' world. We are on day 6. Miles is winning and we are eager co-conspirators against our own best interest.

We left the hospital on a schedule. It worked well. He ate every three and a half to four hours. Before each feed, we'd wake him up if he wasn't rooting (he never cried!), change his diaper and then breast feed him or go straight to the bottle. Time permitting, we cuddled as he fell back to sleep and then back into the crib until it started all over again. Ah, the good old days before a ten minute cuddle became two perfect hours, when the industrial strength swaddle (thanks to veteran nurses) lost to the $25 organic Kiddopatamus swaddle aka straitjacket became a toy for Miles to escape (and with great fanfare) when his cute sounds once white noise in a hospital nursery each became cause for concern for his ever present parents. Miles is now in charge and we are along for the ride.

Whatever it is we are doing, he is at least thriving. As of the doctors appointment on Monday, Miles picked up over 5 ounces since leaving the NICU putting him at 5 pounds, 12 ounces. He is steadily eating more each time and thanks to the wonder of the nipple shield, taking to the breast a couple times a day. Each day, we are amazed at his growth. His head has become a weight to be managed as we carry him to and fro, always, always worried about supporting it. Even his little ankles are now a little pudgy - the hospital bracelet (yes, I forgot to cut it off) was nearly cutting off his circulation this morning.

All of this growth is in part in thanks to the houseful of products at his service. The Moses basket in his bedroom serves as his daytime retreat. For feedings, he lounges on the Boppy, covered in any one of his receiving blankets to catch up his drool. The newborn Boppy provides comfort in between sessions and then in the evening, he goes down next to Mom in the co-sleeper. At any given time, we know he is breathing and the exact temperature of his room, thanks to the AngelCare monitor. And just in case, he holds his breath for 20 secs, an alarm will go off, loud enough to scare him to take a breath. Should he need a walk, his carseat comes equiped with its own fluffly blanket (not that its needed this week) and sunshade to protect him from all the elements. .All of this comes with 24 hour service of washing and drying his bottles, fortifying and pumping his milk and changing his dirty diapers at every whimper.

And in case you were wondering, we are loving every minute of it.

Our little boy is home!!!

Yesterday was a big day with Miles' circumcision and his first night without the evil monitors and accompanying cords and under the careful watch of his parents.

Who knew a circumcision could be so hard to arrange? Apparently, if you are not doing a bris, it is the job of your OB to perform the rite. But if you deliver 10 weeks early, obviously circumcision is not done right after birth like for full-termers. So when we started down the bris route, the hospital put us in touch with a moyel who also happens to be an OB. However when we decided to just circumcise, the moyel told us to check with my OB who hemmed and hawed and then after multiple phone calls and precious days, she convinced another doctor in her practice to do it.

So yesterday at noon, under the careful knife of Dr. Horowitz and the Olympic Circumstraint, with mom watching on, Miles became an MOT. Fortunately with a circumcision, they use lanacaine to numb the area vs a bris when its just some sweet wine on the baby's gums. And Dr. Horowitz even threw in the prayer, making it more than just the cutting of the foreskin.

Last night felt like deja vu as Dave and I trekked back to the hospital around 10 pm, the same time we went in when I had preterm labor. We checked into our room on the post partum floor, where I had been after Miles was born. And this time, we were those people with a baby in their room. Chrissie, our favorite nurse, removed all of Miles attachments - oh, how much easier it was to hold and move him around!, weighed him for the last time (a whopping 5 pounds, 7 oz), stocked us up with diapers, wipes, swaddlers, burp clothes and medication for his circumcision and then off we went down the hall, where she left us alone with him for the very first time.

Our first thought....now what? And to help us, Miles pooped us and wet through his last remaining clean outfit. After changing him, the clothes and the bedding, he rejected the breast and downed 90 mls (3 ozs) from a bottle in 15 minutes, pooped again and then finally went to sleep. I still had to trudge back to the NICU, pump even more milk for him and finally got to sleep by midnight, giving me two hours of sleep before his 2:30 am feeding. And again, he rejected the boob, opted for 3 ozs in the bottle and while he and Dave snoozed, I pumped once again. When Chrissie arrived at 6:30 am and offered to take him off our hands one last time, we jumped at the chance.

And somewhat sleep-deprived, we brought him home around noon, noting the songs played on the radio - the first music of Miles life. Neil Young's "Long may you live" was first. How fitting. As we unloaded him from the car, a woman with a stroller walking by asked if we were bringing a new baby home. I choked up when I said that it had been a long time coming.

Finally, after 45 days in the NICU, Miles has made it home. We could not be happier and are transfixed by his presence. Baker is curious and so far, aloof.

In his big boy seat

We are now one day away. Miles passed one of the last hurdles, the car seat test. He liked it so much in fact that instead of staying in it for the requisite 1 hour, he slept soundly for two and a half before it was time to change him. The last thing is for Miles to get circumcised which will happen some time today. We opted not to have a bris for him as he won't be able to be around many people for a few months and will do a naming ceremony when he is 6 months corrected age (based on his actual due date of February 4th which would make him minus 4 weeks old right now.)

Tonight, Dave and I will room-in with Miles at the hospital. He will be taken off all the monitors - hooray! - and the three of us will be together for once! It will be up to us to wake him up for his night time feedings and changings but have the benefit of a nurse nearby in case there is an issue. Tomorrow, he will get one last exam and then we will take him home by noon time.

San Francisco friends - we'd love for you to come meet our little guy but don't even think about it if your nose is as much as running! As strong as he is to us, remember he is still minus four weeks old!

Our big boy

You might think we were upset that Miles had to stay a few more days in the NICU. Quite the contrary, it has turned out to be a very good thing for all of us. If he had come yesterday, we would have handled it and it would have been fine. But these extra days have given us time to relax, milk the most out of the nurses and for Dave, finish up work so he is able to take a couple weeks off.

Miles has a few more days to mature, which like time in the womb, every day counts! He becomes more stable every day, and the ever ominous oxygen sat levels stay in the lofty 90s even when he eats. Back when he was learning to nipple feed, we'd often see them plunge to the 40s because he forgot to breathe when he swallowed. And thanks to the encouragement from a crew of amazing nurses this week, I am breastfeeding Miles at every feed for as long as he can go. Last night, he stayed on the boob for a long 45 minutes and only needed half of his bottle afterward to satiate himself.

Today is the carseat test. Miles sits in his carseat for an hour while still hooked up to the monitors to ensure he doesn't desat or have any Brady's. Another family's scheduled departure was thrown off when their little girl had a Brady in the carseat. Fortunately that kind of Brady doesn't "count" except to figure out a better position for him in the seat.

Miles is now 5 pounds, 4 ounces and looks like a different baby from the one we met 6 weeks ago, except for his beautiful blonde hair.

Be careful what you wish for

Yes, I wished for him to come home. But I also wished that he would come home in February after I carried him to full term and that didn't happen. I wouldn't wish harm on my son, really but I might have whispered that a Brady here and there was okay. I wasn't really serious. He should have known I was kidding. But like a good son, he delivered and good enough to keep him in his warm corner in the NICU until 7 Brady free days pass by. Since he had it on Friday, this Friday is the new D-day to bring him home.

Are we frustrated? A bit because the Brady happened on Friday night but today was the first time, we heard it was an issue. We spent the weekend frantically taking care of last minute details and training. And then, Monday morning, its another work week and a new year and the full time docs are in. Apparently the weekend docs feel no need to check in with you or carefully review his chart. You'd think we'd have figured this out after 6 weeks! So our doctor for the week - Dr. Nancy, who is very nice, made the call. So now at least there is time to get him circumcised and yes Dad, he is big enough now.

On the bright side, we are ready so we can enjoy these hopefully last days. We can stock up on groceries, go to a movie or two and as always, spend long hours at the hospital, feeding, changing, and just staring at Miles and for me, more pumping!

And in case you were wondering, the umbilical cord issue is resolved and Miles is now a fighting 5 pounds, 3 ounces. So big in fact that he outgrew two of his preemie shirts.

The last days

If you have been following the blog, you know that one Brady will hold Miles in the NICU for another week. But even that is not so clear He had a Brady today. It was a mild, self resolved one that lasted only 5 seconds but still it had to be charted. It shouldn't keep him but we will know more tomorrow. And now there is the umbilical cord. The cord stump should dry out and fall out somewhere between 7-10 days after birth. He has been in the NICU for 42 days and still has a stump yet until today, no one thought much about it, other than telling us we cant submerge him during a bath. Turns out, it was sutured in there because he had some bleeding when he was born - the same bleed that took 10% of his blood and required a transfusion. So they took out the suture, the stump fell off and the remaining stub was wet. Not a good sign and according to the nurse and doctor on duty, they really arent too sure what to make of it. We have to wait for the surgeons tomorrow. And until then our boy has been undressed and put back in the isolette where they can keep him warm. Maybe I shouldnt have said so many times how lucky we have been!

So assuming there is really no issue with the cord and that Brady isnt counted, he will come home on Tuesday. You know how the last days of vacation feel? Combine that with the feeling of last minute cramming for the most important exam of your life. That is where Dave and I are right now. For the last few days, we have been rushing around getting all that we need for him at home, taking detailed notes on how to feed him, how often, on the breast or not, with what fortifiers, vitamins, and also trying to take advantage of the freedom of not having a newborn in the house. And we still need to learn how to give him a bath but there is that issue with his umbilical cord.

But we are ready. The cosleeper is set up, the changing station is stocked, the clothes are washed, the sheets are clean, the bottles are sterilized, and thanks to our favorite nurse, Chrissie, we are loaded up with hospital goodies. Tomorrow night, we will room in at the hospital. The monitors off, Miles will finally be with just us but with the nurses just a call away.

I won't jinx it by reminiscing about the NICU and giving a post mortem on the best and worst nurses and doctors. There will be plenty of time for that. First, lets see about that Brady, his umbilical cord then he needs to be circumcised and pass his car seat test..and we need to find our camera!

Could he really be ready?

First things first, Miles finally hit the 5 pound mark today by just 2 grams! But on to more important progress....

Is it so bad to want just a few more days? That, when the doctor said "a couple weeks", we countered it with the nurses caution not to expect him home until much closer to his due date. That we never imagined the fifth Brady Miles had on December 29th would be his very last. And that was BEFORE they took him off the caffeine. That we never considered that when push really came to shove, insurance would call the shots on when Miles was ready to go home. The thing is after he can maintain his body temperature, eat from a bottle and go 7 days without an A or a B, there is no medical need for him to be in the NICU, even if he is not even 36 weeks.

So if you have not figured it out by now, Miles is coming home and soon, very soon. And each day, it gets sooner. On Monday, we thought it was end of next week. It seemed like a safe bet. He was still having apneas and Brady's. On Wednesday, Dr. Lewis told us to be prepared for next Wednesday and the social worker scheduled our discharge meeting for Friday. On Thursday, the doctor on call cautioned it might be as early as this weekend based on his last Brady. Then today at our meeting, it was tentatively set for Tuesday, January 6th, when he will be six weeks old and just one day shy of 36 weeks.

You might ask if we are excited? That is just one of the emotions. With all of this time since he was born, we should be more than prepared but somehow it feels like it came out of nowhere. We have been spoiled in the NICU. The nurses measure and prepare the bottles. I just show up, change his diaper, take his temp, grab a clean pillow case and sit down to feed him. When he doesnt burp or won't eat, I ask for help or another nipple to try and when all else fails, they take over. Bottles, nipples, storage containers, vitamins, fortifiers, diapers, wipes, swaddles, hats, clothing...its all provided and washed for you. My point is, yes, we are very excited but nervous, like any first-time parents bringing their baby home. How are we going to take care of him without a nurse on hand? That he is a preemie makes it all the more scary!

All the same, we are looking forward to having him here....finally. No more monitors, back and forth trips to the hospital, endless pumping, parking tickets, etc. Our 5 + pound little man will take his place on 26th Avenue and before we know it, will be chasing Baker around the house, pulling his ears and tail, keeping us up all night and generally wreaking our havoc on our lives.

A word of caution, one Brady resets the count back to 7 days....