Ready to Eat

Yesterday they gave us the go to start feedings by mouth! Abigail's flow was adjusted to low flow so that she can start to learn to eat.

I tried to nurse her yesterday but I had already pumped so she wasn't too interested. Instead I got to give her her first bottle.  (Sorry no picture we'll get one today)

The nurse practitioner reminded me to not get discouraged if she only took a few mL, to remember that this is the first time she is getting something in her mouth.

Well she took all 40 mLbin about a half an hour. And she did it again early this morning for the nurse.

2 feelings by mouth!!!

They adjusted her to 3 feedings a day by mouth and the rest by feeding tube. As she is learning and getting used to it they don't want her to use too many calories eating and then start losing weight.

I'll keep you updated on her progress.

New Room and more changes!

We are now in the yellow section of the NICU (growers and feeders). We moved on Wednesday late afternoon. The room is huge!

They switched Abigail to all high flow/high humidity on Friday. Then on Sunday they lowered her flow from 5 liters to 4 liters. As they continue to lower she will be able to start feeding by mouth!

Joshua loves his sister and actually sat there looking at her for 10 minutes. We had to convince him to go eat because he was being a little too loud. Every time she did something he would comment or laugh about it. "She put her tongue out," or "She opened her fingers," or "She open her eyes." The more he talked the less Abigail was able to lay peacefully.

BREASTFEEDING DETAILS

I am able to start working with Abigail on learning what to do to breastfeed. I have to make sure that my breasts are completely empty because they don't want her to really get anything since her flow of oxygen is still high. She could aspirate if she gets too much and that could cause pneumonia. The first few times I tried she really wasn't awake enough to do much but she still nuzzled and got a bit of the idea. Today when we did I made sure I was here in time to pump before her hands on time at 8:30 when she is most awake. I was so excited that she latched on and sucked for several minutes. She would pause and maintain her latch and keep sucking! All that coordination wore her out though and she was ready to sleep.

Growing up

Abigail is growing up in so many ways.

1. Respiratory: Abigail has been on CPAP for about a week and has been doing great. They started alternating her between High Flow (no pressure to keep her lungs open) and CPAP starting on Monday. She does 4 hours on high flow during the night and day shifts. With continued success she will spend more time on High flow and Less time on CPAP. Then eventually they will be able to wean the flow completely. She is getting between 23-21% oxygen (21% is room air, what we breath).

2. Feedings: They are starting to train Abigail's stomach for accepting regular feedings instead of continous. Currently she is getting 24 mL of food every 2 hours through her feeding tube but instead of it being continous for those 2 hours the feeding pump delivers it all in 1 hour. Gradually the time will be shortened to 30 minutes. Then they will start stretching her to every 3 hours. So far she has done well. During her hands on time they check how much is left in her belly using a syringe to pull back on the feeding tube. So far she has had very little to nothing left.

3. Abigail is starting to regulate her own body temperature. They are leaving the top to her bed open. Possibly by the end of the day she will be moved to an open crib!

In a crib!!

Joshua also surprised us all this weekend! We went to Travis' sister, Kimberly's wedding. We were so excited to celebraate with Kimberly and Tom, and Joshua was excited to be the ring bearer. Now those of you who know Joshua would probably place bets that he wouldn't make it down the aisle. Joshua is not really known for being out going. He is typically pretty shy and clings to Mom in social settings he is unfamiliar with. 

He walked the whole way with is shoulders up to his ears and smirk on his face!

You can see him sitting in the background.
He liked chasing the bubbles as they blew into the church.

What's new

Sorry for the delay in posting this week has kind of gotten away from me.

Last weekend started with a big change for us. When I called the NICU early Saturday morning I found out that they had moved Abigail to a new room. It is still a room on the Green side (more intensive care) but now we have a window.

Abigail is now a resident of the Butterfly pod. It is so great to have a window now and see the daylight. We were upgraded because Abigail is now ready for the extra stimulation and the sunlight will help her start to regulate her melatonin levels.

On Saturday Rose got to hold Abigail for the first time.

Daddy held her on Sunday before Mommy and Joshua got to the hospital. It was great to spend my Mothers day with my "babies"

On Monday, Abigail had some other big changes. They decided it was time to put Abigail on CPAP meaning she would no longer get a respiratory rate through her nasal cannula. The CPAP still provides the pressure to help her keep her lungs inflated but she is taking all of the breaths herself.

On Tuesday my mom got the chance to hold Abigail before going to pick up Joshua from school.

Abigail is now 34 weeks gestation and 10 weeks 3 days old. She weights 3 lb. 12 oz. She loves her pacifer and even prefers the big girl green Soothie over the purple preemie Soothie pacifier. 

Maybe the pacifier will also help put in perspective her size. I know many people say it is still hard to see how small she is in pictures because you can't tell with pictures in her bed. 

Big Brother comes to visit

The sibling ban has been lifted in the NICU. The number of flu and RSV cases in the St. Louis area dropped enough that older siblings are now allowed to visit their little siblings. We found out right Wednesday afternoon and decided to bring Joshua up to see Abigail.

I picked him up from school and told him the exciting news. He was excited to go the hospital as always but I'm not sure what he thought about going to see Abigail. We went home and cleaned up (Joshua likes to play in the rocks at school and is a little dirty when he comes home).

First stop was a haircut. I have cut it in the past but with a wedding in 10 days it was time for a professional.

He was very excited to get his sticker like Mommy and Daddy get!
And doesn't he look like a pretty awesome big brother with his shades.

Getting ready to walk down the hallway.
He's not quite sure what to think about these new people talking to him

He was definitely a little scared.

But started to warm up

 He sat on Daddy's lap for a little bit in the chair in the room but decided it was time for him to get out. We went to play with the activity tables in the hallway then took a trip upstairs to the pediatric outdoor garden. He was a big fan of the roller coaster. I think he could have rode on in for an hour. I very quickly taught him how to walk the coaster back up the hill so he could do it again all by himself.

Before leaving for the night we went back down to Abigail's room to tell her bye. He was more comfortable this time. It is going to take some time for him to get adjusted to seeing his little sister. I look forward to him developing a relationship with our nurses so that going to the hospital to see Abigail is exciting for him.

I did get him to put his hand on her head and say, "Goodnight" before we left

Big Weekend

The Helmkamp's had a big weekend!

Starting with Abigail

On Friday the doctors decided to was time for Abigail to try breathing with out an ET tube (endotracheal tube). So at about 12:30 in the afternoon they took out her tube and put in nasal cannula using CPAP to force air into her lungs.

Last picture with ET tube! (prayerfully)

First picture with nasal cannula

One of the doctors wanted to take out her tube on Thursday because she was ready but another doctor told him to wait because they told me it would be on Friday. Joshua and I spent the morning on Thursday at the Zoo.

Someone loves the train.

Saturday was exciting because Joshua and I drove to Peoria to watch Aunt Kimberly (Travis' sister) officially become a doctor! Daddy stayed home to spend some quality time with Abigail. He held her for the first time on Saturday. (The nurse informed me that he looked terrified) I am so glad he finally had the confidence to hold his little girl. She enjoyed it quite a bit because they were able to come down on her oxygen at that time. No picture though because he doesn't care about documenting quite like I do.

Joshua and Dr. Kimberly Helmkamp

When I went in on Sunday afternoon I asked when she could start to wear clothes and the nurse asked what we had. We are very thankful to another Zion PDO family for sharing their preemie clothes with us.

3 lbs 3 oz

So far Abigail is doing well without her tube. She doesn't seem to be struggling like the last time they tried. They will check an x-ray on Wednesday to see what her lungs look like to make sure that they aren't collapsing. 

Now she gets to spend part of her day uncovered to start to introduce her to more "day" light.

She is up to 9mL an hour on her feedings through her feeding tube which is 7.3 oz a day.

She enjoys being swaddled and is really starting to like her pacifier.

I really enjoy my time getting to hold her every day.