Milk: It Does a Baby Good

Simply put: Jackson is a milk stud.  The nurse we have had for the past two days has really been advocating for weighing and breast feeding after being told about the success I have been having with Jackson at breast.  The other nurses are also supportive, but they did not seem to believe that he was getting much milk from me and went ahead and gavage fed him.  I was certain he was getting a lot more milk than they were assuming.  After all, I was the one sitting there being milked like a farm animal.

To determine how much milk a preemie is getting, we do a weight before and after.  They can then translate their increase in mass from grams into milliliters of milk they have consumed.  Easy science.  We tried this once before using the scale in his isolette (fancy name for incubator) but it was not accurate considering his weight was less than it was before he fed.

Side note: Don't even get me started on how we are throwing around the word weight when we are talking about mass when we refer to grams.  Everyone knows we find mass not weight in grams, right?  If we want to talk about weight in metrics we actually use Newtons as our unit of measurement.  You would take the mass in kilograms and multiply it by 9.8 m/s/s (otherwise known as the pull of gravity on Earth) and that is weight in Newtons.  I digress.

It was time to get out the super-sensitive fancy scale.  We found Jackson's mass and put him to breast.  He spent the first five minutes latched on, eyes wide open, doing nothing.  This seems to be his routine.  Clearly he does not mind keeping everyone in suspense as he takes his time getting started. (side note: come to find out he is just patiently waiting for the milk to let down)  Once he got going he went to town.  I gave him 10 minutes on each side.  It was obvious he was getting milk because I could hear him swallowing.  Again, he is pretty good at pacing himself by stopping to take some breaths.  Also, he has had no choking incidents so far.  In general, this kid is a natural.

I was told earlier as I was on the phone with lactation to not get caught up in numbers.  The important thing right now is that we are both enjoying the process and that he is learning how to control the suck, swallow, breathe reflex.  She said most people are surprised how little babies actually consume at first and get frustrated.  I believe the exact quote from my nurse before I got started was "Maybe we can get him to take in about 5 ml and we can just gavage the rest.".

Jackson consumed 48 ml in 20 minutes.

He only eats 36 ml of food per feeding when fed via gavage.  That little piglet ate 9 ml more than he is supposed to and let me tell you, I had to pull him off me.  He was not done eating!  Now, I understand some people may be wondering why this is a big deal.  Breast feeding is a natural process and all mammals do it, right?  Here is the thing, some babies and/or moms struggle at first for several reasons.  The two main reasons this process can be difficult enough to cause people to give up (besides the obvious: pain!) are:

1. The baby has to know how to manipulate the nipple into a certain shape and location in the back of their mouth to express milk.  
2. This process takes a lot of work and jaw strength; the baby actually burns calories just by feeding.

So here we are.  I have super-baby.  He is only 35 weeks along in gestation (technically) and he has instinctively jumped a major hoop in the NICU.  The feeding and growing process is the longest phase parents and preemies struggle through to get out of the NICU.  If he keeps feeding at this rate, we may find ourselves coasting through the last phase of this process.  

Here is what we need to do to bust out and go home:

• Jackson needs to breathe completely on his own without any support.  He is almost there but he is definitely taking his time.  The cannula he is on as of yesterday offers the lowest flow of air into his lungs (o.5 L) and he is on 25% oxygen (he needs to get down to 21%).
• He needs to regulate his body temperature outside of his isolette, which it seems he will be doing very soon.  The temperature inside the isolette is being lowered a o.5 degrees Celsius every 12 hours and he is now in clothing full time to help him stay warm. 
• It needs to be proven that he can feed on his own, from breast or bottle, at every session or a certain amount within 24 hours so we can take out the feeding tube.

All of these things are within reach.  The doctor is giving us a 10-14 day time frame as an estimate depending on if he continues to progress as he is.  Jackson gained 66 grams in mass and is 4 lbs. 7 oz. as of Monday evening.  He continues to get bigger and stronger.  Even though weight is no longer a factor when considering the proper time to leave the NICU and go home, we need to see him on track as far as gaining weight.  In conclusion, Jackson is doing everything we need him to do to go home soon.

Now all we have to do is figure out how to take one of our favorite nurses with us.....

Did I mention I feel like a farm animal lately?