Thursday, March 19, 2009

Home Again, Home Again, Jiggity-Jigg

Ella, Eli, Henry, and Me
On their first morning out of the hospital


Well, it only took six weeks, and now our family is finally all together! Life has suddenly improved exponentially. Though we are still doing our share of running around, mostly to doctors' appointments.

Almost the moment the staph infection was under control Henry began to complain vehemently about his diminished rations. They began gavage feedings again, but he remained unappeased. He wanted to eat. But between the bowel infection and the staph infection it had been a long time since he'd nursed and he just couldn't remember how to latch. He was so frustrated because he knew he had done it before. So for a time breastfeeding became alternately trying to help him latch and trying to calm him down.

Until that time I had never had any problem with breastfeeding. I remember thinking shortly after Ella was born, "Why on earth did I go to a class to learn this? It's so easy!" Of course it was easy for me - and for Ella. She came out, looked around, and asked, "Where's the food?" and upon latching I could hear her thinking, "Now that's what I'm talkin' about!"

Even though the boys were born "too early" to have the instinct to suckle Henry arrived already knowing how and Eli was just a day or so behind him. In Eli's case it wasn't so much that he didn't know what to do, but more that he didn't expect the usual results! The first time he latched and suckled his surprise was hilarious. Once he tasted milk his eyes flew open in shock, he yanked himself backwards, and stared at my breast as if to say, "What just happened?!" Eating by mouth took some getting used to in his case. After he had come to accept the consequences of suckling he picked up the skill very quickly.

Henry's difficulties helped me understand to a greater degree the plight through which many breastfeeding mothers go. Though I didn't become frustrated as he was attempting and failing to latch, I completely understood why other mothers, especially first-time mothers, would become extremely frustrated themselves. As I'd already had years of successful breastfeeding (2 1/2 to be exact) I really didn't have any fear that I couldn't, nor did I fear Henry being unable to feed. He had done so before, so it was just a matter of remembering and practicing. Part of his issue was impatience: being so frantic to get milk that he wouldn't stop bobbing around and trying to suck at anything he found, not taking the time to get a decent latch. That aspect of his feeding problem continues; if he'd just slow down and relax he wouldn't get nearly so upset! (I have told him this, but it doesn't seem to help. We'll have to continue with lessons on comprehension of the English language.)

Henry - trying to decide if his car seat is edible

Establishing breastfeeding was so important in the boys' cases because they needed to be able to have the energy and ability to take all their feedings by mouth, eliminating the need for the nasogastric tube. Because of Henry's infections, Eli met this goal several days before him. But by that time Henry was taking about 80% of his feedings orally, either by breast or bottle, so we knew they were very close to discharge.

As excited as we were by that prospect, Derek was worried about one thing - since Christmas (when I'd received a gift certificates both for the movies and for East Side Mario's) we'd been planning on going out on a date. My husband had been reminding me that it would be our last chance to go on a date for the next 18 years!


Ella and I get Eli into his car seat for the trip home.

So, the night before discharge we sent Ella to Mum's and we hit the town. Most dates don't end how ours did, however. After a wonderful evening we headed back to the hospital so I could go up to the NICU and pump! Home was just too far away and it was a frigid night so pumping in the car was not an option.

Ella - ready to take her brothers home

You know how, as a kid, you look forward to Christmas for weeks and weeks? You think, you plan, you anticipate the arrival of that day with so much excitement and joy. The day we brought our boys home was like that. The anticipation is so great that you don't think the actual event could possibly live up to it, but in this case it did.
Because of some vehicular issues, we couldn't take our boys directly home, but ended up going from the hospital to my parents' for the night. They graciously gave up their room to Derek, Eli, Henry, and me because the spare bedroom in their house is freezing (for some reason it gets very little heat). Although not what we'd expected, it was a blessing. My father got to hold his grandsons for the first time, which he had been looking forward to. And, after a long, mostly sleepless night, I got to sleep in as there were plenty of other folks around who wanted to take care of the boys!

Derek - tired but happily holding Eli

Having Eli and Henry with us all the time has been bliss - bleary-eyed, brain-fried bliss. Between them and Ella we are kept constantly busy all day and boy do they ever go through diapers! At nights, though, they aren't all that bad - especially when I compare them to Ella in infancy. Perhaps because we keep our room dark at night (compared to the NICU's constant lighting) they've been tending to sleep for four hours straight, then they wake, eat, and get their diapers changed, a process that takes anywhere from an hour to an hour and a half, and again sleep for four hours. When I remember Ella's every-two-hours-without-fail night wakings (which lasted for almost two years!), I feel I'm positively well-rested.

It has been a joy, getting to know our sons in our own environment, without the constant presence of others. Henry is very demanding and impatient, wanting a lot of attention. If he's hungry and you have to first change his diaper he will protest loudly until he gets his milk. He also wants to be held all the time. If he falls asleep in your arms and you try to transfer him to a crib or pack-and-play you are almost guaranteed to hear him screaming within the next five minutes. He's also very strong and determined. He can manipulate his body in order to get himself into very interesting positions and places, so we have to keep an eye on him. And when he's awake, he is unfailingly curious. It's very difficult to hold him in the traditional burping position (vertical, against your chest) as he always pushes himself backwards with his hands so he can see all around himself. I don't doubt he'll keep us on our toes!

Eli tends to be more relaxed, most of the time. He does love attention, but doesn't always demand it. Like his brother he wants to be held a lot. I wonder if this is due to being in isolettes for so long while in the NICU. When there they didn't get nearly as much human contact as most newborn babies, and when they were getting attention it was usually because there was some medical procedure that had to be done, so it was unpleasant attention. Now they can get all the snuggles they want, and they want them a lot! Eli, provided he's not hungry and has a clean diaper, will generally lay quite contentedly in a bouncy chair provided someone is around touching him, talking to him, or even making noise in the same room as him. He just likes having folks around. When held in the burping position, Eli will just curl right up and snuggle, often enjoying himself so much he relaxes and falls asleep. He's also pretty good at self-soothing, having discovered that a thumb can be a pleasant appendage, especially when he's waiting for food. And if a diaper change is necessary before milk time, as soon as you begin to do the diaper change he settles down until the change is over before "reminding" you that he's hungry. Whereas Henry goes all-out crying to get what he needs, Eli will give a loud cry and then stop and wait to see if he gets the desired results. If not, he cries out again. Only if you ignore him does he really yowl.

They're both very smart, too smart in some ways! Eli figured out (sneaky boy that he is) that when he wants Mummy, no one else, just Mummy, all he has to do is pretend to be hungry. He did this in the hospital, refusing to accept the bottle that the nurse was trying to give him but rooting around anyway. When she finally gave up and handed him to me to try nursing, he did nothing more than give a little suckle and then he pulled away, smiled up at me, laid his head on my breast and went to sleep! I don't know if he told Henry about that trick, but now Henry's doing it too.

And on Tuesday, when we had a doctor's appointment for the boys, they had an uncanny sense that they were in a medical environment. From the moment that we entered the examination room until the doctor finally left, they both screamed. In fact, every time she came toward them with a medical instrument they howled even louder. They fought everything she tried to do, even something so innocuous as a stethoscope they tried to get away from. After she left the room, however, they both settled down quite happily! It was kind of spooky, and almost funny.

But, having that doctor's appointment made one thing very clear; feeding less frequently since arriving home has done them no harm, so they must be getting more than they did before! Eli had gained a pound - in just a few days! And Henry was up half a pound. They both weighed in at 5 lbs. 8 oz., making them positively hefty compared to when they were born. Getting to self-regulate their feedings, both in terms of frequency and volume has been a very good thing indeed.

Ella and her brothers - who are evidently feeling camera-shy!

Our next big challenge is going to be establishing a routine - one that includes such things as housework and getting the nursery ready.

6 comments:

  1. They are adorable and she looks like such an involved big sister! Congrats on the homecoming. :-)

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  2. Such a beautiful post. Someday you're going to look back at this, and you'll be so glad that you were able to find the time to document this! I'm glad to see that the boys are doing well. Take care.

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  3. Congrats on the homecoming! I hate to say this, but looking at all the baby preciousness has just made me want to have another one! Enjoy the babymoon!

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  4. Momma Snail - Before making any life-changing decisions, read my husband's most recent post called Random Thoughts on Late Night Parenting. It's been a wild few days!

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  5. How wonderful everyone is home!

    I can't imagine how you have time to get anything done.

    Ella does look so sweet. You can tell she loves those babies.

    Take care and keep warm. I won't torture you by mentioning what the weather is like down here in Mississippi.

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  6. So sweet! I love the picture of you Ella and the boys. I am so glad to see everyone is home and well. Ella looks so proud!

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