Ten Months

I've been racked with guilt about not having kept this blog up. It's unfair to unload so much bad stuff onto people and then, when things get good, disappear. But frankly, the in-between has been pretty typical baby stuff (thankfully) and maybe it would have been pretty boring. And it's hard to type with a curious set of hands reaching for the keyboard.

Alex is now 1o months old. Figuring out his adjusted age, compensating for his prematurity, is difficult. They say preemies take about two years to catch up to their calendar age. Pro-rated, that puts him maybe at about 8 months...? Anyway, he's been saying "mamma" for about three weeks and said "dadda" for the first time this morning. But, he's really lazy about sitting up and when you hold him to stand, all he wants to do is jump. So, his calendar is not linear.

Now that we're past all the post-hospital follow-up appointments and Alex is seeming quite normal and healthy, the hole where his brother ought to be is enormous. It's overwhelming to imagine two charming, adorable Alexes. But, I try to keep in mind that Nick would not have been anything like Alex, that he might not have ever said "mamma" and he would probably still be in the hospital ten months later... and that by itself would have been intolerable.

On a brighter topic, Alex's blood lead level is a little high. This took us by surprise. Of course, looking back at all the work we've done on the house, we feel like idiots for not having assumed there were dangerous levels of lead in all the paint in the house and now there is lead dust everywhere. So, the taxing process of super cleaning every corner of our house and abating problem areas begins. We bought a $500 industrial HEPA vacuum, hired a lead tester, and the city is sending someone out today to re-test (they are required to, even though we hired someone).

The good news is that Alex doesn't show any clinical symptoms of lead poisoning and we likely caught it very early, just as he started to spend time on the floor. The bad news is... is this why I can't remember what happened ten seconds ago? I get my level checked in a couple weeks.

Seven Weeks or five months

I'd say that I haven't had any time to post, but the truth is that I have been spending what computer time I have available playing Scrabble online. It's addictive and it only requires one hand. Alex is napping (a rarity), so I'm gonna use my bi-ambulism to update.

At seven weeks adjusted (from his due date), Alex is now a healthy, happy 8 1/2 pound baby - almost four times his birth weight - and we couldn't ask for a better outcome. Sure, he cries sometimes for no apparent reason. He seems to want to eat all the time. He pukes occasionally. He goes for days on 6-7 hours of sleep (total, broken into short naps) and I can't get even the most basic of chores accomplished. But, this is life with a baby. I can't say that I am surprised.

He is smiling now, which, for those of you unfamiliar with this magical milestone, makes all the drudgery so very worth it.  I think he actually might be laughing sometimes.  He likes books and watching me type on the computer. He also seems to really like Jazz. We are encouraged, having feared that our genes would conspire against us to create a tone-deaf jock. I suppose there is opportunity yet for him to find the wrong calling.

I know that most men cringe at the mention of breast feeding, preferring to maintain their version of breasts as objects of desire and not infant buffets. But, given all that I have gone through to breast feed my preemie, I feel that it necessary to discuss some of the things that I have discovered in the hopes that it will encourage other parents of preemies to trooper through, because it can be done.

First, despite the mantra repeated over and over at the NICU about how supportive they were about breast feeding, I felt very much on my own when it came to realizing this unlikely goal. As mentioned in earlier posts, the lactation consultants were militant and uncompromising, and ultimately unhelpful. The nursing staff was focused entirely on getting the baby out of the hospital, no matter by what means (i.e. putting Alex on formula and giving me "you're nuts" eyes when I insisted that I was indeed going to breast feed him at some point). Let's face it, a baby who has been bottle fed for two months is not going to take easily to a more difficult means of eating.

But, something happened with Alex and I, something that was greatly underestimated by both the lactation and the nursing staff. I believe that Alex might not have been developmentally ready to breast feed until a couple weeks after his due date. I know that that is counter to what every expert out there will say. They will say that babies can do it as early as five weeks before their due date. Well, they can eat by mouth at that point yes. But, after having totally given up and resigned to my fate with the pump and the bottle, one day, about three weeks after his due date, Alex just figured it out on his own. And from that point on, he needed to breast feed, often refusing a bottle altogether.

That breast feeding is soothing to a baby might seem obvious, but the focus had been, up until Alex decided he preferred mom to a plastic bottle, entirely on weight gain. The bonding thing, well that would be nice, but... My experience with my preemie is that it has been absolutely essential. I believe that it has made Alex more secure, less fussy, and better able to relax on his own. It certainly has allowed me to relax, and to feel a part of the greater mothering world. There is so little help out there for mothers of such early preemies, it is impossible not to feel further isolated by the plethora of literature or advice written with only full-termers in mind.

There are a few things you can expect if you are attempting this difficult feat. One, a lot of babies need to be taught how to breast feed, not just preemies. So, some of the message boards can lend helpful advice, even if they are talking about their full-termers. Two, the baby ultimately has to figure it out on their own. I worked once a day for a couple of weeks trying to get Alex to figure it out. In the end, he just did it without any tricks or equipment. Three, even when the baby starts to breast feed, it's going to take a couple of weeks for them to get good at it. I still throw a bottle in once a day to top him off when he seems like he isn't finishing up on me. Four, babe will be on a much shorter feeding schedule. In my case, we went from three hours on the bottle to one and half to two hours on the boob. It's a pain in the ass at two, four, and six in the morning. But, it is temporary. Better yet, it soothes him to sleep and makes it easier to put him back down in his bassinet.

I can say that, after four months of working toward getting my 26 weeker to breast feed, it has been excruciatingly difficult, but well worth it.

Feeling Minnesota

The Twins. It's a funny name for a baseball team. Nothing scary or ferocious about that moniker. At best, it implies a talent for deception, or a duplicity in character. I wonder what their mascot is. No matter, it is not their year to be world fucking champions.

And the state- Minnesota.  Every time I look at a map of the US without the names of states written in, I'm always left with one hole, one block that I can't put a name to. That would be Minnesota. The blank state. The lost state. The empty home of twins who have failed to advance to the next level.

Today, I found myself spontaneously crying over our lost twin. I don't know. It is just so unfair that he isn't with us. Alex is about 7 pounds now. Had they been born this normal baby size, Nicholas surely would have survived. There's no point in thinking that way. But, you do. You can't help it.

I also realize that, with no family around to help, raising twins would have made me totally crazy. I don't know how people do it. Alex, with his need to be constantly strapped to my body, can be overwhelming. I get by most of the day with just one hand, a hand that should be tending to his brother. And though AO and I have made progress with breast feeding, he still eats mostly by bottled, pumped milk. I can't imagine doing that with two, all by myself, all day long. Nonetheless, I am terribly sad that I don't have that kind of day right now.

Joey

There are specific activities that I imagined I would do every day with my baby when he finally came home from the hospital. We would take long strolls together on splendid autumn days. We would Kangaroo all the time. I would carry him in a sling every minute of the day to make up for all the time that we were separated. Most importantly, we would breast feed. It would be beautiful. But, like everything that has lead up to this point - twins, Nick's C-cam, a C-section at 26 weeks, twin loss - I shouldn't have expected anything at all.

Though we do go for strolls, they are not always peaceful and they have to be carefully timed in between meals, as Alex has a tendency to puke when sloshed about (who wouldn't?). I had no idea that Philly sidewalks were so terrible until I rolled my not-so-sleeping baby along them and then felt like a bad mom for putting him through such a rough ride.

Most of my day is in fact spent trying to get Alex to finish a bottle and then holding him still over my shoulder for an hour in an effort to keep that bottle down. It's tough to take care of my own needs, such as using the bathroom or eating, when I have a baby in one hand at all times. I've learned to do an amazing array of things with one hand. The sling thing is getting easier as Alex gets bigger and I can trust that his windpipe is not getting crushed. But, as with the stroller thing, puke prevents us from going out whenever I want.  It's clear that, for the next 18 years, nothing is going to happen when I want it to.

And breast feeding... as I've mentioned, it's really, really hard to get him to do it. So hard, I want to give up every time we try. It's more exhausting than washing all the bottles.

But, there's one thing that is exactly how I imagined it. Kangarooing. I had actually forgotten entirely about kangaroo care, the practice of holding your near naked baby skin-to-skin, until I read some helpful info today on how to improve the transition from the bottle to boob. A no-brainer, it was suggested that I kangaroo him more. We kangarooed a fair amount early on in the NICU, when he was tiny and fragile, and it was not an enjoyable time. But, as Alex got closer to discharge, it was so cold in the hospital and the staff was so paranoid about him keeping his body temperature that I stopped doing it just as it would have been most helpful. But, as I sit on the sofa with my usually irritable preemie fast asleep on my bare chest, I can't believe I let this get away from me for so long. Of course. Me and my Joey, relaxing together.

Independence Day

Finally. This morning, Alex got his first full meal directly from me. Getting to this point has often felt like teaching Helen Keller how to speak, with a lot of screaming, scraping, and kicking. I had just about given up on the hope that he could learn to breast feed. But, I kept trying, having developed a complex system that involved my pump, a bottle, a boppy pillow, and a beer. And today, I can claim that that McGuyvering worked. Not that I imagine our very next feeding to be as successful as this. But, I can at least start to envision a life without all that bottle washing. Goodness. It's a full time job pumping and washing.

Tonight, I get to get out of the house. The task of parenting has been unevenly doled out to me in the past few days and I've gotten the greenlight from the hubs to hit the town. Independence indeed.

Playing Around

I imagine that we're not alone in this figuring-out-what-the-baby-wants game. I understand now why people lived in villages with large extended families. Parenting is not natural. It's learned, usually from your own parent (that is, if you think they did a good job with you). Responding to the shriek of an infant is instinct. But, the subtler aspects of caring for an infant can be perplexing. Even with all the books, this feels like we're re-inventing the wheel.

Alex mutters a lot. It's difficult for me to make sense of why or what it is he's blubbering about. Since yesterday marked 40 weeks gestation (full term), I consider Alex to be a newborn. I had no idea newborns talked so much-- or were awake for so much of the day yemmering on in their bizarre baby language. Sure, sometimes he's trying to tell me that his diaper is wet or that he is hungry despite having just been fed. But, sometimes, he's just playing around, I guess. Enjoying the sound of his own voice. Preventing me from getting a restful nap. Reminding the tribe that he exists and not to forget him when they move to another cave.

Puke update: We stopped adding formula to the breastmilk to see if he would hold it down better. Hard to say if that's what did the trick because we also just started Zantac. But, Alex pretty instantly ate a lot more per feed and seems generally less fussy. Given that the first two ingredients of the formula are cow's milk and corn syrup, this is not surprising. Keep adjusting until we solve the puzzle that is our son.

Nice...?

Of course things are going to be different when you get home. Our house couldn't be more different than the NICU. It smells weird all the time. The pets are always barking, meowing, or shedding. The windows are open and the unfamiliar city breeze wafts past our sleeping, confused babe. I can see how moving in here could really mess up a boy's system.

But, I have to admit, I didn't figure Alex would be such a different baby once in our complete possession. Gone are the smooth, efficient 75ml feeds that kept him satisfied for four hours. Now a resident of 1550 E Berks Street, he rarely takes more than 40ml for me and that only with great difficulty and much (much) puking. He wants to snack on these half-meals every three hours, every hour and a half at night. So, yes. Just as he has fallen asleep after a long burping/vomiting, he is awake, ready for more. We started him on Zantac today in an effort to reduce his discomfort and hopefully help him keep more milk in his belly. Then, we have to work on his flipped schedule so we can all sleep at night at the same time.

People keep asking me, or I guess telling me, that it must be so nice to have him home after three months of traveling to the NICU every day to merely visit him. I haven't honestly had time to notice how nice it has been. I suppose on three hours of sleep, not much strikes me as nice. And having to share him with the apnea monitor defies the total freedom I had imagined. But, as the boy sleeps on my lap while I watch the Phillies play from the comfort of my own couch -Yes. It's very, very nice.