Meanwhile

While I've been tending to our family's littlest newbie over the past week, Roscoe seems to have grown right up.

Apparently, a lot can change in seven days. A new baby, a new routine, a big boy who eats sushi and goofs off for the camera.

I can't wait to reconvene as a family of four. I hope it's soon!

Synchronicity

Every baby in the NICU gets a special quilt sewn by a local volunteer.

When I arrived for a visit a few days ago, Merritt's new blanket was draped over his isolette.

SPACE! Constellations, planets, hot air balloons, kites, astronauts, they're all here!!

A week, already?

So far, Merritt's journey in the NICU has been pretty uneventful (thankfully!). He has been stable since he arrived, and spends the time that I'm not with him seemingly content, nestled asleep in his isolette. I can't believe that a week has passed by already.

For three days he was under the bili lights and could only come out for 30 minutes every four hours.

Now that his jaundice has been addressed I can hold him for an hour or so every 4 hours. Usually we try nursing for the first 30 minutes and then do kangaroo care for the rest of the time.

Merritt is slowly being weaned from each of the interventions currently in place (TPN via IV, nasogastric tube feedings, room air nasal cannula, and incubator). The biggest milestone so far will hopefully come tomorrow night when his intravenous nutrition will be discontinued and we'll begin the process of weaning him from the nasogastric tube to the breast.

The stress and strain of the circumstance is beginning to take its toll on all of us. My days begin at the hospital at 7:30 am and I alternate between spending 2-3 hours at the NICU and 1-2 hours at home, with pumping in between. I don't typically make it home at night before 10pm.

The last couple of days I tried to cut down on the back and forth by staying at the hospital all day, but then I missed out on seeing Roscoe. I'm tired, and it has been difficult to find balance in time spent with each of the boys. I feel a greater pull to be with Merritt, but I still feel terrible when Roscoe looks at me with his big eyes and says "miss you" while rhetorically asking "Ug?" (hug). Andy has only been to the NICU a few times this week, and the distance is making Merritt's existence seem abstract.

Andy and I have been brainstorming alternative arrangements to mix things up a bit, maybe we'll switch roles for a day and see how we each feel. All I know is that I really miss my first little guy, and I think it's important that we get to spend some quality time together.

I'm finding comfort in focusing on the few things that I have control over: pumping, nursing, making sure that I'm available for Merritt as much as possible. It's been hard for me to give up control over Roscoe's daily routine but Andy has filled in for me as seamlessly as I knew he would. It's been an unusual opportunity for Poppa/Roscoe bonding, but I know that home-life demands have left Andy feeling equally worn out.

For now, we're literally taking each day one at a time (parent pow-wows commence nightly before bed, in order to plan for the following day). Breakdowns ensue when we try to think too far ahead, and lately my breakdowns are coming more frequently, and without notice. I suppose a good cry is in order every now and then.

Generally, we're expecting at least another week in the NICU, maybe longer. I have a lot of anxiety about what lies ahead for us as Merritt becomes more independent. I'm not sure how easily some of my mothering principles will integrate with the process and procedures of the NICU. Feeding on demand, and responding to his cries are two of my top concerns. I hate to say it, but often the other babies are left to cry for 15 or 20 minutes and then eventually fall asleep without ever being tended to. I guess I'll have to set up camp at his isolette to ensure that my little lion gets all the attention he deserves.

Any other attachment minded parents out there with NICU experience to share with us?

Happy one week birthday Merritt!

Greetings from the NICU

We're a nursing pair!!

Not surprisingly, Merritt's birth story is not as straightforward to write as I had hoped. In the meantime, I thought I'd provide an update on our nursing progress.

First let me say that we're lucky to have an entire staff of breastfeeding supportive nurses working with us. I knew I was in the right place when the nursing guru and aptly named "breast whisperer" was assigned to care for Merritt.

Andy and I were able to visit with Merritt for the first time about 2.5 hours after he was born. Because he was stable I was allowed to hold him skin to skin for about 45 minutes. I started pumping when we left the nursery and have been following an every 2 hour pumping schedule.

My hope was to provide him with exclusive breast milk, so I was disappointed when they wanted to begin feeding him yesterday morning and my milk hadn't yet come in. The plan we established was to pump whatever amount of colostrum/milk that I could, and then they would make up the difference with formula until I was able to provide enough for his full feeds.

My first two sessions resulted in a combined 1/5 of a cc of colostrum, and at the time he needed 5ml every 3 hours. Slowly but surely I've been able to pump more and more, and I am so proud to tell you that I'm now making enough milk to exclusively feed him, no supplementation needed. I feel like one awesome Momma! By tomorrow my milk should be flowing, and I hope to begin banking surplus.

To coincide with his feedings, I also get to nurse him. The Neonatalogist encouraged me to offer the breast for the first time yesterday morning and Merritt surprised us all and latched on with ease. I forgot how intense those uterine contractions are postpartum (way worse this time than last!). They radiate all through my back and down my legs, and yesterday actually required me to deep breathe through them. Needless to say, Ibuprofin has become an integral part of the routine.

It was difficult to meet Merritt for the first time in the context of the NICU. He didn't really feel like our baby, and it seemed as if we had been catapulted into the unknown. All the barriers presented by the environment seemed to challenge our ability to act on our parental instinct. It can be discouraging to have to ask permission to care for your baby: to feed him, to change his diaper, to be an active part of his daily routine. Negotiating for our priorities hasn't been as difficult as I thought it might be, but we have had to make some comprises as well and concede to those things which do not fall at the top of our must-haves list.

Nursing, as I might have guessed, allows us each to assume our respective roles as Momma and Baby, pure and simple, in the face of all this chaos. The hours we spend together, and even the time I spend pumping, are the highlight of my day.

Introducing Little Sears

Merritt Leonidas Sherman was born at 6:20 pm weighing 4 lbs 2 oz, and measuring 17 inches long. He's perfect. I'll share more about his birth tomorrow!

True love, 4-ever

My day was made when I opened my inbox Saturday morning to find the message, "Andy + Jacqueline: Happy Valentine's Day to one of my favorite couples!".

A graphic designer friend of mine, who has over the years shared her talent with us on several occasions, indulged us with a replica print of an inspiration piece she spied online. I wish I had artistic talent and Adobe Illustrator know-how!

I think I love silhouettes almost as much as Jessa does (remember that fun plate we made for Roscoe's grandma?). It brought a smile to my face to hear of her early memory sitting patiently underneath the bright hotness of the living room lamp with her little brother by her side, as her mother carefully traced their shadows.

The gift was such a sweet gesture, and now I'm dying to send her some photos to make a silhouette to celebrate my two boys and the start of their brotherhood. Or of our dog. Or of my pregnant belly. (Wouldn't it be cool to have a 9 month series?)

Jessa, can you hear me?!

Surprise, it's preterm labor

My water broke yesterday around 12:30pm. I wrapped up a conference call, put Roscoe down for his nap and then settled in for a snack and some email catchup. A few small gushes and a double check in the bathroom didn't convince me, but as I walked back to my computer more water trickled out and I was back to the toilet where I sat for 30 minutes with water intermittently dripping and gushing as I called my midwife, Andy, my mom, and my doula, in that order.

36 weeks is the cutoff for home birth. I'm 33 weeks today. After much debate, and because we thought the baby might come quickly, we went to our nearest hospital, instead of my primary choice located in the heart of DC. I wasn't experiencing much in the way of contractions so we took our time at the house--I showered, we packed my bag, and gathered all the necessities including extra pillows. We left around 2:45; Roscoe was sawing logs in his bed, and my mom was elbow deep folding a huge pile of laundry.

When we first arrived I tried my best to resist any internal exams because they significantly increase risk of infection once the amniotic sac has ruptured. When the doctor couldn't visually see my cervix with the speculum she convinced me to do an internal, my first FAIL.

My cervix was soft, thick, and 1 centimeter dilated. We were told the baby might come tonight, or in a week.

The sonographer paid us a visit and Little Sears was well engaged in my pelvis, head down, and butted up snuggly to my cervix. I thought we might get a glimpse of his sweet little face but it was buried. He's measuring right on track (estimated weight: 3 pounds 13 oz. plus or minus 11oz.) and he hasn't shown any signs of distress so far.

We spent over an hour with the neonatal intensive care nurse practitioner to get a better understanding of the NICU's policies and procedures. At this stage in the pregnancy we're guaranteed a minimum two week stay, and of course the realities that go along with that break my heart, but we're trying to stay positive and advocate for the things that are important to us.

I can't imagine leaving him in the NICU alone. ever. We've been told that we can stay with him 24 hours a day, practice kangaroo care whenever possible, and I've expressed my very strong preference that he receive only breast milk. I was a horrible pumper last time so the learning curve will be interesting. Once he is born we will initiate the process to request donor milk in case he needs to be supplemented.

I was transferred to the ante/postpartum ward and ordered for strict bed rest with trips to the bathroom as needed. I've been able to change back into my own clothes and I have a "room service" menu to order from at all hours so, for the moment, I'm pretty content. Overall we've been pleasantly surprised, staff have been really wonderful and we're bummed that they'll be switching shifts in four hours. Of course, I couldn't escape confinement to the bed and continuous monitoring, didn't get to eat for almost 12 hours, or use the bathroom for the first 6, but comfort measures are hard to come by here. Even pillows are a hot commodity and I'm glad we brought three. 'Tis the nature of the hospital I suppose.

I finally fell asleep around 1:30am but woke around 2:00am with contractions that are now 5-8 minutes apart--they're not painful, but I would definitely categorize them as contractions vs. the cramping I've been experiencing off and on over the last two weeks. I'm torn between wanting to keep the baby in as long as possible (I received the first of a series of steroid injections around 6 this evening), and wanting to avoid infection and the higher risk for a c-section. When my body goes into labor they will not try to stop it. My doula is on call, and my hope is that I will still have a natural, vaginal birth. The current estimate is that he'll be born within the next three or four days.

For now everyone is exercising the wait and see approach, which is just fine with me. I'm still processing everything and I'm grateful for this little lull in activity which not only bides us time to emotionally and mentally prepare in the context of the current situation, but to gather our thoughts around our priorities and to adequately communicate them to everyone on staff.

Keep Little Sears in your thoughts, outcomes are typically great for babies at 33 weeks.