One bottle forward, two bottles back

Today was a day of almost lots of progress - one of those oft promised sideways days.  Lucas and Olivia started their days with some good snuggling.  Both babies are now usually pretty alert when they started their cuddling sessions and as they get comfortable and their bellies get full, they fall asleep in mom and dad's arms.  It's pretty wonderful.

Mom was getting ready to go pump as the doctors came by for morning rounds.  They were going to skip by Olivia and Lucas for newer and more critical babies, but agreed to stop, saying "we can do your babies now because they're so easy."  Though I'm sure there will be many other instances in their lives where we'll want Lucas and Olivia to get lots of attention from their caregivers, as a NICU parent you definitely want your children to be the boring ones who get bipassed for other children who need more attention.  We're feeling quite lucky that at least as of now, it seems like our children just need to continue to grow.  Achieving the big milestones they need to reach - holding their temperature, gaining weight, and taking all food by mouth - seems to be largely a matter of continuing their good progrees and letting time take its course.  And since the calendar continues to turn each day, all is looking good.

Despite the promise of time taking its course and helping the babies get closer to their developmental milestones, this morning the residents were as eager as Mom to see progress right away.  Both the intern (1st year resident) and senior resident (3rd year) advocated for Lucas to be weaned completely from his canula, since he did so well on yesterday's step-down plan.  The fellow considered the recommendation, but decided instead to try and advance his eating progress.  Though it will be great to see Lucas off his breathing support, even Mom had to agree with the fellow that it's probably best not to ask too many things of him at once.  That is another important NICU lesson - allow the babies to focus on doing one new thing well at a time, rather than overwhelming them with well-intentioned but over-zealous expectations. 

So instead of moving off breathing support, Lucas got a plan for two breast feeding practice sessions and two bottle sessions every day.  That means a lot more time at the hospital for Mom, since the breastfeeding sessions need to be spread out, and it caused a short-lived dilemma as Mom weighed her desire to do everything she can for the babies with her desire to fulfill obligations at work.  Today the work obligations won out, but plans are already being shifted for twice daily (at least) hospital visits, which is good preparation for the 24/7 care that we'll be providing once the babes come home.  As Mom agonized over how to make all the logistics work with breast and bottle feeds, Lucas tried out another bottle.  It was not as successful an experience as yesterday.  Mom thinks maybe he's calmer when being fed by his parents, rather than the nurse or speech therapist, but whatever the reason, after a short-lived rotation in Lucas's day, bottle feeds are being suspended for a couple days until the little guy can consistently display better coordination.  Since he was getting to try all this early - usually starts at 34 to 35 weeks, and today is only 33 1/2 - we are not terribly upset that he has to wait a little longer.  Maybe he's being a gentleman and letting his sister catch up a bit.

Speaking of catching up, Olivia continues to make slow but steady progress.  She's tolerating her feeds really well, enjoying lots of quality snuggling time with Mom and Dad, and gradually spending more time on room air (21% oxygen).  She lost 10 grams today, so she's going in the wrong direction in terms of weight gain to help get her off cpap, but we're sure that's just a temporary step back - weight fluctation is totally normal, and these guys have tended to follow loss days with bigger gains.  She continues to be a rock star with her pacifier, suggesting that she'll be more than ready when she finally gets the go-ahead to try nursing and feeds by mouth.

All in all, a good day for everyone.  It's a constantly evolving thing, learning to live with babies in the NICU, and we hope that before we really figure it out it will be time to go home.