I decided I would give a weekly update on Mateo’s progress until we have the little guy home. So here’s how things went down during week 1.
Since Nicole had a C-section, we were able to stay in the hospital for a full four days. The nursing staff was awesome and the room was more like a hotel than a hospital. Despite having a nice big TV, our laptops, comic books, iPhones, and iPads, we spent the vast majority of the time talking. This proved to be a much needed break from “reality” that gave us time to really process and comprehend our newfound roles in life. After all, we are no longer just Nicole and Marc. We are now Mom and Dad. For two confirmed DINKS, that’s a lot to digest!
The four-day hospital stay was a blur but there were some notable events and milestones. First, Nicole started pumping breast milk. At this sensitive stage in Mateo’s growth, mother’s milk is truly the best medicine as it is packed with nutrients and antibodies that are specifically designed for his particular needs. This is biology at its best and it reminds me of why I fell in love with science. In the first few days, all we were able to get were tiny amounts of colostrum. Although we knew this was normal and it would still be a few days before Nicole’s milk came in, it was tough for her not to become discouraged. Fortunately, I was able to entertain her by doing an old lab trick called the “human centrifuge”. When she only produced about .25 mL of colostrum, it was really difficult to collect anything at all. The colostrum tends to coat the sides of the pump chute and never really makes it to the reservoir. Daddy to the rescue! By holding the assembled collection vial in my hand and spinning my arm like a windmill, I was able to extract a few precious drops. I would then collect these drops with a small syringe and run the sweet baby nectar down to the nursery. Now we will never know just how much this extra effort will impact baby Mateo’s recovery, but it certainly made a new dad feel like he was contributing to the process. And the new mom was encouraged because she was providing the thing her instincts told her her baby needed the most. By day 3, her milk came in and we now have a significant frozen surplus!
We came home from the hospital on Tuesday and Nicole was pleasantly surprised by her mommy sanctuary. Little did she know I snuck away each day for about an hour while she napped, and with the help of my mom and cousin Traci we cleaned and organized the nursery. The baby shower took place less than a week before Mateo’s big entrance and obviously we weren’t quite ready for all this. As always, family is there when you need them most. So all Nicole had to do was come home, relax, and heal.
How’s the boy doing? In a word, great! He made significant progress in just seven days.
His breathing was pretty good to start, but he did have an occasional spike in respiration rate. As a result, he was given CPAP (continuous positive airway pressure) via those little nostril prongs. Essentially, Mateo was taking every breath on his own, but the positive pressure kept his airsacs open. Every day, the pressure was decreased until exactly seven days later (Friday) when the prongs were removed. He is now breathing comfortably and steadily and we can see his entire face. w00t!
Although neither of us saw any yellowing of his skin, blood tests showed that he did have a touch of jaundice. So there were several days when he slept in his little tanning bed. This is pretty standard stuff even for full-term babies. In Mateo’s case, it was completely expected because he isn’t receiving full feedings yet. Excess bilirubin (a by-product of old red blood cells) usually passes through the gut and comes out in the poop. Since there is no poop yet, the bilirubin builds up causing the condition known as jaundice. Phototherapy is the answer as it breaks down the bilirubin into products the baby can get rid of. As the feedings increased, so did the poopy diapers and as a result, he is done with his phototherapy.
Since Mateo’s gastrointestinal system is so new, he isn’t quite ready to take on full milk feedings. So over the course of the week, the nurses slowly introduced milk with only 1 mL every three hours via a feeding tube in his mouth. As the volume of milk went up, his supplemental IV nutrition went down. By the end of the week, he was up to 23 mL feedings every three hours, and the IV was down to a trickle. We are expecting the umbilical IV to be removed early in Week 2 since there really isn’t much need for it anymore. His mouth feeding tube was removed on Friday and replaced with a less intrusive nose feeding tube. As he begins to take more feedings by mouth, either at breast or by bottle, there will be less and less of a need for the nose tube and eventually that will come out too.
Thankfully, he is getting 100% breast milk right now. Nicole is providing an ample supply. Once he gets to his full 30 mL feedings, they plan on fortifying the breast milk with a special formula to help him pack on the pounds.
Mateo entered the world at 3 lbs 14 oz. As is the case with all newborns, he lost some weight initially. We knew this so we really didn’t inquire about his weight until this Friday. He apparently worked his way up to a full 4 lbs, but then dropped back to his birth weight. But we are trending in the right direction now and with full feedings and fortification, we expect his weight to start climbing this week.
In summary, the NICU is nearly done fixing everything that needs to be fixed. From here on out his stay in the NICU will consist of eating, sleeping, pooping, and being loved. Nicole and I are making two visits each day and we usually hold him for at least an hour. He does latch on to Nicole’s breast but he’s a little young for the whole sucking, breathing, swallowing thing just yet. Most sources say this level of coordination doesn’t begin until week 34, which is this coming week. But at this point, if he latches and gets his feedings at the same time, we have everything in place if/when he decides to suckle.
I think I’ll close this post out with a little video of Mateo sneezing.