On Sunday, I think that my mom came over in the afternoon, and my dad came over in the evening. This helped because I had a lot of work to catch up on.
My mom came over on Monday morning, and my dad came over in the afternoon. I talked with Jill the nutritionist in the morning. I called her because I wanted to know what we should do with the fortification of the breast milk. Henry had been sniffling over the weekend, so we stopped the Similac Human Milk Fortifier, but I had had a cold, which could plausibly explain the sniffling. Jill said that usually, allergies take on the same symptoms that they've already expressed. Henry's symptoms two months ago were bloody stools. He didn't have bloody stools over the weekend, making the cold hypothesis more tenable than the allergy one. She suggested going back on the Similac. At one point, she and Dr. Tsai had said that once we finished up the box of the Similac Human Milk Fortifier, we could then buy the regular Similac formula in the stores and use that as the fortifier (even though it was designed as a formula and not as an additive to breast milk). Well, I compared the Neocate to the contents of the Similac Human Milk Fortifier and the Similac Formula and found that the Similacs were not comparable when it came to important things like calcium. In fact, the Neocate does a little bit better than the Similac Formula, so why switch? The Similac Human Milk Fortifier, however, has about 11 times the calcium content as the Neocate. Jill wasn't aware of those differences. So she was going to talk to Dr. Tsai about getting us additional milk fortifier through the Similac hospital representative. She said something to me about how I probably knew more about the contents than she did. This isn't the first time that a medical professional has told me that. Sigh. I really wish that the medical professionals knew more than I did about these things. It doesn't instill a whole lot of confidence, because I am not medically trained (I just happen to read a lot because this is important).
In our discussion, I asked her how many milligrams of calcium Henry needed each day. The recommendation for his weight is somewhere between 800 mg and 1200 mg. But, that's based on formula babies, we think. Breast milk content from mothers in the USA ranges somewhere between 200 per day and 300 mgs per day. Why the discrepancy between breast milk and the RDA of calcium? Because breast milk absorbs better than does formula in the babies' digestive systems. What is unclear is whether adding fortifier to the breast milk changes the absorption of the calcium in the breast milk. In sum, Jeff and I are designing Henry's diet plan. We're checking in with the professionals to see what they have to say, but I think that there are no clear answers.
On Monday, Henry weighed 9 lbs 9 ozs.
Nurse Michael called on Monday. He had talked with Dr. Bianchi (pediatrician), who had decided to discharge Henry from the weekly nursing appointments. Michael said that he had mentioned to Dr. Bianchi that Henry was developmentally delayed. I was very calm but wondering what the heck he was talking about. I asked him what he meant. He said, "Don't you remember when we talked last time about Henry and you said he wasn't scooting yet. I told you that he should be scooting around now." I just said OK. And, let it slide. I have enough to worry about at the moment. I think that he's forgetting that Henry's adjusted age is two months old. Yes, he was born over 5.5 months ago, but gestationally, he just a two month old! Development is supposed to be measured based on their gestational age. I went to the message boards to ask other mothers when their babies started scooting around the floor...and several people confirmed my suspicions that babies don't scoot that early (preemie or full-term). I mean, Henry can move a few inches if he's so inclined. I saw him turn his body 90 degrees when he was in the crib once. And, he's moved a couple inches on the floor, but he is by no means "scooting" in any consistent fashion. Dr. Tsai seemed pleased with his push ups at the last appointment.
If Henry is like other preemies, he will probably have some delays, hopefully not permanent ones. I was a 33-weeker and was delayed when it came to sitting, crawling, and walking. I was able to pull myself to a standing position around 14 months. In comparison, my sister Carolyn (who was a full-term baby) was able to pull herself to a standing position at 5.5 months. She was a rather unusual child (pure muscle)...way ahead physically on everything. My upper body strength, on the other hand, was on the very weak side of normal until about junior high when I finally caught up and did well in tennis. So I know that delays can happen. On a funny side note, while Carolyn was very athletic, it took her forever to learn how to swim because she couldn't float (without body fat, she sunk like a rock!).
On Tuesday, Henry weighed 9 lbs 9.5 ozs. My mom came over in the afternoon. I had a meeting at school. My dad arrived in the evening. They both took care of Henry, while Jeff and I went to see Avenue Q, one of our favorite musicals. We saw the original cast on Broadway. The traveling version was good.
Jeff took the first night shift. Henry actually slept almost three hours straight at one point during the night! Nothing short of miraculous. When we switched shifts, Henry had another apnea spell on my watch. I fell asleep holding him. He was asleep too. The alarm woke us both up.
On Wednesday, Henry weighed 9 lbs 14 ozs. My mom came in the afternoon on Wednesday, and my dad came in the evening. We had a nice walk Wednesday evening. It was so nice outside that we sat outside on our porch and listened to Big Bad VooDoo Daddy until my dad arrived.
I went to sleep around 9:30PM. I got up around 11:30PM. Henry had been screaming for "La" (milk), and Jeff was too slow (defined by Henry as any demand that isn't fulfilled within 30 seconds). Jeff had felt good in terms of energy, so he continued watching Henry until 3:35AM and got me up. Unfortunately, Henry didn't sleep much at all during the night.
I talked with Jill either Wednesday or Thursday. Basically, she and Dr. Tsai agreed that continuing the Similac Human Milk Fortifier was the way to go. We don't need to continue the 24 cal approach if Henry's gaining weight so readily with 22 cals. We can also skip the occasional fortification and sometimes give him Neocate instead of Similac Human Milk Fortifier as the fortifier. Dr. Tsai got us another box of the Similac, which is great given the expense.
This morning, we had a nice walk. We continue to walk with Henry every morning and evening. I weighed Henry at 9 lbs 14 ozs...no gain, but considering that his last gain was HUGE, an occasional no gain is just fine.
Henry and I had a good time playing this morning. I introduced him to some new toys. He smiled and cooed. He's expanding his vocal range to include a lot of new vowel sounds. "I" was his first vowel sound (he started saying "Hi" a few weeks ago...it isn't consistent, and he certainly doesn't know what the word means, but it is very cute).
That's about it. My mom is here now with Henry.
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