Bump In The Road

A nurse was here again yesterday for a routine visit and by the time she left, both Rhonda & I felt like such horrible parents. The nurse ensures that baby is eating well, pooping & peeing well, that they are gaining weight, that there are no concerns on our part and that mom is okay. We had Linda for the first two visits and for both of those, Brielle had gained weight. We then had Brielle's first doctors appointment and she had gained weight. And this third visit from nurse Crystal yesterday, she had once again gained weight. As of yesterday she weighs 5 lbs 6 oz and that's with her being completely naked. No clothes or diaper to interfere.

As we chatted and then she weighed her, nurse Crystal said that she had gained from the last appointment and that was good. The gain was within the target range but closer to the low side. She explained a bit saying 4 was low, 6 was mid way and 8 was high. Since Brielle was low, but within the target range, we weren't alarmed, but nurse Crystal wasn't satisfied with the weight gain stating that Brielle should be gaining 1/2 oz. to 1 oz. per day, and she wasn't. She then asked about her feeding schedule and we said she has been on demand feeds since being in the NICU and that from there she had already started her own pattern of waking up every 4 1/2 to 5 hours. The NICU staff (doctors & nurses) was good with this since she was being consistent, was content with the amounts she was eating per feeds and in between feed, was sleeping well, peeing and pooping well and was gaining weight. Plus, they wanted her to wake herself up for feeds; not have us wake her. By the time we left NICU they had no reason to think she wasn't doing well and that we could bring her home to continue what we had been taught while in the NICU. Nurse Linda during her 2 visits was also aware of our feeding schedule and we talked about how the NICU staff was comfortable with this; the only thing being that we should try to not let her go past 5 hours without a feed. And our visit to the doctor also had us explain that she was on demand feeds and was waking herself up between the 4 1/2 to 5 hour frame.

So while the NICU staff, nurse Linda and our family doctor all found no concern with our feeding schedule, nurse Crystal did. She became alarmed and told us that Brielle wasn't feeding enough, we were to be waking her every 3 hours and that such a long span in between her demand feeds was not allowing for proper brain growth and development. At this point, I know both my heart and Rhonda's heart sank. Never was it our intention to harm our baby in any way and to have even one person believe we were doing something to delay our daughters growth, was heartbreaking. We immediately said we'd do whatever it takes to ensure Brielle has the means to grow and develop properly and that we'd switch to 3 hour feeds.

After nurse Crystal left, the rest of our day was spent with that horrible feeling in your gut....you know the one....we've all had it at one point. To even think that we were harming our child in any way is a feeling that just doesn't sit right in your stomach. We both immediately went online to do some research into preemie feeding and care and after reading a few sites, I was then confused. Forums where people post questions and get others responses were saying that the average preemie should be fed every 3 hours or follow your doctors instructions if they believe different. But a NICU site stated every 4-5 hours. Confusing, right? With one comment from one nurse, we had gone from "all of the doctors and nurses thus far think we're doing things right, we have a happy, content baby who is eating healthy portions and gaining weight" to "we are starving our baby and her brain isn't developing right."

After a bit more discussion on our part Rhonda started to do a bit more research into this whole weight gain thing. We were happy with the results but nurse Crystal was alarmed and had at that point called us on the phone saying we needed to get Brielle weighed again by the end of this week to ensure her number are going up. Since Rhonda tracks every weight, pee, poop, feeding, sleeping and event that Brielle has, she looked back and did a bit of calculating on her own. The nurse said Brielle wasn't gaining enough weight each day, that they want to see 1/2 to 1 oz gain per day and that she was on the low end of the scale. After Rhonda's calculations, Brielle has been gaining 3/4 of an oz per day which puts her right in the middle. We were relieved to know we aren't starving our child. Not that the nurse once said the word, and she was nice during her visit, but her alarm with the situation left us feeling like that. And if Brielle continues to gain at the rate she is, we both feel that something needs to be said to the nurse about why the concern? If we are missing something, she needs to clearly explain it to us.

As for the feeding schedule, we immediately put Brielle on the 3 hour feed, having to wake her up each time. Last night was our first night of this and I can honestly say that Brielle was not happy or content all night long. We do not want her to suffer in any way and if we need to wake her up, we will. But to see her crying and fussy was a bit unsettling for me. Up until this point she has been such an amazing baby. She has been eating the same amount or more during on her old feeding schedule than the recommended amount for the 3 hour feeding schedule. I'm sure she needs time to adjust and hopefully she will. It's hard to see her going from a well-rounded girl to an unhappy girl.

Deep in my heart I know we have done nothing wrong, that we weren't starving our girl (her cheeks are proof of that), that we had numerous medical staff teach us and then back what we were doing and that Brielle is a healthy, growing baby. But we want what's right for her and if the 3 hour feeds will be better, we will do what we need to for her. One tiny bump in the long road ahead....