I walked into the NICU a few days ago and saw that Josiah was no longer on CPAP, but had a tiny, thin nasal cannula giving him a bit of breathing assistance. I tried not to get too excited, because his cannula was removed once before and he had to go back on it.
But this time was for keeps because he’s been on no breathing support for a week now.
Since there were no tubes in his nose he was able to have his feeding tube moved to his nostril instead of his mouth, which of course makes eating through his mouth easier. Since the last challenge he has to overcome is learning to eat by mouth, this is a huge step forward for him.
For the last week I’ve been practicing latching him onto the breast. For the first several days all he did was lick or chew on me although a couple of times he did manage to latch on, albeit shallowly.
Each day he would suck a few times and then fall asleep almost instantly. He would knit his brow and concentrate intently on what he was doing, almost as if to say, “I know there’s something I’m supposed to do with this and I’m just not sure what it is!”
Today was a real turning point because, with the help of the hospital’s lactation consultant and a nipple shield, Josiah was able to nurse for nearly twenty minutes. I have read over and over that most preemies don’t really get breastfeeding until they’re about 38 weeks gestation. Josiah is just over 34 weeks so this is wonderful.
Even better, when he nursed today, he had no trouble keeping his oxygen level up and had no spells of lowered heart rate, which often happens when preemies take their feeds by mouth.
When babies are born prematurely, they have to do four things in order to be sent home from the NICU: they have to learn to regulate their body temperature, they have to learn how to breathe on their own, and they have to learn how to take their feeds by mouth from some kind of nipple. once they accomplish these developmental tasks, they have to pass a car seat angle test. This means that for 90 minutes they have to sit in a car seat hooked up to monitors and have no episodes of apnea or bradycardia.
Josiah is so close now and progress is happening fast as he gets close to “full term”.
I can finally see the end of this journey.