Josiah Update

I’ve been wanting to update on our little preemie for awhile now, but between nursing him constantly and/or holding him while he sleeps, it’s tough to have time for much else.

Mostly I’ve wanted to write a series about breastfeeding a preemie, only it would have about a dozen chapters because there isn’t just the fact of “nursing a preemie”. It’s complicated, like everything else about preemies, it seems.

The series would end up looking something like this:

• Is This Thing On? Why You Can Pump For Hours And Get Two Drops Of Colostrum
• It’s All In Your Head: Letting Down for a Pump
• Getting to Second Base: Manual Expression of Breastmilk (Alternate Title: Feel Me Up, Buttercup – But Warm Your Hands First)
• This Thing Sucks – The Love/Hate Relationship with Your Pump
• Illegal-ish Drugs From Thailand: Galactagogues 101
• How to Teach a Neonate Who Should Still Be a Fetus For Several More Weeks How to Breastfeed
• Homecoming: Overcoming Nipple Preference After All Those Bottles of Pumped Milk In The NICU. Coda: How to be More Stubborn Than Your Baby Because You Refuse to Pump and Bottlefeed Now That You’re Home
• Feeding Cues … What Feeding Cues? “Demand Feeding” A Baby Who Would Rather Sleep
• Post-Frenectomy: When Your Baby Forgets How to Suck on ANY Nipple (Also, Frantic Googling All Night)
• Angels Among Us: Lactation Consultants Make House Calls
• The Magic of Skin to Skin Contact (And How To Pull It Off With Teenage Sons in the House)
• The Mastitis Diaries, or How To Get the “Flu” Twice in One Month

So… yeah. Complicated.

I can see why so many moms decide to exclusively pump and bottle feed their preemies.

Young preemies don’t have the same feeding cues as termies. They basically need to be feeding constantly when they’re awake, and stimulated to stay awake so they’ll fill their bellies.

Because they tend to have a weak or disorganized suck, they have to nurse for longer periods.

Josiah loved to nurse from the beginning, but mostly for comfort. If he was hungry (for instance, when he woke from a long nap), he would scream and fight the breast. It just wasn’t coming fast enough for him, like all those bottles in the NICU.

The first week he was home from the hospital, he gained a whopping 9 ounces.

But then when he had his tongue and lip tie addressed, he lost weight because he soon forgot how to suck. Talk about panic.

I invested in a digital baby scale so that I could track his weight gain without having to schlep it to the Pediatrician.

The good news is, he still loves to nurse and is gaining steadily. The worst is behind us.

I’m really, reaaaaaaly looking forward to the time when nursing is easy and fun the way it was with my other babies, but I know it will take time.

His adjusted age is only shy of 4 weeks, and many full-term babies take 6 weeks or more to get the hang of nursing.

If anything, this experience has taught me to be patient with my baby and trust that things will happen on his timetable.

Because his chronological/actual age is nearly 17 weeks, he’s a bit more advanced in some areas than a 4 week old. He’s been lifting his head and trying to flip himself over for weeks and is very strong.

But socially, he’s like a newborn. 

Just the other day, he cooed at me for the very first time.

I put him down and changed his diaper, singing the little song I made up for him. Afterwards I was sort of just gazing at him when he did that cute little thing newborns do, bringing his hands together in front of his chest, and he opened his mouth and “talked” to me.

I just about melted. A couple of days later, he cooed at daddy.

We’re still in quarantine mode, and I rarely leave the house. When I do, Josiah stays in the car unless we’re at the park or other open-air area. It’s just too risky to expose him to crowds right now.