A little bit of normal, a little bit of NICU

The Tiny Mighties are doing really well. We were talking to the nurse just yesterday about how amazing it was that they were able to be on the regular nasal cannula considering they were born at only 25 weeks gestation. Somewhat of a miracle actually. Currently they're a few ounces short of 4 lbs.

While we're going about some more "normal" things that you do with babies, a little bit of NICU life still intrudes.
Cameron is anemic which they've been watching closely. He's at the age where his bone marrow should be mature enough to start making red blood cells.
Several weeks back, Wyatt was anemic and he proved that his bone marrow hadn't been ready. He got low enough that his gut slowed down and we had a NEC scare. They had to go through a "rule out" where they go through labs, withhold feedings, and a bunch of other stuff to determine if he has whatever bug they're concerned about. Wyatt had 48 hours of no feedings, which made him very angry and then slowly they had to introduce his feedings back, gradually increasing until he's back up to full feeds.
When I heard Cameron was anemic, panic hit and my mind has been running nonstop about how to prevent Cameron from going through a NEC rule out like Wyatt had.

There's a catch-22 with anemia and their age. They have to become anemic in order for their body to signal their bone marrow to make red blood cells. But with anemia comes more desat episodes. They sleep a lot which with Cameron, is interfering with his learning to nurse and of course, if the anemia is severe enough, it can cause what Wyatt had to go through.
If they give them blood, then their body thinks they made red blood cells and their bone marrow doesn't kick in. You wait to see if he gets better or worse knowing they can't check labs every day because that'll make them even more anemic. You just watch for signs in him to see if he's getting worse.

The plan has been to give Cameron iron and wait. It drives me crazy but I understand the process. Lots of hand wringing and fretting as of late, but we got good news. Cameron has enough iron and his labs show that he's working hard at making some red blood cells. Way to go Cameron!!

So lets concentrate on a little bit of normal.
They're getting better at controlling their body temperature so it was time for their first real bath! Here's Cameron in his bucket.

They were both a little confused at first but then seemed to enjoy spa time. We wrap them in a blanket during their bath to help keep them warm and pull out one limb at a time to wash.

Both boys love their binkies but Wyatt has really taken off with nursing. I think Cameron is close behind and once his blood counts are back up, he'll be off and running as well. Cameron will latch a time or two but is then tired. Wyatt can nurse for a few minutes and then wears out. With them being only 34 weeks gestational age, they wear out quickly.

A sweet little moment when Wyatt seemed to notice me.

One of the problems with being a preemie and nursing is that my supply is that of 8 week old twins. But the boys are just starting. Usually the mother's supply starts out with maybe a teaspoon and gradually increases along with the baby's ability. Complications arise when you have a preemie too young to nurse but have to pump to keep a supply.
If I just put them to breast, it'd be like them trying to drink from a firehose and could actually put them off of nursing. To get around this, I have to pump first so they can play around and only get a small amount of milk if they nurse. Gradually, I'll shorten the amount of time I pump so they're not flooded with milk but can feel like their nursing is getting them rewards. Eventually they'll get strong enough and smart enough to figure out how to control the flow. Then I'll have babies who can do what normally comes naturally for a full term baby.

At some point, I'll have to spend 5 days at the NICU to establish nursing before they introduce bottles. Even when they go home, they'll have to have some fortified feedings, which would be by bottle, to get them caught up on their growth. It'll depend on them and the pediatrician as to how long they're taking fortified milk. I might nurse them every other feeding and my husband can give them their fortified milk from a bottle.

The Tiny Mighties have a lot to learn still, but at least their bodies are healthy and strong enough to start!