A Better Day

Olivia at 1 week, 1 day, with a very soft fuzzy duck for scale. She's warm and dry after her first bath.

So yesterday was a significantly better one all around. We actually got into a bit of a rhythm with nappy changes, feedings, and having her learn a little about breastfeeding. She's getting better at it every day. She also had her first bath, which was great and we learned a lot. All three of us were more rested. Yes, actually a couple of the same things happened; a double-dose nappy change (on her medical chart we enter L/A for Large Amount!), and she pulled her nasogastric tube out so a new one had to be put in; but this time the tube went in easier, she was happier, we were all happier. I just talked to the night-shift nurse on the phone and it sounds like both Olivia and Suzanne had a restful night too. We're hoping to get her off some of her monitors today or tomorrow as well; We're excited for that. So good things all around...

I want to pause for a minute to thank our friends Kate and Wim and Ingrid and Jo and Joanne for all the fantastic food they've provided us with; and in immense quantities! it's now a question of which tasty thing to bring, rather than what can I make- a really nice thing. So thank you guys!

Ups and Downs

Olivia in a quiet peaceful moment with mom. You can probably tell this is a close up from the last photo, since I didn't manage to take any new pictures yesterday.

Well, everyone says there will be ups and downs. In the medical sense, Olivia's doing just fine, but yesterday was a challenging day for all 3 of us it seems. The poor little girl had to have her nasogastric tube changed which, as you can imagine, isn't much fun even if you know what's going on . Of course she cried. The whole thing exhausted her so that she didn't have the strength to nurse, which had been the plan, as we're trying to wean her _on_ to the breast from the tube feedings. And it's not common knowledge (not for me at least) that breastfeeding, although mother and baby have instincts and hormones that make it work, is still something that both need to learn how to do, and can have its frustrations, like when your baby is so tired from struggling and crying that she can't manage to latch on and get the comforting, nourishing milk she needs.

Even nappy changes were challenging yesterday, and seemed to also happen just before we were hoping to breastfeed her, tiring her out yet more; we (Bob at least) are still learning how to do it quickly, and yesterday she had a knack for feeling that the nappy was off and she had a clear shot at the bed or daddy's hand. Yes, I crossed a parenthood milestone myself yesterday and was pooped on for the first time. It wasn't that bad, actually, after all it was _her_ poop! I'm sure the parents out there understand- not sure I would have a few months ago.

By the end of the day all three of us were tired and fortunately we all three got to rest. Suzanne got the best night's sleep she's had in a week, Olivia was peaceful most of the night, and I got an extra hour as well (actually not of sleep in the end, but of time to do chores), becaue last night we switched from BST (British Summer Time, equivalent to daylight savings) to GMT.

More progress- less coffee

Olivia and a very proud Mom (or 'Mum' as they say in these parts). She seems to continue to take steady steps which is great. I forgot to mention that she's been on a drug for a few days- the same drug I'm on right now: Caffiene! I guess with early babies caffiene helps stimulate the respiratory system which is, of course, important. I think she'll be a coffee drinker for sure; 3 hours oafter being born she was already mainlining! As Suzanne said, "all that time in pregnancy I was avoiding caffiene, and now she needs it?"

But I only mention this because she's now _off_ the caffiene, which is a great step. She actually came off the caffiene a couple of days ago. But the great thing about that is that after 5 days without caffiene (which would make me into a wreck!) she can be taken off at least one more of her monitors, since she'll have proven that she can breathe by herself successfully. This is a huge thing, since it's the wires that make it feel like she's in the hospital. It's also one of 2 important steps in the way out of SCBU and towards being in a room with Suzanne.

The other important step that we made yesterday is that she graduated to 3-hourly feeds, and is starting to make good progress learning to breastfeed. Once she's fully breastfeeding she'll tell us when she's hungry, but while the tube is still in they want to feed her on a schedule with measured amounts to track her progress; if she digests all we give her, it's a good sign, and she seems to be doing well at that!

Last night the nurse allowed her out of the SCBU for about 1/2 hour to come to Suzanne's bed for some breastfeeding practice, which was wonderful; it was the first time the 3 of us have been alone together, even though it was only curtians between us and the nextbed, it felt very peaceful and relaxing.

Ok, off to the hospital again...

First international visitor!

On Wednesday, Anne Geissinger, our friend who lives in Iowa, came for a visit. She had been in London on business and made time for the train journey to Cambridge to be with us and meet Olivia. It was wonderful just to have a good friend to be with us, even for a short time. Thanks so much Anne!

Thanks for all the well-wishes!

Just a quick note before I go off to the hospital to thank everyone for all the well-wishes and cards we've received; and all the flowers! Suzanne's corner of the ward is starting to look like a botanic garden, there are so many. It's beautiful. I'll try to remember to get a picture and post it sometime soon. ok, now I'm really off to the hospital!

More Pictures

Here's olivia under the incredibly cute quilt made by the Cambridge Quilters, a group that makes quilts specifically for premature babies in the NICU and SCBU.

I almost forgot another major milestone for us; she's off the IV drip! For about 24 hours that meant that there was just one less hose attached to her (it's very challenging to move around with her with all these leads). But since she was doing so well ff the IV, after a day they took the needle out of her little hand (they'd left it in just in case they needed to re-attach the IV). This was a great thing, because the needle and the associated extra "stuff" were big and bulky, like a little club on her arm. A welcome change. Olivia's still monitored with 2 wires now, one for the pulse-oxymeter, and one for the apnea monitor (in case she pauses in her breathing). this makes it much easier to pick her up, which she seems to really like; any time she's a little upset, we can pick her up and give her a cuddle and she calms right down- I just hope it stays that way!

Ok, I'm off to the hospital. I'll send more updates when I can.

More "baby steps"

Olivia keeps improving day by day. I hardly leave the SCBU for any length of time without finding, on my return, that she's taken another little baby step on the road to coming home.

One small step was the Oro-gastric tube (little tube you can see in the photos that goes into her mouth- it's for feeding) was replaced with naso-gastric tube (you guessed it, the nose), which frees her mouth up for getting a start with breastfeeding. We learned early on how to feed her with the tube- it's pretty easy actually- and we try to do as many of her feedings as possible. Suzanne is expressing milk for her, and after a day or so's perseverence with hand-expressing, and learning what works and what doesn't, she's able to just about keep up with the amounts we feed to Olivia. If we fall short, we can augment with a little formula, but we generally haven't needed that much if at all.

Actually, the increasing volume of her feedings is one of the things that's been very impressive; in several steps whe's up to 22ml of milk every 2 hours. It's actually a pretty large volume to see go into such a little body, but she seems to be making use of it!

Right- on the other end (pun intended) of feedings, we've been learning to change nappies!

Another step came recently in the area of staying warm- she's out of the "hot-cot" and is doing all her heating herself. She's a warm little baby. We frequently to give her "kangaroo care" where we take off her (incredibly tiny!) clothes and snuggle her skin-to-skin with one of us, which is great for both! Studies show that kangaroo-cared babies cry less, have an easier time regulating thier temperatures, breathe better, all kinds of good things. Mom or dad's warmth, closeness, the rise and fall of the chest, sound of the heartbeat, all these things are great for her.

Dad gets a cuddle too

Ok, now that I've put up the original announcement, I can update you all on how things have been going since then. It's only been a few days, but things seem to change all the time. For a start, here's a picture of Dad and Olivia, when she was just 24 hours old. By this time she'd gotten out of the Neonatal Intensive Care Unit (NICU) and into the Special Care Baby Unit (SCBU).

Two big steps there were that she no longer needed CPAP (not sure what it actually stands for but some of the letters are positive and pressure), which helped her breathe a bit- not a ventillator, the way I'd describe it is if you had air blowing out of a straw at a little bit of pressure, and the straw was up your nose. This just gave her little lungs the little bit of extra pressure to help her inflate them. She was still doing all the breathing on her own, but it looked a bit odd, with air hoses strapped to her forehead and a little cannula up her nose. The other great thing about moving to SCBU was that she no longer needed an incubator, but rather was put on a "hot cot" which is kind of like a heated waterbed, with lots of blankets piled ontop to keep her warm. No longer needing the incubator was great because it meant she was out in the open, and we no longer needed to reach in through little holes in the incubator to touch her, and perhaps obviously we could give her a little cuddle! Another big step was removing one of the monitors- it had little electrodes on her chest to monitor her heartbeat, now there's just a single wire that goes to a little LED that shines light through her foot, in the process determining her pulse and oxygen saturation (she's usually at 100%!).

Our story begins....

On this day Olivia was born. At 32 weeks it was quite a surprise! Here's the text of an email we sent to some friends and family after the "smoke cleared":


We would like to introduce you to Olivia Oaksford Hawley, born about 8 weeks early at 6:30 PM British Summer Time (like GMT with daylight saving), 22 October 2005. She was 3 pounds 13 ounces at birth, a beautiful little girl.

We had no clue she was coming. Saturday morning we were doing some 'home improvement' type projects in anticipation of the new arrival, and suzanne had some cramps but nothing to write home about when you're only at 32 weeks... We went out for a walk at 3:30 in the afternoon, and about 1/2 way through the walk the cramps had progressed to the point of being pretty strong contractions. we decided to go home and call the midwife to see what we should do, because of course this was too early for 'real' labor...

about halfway home the contractions were frequent and hard enough (we had to keep stopping so that Suzanne could stand up which helped ease the pain) that we decided "you know, the midwife is going to tell us to go into the hospital anyway, why don't we go straight there?" We did and it was a darn good thing! to make a long story short, labor was incredibly fast and Olivia was born at 6:30, 3 hours after we'd _set off_ on our walk in the woods. One intervention was employed, a 'Ventouse' which is sort of like a suction cup they put on the baby's head to pull her out.

Mom, Olivia, and Dad are going fine; Suzanne had no complications, bleeding, or any of that scary stuff. Olivia is doing all the right things so far, and had good breathing right from the start. since she's so small, she'll have to stay in the hospital for a while (she graduated from the neonatal Intensive care unit (NICU) to the Special Care Baby Unit (SCBU) today, which is great. we're working on fattening her up so she can come home! While Olivia is in the hospital, Suzanne will probably stay there as well, as long as there's a bed for her. She's in the "Sara" ward at Addenbrooke's hospital in Cambridge. There may be a way to call her on a phone at some point, but we're not sure how that works yet... we'll send the details when we know.