Tuesday, April 5, 2011

Working on Weight Gain

Here are the most recent weights for our kids:

Caleb is 3 lbs. 12 1/3 oz
Abby is 3 lbs. 13 3/4 oz.
Elijah is 3 lbs. 12 1/2 oz.
Ellie is 2 lbs. 11 oz.

As you can see from above, our little Ellie is having trouble gaining weight. The doctors added a supplement called beneprotein to the breast milk that each of the babies are getting, but Ellie has not tolerated it well. Her little stomach inflated like a balloon (on a baby that small, it’s really strange looking!), so they had to stop adding it to her feedings. On top of that, they are still restricting her fluid intake because of her PDA issue. If they give her too much fluid, it will blow the hole behind her heart wide open, put her back on the vent, and require the heart surgery we want so much to avoid. The way to cause weight gain is to increase her calorie consumption by 1) increasing the volume of her feedings or 2) increasing the number of calories in each milliliter of food. So what do you do when neither of those are really an option?

The doctors and dietitians are working together to try to increase her calories without triggering a bloated stomach or a worse PDA. This week they added some sort of oil to her feedings which is basically an easily digestible fat. So far she seems to be tolerating it and her weight is slowly starting to creep up. It’s definitely not coming up as quickly as they want it to, but some movement is better than none.

They are also considering starting her on some preemie infant formula for a few feedings a day to bump up her calories since I’m not producing enough breast milk for all four babies. The breast milk that I make is formulated exactly for our babies’ needs, while donor milk, even though it’s really good, can’t be that way. Isn’t it incredible that God makes mothers’ bodies in such a way that it knows how to make the best milk for her baby? Wow! The other frustration with donor milk is that it goes through processing and flash pasteurization before it is given to the baby. The processing and pasteurization removes one key element from the breast milk…the protein…which is exactly what Ellie needs to keep growing. So right now, my breast milk is being concentrated on her. However, because she is getting so much of it, the other babies aren’t getting as much and the doctors don’t want to put the others at a disadvantage.

I’ve tried several things to increase my breast milk, including several of the suggestions that you all sent to me via the blog or Facebook. Nothing is helping it increase beyond about 20 ml a day. That’s not much. I’m producing enough for twins, and almost enough for triplets, but I just can’t do quadruplets. I’m trying not to get frustrated as all get out about this. I’ve been working with 4-5 lactation consultants and trying just about everything under the sun to get the volume up. I had just decided that I’d done the best I could and was ready to except the level I had, when one of the nurse practitioners talked to Sean over the weekend to see if there was anything else I could do. I bet most of you never thought you’d hear a prayer request for breast milk supply, but since that’s what our babies need, I’m not afraid to throw it out there! Please pray that I produce enough for these little guys to grow and that the plugged ducts that plague me on an almost daily basis go away!

The babies are all still splitting their time between the CPAP and the nasal cannula. Caleb gets 3 hours/12 hour shift, Abby gets 9 hours/12 hour shift, Elijah gets 6 hours/12 hour shift, and Ellie gets 5 hours/12 hour shift. They all take turns deciding who will be the front runner each day. We thought they were doing well, but one of the doctors over the weekend told us that they should all be on the nasal cannula 24 hours a day at this point. Our kids are progressing, just not progressing quickly enough for what the doctors like to see. Please keep praying for their respiratory issues and lung development as well!

I’m trying to finish getting things ready around the house for them to come home. I never really got to do much while being pregnant because of morning sickness, my sheer size, and bed rest. I’m in nesting mode now! I’ve been told to do as much as I can now, because soon the babies will start breast feeding/bottle feeding and I will need to be at the hospital as much as possible. I had a few women come over to help me this week with a marathon of sorting clothes into sizes and disinfecting and organizing baby gear. That was a huge blessing to me and we got a ton finished! Now I’m just trying to get a few last things put away, organized, and filed, and we will be ready to welcome our kids home!

Pray for me and Sean as we seem to be more stressed out these days. There is just so much baby related stuff going on at home and the hospital that sometimes we get buried under it. We’ve seen some of our kids take steps backwards over the last week with the nasal cannula and feedings, and others pull forward by leaps in both areas. It’s emotionally hard on us to be tugged in both directions at once on a daily basis…and then have the kids switch positions the next day! Sometimes I just stand in their rooms and ask them to pick a direction and stick with it. This is all part of being preemies, we could just use some extra prayers to not get discouraged and keep going.

--Posted by Rebecca


  1. Rebecca, I have a rather embarrasing suggestion to make to increase your milk. You might want to remove this from your blog page after reading it. Ask a specialist about this before trying it. I would not want it to use up milk the babies need, but then again it might work. The way to increase milk is to nurse the baby every two hours for a couple of days, right? Well, if, over the weekend or a day Sean is home with you, have him "nurse" every two hours while you up the intake of calories and water. Tell him there are several calories in breastmilk, so he should decrease his calorie intake during this procedure. Unless he wants to gain 20 pounds real fast! LOL This is from experience, so you see why I said you might want to delete this on the blog after you read it. I know how desperate you must be!

  2. We are all praying for Ellie so she can gain weight and get to come home. Ours grew really quick on the preemie formula, of course nothing is better than breast milk. Just don't wear yourself out, you'll need your rest when they babies start coming home. The hardest part is gonna be when you have some come home and some still in the NICU, the back & forth will just wear yourself out.

  3. I like Paula's idea. GO SEAN!

  4. I am the mom of a former 29 week preemie and just wanted to say that I remember well those days...your comment about wishing they would just pick a direction and stick to it just resonated with me as I probably said that to my preemie more than once during our NICU stay. I am praying for you. Unfortunately I have no words of wisdom to offer as to how to get "through" this as you truly are just "getting through" it. One day at a time, one step at a time. They do progress. And they do come home. I would have laughed at these words 15 months ago while we were still in the NICU, but now being on the other side of it, I know it's true.

    Unfortunately I have no suggestions really on the increasing. I'm sure you are doing most of what I was given. One thing that was mentioned by a nurse and not a lactation consultant was to keep warm water from hitting the boobs. Otherwise when I was having supply issues, they had me pump every 2 hours and then no more than 5 hour break over night. I was also advised to go until "dry" instead of for a timed amount.

  5. Rebecca and Sean,

    You both are doing so well. Prayers are always with you and the babies. I did not have to go through the preemie stage, but I will say that children in general go through good and bad days just like adults. Keep your heads up they will come home and they will be great kids. Definitely sleep as much as possible because things will change dramatically when they are home. I didn't breast feed so no help on how to produce more milk. Good luck on that.

  6. Rebecca, You are doing fantastic. Please do not beat yourself up at all about your milk. I did not bfeed or pump at all for my quads. They only got formula (high calorie) and did excellent. I bfed my big kids and I can honestly tell you, that health wise- there's no difference in our experiences of our kids. I just knew the work of bfeeding one baby and being that I had 2 kids at home that needed me as well, my body needed to heal and I couldn't add the stress of thinking about bfeeding/pumping for the quads. I'm not saying not to do it, just know that they would do just fine on formula as well....even if it's temporary. I had a few nurses make me feel guilty, but I had more nurses encourage me to do what was best for my family and that the babies would be just fine on formula. I did have guilt, but they did great. I will be praying for you and all your requests, especially for sweet Ellie! Sending you lots of hugs and prayers! Many Blessings to you all!

  7. You know you have our Arizona prayers! Keep your chin up and God Bless!


  8. I'm sure you are getting gobs of advice from people who know a lot more than I do and probably someone has already told you this but for the sake of you and the babies thought I would put it out there. I know you are really stressed but that could be part of the issue with the breast milk production. Telling you not to be stressed will be almost like telling you not to breathe but if you can somehow find a peaceful place within those stressful times it could make a difference. Since I don't know you really well I don't know the kinds of things that might help you feel a bit more peaceful but maybe take some time our for a massage or mani/pedi or a girl's lunch at a nice tea house, something like that, whatever would work for you. I know it seems silly to suggest you try to do something like this with all that is going on around you but sometimes something simple like that can relax you just enough to make a difference. Sorry, if someone has already given you this advice or if you think I am a nut case even to suggest you try to be less stressed but I know there are moments when you just need the world to go away and maybe something like this would help. We continue to pray for all of you!!

  9. Good Morning,

    You message has been heard. I love you both and the 4 precious babies although I have not meet any of you! Praying for more breast milk. Also for the stress to be removed so you and Sean can relax and enjoy getting everything ready for the babies. You are in my prayers.

  10. Teresa has a great idea! Let's do lunch and get a pedicure!
    Love you,

  11. Rebecca and Sean,
    I have been keeping up with your blog. I am amazed at how your babies are doing. God is working miracles, just slowly. I am thinking patience is already in his working. With 4 babies patience will be a gift that her gives you.
    I have seen little ones have a difficult time gaining in our nursery. Sounds like they are trying some good options--it is a good thing that they are being patient with this because the PDA is still a fragile thing thy are dealing with. I am praying for weight gain slow and steady for sweet little Ellie. I imagine when you get this pecious little one home she will surpass her siblings with weight-she is just off to a slower start.
    You sound like a breast milk warrior---I am so proud of how you have kept up with pumping for your little ones. Remember you are under alot of stress (even on the days you don't feel it). Don't give up. I am praying for your supply to increase and I am praying for you to be at peace with the amount you are supplying for your babies.
    I am also praying for all the babies and the respiratoy status--I am amazed at how well they are doing. Now 32 weeks right. Go Ellie, Caleb, Abby and Elijah. One day at a time.
    Sean my prayers are with you-so much to juggle- you are an awsome dad. God knows you can do it. He choose you and Rebecca to be the amazing parents, he knows you can do it.
    I meet Mr. Beckett at CMH last week-he is an amazing little guy. They miss you guys.
    Remember God is carring you through this amazing journey-lean on him he will never leave you or your babies.

  12. The first comment was good and then also about the relaxing is a great idea. I don't know what you are already doing. But I'll just tell you what I was told to help increase my supply. Obviously you can't have them breast feeding right now, so while pumping try having either a picture or video with you of the babies. A video of them crying would work best, usually with a crying baby your hormones will kick in and you should have a let down. Also pump till dry like mentioned above. Also Fenugreek it's an herb you can increase the amount you take up to like 6 pills per day to help increase your supply, you can find this at GNC and lacation consultants usually suggest this right off the bat so I would bet you arlready know about it. I've also seen that Reglan can help with the increase but you have to get a prescription for this. I don't remember the dosing for this though. Hope this helps. I will pray for the supply to meet the demands!!

  13. ok bec, i know you will think I am crazy but I have heard that beer helps you produce more milk. something about the hops stimulating the milk. I have heard one a week or even one a day. I have heard most people drink non-alcoholic or light. as a plus it might even relax you a little. just a thought. i am being serious, even though it seems crazy!


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