July 8,2006 - Updates and Nursing Info.

I have just realized in the flurry of emotions about Judah that I had not informed everyone that Silas had gained five ounces at his doctor’s visit on Monday. That makes a total of eight ounces in seven days. Wonderful news! He is now right on track with what he should be gaining.

I have also discovered that there are very few resources for breast-feeding mothers who’ve had infants in the NICU. The issues we face are either not common enough for web sites to address, or people are just unaware of them. Most likely both statements contribute to the lack of information. However, I have discovered a few items of interest on the La Leche League International website that should be shared with all mothers of NICU babes. For that matter, they should be shared with doctors, nurses and lactation consultants who care for sick babies as well.

1.) Foremilk and Hindmilk: When a woman’s body produces milk, the fatty part, or cream, that is produced sticks to the fat cells which form it. The milk which the baby gets first is more like skim milk high in lactose and low in fat. This is called foremilk. The lactose is a carbohydrate and satiates the infant. It eases the panicked “I’m so hungry I think I might die” pangs and allows the infant to finish nursing at a controlled rate. The baby nursing stimulates the woman’s muscles to start contracting and squeezes the creamier milk down to the infant. This is called the hindmilk.

2.) Nursing Infants: An infant nurses for calories not quantities. If a baby is nursed on one side for a bit, he is getting the low-calorie foremilk. If he is then switched to the other side he gets even more low-calorie foremilk. This means he will need a much larger quantity of milk to satisfy his calorie needs. Since the foremilk has a great deal of lactose in it, this can lead to the baby developing colic. Infants are born with the ability to digest lactose (except in rare cases when the infant will die without a speedy diagnosis) but their guts can be overwhelmed with too much lactose. When not digested properly or in too high a quantity, lactose irritates the lining of the intestines and causes the infant to be gassy at both ends as well as highly uncomfortable; AKA: colic.

3.) What To Do: When nursing your infant, allow him to completely empty one side before offering him the other. In women who produce a high quantity of milk, this can be accomplished by offering your baby only one side during a two hour period. Anytime the infant wants to nurse during that two hours only offer him the one side so that he will be able to completely drain it and ingest the creamy hindmilk. When the two hours is up, switch to the other side and only feed your infant from the second side.

This strategy has helped with Silas’ colic. His guts seem to be working better. Instead of going for three, four and sometimes five days without a bowel movement, he now has a few poopie diapers per day.

Our little bear, at three months old, has already started rolling over. This is not usually expected in their development until babies are four months old. He has not only rolled from his back to his tummy with repeated scrunching movements, but he has also rolled from his tummy to his back. We are all thoroughly impressed.
Now for some updates on the other NICU babes I’ve spoken of before. Dustin and Amanda’s daughter, Aunna, still may need a shunt placed in her body. It is a time of wait and see. But they are still on schedule to leave at the end of July. No news yet about Amanda’s surgery.

Becky is having a tuff time. Joshua has gotten the button in his G-tube without incident however, the infection in his broviac, the permanent IV line in his chest, is infected with two antibiotic resistant strains of bacteria. The doctors can’t kill them. Becky was supposed to take the little guy home on Friday but instead they told her that his broviac had to be replaced. Today around five, Joshua was drugged and tomorrow morning the surgeon will remove the broviac. Then for the next four days they will slam Joshua with lots of heavy duty antibiotics. After that, he will go in for surgery to have a new broviac placed. Another surgery, another intubation. More hateful things shoved down his little throat. He already has such severe oral aversion that he vomits when a drop of water is placed on his tongue. Please pray for this to not be yet another major set back for Joshua’s recovery. Becky needs prayer as well to deal with it all. It just seems like too much for one woman to handle. Joshua will be six months old on the 28th of June and has not once stepped out of the NICU. Pray for comfort for both Becky and Joshua through this next step in their nightmarish NICU journey.

Matt and Rachel are hanging in there with baby Judah. He transitioned well to the second ECMO circuit but as of yet has shown no signs of improvement. Oh Lord, I pray with every fiber of my being that You would relax the muscles around his lungs allowing the blood to reach them. I also pray that his little heart would grow loud and strong with a life sustaining beat. Jesus, I pray for time; time for Matt and Rachel to get to know their cherished Judah. Time for him to play with his big brother Asher. Give us a miracle, Lord. You are the creator of all. I know You are capable of performing mighty miracles. I also know we live in a fallen world where sin has brought with it heartache for both mankind and Yourself. I rest in the knowledge that You are infinitely more knowledgeable than I in all things. I pray now with a mother’s heart for the life of my friend’s baby. Please take his body in Your gently hands and make it whole. Your will be done.

Always with love ~ Tanaya

Jeannie writes:

This is from my girlfriend, Karen, who helped so much when Silas was born, even driving to Portland in my car so she could bring us home. It is her little grandson, Judah that is on ECMO right now:

“I’m just sending the web address for my grandson, Judah Matthew Southmayd. He was born June 27th and is at Legacy Emanuel Hospital in Portland, OR, awaiting stable conditions so he can have surgery for CDH, congenital diaphragmatic hernia (a hole in his diaphragm). He is on an ECMO machine that is taking the place of his heart and lung function until his pulmonary pressure is at an acceptable level. Rachel and Matthew are doing well under the circumstances, but it is a very stressful time. Rachel's sister, Naomi (who just had twins in April) has a website for baby Judah: http://babyhomepages.net/judah. Your prayers are greatly appreciated! I've been in Portland since the 26th, and I am home for the weekend, heading back on Monday, so I've been somewhat out of touch. Check the website for updates. If you want to see the twins go to: http://babyhomepages.net/artoff. Thanks again for your prayers!

God Bless! ~Karen Hinderer Ellis~
Healing Wings ~ www.GlycoPlace.com ”

Pray for pulmonary hypertension to be resolved so that Judah can be taken off of ECMO and given surgery. Time is very important. If the doctors don’t see any improvement in Judah’s condition they will not put him on a third ECMO machine. Karen said that there have only been two babies in Judah’s condition that have been given ECMO a third time and both of them were showing improvement. The machines can last up to seven days and he was put on the second one last Thursday. (I’m just sending this email to those folks who requested updates on Silas. I know what Karen and her kids are going through with little Judah. Please forgive me if you don’t want to receive anymore and let me know. It is hard to think of who might be interested in praying.)