Advice Appreciated

Oliver does well sleeping during the day in between feedings, and he does well at night from midnight until the morning (he nursed at 3am and 4am last night). In fact this morning I was trying to nurse him at 6:30am, and he was just too sleepy. I then regretted getting myself up at that hour because Ian and Nadia slept until 7:30, and Oliver wasn't doing well with nursing as he was still in sleep mode. The one time of day when Oliver wants to eat nonstop (and not sleep a wink) is between about 9pm and midnight. Last night I woke him up at 9:30pm for what I hoped would be his last feeding before midnight. I hoped to go to sleep after that 9:30 feeding. I didn't get to sleep until midnight because he just kept crying so I alternated between nursing, bottles, and burping him during that time span. This has now happened 3 nights in a row (started on Monday night). I am open to any suggestions as to what I might do differently so he would sleep a bit between 9pm and midnight as midnight is definitely past my bedtime, especially if I'm going to be getting up at 3am to nurse him.

I spoke with a lactation nurse today. My questions included: when to start trying to get him off the shield (38-40 weeks and he hit 36 weeks yesterday which means in about 2-4 weeks), how much do I need to keep pumping each day, and should I try to move him toward more of a 2 hour feeding schedule (in the NICU they had him on a 3, 6, 9, 12 feeding schedule). She said pumping two times a day was sufficient. Prior to talking with her I was thinking I'd pump 3 times a day (at least 6 ounces total). He's drinking less than that by bottle each day so I would be pumping more than enough to supplement without dipping into our supply in the freezer. I don't want to pump around the clock in addition to nursing around the clock. Also, we're almost out of room in the freezer. The milk is already taking up half of the freezer, and since my long term goal is to exclusively nurse without any bottles, there doesn't seem to be a point in building a huge stockpile. I just want to make sure I'm pumping enough to keep my supply where it needs to be especially as the shield can interfere with one's milk production. She said to nurse him on demand and wake him up if it's been three hours since he last nursed. I haven't been supplementing the bottles of my milk with the Enfacare like they did at the hospital because that was done to get the milk to 24 calories per ounce, but my milk has more calories than that by itself. I do add vitamins (with iron) to his bottle once a day, sodium chloride to his bottles 4 times a day, and diurol to his bottles 2 times a day. Paul had to drive to Geisinger yesterday evening to get the NaCl. I think it's crazy that it was so hard to get salt water and also that a little bottle of it cost $32.72. The pediatrician's office went the extra mile in trying to find a pharmacy that would make it for us (one that is closer). At first Walmart agreed to do so yesterday, but then they said they couldn't. Today the pediatrician's office found a local pharmacy (one that's not part of a chain) that will make it for us so we won't have to drive to Geisinger for the refills. Any input anyone has on the shield, pumping, nursing schedule, etc. would be appreciated!

 

Today I had Ian take his nap in his bed because I decided to use nap/quiet time as a chance for me to get caught up on making some phone calls. I had Nadia wake him up after he had slept for 90 minutes. Wow. This is such a big improvement! Maybe I should have let him sleep longer because he cried for the first 20 minutes he was awake after his nap. I found out the MFM clinic wasn't trying to address any of the medical bills from the other hospitals. I am very grateful for the success they had with the $2,500 laboratory bill from their hospital, but I was hoping they'd help with the others also because the OB office hasn't been helpful at all. I called the insurance today and pointed out that they paid for a certain procedure code once (the one the MFM office appealed) and not another time. The other time it was about $1,200 at the local hospital. The woman I spoke with said they'll review it within 10 days. I'd be thrilled if at least that bill was also covered. I'm not sure I'm going to have much success with appealing the other bills without some assistance from a doctor's office. I also scheduled several doctor appointments - a feeding clinic visit for Ian, Nadia's 4 year physical, Oliver's 2 month physical, etc.

We stayed at home all day yesterday. Today I ran to the grocery store after Paul returned from PSU. The only thing on our schedule today was an OT appointment for Ian. That will be winding down soon as he's not eligible for Early Intervention once he turns 3 years old in December. The kids enjoying Skyping with Alexis and Gabby this evening.