Tuesday night, I flagged down one of Charlie's doctors to talk to her about his weight issues. Charlie gets weighed every night at 9pm and for the past several days, his weight has teetered around 2560-2580 grams, mostly towards the low end. He should be putting on weight every day, not losing or maintaining. The doctor explained that a feeding tube may be the answer for him - it would help him get the calories he needed and get him over the hump. With a weight gain, his bilirubin levels would go down as well. If his weight stagnates, so will his bili level. When he was admitted at birth, he weighted 2776 grams meaning he's lost about 226 grams (about 8 ounces). To put it in perspective, she asked me how much I weighed and told me that if I would have lost the same percentage, I would have lost almost 12 lbs. within a few days. Then it sounded much more serious. I had made peace with the fact that he may need a feeding tube.
Wednesday morning when I returned for his 9am feeding, the nurse told me that his bilirubin level dropped from 10.3 to 9.2 - which was wonderful to hear! The doctor took him off the photo therapy and since his temperatures are good, had the nurse put him back into an open crib. We could even bring in some clothes for him now since he didn't need the lights on his bare skin for the jaundice!!
As a side note, my poor child will not have anything to wear for the first few weeks! Haha He's about 2 inches too long for preemie clothes and about 2 inches too short and a pound too small for newborn clothes! Right now he's in a onesie and the crotch snaps are almost at his knees. Its actually pretty darn adorable. Its amazing - putting clothes on him makes him look more like a baby...if that makes any sense.
Anyway, also on the list of Wednesday's milestones include his umbilical cord falling off and nursing for all of his feedings. He did really well; staying awake and eating until he was satisfied. This afternoon, he's even signed up for his first bath (and us signed up for the baby bath class) now that his IV is out and he's done with the bili lights.
Unfortunately, there was a downside to accompany yesterday's triumphs. When 9pm rolled around, I anxiously waited for the nurse to bring in the scale. 2568 grams...another 2 grams lost. In the grand scheme of things, 2 grams is nothing, but after a few days of losing "just a few grams" it adds up. Even though he's eating as much as he wants, he's just not putting on weight - a common preemie issue. The doctor on call stopped by and said that they were indeed going to put in a feeding tube, but merely as a supplemental thing; I can still breast feed him or bottle feed him, but the tube gives us the ability to top him off if he doesn't take enough.
This morning, he was awake and hungry, with a thin orange tube up his little nose, when I arrived at 9am. He had been eating well all night and hadn't needed the tube just yet, which is good. His bilirubin levels rebounded a bit today, but he's a day older and according to their magical little formula, he's still in good standing and doesn't need to go back under the lights. Despite the slight feeding setback, the doctor and nurses still think he could go home this weekend. They really want to get him out of here since he's otherwise healthy - they just need to make sure he's on a good path with his weight before they're allowed to release him. It all depends on how the next 24 hours go!