31 Week Preemies

Until we had our triplets last Friday, we had no idea what a 31 week preemie could do on his or her own and what still needed to be developed.  Although Micah and I have had a crash course in our babies' needs, I realize that most of our friends and family do not know what to expect so I thought I would try to explain a little.  I am certainly not an expert and I'm sure I don't use all of the right terminology (I just learned last night that a nostril is actually a nare...), but I'll do my best to explain as I understand right now.

First, they need help breathing as their lungs are not fully developed yet.  Alexis, Faith, and Jack are all on CPAP breathing machines, which essentially helps open up their lungs to help them breath.  Some babies require extra oxygen through the CPAP, and each of the triplets has had occasional extra oxygen as their stats changed, but currently all are on room air.  I am very anxious to get rid of the CPAP machines as all three have oxygen saturation levels of 95-100% most of the time so it doesn't seem like they really need extra help to me, but the doctors are cautious and feel that the machines are helping them as they grow.  As their mom I am just anxious to get a good look at their little faces, which is pretty much impossible with their CPAP's covering their faces (Micah calls it their "storm trooper gear"), but the doctors are definitely the experts in this.

Jack being held by Grammy Howard.  The CPAP totally takes over his face, but his little eyes sure are cute!

Babies don't really learn to suck, swallow, and breath until around 34 weeks.  The nurses told me last night that since the triplets are now 32 weeks than can work on bottle feeding as soon as their CPAPs are off (another reason to hurry it along in my opinion).  So right now they are all being fed through small tubes that go through their mouths and into their stomachs.  Normally this feeding tube would go through the nose so it is less irritating to the mouth, but since they have the CPAPs over their noses our babies have the tubes through their mouths.  This looks very uncomfortable to me, but a feeding tube will be necessary for quite awhile as the babies learn to eat from a bottle (and eventually, hopefully, breastfeed as I don't want to pump forever!). 

All three also have IV's in them for fluids (and probably other stuff like meds but Micah is more on top of all of that than I am).  IV's don't usually last for more than a few days, although I think Jack's IV in his leg has been in since he was born a week ago, but that may have changed during the night as the nurses were concerned it was not going to last much longer).  Alexis' original IV didn't last very long so she had an IV in her head during her second day of life.  This looked brutal, although I know it's fine and a common thing to do with preemies.  Alexis' IV is now in her arm so she has a board on it to help stabilize the IV.

Alexis being held by Micah with her arm board, CPAP, and feeding tube going into her mouth

The main thing a baby of this size and age needs is sleep since they grow while they sleep. This means they need a dark, quiet environment so that they do not get woken up by other things going on in the NICU.  For most of the first week all three were in open beds with heat lamps, but they have now been moved into isolettes (incubators).  I hated this at first since an isolette is a bit like a cage, but I now understand that it is better for them. 

Jack hanging out in his isolette.  We brought in the animal blankies that were given to me as a shower gift, and Jack obviously loves his tiger :).

To make sure that the babies are getting proper care yet not being disturbed too often, they are put on schedules for diaper changes, temperature checks, mouth cleaning, feeding, and weighing.  Every three hours they have a "care" time and Micah and I are able to do a lot of the care ourselves, which makes us feel more like "real" parents and gives us a chance to interact with each baby in a way other than holding.  I have changed some diapers in my life, but learning to change using the portholes in an isolette is a whole new experience!

Here I am working with Jack.  The NICU uses the babies' names, but the birth order is also really important so each baby has a letter on their isolette in addition to their name card.  Alexis is "A," Jack is "B," and Faith is "C."

Another thing that I had to get used to was the fact that premature babies do not enjoy being rocked, stroked, etc.  When holding them they want to be held still.  When you touch them you must move slowly and place your hand on them and leave it there.  When the baby is crying you don't pick him up to feed, rock, etc (any of the normal tricks).  Instead you support the baby's legs and arms in a tucked position which he finds comforting.

I'm sure there are plenty of other things I forgot, but hopefully this gives everyone an idea of how the triplets are different from a full term baby.  We are looking at up to two months in the NICU, which is overwhelming, but if they progress quickly they will come home sooner.