DD2 is our first preemie - DD1 and DS were term, birth center and homebirths. I developed severe pre-eclampsia w/ this one. She was born via c section on July 2, *right* at 33 wks.
At birth she was 3.10 (1650 grams). That was 15th percentile. My older kids were 80-90th centiles so I was a bit surprised at how small she was. No one mentioned IUGR, but I wonder of my pre-e caused growth problems for her, or if she's just genetically small?
NICU stay for 25 days. In the NICU she got my milk but they used fortifier to make it 24 cal/oz (20 cal/oz which is average human milk). Then they changed that to 22 cal/oz after a couple of weeks until she was discharged. For her last six or so days I nursed her for 1-3 feedings/day. Our discharge feeding plan was for her to nurse but get at least 2 bottles per day of milk w/ a formula powder added to fortify it to 22 cal/oz. (1/4 tsp powder to 45 mL milk of Enfasure - an Enfamil preemie formula; in the NICU they used a different fortifier but it was not human milk based; it was called "human milk fortifier" but was bovine based)
Discharged July 26. Next day visit to the pediatrician she was 5lbs 1.2 (every tenth of an ounce counts to me!). Still 15th percentile. So she'd stayed at 15th percentile basically her whole NICU stay, getting the fortified milk for most of her feedings. Ped was OK w/ us doing all nursing (thus no formula). I said I didn't want to do the formula powder if we didn't need it; she said something to the effect of "nature takes care of its own," meaning I guess my milk has what she needs. I SO appreciate that but b/c of the below, question it:
Ped wanted a weight check five days later - she was then 5lbs 5.8oz. Ped said it was satisfactory; do a follow up in one week. So yesterday she was up to 5lbs 11.2 oz. Up 5.4 oz in one week. Ped is OK w/ this and our next appt is in 3 wks for her two month check-up. Ped printed out a growth chart for me. It shows that:
1st visit, 36 wks, 5.08 lbs, 15th %tile
2nd visit, 37 wks, 5.36lbs, 11th %tile
yesterday, 38 wks, 5.7lbs, 10th %tile
So she's dropping %tiles and she's busting her butt eating and having lots of wets and poopy dipes. I think she's consuming as much volume as is nearly possible. I'm basically nursing her on just one breast to make sure she's getting good amts of hind milk (pumping the other side). I fear we need to add formula to our feeding plan (which we've not been doing) to increase calories and keep from dropping %tiles further... Should I just expect that since in the NICU she was getting mostly (all at the beginning; maybe 80% once we started nursing a week before her discharge) 22 cal/oz milk that she'd slow her gaining once home???
Would love thoughts on preemie growth!!