Kangaroo care kedua

Today is Muhammad second day on CPAP, on the second trial. Last 2 days, lepas start diuretics untuk his heart, Muhammad nampak cengkung, lost some weight becaming 1.32kg and less active. Asyik tido memanjang. Nampak pale jugak. Alhamdulillah wa syukrallillah. Lepas transfuse blood, he was extubated. Now with CPAP, oxygen level dia nampak stabil dan dia pun nampak aktif sikit, asyik menggeliat aje, walaupun mata masih lagi tertutup.

Di sebabkan dia nampak stabil, maka saya dibenarkan buat kangaroo care.. ah! seronoknya dapat peluk baby ku ini... Umi rindu kamu Muhammad. Cepatlah sembuh dan membesar..

kangaroo care technique
Baca mengenai kangaroo care

Pertemuan dengan paediatrician si pakar kanak2

Muhammad hari ni dah berusia 2 bulan 2 hari. Lama sekali Muhammad di NICU, dalam incubator dan intubated lagi. Sudah berasa sangat rindu untuk mendakap, mencium dan memeluk Muhammad. Bilakah masanya itu?

Sampai ke hari ini, saya hanya berpeluang 2 kali sahaja untuk meriba Muhammad. Kali pertama masa buat 'kangaroo care' (istilah untuk meletakkan bayi pramatang ke dada ibu-salah satu terapi bonding ibu/bapa dan anak) sewaktu minggu kedua kelahirannya, dan kali ke dua 2 minggu lepas, sewaktu jururawat mahu menyalin kain alas tilam Muhammad dan meminta saya meribanya. Ah... Muhammad sangat kecil, terlalu ringan dan sangat2 fragile. Tapi sangat comel juga.... Muhammad, cepat2lah sihat.

Muhammad sekarang sudah kelihatan berisi. Berat sudah mencapai 1.4kg. Pipi sudah kelihatan. Tiada lagi edema (sembab) yang pada mulanya saya sangkakan masalah renal (buah pinggang). Rupa2nya setelah bertemu enam mata dengan paediatrician (saya, suami dan dia) buat kali kedua, barulah kami tahu yang edema itu disebabkan oleh komplikasi jantung Muhammad. Failure symptom (simtom kegagalan jantung yang merbahaya). MasyaAllah. Yang saya sangkakan lubang kecil sahaja, tapi sebenarnya besar bagi Muhammad. Ada 3 kesemuanya- PDA yang terbesar, diikuti VSD dan ASD. Sudah ada failure symptom, edema dan left atrium dan ventricle hypertrophy (bengkak) juga ada. PPHN sudah terkawal dengan ubat inhaled nitogen oxide diikuti syrup sildenafil, dengan izin Allah. Alhamdulillah, tekanan tinggi di paru2 sudah mula menurun, membolehkan oxygen masuk ke sana, dan pernafasan Muhammad menjadi lebih teratur.

Alhamdulillah, repeat Echocardiogram dibuat semalam, dan PDA yang dirisaukan oleh pakar nampak dah tertutup. Edema sudah tiada, bermaksud failure symptom terkawal.  Tinggal lagi VSD dan ASD yg mengikut pakar, besar jugak lubangnya, tapi masih boleh tertutup sendiri insyaAllah, mudah-mudahan.

Esok perancangannya nak bukak ventilator dan ganti dengan CPAP. Percubaan kedua setelah percubaan pertama hanya  dapat bertahan selama 2 hari, sebelum kembali menggunakan ventilator. Menurut paediatrician tersebut Muhammad tak dapat bernafas sendiri mungkin disebabkan oleh lubang PDA yang besar menghalang oxygen daripada masuk ke paru2. Jadi, mudah2an percubaan kali kedua ini berjaya, tanpa perlu di intubate balik. YaAllah, bantulah anakku..

 Lagi masalah utama ialah  Chronic lung disease. Saya sangat2 takut kalau Muhammad memerlukan oxygen tank selamanya. Tapi menurut pakar, tak tentu lagi. Paling lama mungkin maksimum 8 tahun perlukan oxygen tank sehingga paru2 betul2 matang

Ya, keputusan bukan di tangan doktor. Kerja seorang doktor hanyalah memberi harapan, berusaha dan bersandar sepenuhnya kepada Allah.  Hanyasanya perancangan Allah itu kadangkala sukar untuk dimengertikan.

Mudah2an Allah selamatkan Muhammad untuk jadikan dia pejuang agama. Aku  berdoa.

Muhammad's 2 days to 2 months old

His weight increased to 1.45kg last week, but after edema (which made he look so big, with swollen eye, face and limbs- I hardly recognized him) resolved, it left 1.35kg, and the latest, 2 days ago was 1.38kg.

He was extubated 4 days ago, put on CPAP... I was sooo happy and couldn't wait to cuddle him. (Walaupun sedih tengok Muhammad terseksa dengan tiub merodok hidung dia, dan asyik menangis dan meronta tanpa suara je). However, after 2 days, he looked tachypnoic, with all the accessory muscle seen during breathing and several episodes of apnoea (not breathing at all). Oxygen saturation went crazy. Maybe due to his chronic lung disease that made him difficult to get off the tube.

He was reintubated yesterday. I felt so down. And scared..... what if he need oxygen support the whole life?? Ya Allah...janganlah. And tomorrow Muhammad pediatrician want to see us the parents to discuss the longterm plan? (what does it means? and I hesitate to asked her because I need my hubby's support before hearing it.)

Ya Allah.. bantulah hamba Mu ini... sembuhkanlah Muhammad, wahai Tuhan yang Maha Mendengar lagi Maha Pengasihani.

Damia is turning 5

2 days ago was Damia's birthday.
 She's turning 5 and has learnt a lot! Alhamdulillah,such a bright girl.
 I noted since 2 months ago, she can read.. malay and english. And can do simple math! She can read malay story books fluently, alhamdulillah and several common english vocabs... thanks to starfall.com, peterandjane book and read easy book.

She's hardworking. Going to school is fun for her. And she loove reading and writing and doing origami!

She's a quick learner. By teaching once substract method, she can do it correctly. She also can easily recognize the road to her previous school, danish's home and etc. Dah pandai tekan last called number untuk call ayah dia, tok wan , tokku, ciksu, Tok ayah... haish, abis kredit umi.

 She's a good sister. Always remember her little brother a lot even though she only saw him a few times only in Nicu. When we go shopping, she always thought of him. When she has some cookies or sweet, she'll spare some for him. Soo sweet!

 And..she's bossy..hehe. Isn't it natural for the first child?

Happy 5th birthday my little girl. Ayah and umi want the best out of you... dunya and Akhirah. amin.

Anniversary 1606

HAPPY 6th ANNINERSARY my dearest. Thank you for standing by my side all this time, during up and down.. love you. Forever.

Day 45

Alhamdulillah..Muhammad catch up fast, 1.35kg. Nampak besar dan tembam dah, compared masa mula2 lahir. Dah cheeky.. dan pandai senyum! =) i'm so happy and releived.

A few good things happen, Inhaled nitrogen oxide for PPHN already off. Replaced with syr Sildenafil. Oxygen pun nampak stabil sikit. Jarang2 skali baru desaturate. Few days ago, he developed generalized edema. Check serum albumin, 28g/dl je, tak de la low sangat. Tapi transfuse albumin jugak, sebab memang gross edema, dengan scrotum swollen, ascites, semua lah. Legs dia 2 x ganda .. memang nampak besar sungguh Muhammad. Terkejut masa tengok 2 hari lepas... 2 x check nama takut tersilap incubator anak org lain..hheh.. alhamdulillah, Muhammad size dah back to normal. Nosocomial infection pun under control. Nampak aktif sikit.

Still on ventilator. Oxygen low setting ...30%. Mudah2an tak lama lagi boleh tukar kepada CPAP. Mudah2an lungs dia kuat, dan later on boleh off oxygen. Amin

Damia' dah habis periksa hari ni..hihi.,. kelakar pulak budak tadika periksa. Cikgu dia complain Damia' ni sama je exam ngan tak exam, asyik main2, kacau kawan.. hihi. Biasa la kan, budak2... takkan nak serius ...pelik pulak nanti, matured sangat..hehe. Sibuk nak beli hadiah Hari Guru  untuk cikgu.... buat kad, dan balut hadiah sendiri untuk cikgu kelas dia. Yang kelakarnya, kad untuk makcik tukang masak pun ada.. bila cakap, makcik tu bukan cikgu.. katanya "Tak pe la, Damia' sayang CikNa..". Such a thoughtful.

Nampak sangat dia happy, less moody... mungkin sebab aku dah boleh tumpu kat dia, hantar ambik dia ke tadika. Start balik baca bedtime story.. Seronok sungguh dia. Mudah2an menjadi anak yang solehah, dan kakak yang baik... dan no more hot temper! ngee...

Ya Allah.. jadikan kami hambaMu yang sentiasa bersyukur..amin.

P/s: bila boleh nak transfer gambar dari hp ni?

Adoi laaa!

Saya menderita saluran susu tersumbat (obstructed breastmilk duct ) dan ianya sangat sakit (walaupun tak sesakit bengkak susu (breast engorgement) dan jangkitan susu (mastitis) ). Dan production susu pun kurang. Kalau bangun pagi, yang sebelah normal boleh dapat sampai 200ml, yang sebelah sakit hanya 100ml saja. Bengkak,  demam kejap. Production ada, tapi tak keluar... macam mana niii??

What is a plugged milk duct?

If you're making milk faster than it's getting expressed, it can get backed up in the duct. When this happens, the tissue around the duct may become swollen and inflamed and press on the duct, causing a blockage.  

The first sign of a plugged duct may be a small, hard lump that's sore to the touch or a very tender spot in your breast. Some women also notice redness on their breast. The area may feel hot or swollen, but may feel better after nursing.

If you feel achy, run down, and feverish, it could be a sign that your clogged duct has become infected. (Left untreated, a plugged duct can evolve into mastitis, so don't ignore the symptoms.)

What causes plugged ducts?

Blocked ducts can happen if your breasts are not getting completely drained of milk on a regular basis. Some common situations that may lead to this are:

• Your baby is having trouble feeding for some reason, such as an improper latch, or isn't feeding often enough.
• You're using a pump that's not powerful enough.
• You've abruptly weaned your baby.
• A duct becomes compressed or damaged, due to pressure from a nursing bra that doesn't fit well or from sleeping on your stomach, for example. This may trap milk inside a duct.
• You have an illness such as a cold. Illness may cause you to not want to feed your baby as often or pump as frequently.
• You're under stress. Stress lowers your body's production of oxytocin, the hormone that causes your breasts to release milk. 

You've had surgery, such as a breast biopsy. The area that was operated on may interfere with milk drainage and cause a blocked duct.

What should I do?

Nurse, nurse, nurse! It may be painful to nurse on the affected side, but frequent nursing is crucial to completely empty the breast, which will make you more comfortable and reduce inflammation.

If it's not too painful, nurse on the side with the clogged duct first, because your baby sucks strongest at the beginning and that may help dislodge the plug. If your baby doesn't want to nurse enough to empty the breast on that side, use a breast pump or hand express the milk.

Experts also recommend that you massage the sore area frequently and firmly, starting at the outside of the breast and working your way toward the nipple. Applying warm compresses before nursing can help open the ducts and relieve pain and swelling.

Vary your nursing position. For example, if you use the cradle hold, try the football hold or nurse lying down. This will help make sure that all of the ducts are drained.

Also, many women swear by this trick: Position the baby at your breast with his chin pointed toward the sore spot. Then have him latch on and begin nursing. This directs suction at the plugged duct.

Taking ibuprofen may help relieve pain and inflammation. Ask your doctor or lactation consultant before taking any remedies while you're breastfeeding, though, even if they're the over-the-counter variety. You might also want to check out our breast milk interactions chart.

Next to nursing, the most important thing is rest. This may seem difficult or impossible with a baby to care for, especially if you have other children, but it's an important element of recovery.

To get a bit more shut-eye, consider keeping your baby with you in bed. Put a stash of things you'll need nearby, such as diapers, toys, books, and water, to minimize trips out of bed. If possible, ask someone to help you for a few hours a day so you can get some sleep.

Also eat nutritious foods to boost your immune system, and drink plenty of fluids to stay hydrated.

To help with discomfort, some moms rely on cold packs while others prefer a heating pad. See which provides you with the best relief.

Once the duct is unplugged, the area may still be red or feel tender for a week or so, but any hard lumps will be gone and it won't hurt as much to nurse.

To help prevent future plugged ducts, avoid long stretches between feedings. And make sure your nursing bras fit well and don't have underwires, which can compress milk ducts.

Will clogged milk ducts affect my baby?

Sometimes your milk flow on the affected side may be slower than usual, and your baby may become fussy when nursing on that breast. But it won't hurt your baby to nurse while you have a clogged duct. And the antibacterial properties of breast milk will keep your baby safe from bacteria, even if you develop an infection.

Can I still nurse?

Yes. It's the best way to get the duct unclogged.

What if home remedies don't work?

If you continue to feel pain after trying rest, heat, massage, and frequent nursing for 24 hours, call your healthcare provider. Call right away if you develop a fever at any time, because this may mean that you have an infection that requires medication.

Relieving Blocked Milk Ducts from Breastfeeding -- powered by ehow