Snips and Snails and Puppy Dog Tails

What are little boys made of?
What are little boys made of?
Snips and snails
And puppy-dogs’ tails,
That’s what little boys are made of.

What are little girls made of?
What are little girls made of?
Sugar and spice
And all that’s nice,
That’s what little girls are made of.

Brothers - Destroy and Search

Since becoming a mommy to two handsome little dudes, I have chosen to interpret this poem as the simple stereotype that boys will be out and about getting down and dirty as they get older.

What our boys are really made of includes blood. According to our doctors and nurses, it is extremely common for babies to have dropping hematocrit levels. (And, we’re back to the “he’s tiny” diagnosis.) After the color and energy burst from their transfusion, we’re back to lowering levels.

So in order to test for anemia, more blood was taken from Search (oh, the irony…). No need for another blood doping just yet, but docs wanted to verify his “retic” count. Reticulocytes (retic for short) are immature red blood cells made by the bone marrow. Once they spring forth into the bloodstream they will develop into grownup blood cells after a couple days; only about one percent of red blood cells are retic. Search’s blood test measured the rate that the retics are being made – creating more oxygen bearing transports through his body. Results were lower than the standard range, but the doctor believes this is due to the recent transfusion. Transfusions often confuse their little bodies into thinking “no need to produce more reticulocytes – we’re good!”

In the meantime, the NICU continues to fatten up our boys in true fairytale style by upping their caloric content. Although mommy’s milk is about 20 calories per serving, the hospital adds human milk fortifier – a supplement intended for low-birth-weight infants – to each beverage. Both boys are up to 28 calories! At first glance 224 calories per day may not seem like much. But compare those 75 calories per pound/day with only 10 calories per pound/day with a 200 pound person eating a recommended 2,000 calories a day. Our boys are going to end up as the next Michael Phelps! (He allegedly needs 12,000 calories per day.)

But here’s the catch. While the fortifier works like a charm in developing chipmunk cheeks, it’s a lot harder on their digestive systems. So they spend a significant portion of their days trying to poop. I’ve noticed they’re quite a bit more fussy but I get pretty cranky when my tummy hurts too.

Search

Search is still doing well with his bottle. Although I’ve noticed he’s much more amenable to the idea of putting effort into his meal during the evening. Yesterday morning I tried to give him breakfast via bottle. He peered up at me with half-open eyes and steadfastly refused to open his mouth. “I’m all about food Mom, but seriously – it’s naptime.” This afternoon was just the opposite. He was wide awake and as the nurse moved around his isolette preparing dinner he followed the movement with his eyes, opening his mouth and sticking his tongue out at us, “I’m ready people! Feed me!”

Destroy

Destroy thinks he’s ready – and he’s really really interested – but still hasn’t quite caught on. Responding to his cues (big wide eyes, sucking motions and his general obsession with his pacifier), Nurse Anne decided to give him another chance. Destroy took one or two normal sucks on the bottle and realized that this nipple had more than just a taste of milk on it; it just kept coming out. With extreme over-exuberance, he gripped the bottle with both hands and started sucking fast and greedily. Suddenly, mouth full, my little muppet realized he had no idea what to do with the milk now that it was his – all his. It dribbled out the sides of his mouth as his stats dropped since he hadn’t remembered to breathe during the excitement. So we’re going to wait a bit more with him.

My theory (using the expertise garnered from multiple viewings of ER, Gray’s Anatomy and Private Practice) is that lowered levels of oxygen in their blood combined with the added stress of gas plays a large role in the swings of their saturation levels.

Throughout all this medical drama the boys continue to get cuter every day. This is a bit dangerous as they’re also started to get a lot more flirtatious. So what are my big holiday weekend plans? I’ve got a hot date in the NICU with two little chubby guys who have already stolen my heart – even if they are made from snips and snails and puppy dog tails.