for the most part, today was a pleasantly quiet day. eric continued to guzzle his bottle feedings in near record setting time – he cleared away his 40 cc ( 4 more than his feed required ) evening bottle in 15 minutes! the nurses are continually amazed at how well he does with his feedings. currently, he only gets two bottle feedings a day, with the rest being done via a tube. if he keeps up the great work they will gradually increase the number of bottle feeds.
eric put on another ounce and weighed in at 3 pounds 13.2 ounces or 1735 grams. if he keeps gaining an ounce or so a day, he has a pretty good chance of hitting the four pound mark by his ten week birthday!
they also decreased his nasal cannula again to 1.25 liters per minute. he’s started “desatting” ( decreased blood oxygen levels ) a bit more and had a few more “a’s” and “b’s” ( apneas and bradycardias ) around feeding time. this is probably due to the fact that his hemoglobin levels are getting low and has a diminished oxygen carrying capacity; after he gets another another transfusion, which we expect to happen in the coming days, everything should clear up quickly.
i guess there’s no small amount irony in the fact that we haven’t finished getting our registry in order for our baby shower for a baby who is already two months old. our shower was originally going to be on july 31st, but we moved the date to september 19th to give us time to adjust to being in the nicu.
some might remember that there are good reasons why kris trots me out to babies ‘r us in the evening. we had a fun time picking out a bunch of cloths for eric; “grandma pam” accompanied us to the store and spent entirely too much money, but i suspect that grandmas like to do that sort of thing. thanks! grandma pam
today was yet another day tiny little steps of progress. first, eric had the rate of nasal cannula air flow turned down from 2 to 1.5 liters per minute. you might recall that the last time they turned down his flow, he started alarming often that the nicu staff thought he might have an infection. it’s amazing to see how differently he responded after only ten days. it’s even more amazing when you think about how much lower his hemoglobin levels compared to then ( he’s still due for another transfusion ), which means his oxygen carrying capacity should be lower, but his stronger lungs can more than make up the difference.
the fortifier seems to be working, as he put on another ounce and weighed in at 3 pounds 12 ounces or 1700 grams.
eric completed the transition to three hour feeds appears to be tolerating the increase in feeding volume wonderfully. his first “3 hour” bottle feed was an enormous 36 cc meal and the nurses didn’t really expect him to take the whole thing down before getting too tired. but they were pleasantly surprised to be proven wrong. he drank the entire bottle in about 22 minutes!
you’ll notice that we’re very aware of exactly how long it takes eric to eat. that’s because we have exactly 30 minutes to get him to take his food via a bottle. if he doesn’t get everything down in that time, then he’s “gavaged” ( the term for tube feeding ). the strict timing is due to the fact that you want him to have the most amount of time to fully digest his food before the next feeding; and the staff begin to get concerned about how many calories he’s burning while bottle feeding after a half an hour. it’s strange to think that the extra calories burned from being out of the isolette can make a big difference.
so there’s a bit of strategy involved to get him to take all the food in the proper amount of time. one tactic is to switch his bottle nipple during his feeding to make it more or less difficult to get the milk. you can differentiate the nipple by the color of the plastic ring surrounding the nipple. a white ring indicates the most difficult and a red ring is the easiest, while peach is a medium difficulty nipple. we found that we had to use all three nipples during his feeding to make it easier for him to get milk as he got increasingly tired. why not just start with the “red” nipple? because if he’s not tired, he’ll get too much milk at once and gag.
who knew that feeding could be so complicated? that said, he’s doing fantastic and word spread quickly through the nicu that he was able to take his first “3 hour feed” bottle in the proper amount of time.