tonight we finally received some clarity from a nurse as to why the neonatologists and surgeons are so seriously considering eric to be a candidate for g-tube and nissen surgery, despite the fact that he seems to have stabilized and isn’t showing any obvious signs of abnormal discomfort during feedings. his upper GI series showed that he he begins to reflux at around 10-15 cc’s ( which isn’t a lot when you consider that his entire feeding is 45 cc’s ) and babies that begin to reflux at such low volumes get immediately put on the short list for being candidates for the surgery, since it’s often their experience that babies who begin to reflux at such low volumes eventually need the surgery and procrastinating just leads to esophageal damage.

so, it looks like we may need to balance the doctor’s recommendations against the growing number of negative opinions we’ve received from parents who have had children that have had the surgery. indeed, our nurse tonight who clarified why he was a candidate told us that she had three (!) children who had the surgery done and she wouldn’t recommend it unless it was absolutely, positively necessary and all other options had been exhausted.

speaking of exhausing all options, while the barley we’ve been adding to eric’s feedings has been working well to control his reflux by thickening the food and helping to keep it in his stomach, it seems to be giving his “gas”. and when he grunts trying to relieve himself of the gassy feeling, he pushes the milk out of his stomach and through his nose, which is pretty much defeating the purpose. so we decided to replace the barley with pulverized rice on the hopes that it would be a little more gentle on his digestive system. apparently there was some debate amongst the nurses as to whether or not the pulverized rice would simply dissolve in the milk; some of the nurses thought that barley should only be used for breastmilk and rice for formula, but others thought that was nonsense. it’s funny to see how much debate there can be over relatively simple things, little less the much bigger issues. in the end, the rice seemed to stay suspended in the breastmilk just as easily as the barley.

i think i’ve mentioned this before, but against the recommendation of the “back to sleep” advocates, we like to put eric on his stomach to sleep because he seems to enjoy it so much. micropreemies are at greater risk for “sudden infant death syndrome” when sleeping on their stomachs but we break the rules as long as we know that someone is always nearby to watch him closely.

when he’s on his stomach, it’s much easier to just what a head of hair he’s developing. it’s a little tough to tell from the picture but he’s got quite a “swirls” coming and maybe a few curls.