Wednesday, May 6, 2009

Can I have some real food, please?

After being off feeding for almost a week, Adam got the green light from Dr. Clark to put a little breast milk in his belly again. This, of course, means good news from all his GI tests that were done. Radiology has indicated that there are no anatomical issues requiring surgery that are causing his digestive problems. Just a little reflux. So that puts us on the path of determining his 3 distended belly episodes in 3 weeks is due to having a preemie belly. Great news. And relief. He started on 4ml of breast milk yesterday afternoon. That course will continue for 2 days and then they will determine a feeding schedule that is a slower pace for him to handle. The nurse tried to give it to him through a bottle but he looked at her like she was a crazy woman. So apparently being back in the critical care area for a week has made him think he shouldn't have to put forth effort...we'll have to work on that!

He continues to have the PIC line in place to deliver a balance of IV nutrients until he is on a more substantial feeding schedule. His weight 2 days ago was 3lb 7oz. We aren't really taking that to heart since he has been on 3 different scales in the past week with room changes, and the barium they put in his belly for the upper GI is like cement sitting in his stomach! We'll see what todays weight update brings. Head measurements continue to be in the normal range. Both babies will receive another head ultrasound at 34 weeks - sometime next week.

The doctor also put in an order to have Adam moved back to 1218 to rejoin Sara as soon as a bed opens. Another sign that he is not needing urgent critical care again.

Sara continues to be a quick learner with the bottle feeding process. Monday she took 100% of both bottles. Yesterday she took 100% and 75%. That qualifies her to advance to stage 3, which is 3 bottles a day. She would need to take 50% of all 3 for 2 days, then 50% of 4 bottles for 2 days, 50% of 6 for 2 days, and finally 100% of all 8 bottles for 2 days to qualify to go home as far as feedings.

She would also need to be able to maintain her body temperature. Her weight 2 days ago was 1460 grams, or 3lb 3oz, so we'll see what her update brings today. At 1500 grams, the doctor could request she be moved out of an isolette and to an open air crib to test how she does.

Her bradycardias have been so infrequent that Dr. Clark stopped her caffeine yesterday. Both babies have received that since birth to stimulate their brain and help them remember to breathe. If she is off caffeine for 7-10 days before going home, she would not require a home monitor to assess her breathing and heartrate. As of last night, she had 2 bradys during the day. One more and Dr. Clark would consider putting her back on the caffeine for a few more days. Sara has always like a challenge so we will see what the overnight outcome is when we arrive for this morning's visit.

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