This week has been a great week for Sydney.
She is now 3lbs 13 ozs. This is 1 pound heavier than when she was born 5 1/2 weeks ago.
For the past little while, Sydney has been on continuous feeds. Instead of doing one huge feeding every 3 hours, the docs had her food going in her nasal feeding tube on a constant flow. This way she can be on "full" feedings and off her supplemental stuff (supplied through her PICC line). Her tummy wasn't really ready for a big feeding, wait a few hours and then another feeding. It was too much food for her at one time and she would throw up a lot. They had her on 10ml/hr all day & night. On Tuesday, they kept her on the same amount of food 30ml every 3 hours (which is 10ml/hr), but they administered it through her feeding tube in 2hrs. So she ate for 2 hrs and had an hour of rest. Wednesday they bumped up her amount to 33ml/3hrs and gave it to her in 1.5hrs. Thursday it was 34ml/3hrs in 1.5hrs. She really hasn't been throwing up or refluxing that much. She does do the occasional spit up, but that is to be expected. They are doing this to get her ready for a bottle feed. They will be working her down to eating her full feed (which changes depending on her weight) in 30 min. I was very nervous about taking her off the continuous feeds at the beginning and when they started bumping up the amount - I didn't want them to have to stop her feeds, begin from a small feed, work our way up...etc. It is a great relief that she is handling them. Her bowels have been doing great too...the nurses now know that I want to know when her last poop was etc. If I go to change her diaper and she has pooped, I clap and say "Yay! You pooped....good girl!" It is the little things in life that bring some much joy! Just remind me in a few months when I am changing the nasty poopy diaper about how excited I was when she would poop!
To help get Sydney ready for bottle feedings, we have been working with different pacifiers too.
Her favorite (and mine) is the pre-preemie sized paci. It is perfect. You can still see her and she can hold it by herself in her mouth.
They keep telling me that the itty bitty paci is wrong for her and she should be using the purple (preemie) paci. It is HUGE! You can barely see her and she can't keep it in her mouth for more than one or two seconds.
After just a day or two on the purple paci, the nurses decided that she really needs to be on the green (newborn) paci. This has the same size nipple as a bottle and since we are working our way towards trying a bottle in a few days, she really needs to be strengthening her mouth. (The only problem is is that I cannot see my daughter anymore with this one!)
It is about half the size of her head!
Another great accomplishment this week...getting off the nasal cannula! She is on room air, breathing on her own, no assistance, no safety net, nothing! She tried this about a week ago, but only lasted a few hours before she tired out and kept dropping her oxygen saturation levels and had to be put back on the cannula. She has done beautifully this time around. She might drop her oxygen saturation for a second, but then recovers fast.
The tube in her nose is her feeding tube.
(This last one was just a cute fun picture...she HATES her hands swaddled up. They need to be free so she can put them up by her head and relax. The nurses are more willing to do this now that she doesn't have a nasal cannula to pull out of her nose - the little stinker!)
Today the doc came in and changed things up some more....She is no longer on caffeine. Preemies need caffeine in their system to help stimulate the part of the brain that tells her lungs to breathe. She is now old enough and doing well enough that the doc feels like she doesn't need this "help" anymore. The caffeine will stay in her system for about a week, so she will be 34 weeks by the time it is all out. If she needs more, they can put a little in her formula ... because ... another accomplishment:
She has no more PICC line in her head! She is tolerating her feedings so another safety net has been taken away. YAY!
This is where it use to be in the back of her head behind her ear. We had to be very careful when handling her head or laying her down on that side because of the PICC. Not that I won't still be careful...
Next milestones:
1. bottle feedings
2. keeping body temperature up and moving to an open crib out of the temperature controlled isolette.
We are so proud of our little Sydney! Love this girl!
As soon as she gets up to full feeds for all bottles, she will get to come home. It is very hard to not want to push her to do it now! I want her home now! She will start out taking 1 bottle (35cc - this is just a little over an ounce) every day. When she takes the whole bottle, then she will move to 2 bottles (1 day, 1 night). They bump her up slowly, they don't want to tire her out too much. Their schedule is 1 bottle, 2 bottles (1 a shift), 4 bottles (2 a shift), then 5 bottles - this gives her a bottle that she will do back to back with another bottle, 6 bottles, and all bottles if she takes them. She also has a time limit on how long they will let her feed her bottle - this is to help her not tire out too much too. The rest is put in her nose tube. They will also be slowly bumping up the amount of food she eats. So just as soon as she gets to where she barely takes 35 ccs, then they will have her start doing 40ccs.
I remember the frustration I felt watching Noah do these feeding schedules in the NICU in Ogden. I just kept thinking, "well, if you want Noah to be successful, then quit bumping up his feed amount. He will eat all bottles all day if you quit making the amount more!"
