Hello Low-Flow!
Hello to you all.
Rebecca and Xavier are doing very well. Rebecca is recovering nicely from her c-section. She is still a little sore at times, but has been pain med free for three days now. Praise God!
Rebecca's milk is coming in slowly, but we have seen several times with better than 20 ml! We've been able to "bank" a good amount, but Xavier is fast approaching a point when he will drain the bank. Rebecca is persevering and we are seeing some increase on a daily basis.
Xavier is doing extraordinary and everyone is well-pleased with his development. Yesterday he was moved from 3 ml milk every two hours to 4 ml milk every two hours. His weight today was 755 grams, a new record! He gained 25 grams in a day. This afternoon, he was moved to 5 ml milk every two hours. He is keeping his food down (mostly) and he is digesting it all within the two hour window (we know this because the nurse will pull back the plunger on the syringe connected to his feeding tube--an OG--and nothing is pulled from the stomach). I am proud to report Xavier had a good sized bowel movement into his diaper which, I hear, was very messy because of another temporary piece of equipment connected to his "front side" at the time. Way to go Xavier! (it was a goal for him to have such a movement)
He has had a couple of bouts of burping up some milk. Today's nurse, Allison, and I discussed his history some and she thinks he just needs to be fed a little slower--not all the milk at once. Although both feedings we gave today (at 4 ml) did not come back up. Feeding is done via a gravity feed; the warmed milk is placed into the syringe, the syringe connected to his OG and then gravity gets it into his stomach. (No, he is not practicing for his college years!)
He was dropped from 1.5 liters/minute in his high-flow oxygen to 1 liter/minute yesterday. Today, his high-flow was replaced with a low-flow line. This is a slower feed, no moisture added. The flow was started at 0.03 liters/minute then dropped to 0.02 liters/minute about two hours later. The high-flow was not so much about him breathing in air (at that volume he did not get much air from the flow), but to help coach him to breathe on his own. The low-flow has slightly higher oxygen, but he gets more since it's low-flow. By next week some time he may be free of his nasal tubes!
Also exciting, the doctors are thinking within the next week to ten days Xavier will be completely on a milk diet and off both his drip feeds. That means his PICC line will come out! He will still be wired with heart, blood and temperature monitors for as long as he is in the NICU, however.
The general formula for babies is 700 ml of milk a day for every 1000 grams. Xavier is currently at 60 ml day, so he has not worked up to the full amount. He has started accelerating toward that however, which is why we are praying for Rebecca's milk to fully come in!
Xavier started physical therapy yesterday. There is a balance between him spending calories on moving and spending calories on growth, so his sessions are light and last less than thirty minutes. All his therapy is designed to simulate his in-utero environment. He gets moved around (his little bed moved back and forth to simulate movement in the womb); he gets little resistance exercises to simulate his cramped fetal position and resistance of the uterus when he stretches or explores; he even gets a little massage to help relieve any stress.
Mom got to kangaroo with Xavier again today, but so did dad! Dad got him for more than an hour and a half. He slept so peacefully on both mom's and dad's chests, but complained when we woke him up as we returned him to his pod.
Always, and with sincerity, we thank you for your prayers.
Xavier unbound (almost). Taken Monday, by Wednesday the high-flow tubing (shown here) was replaced with smaller, low-flow tubing.
Mom kangarooing Xavier. Today he is tucked in under mom's shirt, covered with two warming blankets and finally covered with a fleece blanket. His head radiates so much heat, he gets to wear a little hat outside the pod.
