Friday 9/27/2013

Ava is a cutie pa-tootie today. She seems so much happier. She hasn't vomited or retched since they stopped the lasix and potassium chloride. Speech therapy let her have 5mL from a bottle today of breastmilk mixed with babyfood bananas as a thickener. Ava did really well, and she is allowed to do this 3times a day when she is awake and alert. Of course nursing won't do it unless they have to or are feeling motivated, depending on the person,but its a big step for Ava. They put a second tube down the other nostril into the stomach. So she has a little breastmilk going to the stomach and the rest going down the other tube into the small intestines. The one going to her stomach started at 2mL per hour and is increased by 1 mL every 12 hours to a maximum of 15mL. As the feeds to the stomach are increased and the feeds to the small intestine are decreased. Everything is still on a continuous feed which means she doesn't feel hunger-which isn't really good for practice bottle feedings. She does not associate eating with the comfort of feeling full. After the food has all been transferred to the NG tube into the stomach, then the timing will be condensed so she is only eating every 3 hours, and we will feed her every 3 hours at home.  The NP said that she wanted another swallow study next week to which I pretty much said - "no thank you," so she consulted with therapy to see what they could glean from the last 3 studies.   We are going to finish weaning the morphine soon and possibly start weaning the clonidine this morning. It will take 14 days to wean the clonidine- then we will see where we stand from there.  The ativan hasn't been touched. She is all smiles lately. Shaun and I think that the potassium chloride really bothered her belly. The poor baby is bored sick and needs to come home. There are already 4 other babies on the unit with RSV or respiratory disease so we want OUT of there. I guess RSV season hit early this year-beware. This may prevent the twins or anyone under 14 from visiting babies in the NICU.