A breakdown in communication

sJosh had a really good night, and a really good day.  He only had two clusters of desaturation last night, and two during the day, all around his feedings.  He is still getting his erythromycin because it seems to be helping with his reflux.  Josh has had no apnea recently, and Mom and Dad are hopeful that Josh's little brain has grown to the point that he is breathing all the time.

Josh is getting to be a big boy!  He gained 30 grams last night, and is now up to 1,865 grams (4 pounds 1.7 ounces).  The doctors decided that he is big enough that they pulled his transpyloric feeding tube back a bit to make it simply a gastric feeding tube (goes to the stomach instead of bypassing the stomach).  They also increased Josh's feedings from 11 ml per hour to 11.5 ml per hour based on his increase in weight.  The goal is to start decreasing the time over which Josh gets fed until he is back up to bolus feedings.  This will help with his breastfeeding, as he will then get hungry when it is time to feed.  With is current continuous feedings, he is never really hungry.

Josh fed really well for two of his feedings today.  The feedings have been a little frustrating, because there has been a miscommunication with the nursing staff.  Because Josh is on continuous feeds, his feeds are hung up in 4 hour doses, but when Mom comes in to feed Josh in the morning, we have been asking that his feedings be timed to end when he is supposed to feed (that way the precious breast milk is not wasted).  However that information has not been getting to the nurses as they change assignments from day to day, and so having to personally make sure that each new nurse knows his feeding schedule every day has been frustrating at times.

Josh has done pretty well during his feedings so far, and continues to get better and develop more stamina after each day.  And also after he feeds, he has been very vocal about wanting to be close to and connect with his mommy and/or daddy.  If he is put back in his isolette after his feeding, he screams and thrashes around.  However, if he is bundled up and held, he goes right to sleep.  Of course, his mommy and daddy don't mind at all getting to hold him, so it isn't really a problem.  The only problem is that it makes mommy and daddy wish more and more that Josh's time in the NICU would come to an end so that he can come home.

Prayer Requests:

• Josh do well on his gastric feedings, and that he can go down to bolus feedings soon
• Josh be able to be weened down to room air soon, so that he can get the nasal cannula taken off
• Josh's reflux go away with the medication that he is taking, and that he outgrow it soon so that he would not need the medication and the reflux won't interfere with feedings
  
• Mom's milk supply increase to meet Josh's needs
• Dad have a safe drive home tomorrow from his business trip

Praises:

• Josh is up to 4 pounds 1.7 ounces!
• Josh likes to be held, and Mom and Dad like holding Josh
• Josh is really starting to feed well
• Josh is starting to hold his temperature well

 (Josh in his usual position when Mommy arrived this morning)

 

 (This kid makes sleeping look like an art form)

 

 (Josh with his hat off while Mommy was trying to get him more awake to eat this morning)

 

 (Josh after he repositioned himself)

 

(Josh all snuggled down in his blanket napping on Mommy's lap)