The adventures of Joshua Alexander Cobb: A day of big firsts!

Josh had a great night last night. He has now been mroe than 36 hours without any desaturations. Everyone is quite impressed with our little guy. Since he is doing so well on the erythromycin, they have decided to continue it indefinitely. The doctors decided to try to give Josh's tube feedings over 30 minutes (from 1 hour 30 minutes), but this was a bit too big of a change, so they changed it to 1 hour in the evening. He tolerates this fairly well with only a few episodes of bradycardia, which resolve quickly on their own. The episodes are definitely related to his reflux - you can see him rapidly trying to swallow when they occur. Josh gained 5 grams overnight so his weight is now 4lbs 2oz.

Josh also spent a majority of the night with his oxygen on the bridge of his nose instead of in it (he kept removing it). So this morning the nurse practitioner wrote to turn off his nasal cannual. This is the first time since Josh was born that he has not had some sort of respiratory support!! Josh has done very well on room air with his oxygen saturations ranging 88-96%, mostly at 96%, even during breastfeeding. Josh has had a few episodes of desaturation today, all associated with reflux - probably related to his feedings being given over a shorter period of time. Mom and Dad are very proud of our litte guy and are hoping we are done with oxygen therapy forever!

On Friday Mom and Dad had started dressing Josh in clothes and when they arrived on Sunday Josh was again naked. We think he was undressed to do his weight Saturday night and was not redressed. Some of the nurses do not like to dress a baby while in the isolette. When our regular nurse practioner arrived this morning, she wanted to know why he wasn't dressed. I told her of our experience over the weekend and she was not pleased. So Josh now has an order that says he is to be dressed while in his isolette. In addition to getting to dress him again, our nurse today said that Josh is not needing the support of his isolette as much. So she changed the settings so it keeps a steady temperature in the air and then it can be adjusted down to compensate for Josh's body temperature. So his isolette is set to 28 degrees and his body temperature has been staying at or above 36.5.

Josh had a rough start to the day with breastfeeding. At his 9am feeding he was very awake and alert, latched well, but wouldn't eat. He did this for about 30 minutes but never actually ate anything. This was very frustrating for Mom, espeically because she feels this is the result of getting out of our routine this weekend. Our wonderful lacation consultant had already arranged to come by for his 3pm feeding, so Mom was very excited to get some help from her. After a few adjustments, Josh had one of his best feedings so far and ate for about 12 minutes. Mom and Josh were both very pleased with this!! So hopefully we are back on our way to having a good routine and good feedings.

Prayer Request:

Josh would be able to stay on room air and not need any more oxygen
Josh would be able to tolerate his feedings at the faster rate and his reflux would not become worse
Josh would have turned a corner with breastfeeding and be able to slowly increase the duration and frequency of feedings
Josh would be able to hold his body temperature well after the changes to his isolette temperature controls were made
Josh would begin to gain weight steadily again

Praise: