The adventures of Joshua Alexander Cobb: I spy with my little eye

Josh started his second day at the NICU 2 well. He gained 10 grams, and is now at a total of 1570 grams (still 3 pounds 7 ounces). Josh has been tolerating his continuous feeds of 10 ml per hour pretty well. He did spit up some food today, but his A's and B's have been decreasing some. He had a relatively quiet day today, and was asleep for most of the day.

One big thing that hapenned today was that Josh had his first eye exam. One danger that preemies face is that there is a delicate balancing act concerning the amount of oxygen that they get. The most important thing when they are first born is that they have to be able to breath and get oxygen in their blood. Because a preemie's lungs are underdeveloped, they usually require higher than room air (21%) oxygen just to be able to breath. However, their eyes are also underdeveloped, and high levels of oxygen can lead to retinopathy of prematurity, where the oxygen actually damages their eyes. So their blood oxygen levels are monitored closely, and the goal is to give just enough oxygen to keep their blood oxygen at an acceptable level, but not too much that it damages their eyes.

A level of oxygen that is considered to be "high" for a preemie is anything over about 50%. Fortunately, Josh's lungs were developed enough when he was born to where he rarely required a high level of oxygen. When the doctors performed the eye exam, they grade on a 3 level scale. It measures the amount of blood vessels in the eye, with 3 being blood vessels supporting the entire eye, and 1 being a low level. Josh graded out to a 2, which is appropriate for his age and level of prematurity. They will continue give him eye exams every 2 weeks, and we hope that as he grows, his score will increase to a 3 by the time he is discharged. If not, then Josh will continue to have regular eye exams once he is discharged.

Josh continues to have good breastfeeding and bonding time with mommy. Josh seemed to have more episodes of desaturation and apnea/bradicardia during kangaroo time than he normally has, which give mommy and daddy some cause for concern. Josh may have just been having a bad day or sleeping very soundly, but he did not seem to be his usual active, stretchy self today. We pray that he gets good rest tonight so that he can be back to himself tomorrow, and that he is not getting sick.

Prayer requests:

Josh get good rest tonight so that he can have some good awake periods with mommy and daddy
Josh be protected from any infections, and that he not get sick
Josh continue to have less A's and B's or desaturations, and that they go away soon
Josh continue to gain weight consistently and regularly
Mom's milk supply increase to meet Josh's current and future demands
Josh continue to grow stronger to be able to exclusively breastfeed

Praise:

Josh's eye exam went well and there are no signs of retinopathy of prematurity
Josh is up to 1570 grams, 3lbs 7oz
Mom and Dad have the freedom to hold Josh more often now that he is in the NICU 2
Josh continues to do well with breastfeeding attempts