Up, down, up, down... this is the way of the roller coaster

Josh had a rough night with lots of desaturations.  When Mom arrived this morning, the plan was to increase his oxygen back to 100cc per minute and to watch him closely.  If he continued to have desaturations, then they would send labs to make sure he didn't have an infection.  Josh looked healthy, was moving around well and did not seem to have any indications that he had an infection (other than his eye infection, which seems to be mostly healed up).  Josh's cultures from his eye came back with three organisms, the same ones that were in his ET tube.  The nurse practitioner said that it is likely that Josh's airway is colonized with these bacteria and that he will outgrown the colonization over time.  His blood cultures continue to be negative.

Mom and Dad were a little concerned about the increase in oxygen.  The doctors felt that increasing his oxygen made sense because we were asking him to work harder with the breastfeeding, so he needs more help with other areas until he got use to the change.  That explanation made us feel better.  Apparently it is normal for a preemie to be weaned up and down on oxygen while the baby is learning to do new activities, such as feeding.

Josh did well with his noon breastfeeding attempt.  He ate for 11 minutes during this feeding, which was much better than yesterday.  It appears that his latch is still good and that as far as Mom can tell he seems to be doing well with his suck, swallow and breathe reflex.  Mom has an appointment with the lactation consultant tomorrow to make sure things are going well.  The nurse practitioner said that we can continue to add feedings slowly as Josh tolerates it.  In the mean time, Mom can feed Josh if he seems interested in eating, even if it isn't a normal feeding time.  To help Josh to keep up with his weight gain, his feedings were increased to 11ml per hour.  Josh gained 5 grams today and is now 3lbs, 11oz! 

Josh continued to have frequent desaturations this afternoon.  Mom and Dad were looking forward to giving Josh a bath, but because of the desaturations, we weren't able to do that.  Instead, after several attempts, the nurse drew some labs to see if Josh had an infection.  His labs came back clean, and so it does not look like he has an infection, or something else wrong - although we are still waiting on a final result from his labs.
Prayer Request:

• Josh would have less desaturations and continue to have very little apnea
• Josh would continue to grow and strengthen over the next few weeks so he is able to tolerate increased activity and could be weaned from his oxygen
• Josh would continue to do well with breastfeeding and be able to take in a full feeding
• Josh would not develop any further infections and his eye infection would heal up fully
• Mom and Dad would be able to feel rested even when sleep is limited.

Praise:

• Josh's weight is up to 3lbs 11oz!
• Josh is doing well with breastfeeding and able to go longer today
• Josh continues to be active and have good awake times during the day 
  

(Josh sleeping this morning after a rough night)

 

 (Josh getting his chest PT.. he squirms a lot during this)

 

 (Isn't that just a beautiful face?)

 

 (Josh trying to make his escape from the isolette)

 

 (Ah mommy, why did you have to go and stop me from getting out?)

 

(A tuckered out Josh after getting stuck multiple times for blood tests)