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)

Josh is a big boy!

Josh had an excellent night. He had no episodes of apnea or desaturation last night. His only episodes today were associated with his breastfeeding times. This is great progress - Mom and Dad are very excited that Josh is doing so well.  He continues on 25 cc of oxygen and is tolerating this well.  The nurse practitioner said that they might try a room air trial in the next few days.

Josh is continuing on his tranpyloric feedings at 11ml per hour.  Since Josh is doing so much better with his reflux on the erythromycin and the transpyloric feedings, they are going to change him to gastric feedings, most likely tomorrow to see if the erythromycin continues to work well.  If it can't control his reflux during gastric feedings, then the doctors will consider changing Josh to different medications to get his reflux fully under control.  Once it is under control, he should be able to tolerate oral feedings better.  An advantage to being back on gastric feedings (feedings directly to his tummy not his intestines) is that they will be able to work Josh back up to bolus feedings every 3 hours, training him to be hungry every 3 hours and to expect food.  This will help with breastfeeding attempts and getting him on completely oral feeding.

Josh did well with his breastfeeding attempts today.  He was able to eat 3 times, 1 of which was for 15 minutes.  He does need a little bit more oxygen while eating, so that he doesn't have to work so hard with his breathing and can use his energy to eat more.  His weight is up 25 grams to 4lbs 1oz!  He is also holding his body temperature better while in the isolette, with the temperature of the isolette being lower than before.  This is a good sign as Josh will be transitioned from his isolette once he is taking all of his feeding orally.

Josh had quite a relaxing day today.  He was not fussy at all today.  In fact, he enjoyed a nice 3 hour nap in Mom's lap.  He also enjoyed getting to spend some time with Dad via skype today.  Josh actually woke up and smiled to the sound of Dad's voice.  Both Mom and Josh are looking forward to having Dad back home soon.

Prayer Request:

• Josh would continue to grow big and strong, developing the stamina needed to take off his feedings orally
• Josh would continue to not have any apnea and less desaturations
• Josh would do well with the changes coming in the next few days (gastric feedings, room air trial)
• The medication he is on for reflux would completely stop his symptoms so Josh isn't in pain from the reflux
• Josh would not get any more infections while in the NICU
• Mom, Dad and Josh would deal well with being seperated

Praises:

• Josh weighs 4lbs 1oz!
• Josh tolerated 3 breastfeeding attempts today and ate fairly well
• Josh was a more content baby and both he and Mom enjoyed some bonding time today
• Dad, Mom and Josh are very thankful for family and friends who have been checking up on and helping out Mom and Josh while Dad is gone.

(Josh waiting for Mommy to get there this morning)

 

(Josh showing off how relaxed he can be in bed)

 

(Josh enjoying being held and cuddled by his Mommy)

 

(Josh looking happy after getting his feeding)

A fussy baby day

Josh had a good night last night. Although he has been a little fussy today.  When Mom arrived this morning she found a very awake Josh.  He was ready to eat and did his best time so far - 20 minutes of breast feeding!  Mom was very proud of him and after some cuddle time Mom placed him back in his bed to pump.  Well, Josh wanted no part of his bed.  He started flailing around and would not calm down, so Mom gave him his pacey, which worked for a few minutes.  Then he started flailing again and when that didn't get him what he wanted he started a full wailing at the top of his lungs.  He cried for about 5 minutes before Mom could finish up what she was doing and pick him up.  As soon as he was swaddled in Mom's arms he was calm and happily looking around.  He drifted off to sleep in Mom's lap shortly there after. 

He woke up again around noon and having his nose suctioned out, Mom attempted to feed him, but he only made it 8 minutes.  This time he was completely sacked out and didn't wake up when Mom put him back in his bed.  Mom then snuck out to get some lunch.  When she got back Josh started crying again.  This time Mom was able to reposition him and calm him down in the isolette.  He was then very awake and enjoyed some story time with Mom.  Since it was close to his next feeding time, the nurse did his hands on time a little early.  Josh was completely sacked out afterward, so Mom decided to wait to feed him until later in the evening, which he was much more awake for.

In addition to being a little fussy today, Josh also has had more awake time today.  We are not sure if he isn't feeling well or if he is overtired and not able to rest well.  His tummy is measuring a little bit bigger, but he is getting extra volume with breastfeeding and hadn't pooped yet.  The nurse did point out today that he has an umbilical hernia, which is common in preemies (and other babies) because their abdominal muscles aren't well developed yet.  The nurse said that although it may be a little bigger, it should resolve by itself.  When Daddy got there after work, he got a chance to change Josh before pulling him out for his evening feeding.  Daddy happily changed his pee-peed diaper, only to have him fill up the new diaper with an explosive poop.  Everyone around little Josh heard him fill that diaper!  So Daddy got to change his first poopy diaper since the one where Josh had a meconium blowout.

Josh gained 35 grams yesterday and is now just over 4lbs (1815 grams)!!!!!! We are very proud of our little man crossing over the 4 pound mark.  Josh is still tolerating his continuous transpyloric feeding.  He is also doing pretty well with breastfeeding, although he doesn't have the stamina to do more than 2 feedings in a row or eat if he didn't get some good sleep between feedings.   Mom and Dad are hopeful as he grows over the next week or two he will be able to tolerate his feedings all in a row. 

Prayer Request:

• Josh would be able to rest well despite his noisy neighbors
• Josh would not get another infection while in the NICU
• Josh would develop stamina so that he can take all of his feedings orally
• Josh would not have any desaturations or apnea and be able to be weaned off of his oxygen
• Mom would do ok while Dad is away on business
• Mom's milk supply increase to meet Josh's needs
  

Praises:

• Josh is 4lbs today!!
• Josh continue to do well with breastfeeding
•  Josh continue to have good interaction with his parents

 (Josh sleeping peacefully when Mommy arrived today)

 

 (Josh feeling upset after being put back in his isolette before he was ready)

 

 (A exhausted baby all tucked in for a nice long nap)

 

 (Josh starting to wake up before his evening feeding)

Its the snoozy baby

Josh had another good night last night, with very few episodes. He lost 5 grams, but that was expected considering he had a 4-diaper poop blowout the previous night after he was weighed. His average daily gain is in a good range, and so the doctors are not concerned. Josh did well with his breathing over night - having only a few episodes of apnea or desaturations. Then this afternoon he had several episodes of desaturation, most of which could be contributed to reflux.  We elevated the head of Josh's bed and the nurse suctioned him, both of which seemed to help.  Josh's oxygen was increased back to 50cc but will hopefully be weaned later this evening.


The plan for today was to try to get Josh to breastfeed three times. However that schedule is totally dependent on Josh. When Mom and Dad got to the hospital after church, Josh was snoozing. He was so deeply asleep, that even after a diaper change and some washing of gunkies off of his face, he fell right back to sleep. He woke up for about a minute to try to breast feed, but then fell right back to sleep. This could be a combination of the fact that he is still getting fed through the tube, which means he isn't really ever completely hungry, and he may have had an active evening and need extra rest today.


Mom and Dad then went to lunch and came back and Josh was still a pretty sleepy boy, and not really interested in breastfeeding. But once Dad changed his diaper and did his chest PT, Josh seemed much more awake. Just as Mom was about to start feeding Josh, the lactation consultant came by, which was perfect timing. Last week when she came by to check Josh's latch, he was already done eating. Josh ate like a champ and she was able to get a good look at his feeding technique. She said he had a great latch, swallowed well and was definitely getting milk while feeding. She was quite impressed with how well he is doing!! We are very thankful for answered prayers related to Josh's suck, swallow, breath reflex developing so early and him being able to breastfeed already. He also had a very successful early evening feeding prior to Mom and Dad heading home today.


Josh's personality continues to develop more everyday. Mom and Dad think they could sit and watch him all day long. Today we had a particularly good time watching his facial expressions, especially while he was sleeping. He makes some pretty cute faces, including a sneering face and a kissy mouth face. He also likes to imitate nursing while he is sleeping - which is also very cute.

As Josh continues to do well each day he is making tiny steps toward going home.  Mom and Dad are very much looking forward to having Josh at home when he is ready.  The things Josh has to do to make it home are: eat all of his feedings, steadily gain weight, hold his body temperature, and not have any apnea/bradycardia/desaturations for one week.  He can come home on oxygen, although, we are hoping he won't need it.  Please be praying for this specific things as we are beginning to look towards discharge  hopefully sometime in the next 4-6 weeks.


Prayer Request:

• Josh would have no apnea or desatrutions and his oxygen could be weaned back to 25cc (and 0 ccs eventually)
  
• The medicine Josh is on for reflux would help him and he would not have any more severe reflux
• Josh would be able to develop the stamina needed to take oral feedings every 3 hours
• Josh would continue to do well with breastfeeding and be able to take full feeding each time he eats
• Mom's milk supply would continue to increase to keep up with Josh's needs (nursing has helped some)
• Mom and Dad would have patience while awaiting Josh's discharge from the NICU
  

Praise:

• Josh had two every good breastfeeding sessions today
• Josh's weight gain has been pretty steady for the last 2 weeks and he is getting stronger everyday
• Josh is becoming more interactive with Mom and Dad and the nursing staff
• Josh is making good progress towards going home

 (Josh sacked out when Mom and Dad arrived - we think he must have been out partying with the night nurses)

 

 (Josh back in bed after not waking up for his noon feeding)

 

 (Burrito baby making kissy faces after a very filling mid afternoon snack)

 

 (Josh being very awake and interacting with Mommy and Daddy for about 30 minutes before his evening meal)

 

 (Josh the burrito baby - look at those cheeks!)

 

 (Josh holding his own pacey with two hands after being put to bed for the night)

Burp goes the baby

So Josh had a pretty goodnight last night.  So good in fact, the nurse was able to wean his oxygen to 25cc!  Josh seemed to tolerate this change quite well. Mom and Dad did increase his oxygen to 50cc per minute while Josh was breastfeeding - to give him a little extra support while eating.  If Josh is able to to tolerate this level of oxygen for a  few days, the doctors will try him with no oxygen, which would be very exciting!  Josh did well today with desaturations, having two episodes - both associated with feedings.

Josh continues to do well with his transplyoric feeding.  He is also doing quite well with his breastfeeding.  He ate two times today, both for extended periods of time.  Because he is eating orally, Josh has had a new experience over the last few days -  burping.  His facial expressions while being burped are very funny.  The first few times he opened his eyes really wide and looked shocked that anyone would inflict such violence on a baby.   Josh gained 75 grams overnight and now weighs 3lbs 15oz!  Four pounds is right around the corner!

It seems that Josh is having a lot of first over the last few days with breastfeeding and big boy baths.  Today was another first - Josh actually fussed after being put back in his box because he wasn't done being held!    As a general rule, Josh is not a fussy baby.  He does fuss when they stick him or change him.  He is very laid back.  But today after his noon feeding, Mom and Dad both spent some time cuddling with Josh (aka the burrito baby) before putting him back to bed so the nurse could work with him some.  Dad put Josh in his isolette but couldn't get Josh to settle down - he was flailing his arms and legs.  None of his normal calming routines worked. We let the nurse do what she needed to and he settled back down with his pacey.  Well, that didn't last but a few minutes and Josh started to fuss. As soon as Dad got him all swaddled up, Josh stopped crying and drifted off to sleep in Daddy's arms.  Needless to day, we both are enjoying the idea that Josh likes to spend time with us as much as we do with him.

Prayer Request:

• Josh would continue to do well on the 25cc of oxygen and be able to be weaned to room air in a few days
• Josh would continue to do well with breastfeeding and would soon be able to take all of his feeding orally
• Josh would not get any more infections while in the NICU
• Josh would continue to grow stronger and gain weight everyday so he is ready to come home from the NICU soon

Praises:

• Josh is now 3lbs 15oz!
• Josh is doing very well with his breastfeeding
• Josh's personality is continuing to develop and he enjoys spending time with Mom and Dad
• Mom and Dad went on their first date since Josh was born (that's why the blog is late :-)

 (Josh zonked out when Mommy and Daddy arrived this morning)

 

 (Burrito baby after his noon feeding -doesn't he look content?)

 

 (Our happy family)

 

 (Josh upset that he was put back before he was ready)

 

 (A happy Josh sleeping after some extended cuddle time with Daddy)

 

 (Doesn't everyone feel better after a good burp?)

Rub a dub dub... its a baby in a tub!

Overall, Josh had a much better day yesterday then he has had recently.  He had 6 episodes of apnea and 2 episodes of desaturation.  This is a huge improvement from the last several days.  So much so that in fact, that they doctors have decided to start a medication for reflux.  So Josh started medication called errythromycin which is suppose to help GI motility.  He will be on this for two weeks and we will see if that helps things to move through his GI tract faster and decrease his reflux.  Mom and Dad hope this new medicine will make Josh feel better quickly.

Josh is tolerating his transplyoric feedings quite well.  His feeding rate is back up to 11ml per hour.  Josh gained 15 grams and is now at 13lbs 12 oz!  The doctors also said that Josh can attempt breastfeeding 3 times a day if he is interested during the day.  His feeding are to be held for one hour during each breastfeeding attempt so he doesn't get too much food in his belly.

Josh woke up around 11am and ate for about 11 minutes before falling asleep.  Josh hadn't has a bath in several days, so Mom and the nurse bathed Josh.  It was his first time having a "tub" bath, which Mom enjoyed even if Josh found it all a little distressing,  After his bath Josh was very awake again, so Mom attempted to breastfeed again.  Josh did an amazing job - he ate for 15 minutes total - eating so much that he had a bought of reflux!  Mom was very pleased with his good effort today.  Needless to say Josh was exhausted after his bath and feeding - he was a jello baby.  Mom poured him back into his bed and he slept for the rest of the afternoon!

Prayer Request:

• Josh would do well with his new reflux medication and it would help him to do better with his feedings
• Josh would have less/none desatruations/apnea
• Josh's eye infection would continue to heal up and he would not have any other infections while in the NICU
• Josh would continue to do well with his breastfeeding, be able to get on a schedule and feed multiple times a day

Praises:

• Josh had less episodes of apnea/desaturations
• Josh had his first big boy bath in a tub!
• Josh breastfeed twice today for more than 10 minutes each time
• Josh's weight is up to 3lbs 12oz!

(Josh sleeping comfortably this morning)

 

 (Josh's "comfortable" position... notice both the arm and leg hanging off of the edge of the bed?)

 

 (Josh waking up as mommy starts to interact with him)

 

 (Hey, that's mommy!  Yeah!  Mommy is here!)

 

 (Do you have milk for me?)

 

 (Josh sleeping after a nice breastfeeding session)

 

 (Josh during his big boy bath - he didn't like it very much)

 (Josh wide awake and squeaky clean after his bath -he is a burrito baby)

 (Josh zonked out after all of the afternoon activities)

Mr. Josh has an opinion

So last night and today were much better than yesterday!  Mom and Dad called around 1am to check on Josh and were told that his lab work looked good - there was no sign of infection.  This was very encouraging news.  They were also told that the doctors had decided to start Josh on transpyloric feeds, where a feeding tube goes from his nose, down his throat, through his stomach to the upper part of the intestine... thus bypassing the stomach.  The doctors feel that if Josh's desaturations are caused by reflux then this new tube should significantly decrease his episodes.  If after a few days Josh is having less desaturations, then they will start him on a medication for his reflux and go back to feeding him via the gastric feeding tube.  Although it is hard to tell anything definite yet, Josh has had significantly less desaturations today compared to the last few days.  We will just have to wait a few more days to be sure that reflux is the root of the problem.

Josh continues to be on 100cc of oxygen, but his saturations are doing much better and they might start weaning this soon.  Josh is also getting continuous feeding through his new feeding tube.  The feedings are running a bit slower 8.75ml per hour.  Mom forgot to ask why the rate was slower during rounds, but she will ask tomorrow.  Josh gained 30 grams yesterday and now weighs 3lbs 11oz!!  He is getting much chunkier - we are surprised everyday at how much bigger he looks.  There seems to be new fat on some part of his body every day.  Josh also impressed his nurse today with a huge poop!  He pooped through his diaper and covered his snuggli - he seemed to feel much better afterward.  Conveniently, Mom had left to go to an appointment and missed the whole thing!

Josh attempted to breastfeed again today.  He continues to latch well, but only fed for about 6 minutes today.  He was very tired during today's feeding, which might be because he had such a busy night with getting his feeding tube.  Josh did show interest this afternoon when Mom was holding him, but Mom had just pumped, so there was not much satisfaction to his attempt.  Tomorrow is a new day and hopefully a better day.

Dad came to have lunch with Mom and Josh today, which they enjoyed very much.  Dad also got to spend some good time holding and bonding with Josh this afternoon.  Josh is becoming more vocal guy when he is being held.  He likes to express himself with little grunts and squeaks.  He is quite the conversationalist!  Both Mom and Dad enjoy having chats with our little man.  

Prayer Request;

• Josh continue to have less/no desaturations and apnea
• Josh would do well with his transpyloric feedings and it would decrease his reflux
• Josh would be able to stay awake during breastfeeding tomorrow and be able to increase his stamina with feedings
• Josh, Mom and Dad would all get good rest tonight
• The medication Mom is starting to increase her milk supply would be effective

Praises;

• Josh does not have an infection and his labs look good!
• Josh is up to 3lbs 11oz
• Josh continues to show interest in breastfeeding and is making a good effort
• Josh continues to grow and becomes more interactive everyday

 (Josh wide eyed and awake for mommy this morning)

 

 (When do I get my cuddle time with mommy?)

 

 (Josh in one of his usual "comfortable" positions)

 

 

 (Daddy and Josh enjoying some time together)

 

(A happy baby being held by his daddy)

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)

Glug, glug, glug... who's that drinking? It's Josh!

Josh had a milestone day yesterday.  He went one whole day without any apnea!!!!  This is quite an accomplishment for such a little guy!  We would like to say the trend continued today, but he did have one brief episode of apnea this morning.  Oh well, at least he has proven he can go without any apnea.  Josh is continuing to have quite a few desatruations throughout the day.  The doctors feel this is still related to his reflux and are going to wait it out to see if it improves once his feeding tube has been removed.  While it is hard to be patient and wait to see if his reflux will improve, we will do our best to be patient.

The culture from Josh's eye came back with two organisms growing in it.  The nurse practitioner said that his eye drops are approriate to treat the infection in his eye.  His blood cultures are still negative, so we will continue to wait to make sure he doesn't have a blood infection from his eye, or an eye infection in his blood.  Josh is not acting as if he is sick, so Mom and Dad are encouraged by this.

Josh continues to tolerate his feedings well.  He gained 25 grams yesterday and now weighs 3lbs 10oz (1,665 grams)!  Mom and Josh also got to attempt breastfeeding today.  His feedings were turned off for one hour prior to our attempt to help him feel hungry and were left off for another hour to give us plenty of time to try feeding.  Josh did very well!!  He was able to latch and feed on one side for 6 minutes before he had some reflux and desatruated.  He then fell asleep when we tried the other side.  When his nurse hooked his feeds back up, there was fresh milk in his tummy, which means he was able to successfully eat!!!!

About three hours later he became very restless and Mom decided to do some Kangaroo Care.  Once Josh was all cuddled in, he started rooting around - so Mom let him feed on the other side for another 5 minutes before he fell asleep again.  Mom and Dad are very proud that Josh was able to do so well on his first day of breastfeeding.  One of the nurses said that she had never seen a baby be able to breastfeed at 32 weeks!  We are quite impressed with out little guy!

Josh continues to be very active. He seems very intent on scooting his way out of his box.  He has tried twice today to leave through one of the side holes.  He also continues has facination with pulling on his lines and tubes.  Today he has been pulling off his EKG leads.  He has had 2 sets of leads since 7am this morning.  Mom and Dad are amazed how active Josh is and feel encouraged that he is able to do so much for such a little guy.

Prayer Request:

• Josh's eye infeciton would clear up quickly, his blood cultures would remain negative and he would avoid further infections while in the NICU.
• Josh would be able to build up some stamina with his feedings and be able to work up to a full feeding soon.
• Josh's reflux would decrease and/or stop
• Josh would have no apnea and his desaturations would decrease/stop
• Mom and Dad would be able to get good rest and find balance in getting things done
• Mom's milk supply increase to meet Josh's current and future needs

Praises;

• Josh did really well with breastfeeding!!!!
• Josh is up to 3lbs 10oz
• Josh had one full day without apnea
• Josh is very mobile and is motivated to go home (as evidenced by him trying to escape from his box on a regular basis

(Josh settled into his pattern of sleeping in the morning and being active in the afternoon)

(Josh seems determined to try to crawl out that door)

(Foiled by the door that only has a handel on one side!)

(Josh taking a break from his jailbreat attempts)

(Josh resting peacefully when Daddy got to the hospital after a long day of work)