Gestation: 38 weeks, 4 days
Weight: 4 pounds, 14 ounces
Feedings: Continuous feeds of unfortified milk through a post-pyloric feeding tube on a pump running at 9 ml per hour
Abby didn’t get her post-pyloric feeding tube placed successfully until 6:45 PM on Monday night. Eventually she had to be taken down to fluoroscopy (which is kind of like a real-time x-ray video), where they could actually see to put the tube down past her pylorus. After the tube was placed feedings were started at 5 ml per hour.
Since having the feeding tube placed, Abby has occasionally spit up what looks like (excuse me for being graphic) bloody mucus. The doctor isn’t concerned about this, as it it probably just from all the irritation that occurred by poking that feeding tube down her throat all day.
Tuesday morning Abby’s electrolytes were almost normal, but her potassium was still low (2.9, but they would like it to be 3.5). So it was another day of waiting as her feeds were bumped up to 9 ml per hour.
Tuesday night Abby had an eye exam which came back normal, but the blood vessels in her eyes are still developing. She’ll have a follow-up visit in two weeks.
Today Abby’s potassium was still low, but everything else appears to be ok, so she is off of the IV and only receiving the milk feeds through her tube. She will receive oral potassium supplements and they’ll check her levels on Friday morning. Her feeds will be increased by 1 ml per hour every four hours until she reaches 13 ml per hour sometime tonight, which will be considered “full feeds” for her weight (which is now 4 pounds, 14 ounces, the biggest she’s ever been).
If Abby demonstrates that she can tolerate full feeds well (and hopefully starts stooling!) then tomorrow they will introduce a fortifier to see if she can tolerate the fortifier fed to her intestines. If she tolerates the fortifier, then we will be able to introduce oral feeding again and try to identify where the problem lies. She could still have a surgery on her pylorus, but we’ll just have to wait and see.
We asked the doctor today about Abby’s infrequent stooling and found out that they aren’t concerned at all. If Abby only stools once a week, they’re fine with that. As long as Abby’s stools aren’t dried out or causing any pain and her tummy stays soft, they’ll let her go as long as she needs to without giving a suppository. And Abby’s tummy is nice and soft.
Our big prayer request is that the doctor will decide to give Abby a fortifier other than HMF, the fortifier they like to use for all their babies, and the one that seems to be giving Abby the most problems. Or, if they do start her on HMF, that she’ll be able to tolerate it better when it’s not going into her stomach, but past it.
Dan’s Mom came down today and is, as I type, cleaning our apartment for us. After seeing Abby, she feels a lot better than she did just reading the updates, so I thought I would include her observations for the encouragement of anyone who doesn’t get to see Abby in person. Abby is very healthy. In fact, they have mentioned the possibility of moving her out of the intensive care unit, because her issues are just not intensive care material anymore. Abby’s only problem, that we know of now, is that she can’t keep her food down. She is alert and comfortable (except when they’re poking her for blood work) and looks like a small, but very healthy baby. And, even though we contribute some of this to fluid retention from the IV and not stooling for 6 days, she is up to a whopping 4 pounds, 14 ounces.
Praise the Lord
We are thanking God for:
-that Abby is almost to full feeds of unfortified milk and off the IV
-that Abby’s eye exam was normal
-that Abby is gaining a lot of weight
-that Abby’s potassium will come up quickly
-that Abby will tolerate her full feeds very well (and stool!)
-that the doctors will decide to put Abby on a “friendlier” fortifier than HMF