Sunday, July 24, 2011

Week Three

This Friday Lillian turned three weeks old.[1] She's made more progress, but we've passed most of the milestones already, so there's not as much to report this time around (that's a good thing):
  • She's been improving in how much milk she can get out of breastfeeding
  • She's gained a pound over her birth weight
However she's still been experiencing a lot of acid reflux. The Prevacid is supposed to help with that, but it's still a problem. It often interferes with her feeding. Sometimes she'll spit up and start to choke. Once that happens she's no longer interested in feeding. Other times she'll hold her breath to prevent the spitup from getting into her lungs and then she'll desat.[2] So now when she's breastfeeding we blow oxygen into her face to lessen the effects of her holding her breath.

WARNING: If you are bothered by pictures of infants in intensive care, you probably shouldn't read on.

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As the number of tubes in our baby has decreased, our involvement in her care has increased. They have us check her temperature, change her oxygen cuff to the other foot, change her diaper (which sometimes means changing her clothes, too), give her baths, weigh her, etc. Some are less fun for her than others. For some reason she really dislikes having a thermometer stuck in her armpit.

One of the nurse practitioners noticed that Lillian favors turning her head to the right when she's lying on her back and so, since the bones in her head are still soft, her head is flattening out laterally.[3] To counteract this, they've started using a Halo with her, a gelatin ring that her head sits in so that she can't turn it. You can see it behind her head in a few of the photographs in this post. It looks like a misshapen doughnut, just a little larger than her head.

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This week we attended a class to learn how we can help Lillian come home as soon as possible. One of the things we learned were how to recognized when a preterm baby is stressed or overstimulated: flailing arms and legs (what they call 'saluting' and 'sitting on air'), sneezing, and hiccuping. This can be caused by moving them too quickly or too suddenly, loud noises, too much noise, bright lights, etc.[4] In this video, we've just put Lillian back into her bassinet after a feeding but we haven't swaddled her for the night, yet. Even though the lights were low and we were moving her slowly, she was a little stressed out because we had to weigh her to see how much milk she'd consumed.[5] She handled it pretty well, but one sneeze did sneak out.




Since Lillian can wear clothes, now, we've started bringing some of our own for her to wear. Many friends and family have generously given us preemie clothes for Lillian. Perhaps you might see something you gave us![6] And I'm still learning the names: onesies, sleepers, sleeping sacs, etc. The sleeping sacs (middle photograph) are ridiculously difficult to get on and off a baby with five cords [7] stuck to her!


If you recall from last time, Launa, one of the nurses who has taken care of Lillian a few times, likes to doodle on the cups used for warming up milk. Well, we had her a few more times. Since we started bringing clothes for Lillian, Launa made us a 'dirty-clothes bag' [8], too, and drew on it—an excellent choice given that Leann worked with the giraffes when she was an intern at Hogle Zoo a few summers ago.


Much to our surprise, the pink Stargazer lilies made a comeback and appeared next to their yellow cousins. So, once again you get more of Lilli's lilies.

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Can you wave goodbye to all the nice people who are reading about you, Lilli?


Notes:

[1] For more about her unexpected arrival, see here. For week one milestones, etc., see here. For week two milestones, etc., see here.

[2] That's short for desaturate. It means that the percentage of oxygen bound to hemoglobin in her red blood cells drops because she isn't breathing in new oxygen.

[3] The nurses at the hospital disparagingly call this "bread head". You see a similar thing happen when mothers leave their babies in their car seats or swings too much, though in this case the baby's head flattens dorsoventrally, which makes their face look like a pancake.

[4] Preterm babies that are frequently overstimulated are more likely to develop attention deficit disorders as they get older.

[5] We're able to do this because 1 ml of water = 1 g = 1 cm3 (by definition).

[6] Alas, I cannot give anyone credit because I have no idea who gave us which outfits. Leann says that's pretty typical for someone infected with a Y chromosome.

[7] The oxygen cuff (pulse oximeter), the feeding tube (nasogastric tube), and three leads (electrodes) for monitoring heartbeat and respiratory rate.

[8] And we've already needed it, too!

1 comment:

  1. Oh, she is looking so good! How exciting that she might get to come home early! (Tough to keep her in until April, though...!)

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