Full Feeds!

Mikaila had mostly a good day today. They got her to full feeds early this morning and, for the most part, she tolerated them well. She had an aspirate (she is fed through a tube that directs the breast milk directly into her stomach, the portion she doesn't digest in any feeding is called an aspirate) with her noon feeding. However, she tolerated her 3pm feeding absorbing the entire serving. Let me expand on the feedings as I mentioned yesterday that I would. They began feeding her 3mls of breast milk every four hours or 18mls/day. They agressively pushed her, upping her feeds by a ml every 6 hours and moving her to feeds every 3 hours. I mentioned that she is at full feeds. For her size, full feeds are 13mls every 3 hours or 104mls/day. They will scale the feeds as she grows. She had a bit of a setback on Saturday. They had pushed her to 11mls every three and they decided to add the milk fortifier. The fortifier adds a few calories and adds calcium and phosphorous. These elements are critical for preemies as their bones, particularly the ones that form their rib cages, have yet to ossify. Mikaila did not react well when they added the fortifier. She became extremely distended. The doctors decided to give her a break. They held her feeds for 12 hours relying entirely on an IV to provide critical nutrients. She lost 45 grams that day; a pretty dramatic number considering she was only 660 grams at that point. When they began feeding her again that night, they moved her back to 7mls every three hours. It was a very difficult day for us. She had been progressing so well. The doctors really pushed her and when she couldn't take it anymore, she pushed back. She has recovered well and is up to 740 grams as of last night. We expect another 20-25 grams when they weigh her tonight. They will probaby try to add the fortifier again tomorrow or the next day. Wish her luck.

I said that her day today was mostly good. This morning, her belly was a bit distended and she was a bit pale. They drew some blood and did a stomach xray and saw two things; she had a bunch of air in her belly and she was a bit anemic. To remedy the first problem, they took her off of the Sipap and placed her on a nose canulet.

The Sipap was giving her constant pressure and apparently, much of it was being swallowed. The nose canulet is essentially the nose tubes connected to the mobile oxygen tanks that you see once in a while. They have since reduced the pressure in the nose canulets to stop this problem with her swallowing air. Just to be safe, they upped her oxygen to 25%. The problem with her being low on blood is not new and is pretty much expected. They have to draw blood often and she is too small to produce enough to keep up. This is actually the second time they have had to transfuse her although with preemies of her size, they consider all of these small transfusions as being part of one single transfusion. They order one unit of blood. That unit is good for 30 days. They use that same unit as needed limiting her exposure to a single donor. It is very likely that she will need more transfusions as she progresses. She reacted very well to her transfusion and is finishing the day strong.

They will probably take out her picc line tomorrow. That is good news as every artificial entry point into her body is a potential target for infection. I think that is about it for an update. Thank you again to everyone for their wonderful notes, gifts, thoughts and prayers.