Emma's Story: Change of Scenery

Day 99

My apologies for the long delay between postings! We've been busy as always and have also been working on getting Emma's room together. Still a long way to go but we're making progress!

Overall, it has been a relatively quiet week. Emma is still working on the bottle feeding and still trying it once per shift. We are starting to see some improvements in her coordination; she doesn't desaturate or brady nearly as much, which means she is remembering to breathe (always a good thing!). It will also continue to take some time for her to have enough strength to keep nursing, as it's a lot of work for her and she gets tired easily. She is now getting 45 mL every three hours.

Emma had the ENT (ear, nose, and throat) doctor take a look at her this week after all. They said everything looks normal and she just has a little swelling around her vocal cords, which is also pretty normal given the extended time she was intubated. This should resolve on its own and likely doesn't interfere with her feeding.

Emma also went in for a "swallow study" on Friday. This is done by putting barium in her feeds and then taking x-rays to see how her feeds progress through her system. Unfortunately, she flunked, which means that she does have some "silent reflux". Basically, her food comes back up her esophagus like typical reflux, but she doesn't show the usual signs like spitting up frequently or desaturations (which is why it's silent). They then monitored how she did when she was fed formula thickened with rice cereal and she was fine with that, since the thicker feeds generally stay down better than regular milk. The current plan now is to give her the formula and rice cereal each time she bottle feeds, and then she gets the regular milk for all her other feedings. It's good to know that Emma has the reflux, but it probably doesn't have too much of an impact on her progress with the bottle. If things seem to get worse for her, they might give her more of the formula/rice cereal instead of milk, but we'll just see how things progress.

Well even though she's have some feeding challenges, it hasn't had any impact on her weight gain! Emma is 2430g, or 5 lbs, 6 ounces! She is looking wonderful and starting to outgrow some of her preemie clothes!! We can't believe how fast our little peanut is growing!

Emma was also finally moved over to the special care rooms in the NICU! It's just down the hall and is pretty much the same set-up as her old room. It's a little bit of a bizarro world though, since everything is the same but a little bit different. There are currently 6 babies in her room, and there are usually 2-3 nurses in the room, so sometimes one nurse has 3 babies. In her old room, there were usually no more than 4 babies and 2 nurses. While some of her nurses are the same, for the most part she has all new nurses, which is a little disappointing since we had gotten close with a lot of them and they were wonderful. Her old nurses will frequently stop by and visit though, and I'm sure these new nurses will be wonderful too. The babies here are all very stable (they're all in shoeboxes like Emma's), so it can either be very quiet (no monitors and alarms going off), or very loud (lots of crying since no one is intubated or in isolettes). We're just very happy that Emma is moving closer to the door out of there!