Wednesday, July 22, 2009

First Feedings

Day 26: Wednesday, July 22

Blaise and I dropped my mom off at the airport early this morning. It has been so nice having her here. I so needed her help physically and emotionally. I miss her already.

We headed over to the hospital right away. We hoped that we would be there for rounds and possibly for his first feeding. When we arrived at the bedside we were thrilled to see that the nurse was the same one that was with Blaise and Will on day one. He was sound asleep and so peaceful. She had him wrapped up really tight and told us that she had sung to him a little bit and that it really calmed him down. His warmer on the bed was turned off just to see if he could handle it on his own. I had never seen his heart rate so normal, not since before he was born at our non-stress tests had he been down in the 150's. His entire hospital stay it has been normal for him to be in the 160's and 170's. We wonder if maybe he is just more content to be on the cooler side, or maybe he just really liked being sung to. Also, the swelling in his belly is almost completely gone.

We were there for rounds and they did give the go ahead to start feedings today. He will get 4cc's every three hours. That's less than a tablespoon for each feeding. His first feeding was at 2pm and by then we had a new nurse for the afternoon. She was really great. She performed the actual feeding (good thing, because it was quite the juggling act) but she was really good about walking us through it and letting us be as involved as possible. The thing was that since 4 cc's is such a small amount, they just put the milk in a syringe and squirt it into the nipple of a bottle. We had quite the time trying to wake him up. He was half asleep during the feeding itself. He kind of choked and spat at first, but once he figured out the sucking-breathing-swallowing thing he guzzled it all. We had so much fun watching him try out this new thing.

Wednesdays at 12:30 they have something called Parent Hour. We got free lunch while we listened to a presentation about baby stress signs and soothing techniques. It was really informative and interesting. There were at least a dozen other couples and parents there. We all went around the table and shared our brief stories. It amazed us to hear about other babies that had so many complications or worse conditions than ours. We all mingled afterwards and Blaise & I met a few parents that we had some good conversations with. It was really neat to connect with other parents that are living the NICU life too. There was also a whole table full of donated items like blankets, hats, teddy bears, binky's, and other baby stuff that was up for grabs. It was a really nice break and such a humbling experience.
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3 comments:

  1. UnknownJuly 23, 2009 at 6:26 AM

    What a cutie!

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  2. JeriJuly 23, 2009 at 7:14 AM

    Hooray for Will! (and I have to say again - HE IS SO STINKIN' CUTE!)

    ReplyDelete
  3. JessJuly 23, 2009 at 9:11 AM

    I am so happy for you guys!! He is so cute! It's fun to see him without all the tubes, and it will be even funner when you guys are able to take him home. I'm so glad that you have been blessed through this experience. I'm so glad for all of you!

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About Gastroschisis

I have posted some links for your information and research, but here's the run down on gastroschisis.

What is it?
Gastroschisis is a birth anomaly in which the baby's abdominal wall does not close all the way during early development. These abdominal defects can result in several problems, the least of which is gastroschisis. This is when some of the intestines escape through the small opening in the abdomen and are now outside the baby's body. During pregnancy these organs are exposed to the amniotic fluid for some time which makes the once maliable and functional bowel stiff and swolen.

How is it treated?
Since gastroschisis is not as serious as other similar defects, it is not dangerous to still deliver the baby vaginally. Upon delivery the baby will go to the NICU and be examined by the pediatric surgeons. At this point of evaluation, there are several courses of action. What needs to happen eventually is that the bowel needs to be surgically put back into the abdomen of the baby.

Option 1: If the bowel has little damage, is quite maliable and healthy, and the baby's belly seems to have the room to accept all of the intestine at once, the surgeons will perform a "primary closure". The surgery is fairly simple. They will make an incision to enlarge the opening enough to push the bowel back inside and sew it up once it is finished.

Option 2: If the bowel is stiff and swolen and or the baby's belly does not have the room to accept it all at once, they will perform a "staged closure". This is more complicated and takes some time. This invloves placing a "silo" over the bowel (this is basically a bag that holds the bowel suspended above the opening). This silo will be somewhat inserted into the baby's belly so as to allow the abdominal fluids to enter and thus healing the bowel by bringing the swelling down and making it malleable again. As the bowel heals and with a little assistance from the doctors the bowel will slowly but surely re-enter the baby's abdomen.

Recovery
A staged closure can take up to a week or two. So you may ask why does he have to be in the hospital for 5 to 6 weeks. Since the baby's system is not used to the pressure introduced by this bowel that is now inside the abdomen, and the bowel has been exposed to the amniotic fluid for so long, it simply takes time for the baby's digestive system to normalize. Aside from the digestive system, other things may be affected such as breathing due to the increased pressure inside the body. The baby's recovery can be broken down into three distinct stages. Pre-Surgery, Post-Surgery/Pre-Feedings, and Post-Feedings.

The first is simply the waiting period before the baby's bowel can be put back inside.

The next period is after surgery, the baby's system is still very fragile and can only be fed interveinously. During this time the amount of nutrients is slowly increased until the baby is ready for the final stage, when his body can accept real food.

Once on breast milk feedings from a bottle, the baby is closely monitored. The process is slow as the baby must phase into these feedings from the IV. Once the baby is up to full feedings and is gaining weight, we can all go home!

Long term effects
Once the baby has fully recovered and is ready to go home, he should be fit as a fiddle and have little or no related complications thereafter. The main thing that he may experience is a case of acid reflux, but this can be treated with medication and it usually will go away as he grows and gets older.