Friday, October 24, 2014
NICU Day 33
Dr Anderson saw Baby Girl today. I really enjoyed speaking with him. He's a very personable and engaging doctor who provided a lot of really relevant information and really great explanations of the issues. He said that Baby Girl was tachypneic (breathing fast) 30% of the time, so he decided not to wean the NIPPV. Given the options, putting effort and calories into growing is a better option than into breathing with less support. Overall, her lungs look good on Xray. Dr. Anderson said that if he were to look with a microscope, he'd probably find mild damage from the support she is on, but overall, she looks really good from a respiratory standpoint.
Baby Girl is currently gaining about 18 grams a day on average. He'd really like to see her gain 30 grams a day, so he is upping her feeds to 23ml to try and boost weight gain.
Happily, we get another day off on labs. Given her last set of results, he thought she wouldn't need new labs for 3-4 days from her last set, which occured a couple of days ago.
Dr. Anderson also explained infant anemia. Babies are usually anemic about 4-6 weeks after they are.born. they have a lot of red blood cells at birth due to totally normal low levels of oxygen in the womb. Upon birth the systems that create red blood cells take a break because o2 is so prevelant. Thus the anemia. Transfusions are given to preemies because anemia hits them harder and faster than termies. because baby is small and we want to direct calories to growing rather than other activities such as making red blood cells
When Dr. Anderson examined Baby Girl, he commented that she sounded good, no murmur (inappropriate heart sounds), no wheezing (inappropriate lung sounds).
Overall, he said, he wanted to be clear that he is NOT worried right now. He is very happy with Baby Girl's current status and he is content to continue waiting for her to grow (with a little help in the form of a bit more food).
Baby girl high satted the whole time I held her. They pushed her O2 back down to about 27% and she remained there when I called to check her wait a few hours later.
Weight: 1180 grams (up 80 grams) - 2 lb 9 oz
Milk: 1090 (36.33 oz)
Feeds: 23 ml pushed over 30 min, Iron supplement and 1ml, Tri-Vi-Sol, .4 ml protein x 8/day (every feeding)
NIPPV at 20, 23%-36% oxygen.
No labs in the morning
Day Nurse: Carroll
Night Nurse: Kate & Allie