Mario had another awesome day today. His oxygen level was weaned throughout the day and he has now been completely weaned off of it and the cannula has been removed. His night nurse will monitor him throughout the night to make sure he tolerates it well, but so far he was doing beautifully without it.
His IV was also removed today. The resident had agreed that if it started giving him problems it could be removed and not restarted. Well, it started leaking this afternoon and his nurse, Sara, was all to happy to remove it for him.
His feedings have also been increased. At his midnight feeding he will be given 26mL. They will keep him at that for a while and probably start adding fortifiers to the breastmilk early next week. These fortifiers will be things like additional vitamins and minerals, possibly caffeine (to help with his breathing - it will stimulate him), and even calories to help him gain weight. Thank goodness my milk supply is coming in nicely so I can provide him with plenty of breastmilk to help him grow. As long as he doesn't have to be put back on the cannula, his feeding tube will be moved to his nose tomorrow. This will be more comfortable for him and will allow us to progress towards nipple feeding.
The nurses are very encouraging and I am doing much of his care when I am there. I must say, tonight was nice to have two less tubes to worry about when changing, dressing, and weighing him.
His weight tonight was 3lbs, 13.4 oz. He gained 10 grams over the past day, which is a little under 1/2 oz. Hopefully with the increased feeds he will continue to gain. His bilirubin levels had gone up again based on the results of this morning's bloodwork. His level was at a 10.8 and his light level is at a 13. So, they will be rechecked in the morning. Babies generally reach their peek bilirubin levels at 3-5 days of age, so hopefully his levels will start decreasing and his jaundice will go away.
Dom and I had him out of his incubator quite a bit today holding and cuddling with him. We both held him all swaddled up this afternoon and this evening I kangaroo cuddled with him for about an hour. They are continuing to gradually lower the temperature in his incubator and he is getting very close to being moved out of it.
Grandma and Grandpa Ferreri, Grandpa Phil, and Aunt Brynn all visited with Mario today. He is starting to show a pattern in his sleep cycles and is awake and alert at feeding times (every 3 hours). That is a good sign as we move towards nipple feeding. He also continues to like to suck on his pacifier.
We are all very encouraged and happy with the progress Mario is making. We are still very aware that he will likely have ups and downs, but so far pretty much everything has been positive. The nurses warned us that preemies of his age often have the most difficulty with the feedings and not to get discouraged if he has good and bad days with that. We know that will be his biggest hurdle toward coming home and he will set the pace for that.
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