Wow, I can't believe Mario is already 1 week old! At times it seems like it can't be possible that a week has already passed. Other times it seems like it's been much longer than that. He has progressed beautifully and come so far this week. If he keeps it up at this rate he'll be home in no time ;)
His feeds remained at 33mL /feeding of breastmilk 22 (meaning fortified with 22 additional calories). Initially the resident wanted to increase his feeds today, but his nurse advised against it and felt that giving him another day at 33mL would help with the reflux issue. They did put him on the feeding pump to give him his feeds over 60 minutes. That seemed to help with his reflux apnea and he was only written up for 2 spells as of 10pm this evening. He only gets written up for spells they have to stimulate him to help him recover. And, even those write-ups weren't bad and just involved some repositioning and back rubbing. His day nurse also commented that his self-stims (spells that he recovers from on his own) were fewer in numbers today as well. Those are all good signes that we were correct in thinking the apnea is related to reflux. He'll probably be on the feeding pump for a few days and they'll gradually wean the time down to 10-15 minutes/feed, which is about what the gravity feed method was taking. The use of the feeding pump will hopefully help him until he grows out of the reflux (usually around 33-34 weeks) and they much prefer doing this to having to resort to medications for reflux. They will likely increase his feeds by a few mLs tomorrow.
He is looking less "pumpkin-like" today, good signs that the jaundice is going away. He also has his pooping skills mastered, which is how the body expells the bilirubin.
Today, Dom and I both spent time holding him all swaddled up and assisting with his care. His weight was up again this evening. The little man gained .6oz and is now at 3lbs, 15.6 oz. . .he's a whole oz above his birthweight now.
This afternoon I worked with the lactation consultant and worked on nuzzling/breastfeeding. Mario is taking to it like a champ. Angie, the lactation consultant, had me only pump for about 5 minutes to get some of the milk out of my breast before we worked with Mario on things. He was suckling away and I'm sure at least got a taste of milk. She commented how great we were both doing and praised my breastfeeding skills. Not that I know what I'm doing, I'm just listening to what they tell me and going with instinct on this one. Tomorrow I will meet with her again and we will continue working on things. Having lactation consultants right in the NICU has been a wonderful resource and I really appreciate all of their guidance. All of these are great signs toward our progression to nipple feeding.
Mario's incubator temperature is slowly being lowered. As soon as hit hits room temperature (for the NICU, which is kept rather warm, between 70-75) and he can maintain his body temperature, he will be moved to a big boy bed. Hopefully that will be relatively soon. It will sure make changing diapers and clothes easier than reaching through the armholes into the incubator!
Dom and I took an infant massage class offered by the NICU tonight. It was really a good class and we can't wait to try things out on Mario. We have to wait until he is 33 weeks to start though, which is this coming Sunday.
Mario's day nurse, Sarah, who has him as her primary, commented that Mario is becoming quite popular in the NICU among the nurses. She said they were talking about how cute he was at lunch today and how everyone wants to work with him. The other nurse who has him as her primary, Colleen, hasn't gotten to work with him yet because she's been working the same days Sarah has. But, I'm sure we'll get to work with her one of these days. Our little man is already a ladies man ;)
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