This is what Jac looked like when I arrived this morning
When I arrived this morning I found a very happy little Jac fast asleep. He was so comfortable that his nurse and I waited quite a while to do his cares until he started to stir.
Jac continues to do well on his feeds. He stayed at 2.0 ml / hour. We have now added fresh breast milk to his feeds. This means that for 4 hours he gets colostrum and then for the next 4 hours he gets fresh breast milk. The reason for doing this is to give him some additional protection from the infections in the hospital. When I am exposed to an infectious agent my body will produce antibodies to it and within a few hours those antibodies will be expressed in my breast milk hence providing Jac some protection from the infectious agents in the hospital.
Jac remains on the high flow nasal cannulae. He had been at 2 liters of flow and last night he was moved to 1 liter. (The flow rate refers to how much air he gets in 1 sec) down from 2 liters. This means that Jac has to work harder to breathe and he tolerated it very well. He had a few desats during the day - especially when he was moved and we had to increase his oxygen to get his sats back up - but these episodes only lasted a few minutes and Jac did not seem to be working extra hard to breathe - they mostly happened when he was crying!
Jac was awake quite a bit yesterday - some of it in a quiet alert state and quite a bit of it crying. For a little bit Jac was in a quiet alert state - and I put my face down at the portal and we looked right in one another's eyes for a few seconds. It was a beaatiful moment and I wish Daddy had been there to share it. I know he was looking right in my eyes and that he knows at least that he sees me all the time - even if he doesn't know I am his Mom or what that means!
Jac right after Kangaroo care - still fast asleep - before we got him wrapped back up
Jac and I got to do Kangaroo again again today. It was very nice and we fell asleep together. I was in the lounger chair with him on my chest. While I was asleep his nurse checked his temperature and gave him an extra blanket. I am supposed to heat up enough to keep him warm but I usually run a little cold. We used to use the portable warmer to keep warm but we have now progressed to using just warmed blankets. We spent about 2 hours together and during that time his nurse replaced his isolette. He had been in the other since his arrival at the NICU so it was nice to have a new one.
After we got Jac in his new isolette the flow rate for his nasal cannula was reduced to 750 ml / second from 1 liter / second and his study gas was turned off. We don't know if the study gas is NO2 (which should have been providing some benefit to his lungs). He seemed to tolerate the lower flow rate with aplomb but I am very concerned about the next move which is to low flow nasal cannula. I am worried because of the problems we had last time in the ICC. I am holding out hope that weaning his high flow down slowly as we have and that he should have gained more strength will mean that that transition will also go well - although I have made it very clear that I don't want him moved to low flow without me being there so I can watch him very carefully.
Jac did not seem to like his new isolette - or something else - because he spent about 1.5 hours crying on and off after he was in there. His nurse and I could not figure out what was wrong. After changing his diaper and his position, adjusting his canula and his swaddling just before Daddy arrived he finally calmed down and stopped crying. At that point I had been standing over his isolette with my hands containing him in an attempt to help him get organized and soothe himself. Tiring for Momma and for Jac. Once he calmed down he slept soundly until we left around 11:00 pm.
Jac is spending more and more time awake these days. It is so nice to see him awake, looking at me. He is able to move his eyes purposely for very short periods of time (a few seconds) before they drift off again. He is also crying more - which to me shows that he is feeling well enough to tell us that he doesn't like something and we need to figure out what it is. He now changes the position we put him in if he doens't like it. When we put him on his tummy now, he frequently rotates himself to one side so he is half on his side, half on his belly. I am so happy to see him showing preferences and moving around. He has also started to be able to move his head a bit - fractions of an inch really - but it's a start! Go Jac!
His weight tonight was 800 grams - up from 770 yesterday! Keep on growing!
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