A Round Belly Means What?

We visited with Farrah last night and Ray held her. The night before, I did kangaroo care with her. She was very relaxed while I held her, but then she was more active than she should be after being put back in her bed. It seemed like she was fighting to stay awake, and we attribute that to her hearing our voices and wanting to be a part of what was going on. As we drove home, we saw that we missed a call from the NICU. Typically, the NICU nurses don't call unless there is an emergency or a change of treatment. This time, it was Farrah's night nurse calling to let us know that Farrah calmed down and all her numbers looked great. She said that she thought it would help us go to sleep easier, and she was right.

Farrah seemed very tired yesterday and slept the entire time that Ray held her. She is doing ok with the breathing tube and is letting the machine do most of the work for her as she continues to rest. We were told that she had been having a quiet day and had been sleeping most of the day before we came in. She was peeing and pooping as she should be and was sleeping all the time. Sleep for NICU babies is critical and encouraged, so we are not concerned if she is sleeping a lot as long as her monitored numbers look good.

Last week they added a fortifier to the breast milk she receives through her feeding tube, and it appeared that she could not digest it very easily. Her belly was getting big and filled with gas. Her nurses needed to remove the extra gas to get the roundness down. It was apparent that she was not tolerating that fortifier well, so they switched her to a different one called neosure. Her weight has been fluctuating too. At one point, she was getting close to 3 pounds, then they gave her a diurectic and she went down to 2 pounds. As of last night, she weighed 2 pounds, 5 ounces. Up. Down. Up. Down. The nurses thought that she was tolerating the neosure better than the first fortifier, but early this morning Farrah's belly was very full again and when the nurse tried to examine her, Farrah was not happy about it - she did not want her tummy touched. The quick solution for a full belly is for Farrah to poop on her own. Since this had not happened during the night shift, it raised some concern. They at first made the decision to hold all her feeds for now, continue with the IV nutrition, and monitor her. We called the NICU a few hours later for another update. This time we were told that she had pooped and her belly was smaller, as they had hoped. However, they were suspicious that she may have an infection of some kind, so they drew some blood and will also do a culture. The decision was made to pull out Farrah's PICC line in case there is an infection. They put a peripheral IV in her foot, and that is where her nutrition will go as long as she is not getting any feeds. It could just be that her digestive system does not tolerate those two fortifiers right now. When they resume her feeds (hopefully this afternoon), they will hold off on the fortifier and see if there is any improvement when she goes back to straight breast milk. We are anxiously waiting to find out the results from the blood culture. They also drew blood for a CBC and will look to see if her white cell count is high, which would indicate that she probably has some type of infection. If that is the case, they will start her on IV antibiotics right away.

It also looks like she will need another blood transfusion in the next few days, as her hemoglobin is a little low again. By NICU standards, Farrah is still considered level 3 and critical. There are babies in the NICU who are much sicker than her, but her main issue is that she was 12 weeks premature and that she is little. She has a lot of catching up to do in terms of developing. Fortuantely, since her delivery, she has been doing good in the NICU. Her one month birthday is on Monday. We will celebrate it by bringing in a new balloon for her bed and I may make a sign for her bedside.

Prayer requests:
- That Farrah's lung will get strong so she can start breathing on her own
- That Farrah's doctors can figure out a good fortifier that Farrah can tolerate so she can start having much needed weight gain.
- That Farrah be protected from any infections throughout her time in the NICU.
- That the insertion of a new PICC line goes smoothly.
- That her blood transfusion (if she needs it) goes smoothly.

The photos below were also on facebook, but they are are most recent ones from the past few days.