Sunday, December 11, 2011


Baby Millie with her La La's hand by her head. La La is Scott's Mother Laura. 

Baby Ruby with my hand lying on her.

Scott and I ran into the neonatologist (Dr. K) outside the elevator by the NICU this afternoon. He made a point to tell us that so far Millie and Ruby are atypical 27 weekers. Atypical in that they are not on ventilators as most babies at their gestation would be at this point. He was very cautious though, and said that there is still a chance that we would need to ventilate one or both and to not be surprised or upset if this happens. Ruby continues to do great on room air (21% oxygen) with her CPAP. She was having some apnea spells when we were up there earlier. Dr. K said  that as long as she only has them every so often (up to 1 or 2 times per hour) then she is fine on the CPAP. If she starts having clusters of them and continually needs to be stimulated to breathe, then she would need a ventilator for a few days.

Millie was briefly on room air oxygen this am then she started struggling, and they had to keep increasing her oxygen needs. When they got up to 40% they decided to intubate her briefly to give her Survanta. Survanta is a medication that is put directly into the lungs (which is why they had to intubate her to give it). Survanta is actually surfactant which is a natural substance made by the lungs of term babies. Surfactant keeps the lungs from sticking together so that the baby can breathe normally. Premature babies do not make enough surfactant. This medication can be given up to 4 times total. This was Millie's second time to receive a dose. Our nurse told us that if she had been on the ventilator then they would have automatically given her several doses of it. Because she is not on a ventilator and it is traumatic for her to get intubated, then they wait to give it to her if she really needs it. This is the reason that Millie has gotten Survanta and Ruby has not. She has really needed it, but the good news is that after receiving it she starts to breathe much better and she is now back down to about 36% oxygen. 

While I was visiting the girls this afternoon they started feeding them colostrum. They were each given 1 cc  of colostrom through a feeding tube that goes into their stomachs. They already had feeding tubes in place to help get air out of their bellies (the CPAP pushes air into the stomach as well as the lungs). They will get this every 6 hours, and if they tolerate it then tomorrow they will get a little more. Obviously 1 cc is not for nutrition - they are still on TPN, but we are starting to test out their bellies and help them start working towards feeding through feeding tubes and not IV. That's it for now. Hope this is making sense. Let me know if there are questions and I will try my best to answer! Elizabeth

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