Friday, January 2, 2009

Original due date

Today marks both Max's 10 week anniversary in the NICU and Max and Ada's original due date. In one sense, Max is now a full term baby (and at about 7 pounds he certainly weighs as much as many terms babies). In reality, though, as nice as the NICU is, a day in the NICU can't compare with a day in the womb.

Max seems to have his days and nights swapped around, so that last night--when Carolyn and I were at home--he was quite active but today--with Carolyn there all day--he was quite drowsy. Needless to say, we'd prefer Max to be the same wake/sleep schedule as the rest of the world (college students excepted). Because Max is more active at night than during the day, the nurses are getting to know him a little better than we do. They report that he likes to be picked up to be soothed.

In medical news, Max gained more than 100 grams overnight but his diapers were relatively light, suggesting that he's retaining fluids. This can contribute to difficulty breathing, so the NICU team put Max on Lasix.

Carolyn tried exercising Max and getting him to use a pacifier. In both cases he seemed more interested in sleeping than in exercising.

Carolyn did learn an interesting fact about Max's condition and the NICU team's plan for him from physical therapist S. She said that (I'm paraphrasing) when it comes to the suck-swallow motion, Max's form, his technique, is fine. However, his endurance is poor. It takes Max a lot of effort to suck or swallow, so that he quickly becomes exhausted. Why is this? Because Max is devoting a large amount of effort to simply breathing. The plan is to let Max's lung capacity develop by feeding him with an ND tube, which ought to cut down on food aspiration. S. said that all babies learn to suck and swallow; the most urgent job for Max now is to get strong.