Monday, July 21st - Our 1st Bottle Feed

When I arrived I found Kinley asleep on her belly in her new "big" crib. As promised, there are pictures of her new crib below, but I waited until she was awake before I took them.






Brecklyn is Kinley's nurse today (she is one of Kinley's ECMO nurses) and she tells me everything I had missed. Nancy, from occupational therapy, has already been by and given Kinley her first 10 cc bottle of the day. Kinley took all 10 ccs without any problems and then Nancy did a little tummy time with her.

Amber, the nurse practitioner, stopped by and gave me an update on all of the changes they will make to Kinley's care today. Yesterday Kinley's continual feed was moved up to full feedings (28 ccs per hour), but they are going to increase it again today to 30 ccs per hour. The reason they are doing this is because they simply want Kinley to have the extra calories for growing and gaining weight. For medications, her ativan and erythromycin will remain the same today, but they will lower the dosage on her methadone. They ran some tests on Kinley this morning and found that her hematocrit and hemoglobin were a bit low. This means that her red blood cell count is down a tiny bit so they are going to start giving her a liquid multi-vitamin with iron supplement, once a day through her NG tube, to help stimulate the production of red blood cells. Amber and Brecklyn both tell me that the iron supplement tastes horrible and can cause an upset stomach, but they are hoping that the milk from her continual feeds will lessen the stomach irritation. Luckily, since Kinley has an NG tube, we can avoid the taste, but lets hope her stomach can handle it. Also from this morning's tests they noticed that her sodium levels were on the low side. Sodium is an electrolyte that helps the body retain water. To help raise her sodium levels they will give her a dose of sodium chloride through her NG tube.

Kinley is asleep when both the sodium chloride and the multi-vitamin with iron supplement arrive. Both are liquids and can be given through her NG tube. Brecklyn gives the sodium chloride first and then the multi vitamin with iron supplement. Kinley remains asleep and it looks like the new additions to her belly will not be a problem, but about half an hour after receiving them Kinley vomits all over herself and her bed. From the smell I can see why the iron supplement causes an upset stomach. We have to replace Kinley's entire bedding and her clothes. Brecklyn also has to put Kinley's NG tube back up her nose. While we were getting her cleaned up she decided to make the moment a bit funny and pooped her pants.

Kinley was weighed the other night. She is now up to 10 pounds and 1.6 ounces.

Yeah, mommy's here. Kinley either finds mommy very exciting or very relaxing because soon after Kathy begins talking to Kinley she explodes in her diapers. It was so loud that it startled Kathy, not to mention that she was also leaning over Kinley when it happened. Kathy and I are becoming quite the pair at changing poopy diapers. We did not get any extra diapers dirty and Kinley never got upset.

Around 6:00 pm Kathy and I get our first opportunity to give Kinley a bottle. Kathy says that I can give her first bottle since I can't breast feed her. That works for me. Brecklyn helps me get situated and we begin. Kinley didn't want me to be too comfortable so she begins to cough before the bottle is even in her mouth. I don't think I like her sense of humor. Brecklyn gives me a few pointers on how to give the bottle without making Kinley gag and once she took a hold it was pretty smooth sailing. Kinley seems to have a pretty good grasp on the "suck, swallow and breath" pattern of bottle feeding. We are very lucky in that instance. Now all she has to do is get breast feeding down. Kathy and Kinley will work with the lactation nurse tomorrow on that.