Tuesday, July 15th - Let Tummy Time Begin

Update from this morning's rounds: Kinley's oxygen flow (0.5 liters per minute) and support (21%) will remain the same today. We won't be able to get rid of that nasal cannula just yet, maybe tomorrow. Dr. C would like to see Kinley's average blood oxygen saturation a bit higher before removing it completely. Yesterday Kinley's blood oxygen saturation was in the low to mid 90s. All of Kinley's medications (methadone, ativan and erythromycin) will maintain the same dosage today, but the frequency of her methadone and ativan will be moved from every 6 hours to every 8 hours. Also, going forward both her methadone and ativan doses will be given through her NG tube instead of through her Mid line. This means that Kinley will be responsible for absorbing her drugs through her digestive tract. Speaking of digestion, Kinley has not had any more poopy diapers since yesterday afternoon, but that shouldn't stop her from eating more. Her residuals from yesterday and last night ranged from 2 to 12 ccs with the average being around 10 ccs. This is pretty good because it means the only thing remaining in her stomach is her last hour's worth of food. So Dr. C has decided to have Kinley's continual feed increased from 9 ccs per hour to 13 ccs per hour.

Occupational therapy (OT) made it by today to evaluate Kinley's range of motion. Everything they saw looked good, but they never did anything to test Kinley's oral stimulation to see how soon she might be able to begin eating orally. Hopefully they will do that tomorrow. They did show Kathy a few stretches that we can do with Kinley to make sure she maintains her range of motion though. And the big news is that we can start doing "tummy time" with Kinley. Tummy time, as you are probably already thinking, is time that babies spend on their bellies. But it is important because it helps babies increase the muscle control in their necks. Tummy time for now will simply consist of Kathy or I holding Kinley to our chest and letting her work on lifting and turning her head.

Kinley is doing well with her oxygen flow and support. She has been keeping her blood oxygen saturation consistently in the mid to high 90s and she occasionally hits 100%.

At 5:00 pm, Katie (Kinley's nurse) does her first residual check on Kinley since she has started feeding at 13 ccs per hour. Kinley had 20 ccs of residual, but that is still within range to continue her feedings. It is not shocking that Kinley's residual was so high since she just started on a larger feeding schedule.

Still no poop, except for one tiny spot on one of her diapers. Maybe Kinley is simply waiting for right before the evening shift change. That is what she has done the past two days. It is hard to believe that I am saying this, and I am sure that it will change in the future, but we are always so happy when Kinley has a poopy diaper.