Thursday, August 7th - Kinley has Thrush

When I arrived I found out that Kinley has had a good night and morning because she has kept all of her food down. Nancy, from occupational therapy, has just finished doing some rolling and tummy time with Kinley.

During rounds, Kinley's bottle feeds will be increased to 55 ccs and the remaining 35 ccs will be given through her NG tube over the time frame of 1 hour.

I ruined Kinley's non-vomit streak during her 11:00 am bottle feeding. She had a cough/gag and vomited up about 10 ccs. She did finish the bottle though.

Nancy, from occupational therapy, gave Kinley her 2:00 pm bottle since she hasn't fed Kinley in a while. Kinley had another cough and gag and ended up throwing up about 20 ccs. Once again, she was still able to finish the bottle though. Kinley has been getting tired at the end of her bottles and we believe this is the reason for her vomit. While she is tired, it looks like she is letting her mouth fill with milk, but then she forgets to swallow. Once her mouth is too full with milk it begins to run down the back of her throat causing her to cough, gag and vomit. Because of this Nancy decided to make a new feeding plan for the nurses to follow. It includes when to burp Kinley and when to stop feeding if she is getting tired.

Kathy gives Kinley her 5:00 pm bottle and she eats 30 ccs before getting too tired. We decide to stop because we don't want her to throw up anything. At this point in Kinley's recovery it is much more important that she keeps down her food/nutrition than finish her bottle feeding. The remaining portion of Kinley's bottle is added to her NG feed.

We return from shift change to find out that Kinley has thrush. Thrush is a fungus that grows in the mouth. It is mainly common in babies. Indicators of thrush are a white tongue and difficulty eating. Overall we feel that Kinley has been eating pretty well, but maybe she will do even better once her thrush is gone. Kinley will be started on nystatin to help get rid of the thrush.

At 8:00 pm Kinley eats her entire 55 cc bottle and didn't even get tired. Hopefully this means we caught her thrush early and it will be easy to get rid of. Kinley stayed awake until at least 10:00 pm when we had to leave.