Sunday, March 15, 2009

March 15 - Open Crib Day

Colton moved to the open crib today! He is now working to prove that he can maintain his own body temperature without the help of the isolette. He moved into the new crib at 2:45 today. He also had orders written on his chart for Mom and Dad to begin to learn to use and place the NG tube (his nasogastric feeding tube). On Monday, the social worker will begin to arrange for all the equipment he needs to be discharged home. Mom and Dad will also learn his medications and how to administer them.

Colton has come a long way from 3 lbs 12 oz weighing in last night at 6 lbs 15 oz just under the 7 lb mark. While he may appear to be an average sized full term baby, he is very far developmentally from a full termer. Colton has done excellent in the weight gain department on his diet of breast milk and calorie fortifier via the tube. The neonatologist have strict guidelines based on age and weight for nutrition for the preemies. Even if they do better than expected in the weight gain department, as Colton has done, that doesn't mean they even begin to compare to a full termer. Colton should have spent the last 6 weeks (plus a couple more!) growing and developing in utero. To be able to grow and develop outside, means he has had to sacrifice development in order to learn to breath, digest food and survive on the outside. All preemies seem to struggle in some areas and work like a champ in others. Colton seems to have the digest food and grow part down pat. Actually eating the food by bottle and remembering to breath properly are harder for him. If it was easy to grow the babies on the outside in the isolette, I imagine they would let everyone get out of the 3rd trimester. I have heard it can be trying...I wouldn't know! I have 2 children and I have only been pregnant a little over 13 months total!

As a pediatric physical therapist, I am acutely aware of what is normal development for a premature infant. When Colton is 6 months old, doctors and therapists will expect him to behave as a 3.5 month old infant due to being born 2.5 months early. As with a full term infant, he will excel in some areas and lag a bit in others as he works to develop. Infants born before 32 weeks gestation often lag behind even more due to additional complications they may have. Most preemies catch up with their full term peers by 2-3 years of age. Basically, he is ahead of the curve by getting to come home before his due date! Even if it is with some equipment.

Sydney took off and grew like a weed after we brought her home from the NICU 8 years ago. Since she was 2 years old, she has been 90 percentile for height after starting below the 5th when she was born (Sydney was born at 32 weeks and 3 days gestation). One of the most frustrating things for us was people who assumed she was older and therefore expected her to act the age they thought she was based on her height. We were acutely aware then based on veiled comments or body language how people thought she was not acting her age. It is unfair to expect a 3 year old to have the skills of a 4 year old. The same holds true for Colton. It's tempting to think he is ready to leave the NICU and will be "caught up" or "normal" strictly based on his weight and size. Unfortunately, our society expects certain behavior and characteristics strictly based on size. Make no mistake about it, Colton is doing very well, but he is still a fragile premature infant. I am very thankful he is not had a failure to thrive, which can be very common diagnosis for preemies who do not gain weight well.

This week will be a blur of training and preparation to bring Colton home. The target date remains Friday for his homecoming. I plan to send out birth announcements after we get Colton home, settled, and get the NG tube and stickers off his face so he can have a beautiful picture without medical equipment to accompany his announcement. That is probably still a couple of weeks off.

In addition, RSV season runs through the end of April, so Colton will have to put off company until the end of April. I know everyone is very anxious to see my little man in person; but we will have to wait for his debut on the red carpet. Thank you for your understanding. RSV is a simple cold in adults and older, healthy children. RSV can be deadly for premature infants. This is something both the doctors and the nurses are crystal clear about - your child can die if they are exposed to RSV in the coming weeks. Short of Jesus Christ knocking on the door to visit, we may respectfully ask everyone else to wait until cold/flu/RSV season is over. Next RSV season, Colton will receive special RSV vaccinations to prevent infection. His lungs remain premature and at high risk of damage from illness. We just want to be clear that we are not trying to be rude but have to put Colton's health first. Trust us - we want to show him off and will do so when the danger of the season is over!

Thanks for your support and we look forward to everyone meeting our little man later this Spring. We will continue to update with pictures and reports. Look for a huge spread on homecoming day!

Wendy, Bret, Sydney and Colton


Kelly said...

LOVE seeing Sydney with her little brother!!

Informative post today, and I appreciate the lessons learned.

I look forward to lots more pictures here once you get him home. As for a visit... I don't think you have to worry about me. After all, I've yet to meet your husband or daughter in real life, LOL! (I know, I'm terrible about visiting people!)

Lora said...

Great post Wendy! I'm so excited for you to finally get the big man home. HUGS

Pam said...

Awww.. I love the photo of Syd and Colton, too!!!

Informative post, indeed.

Sam, due to his ADHD and stimulants is very small for his age.

Connor, on the other hand, with his PDD delays is much less mature, physically as well as emotionally (not to mention socially due to his lack of social skills).

I often forget just how behind his peers he is until I see him in a setting with them. The difference is startling.

I find myself, preemptively, telling people what Connor's issues are, in situations when I know they are looking or talking to him like he's not acting or talking like the average 11 year old.

Scooter said...

Keep up the great work. Sorry we missed you guys over the weekend.