His feedings are on their final schedule of being delivered 8 times a day (every 3 hours). He will continue to be fed every 3 hours up through his discharge from the Neonatal ICU. Right now he is getting 35 milliliters of milk pushed into his stomach every 3 hours. It is pushed through that orange tube that you see in the pictures. That 35ml volume will increase as his body weight increases. Those feedings started out being slowly pushed in over a 2 hour period. They decreased the rate down to 1 hour, then down to the final and fastest rate of 30 minutes. He was immediately digesting the fast 30 minute feedings, so they then gave him a 'bottle test' where they replace one of his pushed feedings with the same volume in a bottle. On his first bottle test, he took the full 35ml in 10 minutes! Based on those results they decided to replace two of his daily pushed feedings with bottle feedings. He is doing very well on those 2 bottles each day and they will probably replace another pushed feeding with a 3rd bottle soon. Sucking, swallowing, and breathing is very tiring for a preemie baby, so they introduce the bottle feedings slowly. When they replace all 8 of his daily pushed feedings with a bottle he will be fully graduated from feeding school!
He was also moved out of the incubator and into a regular unheated crib. This is another one of the final milestones of the Neonatal ICU. The staff felt that he was maintaining his temperature well enough on his own, so he no longer needs the heated incubator.
He has a few more steps to make before he can come home. We continually get asked if he will get discharged when he gets to 5 pounds. His weight is a direct indicator of his health and growth, but has very little to do with when they will discharge him. His discharge from the NICU is based on 3 primary milestones. 1, his ability to maintain his body temperature in an open air crib. 2, his ability to suck, swallow, and digest 8 bottle feedings every day. and 3) his ability to maintain his breathing rate and heart rate. Each day he still has a couple of apnea and bradycardia spells where he stops breathing which then causes his heart rate to fall. We are still 5+ weeks before his due date and breathing is one of the very last areas of the brain to develop. The apnea spells usually resolve on their own 2 to 4 weeks before his due date. We expect him to be in the Neonatal ICU for another 2 - 3 weeks. It's hard to accurately guess at this point, but it looks like he'll probably be coming home near the end of October.
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