Our rollercoaster ride continues in the NICU. Yesterday morning we were woken up by a phone call just before 5am to say that Lucy was sick again. She had stopped digesting her food and was having a hard time breathing on the conventional ventilator. So once again, Lucy is on the oscillator. There could be some different reasons for this setback. One possibility is that she has another infection and so she is on antibiotics to be safe until the cultures come back indicating if they needed. The other possibility has to do with positioning. Lucy has been retaining a lot of fluid for a few weeks and lately it has been collecting in her legs and midsection. To relieve this, the doctors decided to reposition her so she was lying more flat (she is normally on an angle with the head higher than her body) so that the fluid would move. However, as the fluid moved, it likely pushed on her stomach and lungs making it more difficult to breath and digest. This led to lungs collapsing again. The oscillator helps to re-inflate the lungs and she has also been given some medication to help get rid of some of the fluid.

As the day went on, her oxygen levels went from 100 percent to about 50 percent. The parameters of the oscillator were originally set very high but have started to come down. Lucy started to move more as the day went on. She was started back on feeds - at 7mL, down from her high of 15mL - but is only partially digesting them. Her legs and feet look like they have lost a lot of fluid. She had a stable night last night. Things went backwards in a hurry but they are starting to improve.

Ella continues to be well. We are able to kangaroo everyday now and it is truly the highlight of my day! She is still on the high-flow oxygen and getting more and more stable everyday with fewer desaturations and heart rate decelerations. Hopefully she will start trying the low-flow oxygen in the next few days. The one difficulty she has had is that the incision from her surgery opened up a little and is infected. She is on IV antibiotics for a week to be sure everything clears up.

The girls are now 34 weeks gestational age. At this point babies are developmentally able to suck, swallow, and breath at the same time for feeding. It is at this point that babies in the NICU will be introduced to nursing or bottle feeding. Until now, both girls have been fed exclusively through their NG tube (which goes from their noses to their stomachs). A syringe full of milk is attached to the tube and the milk is slowly pushed into their stomachs. They are often given a soother at the same time to make the connection between sucking and a full stomach. Lucy will continue to be fed this way until she is on high flow oxygen. Ella will be able to begin exploring nursing this week.