Off of perfuser feeds
The doctors have decided to try Robin on two hourly feeds rather than the continuos perfuser feeds. Whilst the Perfuser was a slow continuos feed of milk, via nasal gastric tube directly into his stomach, the two hourly feeds are the same amount (11mls an hour) but given to him via gavage (gravity feed) through his nasal gastric tube.
We had tried this a few weeks ago, but due to his frequent bradys (drop in heart rate) they were more comfortable with perfuser. Now that he is a bit bigger, and his bradys have settled down, the doctors are ready to trial periodic feeds again. This is an important step on the road to coming home, as one of the conditions of being released home is that he can feed via breastfeeding (or bottle – which we want to avoid) but breastfeeding can be supplemented by gavage feeding if required. There would be no way he could come home on perfuser feeds.
The main thing we need to look for is that he tolerates having 22mls of liquid in his tummy at once (and doesn’t vomit it up), that he continues to gain weight, and that his bradys and desats don’t increase.
Nicki is watching how to administer the gavage feeds, in order to complete the first step I training to administer them herself.mTo do this, a small amount of milk is suctioned out from his stomach, through his nasal gastric tube, and tested on litmus paper. Litmus paper tests the Ph of the milk, and if it is acidic, it indicates the tube is in his stomach, due to the presence of stomach acid. However, if the test shows an alkaline value, it indicates that the tube has moved out of his stomach, and potentially into his lungs or airways. Obviously this is important, as we wouldn’t want to gravity feed liquid into his lungs! We then connect the gavage syringe to his nasal gastric tube, and let it slowly feed into his tummy, over about 10 minutes.
Granny Suzy changed his nappy and got to clean up a big poo (he hadn’t gone in two days!)
Late in the afternoon, Nicki started to get a cold sore – very bad news for premie babies. Unfortunately a cold sore (HPV-1 virus) could be fatal if Robin was infected, so all precautions are being taken and it’s quarantine for Nicki – She’s very sad about not being able to see him for a few days, but is doing everything possible to minimise the risk. It’s especially hard since Peter is going away on Sunday, so Robin will be short of visitors and cuddles for a few days. Our hearts are heavy for the little guy 🙁
Visitors: Granny Suzy, Poppy Roy
Stats
Weight: 1620 grams
Air: Optiflow 5L/min, 21%
Feed: 22ml / two hourly (gavage)
Nurses: Tamara / Debbi
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