Tuesday, we could see that something was wrong. Samson was very docile, in a deep sleep, and would not rouse for skin-to-skin or our first attempt at latch-on. Unlike every other visit, he did not open his eyes when hearing our voices or cry when returned to the warmer when we needed to leave. The IBCLC said that this is common with preemies, but Dad and Mama were not convinced. Most alarming of all was that as the afternoon wore on, his heart rate shot up near 200 BPM and stayed there, although he was not doing anything but sleeping -- this is not good.
By 5:30p, we received the call from Dr. C that it looked like an opportunistic staph infection common in preemies, entering the blood through one of his numerous IV sites (these get changed every 1-3 days). Samson was put back on the high-flow nasal cannula and constant gavage, and we were told that he might have to go back on to the CPAP if his breathing didn't improve soon. Several types of antibiotics were started and feeding was suspended again (the first time was during the treatment for the PDA the previous week). There were lots of diagnostics: blood cultures, stool for blood, x-rays looking at GI tract, spinal tap (agh!) and more, chasing the source/type of infection. We were terrified (again), back to "your wife could die and you need a c-section right now" anxiety levels.
True to his name, Samson came back swinging. Within 12 hours of receiving the meds, Samson was showing improvement, back to his grumpy self, screaming and kicking when anything wasn't to his liking. Oh, thank heavens! We were cautious with our optimism, not wanting to get our hopes up too high, but each report after that was more positive than the next.
By Thursday, he was back on gavage feeds and ready to try that nursing thing again. Successful latch-on was achieved (way to go, little boob-man!) and we started a daily breastfeeding appointment to fit in with his other gavage feeds and single bottle feed.
Dad finally got to hold (yay!) and offer the first bottle on Thursday night. The boy wasn't too interested in that hard nipple after his awesome experience with the breast, so we're gonna try to convince the doctor that his 2 "by mouth" feeds per day be nursing. That will probably be a challenge, as the clinicians like being able to easily measure how much he's consumed and the breast doesn't have those handy mL markings like the preemie bottles do.
Now we are getting back to "feeder-grower" status, and looking forward to once again starting to remove the wires and tubes one-by-one. Friday afternoon, they moved Samson out of his open warmer to a cozy, quiet isolette, and we expect that the nasal cannula will come off soon. He is regulating his body temp well and will probably get into an open bassinet (and get to wear his own clothes) by the end of the weekend.
Of course, after this latest round of panic, we'd rather see him progress slowly & steadily and keep all of his supports until he really doesn't need them any more.
