Lots of people have been asking when they'll let him come home. There is no set date or specific weight he has to get to, but there are several things he has to be doing and tests he has to pass:
- He has to be taking eight bottles a day. They want to be sure that he will be able to obtain enough nutrition once he's home. Once he reaches the goal of eight bottles a day (which means one every three hours), they will switch to what they call "ad lib" feeding, where instead of waking him to feed him every three hours, they let him determine when he wants to eat. When he wakes up and shows he's hungry, whether it's by crying or rooting around, they'll feed him. The nurse said they like to try to get them down to feeding every 3.5-4 hours by the time they're discharged which would be wonderful! Most newborns eat every 2-3 hours, so if I can get an extra hour or two in between feedings, I'll take it! Of course, if he's only eating six times a day, he'll have to eat more at each feeding, but it should all balance out.
- He has to pass what they call the "room air challenge". They disconnect him from his oxygen and he has to get through 40 minutes without his oxygen saturation dropping below 80.
- He has to have gone five consecutive days without any bradycardia episodes.
- He has to be gaining weight. There is no exact amount, he just can't be losing weight or not gaining any.
- He has to sit in his car seat and not drop his oxygen saturation. Apparently, because they tend to be kind of scrunched up in their car seat, it can decrease the amount of oxygen they're getting, so they want to make sure whatever seat we have, he can manage to breathe in.
When I spoke to Nurse Shawna today, she mentioned that there was some discussion of Cayden's hernias during rounds this morning. The docs aren't convinced that they're true hernias - they may be something called a hydrocele, which is just fluid in the space rather than actual intestines. This is good news! Fluid will eventually be absorbed by his body and won't require surgery. I'm keeping my fingers crossed that this is the case!
Also, I wanted to mention that as of last Thursday, baby Bianca was stable and doing well. I haven't gotten an update from her mom since then, but it sounds like the RSV just has to run its course but that she should be o.k.
And speaking of RSV, yesterday Cayden was given a shot of Synagis, which is a vaccine to prevent RSV infection. It's given monthly through the RSV season (October-April) to babies who meet the criteria. I don't know why they waited until now to start giving it to him, but he more than meets the criteria because his birth weight was so low and because he has a snotty-nosed brother at home waiting for him! (Having a sibling under a certain age is one of the criteria.) I'm not sure, but I don't think Bianca got the vaccine. Hopefully this will keep Cayden from having to go through the same ordeal.
As of last night, his weight was up again - 5 lbs. 2 oz.