The (Meal) Plan

After evaluating Colin's slow growth and his nutritional profile yesterday, the neonatologists have implemented 2 changes in Colin's diet. First, they have started to increase his volume slightly (from 20 cc's yesterday per feeding to 22 today). Second, Colin will start taking what is called "hind" milk. Basically hind milk is the milk produced after about 4 minutes of pumping - it's more calorie-rich than the initial milk that is produced. This means that mom has to pump for 4 minutes, stop, throw the milk out that she just pumped, then resume pumping to capture the more calorie-rich milk for Colin. As if pumping, storing, labeling, and cleaning wasn't enough, now there's an extra couple of steps involved. What mom's won't do for their children! :-)
We also received explanation as to why Colin's potassium levels were low. Potassium is used by the body to lay down new nuerons and tissue (for growth). So the fact that Colin is using his potassium means he's trying to grow, he's just struggling because of the feeding issues and his diminuitive size. So the thought is that once he gains just a little bit more weight, he'll finally get to that "take-off" point where the growth speeds considerably. This seems like a logical explanation, and certainly a much more benign explanation than what we could have been given. It does somewhat ease our anxiety over his upcoming head ultrasound. We must remain patient since Colin is really, truly doing so well in most every other area. Our little man just needs to grow!
Speaking of doing so well in other areas, apparently the doctors feel so confident in Colin's progress (aside from his growth) that as of this morning, Colin was moved to a different section within the ICN, called Special Care. Special Care is for preemies and term babies who are showing enough success that they require a little less intensive monitoring. It's the final step before going home! That being said, some babies can stay in Special Care for several weeks and even months. The bottom line for Colin is that he truly is, for now, just in a "feed and grow" mode.
Ania and I are asked frequently what the discharge criteria is for babies like Colin. It's not just a weight in pounds, rather it is several criteria, some of which include having no more bradycardic and desaturation episodes, regulating his own body temperature, and be only on bottle and breast feedings (no tube). If these and some additional criteria are reached, Mr. C will finally get released into this amazing and crazy world of ours! Although being moved to Special Care really is a big deal, he'll likely be there for quite a while longer. One of the smallest babies ever to take a bottle feeding, and now one of the smallest ever to be moved to the Special Care section of the ICN - our small, but mighty Colin!