May 22, 2011- May 27, 2011

5/22
Fentenyl was discharged completely and he was given tylenol by mouth with each feeding.  He was also changed to a by mouth antiobiotic so that the central line could be taken out. 
5/23
This is the first day that we tried the bottle, but he did not want it, however he had sucked on his paci for a minute or 2 so that was a good sign.  Still tired today.
5/24
Ate 10ml from bottle at noon and 15ml from bottle at 6pm. Increasing like this was a good sign to us. 
5/25
Ate 8 ml from bottle at noon, 20ml at 3pm, 5 ml at 6pm. 
5/26
Ate 16ml from bottle at noon.  After this Tripp was much more congested, and the doctors thought we should hold off on the bottle anymore as long as he was having a hard time breathing.  A chest xray was done and came back showing some atelectasis and haziness.  The doctors weren't sure if this was from him aspirating some or if this was an infection he had picked up.  So for precautions he was started on vancomyocin and gentamicin and blood and urine cultures were obtained.  A swallow study would also be done the next day.  Also Tripp has been consistantly losing a small amount of weight over the past days, and his breastmilk is now being mixed with some enfamil concentrate so that he can get more calories in a feeding with the same amount of volume he needs. 
5/27
A swallow study was done this morning and concluded that Tripp is aspirating some each time that he swallows any milk.  The test was done with milk, a medium consistency of milk and rice cereal, and then a thicker consistency of milk and rice cereal (this is because sometimes the thicker consistency is easier to swallow and the baby will not aspirate).  Unfortunately he did aspirate some into his lungs with each of the 3.  The plastic surgeon then came by, and said he wanted to continue to observe Tripp until the beginning to the middle of next week and that if he did not improve any with his airway that he wanted to talk with us about doing a jaw extraction.  He wants to see how he does over the next few days because he would be in the hospital for a prolonged period of time after having this surgery and it is not something that he likes to jump into.  As of now, if nothing else changes Tripp will most likely have to have a gtube put in sometime to be able to come home.  We are able to continue to work with him with a bottle but only with a very small amount of milk, due to the aspiration, one time a day.  Now he is getting the rest of his milk by a ng tube, but would be getting that by the gtube if that is put in.  Last night Tripp weighed 10lbs 10 1/2 ounces.