A's and B's

One of the problems that preemies have to overcome is episodes of apnea (a pause in breathing) and bradycardia (a too-slow heart rate), or "A's and B's". Our babies are no exception. In some cases the apnea is caused by reflux (it hurts, so they hold their breath), in other cases it's just their brains not having matured enough to keep their breathing and heartbeat steady.

The monitors sound an alarm if the heart rate drops below 80 or if breathing slows too far or stops for more than 20 seconds, and there is a nurse at their side within seconds. Fortunately both James and Kathryn usually recover from their A's and B's on their own, often before the nurse even gets there. Sometimes they need a little stimulation, but nothing more than that. It's a scary few seconds, but we can take comfort in knowing that this isn't a life-threatening problem thanks to the close monitoring, and that it will go away eventually.

We are very fortunate in that our babies are not "sick", just premature. All of the problems they do have are ones they will grow out of over the next few weeks and months. All of the care and support they need right now is just there to take the place of the support they would have had in the womb. Even their beds, inside the incubators, are cozy little "snugglers" that give them the feeling of being contained, but still able to move a little -- just like they had inside.

On the good news side, James had his scalp IV removed last night, so they are both completely off of IVs now -- one less tube! One less invasive thing! Yay! They are still tolerating their feedings well, they have very little "residual", or left-over food in their tummies by the time the next feeding starts, and they've been having plenty of bowel movements. Their digestive systems are another thing that will take a little time to mature, which is the reason for the slow, gentle tube feedings -- they eat every four hours, but their little bit of formula is given over a three hour span.

I held each of them, kangaroo style, for about three hours yesterday, James in the morning and Kathryn at night. It is an incredibly peaceful experience, for them and for me. I'm starting to understand better what is going on with their little bodies and brains, and with their care and the NICU environment. I am starting to see changes in them even at this early stage... not just the medical changes, but more calm alertness in the times when they are awake. I am also learning what bothers them and what soothes them. With all of the helplessness that goes along with this environment, it's a great feeling when Mommy's touch or voice is the thing that helps them relax and get back to sleep.