Since birth Merritt has had a decreasing number of "spells" (a heart arrhythmia called bradycardia, and blood oxygen desaturations) that are a consequence of persistent reflux and immature suck-swallow-breathe coordination. Almost all of his spells occur during feeding, the worst of which result in Merritt turning blue around the mouth, which I have learned to identify (it's pretty hard to miss) and intervene by interrupting feeding and ensuring him adequate recovery time. Merritt's spells continue to improve every day, which is a great sign, and over time we expect him to fully outgrow them.
Because of his spells, we took Merritt home from the hospital on a cardio-respiratory monitor.
The monitor does give us some peace of mind. We can take a quick a look at the interface and know that Merritt's heart is beating, and that he's breathing. The absence of alarms going off also serve to support the idea that Merritt is doing a-okay. On the other hand, the wires have proven to be a nuisance, and the travel pack that the wires attach to can be burdensome when trying to execute normal daily activities like carry the baby around the house, or take a walk around the block. The alarm is intense, like a home fire alarm, and has legitimately gone off only three times for a few brady episodes. It has also gone off a number of other times for things like migrating leads, and to signal a battery in need of recharge.
The machine doesn't monitor oxygen saturation, which is Merritt's downfall, and existing studies don't really support the efficacy of the home monitor for our purposes, but we've got it 24 hours a day for the next two weeks, and probably in some capacity for at least another four weeks after that.
Merritt had his first pediatrician appointment this morning. It was a family event, and was surprisingly stress-free (relative to my memories of first outings with Roscoe as a newborn).
Merritt has gained 5 ounces in the past 4 days, which is impressive--particularly since he's not being supplemented in any way--and he now weighs 5 pounds 2 ounces. Moving forward we would like to see him gain between 1 and 2 ounces every day--1 ounce for good growth and the rest to help him catch up. I was relieved to hear that the pediatricians are confident that Merritt will close the preemie gap by 6 months. For now, he's acting more or less like a full-term baby eating every 2.5 to 3 hours with brief periods of alertness, and sleeping most of the time.
Even though he's 4.5 weeks old, we probably won't be able to coax a smile from his little bird lips in the next week or so as could be expected based on his age--it will probably happen closer to 12 weeks. I do know that there's a little dimple hiding out on his left cheek, so stay tuned for that!