James was a bad boy today; he had his first two episodes of apnea. Very common in preemies, this is when a baby "forgets" to breathe for at least 20 seconds, and needs to be reminded by rubbing his back or tickling his foot. The respiratory therapist on overnights is an old friend of Michael's, and described the episode as pretty minor. Frankly, if James is going to pull a stunt like this, he is in exactly the right place. We would like him to get this all out of his system prior to coming home!
Medically this meant looking for an infection, although they decided against another lumbar puncture because otherwise he was looking well. They also checked his caffeine level and raised the infusion rate a little. IV caffeine appeals to many of us, but in a neonate it helps them remember to breathe. Also, because of the possbility of reflux causing the episodes, the feeds were changed to a pump from the gravity infusions. He now gets his milk slowly, over the course of an hour, instead of all at once.
As though to prove that the cause of the episodes was really the reflux, James spit up a nice 4-5 mL all over Michael with one of his last gravity feeds. Luckily it was on one of Michael's 2:00 am trips to the NICU after an evening shift, so he was not on his way to a meeting!
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