Tuesday, April 27, 2010


Kieran is 35w4d today - wow, tomorrow marks 6 weeks since he was born. As of April 25th, Kieran is a 5-pounder! He was also 18 3/4" long. Today he clocked in at 5lb, 3.2 ounces. He's pretty much outgrown the preemie clothes lengthwise, though there are still a few that fit him. I had to bring in newborn clothes for him to wear now that he's back in his crib. Oh yeah! Speaking of clothes & the crib - no more isolette! He's back into his open crib/bassinet & back in his clothing now that he's off oxygen.

In the crib Monday night.

The past few days have brought just a couple medical updates. On Saturday the nurse practitioners attempted to place a PICC line for Kieran's IV line - he'll be getting gancyclovir, the antiviral to treat his CMV, through the IV. Attempts were unsuccessful, and Sunday's attempt was as well. Third time was the charm, though, sort of - they got a peripheral IV in last night, so it doesn't go in as far down the vein as a PICC line, but it's good enough and should last longer than a regular IV line. This is important because Kieran needs the med through IV and his other IV's in his arms and legs kept blowing. So hopefully it stays put! It's in his scalp, which is still weird to see, but I actually prefer an IV there - it's out of the way, he can have full range of motion of his arms and legs without an IV bugging him and he can wear clothes normally. He is now tentatively scheduled to be on the IV medicine 1-2 weeks; the infectious disease doctors haven't fully decided yet, so I think we'll be taking it day by day. Also CMV-related: Kieran had another eye exam to check vision and he had a brain ultrasound, as he is at risk for vision loss and developmental delays. Kieran's eyes are right on track for development for his gestational age, and the brain ultrasound showed no issues. Next ophthalmology check up is in 3 weeks.

Right before the feeding tube came out, 4/27

We can tell that Kieran is definitely feeling better! His white blood cell count is up, and his platelet count is slowly improving. He's nursing beautifully and taking full bottle feedings when I'm not there. He did have the feeding tube in his nose for 2 days but it's back out again and I doubt he'll be needing it again. His full feeding (when he gets bottles) is 45ml, but tonight he took 50ml! He did need oxygen again for a short time last night/early morning because he was stressed after his eye exam and PICC line placement, but hopefully he won't need it again :)

PICC line on the scalp (the arm IV came out tonight)

Kieran had a visit from Josh's dad and stepmom Tom & Karen tonight, and Josh had a great evening with him. He gave him a bath for the first time :) We talked with each other tonight about how we're getting so anxious to get him home. I know he's where he needs to be right now, but we're getting pretty tired of the constant trips to the NICU after 6 weeks - we're just ready to have him all to ourselves at home! His cloth diapers are all clean and ready for him, slings and wraps are ready to keep him warm & cozy next to mom and dad, clothes fill up his dresser & we are setting up the co-sleeper next to our bed this weekend. All we need now is Kieran! All in good time, right? :)

Friday, April 23, 2010

5w3d: the mystery is solved!

Yesterday was really tough. We found out that Kieran does have the CMV virus they tested for. CMV is cytomegalovirus, a member of the herpesvirus family transmitted through person-to-person contact. (Other members of the herpesvirus family cause chickenpox, infectious mononucleosis, fever blisters, and genital herpes.) It's estimated that between 50% and 80% of adults in the United States are infected with CMV by 40 years of age, and those with a healthy immune system can keep the virus in check. However, it can have devastating effects if a pregnant woman acquires it during pregnancy or a person with weakened immune system acquires it.

Friday: 35 weeks/37 days old - no oxygen & sleeping just like his dad ;)

Kieran's neonatologist does not think that Kieran was born with the virus, but rather that he acquired it sometime after birth. If this is truly the case, then that's a huge blessing - babies who acquire it in utero can suffer permanent disabilities. I found these facts on the CDC website and they astounded me. I have never even heard of CMV, and I pride myself on being well-informed & well-researched about things related to pregnancy. We've all heard of not changing cat litter while pregnant to prevent toxoplasmosis, but have you ever heard of CMV? Though Kieran didn't acquire it in utero, I want to share these facts because knowledge is power and pregnant women can take action to prevent CMV infection!
  • CMV is the most common virus transmitted to a pregnant woman's unborn child
  • Approximately 1 in 150 children is born with congenital CMV infection
  • Approximately 1 in 750 children is born with or develops permanent disabilities due to CMV
  • Approximately 8,000 children each year suffer permanent disabilities caused by CMV
  • Congenital CMV (meaning present at birth) is as common a cause of serious disability as Down syndrome, fetal alcohol syndrome, and neural tube defects
As I said earlier, they don't think Kieran has a congenital CMV infection, but rather that he acquired it post-birth. If he did acquire it post-birth, he could have gotten it from anyone, but particularly me, Josh or Maia; Maia could have picked it up at daycare, for example. We'll never really know. That being said, it's a very common virus, but it puts Kieran at risk for a few things because of his weakened immune system. He is at risk for vision problems, developmental delays, and hearing loss. The simple fact that he acquired it after birth and was not born with him does mean a lowered risk - he may never have issues with any of these things - but it's very important that we monitor him because some of the symptoms can show up later in his childhood.

So now that we know what's up with Kieran, here's the game plan. He was started on the antiviral gancyclovir via IV yesterday. When given to babies born with the virus, the course is 6 weeks, but since he acquired it later, the U of M doctor who specializes in infectious diseases & CMV will decide how long Kieran should be on it - preliminary estimates are 2-4 weeks. After that he can probably switch to an oral med, and how long he has to be on that, I don't know. Other plans: He will receive a brain ultrasound in the NICU soon, and will have an MRI of his brain at Children's post-discharge. The ophthalmologist will check Kieran's vision again (nothing new, since he'll be getting his vision checked regularly anyways.) And he'll have the standard newborn hearing test in the NICU before he goes home, but we will also do hearing screens at 6 months and 1 year, and probably each year after that for awhile.

Saturday - no tubes on his face! (but he does have a scalp IV, yuck.)

Ending on a positive note - we figured out what's wrong with him, YAY! Kieran's WBC & platelet counts will hopefully go up now that he's being treated with the antiviral. His breathing has already improved in the past few days - he was taken off oxygen early yesterday morning and has been having great O2 saturations ever since, and no apnea episodes! He is back to nursing and milk feedings, which he loves! (He missed out on for 48 hours while they did the investigative work.) Today he weighed 4 lb 15.2 ounces - almost 5 lbs!!! Crazy! He was so alert today and really acting like a healthy little guy :) As for Kieran's kidney issues, it's highly unlikely they have anything to do with the CMV and they probably are just related to being a preemie or his enlarged kidney. Various kidney labs will be continue to be tested regularly while he's in the NICU and we'll follow up with the nephrologists at Children's at a later time.

I spy some chub!

One last thing: my mother-in-law Gale, who came up from Georgia and has stayed with us and helped with Maia and the house since Kieran was born, had to leave suddenly this morning, as her husband Jim's father passed away and she went to be with him. She will not be coming back, which is unfortunate, but what a blessing & a gift that she was able to be here for us for 5 1/2 weeks! Gale was an amazing support person in my early postpartum weeks, Josh was comforted by her presence, and Maia thrived during this crazy time thanks to her "GiGi." To Gale: thank you for your selflessness, generosity, love & support. We miss you already!

Thursday, April 22, 2010


Okay, update time! I wish I had something conclusive to say...yesterday Kieran's neonatologist said he was "perplexing;" today, she said he was "puzzling." Not exactly what you want your child's doctor to say! Basically we know this: Kieran's white blood cell & platelet counts are down - usually indicative of an infection, but all cultures are clear and he shows no signs of any infection, so his antibiotics were stopped. So next they checked for possible viruses - nothing there either so far, except we await two tests to rule out CMV (a very common virus in the herpes family) and toxoplasmosis - very unlikely it's the latter, but they're checking it anyways since we have cats. Then the neonatologist thought it could have something to do with his bowels but an abdominal x-ray ruled that out, too. Liver function is all normal and the echo of his heart checked out fine as well. So we're leaning towards something with the kidney now.

Kieran has hydronephrosis (an enlarged kidney) which we've been keeping an eye on since he was in utero. A recent renal ultrasound to re-check it indicated the kidney looks about the same and looks healthy from the outside. Based on the fact that Kieran's been spilling some protein into his urine, they've run a battery of tests to see what that could mean. Since his neonatologist doesn't specialize in kidneys, some nephrologists from Children's St. Paul have teamed up to try and figure out what's going on and they've ordered some of the tests that have already been done to compare to the past few days (protein, protein/creatinine ratio in the urine) and some new ones -and albumin level and maybe another one, too - I don't remember. If you know anything about kidneys maybe you'll know what I'm talking about! Anyways, those are the labs being run, and the lab results will be back tomorrow morning. I hope we find out what's going on soon! I'm about to call in Dr. House to help figure out what's up ;)

Back in the isolette while on the oxygen

As for today, Kieran is doing well. He's now 4lb, 12 ounces. We did some kangaroo care today and he loved it! He's been on either very low oxygen or room air funneled through the nasal cannula. He is starting back on feedings today - 10ml every three hours of straight breastmilk (no added fortifiers) and he will continue to be on IV nutrition until we get back to his full feeds (around 40 ml.) Kieran doesn't have the feeding tube right now so he's just been getting bottles of milk and when I gave him his first taste of milk after 48 hours he gulped it down SO fast, he was so excited! He's taken each bottle with ease so perhaps we'll never see the feeding tube again!!! His doctor said he would be able to breastfeed again tomorrow, most likely, which is wonderful :) It's been hard to hold him (and especially to do kangaroo care with him) and not be able to nurse him when he's rooting.

Kangaroo care with mama (love that flattering NICU lighting!)

All in all, I'm praying this all gets resolved soon. One of the neonatal practitioners mentioned that in a preemie like Kieran, something small can set off a chain reaction, so whatever is bothering him could be the reason his WBC & platelet count are low, and that in turn messes with his oxygen intake and is the reason he keeps de-satting. The sooner they figure out what's bugging him, the sooner he'll feel better and we can get back on the path towards going home.

Tuesday, April 20, 2010


Wow, it's been too long. Life's just been too busy to update as frequently as I'd like, so now there's a huge bunch of things to update on. Oh well.

Tomorrow Kieran will be 5 weeks old/34w5d. Today he weighed 4 lb 9.2 ounces - he's getting so big! He's nearly outgrown some of his preemie stuff and is wearing a bit of newborn sized clothing. Feedings-wise, he's doing really well with both nursing and now bottlefeeding. The nurses introduced a bottle to him last week and he took his first full feeding (38ml) last night over 30 minutes. As for breastfeeding, it was decided Monday that if Kieran nurses 10 minutes or more at feeding time he doesn't have to have a tube feeding - he nursed 15 minutes and 12 minutes at two separate feedings yesterday, so he didn't require the feeding! So awesome!

There are quite a few medical updates, so I'll bullet-point them to keep them all straight.

  • On Saturday Kieran did end up requiring a blood transfusion. I appreciate that his doctors gave him some time to let his hemoglobin increase with medicine, but it just wasn't working. He had some other side effects of anemia such as paleness, lethargy (we couldn't wake him up for feedings) and lower oxygen saturations, as well as increased stop-breathing spells. He pinked right up after the transfusion and responded well, and he was so alert on Sunday and Monday!
  • We found out Kieran has inguinal hernias, which are very common in preemie boys, and will require surgery post-discharge (though I'm not sure when.) If you don't know what that is, here's some info from babycenter.com: "During gestation, a boy's testicles develop inside his abdomen, and then, sometime before birth, they push through a tunnel in the tissue between the groin and the abdomen (called the inguinal canal) and descend into the scrotal sac.In about 5 percent of babies (mostly boys, and especially those who were premature), the opening remains large enough to allow a loop of the intestine to poke down into the tunnel. Inguinal hernias do not improve on their own."
  • Today Kieran had a bit of a setback - I arrived to see him and he was on oxygen. Apparently his oxygen saturations were in the 60's and 70's - NOT good considering he's supposed to be in the mid-80's to mid-90's+ (100 being the best.) He wasn't acting like himself either, and wasn't responding to oxygen blow-bys so they put a cannula in his nose and he's on low-flow oxygen now. That, combined with some funky lab levels - protein is down, hemoglobin decreased, plus a few other things - led his neonatologist to believe he could have some sort of infection, maybe a bladder infection or UTI (yeah, again! How many times has this kid been on antibiotics!?) so a battery of tests are now being run - urine culture, urine analysis, urine protein/creatinine ratio, and stomach x-ray, as well as a protein level, because he's spilling protein into his urine. We should get the lab results back tomorrow morning. He had a lung x-ray this morning and they said it was slightly cloudy in one area, which could be nothing/normal for him, but he got a diuretic in case he had fluid in his lungs. They also decided to hold feedings for 24 hours and just give IV nutrition while they run tests, so no milk for 24 hours :( He is now on antibiotics again as a precautionary measure. This could have something to do with his enlarged kidney but he had a renal ultrasound today and the radiologist actually noted that it looked like the kidney had decreased in size. So basically - WHO KNOWS. We're not sure what's up with him at this point, but we're working hard to figure it out. Whatever it is, it's bothering him enough to in turn affect his breathing/oxygen saturations. I really hope they figure out what's bugging my little guy. Once we do, he'll be that much closer to coming home, especially since he's doing so well with his feedings. So please think happy thoughts or pray for a resolution to whatever this is! I will update the blog as soon as I know what's going on with him.
Now onto some pictures to end this entry on a high note!

Getting a visit from his Aunt Kristina on Saturday - this was her first time holding him!

Grandma Gale, Josh's mom (or GiGi, as Maia calls her) also holds Kieran for the first time on Sunday.

Kieran today - back on O2 and hanging out on the warming table right before they drew some urine from his bladder for tests.

My sweet boy & I cuddling after IV placement & the bladder tap - he needed some loving after the rough day!

Look at this sweet face!

Wednesday, April 14, 2010

4 weeks

It's been a busy few days for Kieran - as well as his parents! I'd like to write a long blog entry but I need to keep it quick tonight; I am so exhausted from a very busy week finishing up school projects, helping my dad in the office, and visiting Kieran twice a day...whew!


First off, Kieran is 4 lbs, 1.8 oz as of today! On 4/3 he hit 3 lbs, so to gain a whole pound in 11 days is so wonderful! Also, Kieran was moved out of his isolette into an open crib/bassinet last night. What a big change that is! We can kiss him & touch him - so much easier than reaching in the portholes - and can see him close-up, pick him up more frequently. It's wonderful!

As you can see here, he's bundled up quite warmly. This is because he needs a little help maintaining his body temperature now that he's out of the isolette. Josh is reading him a story, one of their favorite things to do together :)


As for other health-related items, things have been stable with the anemia, but he seems rather pale to me and continues to have de-sats, or dips, in his oxygen saturation. They did double his iron, so we'll see if that helped any, but a blood transfusion is still a possibility and I personally think that may help him out a bit. So we'll see where that goes. Kieran also had an eye exam with an ophthalmologist from the University of Minnesota. She is checking him for retinopathy of prematurity. Basically, when a baby is born prematurely, the retina is only partly formed. The blood vessels have grown into the retina at the back of the eye but not into the rest of the retina. The closer a baby is born to full-term, the more normally developed the retina. It would found that Kieran's eyes looked good and appropriate for his gestational eyes, and we'll have a follow-up appointment in 3 weeks. She will also see him at age 1, 3 & 5, as Kieran is at risk for various eye problems like strabismus and misalignment, to name a few.

Feeding: Kieran is still nursing during 1-2 feedings a day (I see him about 3 feedings a day, typically.) Yesterday he nursed 7 minutes, the longest he had ever nursed! He also needs to learn how to take a bottle, especially since I can't be there for every feeding, so the nurses just started introducing him to one. He took 10 ml's last night and 11 ml's at a feeding attempt today. This is a great start.

Resting after a nursing session.

Speaking of feeding, the nurse practioner told me when we can expect Kieran to come home: when he can take full feedings from bottles & breast AND he has 5 days of zero stop-breathing episodes, he can come home! So for the next few weeks we'll really be focusing on feedings and hopefully he will continue to outgrow the apnea/stop-breathing episodes. And of course, we'll have to start getting things ready at home for Kieran - he could be home in 2.5, 3 weeks!!!

Finally, this isn't Kieran related but it is Collins Family related - we have a sick cat: our 5 year old cat Keiko is very sick and we're trying to figure out what to do with him. We think he has hepatic lipidosis, a disease in which for whatever reason, the cat stops eating. His liver eventually shuts down and he becomes jaundiced & dehydrated - I think the link does a better job of explaining it, but you get the idea. He had this disease 2 years ago when Maia was born and he almost died from it because it took us awhile to catch it. Apparently Keiko gets sick when I give birth...? Anyways, he's lethargic, he's stopped eating & drinking and thus lost a ton of weight, and he's vomiting, too. :( We're going to be taking him in to the vet tomorrow to see how progressed the disease is and if there's anything they can do for him with our monetary limits, as his care last time was VERY costly and we just can't afford that every few years. Please keep our sweet boy kitty in your prayers.

Sunday, April 11, 2010


Kieran is now 33w3d. He has had a few medical issues pop up in the past few days & we have also continued to work on breastfeeding. Kieran was 3lb 11.2 ounces yesterday - he gained 9 ounces in 5 days! That is awesome weight gain!

Cuddling with my little dude.

Medical stuff: Speaking of weight gain, his doctor was actually slightly concerned about the fast gain. They checked him for edema/water retention but found none, though they did give him one dose of a diuretic just in case he had some fluid in his lungs. He lost one ounce - today he was 3lb 10.2 oz, so it appears we have nothing to worry about. I did tell his nurses that I have been known to have some high-fat content milk - I told her that my friends and I joked that I made "cream" with Maia, and that for quite a few months after she was born, Maia was averaging weight gain of 3/4 lb a week, so it certainly would make sense to me why Kieran would gain faster. I told Patti, his nurse for the past few days, that when I would pump milk for Maia and leave it in the fridge, it would separate - the high-fat milk rising to the top, taking up half the bottle! Sure enough, when Patti took out some milk from the fridge today, she noticed the same thing, so they have proof now! :)

(Edited at 3:30 AM to add: Just called the NICU - Kieran gained 3 ounces/90 grams yesterday - the most he's ever gained - and is now 3lb, 13.6 ounces! Wow!)

The other thing we've been dealing with medically is that Kieran's anemia hasn't really improved - he's been holding tight at 10.2 for a while and they'd like to see it a bit higher. They mentioned perhaps doing a blood transfusion of just red blood cells to help him out, and in turn that will help out his oxygen saturation, which tends to dip low somewhat frequently right now, because there will be more red blood cells in his blood. Is this making any sense? I feel really brain-fried right now, ha! Anyways, he may or may not get the transfusion. They'll watch his saturations for another few days and check his hemoglobin again. He should grow out of the anemia as he builds up more of his own red blood cells eventually, but if he doesn't remedy it, the transfusion should help. I was told it's very common for babies born at his age to need one transfusion and be fine after that. A good thing is that he isn't really having any stop-breathing episodes - he had none on April 8th, 9th or 10th, and just one today!

Feeding: Pumping is going very well, and I've noticed an increase in the amount I'm pumping for the second time. I am starting to get a bit pump-weary. That's to be expected though, when you pump 8-9 times a day every day! Oh well, it's worth it for my little guy. Kieran is getting 30 ml 8 times a day, and I am pumping about 700+ ml a day, so I'm making 3 times what he's taking in now! Needless to say, my freezer needs some help, it's SO full! I'm currently trying to find someone to donate it to, but if I don't find someone locally I plan on donating it to a milk bank - there is no way he'll ever drink all of it! Anyone have a deep freezer I can rent some space in!? ;)

As for nursing, we've nursed each day since he started last Wednesday! I try to be in the NICU for 2 feedings, and Thursday he nursed one side during one feeding. Friday he did the same, and Saturday he nursed both sides during one feeding and one side during the next! Josh got to witness the little guy in action and is very proud as well :) Today he nursed during one feeding and it was 5 minutes long - the longest he has ever nursed! Until now I have been pumping before he nurses so as not to overwhelm him & his tummy (as he still gets pumped milk through his feeding tube) but today his nurse told me that I could nurse him without pumping beforehand to see how he does! She told me that if he nurses 10 minutes, they would probably give him 10ml of milk post-nursing session, so if he nurses 5 minutes they'll probably give him 15 or 20ml or something like that. SO exciting!!!

Josh gave Kieran a bath for the first time this weekend - a sponge bath since he has a temporary IV.

It's so quiet right now at home - Josh and I are alone right now! Maia went on a 7 day trip with her Grandma Gale to the Upper Peninsula of Michigan to visit Gale's mom Beverly. So far she's doing well - Josh and I are missing her pretty badly, though! I miss her running around everywhere keeping us on our toes, and I actually miss her constant chatting, ha! I have a full & busy week ahead though - finishing up a class for college (I missed a few classes since I had Kieran so early!), helping my dad out at the office a bit, and visiting Kieran more often to be there for more nursing sessions. I'm tired just thinking about it all, but I'll take it one day at a time and it will be fine :)

Wednesday, April 7, 2010

3 weeks

Wow, 3 weeks have gone by? Kieran's NICU stay is really flying by; he'll be home before we know it! Kieran has had 2 wonderful days since I last posted! He really hasn't had many stop-breathing episodes, and each one he has had, he's remedied himself quite quickly. This is good news! If he keeps this pattern up he won't have to go back on caffeine or other medicine. One of his nurses thought that perhaps the starting of protein plus the increase in feedings - he went from 26 to 28 ml every 3 hours - might have increased the reflux and thus, more stop-breathing episodes. But as he is getting used to it, perhaps that's a reason they've calmed down. He's also gaining so well still: on Tuesday he was 3.44 lbs - he gained 2 ounces in one day! Today he was up to 3.52 lbs. Also, I just learned that he was 17 1/3 inches long on Sunday. That's up from 15 3/4 inches at birth. He has had some pretty impressive growth and it's so exciting to see!

Today was a particularly awesome day for a few reasons. I gave Kieran a bath for the first time & it was so fun! He was quiet in the beginning, but once I got him in the little tub for his rinse he started crying pretty loudly, which made me laugh because it was so stinkin' cute! I'm not a bad mom for laughing at that, right? ;)


Then, the absolute best part of the day came next! After his bath we got set up for his 2pm feeding (which is still given through the tube in his nose) while doing kangaroo care. Since sometime last week I have been introducing Kieran to the breast and I've just been trying to get him interested by putting a little milk on his lips, letting him nuzzle, putting milk on my finger and giving that to him, etc. Most of the time he hasn't been interested in sucking at all but he does seem to like the milk I give him on his tongue. Anyways, today he was wide awake post-bath and opening up his mouth, so I positioned him in a cross-cradle hold (you nursing mama friends of mine will know what that is - it's a position that allows me to support his head/neck with my hand, as his neck muscles are not very strong at this point) and for the first time, he opened his mouth and had a great latch! He stayed on for 2 full minutes - when previously he had only stayed on for seconds - and during these 2 minutes his jaw was moving and I actually saw and heard him swallowing! During this time he would suck a little, then take a break, and then start sucking again. When I peeked at his monitor during these 2 minutes, I noticed that he was taking in 99-100% oxygen! SO awesome! I started tearing up and could not stop smiling!!! I called his nurse over and she cheered for me - the nurses are all so supportive of breastfeeding and are cheering Kieran & I on. :)

Most of my friends and family know how important, wonderful & special breastfeeding is to me, so you may know how eagerly I awaited this day - a very special day for us! And I'm so proud of him to be sucking - possibly nutritive sucking - at 32w4d/21 days old. Oh man, I'm tearing up again...someday I'll be able to say goodbye to this breast pump and just hold my son close & nurse him whenever he wants - I can't wait! And I can't wait for tomorrow when we get to do it again!!!!!!!

Monday, April 5, 2010


Wow, I didn't realize how long it had been since our last update! Kieran is doing well, just on the eating/sleeping/growing plan so there isn't much to report on a day-to-day basis. I'll start with his medical updates first, and then on to pictures and video from the past few days!

  • Kieran hit 3 pounds on Saturday (32w1d) and today he weighed 3.24 pounds! He is gaining around 20-30 grams a day and hasn't had any weight loss, so here's hoping we see some chub soon!
  • Today we started adding a little protein powder to his milk, as his protein levels were just slightly low.
  • As I've mentioned before, Kieran has had an enlarged kidney we've kept an eye on since discovering it at 20 weeks. His doctors plan on doing a VCUG scan - basically they will use a dye to see if his kidneys reflux back up into his bladder, something that would require surgery (I think? I don't entirely remember.) This will be done as an outpatient scan at Children's Hospital after he gets discharged, but for the meantime they started him on a half-dose of amoxicillin as a preventative measure.
  • He was taken off his caffeine last week and as a result, we have seen some more stop-breathing episodes. This isn't really a bad thing, necessarily - it's very normal for preemies to stop breathing for multiple reasons. We think the most common reason right now is reflux-related. Preemies lack muscular development, and one muscle that isn't very developed is the sphincter around the esophagus, so his food tends to come back up slightly, which mostly results in him "chewing" on it and then he stops breathing because he's focused on that instead. Most of the time, he fixes it himself and starts breathing again within seconds, but occasionally needs stimulation to remind him to breathe. The doctors are not really concerned with any of this, as like I said earlier, it's very normal for his age & he doesn't usually require a lot of stimulation to remind him to breathe. Still, it can be trying for Josh & I. For example, before the caffeine was stopped and he had very few episodes, we could spend an hour or two holding him calmly - he never really set off the alarm, which goes off when he de-sats to 85% oxygen intake or lower. But with these recent episodes our kangaroo care sessions sometimes get cut short when we have to put him back in the isolette to relax, and the nurses come back often every time his alarm beeps, so the time spent with him isn't super relaxing. But all things considered, this is within the realm of normal and Josh and I are just trying to remember that it's not even necessarily a setback, since he did stop the caffeine recently. He's basically acting his age and we just need to take it in stride.
In other news, Maia finally met her little brother for the first time this weekend! They lifted the H1N1 ban and siblings under 10 are now allowed in the NICU, so we all went to visit Kieran this past Saturday night.


Our first official family picture!

Meeting him for the first time

Maia wants to take Kieran "bye-bye"

And a few pictures from Easter Sunday - Maia visited again and brought Kieran's Easter basket

My tiny peanut

Trying to get a shot of Maia in her fancy Easter dress