The Light.

Tonight Calder is under blue photo-therapy lights...he's not really this color. The lights help diminish his bilirubin levels. Bilirubin is basically waste that should only be present at certain levels, so since the body isn't able to get rid of it, the lights do it instead. The band around his head is to keep on his little sunglasses while he soaks up some rays.

Calder was diagnosed with a patent ductus arteriorosis (PDA), which is fairly common in preemies. In short, it’s a blood vessel that’s open in the womb that should close after birth, but hasn't yet.  When open, it allows oxygen-rich blood to mix with and be diluted by oxygen-poor blood. Tiffany, one of our NICU nurses, suspected the condition based on his vitals and the doctors confirmed the diagnosis by listening for a murmur and checking it out on an echocardiogram. The first treatment option they’ll pursue is medication, one dose of indomethacin for three days; if the hole does not close, they can give round two over the course of the next three days. If the medicine doesn't lead to improvement the second time, they’ll opt for surgery. (There is another medical procedure available to treat it, but only in bigger kids.)

The nurses say the hole almost always closes with the meds, though the doctors did not (and don’t usually) express the same optimism.

They are giving him 1 cc of breast milk every several hours to test how well his gut can digest it. This is called a "trophic feed." A "trophic feed" is one that is too small to provide entirely for the infant's nutritional needs but one that has the potential to produce some positive gastrointestinal or systemic benefit. They keep the amount to a minimum in an effort to avoid necrotizing enterocolitis, an infection of the intestines. Pretty serious stuff. 

His first head scan came back normal. But because this one was done so soon after birth, and bleeds tend to occur in the first several days of life, they’ll do another scan next Tuesday. Bleeds become much rarer after 30 days.