Potato Head Baby

We had another crazy week in the NICU, more crazy then a typical NICU week. We were still reeling from the shock of Landon's broken femur, his possible infection, and being put back on the vent when we got more bad news. Every other week he gets an eye exam for a condition common to preemies called ROP.

It is unknown what completely causes ROP in preemies, but doctors believe it has something to do with the oxygen many preemie babies need in the NICU. Basically, a baby's eyes mature in the third trimester and the oyxgen levels in the womb are optimal for that eye growth. When a baby is born very early like Landon was, they often need high amounts of supplemental oxygen to help their lungs work. Researchers have found that since this oxygen is not the optimal level as in the womb, it can cause the blood vessels in a baby's eyes to grow out of control. In the worst cases, the blood vessels can grow so out of control that the retina could detach causing blindness.

There are different stages of ROP depending on how bad the blood vessels are out of control and where in the eye those blood vessels are located. In Stage 3, most eye doctors will recommend laser surgery on the baby's eye to destroy the part of the eye that triggers blood vessels to grow. This causes a loss of peripheral vision, but saves his overall vision. Once a baby's eyes are mature, then the risk of ROP is gone. Since maturity often occurs around 42 weeks, Landon only had a few weeks until his eyes were mature. Most preemies have a small amount of ROP that resolves as they get older. Landon had a small, unconcerning amount in every exam. This wasn't too scary given that almost every preemie baby in the NICU had that same amount.

That was until this past Monday's exam when we were told his left eye was now Stage 3 and coming extremely close to needing surgery. This was such a shock when all of his exams had been clear and he was so close to having mature eyes. Not to mention all the other bad news we had gotten, this really was a hard blow. We decided to be proactive about treating this condition. I remembered that one of the doctors had told me about a new drug that recent studies have shown works just as well on ROP as the eye surgery without the loss of peripheral vision. I immediately read the research on the drug and requested that his eye doctor consider trying this drug in an attempt to avoid eye surgery. After some back and forth, the eye doctor agreed to try it and he received the injection on Thursday. We were told it should only take a few days to see if it worked and the doctor will be back on Tuesday to check. We are hoping and praying that this one thing goes right for baby.

Now that you know more about preemie eyes then you ever wanted or needed to know, on to the good news! Landon was able to get off of the vent and is now back to the baby elephant mask woohoo! We hope this is the last time he is on the vent before his stomach surgery. Even more importantly, Landon started getting fed breast milk on Friday! His is very slowly being fed small amounts through a tube in his nose to get his gut used to food and digestion again. So far it has gone ok, though his poor tummy is bloated. That is not a total shock, imagine if you had not eaten in 3 weeks and then starting eating again, you would have some bad gas!

It is important he tolerates his feeds for a few reasons. First, the breast milk will help his bones to grow strong. It will also help his liver as the nutrient fluid they are currently using has been very hard on his liver. Also, we will eventually be able to bottle feed him. Though there is a small chance that having the vent tube in his throat for so long may have created an oral aversion for him, making him not want to put even good things like bottles in his mouth. We will hope that is not the case and look forward to the day we give him his first bottle! The last reason why it is important he tolerates his feeds is that if he cannot tolerate breast milk, he will need to have his stomach surgery sooner than would be best for him. The bigger we can get him before surgery, the better off he will be.

On the upside, Landon has grow by leaps and bounds! He is nearly 7 pounds and still growing. This means he is right on track to be on a normal growth percentile for his adjusted age. We laugh because when we saw him first on an ultrasound, we called him pickles since he looked like a pickle. When he was born we called him a peanut and now I call him Mr. Potato Head because he is so big his head looks like a potato. Which probably isn't as bad as when I call him a Tomato head (this is when he cries.) He is almost so fat we may have to call him a yam soon!