[realnursealso/LPN]

Hi all, need to pick your brains. My dear little grandson was born 1/26 at 5:17am. My daugter did not realize she was in labor d/t the fact it was so early. Anyhow little Daniel was born 1 hr and 17 minutes after my daughter arrived at the hospital. He is actually doing fairly well, not on o2, but is on an apnea monitor. He had been trying to eat from a bottle and was doing ok, but they told my daughter and son in law, he was using alot of energy trying to suck, so today they put an ng in. He has not had alot of episodes with heartrate, but has had a few of below 100. Today my daughter told me they are going to do a cat scan of his brain. I asked her if they felt their was a problem with his brain. She told me no, but that they did this as routine? to check for any hidden problems? Is this so? Of course my nurse imagination went into overdrive when she said this to me. She is in Illinois, I am in NY. He is in the NICU d/t being so early. Guess I just need some encouragement, just worried. So thank you ahead of time for your help. And maybe if you have time, could you say a little prayer for him too? Thanks

[cathys01]

How early was he? How much does he weigh? Did he have any problems during/after the delivery?

We do head ultrasounds on DOL 3 to rule out IVH, and CT may be ordered if brain injury is suspected. Of course, I've only worked in one NICU, and I know each hospital has different protocols.

[DutchgirlRN]

How much did he weigh? My prayers are with your grandson, your daughter, and you.

[Jerico]

They do the scan: usually for ruling out head bleeds.
They said they'd put down an NG tube: usually so he won't be burning up much needed growth and energy calories by sucking at a nipple. They should let him at least use a pacifier as they feed him via NG. That is so he will at least associate the nipple with the feeling of his tummy filling.

[moonchild20002000]

Are you going to be able to go to see them? You would probably feel better if you could.
I'm praying for you and your family. Let us know how hes doing.

[Jerico]

Meant to add:

At 33 weeks he'll likely be fine. My grandaughter was 35 weeks and she had NG tube and brain scans as well.

She is 21 months and perfectly fine.

[realnursealso/LPN]

Sorry, Daniel weighs 4lbs and 5oz. and he is 14inches long. Thank you all for the prayers and your info. Worried grandma here

[prmenrs]

That's a good age and a good wt. It's perfectly ok to have problems eating @ this stage. The ng tube will allow him to get nourishment, grow and mature. Eating involves more than it seems: sucking, swallowing and BREATHING all @ the same time. He will learn to do it. Encourage her to breastfeed. That first milk, the colostrum is liquid gold--it will help the baby's immune system and help him fight infection. Use the lactation nurse.

It's also important to do ultrasound exams of the brain, and, indeed, it's routine. There is a structure in the fetal brain (in the ventricles) called the germinal matrix; it has lots of capillaries and it is not well supported by any other tissue. This thing is gone by term. Just thru the stresses of being born, the germinal matrix can bleed. That's called Intraventrical Hemorrhage, and that's what they're looking for on the Ultrasound.

Be prepared for him to get jaundiced and need "bili lights". Their livers are immature. Every body system he's got is immature. Any problems that arise are a reflection of that fact.

What you can do as the grandmother is to support your daughter. She's dealing w/a lot of stuff: the loss of the rest of her pregnancy, wondering what she did wrong (NOTHING!!). She's sort of in shock. Be the sounding board. When they get news from the docs, just listen. If you are allowed to go to a parental conference, take notes for her. If she asks you what something means, tell her you'll look it up and get back to her.

Support your son-in-law, too. Dads sometimes put aside their own sorrow and fear to support Mom. If those things aren't dealt w/, there'll be problems down the line.

If you're close, feed them, do some housework. In other words, be supportive by being as helpful as possible.

And don't let anyone make your daughter feel in any way inadequate because the baby was born early.

Let us know how things go. We'll all be praying for your grandson and your family.

[Gompers]

Everything he's going through sounds perfectly normal to me.

NG tube: Babies just develop the suck-swallow-breathe pattern at 32-34 weeks gestation. It's a lot of work for them to bottle feed, and they often get fed every 2 hours until their stomachs are used to recieving food - so it's routine to place and NG tube so that the baby can rest and still get nourishment. He's going to be using many more calories now than if he was still in utero, so we do whatever we can to save precious energy. By putting him in an incubator, alternating NG feedings with bottles, and decreasing stimulation, we're giving the baby ample time to sleep and grow.

Apnea monitor: Most NICUs keep all their babies on monitors until discharge. It is an intensive care unit, and we do prefer constant monitoring. And at 33 weeks, he's still got an immature respiratory center in his brain. He might "forget" to breathe here and there, so being on the monitor is a good idea for now. If he doesn't have any apnea spells, then that is great. But it's better to be safe and keep him on monitors until he's more mature.

CT scan: Most hospitals routinely do ultrasound instead of CT on preemies, at least for the first scan. However, not every hospital is the same, and CT scans might be done in different institutions. But whether it's an ultrasound or a CT, it is normal to get a brain scan in every preemie.

Congratulations on your grandson! Are you going to be able to go and visit soon?

[DDRN4me]

first, congratulations on becoming a grandma!!
second, remember that you are grandma..its ok to turn the nurse off and be mom/grandma if you need t o. YOu will have the advantage of understanding more of the terms, so you will be a great asset to your daughter and sil. Just the NICU setting is overwhelming to parents.
Many 33 weekers do just fine, and he is a good size, so that will be an advantage to him. And, you have so many wonderful resources here on this board, dont be afraid to ask!! God Bless and keep us posted! mary