Day 61 - Inguinal Hernia, CPAP Peep 5, Oxygen 25%, rapid breathing

My baby Hao, you are still on CPAP today. 

When we visit you in the evening, the CPAP prongs mask has disconnected from your nose. Your oxygen saturation is alright, but you breathe too rapid, up to 120 times per minute. Your nose were bleeding as well.

Your mom get a nurse to fix up the mask for you. You still have rapid breathing even thought the mask is well fitted to your nose.

I was very at that moment. But I still try to calm down myself so that I can calm down your mom. I told her do not panic, but monitor. I get her to start talking to you so that we will receive her energy.

Your respiration rate eventually has coming down to 30-40 times per minutes after a while. You must be distressed for hours where no one notice your mask has disconnected from your nose. 

You are detected to have Inguinal hernia today on both side of your groins. I believe you will need to go through a surgery to repair your hernia. Probably when your weight reached 2400g. 

Good boy, let's catch some rest and get stronger tomorrow. 

God bless!

Day 60 - 1415g, 10th blood transfusion 28ml, CPAP Oxygen 25%

Baby boy, you started to have good weigh gain. You are at 1415g today, another 85g to cross the important milestone.

You have a lot of secretion, thick one, and mostly in the nose. The nurse told us that you looked tired in the morning. Even after suction, you are still struggling to breathe. Hence, you are returned to CPAP ventilation with PEEP 5, Oxygen 25%. A blood sample is taken due to this as well.

From the blood test, your red blood count is below 8. Hence, a blood transfusion is warranted. This is your tenth blood transfusion since you are born. And it is 12 days gap from your last blood transfusion.

I hope your low red blood count is purely due to the immaturity of your bone marrow only.

I hope over days, your bone marrow, lung, liver and gut are growing stronger and stronger.

Son, you look tired today. Have a good rest and get well soon.

God bless!

Day 59 - Oxygen Air Blender

Boy, the new device that replaced the ventilator is Oxygen Air Blender.

The milk feeding has increased to 18ml every 2 hours in the afternoon.

Be it invasive ventilation, CPAP or oxygen air blender, you are always trying to pull of all the tube that supply you oxygen.

You did it again on the oxygen air blender mask. Yes, you can breethe without the mask, put it will consume much of your energy which suppose to nurture your organs and improve your weight gain.

Due to your hyper active behavior, you have poor weight gain. Besides, you have prolong the period of oxygen dependency. 

This directly extended your stay at NICU.

Be calm boy. You have gone so far, very soon you will be able to breethe without any oxygen aid.

God bless!

Day 58 - Off from ventilator

Baby, you cross another milestone today. You are off from the ventilator, and now aided with oxygen & air mixer. You shall be very comfortable now without the CPAP prong mask.

Your progress well today. I believe very soon you will be able to breathe by yourself.

The nurse has decreased your milk feeding to 14ml in the early morning in view of your bloated tummy. Your feeding has resumed and maintained at 16ml in the afternoon till evening.

In the afternoon, the nurse gave you a try to suck the milk by yourself. As expected, you forget to breathe while you were sucking the milk. But, it was a good try. 

Sucking milk while breathing may be the first multi-tasking skill that you need to learn.

Boy, papa is proud of you. I can see the strong fighting spirit in you. 

Staying strong and be stronger.

God bless!

Day 57 - 1330g, CPAP Oxygen 25%

Baby Hao, you gained 50g in these 2 days time. You are now at 1330g. Another 170g to cross the 1500g milestone.

Crossing 1500g is a significant milestone for all the preemies. As per doctor Choo, most of the complications of the preemies will be recovered after passing 1500g. 

In the morning, your oxygen setting was at 21%. But in the evening, the setting has been increased back to 25%. It is ok baby, you have tried your best, let's rest for a while and strive again.

You continue to sleep well after the increased of milk feeding volume.

As per the nurse, your secretion at the nose is thick and a lot. This shall be the main cause that hold you down.

I am so sorry that you inherited the sinus nose from me. Your grandfather has similar problem.

I like to see your chubby face. You are adorable. 

Rest well tonight and challenge the next milestone tomorrow. 

God bless!

Day 56 - 20ml milk feeding, CPAP Oxygen 25%

Boy, doctor has finally increased your milk feeding volume from 18ml to 20ml every 2 hours after so many days.

You are less desperate for food after the increase of the milk volume. You sleep better.

It is because the intention of the doctor is to set you 1 milestone at a time. You are coping well with CPAP, which means you are ready for another milestone challenge, in this case is your feeding intake volume.

You are still on ursodeoxychohe Achod medication as your gut and liver are still not mature enough. Which both organs have signifant impact on your digestion system.

You also changed bed location and sleep in another incubator today. 

Rest well and get ready to cross another milestone.

God bless!

Day 55 - 1280g, CPAP Oxygen 25%, IVH recovery

Baby boy, you have weight lost of 10g against the last measurement.

I believe it is because of the change of ventilation mode from nIPPV to CPAP. You need more energy to breethe. A part from that, you always pull off the mask resulted you need to breethe with any aid until the oxygen desaturation alarm trigger the attention of the nurse.

Doctor put you back to CPAP today morning with oxygen at 25%. You were put at prone sleeping position in the morning and evening.

We noticed that you were very uncomfortable with the prone position in during our visitation in the evening. You try to move your body.

You started to pull your leg over, slowly you stretch your body to turn around. Yes. After a few minutes, you managed to turn yourself from prone position to side position.

We are happy to see that. It tells us that you have strong muscles, strong will power and good motor skill.

The nurse in-charge told your mom that you have recovered from IVH stage 1.

You did well and keep doing better.

Proud of you.

God bless!

Day 54 - CPAP trial

Boy, when your mom visited you in the morning, you were under CPAP mode at pressure 6cmH2O.

Moving from nIPPV mode to CPAP mode is a big milestone. I received this good news from your mom and was very delighted.

In the evening, when we were visiting you, the alarm of your medical monitoring system keep beeping due to desaturation of oxygen. 

The nurse then carried out suction procedure and put you back to nIPPV mode with oxygen at 30%. As expected, you bleed everytime when suction is performed. We can see your blood in the vacuum filter.

It was extremely heart pain to me. I can see your mom was panic, but she tried to keep herself calm. From her eyes, I see sadness, endless pain and miserable.

After the suction, the situation improved. But even under nIPPV mode, your oxygen saturation is still not as good as past 2-3 days.

Your mom is very disappointed. I told her that it is common for preemie to take

A few step back after some good progress.

I believe that you are progressing every day. You have strong muscles, and it is alright for you to take some rest after more than 12 hours of CPAP trial.

I believe you can. Have some good rest and strive when you are ready.

God bless!

Day 53 - 1290g, nIPPV Oxygen 23% at 15bpm

Boy, you have great improvement on your weight gain. You are now at 1290g, another 210g to cross the 1500g mark.

I believe the new CPAP prong mask has significantly contributed to your breathing ability and lung function. You are able to rest well as the mask is always intact despite how aggressive your motion is.

You are still on 18ml milk feeding every 2 hours and your digestion system is able to cope well.

We can now hear you crying even thought you are inside the enclosed incubator. It means your lung is getting stronger that enable you to cry out loud.

You are still suffering from the secretion that cause your nose blockage. I know it is very painful for you to go through the suction every 4 hours, and it causes you bleeding. Bear with it eventually you will recover and be alright.

God bless!

Day 52 - Trial on new CPAP prong mask, nIPPV Oxygen 30%

Baby Hao, you must be very comfortable today. Professor Doctor Choo has put you on trial on a new CPAP prong mask. The intention of the NICU is to replace the existing mask which is loosen easily with a new type.

You are chosen to be the first trial before they confirm the order because you are the most active baby at NICU. It is normal for you to take out the mask by yourself, multiple times in a day.

The new mask fit you well. No matter how you fight and try to pull it off, it is still intact. I believe your breathing can improve faster with this new toy. It cost the hospital MYR1000 per piece. At this moment the USD vs MYR exchange rate is USD1.00 for MYR3.80.

Doctor Yip also mentioned that the incubator that you are staying in cost the NICU MYR180,000. This amount of money can buy us a full specification Toyota Camry or Mazda6 in 2015. It is definitely more expensive than the car your papa is driving.

You are unable to pull off the new mask. But you did pull out the feeding line.

Physically you look strong and tough. You have strong muscles especially at your chest. You will be looking great if you can breethe well.

I am happy that you are contributing to NICU on the trial of the CPAP prong mask. 

I hope you will read all my post at different age of your life. And I can really see how deep your mom love you. Your bonding with your mom is so strong.

During your stay at NICU, your eldest sister persistently insisted to accompany your mom in every visit. And your elder sister has also been with us in most of the visit.

Only parents are allowed to enter NICU. Thus, your 2 little sisters are staying outside and waiting for us.

Can you see the chain of bonding?

You are the youngest man in the family. You need to grow stronger than me and take good care of all the ladies, especially your mom.

Stay strong, my man.

God bless!

Day 51 - nIPPV Oxygen 25%, 18ml milk feeding

Boy, I believe you are inherited with my sensitive nose. You have severe nose block that require frequent suction.

You were struggling in the morning. We can see that you were using a lot of energy to breathe, because your nose is block. Your chest and abdomen muscles were seen aggressively expanding and retracting.

Your mom is very worry on your situation. I told her worse case you will use more energy and resulted slower weight gain. 

You continue to digest well with 18ml milk feeding every 2 hours. Hopefully the primary doctor will increase your milk feeding tomorrow based on your weight.

In the evening, after the suction, you sleep well. You are so sweat, just like your sisters.

Stay strong and get stronger everyday.

Papa, mama, sisters and your grandparents love you.

God bless!

Day 50 - 1220g, nIPPV Oxygen 25%

Baby Hao, you have good weight gain. You have crossed the 1200g milestone. Now, we shall aim for 1500g.

The doctor has prescripted to add in 0.6g Carborie into the breast milk. Carborie is glucose polymer module that will give you more energy. 

You are still on alternate feeding between preterm infant formula and breast milk. 

The ventilator oxygen supply has been weaned down to 25% in the morning. I believe you will continue to do well and achieve Oxygen 21% in another 2-3 days.

Everytime when you are hungry, your mouth is sucking the feeding line. The nurses said you shall be able to get out from feeding line very soon. But before you can do that, you need to get off from the ventilator

So now, you need to continue to strengthen your lung, chest muscles, abdomen muscle and improve your stamina.

A part from that will be gaining weight. Size does matter for you. Crossing 1500g is key.

Stay strong boy.

God bless!

Day 49 - 9th blood transfusion, nIPPV Oxygen 30%

Today is Muslim festive season, Aidilfitri. 

We went to hospital in the morning to visit you. Doctor James Liew told me that you are stable now when I met him at the entrance of NICU.

However when I met you at your incubator, you looked struggling to breathe, and oxygen saturation is hovering at 75% to 85%. 

Doctor James Liew came in. He ordered a suction for you and took your blood sample to test your blood gas.

You were better after the suction. You still have a lot of secretion, and some of them turned into solid.

The blood gas result was similar to the last few days reading, red blood count at 8.8. Doctor James Liew ordered a blood transfusion for you.

Your mom become very emotional. The worse off when the doctor unable to put in the line after trying on both of your hands and your right leg.

Boy, you need to recover faster for your good self as well as to reduce the pain of your mom. 

I believe you are. 

Stay strong and grow stronger.

God bless!

Day 48 - 1190g, nIPPV Oxygen 25%

Little boy, you at weighted at 1190g today. Since your extubation, your weight gain pace is at 5g per day. It is slower than what we expected. Maybe it is due to the reason that you have been aided with invasive ventilation for more than 40 days.

Your feeding has increased to 18ml every 2 hours. Your tummy has no longer bloated. Effective in the evening, you will be feeding with preterm formula milk and breast milk at alternate basis.

Boy, you have gone thru a lot. You need to stay strong, gain more strength and weight in order to detach from the ventilator.

The beautiful world is waiting for you outside NICU.

God bless!

Day 47 - nIPPV Oxygen 23%

Baby Hao, you are doing great today.

Doctor has weaned down your oxygen setting from 30% to 25% in the morning and subsequently to 23% in the afternoon. The oxygen at room is at 21%,    you are now very close to be able to breathe without the ventilator.

A part from lung function, you need to strengthen your muscle especially at your chest and abdomen so that you will have the stamina to breathe.

Doctor Yip commented that you have gone through a lot of up and down. She said that you are now stable and on steady growth.

Do you know that you are consider senior citizen at NICU?

There is a serious infection going on at the NICU. Many of the infants are infected. Hopefully it is now curb from spreading.

Let's pray that all the babies are on their path of recovery and get healthy soon.

Stay strong.

God bless!

Day 46 - 1180g, Eye exam, nIPPV Oxygen 30%

Oh boy, you have poor weight gain. You only gained 10g in these 2 days.

You have eye exam today for ROP. The result is alright, but you still need to inspect your eyes for another few round to really ensure you are free from ROP.

Your feeding is at 17ml every 2 hours. Your stomach is less bloated now.

There is a massive infection at the NICU, the nurses are busy with reshuffling of the infected infants into the other room.

You are strong boy. You really active. You cried because you are hungry, and you are sort of fighting to protest. 

You need to save your energy to gain weight. Too aggressive is no good. Your hear beat and respiration went sky rocket when you were fighting.

There are also several occasion that you took out the ventilation cap. You have no problem breathing without aid but it will cause you to deplete your energy very fast which may cause problem in gaining weight.

Doctor Yip said your blood platelet count has normalized which is a great achievement. But your red blood count is slightly lower at 8.8.

Rest well and recover soon.

God bless!

Day 45 - nIPPV Oxygen 30%

Oh boy, when we arrived at NICU, the oxygen cap was out from your nose. Yes, you pulled it out again.

Even thought you are not aided, but your oxygen saturation is greater than 90%. But we can see you use more energy to breathe. I would say it is a good sign. I m confident you will be able to permanently take off the ventilation in days or another 1-2 weeks times.

3 of your neighbors were sent to quarantine today due to infection. I hope you are not infected. Mean while I hope the babies to recover as soon as possible.

Your abdomen looks much better now. Maybe your digestion system has improved. You are still on preterm formula milk, not sure when will doctor resume you with breast milk.

Boy, listen to your mom words. She spent hour talking to you everytime she visits you. 

She loves you so much and what you need to do is progress well and let her carry you at her arm.

Let her bring you home soon.

God bless!

Day 44 - nIPPV Oxygen 30%

Hao, today is your fourth day after extubation. You are coping with it well. Keep it up.

Papa and mama met Doctor James Liew this morning. He said your lung is still weak, and they will continue to monitor your oxygen requirement. These 2 weeks will be very determining to see if your lung can cope with room oxygen 21%.

Doctor James Liew said it is key milestone for you to be able to breathe by yourself without any aid before your adjusted age at 36 weeks.

You digest well with the preterm formula milk and you are on full feeding now. I believe you are be able to make it and free from the cpap by 36 weeks adjusted age.

You are now only on feeding line that go through your throat. Both your hands and your legs are free from any lines. I believe you have never as comfortable as of now. You sleep well everyone we visit you.

Hopefully the good sleep will also expedite your recovery.

While I am writing this post, your mom is talking to you. She also hold your hand while she is praying to the God

Mama's boy, stay strong.

God bless!

Day 43 - 1170g, full feeding, nIPPV Oxygen 30%

Baby Hao, you are doing well on your third day of non-invasive venlitation. Doctor has weaned down your ventilation setting in the morning, lowered the bpm and oxygen % to 21%.

It is a bit tough for you. Nurse has increased your oxygen to 25% and subsequently 30% while maintaining the low bpm parameter.

You closed your eyes tight since extubation. I believe you are focusing yourself very much in breathing.

Practise makes perfect. Keep doing it and you will master the skill. Keep practicing it and your lung will gets stronger.

You are weighted at 1170g. Another 30g to cross 1200g milestone. After that we shall target 1500g and 1800g. 

You are on full feeding today. 15ml every 2 hours. Your abdomen is still bloated. You are free from hypoglycemia now and I hope you can digest well and I do not want to see another blood transfusion on you.

I believe you hear your mom talking to you everyday. She is the woman whom gives you life, be strong, recover soonest and stop letting her worry.

My little boy, be brave and strong like a man. I know you are.

God bless!

Day 42 - nIPPV Oxygen 25%, 12ml feeding

Today is your second day of extubation. You did well, thus the oxygen supply has reduced from 30% to 25%.

Your waist line increased by 1.5mm. It is bloated but soft. Hence your feeding has increased to 12ml every 2 hours.

Your mom is still very worry about you despite you are less ill now. To make her relax, I try to crack some jokes. One of them is saying that you are like supermodel, measuring your waist line every day. Hopefully she can has some peace of mind.

I think you are doing well and believe you are on the right track of recovery.

Boy, you need to practise breathing seriously and exercise your lung.

Stay strong and God bless!

Day 41 - 1145g, Extubation NIPPV Oxygen 30%

My little boy, you are on second trial on extubation today at 9:00am. The initial oxygen setting was at 35%, and it has been weaned down to 30% in the afternoon.

You have less movement today. Maybe because you are concentrating to breathe with your nose.

Your are weighted at 1145g. Another 55g to go to achieved 1200g. You shall gained weight faster after extubation, and really hope to see you gaining 20-30g every day.

Doctor Yip said your IVH is remained the same. And papa also hope you will do well with the eye exam next week.

You are on 8ml preterm formula milk feeding today. As per the nurse, your abdomen is still bloated but has improvement on your waist measurement (smaller size).

You are a true fighter. Stay strong and grow stronger everyday.

Have faith in God and pray for God's mercy.

Day 40 - 8th blood transfusion, Abdomen bloated, SIPPV Oxygen 35%

IMy boy, your stomach is still bloated. Due to that, your feeding is still maintained at 5ml. And you have your 8th blood transfusion today.

Doctor has switched your diet from breast milk to preterm formula milk in the afternoon. 

Doctor suspect you are feeding intolerance due to your digestion system is not able to handle the bacteria in your mom's breast milk.

Papa hopes the preterm formula will work well with you as you shall be feeding at 12-13ml every 2 hours. 

You must be very hungry. I see you sucking the ventilation tube with one of your hand holding on it. 

The good news today is the nurse said your secretion has turned to white color from yellow color. It means the secretion is not as thick as before.

Stay strong and God bless!

Day 39 - 1120g, 5ml feeding, SIPPV Oxygen 30%

Hao, you have achieved another milestone on your weight, you have crossed the 1100g line. Your weight is at 1120g.

Your stomach is still very bloated. Doctor tried to increase your milk feeding to 8ml but it is reduced to 5ml in the evening. 

The doctor has reduced the ventilation maximum pressure setting to 12mmHg from 17mmHg. But the oxygen supply has increased to 30%. You need to continue to improve your breathing effort as papa would like you to be extubated.

You look slightly pale today. It must be frequent blood sampling due to your hypoglycemia. I hope your bone marrow is more mature now to supply you red blood cells so that the doctor will not order you another blood transfusion.

Brave boy, be strong and recover soon.

God bless!

Day 38 - 5ml feeding, Nystatin Oral Suspension & Ursodeoxychohe Achod

Today is an eventful day. Your mom went to visit you in the morning and found out that you are fasting and need to take X-ray for your chest & abdomen.

The nurse told her that you are only able to digest half of the feeding of 10ml every 2 hours.

At that moment, your oxygen setting was at 35%. Increased from 25% yesterday.

Your mom texted me the above and that made me very worry. I can feel the pain she has, and definitely can imagine it is at least 10 times more painful than me.

I thought you will need to on several days of fasting and then I quickly call your mom to sign consent form for insertion of the long CBL line for TPN supply, because that procedure require contrast media that warranted for a consent.

She off her hand phone after texted me. I am unable to get hold of her, I leave her with some text messages and quickly call your grandfather-in-law who accompanied your mom to ensure the consent form is signed.

I would not want you to delay any seconds in getting nutritions. 

Your mom returned my call saying that doctor requesting her to purchase Ursodeoxychohe Achod for your treatment.

The pharmacy of the hospital is located at the main tower, and the hospital compound is designed like a maze. I can sense she wanted to get you the medicine as soon as she can, meanwhile I also doubt if she is able to locate the pharmacy. I did not stop her, I let her try. 

I went to hospital in the afternoon to check out the results of your X-rays and also to buy you the medicine. 

Your abdomen X-ray looks fine. Just bloated. Ursodeoxychohe Achod is to improve your bowel movement and digestion. I hope the medicine help. Your feeding has been resumed, 5ml every 2 hours.

Your chest X-ray shows that your lung is still weak. But while I were leaving the NICU in the afternoon, the oxygen supply has reduced to 25%, and your oxygen saturation is near 100%.

You are also precripted with Nystatin Oral Suspension. I believe it shall be due to the mouth thrust, even though it is not visible as per papa and mom observation.

Again, you were crying today. You must be hungry due to fasting or feel unwell due to stomach bloated.

Stay strong and we love you.

God bless!

Day 37 - Hypoglycemia, 10ml feeding, SIPPV Oxygen 25%

My boy, today when I asked Doctor James about your condition, he have me a thumb up before commenting. You must be doing great.

Doctor James said you are actually ready for extubation last week, but due to your hypoglycemia, the extubation trial will be postponed to this week.

Doctor James also seconded Doctor Yip that your tummy is bloated, and it is common for you and some of the premmies. 

Your mom has already hear from Doctor Choo that you will be extubated this week, she keep praying for you and give your lots of encouragement to ensure you will do well.

Today you opened both your eyes wide and starring at your mom. You don't do that to papa, you will just look at me for seconds and then close your eyes. You must be mommy's boy.

As per the nurses, your digestion is alright. But there are some residue of 0.5-1.0ml of the previous feeding when the nurses performed suction. Even thought it seems to be alright as per doctors and nurses, but it still keep us worry.

Papa strongly believe you will be doing well with the coming extubation and will eventually gain weight and grow healthily.

Both your sisters were with us during the morning and evening visits. They were waiting outside NICU because only parents are allowed to enter.

Boy, when you are extubated, just keep breathing and consciously improve your breathing. Breathe in deep and steadily.

Proud to be your dad.

God bless!

Day 36 - 1060g, Hypoglycemia, SIPPV Oxygen 25%

My boy, your left leg is swollen due to the line. The doctor has remove it and put a new line at your right hand.

A part from hungry, it could be a reason that make you cry yesterday.

You have gained 5mg today. You are at 1060g.

Your feeding is maintained at 10ml breast milk every 2 hours because of the glucose supplement to treat your hypoglycemia.

If everything goes well, you will be extubated next week.

Finger cross and God bless!

Day 35 - 1055g, SIPPV Oxygen 23%

Baby boy, you will not be weighted everyday because you are off from total parenteral nutrition (TPN).

You gained some weight, you are at 1055g today. The weight gain is a bit slow as compared to doctor expectation of 20-30g per day.

Doctor has also discussed with your mom about her diet. They suspect your glucose deficiency may be due to the quality of breast milk. Which could be also resulted from her diet.

The Caeserian section operation for your delivery has caused your mom's red blood cell count dropped drastically. She received blood transfusion 1 day after you were born. 

She was so weak and she looked pale for weeks after discharged from the hospital. She has just recovered 1-2 weeks ago.

Maybe it is a good idea to mix some formula milk for preterm baby when you reach 1200g or above.

It is painful for papa and mama that you need to go thru so much at the beginning of life. On positive thinking side, I believe this NICU journey will make you a very strong man in the future.

You were crying when I visited you. Because you are intubated, we could not hear your voice. 

You were fighting, with your 2 hands and 2 legs. You keep crying. We thought you were feeling unwell. 

The nurse was very helpful. She come and soothed you, but you still cry and fight after a very short while.

She then changed your positions. You finally calm done after she put you on prone position. You were sucking the ventilation tube. Your mama noticed it. You cry because you are hungry.

 

Boy, continue to improve your lung and breathing, we want to hear your voice.

Develop your will power and pray to God for blessing and mercy.

Day 34 - SIPPV Oxygen 25%, Glucose deficiency

My boy, you continue to do well with breathing. Event thought your tummy is bloated, your digestion system is doing fine.

Your glucose level is low. Doctor will prescript you with feeding glucose, at the same time restart the antibiotic as it can be an infection that cause the blood glucose level to come down.

Meanwhile your blood is sent to lab for culture. Hopefully it is not due to any infection. 

Boy, you have gone thru so much at NICU. Really hope that you will be able to  extubate next week.

Continue to stay strong. You have gone thru the most challenging first 30 days of your life, you shall be able to get thru the rest of the days 

God bless!

Day 33 - 7th blood transfusion, SIPPV Oxygen 25%

Baby boy, your mom visited you today morning. Because papa was not around, your mom has to discuss and understand your progress with doctors.

Doctor Yip stopped the Bromhexine Hydrochloride as she found it is not effective on you. I also think that this medicine may be the root cause for your bloated tummy. 

I hope your respiration system will continue to improve even without Bromhexine Hydrochloride.

You have the 7th blood transfusion today. I really hope this is the last blood transfusion for you.

You no longer needed TPN today. The long feeding tube, CBL line has been taken out from your right arm. You must be feeling better today.

Doctor has also reduced the oxygen supply from 30% to 25%, stay strong and continue to do well.

God bless!

Day 32 - 1045g, 11ml milk feeding, SIPPV Oxygen 30%

My little boy, you gained some weight after 2 days of weight lost. Your weight lost is due to reduction of supply from the TPN where TPN will cause water excessive water in the body.

You have eye exam today on retinopathy of prematurity (ROP). Due to your eyes are still immature, nothing is detected. Another scan will be done in 2 weeks time.

You must have suffered a lot during the eye exam. We see you opened your eyes and looks very weak. We see that you look vulnerable and scared.

Your mom was calming you down, talking to you. You are active, but less responsive. Papa know, you gone thru a tough day.

Your tummy is bloated. Doctor Yip said some preterm babies are like that, bloated tummy. I hope you fall into the "bloated tummy" group.

You passed motion 4 times today, and you are on full feeding now, at 11ml every 2 hours.

Hao, get stronger and breathe on your own.

Love you.

God bless!