Fortified Milk Now
Absolutely not much happening today but fortifying our milk. Now she is at full feeds and getting fortification with multiple vitamins.
She is still on the ventilator. She is still very tired. All her antibiotics have been stopped and all her IV fluids have been stopped. She is taking in only fortified milk. Period. Growth is now the most important item.
Oh yeah, we need more balloons in those thoughts. Many, many more. She had her first eye exam today, she is okay at this juncture but at a risk for retinopathy of prematurity.
Here is all that jargon in one convenient hard to swallow pill. This was and is my biggest fear from birth. I did not sleep last night and I was there this morning at 7.00 AM preparing for the eye exam. The foundation I have begun is going to teach all of this, you will hear more on this foundation by Friday!
Statistics
ROP occurs in over 16% of all premature births. In babies weighing less than 1,700 grams at birth, over 50% will develop ROP. In the United States, over 2,100 children annually experience the complications of ROP. Of those estimates of 500 to 1,200 cases of new blindness or severe complications are reported. Studies have found that about 30% of infants with advanced ROP have 20/200 or less in their better eye.
Risk Factors
There are a number of risk factors that are associated with ROP. These include:
Infants born under 32 weeks gestation
High levels of supplemental oxygen
Weight less than1500 grams (the lower the birth rate, the higher the incidence)
Concurrent illnesses
Anemia
High carbon dioxide levels
Seizures
Bradycardia (low heart rate)
Apnea
Mechanical ventilation
Blood transfusions
Intraventicular hemorrhage (bleeding into the brain)
Multiple prenatal maternal factors including heavy smoking, diabetes, and preeclampsia
The Cause
From 16 weeks to birth, retinal blood vessels grow out from the optic nerve to reach the peripheral retina. The last twelve weeks of a normal 40 week gestation are crucial in the development of fetal eyes. In premature infants, the normal growth of blood vessels stops. It is theorized that the area without adequate blood supply emits a chemical trigger to stimulate growth of the abnormal vessels. These vessels lead to a formation of a ring of scare tissue attached to both the retina and the vitreous gel that fills the center of our eyes. As the scar contracts, it may pull on the retinal creating a retinal detachment. Regardless of the gestation age at birth, ROP seems to occur at about 37 to 40 weeks.
Our understanding of ROP is changing. Traditionally the view was that high oxygen exposure was the cause. While it is certainly one of the major factors, studies now show that it is not just exposure to oxygen or other toxic agents after birth, but may also relate to actions that occur to the fetus prior to birth. Both chronic hypoxia (lack of oxygen) and intrauterine growth retardation may relate to ROP development. As many as one third of ROP cases may be the result of prenatal conditions. Light exposure has been suggested as another factor. To date, scientific studies have not confirmed light as a cause.
Detection
High risk premature infants are usually monitored by a retinal specialist or pediatric ophthalmologist during their stay in a neonatal care unit. Guidelines for screening will vary within different hospitals, but recommendations may typically include:
Infants born at 23-24 weeks should be examined within three to four weeks.
Infants born at or beyond 25 to 28 weeks should be examined by the fourth to fifth week.
Infants born after 29 weeks should be examined prior to discharge from the hospital.
All premature children are at a higher risk for other eye and vision complications. Thus, eye examinations every six months are recommended for all infants born under 32 weeks or that weigh less than 1500 grams. Twenty percent of these premature infants without ROP will still develop a crossing or turning out of the eyes and significant refractive problems requiring prescription eyeglasses.
She is still on the ventilator. She is still very tired. All her antibiotics have been stopped and all her IV fluids have been stopped. She is taking in only fortified milk. Period. Growth is now the most important item.
Oh yeah, we need more balloons in those thoughts. Many, many more. She had her first eye exam today, she is okay at this juncture but at a risk for retinopathy of prematurity.
Here is all that jargon in one convenient hard to swallow pill. This was and is my biggest fear from birth. I did not sleep last night and I was there this morning at 7.00 AM preparing for the eye exam. The foundation I have begun is going to teach all of this, you will hear more on this foundation by Friday!
Statistics
ROP occurs in over 16% of all premature births. In babies weighing less than 1,700 grams at birth, over 50% will develop ROP. In the United States, over 2,100 children annually experience the complications of ROP. Of those estimates of 500 to 1,200 cases of new blindness or severe complications are reported. Studies have found that about 30% of infants with advanced ROP have 20/200 or less in their better eye.
Risk Factors
There are a number of risk factors that are associated with ROP. These include:
Infants born under 32 weeks gestation
High levels of supplemental oxygen
Weight less than1500 grams (the lower the birth rate, the higher the incidence)
Concurrent illnesses
Anemia
High carbon dioxide levels
Seizures
Bradycardia (low heart rate)
Apnea
Mechanical ventilation
Blood transfusions
Intraventicular hemorrhage (bleeding into the brain)
Multiple prenatal maternal factors including heavy smoking, diabetes, and preeclampsia
The Cause
From 16 weeks to birth, retinal blood vessels grow out from the optic nerve to reach the peripheral retina. The last twelve weeks of a normal 40 week gestation are crucial in the development of fetal eyes. In premature infants, the normal growth of blood vessels stops. It is theorized that the area without adequate blood supply emits a chemical trigger to stimulate growth of the abnormal vessels. These vessels lead to a formation of a ring of scare tissue attached to both the retina and the vitreous gel that fills the center of our eyes. As the scar contracts, it may pull on the retinal creating a retinal detachment. Regardless of the gestation age at birth, ROP seems to occur at about 37 to 40 weeks.
Our understanding of ROP is changing. Traditionally the view was that high oxygen exposure was the cause. While it is certainly one of the major factors, studies now show that it is not just exposure to oxygen or other toxic agents after birth, but may also relate to actions that occur to the fetus prior to birth. Both chronic hypoxia (lack of oxygen) and intrauterine growth retardation may relate to ROP development. As many as one third of ROP cases may be the result of prenatal conditions. Light exposure has been suggested as another factor. To date, scientific studies have not confirmed light as a cause.
Detection
High risk premature infants are usually monitored by a retinal specialist or pediatric ophthalmologist during their stay in a neonatal care unit. Guidelines for screening will vary within different hospitals, but recommendations may typically include:
Infants born at 23-24 weeks should be examined within three to four weeks.
Infants born at or beyond 25 to 28 weeks should be examined by the fourth to fifth week.
Infants born after 29 weeks should be examined prior to discharge from the hospital.
All premature children are at a higher risk for other eye and vision complications. Thus, eye examinations every six months are recommended for all infants born under 32 weeks or that weigh less than 1500 grams. Twenty percent of these premature infants without ROP will still develop a crossing or turning out of the eyes and significant refractive problems requiring prescription eyeglasses.
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