Monitors and wedges

You may remember me mentioning here that the babies have reflux.  The NICU/PCN doctors were hesitant to discharge any of the babies because they continued to have bradycardia and apnea associated with the reflux.  The nurses knew that the babies were ready to come home, despite the bradyies and apnea - they were confident that our babies would, like most babies, thrive when they got home.  We had one particular nurse who decided to make it her mission to convince the doctors to discharge our babies!  She is a night shift nurse, so she isn't usually present  when the doctors do their rounds each day. She recruited a day shift nurse who she thought would be successful in encouraging the doctor to consider sending our babies home with heart and apnea monitors.  The nurse assured the doctor that Jon and I knew what to do should a baby have a brady or apnea event -- we'd been responding to brady and apnea alarms since they were just a few weeks old.  Finally, the doctor agreed -- the babies could go home, but they all needed monitors and they needed to sleep on wedges with Tucker slings.  We were happy to do whatever, if it meant that we could finally welcome our triplets home!

The monitors are set to alarm whenever the baby's heart rate drops below or rises above certain levels.  The monitor also alarms if the baby doesn't take a breath for 20 seconds.  It has lights that blink with each heart beat and breath that it detects.

Colin and his monitor

Each monitor has two leads that stick to the baby's chest.  

Front of the lead

Sticky side of the lead

   

Colin, my handsome model, wearing both of his leads

The monitors also alarm when there is a loose connection - this is the alarm that we hear ALL. OF. THE. TIME.  If the sticky part of the lead gets wrinkled, the alarm goes off.  If we catch the cord on a piece of furniture, the cord tugs on the lead and the alarm goes off.  Sometimes, it seems that if you look at the monitor wrong, the alarm goes off.  The alarms are intended, in part, to startle the baby.  I think our babies have heard the loose connection alert so many times that they sleep through the alarms now!

We recently got foamy, fabric bands to put around the babies to cover the leads.  The band has helped reduce the number of loose connection alarms because it keeps the lead from moving, even when the babies wiggle around.

Colin wearing his band and showing us his umbilical hernia (it will go away as he grows)

The monitors record any brady or apnea event that occurs.  From time to time, our pediatrician orders a download of the monitor's data.  After the first download, we learned that many of the apnea alarms we'd experienced were actually false alarms.  The babies often take very shallow breaths that don't move their chests enough for the monitor to detect that a breath has occurred.  Our pediatrician wants to see a few "clear" downloads before she allows us to take the babies off the monitors.  We expect it will be a few months before all of the babies are monitor-free.

Lots of babies and cords!  (Colin, Cash, and Grace)

The wedges that the babies sleep on elevate their heads 45 degrees above the plane of the crib's mattress.  Since the incline is so steep, they sleep in a sling that attaches to the wedge.  The babies all deal with reflux better when they sleep on their bellies, so the doctor ordered belly sleep in addition to the wedges and slings.  I know this picture of Grace asleep on her belly in her crib with blankets and cords near her is very different from what we've all learned to do to prevent SIDS,  but the babies' monitors would alert us within seconds of a breathing or heart rate issue. 

Grace always tucks her hands under her chin after she falls asleep.   So sweet!

Colin

Cash

At the triplets' 4-month check-up, our pediatrician suggested we try taking the boys off the wedges.  I think they were a little surprised to be put on their backs at bedtime.  After two nights off the wedges, and an increase in brady alarms, we're not convinced that they're ready.  Maybe they'll take the wedges to college with them!