Friday, October 11, 2013

Bottle feedings

On Wednesday of this week I gave Stokes a bottle for the first time and he drank 10 cc's. Yesterday Thomas gave Ryan a bottle and the nurse gave Stokes a bottle and they each had 20 cc's. Today they each took a full feeding (40 cc's) and the nurse gave William a bottle for the first time. He took 6 cc's for his first attempt and got the remainder through his feeding tube. 

Here's the deal with feeding. It's something the boys have to learn to do but it's difficult for them. It takes a lot of coordination to suck, swallow and breathe. In addition it's a lot of work for these little guys so it tends to wear them out. For a bottle feeding, we have to be aware of the time. The goal is to finish in 20 minutes but we can use up to 30 minutes, and that includes burping. We absolutely cannot go over half an hour because at that point they are expending too much energy. While bottle feeding we try to read the baby's cues to make sure they are ok. We try to see that they're swallowing and breathing and not getting too stressed out. We periodically check the monitors to make sure their heart rate isn't dropping or elevating too much and that their oxygen saturation is at a good level. If anything seems out of whack we take the bottle out of their mouth and give them a little break. 

Initially we just introduced the boys to a bottle but now we are trying to do full feeds. To start out they can take 1 bottle feeding per day. Once they have taken a full feeding for 2 days in a row, we can move them up to 2 bottle feedings a day. Once they take both of those full feedings for 2 days in a row, they go to every other feeding and then every feeding (they "eat" every 3 hours so they have 8 feedings per day). The difficult thing is that you can get stuck at one of these levels and not be able to move forward. In addition, as soon as you get the baby to take a full feeding the doctors or nurses may decide to add, say, 5 more cc's to their feeding amount. The more milk they get, the harder it is to get them to comfortably take the whole feeding within 30 min. It is very common to take a step forward just to take a step back during this process . So far so good for the Peery boys, but Thomas and I understand that we will probably have some setbacks or get stuck somewhere along the line.

Pictures of Thomas holding William today



Weekly alligator pictures (taken this evening):

Stokes

Ryan

William



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