Baby Jac had another refluxy day. He ate well in the AM with his nurses (full feeds at 6 am and 9 am) but at noon with me he only ate 12 and at 3 pm he ate 15.
Each time I tried to feed him he started out really hungry - ate a bit - and then the reflux started and he quit eating. It is so hard to watch him reflux - I want to help him and there is nothing I can do but hold him and wait. Argh.
He was not interested in eating at 6 pm and I don't yet know what he did at 9 pm.
I asked the NAP team today about what I might be doing wrong that is slowing down his ability to feed. She told me that if it looks like he is not swallowing all of his milk that I need to do a better job of tilting the bottle down so that he has a chance to swallow. It seems as if he is swallowing after each suck but that he is not swallowing all that he has sucked so he ends up with too much in his mouth.
The process for him should be suck, swallow - suck, swallow (n times - usually - 3 - 5) and then breathe, breathe, breathe. I think the problem is that he is doing the swallows - but swallowing everything - so I need to help him pace better by tipping the bottle down after 2 or 3 sucks and giving him an empty nipple which he will suck and then swallow - and swallow what he already has in his mouth. I will pratice this with him tomorrow and see if we can make more progress.
He is getting so close - every day the nurses and the NNP and I talk more about how we get home. Once Jac is eating ~ 70% of his feeds by mouth we will move to ad libitum (ad lib) feeding - which means when he wakes up he gets fed - which is what most babies do! He is not supposed to go more than 4 hours without eating and they set a minimum amount he is supposed to eat in 12 hours. If he does not meet the minimums, the NNP, the nurses and I will then decide what to do! So exciting. The NNP thinks he will get to ad lib feedings in the next few days to a week. Go Jac! We are so close to going home little boy!
After he gets to ad lib feedings he needs to gain weight 2 nights in a row and then he can go home! If he is barely gaining weight he might have to do it for 3 nights before they will let him get home.
Go Jac Go!
P.S. For more information on feeding in preterm infants click here.
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