Feeding update

Feeding continues to be a big issue. *big sigh* I keep reminding myself that it could be much worse. Our girls are so healthy and happy. There are so many children who are so much more sick and require so much more care. At least our girls have throats and stomachs. Some kids doesn't even have that. Still, when trying to feed the girls, it's hard to feel thankful.

Here's the latest...

Abby has not been progressing as hoped. She hates her NG tube. She refuses to eat well when it is in. It had become a Catch-22. She can't get rid of the tube because she isn't eating enough. But, she won't eat enough with the tube in. So, she can't get rid of the tube. You see the dilemma. So we have a new plan.

Currently, we are tubing Abby only at night. She receives a gavage only feeding at 12am, 3am, and 6am. We give her 120mls over 1 hour. If she tolerates that amount, we will increase it to 150mls. After the 6am feed, we will take out the tube and give her a bottle from 9am to 9pm. During the day she needs to average 45mls per feed. If she does this, she will get enough calories and hopefully gain more weight.

This little plan is actually a temporary fix. We have decided to go with the G-tube. If you remember, that will be inserted surgically, directly into her stomach. We will probably follow a similar schedule of oral feedings during the day and gavage at night. The benefit is that the tube will be out of her throat and we won't have to put it in and out - which is a very uncomfortable procedure for Abby and emotionally awful for us. She first has to get a gastric emptying study (looks at how the stomach empties) so she can then be scheduled with the surgeon. We have no idea how long that will be. Hopefully only a week or two more. There is a chance she will improve considerably on the new off days/on nights schedule and we won't have to do it at all. We can only hope.

Now, for Natalie. I had thought Natalie was doing quite well, but when I looked at the data in my nifty little charts, I realized she was falling short about 150mls per day. That's quite a lot. When a pediatrician appointment Tuesday revealed she's only gained a few ounces, we decided to tube her at night as well. We just hated doing it. So did she. I was so worried we'd have to consider a g-tube for her as well. It felt so awful going backwards.

The good news is the doctor today at the Duke Clinic was okay with her weight gain. He said we did not need to tube her at all. Instead, we are adding more Elecare to the breast milk to make it more caloric. Since she's getting more bang for her buck, she can eat less. She still needs to average about 50ml per feed. She should be able to do this. (Abby is also getting the souped up breast milk.) We are hopeful this will keep Natalie heading in the right direction. If we don't feel we have to force her to eat so much, maybe her feedings will be more pleasant and maybe she'll eat more.

Woo - that's a lot of rather technical info about eating. Bottom line: Nat - doing okay. Abby - not as good - getting g-tube soon. Stay tuned for updates...