Everything about feeding is trial and error. Is it a stamina issue? Does he know what hunger is? What do we do about both of those things. The first thing we did was never let a feed go longer than the hour the feeding pump would run. We always offered the bottle first and whatever he didn't drink went in the tube. As it is, by the time that ends you feel like you are starting the process all over again for the next feed. Some days it feels like all we do is feed him. When that hour is all through the bottle at least you got some extra snuggle time. Now that he rolls and wiggles a lot..the less milk we run through the tube, the better. It is getting harder to have him sit while the milk runs through the tube. We are starting to think it is a stamina thing and he needs to also realize his hunger. He has the ability to drink about 2oz pretty quickly when he wants to. At times he seems like he drinks enough by bottle to get that weird feeling in his tummy (hunger) to go away. Then, since we stay on a schedule, he doesn't have a chance to think about that weird feeling again because we are running the rest of the milk through the tube. We recently tried one day of on-demand feeding to see if he would tell us he was hungry--meaning we will see what he drinks out of the bottle every 3 hours and catch up to the necessary daily intake with a tube feed while he slept. This lasted one feed and then I chickened out, feeling that he isn’t ready and there needs to be another way. I will revisit this “trial” after we have the swallow study done and we know that all the milk and food goes down the correct pipe. Until then, my other strategy is to have all the milk in (via tube and bottle) within 30 minutes. That is the typical time it takes other babies to drink a bottle. Let’s try getting him to consistently drink 3 oz in 30 minutes for a couple days then we will push him to drink 4 oz and so on. So we put 3 oz in the tube while he drank 3 oz from bottle and all is complete within 30 min. This now creates more time before he needs to eat again with the hope that his tummy feels hunger for the next feed. Maybe he will get the idea soon. It finally did not feel like all we did was feed him. He also had more time to play and roll around--working up an appetite. Below is what the week looked like. I think it may be working. The days that we had some trouble, I will say staying consistent, is largely due to his teething. He has been showing that he gets the idea of hunger, but the pain of his gums at times causes him to not want to drink.
**Note: Anything he didn't drink out of a 6 oz bottle was fed through his g-tube at the same time**
Day 1: 4 out of 6 bottles he drank 3 oz.
Day 2: 5 out of 6 bottles he drank 3 oz.
Day 3: The first 2 bottles of the day he drank 3 oz. The last 3 bottles we pushed him to drink 4oz
Day 4: All 5 bottles he drank 4 oz.
Day 5: He took a short nap and after a little playing was actually screaming for the bottle. He drank 4.75oz in only 30 mins. The other 4 bottles he drank 4 oz.
Day 6: The first 2 bottles of the day he drank 4 oz and then we were on the go for 2 more where he still accomplished 4oz both times.
Day 7: Drank all 6oz of the first bottle of the day, but it took about 45/50 minutes. The second bottle he drank 4 oz. He woke up screaming after a very short nap (he is teething badly), so he was very sleepy during the 3rd bottle feed and only drank 3 oz. Drank 4 oz for last 2 bottles
Day 8: He drank 4.5oz for all 5 bottles.
Day 9: He drank 4.5oz for all 5 bottles.
Day 10: 1st bottle he drank 4.5oz. The 10am bottle he drank 3 oz in 10 minutes and a total of 5 oz. (He also had about 1 hr 10 min nap that he woke up from himself. Then about 20min to play). 1pm bottle he only drank 3.5oz after his physical therapy session because he was so tired from not napping (we have to adjust his schedule a bit for Wednesdays at least). Woke himself up after a 2 hour nap and drank 4.5oz at 4pm. Didn't nap again and only drank 4 oz.
Day 11: The first bottle of the day he drank 4.5 oz. He struggled a bit for the 10 am bottle and only drank 3 oz. For the 1pm and 4pm bottles he drank 4 oz. He drank 4 oz of the bottle at 7pm.
***Note: We will continue to do this as long as it seems to be working and push him a little bit more every few days. Little A has a swallow study coming up, so we will check back in after that if we change anything up and start a new “trial”.***
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