Wahoo!
Tuesday was a little discouraging. The morning started with hearing that Kaylee only took 10mL total out of all three night feedings. That seemed so out of character for her... even before she was really eating well, she would have at least one full feeding a night. Then the 8:30 am care time rolled around and she was not even interested in the bottle. She got most of her 8:30 feeding and all of her 11:30 feeding through the tube. And that was REALLY out of character... normally she is wide awake for her 8:30, and if not 8:30 then the 11:30 for sure. She must have felt my frustration... because she picked up at the 2:30. She did better during the afternoon and evening... finally drinking almost a full bottle at the 8:30 pm.
It was at the 8:30 feeding that it dawned on me how hard she was working to drink. She sucked and sucked and sucked for 15-20 minutes and only took about 20-25 mL. That seemed like a lot of work for so little milk. She seemed to really like the shape new Nuk nipple we bought at Target because it fit in her mouth better than the ones from the hospital, which were the same shape, but had a much narrower base. We'd been using the medium flow nipple since the weekend. I asked the night nurse to try the fast flow nipple. The last time we tried it, she kept choking... it was too fast. The nurse had wonderful luck! She took full feeds (plus a little extra sometimes) at 2:30 and again at 5:30.
She took a full 65mL at the 8:00am this morning... and she downed it in about 15 minutes. We were thrilled that the high flow nipple was working so well and she wasn't choking on it! At about 10:00, an hour before her scheduled care time, I get a call from the nurse... Kaylee had been wide awake since I left, and now was super mad because she was so hungry. Unfortunately, I was in the middle of pumping, so was unable to make it back to the hospital immediately, and Kaylee couldn't wait any longer. In fact, the nurse didn't even think Kaylee would be able to wait long enough to make the 5 minute drive to the hospital. So she went ahead and fed her, offering her a full bottle, allowing her to take as much or as little as she wanted. She ate another 35mL in the 15 minutes from the time the nurse called to the time I showed up. Also in her fit of hunger rage, she managed to hook her fingers in her tube and ripped it right out. We joked that she was tired of the stupid tube and she was ready to prove to the nurses that she is capable of eating on her own. They are leaving the tube out unless she shows them otherwise, by refusing a feed at any point. Because she took so much in the morning, we allowed her to sleep until 1:30. They have some formula to figure how many mL a baby needs to sleep so long... so based on her morning feed, she was going to be fed 5 hours from 8:30 start time.
1:30 she wide awake. Great! I requested a meeting with the developmental therapist for 1:30. The Nuk was working great, but a number of nurses, the therapist, online forums, they all talked about the Dr. Brown nipple being wonderful for kiddos with suction problems. Even though I brought it up to two different nurses this week, no one would bring me a nipple to try... so I figured she would help me to determine whether or not it worked any better for Kaylee. It's a standard shape nipple (rather than the orthodontic shape of the Nuk) and the bottle has a nice air return device so Kaylee doesn't have to worry about releasing her suction to let air back in the bottle. We tried the high flow, because it was comparable to the high flow Nuk. She did wonderful!! A full feed in 15 minutes again... and she didn't need the cheek and chin support she needed with the Nuk, she was breathing better while eating, she didn't drip as much, and she didn't suck as much air! Wahoo!! We found our nipple! :)
At the 5:00 she was pretty sleepy... so sleepy I normally would have made the decision to tube feed her. However that wasn't an option. So we were off and running with the Dr. Brown bottle. Even through her half asleep state, Kaylee drank a full feed (52 mL)... enough for her to sleep for 3 hours.
The doctors determined today that she can now dictate her own schedule a bit... they offer her 75 mL of milk per feeding. The minimum she needs to eat is 55mL... that's enough to go for three hours before the next care and feeding. If she eats 72mL, that's enough for her to go for 4 hours.
The 8:00pm care was great! She was wide awake, so we tried to breastfeed. She drank until she was acting sleepy so we weighed her... she ate 30mL. We put 60mL in the bottle and allowed her to eat until she was full. She ate another 30mL from the bottle. Yet another full feeding. The nurse was explaining that at this point, because she's taking full feeds, they aren't as worried about getting a weight and knowing exactly how much she took from the breast. They figure whatever she didn't get from the breast she will take from the bottle. They only weighed her because I was curious and wanted to know.
2:30 Thursday morning will mark 24 hours of full feeds! We are almost there!
Go Kaylee Go! :)