The big news this past week is that Lincoln began taking bottles for his feeding when I cannot be with him. He has done really well with going back and forth from bottle to breast. Last Sumday I gave him a bottle, just to try it out. He did great for his first time! He as able to drink 20mls or so (over half an oz) and didn't choke. I was able to get an idea of what type of volume he may be getting at the breast by watching him eat from a bottle and being able to measure how much was left after Linc called it quits. Last Monday I asked speech therapy come and evaluate Lincoln for bottles. They fed him with different flow nipples to see which he prefered and showed me a few tricks on holding him while he eats and what signs to look for that may mean he needs a break. Since Lincoln is new to bottle feeding, he doesn't always take a breathing break when he needs to. Dan was able to feed Lincoln Monday night for the first time!
After three combinations of bottles and nipples throughout the week, Lincoln has setted with a Dr. Browns bottle with a preemie size nipple (lowest flow available) that he seems to do best with. He has taken several half bottles and two full bottles so far! He does sleep through usually two out of his eight feedings, but he is doing great! The staff at Children's all agree that Lincoln is probably the best oral feeder they have seen out of all the past CDH patients. Whatever volume Linc doesn't take orally is just put in his NG tube so that he still gets his full feed. Although Lincoln and I both enjoy our breastfeeding sessions, the doctors and I want to be able to see how much of a volume Lincoln is taking orally. We still get a few breastfeeding sessions in per day, but most of Lincoln's PO feedings are by bottle now.
Lincoln has gained weight this past week but is still on the low end of acceptable, so the docs want to increase Lincoln's calorie intake. They tried fortifying his milk this week to give him more calories without increaseing the volume he takes in, but he was intolerable of it, so increasing the volume of milk he takes every feeding is a better option for his tummy's sake! Linc has become very active and burns a lot of energy while he is awake. Adding more PO feedings also increases the calories he burns every day.
As for Lincolns respiratory status and narcotics, he is still on 2L of flow and getting morphine every 3 hours. Same settings as last week. They tried to wean him to one liter of flow and morphine every 6 hours this week (not on the same day) but Lincoln wasn't quite ready. He just needs more time to grow. Still no word on when he can come home. The bad (and good) thing about being under the care of teams of doctors is that they all have to agree. Each doctor I speak with individually tells me different requirements (off/on low oxygen, feeding tube/all oral feedings, morphine etc.) but they all agree that he is not quite ready yet.
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