Sunday, August 13, 2006

New Philosophy, Happy Baby

Now that Ellie's line infection has seemingly gotten under control, we have started feeding her again to keep her bowel happy and keep her moving down the road. Moving down the road but with an entirely different driver.

Dr. Jennings believes that Ellie's dilated bowel is very stressed and that our goal should be to bring it down in size first and foremost while allowing it what it needs to continue to thrive and be there when she needs it.

The plan is slow feeds (2 ml/hour)for a week or two. Just enough to bathe the insides of her small bowel with food which will keep it healthy and active, but not so much that will stress her bowel or, even worse, make it larger and less functional. His estimate is that Ellie's bowel can hold 500 ml of food before it backs up and that we could have a problem with overfeeding her and not know it for days or even a week before she shows us that she is over fed. The big quantities that we were so excited about a while back could have been bad thing.

Slow and cautious feeds is the order of the day.

On Thursday night we thought about starting her on the pump but opted not to start her on a new thing at night. We learned this the hard way- sometimes she has trouboles with the first day of food and it is better to have those troubles during the day instead of at 3 AM.

Friday morning we started her with 2 ml bottles throughout the day. She wasn't too keen on them. I think that she amy have forgotten what they were but she was ready to roll on the later bottles that day. She got eight hours worth of food by the end of the day.

Since continuous feeds are easier on the pump at night when we met with Dr. Jennings that night we agreed to put her on the pump that night for another 8 hours at 2 milliliters per hour.

She tolerated this for six hours before giving me the 'full' sign with stomach cramps, a sore belly and kicking legs. We stopped the feeds and gave her Saturday off. No pain, no cramps.

I like this slow thing.

Saturday night there was some question about how we would go about her feeds. Abby and I were nervous about overfeeding but we knew that she needs something in her belly to send down the pipe. On the other hand, the resident on duty had orders to feed her at 2 ml an hour.

Knowing Abby, I shouldn't be surprised how this story ends. Not only did we successfully feed her how we wanted to, but by the time we finished talking to her, the resident fully supported this and let us write the feeding plan for the night. Yup, handwritten notes on lined paper at her bedside.

I guess that it follows the cardinal rule of babies: You know your baby best. Sometimes it takes a little persuasion to get this across.

So far so good on the feeds. she is slurping the tiny bottles and taking the pump feeds at night.
Hopefully things won't back up and we can let her bowel come down.

A long way from the earlier feeding plan of push, push, push. This makes a lot of sense and we are very happy with our new fearless leader.

Ellie likes it, too.

1 comment:

beth brogan said...

Ellie was the happiest baby today! She really reacts to everything and when she smiles, it takes up the whole bottom half of her face. As we walked out of the room this afternoon, before I said a word, Bob said, "That is a really cute baby." If he hadn't said it by the lobby, I would have made him say it, but he said it on his own (really, how could he not with today's performance...) Nice work.