Beginning to Bottle, Day 75

Barnaby has had a feeding tube ever since he stopped getting TPN (iv nutrition). That feeding tube puts milk right into his stomach and has allowed him to get to six and a half pounds with two impressive chins, but has been not without its problems. Most babies have reflux of some sort but often it’s just a little harmless spit up here and there, for Barnaby the reflux was causing vagal nerve stimulation that was causing him to “spell” (drops in heart rate) and the doctors have spent a lot of time trying various configurations to help with that. For a while they put his feeding tube deeper than his stomach as an “N J” tube, they have also tried various feeding schedules including continuous feeds where he is getting just a little bit of food all the time through a super slow pump.

Over the past few days he has had very few spells but he can’t go home from the hospital with a feeding tube. Since he is constantly getting food his motivation is low to learn to eat the old fashion way. Still, he has begun practicing nursing and bottle feeding just a little bit at a time. The goal is to get him to like it and have positive associations with nursing so rushing him is counterproductive. A big gulp that causes him to aspirate and cough can put him off nursing and the last thing we want is a nursing strike! So we take it slow, move at his pace, wait for him to be awake and showing feeding cues, and sometimes when all of the stars are aligned he does well with it.

Last night he woke up and took 10ml from a bottle. The most he’s done yet and tiny fraction of what he’ll need to be consuming to remove the feeding tube. Being in the NICU this long we have seen a lot of other babies progress with feeding, some are slow and it can take months past the due date to get to good nursing habits, others have breakthroughs where they seem to just mature into it all the sudden. Like everything else he does, Barnaby will do this on his own time.