Still here!

Whoops! Missed a day. Between feeding, changing, etc, and getting to spend some time with Tina and Steve, yesterday's post just fell out. But things are going along quite well, in fact. Olivia's breastfeeding continues to improve, and we've only given her food via the tube once in the last 24 hours. really nice- maybe soon the tube can come out!

For those of you who are wondering, here's what's involved in a "Tube feeding": (feel free to skip this if you don't want the gory details, but I think it's rather interesting!)

1. "Aspirate" her tube. This means drawing a little bit of her stomach contents and testing the PH. If the ph is wrong, the tube could be in the wrong place, like, say, her lungs. It would be bad to put milk there.
   
2. Change her. This gives her a chance to wake up and see if she's up for breastfeeding, so we might be able to avoid the tube. We don't want to be too enthusiastic, though, because we don't want to tire her out. It's a balance.
   
3. If she's wakeful and "rooting" (signaling that she's ready to breastfeed), try her at that. Assuming she doesn't get a "full feed" (defined in this case to be 10 minutes breastfeeding), move to the next step.
   
4. Sterilize a 20 ml syringe and a small bottle.
   
5. Measure out 36 ml refrigerated expressed breast milk (EBM) into the bottle.
   
6. Warm up the bottle in a cup of warm water.
   
7. Draw the EBM into the syringe, and pull the plunger just past the stop at the end (being careful not to pull it all the way out and dump the contents of the syringe).
   
8. Connect the syringe to the tube.
   
9. Remove the plunger and let gravity flow the EBM into Olivia's tummy. Sometimes the flow will stop so one has to "help" it along by replacing the plunger and giving a little push.
   
10. Wait. Gravity feed can take 10-15 minutes. Hold the syringe above Olivia, but not too high (creates too high flow rate and she spits it up).
    
11. When the syringe is empty, remove it from the tube and recap the tube.
    
12. Express the breast milk that she would have drawn out herself and refrigerate it for later.
    
13. Burp her and clean everything up.
    

This seems to take a long time. We're really happy she's taking to breastfeeding so well. She rarely needs the full 36 ml any more. The system is, if she doensn't breastfeed at all, give her 36 ml. If she breastfeeds fro less than 10 min, give her half, 18 ml. If she breastfeeds for longer than 10 min, she doesn't need any additional "top-up", which is the goal. Over the last day or so, she's been in the latter category most of the time, which is great. We're hopeful that in the next few days she'll progress to all breastfeeding, which will mean the tube can come out! Ok, that's a lot to digest (no pun intended) for one post, so I'll leave it there.