Day 114

CURRENT WEIGHT: 5 LBS, 3.4 OUNCES

Truman's canula is being turned off today, so he's going to have another run breathing all by himself.

Truman has surprised everyone, including the medical staff, on how well he is eating. Since he started eating again, he has taken every feed by bottle or breast with the exception of one (and that was because of craziness at the time in NICU rather than refusal/inability to eat). It has been discovered that he bottle feeds best while lying on his side, probably because it's more like breastfeeding, which he is a champ at.

His IV came out overnight, and they did not replace it, so he is off of his post-op TPN completely. He continues to be voraciously hungry. As a result, his feedings are now "ad lib" with a minimum of 35 CCs each time, and the milk has been fortified to have more calories. That means he has to take 35 CCs (or 1.2 ounces) by bottle or the rest will be gavaged, but he is allowed to eat as much as he wants beyond 35 CCs. When he breastfeeds, he is not supplemented. Although NICU has a "30-minute rule" on eating because it's believe that taking longer than that to eat by bottle or breast costs more calories than it gains, if Truman continues to scream with hunger after half an hour of breastfeeding, I let him continue. I talked with his practitioner and the thought is that he's wasting just as many calories screaming as he is with prolonged nursing.

He also has finally started losing some of the extra fluid he retained following surgery. He lost four ounces yesterday. Hopefully, he will drop the rest of the extra fluid in the next day or two so that we can know what his "real" weight is to monitor gain.

We talked with the practitioner last night about what he needs to accomplish to come home. One step was getting off the canula, so we are hoping he succeeds this time off of it. The other is that he needs to be able to take all of his feeds by bottle or breast and gain weight consistently for several days.


--Kara