Non-nutritive sucking experience...

Today Ethan had a non-nutritive sucking experience at breast. In other words, Ethan got to try breastfeeding for the first time! Sort of. I pumped and then he latched on while he was getting his tube feeding. He immediately started sucking away and loved every minute of it! He was so calm and well positioned. He even brought his hands to his face, which is a big deal for him. (Check back for photos... after I find the discrete ones!)


Now don't get crazy because I'm a little excited... There has been so much confusion and controversy in the nicu over 'breastfeeding' that we thought we'd call it something else until that's actually what we're doing. Apparently some folks have been thinking that I somehow want to breastfeed Ethan full time. Obviously Ethan is on super high, 30 calorie supplemented milk and he's barely gaining weight. So I obviously understand that 'regular' breast milk isn't going to do the trick. Breastfeeding full time is not the goal at this point. Maybe some day he might get to breastfeed once or twice a day and have bottles the rest. That would be best case scenario at this point. I get it. I really hope everyone else gets it now too.

So, finally this morning Kristy the OT talked with Dr Nau. They agreed that Ethan's primary feeding goal is to eat orally. That starts with suck training/finger feeding (a feeding tube taped to a finger connected to a syringe of milk) to help Ethan develop a more normal and safe suck and swallow. Right now he tends to use compression rather than suction so we are rewarding him with milk in his mouth every time he uses appropriate sucking. (Yes, yes it is just a little like training a dog. Isn't it often that way with kids? We're just starting early...)

Ethan is allowed to do finger feeding with every feeding when he is awake and stable. The nurses can do it too if they are trained and willing. Then twice a day he is allowed to have a non-nutrative sucking experience at breast. We're also calling it that since his suck isn't really good enough to pull the milk out yet.

This is the plan for this week. Next week he might have a swallow study to make sure he can manage larger quantities of milk without aspirating and then start with some bottles.We'll see where it goes from there.

Oh yes, and underlying all of this was Ethan's co2 of 99 this morning... I sure wish we could find the magic combo of what he needs to make this better. It was 91 at 6. Ugh. Nau might try a transcutaneous co2 monitor. It's not really accurate, but it can help to try and see trends without poking him all the time.

His growth has been good over the past 10 days. They keep increasing his caloris and volume and he has gained over 1 oz per day.

Allison is still awake... it's 11:20pm. I finally put her in her crib with the lights and music machine thingie. It's like baby tv. Hopefully it works.