Too Many Changes for Liliana’s Feedings?

How do you know when to stop if something isn’t working? Do you keep going, hoping that what you’re doing will eventually work out, or do you just stop completely and fall back on what was working before?

Last Friday we went to Liliana’s nutritionist. Since Liliana had been getting her 1000 daily calories consistently and was tolerating the mix of 90ml Peptamen Jr 1.5 and 80ml Peptamen Jr 1.0, we decided we could increase the ratio so that it would be 120ml of the 1.5 and the rest being 1.0.

Liliana’s OT had suggested moving a feeding around so that Liliana would have a window of time to be hungry for oral feedings, so another decision was to eliminate a daytime feed by adding it to the overnight feed. She had been tolerating her overnight feeds for 2 weeks at that point, and everything I was doing seemed “right” because Liliana was doing well with her feedings…

…until I implemented the changes. She’s no longer tolerating her overnight feeds, even the ones that have the same volume and formula ratio as ones she’s tolerated before, and she’s having trouble with her daytime feeds. Although it seems that Liliana’s eating more orally and drinking more, she’s also throwing up more of her formula.

While I do find that I can be more flexible with time and going out without Liliana’s feeding pump, I don’t know if only doing 3 daytime feeds is helpful at this point. I worry about Liliana’s stomach getting even smaller if there isn’t any food in it, and what we want is for it to get bigger so she can tolerate more. Maybe I could do a larger volume per feed, but at a slower rate? That would decrease the amount she would need to have overnight.

In any case, doing only 3 daytime feeds frees up a lot of time for Liliana to move around, wear her brace, and we can actually go out without needing to make formula mixes and putting all of her feeding equipment into her little bookbag. Last Saturday there was an Early Intervention get-together at a nearby park. I was able to take a few pictures:

Damien crawled around a little and was able to stand up to play on percussive piano keys and an abacus.

Liliana has a dinosaur checking her out.

Damien enjoyed the baby swing. He likes it best when you tickle his legs as he swings towards you..

Rawr, dinosaur!

Liliana's favorite thing was to run up and down these ramps and to step up and down the stairs.

Sean pushing both kids on the swings. Damien liked watching Liliana.

It was a really nice playground; we liked it enough that we’re planning to have a get-together there for Liliana’s birthday. The details are on Facebook. I’m planning on making sweet potato cupcakes (per Sean’s request) and chocolate chip cookies. I would like to make one more thing that’s more baby-friendly, but I’m not sure what.

Any suggestions?

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