Sunday, November 16, 2008

Bedtime

Every parent has a been time routine. When you have four children, your bedtime routine is as rehearsed as a major orchestral production. Drew and I each have our individual roles at night and we do them in sync as we are working towards the goal of getting everybody sound to sleep. Things are different now! As a breast feeding mom I have been blessed with the ability to put a baby to sleep while nursing. It is such a peaceful way to end the day. It is not easy for us to do this now. Lucy now has to be hooked up to a feeding machine. The pump for her machine is called a "Joey" so we have nick named her feeding tube GI(Gastrointestinal) Joey. We need to begin feeding at 7:00pm so that it can run continuously for twelve hours. I have noticed that when Lucy is nursing and GI Joey is running, she is gaging from the feedings. She is used to nursing before bed so we are going to see if we can make some adjustments to the continuous feeds, perhaps pause them so that she can nurse to sleep and then turn Joey back on. They were strict about turning off the machine while breast feeding when we were in the hospital, but not sure why? So we'll add that question to our list. We also need to weigh Lucy before and after every feed so that we can get an accurate measure of how much breast milk she has consumed. I can no longer nurse her to sleep then lay her down in her crib. She needs to be weighed after her feed and hooked up to Joey. To begin tube feeding, we have to go through quite a procedure. First, calculate the amount of food needed for her night feed, currently around eighteen ounces. This calculation is still changing as we are slowly increasing the flow rate on her feeds. After this we add the food to her IV bag. We are using a combination of breast milk and formula for her feeds, the formula can stay at room temperature for twelve hours but the breast milk can only stay at room temperature for four hours, so we are beginning with breast milk and then adding the formula sometime in the middle of the night. Last night I heard a very silent "oh sh**" on the baby monitor. When Drew was adding the formula, he didn't remember that there is a cap on the top of her bag as he began pouring. Good thing it was the formula and not the breast milk as every ounce of breast milk is worth its weight in gold! After getting the food ready and Joey primed, we need to check GI Joey for placement. We first flush the tube with 5ml of warm water, then we listen with a stethoscope on her belly as we push air through the tube you should her a whoosh of air in the stomach, then we pull back on the syringe and check for contents of her stomach, and as an added measure of protection you can check the pH of the contents. Checking for placement is so important, as you want to be sure the tube is in the stomach and not the lungs. Now we are able to begin her feed. We need to attach GI Joey with tape to her back so as to prevent her from getting tangled in the tube. I thought I was worried about dangers in the crib before, now I have ten feet of tubing to worry about. This is the exact opposite of the peaceful way I am used to putting her to bed. I have been feeding Lucy around the clock every three to four hours since about three months of age. The GI doctors thought that a plus to the night feeds would be that I would get more sleep. I have found this to be the exact opposite, I am waking every hour just to check on her. Hopefully, my fears will calm as time goes on. The learning curve is steep, and believe me we can only get better at this new routine. This bedtime procedure is for just one of our children, we sill have three others who need their teeth brushed, hair dried, stories read, and to be tucked into bed. We have noticed an overall mood change in Lucy, she appears to be less moody and has given us more smiles this weekend than we have seen in a while! I feel like we are "playing doctor" as everyone here wants to help with the process. Fischer price makes a decent stethoscope, you can really hear with it!

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