Cue Based Feeding

Jerry and Rita picked up Ava and Casey today and brought them to the zoo with their cousins (Elsie, Anika and Cole). Ali and I went up to the hospital to have snuggle time before the OT arrived.

The OT did many of the same exercises as yesterday. Brady had similar results with his muscle tone, reflexes and natural movements. The OT was very pleased with his overall progress.

We learned that Brady had 55 ml with a bottle at 5 p.m. yesterday, 55 ml at 8 p.m., and 40 ml at 1:15 a.m. He slept through the next two feedings and was gavaged.

Our nurse arrived at 7 a.m. and decided to move him to cue based feeding. Instead of feeding Brady every three hours, we are now looking for cues from Brady that he is hungry.

Brady's signs that he is hungry could include: increased alertness, moving his arms and legs, moving his mouth and tongue, making noises, and eye movements. Crying is considered a late stage of hunger, so we can often catch those signs before he cries.

The OT started working with Brady at 11:30. She woke him up with her therapy and noticed most of those signs listed above. I started feeding Brady at noon and he took 25 ml.

Ali and I left for lunch and our nurse noticed more signs from him while we were gone. At 12:50 she fed him 20 ml. At 2:00 she started feeding him again. Ali and I arrived back from lunch and Ali continued feeding him. He ended up taking 15 ml during that feeding time.

We had some good snuggle time with him for the next hour or so. Eventually he woke back up and started crying. I started feeding him at 3:15 and he took 25 ml.

When Brady was on scheduled feedings, he was getting 110 ml every three hours (440 ml every 12 hours). On the cue based program they want him to take 380 ml every 12 hours.

Brady took 85 ml over the four hours we were feeding him. It will be interesting to see how he did after we left. They will gavage anything he doesn't take by bottle over the 12 hour feeding periods.

The best part for us today was disconnecting Brady completely from his heart monitor the entire time we were there. Ali and I were able to walk around the room with Brady. We stood with him by the window and watched the activity outside. They hooked him back up when he was in his crib, but it was nice to have that freedom while we were holding him.

Ali and I also left the hospital for lunch today and drove to Sally's on the U of M campus. We've both grown tired of the cafeteria food at the hospital after eating it for three weeks. :)

We can't wait to get Brady outside to breathe this fresh spring air.

With love,

Tyler, Ali, Ava, Casey and Brady