Honey, Make Me a Bottle

     As my last post said, we had a swallow test done. During the test he wasn't aspirating the Barium but he had a lot of penetrations, Penetration is when food or liquid goes into the trachea but stays above the vocal cords. Aspiration is when it gets past the vocal cords and goes into the lungs. Based on the high frequency of penetrations and near aspiration, they concluded that he is aspirating from time. They tried various consistencies of Barium --half nectar, nectar, and honey-- and the one that had very few penetrations was honey.

     After the test we went to a conference room and the speech pathologist worked out a recipe for me with how much rice cereal to add to each ounce of formula to get a honey consistency. Then we tried various nipples until we found one that worked for him. Dr. Brown's stage 3 (fast flow) was the magic nipple but his Mama is pretty crafty and I was able to make something similar with his regular Playtex Vent Air nipples.

     He's doing well with it but his intake is starting to go down. I started him on 6 oz bottles of this new consistency because with the rice, a 6 oz has the same amount of calories as the 8 oz bottles without cereal. I was really hoping that this ratio adjustment would work great and there would be no other tweaking needed. That would be too easy though! He will sometimes finish the 6 oz bottles but mostly he doesn't finish them. I either need to adjust the nipple size so it comes out faster for him or I'm going to have to increase the calorie per oz ratio. Right now he's at the 24 calorie per oz ratio that he's been on since he was in the NICU but we might have to go up.

     Another problem we might run into is constipation. That much rice can constipate babies so we might have to give him Miralax to help him go because I am NOT going to do a 3x weekly routine of suppositories if there's another avenue we can take. No pun intended but well, it kinda was!

     Hopefully this will solve the constant congestion and avoid another round aspiration pneumonia. At least til winter comes and nasty school germs are being brought into my house from Aaron and Eli. I might just stick a gallon jug of sanitizer outside the front door!