Day 48 -

So a few days ago we went to an ad-hoc feeding schedule. This was great news to me, I knew from talking to one of the doctor's that this is one of the last steps, if they can gain weight on this feeding schedule, they are deemed ready to go home (of course, this is feeding only, we've also got oxygen to deal with).

So, the doctor explained it to me and it seemed pretty straight-forward. They would go to feeding Jonah whenever he was hungry and see if he gained weight. Simple, right? As it turns out, no. Every nurse interpretted this differently, and one actually had the doctor clarify her orders and then still interpretted it differently than me. Notice I didn't say "wrong", I said "different than me". See, I'm trying to be reasonable. But I'm having to struggle to be reasonable as the rules seem to change every 8-12 hour shift. Different ideas:

1. Feed him by mouth and whatever he doesn't take give him in the tube (wait, how is this different than what we've been doing?).
2. Feed him by mouth and if he doesn't eat X amount in an 8 hour shift, feed it to him via tube (better, but 8 hours could only be two feedings, so one bad feeding and we're sunk).
3. Feed him by mouth and if he doesn't eat X amount in an TWELVE hour shift, feed it to him via tube (now we're getting to what I thought I understood from the doctor).
4. Then there's the misunderstanding of whether they should offer food every 3 hours, or every time he seems hungry, or just let him sleep. Since I'm not there at night, who he has for a night nurse makes how much he took in volume really vary.

The first day we went to this, we were still on regular breastmilk. After a day, they upped it to 22 kcalorie fortified breastmilk (take my milk and add some extra powdered formula to it to make it more calories in the same volume). He gained on that, but they wanted to take it to 24 calorie the next day. He definitely had a harder time digesting this and I didn't like it, but I differed to the doctors, plus I knew he only had to gain weight for a few days and we could go home, where it would be much easier to bring him back down to regular breastmilk. In the meantime, I could still breastfeed once a day, but since every last mL counted and he took less when he nursed, I gave it up in hopes of moving us home a bit sooner.