Adjusted/Actual feeding & sleeping?

mrsV719

LO is almost 4 months actual but only just over 4 weeks adjusted. He has severe reflux which causes a lot of eating issues. He eats every 3-4 hours and won't eat more than 2oz. He is gaining weight like a champ (1/2 oz- 1 oz/ day). Because he won't eat more than 2oz, I still wake to feed if he goes the 4 hours. But, I see that many 2 months old eat every 4-6 hours and eat 4-6 oz. When it comes to eating and sleeping-- do we go by actual or adjusted age? When do we let him be more on demand? Will I ever get more than 2 hours of sleep in a row?!?! TIA

SurpriseMama

I have been wondering the same thing, I'm glad you asked!

 

My son is eating 3 oz, and we wake him every 3 hours to eat during the day. At night, I let him go as long as he wants because it's better for all of us to sleep. I figure as long as he is gaining, he is getting enough. At night, he finishes a bottle around 12 am, wakes up for a little snack around 5, then again at 7. It's working for all of us for now, and the ped isn't worried. 

njdcgirl

I go by adjusted age for everything.  If he acts "older" in some regards I'll follow his cues, but I expect him to act like his adjusted age.

I'd check with your pedi to be sure, but if LO is gaining weight well you should be able to move to feeding on demand (how much does he weigh now?) and hopefully get some more sleep.

As for only taking 2 oz, how much are you offering?  When you space out the feedings a little more he will probably take more.  Maybe slowly add a few more ml each feed and see if he'll increase his volume.  Unfortunately, I know some kids with bad reflux really resist taking more b/c of the pain.  Do you think his reflux is under control with meds?

And, ((HUGS)) and hope you get more sleep soon.

SWR&MSM

My nugget came home on a 27 cal diet.  And from February to April she only ate 2oz per feeding and was only taking 14oz total during the day.  I was concerned that she hadn't increased her volume and when I brought it up to the pedi (which we had just switched to) she had us drop to a 24 cal diet and see what happens.  Within 2 weeks she started eating 3 oz bottles and was up to 21ish total oz.  So my first question is how many calories (if any) is your little one on?  As that might have something to do with it. 

After we dropped calories, we had a weight check to make sure she was still gaining appropriately and at that time the pedi said she can sleep as long as she wants at night, but still eat every 3-4 hours during the day.  So far the nugget hasn't gone more then 4 hours without eating day or night.  While I'm happy she is eating, I'm bone tired.  I would call your doc - but can you let him go during the night and see what he does during the day?  My girl pretty consistently takes 7 bottles - she regulates herself pretty well. 

schenkertobe

My pedi said with these things you go by their adjusted age. For sleep he told me that a term baby, you go by age (months) + 2= approximately stretches of sleep  in hrs at night. For a preemie that age is the adjusted age. So for your LO, you should expect only 3 hrs stretches of sleep. This is all highly variable though of course.

ShannonSky

njdcgirl:

I go by adjusted age for everything.  If he acts "older" in some regards I'll follow his cues, but I expect him to act like his adjusted age.

I'd check with your pedi to be sure, but if LO is gaining weight well you should be able to move to feeding on demand (how much does he weigh now?) and hopefully get some more sleep.

As for only taking 2 oz, how much are you offering?  When you space out the feedings a little more he will probably take more.  Maybe slowly add a few more ml each feed and see if he'll increase his volume.  Unfortunately, I know some kids with bad reflux really resist taking more b/c of the pain.  Do you think his reflux is under control with meds?

And, ((HUGS)) and hope you get more sleep soon.

All this! My DD was "allowed" per the pedi to sleep and feed on demand once she hit 6lbs, which took her 3 or 4 months.

beyoga

Reid is 8 months actual and 4 1/2 adjusted.  We go by his adjusted age.  Of course he was a micropreemie (weighed 1 1/2 lbs at birth).  It works well for us. He is right on target for his adjusted age.

mrsV719

To answer some of the questions:

 

how much does he weigh now?  8lbs 10oz (started at 2lbs 2oz)

As for only taking 2 oz, how much are you offering?  Generally 2 oz but it is a fight to get through all 60mls. Often he only takes 40-55mls out of the 60. When offered more to him, he does not take it.

Do you think his reflux is under control with meds? Not at all. It is miserable. 

So my first question is how many calories (if any) is your little one on? He was on 24 cals, but when they added in the rice/oat cereal they took away the 4 extra cals b/c the cereal adds cals. So he gets 20 cals from the formula and then 1tsp per oz of cereal. 

I would call your doc - but can you let him go during the night and see what he does during the day? We generally do not have to wake to feed. He is pretty consistent about waking every 3-4. We do not wake to feed at night (I don't think I said that originally-- sorry!)... only during the day.... and it is rare that I do it. 

Thanks for all the input. With all the stress of the NICU and now the severe reflux that is so bad I cry all day-- I am just waiting to have a "normal" baby. I just feel like... we have already been through so much with the NICU, and now we are dealing with the reflux, and now he is becoming more and more irritable... I wish we could just catch a break. 

njdcgirl

Sorry you are dealing with a miserable baby. I'd work on the reflux - there's no way LO will take more food if he's in pain. I'm sure you and his doctors are working on it already so I hope you find a med combo that works. Is she on Previcid? Good luck hon!

mrsV719

For the reflux-- He is on Alimentum formula mixed with alternating rice and oat cereal. He is on Zantac (3x day) and Prilosec (2x day). We keep him upright/angled for up to an hour after feeds and never lay him flat except to change his diaper. 

We have a follow up with GI on the 23rd so I think my Pedi is waiting for that to make any changes to anything. I hope things get better... for myself but more so for him. It isn't fair to him to go through this.

 

(Oh and of course DH comes home and he eats like a champ and then falls fast asleep for him! He prob wore himself out all day!)