End Game.

We have a plan.  And it means that we will be out of the NICU within the next two weeks.

Th first step is to Go back on Erythromycin.  Erythromycin increases motility i.e. it makes Dylan poop more frequently and more easily.  When he's not pooping well, he's not eating well. I'm sure we can all relate.

Dylan is supposed to eat 66 mls per feeding (8 times a day), but if he can consistently get in the 50's, we can fortify the milk to get up to the necessary calories.  We were really close to this about a week ago (before switching meds) and I am very hopeful that we can get back there soon.

So far we've been back on Erythromycin for 3 days and Dylan is averaging about 35mls with a high of 52 and a low of 5. Still very inconsistent.

The Erythomycin trial will last about a week.

If it really works...we go home.

If it doesn't, there a few last ditch things we will try.

1) We will experiment with different bottles and nipples.

2) We will try different feeding schedules. Right now he's eating every 3 hours. Sometimes he wakes up before, sometimes we have to wake him up. He very rarely cries out of hunger. We could go to every 4 hours, but then he needs to eat 90 mls which I'm not very confident about.

I asked if we could feed him ad lib (whenever he wakes) during the day, without giving the rest through his tube, and then make up the difference at night. I'm hoping this will make him hungrier and help us figure out his natural schedule.

3) I might try exclusively breast feeding. I've kind of given up breast feeding lately because it's extremely stressful to schedule breast feeding, bottle feeding an pumping. I don't think he'll pick it up quickly, but I might stay 24/7 in the hospital for a day or 2 to see.

4) We might try formula. There is no great reason that he will like formula better than breast milk unless there is something I am eating that exacerbates his reflux (which drs do not really think). But we might as well give it a shot.

And if none of this works in the next week or so, we will get a g-tube.

The g-tube goes directly into Dylan's stomach. We would feed him normally during the day -however much he takes- and then make up the difference at night. I was very reluctant to go to a surgical option, but it might just be the trick we need. It will remove the pressure of him having to take a certain amount to gains weight, and it will remove everything from his throat, which I'm sure he will prefer.

It's rather simple for a surgery (although still surgery) and we'd leave it in for at least a year even if he does great by mouth, just in case he has a regression later.

Either way, we should be home in about 2 weeks. Everyone agrees that he will do better at home anyway, so it's about time we get there!

In other news, Dylan took his first trip outside this weekend. All of us really enjoyed it! We get to take him out everyday now...doctors orders :).