What was new today?

Slight change in feeding methodology.  Anna's had one or two episodes of emesis -- what is called "spitting up" outside the NICU.  So they want to slow down her feedings to see if she'll keep more down.  The gravity-feed method they were using previously will only go so slowly, and the nurse can't stand there forever with the syringe in hand.

Much better than gravity is the device pictured.  It's got a syringe with breastmilk laid horizontally, then a piston that extends out to the right and gradually plunges the syringe down the very narrow NG tube and into the stomach.  In this case, Anna and Evelyn each had 30 ml of milk administered at a rate of 60 ml/hr.  In other words, the machine pushed 30 ml of milk into each of their tummies over the span of half an hour.  A speed that slow would be impractical for a nurse to do manually, and it better simulates the rate of milk intake from nursing.

The amount of each feeding is now going to hold steady at 30 ml, but they're fortifying the breastmilk with more calories, gradually increasing the richness of the milk to speed weight gain.  A nurse said today that we're probably not too far off from weaning them from the feeding via the tubes (the technical term is "gavage"; I recommend against Googling this because it's also what they do to geese destined for pâté de foie gras).  They'll then be on a combination of nursing and bottle feeding for a while, then (it is sincerely to be hoped) breastfeeding exclusively.