It's funny to think that I actually have some time to provide an update! Exactly a month after my last update, thought it would be good timing!

The last update, we were hopeful that Mae was going to go to full feeds at 48mls/hour. But my body decided otherwise! When we increased her to 46mls/hour I could not keep up with her amount! First time that has ever happened and she was going through milk like no other and my frozen supply was depleted!

So, with that being said, we had to make some changes! For the past few weeks, we have transitioning to formula, and with that transition, it has to be a slow and steady process. We had to get approval from MNGI to have formula covered by insurance since she will be fed through G-tube for a while. That delayed the process a bit, and we didn't want to go down on her mls she was receiving. So, on Friday, we had to get Similac from the store to get us through the weekend. With how much she was taking in, we had to start a ratio of about 30-40% formula and 60-70% breastmilk. I was just producing enough to keep up with her. We had to see how she tolerated that, while we were waiting for approval for the formula from MNGI. The approval came that next Monday, and we received the formula on Tuesday that week. This formula is different than the formula at the store, so we had to keep her where she was with the new formula. 

The past few weeks, we have been slowly increasing her formula ratio. Currently, we are at 75% formula and 25% breastmilk, so next week we will transition her solely to formula! 

She has been tolerating the transition very well, with a few emesis here and there (I think it's Mae induced from jumping in her crib too much lol). 

The important part is making she is gaining weight with her formula. While we transition, the plan was to pause weaning her TPN. 

But in one week, she gained .5 lbs., which was more than expected and she got another 15% wean on her TPN, which is a huge jump! She is now getting 435ml of calories from her TPN. And we weren't expecting to wean her TPN while she was transitioning to formula, so that was a nice surprise!

When we get back up to 100% formula fed, we will start raising her mls per hour again. While we wean her completely from TPN, she will need to receive those calories via internal feeding (g-tube feeding) so 48mls is not our end goal as we will need to keep increasing making sure she is still gaining weight while we are weaning her IV nutrition through her TPN. Which can take up to 6 months of weaning, but it's solely dependent on her gaining weight.

So, before we can even think about intermittent feeds, we will have to keep working on weaning her TPN and increasing her continuous feeds for the next 6+ months or so!

Lots of work, but so worth it all!