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Special Needs Sunday: Nighttime Feeding Survival List

03 Aug

Jenna’s largest feeding of the (24 hour) day is overnight.  While she’s sleeping (and hopefully so are we) she’s hooked to her feeding pump, and it runs most of the night.  Unfortunately, a full night’s sleep has often been a rarity due to Jenna getting tangled in her tube, the tube coming disconnected and pumping all over the bed (resulting in screaming and soaking wet baby), the tubing getting kinked, or vomiting.  Or all of the above on a really bad night.  Here are a few tricks we’ve learned that have helped us survive.

Elevate the end of the crib where her head is.  The instructions for the Infinity Pump that we use recommends keeping the upper torso elevated at least 30°.  (I should also note that our pulmonologist recommended elevating her as much as possible during night feeding due to a fear that she might be aspirating formula and perpetuating her chronic lung disease.)  At first, we did this by placing large books under the mattress.  This gave a little elevation, but not enough. We tried creating an inclined “ramp” out of a changing table pad and pillow, but all she did was slide down it until she was flat on the mattress again.  Same results with simply using a pillow (or two) – she just won’t stay on them.  Finally, we discovered Spacebabies.  They’re blocks that stack under the legs of the crib to elevate one end.  Brilliant!  We’re just starting to try these, but hoping we’ll have better results.  Hopefully she doesn’t just turn around in her sleep so her head is at the base of the incline. 

Set IV pole w/pump at foot end of bed.  We did this largely due to fears of strangulation if her head and neck got tangled in tubing, and decided to put it as far away from the “danger zone” as possible.  We’ve had minimal problems with her upper torso or neck getting tangled, but we still struggle with legs and feet getting tangled up.  When Jenna also had oxygen tubing, we ran it down the back of her pajamas and out at the same place as the g-tube.  Same with an NG tube.  This kept all tubing away (as much as possible) from her neck and head.

Cut a slit in zip-up pajamas for g-tube to come out.  I’ve already talked about this, so I won’t dwell.  I will say that we’ve also tried running the tube down the leg of pajamas to come out at the foot.  This seems to decrease tangling (although it still occurred), but it makes it a pain to have access to the tube if you need to administer meds in the night, etc.

Run the tubing out between the slats of the crib instead of up and over the top.  This allows for more slack in the tubing, which equals less risk of it pulling disconnected or pulling out the g-tube.

Hang onto your socks…..We used bumper pads.  Gasp!  Choke!  Before you call Child Protective Services, you should know that we didn’t bring Jenna home until she was three months old and already easily turning her head away from stuff and beginning to roll, etc.  She never snuggled up against the side of the crib, she was on an apnea monitor, and we slept in the same room as she did for the first several months she was home.  To be honest, I did frequently worry about it and wondered if I was a horrible mother, but the pads not only seemed to keep her warmer and the crib less drafty, they also kept the puke in the crib (or absorbed in the bumper pads), which saved our floors.  A more pediatrician-approved alternative would be to get a large washable rug, drop cloth, shower curtain, tablecloth, tarp, etc. and place it under the crib.  Believe me, when projectile vomit is a common occurrence, you want something protecting your floors and making cleanup as easy as possible.

Always use a baby monitor.  We have learned the little warning sounds that occur before vomit and can often be there in time to catch it before the entire bed is soiled now.  When she was younger, we were more concerned with choking and aspiration, and rushed to get there to turn her on her side.  I seriously don’t know how we would have made it without the monitor. 

Use a pacifier.  For the baby/tot – not you.  I know there are all sorts of opinions on this matter.  I’m just going to tell you ours and what works for us.  It has always seemed likes Jenna is much less likely to vomit when she has the paci in her mouth.  Our theory is that it’s because she’s constantly sucking and swallowing when she uses it, but we don’t actually even know if it’s just a weird coincidence.  No matter what, it gives us a good warning sign when she’s about to vomit, because if she does have the paci, she spits it out first, and that’s the ONLY reason she’ll spit that thing out.  She only used it “full-time” until she was just over one.  Now we give it to her on car (or plane) trips when she’s on the pump (and more likely to vomit), and at nap and bedtime (when she’s also on the pump).  It also has the added bonus of instantly calming, soothing and settling her when it’s time to sleep.  She pops it in her mouth and her eyes instantly start to droop and glaze over.

Use a clip light on the crib.  We used this when she was an infant when we were also frequently doing diaper changes in the night along with all the other night feeding care.  We clipped it at the foot end of the crib and had instant, helpful light without being too blinding to awaken her.  Since we renovated our home, we installed a dimmer switch in her room which works great too.

Program the pump so the display lights up at night.  This provides a useful nightlight, but also makes it much easier to read the display when you go in during a problem without having to fiddle with lights.  Both the Kangaroo and the Infinity pumps that we’ve used have had this option.  You may want to also use an additional nightlight, depending on how much light you want in the room.

Use a sound machine.  This masks the sound of the pump running as well as any other household noises.  Jenna was so used to all the background “white noise” in the NICU, that we weren’t sure how she would do in a completely quiet room at home.  The sound machine works great.  Plus, there’s the added benefit that WE can hear the sound of ocean surf via the baby monitor.  Soothing for Mommy and Daddy too!

Keep a cloth diaper (or 2 or 3) draped over the edge of crib.  This makes it quick and easy to grab one as you rush in to take up the “catcher” position for the impending puke.  We’ve also tried keeping a bowl handy, but for some reason, Jenna HATES a bowl and pushes it away as she pukes.  That’s NOT helpful.  Use what works for you, but keep it near the crib and always in the same place so you can easily grab without looking or thinking.

Keep necessary supplies easily accessible and always stored in same place.  Again, in the adrenaline flooded atmosphere of vomiting and fear of choking, you don’t want to have to do a lot of thinking.  AND if you were awakened from a sound sleep after infinite sleepLESS or sleep-interrupted nights, you CAN’T do a lot of detailed thinking.  If everything is always in the same place, it’s a lot easier.  You develop a “puke routine.”  Here’s a list of what we always have handy, as close to the crib as possible, and always in the same place:

  • Cloth diapers.  A lot of them.  We’ve been known to go through a drawer-full in just one night.
  • Extra pajamas.  Have multiples.  Or at least something comfy that can double as pjs in a crunch.  Our record is 6 pajama changes in one (very bad) night.
  • Extra sheets and blankets.  Nuff said.
  • Extra paci.  If any puke touches the one that was in her mouth, she won’t have anything to do with it.
  • Baby wipes.  I try to make sure the dispenser box is full at bedtime.  A baby soaked in formula is VERY STICKY.  So is the mattress that the tube leaked all over.  Puke also often requires a few of these afterward.
  • Diapering supplies.  A baby soaked to the skin from a disconnected tube also gets the diaper soaked from the outside in, even if it wasn’t already wet from the inside out.
  • A flashlight.  Just in case.  Maybe you need to look around for something with more light than you have available, but don’t want to switch on the overhead.  Like when your hubby doesn’t put something back where you always keep it…… (smiles)  It has also come in handy for us during a couple of power outages.  We always keep one beside our bed and in a drawer near her crib.

Probably some no-brainers on the list, but maybe something triggered an “Ah-Ha!” moment for you.  I know you have some tricks you’ve learned (sometimes the hard way if you’re like me), and I’d love to know them too.  Take a moment to share the love and post them in the comments.

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1 Comment

Posted by on August 3, 2008 in Uncategorized

 

One response to “Special Needs Sunday: Nighttime Feeding Survival List

  1. Kindra

    January 25, 2010 at 6:36 am

    I found this very helpful. Thank you.

     

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