Update

The feeding specialist paid Mikaila a visit mid-week to assess her feeding issues. We have been able to get Mikaila's feeds back into the acceptable range but she still fights us more often than not. My hope was that the specialist (through early intervention, Schenectady County) would arm us with tools and techniques to re-train Mikaila to welcome and enjoy her bottle. The specialist observed Mikaila take a bottle and of course she took it without issue. She did push the nipple out at one point mid-feed but she took it back in after a burp without too much of a fight. This is not typical behavior. We generally have to coax the nipple into her mouth and constantly reassure her along the way. If Kim administers the feed, I have to be at the ready holding Mikaila's hands to avoid her knocking the bottle out of her mouth. I also generally move my mouth as if I were taking a bottle as Mikaila often will mimic what she sees. Back to the specialist. After observing her feed the specialist came to the conclusion that Mikaila's issues are likely not medical. The far more likely cause is an aversion resulting from negative feeding experiences; her formula and milk allergy that led to very uncomfortable reflux and substantial spit ups.

We really didn't get any techniques from the specialist. She did recommend that we change up our patterns. Mikaila often will get upset and sometimes hysterical when we put her in position to eat but before we even introduce the bottle. The specialist mentioned that we might change her position. Also, we have noticed that when Mikaila gets very upset often the only thing that will calm her down is swaddling her. When she gets hysterical she will not eat so we need to be more proactive to avoid her reaching that state. She generally eats without issue when she eats moments after awaking from a nap. We have been using that to our advantage as well and she validated that thesis. The take away is that we have to keep her calm and only introduce the bottle when she is calm.

When Mikaila went to the doctor last, she weighed 9 lbs 9 ounces. Some five days later, she still weighed 9 lbs 9oz. However, her feeds following the doctors visit had been very difficult and at the same time we were trying to get her re-aclimated to breast feeding so her lack of weight gain is not surprising. Two days later she had gained 2 more ounces placing her at 9 lbs 11 ounces on 9/11. Her feeds have gotten better since then so we do expect her to begin gaining weight again. Getting back to her doctor's visit, the doctor wasn't concerned with her weight. The trend was still acceptable so we will continue our current course of pure breast milk. At this point, 1/2 ounce per day is more realistic

I think that is about it. We'll add a few pics in a bit.