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Our goal has always been to get her the maximum amount of calories based on her weight. Our surgeon said a little overfeeding is better than underfeeding. We started on 5 feeds per day with an overnight continuous feed, but quickly dropped the continuous for 6 larger feeds, then moved to 7, then 8 feeds per day.

You should talk to professionals but should also feel comfortable making these changes yourselves based on what you think is best. We steadily raise the dose & rate almost every single day, trying to keep up with her growth, and if she has more than a tiny amount of spitup, which we track either way, we slow down or lower the dose. As a newborn, we aim for 120 kcal/kilogram. We are usually closer to 100, which our dietician says is fine.

When we left the NICU, we continued their pace of 1 feed per 3 hours, but have since switched to 1 feed every 2.5 hours, with a 6.5 hour gap between the start of the final feed and the start of breakfast. We read that formula babies can go up to 11 hours overnight without a feed, but that seems extreme.

Example Schedule

Our daughter is lucky to have one “work from home” parent and one “stay at home” parent. Our schedule may not work for all family dynamics & lifestyles. This schedule is ever evolving, based on different factors, but this example seems to be working quite well for the time being.

Parent number 2 wakes up at 5am 7 days per week. They change the diaper, then use a clorox wipe on the pump & backpack and clean/tidy the baby areas. They rinse off the g-tube extension, which has been soaking overnight in vinegar. They setup a fresh enteral bag, adjust the pump dose & rate for the day, and mix the first feed, giving it time to sit. The first feed, Breakfast, begins at 6am, and we listen to an audiobook together to wakeup. After the feed is done and the bag is flushed, we have our first skin to skin tummy time (s2sTt).

We do 5 s2sTt’s throughout the day. These are scheduled for up to an hour, but can be much shorter, or skipped entirely, depending on factors, and often just turn into contact napping. The goal is one total hour of solid tummy time per day.

At 8:15 AM, parent 2 puts away everything on the steam sterilizer drying rack, mixes the feed, changes the diaper, and puts on classical music. At 8:30, we start the 2nd feed, Tea Thyme, & at 8:45 we run the steam sterilizer and start the laundry load of dirty cloth diapers. Around 9:15, we empty the steam sterilizer onto the drying rack & flush the enteral bag after the feed ends, and our second s2sTt begins around 9:45.

At 10:45 AM, parent 2 mixes the feed, changes the diaper, and sets up contrast cards for the baby to look at, the classical music is usually still playing. Then parent 2 adds the rest of the baby laundry to the machine, mostly blankets, changing pads/liners, muslin rags, & 1 washcloth, washing the dirty diapers for a second time with the rest of the baby laundry. 2nd Breakfast begins at 11am, and around noon, after flushing the enteral bag, parent 2 puts all the laundry in the dryer together and prepares lunch for parent number 1. The third s2sTt begins around 12:15.

At 1:15 PM, parent 2 mixes the feed, changes the diaper, and turns the music back on if we turned it off for a nap. At 1:30, the baby gets her Lunch, as well as a multivitamin supplement 3 days per week. At 1:45, parent 2 puts the baby’s laundry away, and then the 4th s2sTt begins around 2:45.

At 3:45 PM, parent 2 mixes the feed, changes the diaper, and puts on an audiobook in a non-English language. This is a bit early, but we want to expose her to these sounds as soon as possible. At 4pm, she gets her 5th feed, Afternoon Tea, and around 4:20, parent 2 takes a break and hugs parent 1, who is done with work for the day. Parent 1 has a couple hours between work and the next feed to take a nap or run some errands. Either parent does s2sTt around 5:15.

At 6:15 PM, parent number 1 mixes the feed and changes the diaper. One parent, either or, tells the baby a story, either made up on the spot or from a book. Baby’s Dinner begins at 6:30 and then it is bathtime.

At 8:45 PM, parent number 1 mixes the feed and changes the diaper. Baby is usually asleep around this time, and we try not to overstimulate her. We keep the lights low all over the house (adjustable LED smart bulbs), and just chill together. Baby’s Supper begins at 9:00.

This is around where parent number 2 goes to bed. The baby loves to get up around 11pm and party with parent number 1, who loves to stay up late on school nights. Parent 2 has no idea what they do together, other than that the Midnight Snack, the 8th feed, begins somewhere around 11:30 PM, and then parent 1 soaks the g-tube extension in vinegar for the night.

Parent number 1 eventually puts the baby to bed in her crib next to our heads in our bedroom. Parent 1 is typically the one to wakeup in the middle of the night if the baby is crying, but this almost never happens. After parent 2 wakes up at 5am, parent 1 gets a few more hours of uninterrupted sleep before the workday starts, and everything begins anew.

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We have now moved to a similar schedule but the first feed is at 7:30 AM, we do 7 total feeds at differing rates, doses, & intervals, and the last one begins at 11:30 PM.