Tube Weaning - Day 3

And...we're off!!  We have initiated the Reduction phase of the Tube weaning process.  This phase involves cutting the amount of food Joy receives through the feeding tube by ~10% each day for 5 days.  By the 5th day, Joy will only receive roughly half of what she normally gets through the tube.  We still try to feed her by mouth prior to her tube feeds, and we record how much she eats and how each person is feeling throughout the process. The goal is to for Joy to feel hunger when we start the intensive phase of the feeding program on 6/24.  From what I understand, she will not receive any food through her feeding tube starting day 6.

Here is the feeding schedule for the Reduction phase:

Feeding Time	Tube Volume	6/19/13 (Day 1)	6/20/13 (Day 2)	6/21/13 (Day 3)	6/22/13 (Day 4)	6/23/13 (Day 5)
7:30	115 ml	70 ml + 45 ml H20	70 ml + 45 ml H20	70 ml + 45 ml H20	45 ml + 45 ml H20	45 ml + 45 ml H20
12:30	115 ml	115 ml	70 ml + 45 ml H20	70 ml + 45 ml H20	70 ml + 45 ml H20	45 ml + 45 ml H20
5:30	115 ml	115 ml	115 ml	70 ml + 45 ml H20	70 ml + 45 ml H20	70 ml + 45 ml H20
9:30	115 ml	115 ml	115 ml	115 ml	115 ml	115ml + 45 ml H20
TOTAL	460 ml					275 ml

• Day 1 - Joy was her usual self, playful and talkative.
• Day 2 - Joy seemed to be her usual self but she didn't eat as much, had trouble with her naps, and has started to show signs of constipation.  We were instructed to provide prune juice and additional water.  
• Day 3 - Joy was visibly upset due to constipation but slept much better.  Still no signs of hunger.

In the meantime, Joy has been progressing nicely with her creeping/crawling skills.