Math

I remember kids in school complaining about learning math and saying that they would never need to use it as an adult.  FALSE.  I use math all the time.  Every day.

I remember teachers saying, "You're not going to be carrying a calculator with you every where you go."  Also FALSE.  

I was hopeful that Hannah would be able to ditch the feeding tube as soon as she got her surgery, but this is not so.  There I go again, getting my hopes up!  I can listen at her throat with a stethoscope and hear her swallowing, and it sounds kind of normal.  However, being NPO (no food by mouth) for almost 4 months, essentially her whole life, she doesn't want to suck on a bottle and has pretty much lost this skill.  She can't remember how.  Additionally, if I shove a bottle in her mouth, or even a syringe with milk in it, she will arch her back and cry and turn away.  This shows that she is averse to oral feeding at the moment.  So far, all we are able to do to introduce food by mouth is to dip her favorite pacifier in milk and let her lick or suck it off.  We will be seeing a feeding therapist on a weekly basis for the foreseeable future, and I have a feeling the next month will be very frustrating.

So while I'm teaching my 12 year old daughter how to navigate the social tumult of sixth grade, my 10 year old how to master his times tables, my 6 year old how to read complicated words and use table manners, and my 2 year old how to poop in the toilet, I am concurrently teaching my 4 month old infant HOW to suck and swallow.  This was not in the job description, and there really isn't a user manual.  Buzzfeed, Babycenter, and What to Expect do not have bullet lists on this.

Not only does she not know how to suck or swallow, but she doesn't get hungry.  In order to get her to want a bottle, or any food by mouth, she has to learn to recognize natural hunger cues.  This can't be done with a 20 hour continuous feed.  This means moving away from the continuous feed on her NG tube and starting bolus feeds. 

So what does this have to do with Math?  Everything!  As long as the NG tube delivers all of her food rather than her body telling her and her telling us when she is hungry, I have to determine how many calories she needs per day and convert it to mL per hour on her feeding pump.  Then I have to use my crazy math skills to get her that amount of calories in a progressively shorter time span each day so that eventually she can have 7 feedings per day, each lasting 30 minutes.

Here's how the story problem looks:

• Hannah weighs 12 pounds.  In order to gain the recommended 18-30 grams per day, she needs 114 calories per kilogram of weight.  Each ounce of fortified breast milk contains 26 calories.  How many milliliters per day should she get?
• How many milliliters per hour should she get if her feeding pump is on for 2 1/2 hours and off for 1/2 hour throughout the day (7 feedings), with a 3 hour break overnight?
• Every fourth day, her feeding is condensed by 15 minutes.  How many milliliters per hour does she receive at each adjustment?  How many days will it take to get to 30 minute feedings seven times per day, and how many milliliters per hour will Jenny need to set the pump to?  Assume that Hannah's weight increases by an average of 20 grams per day, and the total calories per day is recalculated accordingly with each adjustment.
• Extra credit: Using the formula of 1 tsp powdered formula per 45 mL of breast milk, with 1 tsp weighing 2.5 grams, how many 12 oz containers of formula does Jenny need to buy for Hannah in order for her to gain 2 pounds according to the above feeding schedule?  How much does that cost at $17 per container?
• If Jenny has 13 watermelons and Chris has 87 pencils, when will they be checked into the looney bin?

You don't really have to do the math, because I already have.  But what the heck, if you really want to and you get it right, I'll make you some cookie dough.  Given how hard it has been for Hannah to go up even 2 mL at a time in the past, this rate of increase might be too much for her or too fast.  Who knows? Maybe I'll have to adjust it by ten minute intervals instead of 15.  We started at 17 mL/hour back in December, so we've come a long way, but we sure have a long way to go!