Gaining some weight or else NG/G tube?

Its been a busy past few weeks and I haven't wrote much since the last blog.  Also still working on part II of the 1st year write-up.  

So, this past Wednesday (4/17) Trent went in for his GI and nutritionist check-up.  His Doctor was not pleased at all with his weight gain.  From the last check-up and now, Trent has only gained about 3.5 oz at 11 lbs 13.5oz.  That last check up was about 5 weeks ago.  Normally, a baby should be gaining roughly 1 oz a day; and had he reached this goal, Trent should at least be 13 lbs at the very least.   His Twin brother Troy weighs in at 16lbs 14oz for comparison measure.  Trent does have a fairly decent oral appetite, no vomiting or anything like that.  But Trent is only able to take in about 3-4 oz of milk per feed (for comparison, Troy takes about 5-6 oz a feed).  Trent's goal is 600 calories a day, and at 27 cal/oz of formula which equates to about 23 oz a day and at about 5 milk feeds a day (every three hours), that means he needs to consume about 4.5 oz each milk feed.   We're obviously not at the 4.5 oz a feed.  

So his GI doctor is requesting a stool sample test to see if he's absorbing the nutrients.  She is also throwing out possible next steps if Trent doesn't show signs of improvement on his next visit in two weeks of his weight.  Some next possible step she mentioned is a NG Tube (Nasogastric intubation) a tube through the nasal passage way down to his tummy and feeding him during the evenings.  I of course would prefer that he not be on the tube.  I have heard good things about the NG tube (short term), but if Trent goes on it, it'll be long term.  The NG tube does definitely help with weight gain as you're force feeding.    But drawbacks I've heard is vomiting, gagging and possible affects to the vocal cords and affecting his eating by mouth since now there's gonna be a tube in there.  

So the next couple of weeks, we will increase his "solid" feeds (from two feeds to three) to offset the smaller volume milk feeds and also fortify all his feeds including his middle of the night feeds despite us being in zombie mode.  Every calorie is going to count.    We're also hoping that his stool sample doesn't indicate anything abnormal.  

Shortly after our visit, Trent all of a sudden developed a much better appetite.  He's been able to eat all his rice cereal and his baby puree foods.  We're selecting the high calorie ones.  Since Trent will only consume the same amount in volume, need to trick him to get more calories with the same amount.    Trent seems to like his chicken and beef baby puree foods, I'm guessing he likes the salty-ness.  I've read that OEIS babies tends to lack sodium and have a taste buds for salty stuff.  

So far, Trent's been able to take in about 400 calories in milk and 200+ calories in solid feeds to get 600 calories.  I'm praying that the calories is being transformed into weight gain.  As the engineer I am, i'm tracking his every calorie in a spreadsheet to ensure he stays on track.  

So far, the past few days after the visit, We were able to get Trent to take in about 600 calories.  And some feeds, he's even able to take in close to 4 oz of milk (that's a really good single feed).   He seems to really like his baby puree Beef and spinach, Chicken brown rice type feeds more so then the fruity sweet ones.  Also his rice cereal has been pretty good up from 2-3 table spoon to 3-4 table spoon.  The one thing I learn that may be contributing to his better eating habits is methodology, I have to thank my mom for giving us some pointers and also encouraging us to be more patient and not give up on his feeds at the first sign of refusal but to try to persuade him to eat a little more after he stops. And so far, it's working, able to get Trent to take in another 20-30 ml (or 1oz) and putting in some fruity puree stuff with his dull tasting rice cereal.  

So please Pray for Trent that he shows signs of weight gain.  Our target is for him to his 12lbs 11 oz by his next GI visit.  

Thanks