Wednesday, August 31, 2011

Soren feeding updates

It's been awhile since I have updated on Soren's growth, feeding, and medical issues. I wanted to save growth and development for his 2 month post on September 5th, but thought I would do a separate post updating on feeding and medical issues. I could probably write a book on Soren's feeding protocols; every chapter would be a new week and a new protocol, as it seems this is how things have been going. When Soren was first diagnosed with reflux and aspiration, our pediatrician said we could continue to breastfeed but if we ever needed to give him a bottle, it would need to be thickened formula. A couple weeks later (I think, *scratches head*), he hadn't been gaining weight fast enough so his pediatrician wanted us to alternate feedings between breastfeeding and thickened formula. This feeding regimen brought all sorts of issues. Soren was getting very constipated and would grunt and try to push, turning red and scream. We were getting very little sleep at night because he would be up grunting all night trying to have a BM. As recommended by his ped., we tried giving him a little bit of pear juice, rectal stimulation, and leg exercises, but none of this worked. Eventually I had to resort to giving him Miralax. This worked however, the constipation would act up again. I also noticed a large drop in my milk supply. Giving thickened bottles just didn't feel right for me as I continued to watch my son be in pain. So I went against pediatrician orders and went back to exclusively nursing him. After I did this he had an appt. a week later and had gained lots of weight, so I was really excited! I confessed to the pediatrician that we switched back to exclusively nursing and she said "Good for you, I'm glad!". She said we could 'go back' to exclusively nursing and if he needed a bottle it would need to be thickened formula. I also started to take Fenugreek 3 times a day and my milk supply seemed to get better.

That week I also visited the lactation consultant at the hospital where I delivered and we were discussing his reflux and aspiration problems. She had mentioned that the Dr. Browns bottles seem to flow slower than the Avent ones we were using. Though she never encouraged me to try switching bottles and putting breastmilk in them against his pediatrician's orders, it sparked curiosity in me. I started doing some research on the Dr. Browns bottles, and discovered they made a preemie nipple that was a super slow flow. We were going down to Iowa for a wedding and I knew he would need to get bottles a few times over the weekend, so I went out and bought 2 bottles and 2 preemie nipples to give them a try, and promised myself that if he aspirated while drinking breastmilk from these bottles, I would immediately stop and not try anymore. Well low-and-behold, they worked! When we returned home we continued to nurse and use the Dr. Browns bottles if we ever needed to. I began to feel like maybe things were settling down and we were beginning to fall into a routine.

Then last week he had his 2 month appt. (at 7 weeks, we needed to do it early for insurance purposes), and he weighed 8 lbs. 2 oz....he only gained 5 oz. in 2 weeks! Our pediatrician then requested we do 1 thickened bottle a day as she felt that the thickened feeds stayed down in his tummy better, though he seemed to spit it up just as frequently. Everything seemed to go downhill from there. That night he ran a low-grade fever due to his 5 (!!!!) immunizations. The next few days I started to notice he was spitting up much more in volume and frequency...something just didn't feel right. On Friday we went back to the lactation consultant and did a before-and-after feed weight check, and he took in 3 oz. which was perfect for his current weight. But then he spit up. A ton. He covered the lactation consultant. She began to see what I meant by 'projectile' and that I was not exaggerating his spit-up issues. I mentioned to her that it seemed that his spit up was a bit improved when he took the breastmilk from the bottle. Her suggestion was to pump and bottle feed him, and call the pediatrician that afternoon and let her know about his worsened spit-up. I called and of course our ped. was on vacation. I began to worry, so we got in that early evening with another pediatrician at his clinic.

From Tuesday at his well-child check to the appt. on Friday, he gained 4 oz., which was a perfect weight gain (even though I only did 1 night of a thickened feed). This ped. thought that he might have pyloric stenosis, and wanted him to get an abdominal ultrasound done to see if he had it. She also gave us Zantac to give to him in the mornings along with the Prevacid he was taking in the evenings. I asked if he might have a milk allergy or other food allergy, and she said that if he did, he would have blood in his stool, which he has not. After I had read more about pyloric stenosis, I thought that it sounded a bit worse than what Soren was experiencing, however many of his symptoms seemed to fit the diagnosis. We went this Monday to have his ultrasound done and they have found nothing. Our pediatrician talked with the ped. who ordered the test and they both came to the agreement that they would wait and see how his weight gain is at his next check before they pursue any more testing.

So now we are just waiting. In the meantime I am pumping and feeding him a bottle. This is getting exhausting quickly, as a feed usually takes an hour between both, and then it's only an hour break before he wants to eat again (he likes to eat every 2 hours). I am only able to pump 2 oz. at a session and he likes to eat 3 oz. so it's getting stressful. I've had to give him formula once a day and our freezer supply is quickly dwindling. I usually do compressions while pumping and get a bit more this way. The interesting thing is I pump and pump until I seemingly 'run dry', but then sometimes I'll put him on afterwards and he can pull a lot more out as evidenced by his swallowing sounds.

I will confess that I am really terrible at forcing myself to drink water...any suggestions? Maybe at every pump session I will make myself drink 8 oz. I have also just made a "pump station" right next to my computer in the living room so I don't get so bored. I also just ordered More Milk Special Blend from Amazon. This is supposed to be specially formulated for women with PCOS (like myself), who have a tendency to not grow enough mammary tissue during pregnancy. I'm not sure if I have this issue, as when my milk came in I had a plentiful supply (then quickly dwindled), but I figure it can't hurt. So...if any of you have recommendations for increasing my pumping supply, I would love to hear it!

It's hard watching him continue to spit up so. much. It doesn't seem to bother him though except on occassion when he aspirates from it coming up (yes it can happen, I asked the ped.). He goes through a minimum of 5 outfits a day, I could go through just as much but I've resorted to wearing clothes covered in spit-up unless we're leaving the house. I'm getting really bothered by the constant change in feeding protocol; I feel like once we finally seemed to be developing a routine, it changes. I'm doing my best to be flexible, but it's getting harder. I also feel like once we may have figured out a 'trick' to reduce his amount of spit-up, he throws us for a curve ball...nothing has been consistently working with him, even the special bottles.

I know he'll eventually grow out of this, but it's hard knowing he's not growing well. So many people ask how old he is when we're out in public and they all look shocked when I say "8 weeks", and they respond "Oh wow, he's so tiny". My response is that he was premature, but I know in my heart, not by much. He still wears newborn clothes at 8 weeks, and he is just starting to wear some 0-3 month clothes and he's almost 2 months. As much as I love the little baby stage, I can't help but have some anxiety that he's not growing. He's developing appropriately, his head and length are growing, he seems to be happy, but he's not putting on much weight. And in some irrational ways, I feel it is my fault. I have begun to develop some symptoms of Post-Partum Depression, and am increasing my dose of Zoloft. All of this is hard, but he's so worth it. And continuing to fight the fight with breastfeeding will be worth it too.






Thursday, August 25, 2011

"Just Another Day in Paradise"

After nursing Soren tonight, he projectile vomited all.over. Yet he screamed, because now his tummy was empty and he was hungry again. I wiped off most of it, made him a breastmilk bottle, and gave it to him, knowing I could change him after his feeding. As I'm feeding him all of a sudden my leg starts to feel wet and warm; this is what I look down to:


Runny breastmilk poo. Awesome. Well, we both needed a bath anyway, I figured, so I get the bathtub ready and we take a bath together. Everything's going great, he calms down and loves being in the water. I get out of the bathtub with him and go grab my cell phone so I could take a picture of his cute hair. As I'm walking back to the bathroom he projectile vomits all.over.himself, and clean, mind you.

Not only is he covered in curdled breastmilk spit-up, so is the floor on the way leading from his bedroom to the bathroom.

Grrr, so we hop back in the bathtub to get him rinsed off. We then get out, head back to his room and I start changing him into his bedtime pajamas. Well what-do-you-know, he projectile spits up all over his clean pajamas. So new clean pajamas round 2 go on. I'm still undressed myself, so we head to my bedroom and I put him propped up on the Boppy, but as I do so, I look down and notice this:

Cat vomit all over our bedroom sheets. Fabulous. 1.5 hours of pure chaos in our home passes, it's now 10:00 and 2 loads of laundry are in and little man is sleeping.

But look at this little precious, innocent man; today was "Just Another Day in Paradise".

Wednesday, August 24, 2011

Frustrated

I took Soren in for his 2 month appointment yesterday (even though he's 7 weeks and it's a bit early). He only weighed 8 lbs. 2 oz., his ped. said he needed to be at least 8 lbs. 8 oz. So now we're back to a bottle a day of thickened formula. I explained to her that he's eating constantly, my supply seems plentiful now, but he continues to spit up so. much. Some feedings he does great, but then there's feedings he projectile spits up most of his feedings. I'm beginning to feel drained and frustrated. Why? Why is he not gaining weight? Why is my milk not good enough for him? What am I doing wrong?

Sunday, August 21, 2011

Our First Family Camping Trip

For many years when I dreamed of having a family, one of the first experiences that came to mind which I wanted to share with my children was camping. Growing up, my mom and step-dad took us camping almost every year. Since Brian and I got married, we've been camping every Summer. I couldn't wait to take Soren camping and start all sorts of fun traditions! Last year our extended family started a first annual family camping trip, this year marked our second. This year we stayed at Banning State Park in Minnesota (where we're from which has AWESOME state parks!). Camping with a baby was a bit challenging at times, but we had a great time and are thankful for the help our family provided. The first evening we arrived we set up camp, and made brats, hot dogs, and beans for dinner. We quickly found out how terrible the mosquitoes were, and this whole weekend I was VERY thankful I bought screen netting to put over So-so's car seat and stroller to keep the bugs away. In fact, I have 55 mosquito bites (yes I counted them), Soren has 0! That's a win in the momma department!



I was worried how he would sleep, but he did great! Brian and I have our own twin air mattresses (sleep MUCH better this way, trust me!), and although we brought our Rock n' Play sleeper, I had Soren sleep up curled on my arm because it was so cold, and I couldn't see him in his sleeper from sleeping down below on an air mattress. He was all cozy in his fleece swaddler and hat, it reminded me of when he was a newborn *tear*. The first night he slept for 5 hours straight before nursing, then another 4 hours!

All snuggled in, ready for bed

Good morning sweet boy!
On Saturday morning, my mom made doughnuts on the camp stove for breakfast, which has become a tradition in the family! Yum! After breakfast, the family went and explored the hiking trails, but I quickly discovered that the already-bad mosquito problem was 10 times worse in the woods. We went back to our campsite and took a little cat nap in our tent while Brian and the rest of the family continued to explore. Saturday for lupper we had Meatballs and Gravy and rice, also delish. Brian went home Saturday evening as he had to work on Sunday. Saturday evening a storm came through so Soren and I quickly ran to our tent and hung out. By the time the storm had passed, it was time for bed. Saturday night he was up every. 2. hours. Seriously. And I had to get up and walk to the toilet 3 times that night after his feedings. The temp. had gotten down to 51 degrees, it was pretty chilly, but luckily we came prepared and were able to stay warm under lots of blankets and wearing layers.













Sunday morning my mom made French toast, bacon, and eggs! After breakfast they went for one last hike while I took down our tent and screen tent and packed the car while Soren slept. I can say being 'on my own' with him Saturday evening and Sunday and having to pack up camp and put things away by myself was difficult- to all the single mommas out there who take their kids camping, I have so much respect for you!

Here are some things I learned about camping with a baby, in case you need some tips:
* Bring lots of layers of clothing for you and babe. Long sleeve shirts and pants are great because they protect from bugs (except these mosquitoes on steroids we encountered this weekend) and the sun; also hats for the babe if it gets cold
*Stroller and carrier are nice to have
* The convenience of breastfeeding really proved itself this weekend, no bottles to prepare
* Have a screen tent and bug netting
* A lantern in the tent is helpful for night feedings
* Be flexible
* Keep what you can in the vehicle in case a storm rolls through- caring for a baby really hinders your ability to quickly protect stuff

Next year will probably be even more of a challenge if he's learning how to walk (think dirt and mud), but I can't wait!

Monday, August 15, 2011

Wedding Weekend

Last Fall I received the call that my great friend Hesper was engaged and she asked if I would be a bridesmaid- I was ecstatic and so excited! Shortly after, I found out I was pregnant, and my due date would be July 29th; the wedding was set for August 13th 5 hours away from where we live. We decided we would play it by ear, not knowing how I would be feeling given my due date was so close to the wedding. Luckily it worked out that Soren was born early (not happy that he was premature, but you gotta look at the silver lining I guess).`We headed down for the wedding this past weekend for our first big family adventure. We stopped three times on the way down to feed him, once at our Alma Mater, Wartburg College, where we met.

In front of Dancing St. Francis Statue on campus

Daddy showing him the Fine Arts Center where all his music classes and rehearsals were held



Students would be fined if they were found going in the fountain...it became a well-known dare to do so... had to get him initiated into the Wartburg culture ;-)

Next we were headed down to Coralville, IA where our hotel was located. It was nice that we were able to get a room with a mini fridge in it so I could store pumped milk throughout the weekend. Thursday night, the bride and bridesmaids went out for dinner; it was nice to be out with the girlies, and I had my first 'adult beverage' since before I was pregnant...it was kinda nasty and I only had 2 sips before passing it off to the bride ;-).

On Friday we got ready for the rehearsal and dinner. It was fun roaming Iowa City, we had never been there before. Soren slept through the whole dinner! We got to eat at the Brown Bottle for the rehearsal dinner and enjoyed some of our old favorites when we went to another location in college. Next to my own, they have the best Fettuccine Alfredo...yum!

On Saturday, Soren and I headed over to the bride's parents' house for hair and to hang out with the girlies; daddy stayed back at the hotel and enjoyed some peace and quiet. Soren was pretty fussy on Saturday, he hadn't really slept much throughout the whole day, but slept for the whole reception. Here's some pictures of the wedding:

The Bride & Soren the morning of the wedding
Friends!

Momma Love

Lovely Bride!

Soren & Cora

Sleep Boy

Sunday morning we were on our way home! We took a different way home and stopped at Uncle Ryan & Aunt Tracy's house so they could meet Soren and Soren's cousin A.J. and him could meet. Grandma and Grandpa were there too and were very excited to see Soren!




Our travel time on the way home took 7.5 hours! We were stuck in construction traffic for an hour and it was not pleasant! Soren was hungry and screaming, so we had to pull off on the shoulder to nurse him while people were stuck in traffic next to us. Then I changed his diaper in the back seat, also good times. It was a great weekend together as a family, but we're glad to be home. This weekend we are going on our first camping expedition with my family, should be interesting :-)

Sunday, August 7, 2011

1 Month & Medical Updates

So this is about a week late, but life and taking care of a baby happens, so oh well.

I can't believe my little guy is already 1 month old! In some ways it feels like the memories of his birth are slowly fading (I NEED to write his birth story soon!), and at other times, it feels like I just met him for the first time. To say our lives have changed for the better is an understatement. I feel like I tried so long to fill a void in my heart through shopping, eating, web-surfing; now those things have so much less significance in my life now. I feel like my life is complete. Being a mommy has come naturally to me, I feel like I've been doing it my whole life.

At 1 month, Soren has been alternating between receiving breastmilk through nursing and formula bottles thickened with oatmeal cereal. He really seems to have no trouble switching back and forth from breast to bottle, he just likes to eat :-). Because of this crazy schedule and my supply somewhat dropping, I had to pump whenever he received a bottle and also after he nursed to make sure my breasts fully got drained. I have also started to take Fenugreek capsules 3 times a day and smell like maple syrup...not pleasant, but I guess it could be worse. Because Soren is on thickened feeds for half of his feedings, he has been getting really constipated and turns bright red, cries, and tries to push it out but it's only gas...VERY stinky gas might I add! The nurse recommended adding a small amount of pear juice to his bottles twice a day- this did help once, but then it didn't seem to work again. We've also done some rectal stimulation (NOT one of my favorite moments of mothering), but this only worked on one occasion as well. Now we are adding Miralax to his bottle once a day. We visited the lactation consultant this last Friday to have him get a before and after feed weight measurement, and he took 2 oz. from nursing.

When adding the thickened bottles, it brings up so many more issues including needing to pump, prepare the bottle, clean both the bottle and pump parts, and deal with a baby who is hurting from constipation...this has become so much more difficult then just nursing him. Since his lactation appt. on Friday, we have pretty much been exclusively nursing and he received only 1 bottle a day. All of his constipation issues are gone and his reflux doesn't seem to be as bad compared to the thickened bottles. On Friday Soren weighed 7 lbs. 6.9 oz. before the feed. Today at his 1 month pediatrician appt. he weighed 7 lbs. 13 oz., gaining 5 oz. in just 3 days (goal is 1 oz. per day)! This made me feel so much better as a mother, feeling like my body could help my son grow; I struggled emotionally for a while when he wasn't gaining weight. I can't say for certain why the nursing is now helping him gain weight whereas before it was lacking- my guess is that I am doing even more demand feeding with him, sometimes nursing twice in an hour, and also being on the reflux meds. for a bit more time helps the milk to stay down better. It would have been so easy to just say 'screw it' and stop breastfeeding; there were so many reasons it seemed that quitting seemed most logical... but I didn't. I don't know if my supply will continue to be enough for him (I'm only getting at most 2 oz. each pumping session), but I am working hard to try and build it up. After all that we have been through, I have fallen in love with the simplicity of nursing and the bonding my son and I get each session. I love how he puts his hand on my chest when nursing as if he feels it's a safe haven, I also love how he smacks his lips after eating as if to say "mmm, this is good stuff!". I really do love nursing now, even though it was a tough couple of weeks.

As far as sleeping goes, he's starting to develop a normal pattern. He wakes to eat at the 11ish hour, 3ish hour, 7ish hour, and again at the 11am hour. It would be nice to cut out that 3am feed, but Soren's weight-gain and protecting my milk supply is of utmost importance right now. From 11pm-3am Soren sleeps in his Rock n' Play sleeper next to our bed. After the 3am feed I have a hard time getting him to fall asleep in it, he will often make lots of noises and is kinda loud. After the 3am feed I usually then just have him sleep next to me nustled up on my arm. We both sleep soundly doing this and I have no concern about his safety-it would be nearly impossible for me to roll over on top of him. I know there are alot of nay-sayers about co-sleeping out there, but this works for us and I feel like it is also helping to build a sense of security for my son. I don't know what our plan is for transitioning him to his crib in his room, but honestly I'm in no hurry. Maybe once he sleeps through the night, but we'll see. He won't be sleeping with mama forever, no worries ;-). Soren's daytime sleeping and eating routine still varies day-to-day.

Soren is still currently wearing newborn size clothing. Some of his sleepers might be getting a tad bit short, but everything else still fits great. We have some newborn shoes and they are still gigantic on him, they look like clown shoes.

Over this last month I have really figured out Soren's grunts/noises/cries and what he might need. He really does not cry much, only if he's constipated or doesn't get his paci or food in a timely manner. He LOVES his paci! He also seems to sleep better if we swaddle him, especially with the Aden & Anais muslin swaddle blanket...we LOVE that blankie! He seems to tolerate the swing but doesn't like it as much as I had hoped...I think it's too stimulating for him so it wakes him up rather than puts him to sleep. He loves being held by mommy, I seem to have the special touch... or food ;-). He also seems to do really well in his carseat and car rides, which is relieving.

Soren is getting much stronger and better head control. I think because he's nursing and pulls off, I often make him try to get back on without much assistance, so he's using alot of muscles to do so. He is now starting to focus more on objects, and I love when he is able to focus on me when I talk to him. He still crosses his eyes (funniest thing ever) and looks all around. He initially hated tummy time but now doesn't seem to mind it as much. If you put him upright on your chest, he will lift his head up and try to (wobbly) turn his head. He's also still trying to coordinate getting his fingers in his mouth, a couple times he gets his thumb in there, other times it's his fist or two fingers. If you don't get his paci to him quickly, he starts trying to suck on his hand but gets frustrated and even more mad.

As far as Soren's reflux and aspiration go, they both seemed to be doing better. It's been about 2 weeks since he aspirated while nursing, but still occasionally aspirates when he's spitting up. He still spits up a ton, sometimes projectile. I don't hear as much gurgling as before and he doesn't seem to be in pain. Most times he spits up, it also comes out his nose and this bothers him. Because of the reflux and aspiration issues, he is at high risk for colds, ear infections, and RSV. His pediatrician is currently working with filling out paperwork to get him qualified for the RSV vaccine. If he qualifies (which most likely he will), the company will come out to our house once a month and administer the vaccine to him for the 5 months of RSV season. We got a big lecture today at his 1 month appt. about how important it will be to protect him from getting colds. She wants us to keep him away from children and also be mindful of letting others hold him who regularly come into contact with children. Daycare is a big no-no if we can at all avoid it, luckily putting him in daycare wasn't in our plans. She even said if we're out in public and we walk past children to try and shield him, as sneezes can pass germs 10 feet away... looks like we'll be using the Moby and Baby Bjorn alot this Winter! I don't find it difficult to 'share' him with others, but hearing how crucial protecting him is, makes me nervous for others to hold him and to take him out in public now. I just don't want my baby to get sick and end up in the hospital :-(. Good thing is, we're breastfeeding so hopefully that will help protect him at least a little bit. It's going to be hard for me to say 'no' when others ask to hold him, but it looks like Mother Bear needs to come out of her den.

Well, I think that's about all I can think of for his 1 month update. Here's some pictures:




See what I mean about the paci...




Ahhhh...much better.


More pics:




Where's those fingers?

There they are


Soren's 'safe haven'