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.