Thursday, May 28, 2009

Here We Go Again?

Desperate and at my breaking point last night, I cried to M. over the phone that I was bringing Lucy to the doctor's today, because something HAS to be wrong with her (I also went on and on about what a horrible mother I am, and how we are never, ever having another child. Ah, what sleep deprivation will do to your mental state...). My sweet baby, who had been going to sleep with relatively little assistance (though some assistance was needed, she is just a baby after all!) was now refusing to sleep AT ALL. Bedtime was a 3-hour fiasco, which was resolved only when I somehow got Lucy to fall into a tentative sleep and laid her down in bed with me so I could finally get some fitful sleep (note, co-sleeping when you are praying fervently that your baby does not wake up is not restful). Nap times yesterday were a joke, except for the one where she slept on me while I caught up on the last several Grey's Anatomy shows. When she was awake she was constantly fussing/crying and looking for SOMETHING to satisfy her. But when I offered a bottle (and even the breast, at one point, so you KNOW I was desperate since I've basically sworn off that frustration), she would eat a little and cry, then eat a little more and cry more. At the bottle, she has been making lots of sounds like she is choking and swallowing way too much air, arching her back, crying. Signs we had been seeing with her for the last few weeks during one or two bottles a day, but signs we basically ignored since she seemed otherwise content. But Lucy is content no longer, so it seemed pertinent to try and do something about it. Or maybe I just get anxious when we haven't been to the doctor in over two weeks :-). But why oh why do things like this always seem to come to a head when one parent is out of town??

And so I did bring Lucy to the doctor's office, though things always seem a little less dire by the light of day. Skipping to the end result, I just filled a prescription for Pre.vacid. Thus, it appears we are traveling down the road of Reflux once again. The way is very familiar to us, as this is something we struggled through with Finn until he was about 15 months old.

Here are the symptoms/behaviors I discussed with the pediatrician:

- at some bottles (in particular, the first one of the morning and the late afternoon/evening ones), Lucy will choke, strain, gulp air, arch her back, cry, and have a lot of gas (of the burping variety). Some bottles (like the middle of the night ones), these symptoms are not present.

- She spits up a few times a day. Not massive amounts, and not with every feeding, although this may be because we are ultra paranoid about not laying her down right after a feeding. Also, her crib mattress has been elevated at one end from Day 1.

- She is gassy (of the farting variety) and only poops every 2-3 days, and that's usually only if I "induce" the poop (ie take her temperature, give her half an ounce of water).

- Used to sleep well (at least two long naps in her crib, with a couple other shorter ones), and slept between every feeding. Went down for the night relatively easily at around 7 pm with a minimum of rocking, and we would have to wake her most nights at 10 pm for one last feeding of the "day." Now we can rock her or hold her and walk around with her for 45 minutes and she still won't go to sleep. If she does fall asleep, she stirs as soon as we lay her down, or 10 minutes later (just as we start to get comfy in our own bed...). Then we have to start the process all over again. We can start "bedtime" at 6:30 or 7:00, and she won't fall asleep until around 10 pm; this after much angst on our part, much walking around/rocking her, and several extra ounces of food to see if she's just hungry.

- Seems to be eating too much for a baby her age. I figure she's getting between 28-32 ounces a day, when she should be getting around 24. In the last 20 days, she has gained 32 ounces! She now weighs in at 10 pounds 8 ounces. Yikes! That doesn't seem healthy to me. I like a chubby baby, but not a Goliath!

- She is fussier now than she was 5 days ago (when the sleep problems began to manifest).

I am hesitant about this - to me, Lucy has not shown classic symptoms of reflux, aside from the arching at the bottle (which does not happen at every feeding). She has kind of a hodge podge of issues. Yes, she spits up, yes, she gets the hiccups, but doesn't every baby? It doesn't seem abnormally excessive to me. Also, she still doesn't poop regularly, so couldn't some of these symptoms because by other digestive discomforts? Or maybe this is related to a growth spurt (not sure about that one, though, since feeding her doesn't seem to make things better). The fussiness could be related to being extremely overtired, SINCE SHE WON'T SLEEP.

Regardless, I feel like we need to try SOMETHING to make Lucy more comfortable. With reflux meds, we can pretty quickly assess whether this is truly her problem or not, and I'm happy that the pediatrician agreed to skip over Zan.tac (worthless, in my opinion) in favor of the stronger family of PPI (proton pump inhibitor) meds. I'm just not satisfied with the approach that some doctors take, where if a baby is gaining weight well, other symptoms are ignored as developmental "issues" that need to be outgrown. While I'm sure that if Lucy does have reflux she will outgrow it, in my mind that doesn't mean she should spend the next year of her life uncomfortable just because she is still able to pack on the pounds. Doctors should strive for an acceptable quality of life for babies (and thus, their families), not just keeping them on the growth charts. I'm glad this pediatrician shares my mindset, and was even willing to let me recommend the medication I wanted. Have I mentioned before how much I love the entire practice?

We should know in the next few days whether the medicine is helping or not. The doctor also recommended that we add some oatmeal cereal to Lucy's bottles. According to her, this will do three things: 1) Help keep the food down in Lucy's stomach; 2) May cause her to eat less (she will feel fuller, thus may eat a more appropriate amount for her age); 3) May help her poop (rice cereal is constipating, but oatmeal can help bring on the poop). I'm hesitant to do this. I know babies' stomachs aren't prepared to digest cereals yet. And we tried thickening Finn's bottles with rice cereal back in the day, but it didn't stop the spit up (just made it chunkier). Also, Lucy doesn't really seem "constipated," her poop is normal looking when it eventually appears. I just need to make her go more often somehow, without the use of a thermometer! Any positive or negative experiences with thickening bottles with cereal at the tender age of 5 weeks? Also, if you did do it successfully, what nipples did you use? I remember we had a really tough time finding a happy medium of a nipple hole that was big enough to let the thickened milk/formula through but not totally choke Finn.

4 comments:

  1. So sorry to hear you are going through this again! Nate had reflux and even puked until he was 2 when he had too much in his stomach. Not fun times. The worst was seeing him in pain but not knowing if it was reflux or just normal baby behavior.

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  2. All you described IS classic reflux - eating too much is one sign. It's a bit reassuring how classic this sounds (I've done a LOT of research at this point) - because I hope that means meds will work. Penny has always been "unusual" in her symptoms and has been and will be a long road to get her eating issues under control.

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  3. I am dealing with a fussy baby today as well. I am convinced it is the Fenugreek I've started taking and have now stopped. Very frustrating when they fuss so much while eating, isn't it? Sorry to hear that Lucy isn't doing well but I'm glad you got some medicine to at least start eliminating if it's not it or help her if it is!

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  4. I hope you get it under control. I have to say I would be concerned about the poop issues as well. Was the doctor concerned at all? Having to stimulate a BM is just not a great thing, she may become dependent on it. Good luck with the meds.

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