Mommy report:Back to the tube

(Fair warning, possible TMI...I don't usually talk much about breastfeeding, but for the purpose of explaining the situation, it's necessary. I'm not all that comfortable with it, but maybe sharing will allow some good advice from some of you.)

So after an exciting discovery that Braska had gained 2 oz over the last 12 days, the afternoon yesterday started going downhill. She started acting a bit irritable and uncomfortable to start with. As I did my general analysis of the possible causes (yeah, I'm that way), I realized that previous to the 4 days that she's been sans tube, she had been consistently on it for 3 days, during which we'd filled her as full as possible. I had meant to have her weighed at the end of those three days, but I didn't get up to the dr's office to do it. That's important in that I think she probably had gained more at that point and is now down a little to the current 11 lbs 14 oz. I'm judging from how she fits in her clothes and her demeanor. The other factor is that while she's been nursing and taking solids somewhat better than normal the last few days, I have been worried and now feel sure that she still is not getting enough fluid since my milk supply is down.

Last evening while we were at Randy and Karen's she got quite fussy, and in a different way than usual. I started reviewing all the recent situations and was concerned that she was just plain hungry and possibly starting to feel dehydrated. She ate pretty well before bed, so I thought I'd address it further today. Two things changed that. First, I got up to pump at about 1:30 am (yes, after seven months...still pumping during the night...grrrrrr). It had been about 4 hours since the last time, instead of the usual 3 hour cycle during the day, but I only got about 40 cc or just over one ounce total. That's not a good sign, per past experience. This has happened the last couple nights, with the total decreasing each night. But she has been doing pretty well nursing during the day, seeming to get plenty each time, making plenty of loud swallowing sounds, which she didn't do previously, so I hoped that she was taking in enough. Then, she woke up at about 3:00 am. This is important because she doesn't wake up at night. And when I got her up, after I'd just pumped less than 2 hours before, she was anxious to nurse, so I let her try, and she seemed to be taking in some. That is, until she spit up everything she'd just had. She started throwing a fit, but made no tears. This was much the same as the last time she was dehydrated, although not as bad as then, thankfully. I woke up Muncher to walk with the screaming baby while I got things ready for the re-tubing. Once we got the tube in and food started, she calmed down and went back to sleep. I filled her full then and once more during the night, and this morning, although she's not back to her playful self, she's better and seems to be "juicing up" again.

So it's back on the tube for now... if it turns out to be more than a week or so, we'll have to walk the tough decision road toward the G-tube. In the meantime, I'm working to increase my supply to see if we can try it all over one more time. Here's hoping!

Mommy report: Good reports all around

Here's a quick rundown of all the recent appointments and such...

Dietician--Miss Tara was great. We're working on a plan to do continuous feeding overnight via the NG and then take it out during the day to work on spoonfeeding, trying the bottle, etc. We'll also be adding olive oil to her spoonfed foods to bulk up the calories as well as continuing to concentrate the breastmilk by adding powder formula to it for extra cals. And she gets to try some avocado as well...we'll see how that goes. The goal is to avoid needing to go to G-tube, since she's been on the NG for about 5 of her 6 months.

DS specialist--Dr. G felt she was doing very well. She said that considering the surgery at 3 months, she was progressing very well. They drew labs for thyroid, but we don't have them back yet. I really liked this dr and was pleased with her attention to a thorough exam. She gave us a script for stool softener for Braska to see if that helps with her 5-6 days "off." She recommended we see ENT at one year. That's when we'll follow up with cardiology and the DS center again too.

Ophthalmology--The dr said her refractions were right where they should be. She does have the mild nystagmus (wiggly eye) which we knew, but she said she's not sure yet if it will affect her vision later. All other aspects of her eye exam, including dilation, were very good. We return at one year for recheck of the eyes.

Pediatrician, Dr. Y--He is pleased that we're finally hooked up with everyone and have the input we need from the specialists. We have a plan in place and all of us are glad about that. He said she looks good overall, so we'll watch the weight when it's time to make the diet changes, but for now we keep doing what we're doing. She got her 6 mo shots, and barely made a whine. What a champ.

So we actually don't have to go to an out-of-town appointment for 6 months, unless something changes, so that's awesome!! We see Dr. Y next for her 9-month check. I would never have believed 3 months ago that it would be possible to not see a dr for that long! God is SO good!

Mommy report: OT eval

Robin, the OT, was here today to do an initial eval on Nebraska. Overall, she said she was pleased with her progress considering her surgery at 3 months and recent illness. She did well with several of the little test elements, and there were deficits in several, which we expected. Her head/neck strength will be a primary goal and point of beginning for therapy in the next few weeks, on a weekly basis. She did give us some things to focus on when just doing normal stuff at home, to help her in between visits from the therapists.

So very soon we'll be seeing Judy, the developmental therapist, Robin, the occupational therapist (which I think is kind of funny in title, as Braska isn't all that into an occupation at this point), and Luann, the speech therapist/feeding specialist.

Mommy report: Feeding frustration

Just a quick post tonight... and Braska's already in bed, so she'll have to put her 2 cents in tomorrow morning.

She has decided that she does not want the bottle at all anymore. This is the kind of thing that frustrates me more than I expected. When I know she can do something and she seems to simply REFUSE to do it... that is hard for me to take. So she's getting NG for most everything now. I hope this changes soon. It's hard to see her take whole meals by bottle one day and just not take it the next.

Thoughts from any of you experienced feeding issues, especially DS related??

Mommy report: Two steps back

Today so far Braska has been asleep. She will not nurse or take a bottle at all, so they are back to using the NG tube and a pump to feed her at a regulated rate. She took 70 cc from the bottle at 5 am when the nurse fed her, but she wouldn't get up at 8 am when I got here, she only fussed at 9 am when Karen tried to feed with the bottle, and the same at 11 am when we tried to work with her and the speech/feeding therapist. We tried to give her a feeding by NG gavage at about 10 am but after she had about 30 cc, it all came back up...and out her nose mostly! That must be the most horrible feeling. I just hate watching her look so scared when that happens. She immediately falls back to sleep after any bit of stirring. The speech therapist is coming back at 2:30p to see if she's more cooperative then.

The chief pediatrician came to see her this morning and said this kind-of relapse period is not unexpected, but we hope that she would bounce back this evening and tomorrow. She is still very sick, so her great eating yesterday followed by more lethargy today should not be a surprise or great worry unless it would continue downward tomorrow.

Mommy report: Rotavirus

Yes, that's right...rotavirus it is. They decided this morning that Nebraska's acute issue is due to rotavirus. Click on rotavirus for more info, if you'd like. She has been doing better today, but still has a long way to go. She does have a bit more energy today, but nothing like the wiggles and squirms of recent days. She is one hungry little thing, though, and has been eating very well today. She took a bottle three different feedings today, each time taking more than she's ever taken from a bottle. The only catch is that she won't take it from me, but Grandma C has been taking that task and Braska takes it well from her.

They have decided, with the info we have currently, that her weight loss was in fact due to her not getting enough food. So once again, doctors right, RK wrong... shocking, right? Not at all. She apparently was eating enough to not feel hungry and then she stopped. Isn't that what they're always recommending anyway!?! Maybe that's just for adults... So we're aiming to really get the hang of this bottle thing so we can know she's getting enough.

She also was seen by the cardiologists today and another echo was done. Things look good. The arrhythmia from last night was apparently due to the distress of the acute problem, but not related to the previous repairs of the surgery. They did finally discontinued her Lasix, which I'm pleased about considering the dehydration issues. We'll be seeing a cardiologist that specializes with DS soon.

That's the info for today... we appreciate all your support more than we can express.

Mommy report: Weight update

We stopped in to Dr. Y's office today to do a quick weigh-in for Nebraska. She weighed 10 lbs 8 1/2 oz. That's down again. Dr. Y's concerned about her continued loss, and I understand that. But here's why I'm not...yet, anyway... On the DS growth chart, she is at about 50th percentile with length and about the 35th with weight. I understand that she's lost weight, and I am very appreciative of Dr. Y's attention to this (He's great.), but here's my thinking, and I'm curious what some of you others with more DS experience think. Since for the first 3 1/2 months of her life she was fed through a tube with a specific amount every 3 hours around the clock without fail, she gained weight. She gained alot, and very fast, due to our previous pediatrician having us increase her feeding amounts at a very rapid rate. This is obviously not normal or natural. We did this in order to help her gain as much as possible before the surgery. When we were at the hospital for her surgery and recovery, everyone commented on how "huge" she was compared to what they usually see at that age and condition.

So...although I understand the losing thing, it seems to me that since that was all kind of manufactured gain, some of it even as retained fluid, I am more interested in where she is currently on a growth chart, as well as how she is doing daily. She's functioning great. She shows no negative symptomatology. She has good energy. She is not dehydrated in any way. She's doing all the bodily functions that babies should be doing. She sleeps all night long (if we would let her, anyway). She complains when she's hungry, then she eats, then she's good for a while. Seems to be a good system. Both her father and I are short, he never liked to eat, from the very beginning, and I was a very small, slight baby. So this may be more her "norm" than we realize.

I obviously don't want her to be malnourished in any way, but I also don't want to get all worried and pressured about something that's not demanding of that reaction. And I have felt quite pressured lately, (note:the pressure is self-placed), to get her to improve her intake and consistency, etc. So today I pondered a while and this is what I came up with... with help from my mother's wise advice... She may just be finding her way back to her natural weight. We tweaked with nature in a way, at first, for a reason, and now that she's doing things the way it's supposed to be done, she's not fitting the particular mold that's been laid out. I could be wrong. If she continues to lose, we'll be sure to take whatever measures necessary to be sure she's healthy. We're making a few little adjustments this weekend to see if it helps before the weigh-in early next week. Call it mother's intuition or just an RK-gut feeling, but I think she'll start leveling off and gaining properly very soon. Your thoughts and/or tips are appreciated...

P.S. Braska went to bed early, plus her Pop took the camera with him tonight...there are some good pics from today, so she'll post in the morning for all of you who really only want to see what she says anyway.