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The downhill slide.
May. 9th, 2005 07:40 pmAlex has stopped gaining weight.
We went to the pediatrician on Friday, and she'd gained a grand total of one ounce since the previous Saturday. I admitted that we'd slacked off some on the supplemental bottles - partly out of complacency, because she'd gained an ounce a day for ten days, and partly because mastitis hit me like a Mack truck. He suggested that we go back to doing exactly what we were doing before, and I agreed to get her re-weighed on Monday at the lactation clinic. So I did.
Today, she weighed what she'd weighed a week ago Saturday. That's not good at all.
I spent a long time with the lactation consultant. She pointed out that Alex's sucking isn't anywhere near as good as it was a few weeks ago. (I'd noticed that she seemed to be doing some lazy nursing, and that it was hard to get her latched on to the supplemental bottles - she was just mouthing.) She tried various diagnostic measures, including feeding Alex some sugar water from a special plastic tube. Alex struggled to get it down, and then spit it up. So then she started asking me how often Alex spits up (fairly often, and much more than before in the past week), and then about a series of behaviors which I wouldn't even have thought to call symptoms: does Alex arch her back a lot? Yeah, she's started doing that recently. Does she shake her head and stiffen when we try to feed a bottle? Yeah, she's started doing that recently. Does she make noises like she's clearing her throat? Now that I think of it, she totally does. Do we see milk in her mouth after a feeding? Yes, sometimes, and then she re-swallows it. Has she been fussier? Good heavens, yes. Has she been having lots of short feedings and then acting hungry again a little while later? Yeah, that's definitely Alex - at least, a lot of the time.
To make a long story short: she thinks it's gastroesophageal reflux disease. She said it often happens that a baby will gain well for a few weeks, and then will start to fall apart around four weeks or so, as she starts taking in enough of a volume of milk to make reflux really painful. So even Alex's timeline makes sense. And then I started thinking of additional corroborating evidence: Alex used to go down without a complaint after night feedings, and now she cries when I lie her down in bed. (Babies with reflux need to be kept upright after they eat.)
The lactation consultant tried to call our pediatrician, but he was gone for the day. She'll call him tomorrow morning, and then I expect that we'll take her in to be seen. Hopefully, the consultant's diagnosis is right, a trial of Zantac will clear up Alex's problems, she'll go back to nursing contentedly, and she'll gain weight like a little pig. Hopefully.
The consultant was also very concerned about my mastitis. ( medical TMI )She told me to stop nursing for 24 to 48 hours, and instead to pump 10 times a day. In the meantime, Alex is to be fed bottles. If I can't pump enough to give her 8-10 2.5oz bottles (and I can't), I'll need to supplement the pumped milk with formula. I can do some "comfort nursing" after I've pumped, but I'm not supposed to be nursing for her main nutrition.
This is a physically intimidating program (pumping ten times a day?!), and also... emotionally devastating. I feel like a failure for giving my baby formula, even mixed with breast milk, even for only 24-48 hours. And I feel tremendously sad about not nursing her. She loves to nurse. I love to be able to provide her with that comfort and security. I feel empty and inadequate for not having that to give her, even just for a day. I'm afraid that this will be the beginning of the end of our nursing relationship - that we won't be able to re-establish breastfeeding, or my milk will disappear. And I feel like I'm setting myself up for a hailstorm of criticism and disapproval for allowing her to have something besides breast milk.
(Incidentally, if you're planning to leave a comment explaining why we shouldn't give formula or why I should fire my lactation consultant, please don't. We are trying this. Our decision has been made. Second-guessing us will not be helpful.)
We went to the pediatrician on Friday, and she'd gained a grand total of one ounce since the previous Saturday. I admitted that we'd slacked off some on the supplemental bottles - partly out of complacency, because she'd gained an ounce a day for ten days, and partly because mastitis hit me like a Mack truck. He suggested that we go back to doing exactly what we were doing before, and I agreed to get her re-weighed on Monday at the lactation clinic. So I did.
Today, she weighed what she'd weighed a week ago Saturday. That's not good at all.
I spent a long time with the lactation consultant. She pointed out that Alex's sucking isn't anywhere near as good as it was a few weeks ago. (I'd noticed that she seemed to be doing some lazy nursing, and that it was hard to get her latched on to the supplemental bottles - she was just mouthing.) She tried various diagnostic measures, including feeding Alex some sugar water from a special plastic tube. Alex struggled to get it down, and then spit it up. So then she started asking me how often Alex spits up (fairly often, and much more than before in the past week), and then about a series of behaviors which I wouldn't even have thought to call symptoms: does Alex arch her back a lot? Yeah, she's started doing that recently. Does she shake her head and stiffen when we try to feed a bottle? Yeah, she's started doing that recently. Does she make noises like she's clearing her throat? Now that I think of it, she totally does. Do we see milk in her mouth after a feeding? Yes, sometimes, and then she re-swallows it. Has she been fussier? Good heavens, yes. Has she been having lots of short feedings and then acting hungry again a little while later? Yeah, that's definitely Alex - at least, a lot of the time.
To make a long story short: she thinks it's gastroesophageal reflux disease. She said it often happens that a baby will gain well for a few weeks, and then will start to fall apart around four weeks or so, as she starts taking in enough of a volume of milk to make reflux really painful. So even Alex's timeline makes sense. And then I started thinking of additional corroborating evidence: Alex used to go down without a complaint after night feedings, and now she cries when I lie her down in bed. (Babies with reflux need to be kept upright after they eat.)
The lactation consultant tried to call our pediatrician, but he was gone for the day. She'll call him tomorrow morning, and then I expect that we'll take her in to be seen. Hopefully, the consultant's diagnosis is right, a trial of Zantac will clear up Alex's problems, she'll go back to nursing contentedly, and she'll gain weight like a little pig. Hopefully.
The consultant was also very concerned about my mastitis. ( medical TMI )She told me to stop nursing for 24 to 48 hours, and instead to pump 10 times a day. In the meantime, Alex is to be fed bottles. If I can't pump enough to give her 8-10 2.5oz bottles (and I can't), I'll need to supplement the pumped milk with formula. I can do some "comfort nursing" after I've pumped, but I'm not supposed to be nursing for her main nutrition.
This is a physically intimidating program (pumping ten times a day?!), and also... emotionally devastating. I feel like a failure for giving my baby formula, even mixed with breast milk, even for only 24-48 hours. And I feel tremendously sad about not nursing her. She loves to nurse. I love to be able to provide her with that comfort and security. I feel empty and inadequate for not having that to give her, even just for a day. I'm afraid that this will be the beginning of the end of our nursing relationship - that we won't be able to re-establish breastfeeding, or my milk will disappear. And I feel like I'm setting myself up for a hailstorm of criticism and disapproval for allowing her to have something besides breast milk.
(Incidentally, if you're planning to leave a comment explaining why we shouldn't give formula or why I should fire my lactation consultant, please don't. We are trying this. Our decision has been made. Second-guessing us will not be helpful.)
