Thursday, February 27, 2014

GI Specialist

A few weeks ago Lucy's reflux behaviors returned. Around that time we had increased the Neosure from 1 tbsp a day to 2. Slowly the refusals to eat returned along with the pulling off, arching, and crying as if she was in pain. She also started to sleep in a very stiff and arched position. 

I spent a day making phone calls. I felt desperate because my baby, who had been labeled "failure to thrive" wasn't eating well and likely wasn't gaining well. I called the La Leche League and left a message, I called the lactation consultants at the hospital where the girls were delivered, the home health nurse who offered to come weigh her, and I called the pediatrician. The weight check confirmed what I suspected; another week of below average weight gain. She had only gained 2 ounces. I've been told they'd like to see at least 4.

I also called my chiropractor and made an appointment. 

When I finally spoke to the pediatrician that afternoon I asked for a referral to a GI. He asked me a few questions and basically said it couldn't hurt. 

We stopped giving her the Neosure suspecting it was the dairy and she couldn't handle it. I cut out the small amounts of dairy I had started to reintroduce. The LLL put me in contact with another lactation consultant. She had some insight and ideas. She thought that what started as reflux pain turned into an oral aversion. 

We have good feedings and bad feedings. Good days and bad days. Sadly, there are times when he have an entire bad week. But, we've always gotten through it. We always get to the good at the end of each bad cycle. 

The good feedings returned. The nurse came this past Tuesday and Lucy had gained 4 ounces. I was so relieved and happy until the behaviors picked back up again shortly after her weigh in. 

Lucy may be the most stubborn little baby ever. When she's done eating, she's done. If I try to get her to continue she turns her head away. She's to the point now where she won't even look at me when she's finished. This is probably because she knows I'm going to try to get her to eat more. 

Yesterday was our appointment with the pediatric GI. W met me there and I was glad he came along. We waited a long time to see the dr but when we did I was surprised by what she said. She examined Lucy and felt her stomach. She charted her weight and length on a growth curve and told us she was steadily following her own curve. Her weight and height followed the same curve and she didn't seem concerned. She said she seemed healthy and looked good. She asked if Lucy had a mind of her own and asked at what times we saw the arching. I also told her she has started to arch when frustrated or mad too and that was definitely behavioral. 

The Dr said that it likely wasn't reflux because of when it was occurring. She said she didn't doubt she was a colicky and fussy baby and that she did have some reflux. But, what she was doing was all behavioral. She called Lucy a "naughty baby" in a joking way. She then suggested adding rice cereal for calories. She told us adding 1 tbsp to an ounce of breastmilk increased the caloric content from 20 calories to 30. We had only been fortifying with the Neosure to 22 calories. She said we could add the rice cereal to a bottle and give it to her like that it or spoon feed it to her. She said if she started to arch and cry during feedings to back off and offer her to eat again in a little bit. 

As the day went on and Lucy continued to not eat well I got frustrated. It's easy enough to offer a baby to eat more frequently. She happily accepts many times if offered again in an hour or two. The problem is, she's not my only baby. I want them both on some kind of schedule. I need some kind of break from babies for my own sanity. Yesterday when I offered Lucy another feeding Clara started to cry. As Lucy will stop eating if even my arm moves or she hears a sound I couldn't get up to tend to Clara. Instead I had to listen to her cry while Lucy ate. When I finally picked her up her eyes were all red and puffy. I felt guilty and horrible. I felt like I had to choose between my babies. 

Now the pediatrician and GI have told me to give rice cereal. The problem? I really wanted to do baby led weaning. We were going to skip spoon feeding and puréed foods. I wanted to skip rice cereal altogether v

We could put it in her bottle but I'm afraid she'll hate the taste or texture. Something as simple as that could lead to a complete refusal of bottles.

It makes me sad how many things I've had to compromise on because I have twins. It dictated my prenatal care, the birth experience I had, and honestly, the type of parent I have become. So, do I give up on wanting to do BLW? Do we introduce rice cereal but also then whole foods when they are ready? Do we just add the rice cereal to bottles and hope she continues to take them?

I'm not expecting anyone to have the answers for me. I'm just trying to figure things out. 

The LC I've been talking to lately sent me this link last night:
It's nice to know I'm not alone but I can't help but wonder if we created and reinforced those behaviors for her. It's eye opening for sure. 


  1. I dont have any advice but I just want to say thanks for sharing these challenges opening with us. I am nervous about so many things related to taking care of two babies, especially breastfeeding/pumping. It is nice to know that challenges I might face and that other people are surviving!

  2. It's so hard when you feel your parenting style changing because you have two babies that are a product of choice. It's something I'm for the most part past, because I am a firm believer that having a sibling is far greater than any small shift in parenting style. And while I'd love to get pregnant again, there is really no garantee we'll be so lucky. You are doing a fantastic job with your girls- mama guilt is hard, but remember no matter what your situation dictates, you are still doing the best for your girls that you can!
    On the rice cereal- we tried via spoon for our little guy, it was difficult, but once he got the hang if it his weight really did take off and so much of the worry melted away! AND, all of a sudden I had two more content babies- and life was easier. Our used to be smaller guy now out weighs his brother by 1.5lbs, but is still on reflux meds at night.

  3. I also plan to do BLW, but I don't see it as an all-or-nothing thing. Feeding Lucy some cereal with a spoon now doesn't mean she can't feed herself different foods further down the line. I gave M some mashed banana (thinned with BM) the other day, and she sucked some of it off her hands and ate some off a spoon. I figure everything with food this early is an experiment. If you can get some extra calories into Lucy now, I say go for it, and approach BLW like a different thing entirely when it's time.

  4. Our DD had reflux and we introduced rice to her bottles around 4 months. It did help with her reflux but caused some constipation. We switched to oatmeal instead and it caused much less constipation. IMO you can love the theory of BLW but if a baby needs something else it's important to stay flexible. Good luck, hope it helps!

  5. I don't have any great words of wisdom but can share in some of your frustrations. My twins boys are now 9 months old and I've made many changes to how I thought I was going to parent. I thought I was going to do cloth diapers but quickly realized I personally don't have the time (not saying it's impossible but I couldn't handle another thing on my list). I was going to make ALL their baby food! However one of my boys hates anything homemade so we buy our baby food now. I had also planned on pumping breast milk for them - turns out when you're alone and have two screaming kids, pumping is kind of impossible.
    But I've put my personal issues aside and done what I needed to do for my boys to grow big and healthy. We are formula fed, store bought food, and disposable diapers babies. And you know what? My babies don't know any different. They're HAPPY and growing big and strong. And for me, that's a win! And makes it all worth it! Good luck - twins are so hard but so unbelievably rewarding aren't they? :)

  6. I agree with these ladies on the flexibility. I think if your main concern is weight and health, BLW may need to take a back seat. There's nothing wrong with spoon feeding if that is how it best works. I did a little of both with my son and he takes a spoon and finger feeds. You don't want to be stuck with a child who only wants one or the other honestly, as that can be challenging as well. I would say try the bottle with the cereal in it first and see what happens. I know my son's reflux got a bit better after I introduced solids. I understand being frustrated at the loss of these methods of parenting you were hoping for. I too have had to adapt to C's preferences and what worked best for both of us. It's hard, but ultimately you will feel less stress when your Lucy is feeling better and you can attend to Clara more. Good luck!

  7. BLW is not an all or nothing type of thing. We started off using both spoon feeding and BLW. My daughter preferred BLW and made the move to all BLW quickly. I will say that spoon feeding her helped her teach herself how to spoon feed herself. Every little one is different but don't rule out BLW, there are positives to for both.

  8. If she is steadily following her own growth curve, I'm fairly surprised the doc even recommended supplementing with rice cereal. More and more studies are coming out that are showing that rice cereal is really not the ideal first food so many parents have thought it was b/c of the lack of amylase in the guts of infants - it can actually hurt more than it helps:

    That being said, if you feel like it's a necessary step for her for weight gain reasons, don't be afraid to do it! Flexibility is definitely impt in parenting.

    Hellobee had a nice writeup/series on BLW if you want to check it out:

    Maybe someone in there did a modified BLW style like you're thinking of doing? I was afraid of doing any purees w/Stella b/c you are trying to teach them to chew BEFORE they swallow (which is the opposite of purees where they just slurp & swallow)... but I think rice cereal in a bottle would maybe help alleviate some of that potential confusion?

    I don't know, just throwing some thoughts out there. Good luck! We sure loved BLW with Stella and definitely plan on doing it with Harvey as well. I hope it works out for you to do it if that's what you want!

  9. Yes. The guilt of ignoring one baby because you are dealing with the other. It's tough.
    I don't think giving rice cereal means you can't do BLW. My ped recommended rice cereal for Riley to help her keep her food down. She spits up practically everything. She is still gaining enough weight that it isn't really necessary and would be more to make us feel better. I have decided against it because I don't want their first food to be rice cereal. I am also going to try BLW (or some variation of it) and would like them to start eating vegetables first. You have to what is best for you. If the doctor seems happy with her growth curve maybe hold off on the rice cereal. But, if you would feel better with more weight gain maybe try it out. That is super unhelpful advice, I know. Whatever you choose will be fine. I think we have to let go of how we thought we would parent and do whatever works best for our kids.

  10. Yep, I have the twin mommy guilt of one baby getting more attention than the other also. I have one the is very content and another that is extremely needy and fussy. Granted she has a valid reason to be upset, but I feel bad that she gets held more. You are a great mommy. I have no doubt of that. I have learned that we have to be flexible with our pre determined expectations of parenthood. Heck, just getting pregnant never went as planned or was as easy as any of us wanted either. Hang in there Liz. Hugs your way.