Fail

I can't help but feel like a giant failure when it comes to Lucy and sleep. 

As I've said before, Clara goes to sleep on her own every night and sleeps 11-12 hours. Maybe 1 in 5 nights she'll need her paci, but she rolls right over and falls back to sleep. 

Lucy, on the other hand, is turning into a night time nightmare. Last night she went down fine around 7. Around 10 she woke up crying so I nursed her. She nursed well but then refused to let me put her down in her crib without screaming. W tried rocking her and putting her down and that didn't work either. She was screaming as if she was in pain so I tried to lay down with her. This didn't help either. I tried Morrin, I tried nursing again and she ate. With a full tummy she again refused to go to sleep. Eventually she fell asleep in our bed, but that is so far from idea. 

She woke at 5:30 am and nursed but has refused to nurse since. It's 3:30 in the afternoon. 

At the pediatrician yesterday she only weighed 12.8. This was an 11 ounce gain in 6 weeks. Although the ped didn't say much, I know this is not a great gain. When I asked him about the sleeping he said she should be sleeping through the night. He said I shouldn't feed her at night and should let her cry. That she'll figure out real soon that waking up and crying at night doesn't get her anything. He said she'd make up for those feedings during the day. 

I think I'd be fine with letting her cry except for the weight gain issues. The night feedings are often when she eats best because she's the most relaxed. She's 10 months old and only weighs 12 and a half pounds! 

So basically I'm feeling like a giant failure. I tried to problem solve and make changes but it hasn't solved our issues. I don't know what to do or who to ask for help in figuring out where to go from here. Feeling super defeated...

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:

http://www.marvelousloveblog.com/2012/09/oral-aversion-aka-reason-mommy-needs.html?m=0

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. 

First Fevers

The girls had their first fevers this week. It was a miserable day for everyone and, unfortunately, we are still seeing glimpses of the misery. 

On Tuesday we went it the pediatrician. Lucy had gained a little bit better than last time and the dr was happier. We also had the results from the blood work he ordered that showed everything was find. He still wants me to supplement her a little by adding some Neosure to 2 ounces of breast milk and giving that to her once a day. I went out and bought it but haven't opened it yet. It breaks my heart to have to give her anything but my breast milk unless absolutely necessary. The dr thinks she needs more calories than her sister. I've been trying to just feed her more to get more calories into her that way. I'm back to waking up at 3 am with her in order to feed her. It's not fun but it's good to know she's getting a few extra ounces a day. I used to give her the paci and she would go back to sleep but I figured feeding her was probably best to help her gain weight. 

Getting up with her isn't as bad as in the beginning, but gone are my 5-6 hour stretches of uninterrupted sleep.  My body is a bit confused as well. Most nights I'm able to nurse her in a side-lying position so I get to stay lying down in bed. For the first few nights I soaked the sheets and bed as I leaked from the other side. 

Tuesday afternoon the girls were knocked out from their shots. They had to be woken up for most of their feelings. I thought they felt a little warm before bed but we didn't take their temperatures. 

On Wednesday morning I got up around 7 to feed them. Lucy definitely wasn't herself and was very upset. Clara was her usual smiley self. They ate and went back to sleep until around 10. 

Every morning we have the same routine. I feed them in bed and then we go in their room. I change diapers and put a blanket on the floor. They play on the floor and I pump, read them books, sing songs, talk to then, etc. Well, as soon as I put them down on the blanket they both started wailing. They both felt hot so I ran downstairs to get thermometers. I checked Clara first. She had a temperature of 103. Lucy's was 102.8. I called the pediatrician and waited to her back about the dosage of Tylenol to give them. 

I found that out, gave them Tylenol, and hoped for the best. Luckily my mom and FiL were over to help. 

The girls napped in people's arms (something we usually try to avoid) and by the time W came home their fevers were lower. 

You would think since their fevers were lower they'd be feeling better. Not so much. They took turns screaming and also screamed some in unison. By 9:00 I had a migraine and needed W to take over. Unfortunately, Lucy cried for the next 2 hours. I felt horrible that I couldn't help, by my head was pounding and I felt super nauseous.

W survived his time with Lucy. She eventually crashed and fell asleep. 

I was hoping Thursday would bring me babies who felt 100% better. Not so much. They took turns being grumpy and refused to nap in their crib. 

I guess what they say is true. As soon as you think you have a handle on things and feel like you know what you're doing, things change. If anyone knows where my happy and napping babies are, please send them back to me.  

Failure to Thrive :(

My little Lucy is still not gaining weight well. After our appointment on December 2nd we started her on reflux medication. We were giving her Prilosec ,and within a few days things definitely improved. I wasn't a huge fan of this medication because it obviously contained red dye, but I was glad it was working and she was eating well again. Within a week we were running low on the medication. In an effort to avoid the red dye I brought the prescription to a different pharmacy that was able to compound the medication. We picked that up last Tuesday and started it on Wednesday.

Last week Lucy started to come down with a little cold. At first I thought she wasn't eating well because she wasn't feeling well. I also noticed that Clara wasn't eating as well but didn't connect it. I thought maybe she had been going through a growth spurt previously and just didn't need as much suddenly.

By Saturday I put the pieces together. Clara was pulling off during feedings and spitting up more. Her fussiness also returned. Lucy started to arch and cry during feedings and then refusing to eat beyond 10 minutes. It appeared the reflux was back and the new medication, despite being the same thing, wasn't working. I called the first pharmacy with the medication that had red dye and they told me we had a refill of the medication but that it wouldn't be available until after 5 on Monday as it needed to be specially ordered.

The weekend was really rough and I was so grateful W was around to help. On Monday things were horrible with Lucy's feedings and I just told myself I needed to make it to 5:00 and I could pick up the prescription. I knew that one worked and that once I started to give it to her things would improve. Even though Clara wasn't eating as well, her behavior wasn't as extreme and she persisted with feedings despite crying at times and taking frequent breaks.

Monday night I made it to the pharmacy and was told there was no prescription to pick up. When they told me that I stood at the counter and asked why as my eyes welled up with tears. The girls weren't eating or sleeping well and were both incredibly fussy. It was obvious they were both in pain.

The pharmacist looked up the order and under that prescription it said it wasn't available. She was unable to tell me when it would be available. Incredibly upset we spoke and she looked through the prescriptions. In mid November our pediatrician had called in Prevacid as we talked and I wasn't wild about the red dye. I had never filled it. The pharmacist told me it was equally strong to the Prilosec so I decided to give it a try. A $50.00 co-pay later I left the pharmacy with the new prescription in hand and renewed hope.

Tuesday the home health nurse came again to weigh the girls. We weighed Clara first and she had gained 7 oz in the past week, a great gain. I nervously put Lucy on the scale and my heart sank when the nurse told me she had only gained 1 oz in the past week. We talked about different ideas to help with her feedings but I was so discouraged when she left. After I thought about it for a few hours I called the pediatricians office. After speaking with the nurse she said the dr wanted to see her so I scheduled an appointment for yesterday. Both girls continued to be completely miserable. It was rough. I went to bed feeling as exhausted as the first few days at home.

Yesterday we saw the pediatrician. They first weighed her which was the same.as what the nurse had her at the day before with an extra half ounce. Then we waited for the dr to come in. We first talked and told him about the history with the reflux medication. Then he examined her. He said she looked healthy and not like she was sick or malnourished in any way. She smiled a big gummy smile up at him as he was looking her over. We then made a plan. The plan was to add human milk fortifier to pumped milk a couple times during the day. This would up the caloric content of the breastmilk from 20 calories per ounce to 22. We would also give the new medicine some more time to work as she had only been given 2 doses at that point. He also wanted to send her for basic blood work to be sure he wasn't missing anything obvious. We will return the first week in January for a well child visit and recheck her weight then. If at that point she still isn't gaining he would do more involved blood work including a urine sample. If everything from that comes back normal and she still isn't gaining he will send her to a GI specialist.

It eased my mind that both he and the nurse the previous day reassured me of how healthy she looked. She's doing great developmentally and is actually more advanced than her sister physically. Lucy loves tummy time and holds her head so high during these times. Clara still prefers to cry with her face in the blanket. I know she looks fine, but it still breaks my heart that she is now being considered a baby with failure to thrive.

Yesterday and today her feedings have been going really well. She's cried and arched a few times after meals, but she's eating for so much longer. I tried to go to a pharmacy to get the fortifier, but they told me they were unable to get it. The dr warned me that might be the case. I was told if I was unable to get it that they may have to order it for me.

I'm still not sure how I feel about the fortifier. I will do whatever it takes to get my little girl gaining weight, but I hope that is just getting her to eat better. I'm still waiting on a call back from the LC at the NICU who has helped me problem-solve so many other issues in the past. For now though I'm just feeling more positive about her reduced reflux symptoms and longer feedings. I hope we are on the road towards making progress with her weight gain. Her sister's amazing growth on my milk is testament that great gain can be achieved on my milk alone. It's always nice to have a "control baby".