Silent Reflux

Aviana became a different baby the day of her 4th week birthday – overnight she went from Jekyll to Hyde.  I have already written about how tough that week was until we learned that she might have silent reflux. Poor girl couldn’t help it and we felt helpless until we went to our pediatrician.  She confirmed that the symptoms we had seen in Aviana were indeed silent reflux and that it sounded like the medication she was going to prescribe would work a treat.  Aviana was prescribed Zantac (an antacid), she was weighed (a staggering 7lbs 8oz – remember she was 5lbs 1oz at birth! I apparently have super calorific -ex-pi-ali-docious milk!) and her dosage calculated because it is determined by weight, not age – which worked out at 0.6ml twice daily.  We picked up the prescription and earnestly waited for the right time to administer it.

That evening Aviana slept very well, and we slept a little better.  It wasn’t until two days later I noticed a new baby.  Our happy baby was back.  I got several smiles during the day, she slept well and ate well.  She can now lie happily on her back.

She still has gas and struggles to get the poo out, waking herself up after a few hours and trying hard to let it all out (which is apparently very normal in newborns as they learn to use their bowels) – considering she is an IUGR baby, this isn’t overly surprising that she finds it particularly tough to get the poo out (she’s not constipated though).  Hoping this changes soon!

Unfortunately, we have noticed the past few days when it comes close to giving her next dose you can hear the reflux gurgling away in the back of her throat and she starts to get wheezy breathing again.  So back to the pediatrician again on Thursday to discuss change in dosage and frequency.

It’s all certainly manageable, but it is so tough to see Aviana cry when she is clearly in pain and there is very little I can do to help her.  I discussed this with my doula yesterday – what do parents do with babies who live in countries where they don’t have access to medications like we do?  Do they go insane from the psychological torture?  I always wonder what our diets are doing to breast milk and the impact it has on our babies guts…

Breastfeeding my IUGR newborn baby: The first two weeks

I had no expectations when it came to breastfeeding my newborn. Yes, it would be good to breastfeed, but if for some reason it didn’t work out, I wouldn’t be overly upset. Formula milk is perfectly fine for a baby. Well…that’s what I thought I would feel anyway!

Not long after Aviana came into our world, in the golden hour skin to skin, I attempted to breast feed her. Chris and my Doula helped me with Aviana’s first latch. Wait – help from Chris?? Although Chris isn’t an expert in all things breastfeeding related, he did attend the Breastfeeding class with me, and he was able to recollect our learnings far better than I could at that moment of time. My head was a bit foggy after being awake for so long and laboring hard! He was my walking breastfeeding text book (well the fundamentals at the least).  I am so glad we went to this class – one of the most beneficial films we watched was how to visually tell the difference between a good latch and a bad latch.

Fortunately, after a bit of fussing, Aviana latched quite quickly and easily, I was pleasantly surprised. Getting the position right as I held her was awkward. I had never held a baby so tiny in my life. I was afraid to break her!!! And here in her first waking hours I was planting her onto my bosom. It was so innate and natural for her to suckle.

This first feed was rather magical. Yes, it was weird having something tug at my nipple constantly, but it made me feel connected to her. She was mine, she was our responsibility to feed, nourish and love.  It also felt onerous at the same time.  I was worried before hand that I wouldn’t fall in love with her, but this experience banished that worry.

Aviana is a ‘IUGR’ (Intra Uterine Growth Restricted) baby, born 5lbs 1oz, weighing in the less than 1 percentile, but very long at 19.5″ in the 50th percentile! Because she was so teeny we had to stuff her up and feed her every 2 hrs round the clock. Whilst in the hospital, just before each feed she had to have her blood sugar levels checked. She wasn’t keen on this – I mean who would want their heel pricked and a cold thermometer shoved between your armpits every single time you were about to eat some food??  It was a tough first 24 hours, recovering from labour, the first several hours I was surviving on adrenaline, but later I don’t know how I was staying awake as I fed her.  Each feed was lasting at least 30 minutes as she kept falling asleep.  After changing her she slept for an hour or so and then it was time to feed again!

She was 4lbs 15oz 36hrs later when she left the hospital and 4lbs 8oz 60hrs later when we visited our pediatrician. When I heard this weight I was shocked!  She  had lost just over 10% of her birth weight. For most other babies losing this amount of weight was on the edge of normal and to be expected- for her low weight it was a concern. My milk had yet to come in yet, so we were told we should try supplementing the breast with 1 oz of formula with every feed.

Now, I said before Aviana had arrived that I had no expectations for breastfeeding and I would be totally cool with formula.  But in that moment when the pediatrician recommended supplementing, my tear bucket was almost full and I felt a huge level of guilt wash over me.  My brain blamed my body for not providing the sufficient nutrients for her.  What if after the ease of the first few days and my baby latching so well she decided to pack it all in and replace me with the bottle?  I had fallen in love with the idea of breastfeeding, and now it all suddenly felt to be at risk.

DANI-don’t be ridiculous.  Your baby needs the nutrients, supplementing is critical to her thriving.  Buck up – I told myself.

Then the pediatrician asked me how I felt about the supplementing?  I responded – “she needs to thrive and that’s the most important thing.  We can supplement, no problem”.  I don’t know if I had hid my initial reaction of disappointment well.  We didn’t have any formula at home, and with it being Christmas eve and getting late, the pediatrician gave us a tub of formula for newborns to go home with.

The idea of the supplementing was to give her all the time she needed at the breast, then when she was done, to offer her the formula.  Aviana wasn’t keen on the bottle at first, and I was secretly pleased she preferred my boob.  I wasn’t happy with the nipple we had, although it was a Dr Brown’s slow flow, I thought the shape of it was too different to my nipple.  So I sent Chris out to the shops to buy some new nipples.  We went with Nuk Perfect Fit Slow Flow.  This seemed to work better for Aviana and we lucked out at the second try.  We do have other nipples in the cupboard just in case.  Even with a better nipple, we were practically force feeding her the formula.  It broke my heart every time we tried to  give her the bottle.  But it was for her own good – she needed it.  Still on the two hour feeds the feeding sessions now lasted even longer with adding in the formula.  Chris and I worked as a team…he prepared the bottle whilst I breast fed her.  We took it in turns to burp her, then give her the bottle, then burp her.  It was exhausting at night because it required leaving the bedroom.

At night time, Chris and I took shifts to deal with Aviana’s fussing, change her diaper and burp her.  Chris took 9PM -2AM and I took 2AM to 7AM.  This suits us well because I’m a morning person, Chris is a night owl. Of course, I still had to be awake every 2 hours for every single feed.

Three days later we were back at the pediatricians for a weigh in.  Miraculously she had gone from 4lbs 8oz to 4lbs 15oz in 72 hours.  My milk was now in, so the doctor said we could reduce the supplementing if we wanted to but still stick with 2 hr feeds.

Another three days later we were back for a weigh in.  Incredibly, she had gone from 4lbs 15oz to 5lbs 6oz!!!!!  Chris and I high fived each other when the nurse called out her weight!  Aviana was gaining an incredible amount of weight just on my breast milk!  I was over the moon that my body had responded so well to Aviana’s needs.  The doctor said we could now extend to three hour feeds at night as long as we kept up the two hour feeds during the day. Woohoo – another high five!!!!

The prospect of an extra hours sleep in between feeds was worth celebrating!!! Except….Aviana hit her 7-10 day growth spurt and I was feeding her almost every hour.  I was on the verge of breaking down from tiredness.  I started to think that maybe my milk wasn’t sufficient for her.  But I educated myself on this kind of cluster feeding and took the advice not to give up and return to supplementing because my body would respond to the increased demand, I just had to keep up the breastfeeding.  Cluster feeding is normal.  As long as Aviana was pooping and peeing regularly she was getting enough milk.   It was a really tough few days.  But we came out of it and she returned to being an angel baby.

Another six days later (today) and we were back at the pediatricians for Aviana’s two week wellness check up. Aviana had grown from 5lbs 6oz to 6lbs 1oz!  She had moved up from the 1 percentile to the 2 percentile!  The pediatrician was impressed with her progress and said we could move to on demand breast feeding if we wanted to.  She told us that typically she would expect Aviana to be at least 5lbs 1oz (her original birth weight) – and we had exceeded that goal.

Admittedly, I have had it relatively easy with my breastfeeding experience so far.  My nipples have survived, yes they have gotten a bit sore, but the Lanolin the lactation consultant gave me to put on my nipples when I left the hospital has worked wonders.  Aviana latches well most of the time, we struggle a bit with my left boob for some unknown reason (I will go to the breastfeeding group the hospital runs with a lactation consultant every month next week to see if I can figure out why).

The only other thing I will mention is my experience of breastfeeding in public so far.  I bought a nursing cover a while ago because I thought that is how I would breastfeed in public.  My first necessity to breastfeed in semi-public was in the car after we had been shopping at the mall the day after Christmas.  That didn’t feel too public.  The next time was at the children’s health centre where my pediatrician is.  This was quite a benign environment to feed in, I felt comfortable whipping the boob out there.  This gave me a bit of confidence for my next public outing – the grocery store.  There was a starbucks in the store, so I sat with my back facing away from the public and fed Aviana there.  Again I didn’t use the nursing cover.  This all gave me the confidence for me to feed openly in Starbucks in Target and even at a restaurant when we had some lunch with a friend and his daughter.  I will still take the nursing cover with me just in case one day I don’t feel comfortable feeding so publicly, but I am surprised at my own confidence!

va-breastfeeding-law-card-front

Before Aviana arrived I mostly read about women’s stories of failure or problems with breastfeeding, which is why I didn’t have high expectations.  So that is why I’m sharing my breastfeeding story of success!  Here’s hoping it continues, because it is rather economical.

Dani

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Sleep & the 7-10 day old newborn growth spurt

Aghhhhhhhhh….the 7-10 day growth spurt.  It IS a thing!  It’s a way to remind a new parent that there is nothing predictable about your newborn baby, so don’t try it!  Here is our timeline from birth to date assessed by parent sleepiness levels 🙂

The first 48 hours.  You get home from the hospital and you are exhausted.  There is no catching any Zzzzzs when you are recovering from child birth at a hospital.  For the first 24 hours , every two hours the nurses were checking my vitals as well as my baby’s.  Because Aviana arrived into this world just 5lbs 1oz (less than 1 percentile for weight) she had to have her blood sugar levels checked every two hours just before being breast fed.  This meant probably only 60-75 minutes of rest if I was lucky between feeds.

Parent Sleepiness Level = Super Sleepy

48 -72 hours  later.  You spend the next few days after arriving home trying to figure stuff out.  If your newborn baby is like ours at 72 hours old she will probably still want to be held, swaddled and shushed constantly in addition to needing to be fed every 2-3 hours (in our case she had to be fed every 2 hours because she was so small). I woke up to find that Chris and briefly dozed off with Aviana sleeping on his chest.  I quietly freaked out a bit at the prospect of our newborn baby suffocating her first night home.  But realizing that this was actually inevitable when your baby wants to be held constantly, I crept to his side of the bed and picked up Aviana trying not to wake either of them up.  All of a sudden I am super alert and feeling protective.  This must be the adrenaline kicking in!

Parent Sleepiness Level = Extremely Hyper

Days 4-8.  Aviana started to sleep on her own in her crib, and although we still had to wake her up every 2 hours she was sleeping like a trooper.  Huh!  This parenting thing isn’t so bad after all.  She sleeps for an hour, eats for half an hour, poops and coos for like 5-10 minutes.  WE’VE GOT THIS!!!!! People come to visit us, we make it out to the shops, we even make it out to a breakfast diner for my birthday for pancakes!

Parent Sleepiness Level = Slightly Sleepy

Days 8-11.  Who is this hungry caterpillar we have spawned??! I literally just fed you Aviana 20 minutes ago, and you want to eat again! That’s impossible!  Where is it all going?  Ohhhhhh, yup, *liquidy poo sound comes from baby* there it is – it’s one in one out! Aviana no longer wants to sleep, but just eat and poop. And fuss! Fortunately she isn’t a big crier, but it is hard to hear your baby get upset for seemingly no reason.  Those preemie clothes we bought 5 days ago?  She no longer fits in them length wise, but doesn’t fit into her newborn clothes yet.  What is this magic? This must be the 7-10 day growth spurt they talk about.  The pediatrician says we can now move to 3 hour feedings at night time because she has put all her birth weight back on (and more!), but we don’t get that opportunity because she just wants to EAT!!! Breastfeeding makes a mum sleepy enough as it is, put that with back to back sessions…and you get….

Parent Sleepiness Level = Cranky/Knock Out

Days 12 +.  Who is this sleeping angel?   She is a different baby!!  We are back to having to wake her up for her feeds, but that is OK, because she is an adorable sweet heart.  Now, can this last until her next growth spurt? 6 to 8 weeks?  OK lets bring this sleepiness level down.  You can store up sleep right?!?!

Parent Sleepiness Level = Cranky/Knock Out

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