Still Growing Fast

Someday, these posts will focus on more cheerful subjects, but for now we continue our medical updates.

Friday, the family was on the road going to doctors, the pediatrician in the morning and the pediatric gastroenterologist in the afternoon. The first visit was to look at a rash that has taken over baby's face, neck, and ears; this seems to be normal newborn acne and we are relieved that it should resolve on its own. The second visit was to look at Samson's digestive problems, adjust his medications, and talk about any new strategies to minimize his reflux, cow milk protein sensitivity, and colic symptoms.

The good:

• Weight = 9 lbs 5 oz
• Feeding = all meals by breast; finally, no more bottles & round-the-clock pumping!
  
• The cow milk protein sensitivity is likely to resolve by 10 months of age, and Mama can start reintroducing some dairy (small amounts, always with other food) into her diet by April or May.
  

The bad:

• Reflux is still a problem, although he will probably outgrow this eventually. We have tripled his Prilosec dosing and will monitor progress for 3 weeks; if we don't see improvement, the GI doc wants to do a GI study by X-ray, which will require Samson to fast for 4 hours -- hello, misery!
• The GI upset related to the cow milk protein sensitivity will take some time to heal, and the high acid content in breast milk continues to irritate those inflamed tissues. This means that the colic is likely to continue for a while.

Tomorrow, Samson will have his first outing that isn't related to a doctor's appointment. We're attending a baby shower and Daddy & Mama will take turns being sequestered with the baby in a bedroom while the other participates in the party for a few minutes. We'll give a full report on this momentous occasion then.

One month later, we're still in Punxatawney

Monday marks Samson's first month at home since leaving the hospital. It is 2 months and 10 days since his birth, but his adjusted age is only 13 days. This means that Samson is still very much a newborn baby in his development and behavior, so our 24 hour routine still looks like that of a family with a brand new baby.

Ever see that movie (one of the best movies ever) "Groundhog Day" with Bill Murray? That's kind of how Mama and Daddy are living these days. Every day is the same, except in our case, the cycle repeats itself about every 2 hours: feed the boy, burp the boy, try to catch all of the projectile spit-up, hold the boy upright for 30 minutes (to minimize his reflux); if he falls peacefully asleep, place him in his bassinet and use the next hour to clean & ready bottles, pump breastmilk, take a nap, eat a meal, or do another chore; listen and watch for the boy's hunger cues, get another bottle ready, change his diaper, and start again. We keeping thinking, "Maybe today is the day where he sleeps for 4 hours straight," or "Maybe today is the day when he'll nurse well enough to get his whole meal from the breast," or "Maybe tonight is the night when he'll fuss for less than one hour," or "Maybe it's April, our lives have returned to something sort of normal, and we can go out to eat at a restaurant."

Samson does not sleep for more than 2 hours at a time, and usually it's more like 60 minutes. As a result, Mama and Daddy are basically insane from a month's worth of sleep deprivation. We try to trade off in shifts so that each of us can get at least 3 hours straight sleep, but it is almost impossible with the pumping, since Samson inevitably is shrieking through a colic episode when Mama needs to pump, so Daddy has to wake up & comfort him for 30 minutes until Mama is done.

The good news is that Samson seems to be doing better with his tummy trouble, and he's spending much less time screaming & contorting in pain at night. Even though we're not sleeping, it's a little bit calmer, a little less stressful time. He's also enjoying more, about two stretches of 60 minutes or so, of what we like to call "Sammy Time," when he is content to lie on his back and look around, making funny/cute sounds, and pumping his fists and feet in the air. Sammy Time is SO much better than Hammer Time.

Health Update
After 10 days on Nutramigen hypoallergenic formula, Samson still had blood in his stool (not visible to the eye, but positive on lab tests), so we decided to go ahead and return to an all breastmilk diet on Friday. By this time, most of the cow milk protein should be out of Mama's system, and the advantages of breastmilk far outweigh those of the formula. Plus, Samson is still gaining weight like a champ (8 lbs, 10 oz now), and his pediatrician says he looks healthy in every other way. We have an upcoming appointment with a pediatric GI specialist to look further to find the cause(s) and cures for Samson's bleeding.

So now we're back on the breastfeeding project. Samson's suckle power has improved dramatically over the past two weeks, but he still has trouble with his latch. This is probably because his mouth and facial muscles & nerve systems are still maturing, and also because he has been bottle feeding since he first began eating, and he has a learned to thrust his tongue forward in a way that makes his latch too shallow for nursing. Doulas Veronica and Ryka will be coaching us this week to correct this problem. Our goal is to be off the pump & bottle by the new year.

Christmas Elves
On Tuesday, some family came over to deliver a home-cooked meal and some holiday cheer. Aunt Jane, and Cousins Janice and Amanda put up our Christmas tree and got the chance to meet Samson in person for the first time. Thanks, Waltons!














And last weekend, we had visits from Uncle Kevin, Aunt Kelly, and Cousin Lauren.














Aunt Kelly first offered to stay over and take a 3 hour night shift so Mama and Daddy could get some sleep, but after experiencing a few hours of Hammer Time, she bailed and drove back to San Antonio in the middle of the night. Wuss!

Eight Pounds

Our boy is an eating machine. He gained 9 ounces in 4 days and is consuming enough formula for a baby that weighs 3 pounds more than he does. We are working hard to convince him that he isn't hungry after eating a reasonable meal for a person his size. Oink-oink!

As the volume of his feeds comes down to a reasonable level (and the CMA problem is resolved), much of his colic symptoms (reflux and gas pains) should dissipate, meaning less discomfort for Samson and more nighttime sleep for Mama & Daddy.

Tonight, we're on our own again after having had three blissful nights with a doula, Ryka, over to take care of Samson while we got some sleep. For the past three nights, Daddy got 6 straight hours while Mama still had to get up to pump milk, so hers was broken into two blocks of three hours.

Now that we're rejuvenated, we hope we can better manage the nightly ritual we call "Hammer Time." This starts after Samson's 9pm feed, when he begins to get more and more irritated, gassy, and inconsolable, and it lasts until about 4am, with brief 15-30 minute stretches when he sleeps. Daddy and Mama take 3 hour turns comforting the wailing baby, patting and bouncing, walking and talking, singing and humming, swaddling and holding, feeding and burping, wiping and changing. When the sun finally comes up, Samson is exhausted and finally quiets down to sleep, while Mama and Daddy collapse to steal a hour or so nap between feeds & pumping, and the daily cycle begins again. Here we go...

Pictures from Two Weeks at Home

Hello, handsome!
(11/14/2006)















Sleeping Angel/Tyrant
(11/18/2006)















Happy Face
(11/18/2006)




















Hands
(11/21/2006)















Is it time for lunch yet, Mama?
(11/22/2006)

The next thing...

Well, everytime we think we're home free, something new comes up.

This week's crisis is that Samson has developed what looks like an allergy to cow's milk proteins, and that has resulted in bloody, mucusy stool, increased reflux, and severe colic. The cow milk proteins are passed to him through breastmilk after Mama has eaten her usual diet of 75% cheese & yogurt. So, starting yesterday we're back to square one on pumping milk full time and no breastfeeding. Samson will have to drink special non-dairy, hypoallergenic formula for a week or two while Mama goes on a strict non-dairy diet to detox. After that, we start again on the breast and see how it goes.

The trouble with the strict non-dairy diet is that there are hidden dairy products in lots of prepared foods, things you wouldn't imagine. Casein, whey, and anything starting with the prefix "lact-" is off limits, so any prepared foods with added protein-based thickeners are no-nos. Some foods that are labeled "non-dairy" still have some of these cow milk protein-derived additives. Also, many foods that do not have milk products in the recipe may be produced on machinery that also produces dairy-based foods, so they're off limits, too. No butter, no chocolate, no ice cream, no seasoned snack foods (bye-bye Nacho Doritos), no creamy sauces of any kind, and no fast foods, because you can't trust the restaraunts to tell you the truth about what's in their food.

The good news is that Samson has become a new baby since his switch to the gentle formula yesterday. He's crying much less and sleeping more, and we're getting to enjoy some pleasant times together. It's a relief to see him in a state other than discomfort and to get to know him when he's not in distress.

Another positive point is that most babies outgrow CMA and do just fine with dairy at 2-3 years of age. Samson may get to experience the joy of quesadillas some day...

Also adding to our relief is that our new doula, Veronica, started today. For four hours on weekdays through Christmas, we now have an extra set of hands to help with baby care and to give us some respite for a nap or a meal or chores that need doing. The doulas are experts on new baby care, breastfeeding, and special health needs like ours, so we can rest easy with Samson in their hands. This service ain't cheap (we're basically burning through our savings, or what's left before we start paying our share of the medical bills, and I don't even want to think about *that* figure...), but it is SO worth it in order to preserve what's left of our sanity. If anyone is thinking of sending a Christmas present to the family or birthday gift to Mama, please consider making a contribution to the doula fund.