Monday, August 11, 2008

Doctor's Appointment

Tues July 22: 11 lb 3.3 oz
Thurs July 24: 11 lb 2.4 oz (down 0.9 oz)
Fri July 25: 11 lb 4.4 oz (up 2 oz)
Tuesday July 29: 11 lb 10.5 oz (up 6.1 oz)
Thursday July 31: 11 lb 7 oz (down 3.5 oz)
Tuesday August 5: 11 lb 12.3 oz (up 5.3 oz)

The advice I was given last time I saw a public health nurse at the breastfeeding clinic was to continue supplementing Gwen and to weigh her twice a week. For the past two weeks, the Thursday weigh-in has indicated a loss from the Tuesday weigh-in. Now, I understand that "some babies just gain weight slowly" but nothing I've ever heard or read has indicated that an actual loss was anything but abnormal. And for this to happen twice in a row is really weird.

Now, you might be wondering, so let me assure you:
- same scale used every time
- same person weighing her every time (me)
- same circumstances (naked, no diaper) every time

The only thing I've not paid attention to is whether I'm weighing her before or after a feed, or before or after a poop, etcetera.

After this happened for the second Thursday in a row, I made another appointment at the breastfeeding clinic. Seriously, what else can I do? I'm already supplementing, or as I call it, "stuffing as much food down her throat as I can". What more is there?

The nurse I saw was incredibly positive and helpful, and we talked about a lot of things. We talked about reflux. We did a pre- and post-feed weigh-in (she got less than an ounce during the feeding, which is appalling. Fortunately, I am not taking that as 100% accurate or typical). We talked about what a great job I'm doing breastfeeding (yes, she told me I am doing a great job, and told me to keep up the good work. Did I need to hear that? Oh hell yes).

The main message I got was that the breastfeeding clinic could not really do too much more for me, as my breastfeeding was fine. What I need to do, she told me, is take Gwen to a doctor to eliminate any medical cause for her weird weight patterns. So that's what we're doing today.

The nurse also gave me a growth chart and showed me how to plot Gwen's weight from birth. I did so, and learned that while she started out on the 90th percentile, she is now on the 25th. This is not at ALL normal, and while I am not terrified of something being seriously wrong, I do feel it would be foolish to blithely ignore these symptoms. Reflux and milk allergy are our main suspects at this point, as Gwen does spit up a LOT (often it seems she spits up everything we just fed her, which would explain the inability to gain weight steadily!).

I'm nervous about this appointment, mainly because I fear not being taken seriously by the doctor. Doctors, unlike midwives, are not going to take a full hour to examine the tiny patient, take a full history from her parents who are ultimately just making wild-ass guesses about what is going on, and come up with a treatment plan. I fear that the doctor will just brush us off as nervous parents, or declare instantly that "she has colic" (which is a meaningless term if I've ever heard one). The nurse I saw last week assured me that if I didn't like what the doctor had to say, though, I could ask for a referral to a pediatrician for a second opinion.


Anonymous said...

Please don't take offense at a wild stab in the dark from a non-mom but... are you sure you should be weighing her this often? I read a few things on the internet and heard from my friend who had her baby about 2 months ago in England that over there they just don't fret about such things so often, they weigh them every week or couple of weeks and as long as the baby's happy and active and reasonably normal they just don't worry. I expect babies like full grown adults fluctuate day to day, hour to hour depending on when we poop, eat, sleep, shower and retain water...

Also, I'm pretty certain that I started out in the upper 90s percentile (9.5 pounds) and by 6 months I had to have been teeny tiny and continued to be so the rest of my life. I can't help but imagine that is normal for babies to start out high and then go low.

Anonymous said...

Stand your ground with that doctor, lady! You're the expert in your little girl, and you've certainly been spending enough time with her that your thoughts and opinions should be treated seriously. I hope it's a good appointment.

That's some seriously weird growth stats, but at least she's going two steps forward after each one-step-back. She's not losing overall, which is (I think?) a good sign.

Coincidentally I was just reading about milk allergies in The Baby Book (the only reference guide I really have right now), and it said that even milk in the mom's diet can affect the baby if they're really sensitive to it. I had no idea it would travel through breast milk! Are they suggesting you remove dairy from your diet, or just change the formula she eats? I hope you don't have to go through another big diet change...


adequatemom said...

Hi Jess, I weigh her so often on the recommendation of the nurse I saw last time at the breastfeeding clinic. Before we started supplementing her she was gaining really poorly (7 oz in 4 weeks, where norm is 4-8 oz PER WEEK) so the nurse advised me to keep a close eye on her weight to make sure the supplementing was adequate. It's no heartache to me since the health unit is only a block away from my house, and I get to visit with other moms and babies while I'm there.

kitt16201 said...

The best thing you can do is trust your instinct. My pediatrician told me never to doubt myself. She would rather have me overreact than miss something.

Amberism said...

Don't doubt yourself, she's not gaining weight the way she should and you know it. It's not the first-time parent thing, you're instincts are right and I believe the doctor will take that seriously.

You know, I think the drugs we're on make them spit up. I asked the midwife and she said she never made the correlation. But Claire spits up or throws up after every feed too. Callum NEVER threw up. Claire's gaining well now (but I feed her at least 12 ozs of formula a day, because I got tired of worrying about her weigh and if she was getting the nutrients she needs). Not that I've weighed her, but you can tell :). I'm too lazy to go to the scale at the unit.

Keep us updated! We need to know how Miss. Gwen is doing!


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