Thursday, August 19, 2010

Don't Let the Cheeks Fool You.....

As some of you already know, we have had a bit of a scare recently with Declan. Everything looks fine now, but here's the story.

Declan was a pretty little guy when he was born. He had those big cheeks right from the start, but the rest of him was really skinny. When he was born, even though he was right on schedule according to the ultrasound, etc., the hospital insisted he had the tone and feeding ability of a preemie. (They actually said the same about Talia when she was born exactly on her due date, so my doctor thinks that's just the way I grow babies.) We had to supplement him a little bit in the hospital to get his weight loss stabilized, but once we got home he gained like a champ!

He gained over a pound and grew an inch in his first 2 weeks. It was nice to have a baby that grew well, since Talia had slowly chugged along and struggled to gain every ounce until she started on solid food at 6 months. As we continued to have his regular appointments, his growth seemed to slow down a little bit, but he was still doing well - well above the "minimum" weight gain they like to see in little babies.

We actually think he's huge, compared to Talia at this age. He wears clothes that she wore when she was over a year old, after all. The night before his 6 month appointment Rainer and I were talking about how nice it was to have a chunky little guy that always passed the weigh-in with flying colours! I mean, look at him!


We went to the appointment, and imagine my surprise when instead of gaining like a champ again, we realized he lost weight. A bunch of weight. He weighed less at 6 months old than he did at 4 months old. Declan was a measely 12lbs!!!

Our doctor is so great, she did her best to keep me calm while she gave Declan a very, very thorough check-up. Since she is also my doctor and Talia's doctor, she knew our history of Talia being a slow gainer, and had suspected at one time that my milk just doesn't have enough fat. She said she would have been satisfied with that explanation if D had simply started to gain more slowly, but the fact that he actually lost weight was concerning. (Usually she gives us the option of being referred to a specialist if something wonky comes up with one of the kids, but this time she was all "You're going to take him to see Dr. M. My office will call you and tell you when.")

So she sent us home with instructions to fatten this boy up. Easy enough, right? Increased nursing, bottles of formula, solid food. Except once we got home, it wasn't that easy.

Declan had been on solid foods for about 2-3 weeks already. He ate a ton, 3 times a day. So the next step would be to ramp up the solids by offering higher-fat foods. Here's the thing: I. JUST. CAN'T. put butter in the baby's cereal. Just can't. So I emailed the dietician at my work for some other suggestions. Even after I was armed with those other suggestions, you can't just give a baby 6 new things in one day, you have to introduce them one at a time, with a bit of a break in between the introduction of each new food, just in case an allergic reaction pops up. So it will take some time before we have a good rotation of all these new, higher-fat foods.

Next stop, increased nursing. Again, this sounds easy enough. But you're forgetting Declan is one of the McRainer Super Sleepers. I have him on a good routine of waking up, nursing, playing, going back to sleep. 3 times a day he also gets solid foods after nursing. When he's full, he plays until he gets tired, and he gets tired instantly. When he's ready for bed, he's hysterical. He will not nurse, or cuddle, or play around. He screams "PUT ME TO BED AND LEAVE ME ALONE!!!" repeatedly until you do exactly that. Once he's swaddled and has a soother, he calms himself down and is usually asleep before I leave the room. He sleeps for hours and hours, morning, afternoon, and night. So when, exactly, will I squeeze extra nursing into that routine? Never. That's when.

Okay, third method of increasing his calories: supplemental bottles of formula. My first hurdle with this, of course, is getting over myself and giving him the damn formula to begin with. But the boy has to stop losing weight, so get over myself I do. But then I have the same problem as with nursing - when am I going to squeeze in some formula? I would rather he fill up on breastmilk and solids when possible. I don't want to start replacing nursing sessions with formula, that doesn't make any sense to me and will only hurt my supply. So I decided I would do the formula by topping him up with a bottle after I nurse him for the last time at bedtime. Every night we tried to give him a bottle after nursing. Once he took 3 ounces, a couple of times he took two ounces, usually he took less than half an ounce or refused the bottle all together.

So, just to review, that meant that increasing the nursing wasn't really working out, fattening up the solids was possible but would take awhile, and I was sometimes squeezing supplemental formula into him 1-3 ounces at a time. I felt pretty discouraged at this point. I had a baby who seemed happy and content, he slept well, seemed to be eating as much as he wanted to be, but was still losing weight. I couldn't figure out how to get more calories into him. I believe really strongly in the benefits of breastmilk, but could my milk be the problem? Was it time to switch him to formula? Or was the weight loss caused by a much more serious problem, like kidney disease or a tumour?

Then I got the call that the specialist wanted to see Declan on Tuesday - that meant we really had 4 days between appointments, and hadn't been able to do much differently in order to get D's weight up. I braced myself for the likelihood that he had continued to lose weight, and that he would be sent from the specialist's office across the street to be admitted to Children's Hospital.

So imagine my shock when they weighed him Tuesday morning and he had gained weight! Tons of weight! Like, a pound and a half!! I was also super delighted when the specialist came in and said "Really? This is our underweight baby?" Of course, once he had Declan stripped down and pinched him all over (especially on his cute little baby butt) he said "This boy needs a lot more meat on his bones!" He's not where he needs to be yet, and they want to see his weight level out, make sure it doesn't dip again, etc. But he has stopped losing. That is a great sign, which really means it's very unlikely that the loss was caused by a serious problem. Instead, it's more likely that being ready for solids, the 6 month growth spurt, and a possible change/dip in my milk supply all happened simultaneously, creating the perfect storm for weight loss - and it just took him longer than most babies to recover. A slow-to-gain baby, now THAT, I can handle.



Jaclyn and Devan Swallom said...

yay declan!1

shannon said...

Holy smackers Treen. That is s-t-r-e-s-s-f-u-l!! Rest assured that he is lucky to have such an incredimom.

smalltalk said...

wow that sounds like it's been tough! So glad he's on the up and up now though - no complaints when he's killing your back :)