The L word

There are many ups and downs in the lives of new parents... and in the month and a half or so since I've last written, Sophie has certainly given us our share of both. She has had so many wonderful moments...new skills and interests and sounds... and I do look forward to telling you about those. But first I need to write about the challenges, since I am a bit preoccupied with them as of late, and I have a bit of trouble talking about them.

The reality has struck me again lately, that Sophie has more challenges than some babies (although of course, she has far less than others.) When we were about to bring her home from the hospital after those 2 grueling weeks, doctors and nurses reminded us several times that her adjusted age would apply for the first year of her life. That even though she probably wouldn't suffer any permanent side effects from her early rocky start, that being a preemie would definately make its mark on at least her first year in one way or another, and that this should not surprise or upset us.

At the time, a part of me really didn't believe them. I thought "She's going home now, she's fine. She was always going to be a genius anyway, so she'll have no problem keeping up with her actual age. It's only one month anyway." What's one month, right?"
So now I have to remind myself that she really is doing very well when she can meet all the 5 month developmental milestones, but isn't quite meeting all of the 6 month ones just yet. (Even though she was 6 months old on Saturday - real age. She's not quite 5 months in adjusted age.) When her peers are crawling and sitting on their own and she's very interested and seems pretty close but just not quite there yet. I need to remember that she's not slow and there's nothing wrong with this, she's right where she should be. This is really my challenge, not hers. She's quite happy with all the things she can do, and is keen to do more. (More to come on those stories in another post)

But she does have other challenges.

The comments that Sophie collects have always been, "She's so pretty/gorgeous/beautiful!" "Look at those amazing eyelashes (and big blue eyes)!" "Isn't she alert and taking it all in?!"
and ...
"She's so LITTLE."
(tiny, delicate, petite,...any number of nice-sounding synonoms as well.) All of these are comments are quite true (And we're soo proud of her :), and the last one never bothered me until recently. Little has always been a big part of her life, and probably will be for a very long time. That's going to be just fine. But recently I've known that something was not right with her weight gain, and I've been a bit worried that she hasn't been putting on enough weight.

Now, I should warn you, this gets a even longer! I feel the need to write it out. but if you're not super interested in all the details just skip to the BOTTOM LINE at the end.... I'll see ya there :)

Sophie doubled her birthweight by the time she was 4 months, and she was growing really well. But she's been hovering pretty close to that same weight for awhile now. At first it didn't bother any of the health professionals we saw. They just said "keep an eye on it, she seems fine, babies grow at different rates, it's ok that she's little cause she's a premmie..." etc.

We took her to a highly recommended pediatrician with questions about her head shape (she's got a bit of a funny flat spot, but it's slowly getting better) and my concerns about her weight. He insisted that her weight gain was fine at that point, but he encouraged us to start her on solids and get her up to 3 feeds per day fairly quickly, and assured us that she would soon bulk up. He also advised us to take her off her reflux medication completely. "Many babies have outgrown the reflux by this stage, and if there's still any problem, the solids will probably fix it," he told us. You'll also notice she sleeps through the night better and is more settled on the solids." At that stage, she was already sleeping through the night quite well, but we took all of his advice.

Now, Sophie's reflux was a bit hard to diagnose and sometimes a hard one to recognise or even believe. It's called "Silent Reflux" because she doesn't actually upchuck. But after the diagnoses and the medication (at around 2 months), she was much more settled during feeds, seemed to be able to feed a bit longer than before (although she was still a quick eater) and started sleeping through the night for long, happy stretches of time. She was also much happier during the days.
Apparently it's not at all uncommon for preemies to get reflux - as their digestive systems are often not quite as strong and healthy as other babies'.

So back to 4 and half months or so - we took the doctor's advice to take her off the reflux medication (Zantac). We really wanted to believe him that she had outgrown the condition, and that solids would help her grow faster again. But in Sophie's case, he was wrong.

Soon after this, Sophie stopped sleeping through the night. For a whole month she woke up 2 to 3 times a night hungry. She was feeding 11 to 12 times a day between solids and milk. She was more unsettled during and just after feeds. When I worried that maybe she wasn't getting enough from me, we offered her top-ups of formula which she usually refused completely. I fed her as often as she seemed even a little big hungry, I tried all kinds of "tricks" to increase my supply (just in case that was a problem), but none of this made any difference to her behaviour, or to her very slow weight gain.

Last week I took her to a child health nurse for a 6 month check up, and while she had gained some weight since our visit to the pediatrician about a month and 1/2 ago, it was very little. I was alarmed but the nurse didn't seem too concerned. Finally, on the weekend I decided we needed to put her back on the Zantac. That very night she slept 7 hours again! Every night since we've had her back on the meds, she's sleeping much better, and each day seems much more settled at feeds, even able to eat a bit more than she did before.

On Monday she had to go to the doctor to get her 6 month shots. I finally saw a doctor who was able to look at her weight hovering around the same place for the last 2 months and say, um, no- that's not ok! (He's not the most encouraging or nurturing of doctors. He's a bit of a Doctor House, minus the limp and the clever rantings. He's gruff, but good.) He fully supported my decision to put her back on the reflux meds, and we're going to watch her closely in the coming weeks and work hard to get her weight up.

I don't know if the medication will be enough to get her weight up. We really hope so. It's a good guess that the silent reflux was interfering with her weight gain, but like so many things with babies...even the doctors have to guess and check. It's even trial and error for them. If this doesn't work, we'll keep trying other things until she's a much chubbier little bub.

So THE BOTTOM LINE ....
We are working closely with a doctor to get Sophie's weight gain up - to a good size for her (which will still be little, but much fatter than she is now!) We are trying not to stress too much about it...cause that would just be too easy to do!
We're trying not use the L word or any of its synonyms too often at this stage... for the sake of Sophie's super-sensitive and prone-to-worrying mother.

When you notice that she has gained weight, when you see that she has grown and is looking big and strong, please tell us! Tell me she is chubby and fat and healthy (when you really see that).
I think that's all I've got at the moment.

oh, on a totally random note... another language difference I run into all the time now: Americans say "Preemie", while Australians say "Premmie" (with the short e vowel.) I'm often mixing these up, so if you sometimes hear me say (or write) that word and think I'm just weird to have got that word wrong when my baby is one...your suspicions can be put to rest. My weirdness has nothing to do with it. Blame it on cultural diversity.

Good night :)