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Tuesday, April 28, 2009

Colic, Reflux, Allergy, Oh My!

Warning: for those who are squeamish when talking about baby poop, consider yourselves warned! 
I just changed Mister Baby's diaper and saw something that may or may not be cause for alarm. Normally, a breastfed baby produces stools in 'every color of the rainbow,' as I've heard it described. There are lots of reasons why it could be anything other than 'mustard butt,' which, at least in this household,  is what we call the bright yellow stuff. Yellow-brown, brownish-yellow, green, dark green - it could mean a variety of things besides just what you've eaten for that day. 
Greenish poo can mean a couple things - if the baby is getting only the foremilk instead of the hindmilk, for instance, it can produce frothy, greenish poop. Getting the baby to nurse longer or continuing on the same breast at the next feeding can often help. This can also be caused by overactive milk supply, causing the baby to sputter, cough or gag at the breast because the milk is simply too much for him. I tend to have this, at least until my milk supply regulates itself over time, and right now Mister Baby is fussy at the beginning of a feeding or pulls away from the breast and gets sprayed in the face. When he pulls away, I'll sometimes use a cloth or nursing pad to absorb the excess milk and we're good to go. Mister Baby seems to match several of their criteria, including  spitting up a lot, crying and irritability sometimes (but what baby doesn't?). If you think you're producing too much milk, here are some good ways to tell: http://www.llli.org/FAQ/oversupply.html
However, these are criteria for other problems, too, namely a milk protein allergy, which is the part that concerns me. Overactive milk letdown is an easy problem to fix; not so much so for the dairy allergy. Or at least while it's not difficult to fix, the results can sometimes take longer to see. Ask me how I know: I dealt with endless screaming and inconsolable crying for eight long weeks with my daughter before I figured out the problem. Other big red flags with her were a persistent "allergy ring" around the anus that I dismissed as simple diaper rash, stool that changed from normal bright yellow to green to brown and then to blood, and lots of mucus. Considering I have Crohn's Disease, I was scared to death that it was manifesting itself in my infant daughter already - knowing that she could inherit this horrible disease from me anyway, I couldn't bear the thought of her suffering from it so early in her young life. 
We had already visited one of the pediatricians in our group before, only to come home with a prescription for Zantac to treat acid reflux. I never got that filled, because I wasn't totally convinced it was reflux. Sure, she spat up a lot, but there were also episodes of literal projectile vomiting that scared the hell out of me - at times it was so forceful that I couldn't even find where it landed. I was afraid to feed her after she'd vomit up an entire feeding and then be hungry again. 
Then her symptoms manifested themselves in bloody, mucusy poop - not a pretty picture, especially when there were times I'd find that instead of stool in her diaper. After that, I knew something was really wrong, and visited the kellymom website to get some very helpful advice on diagnosing a milk protein allergy. My daughter showed probably all of the red flags, but I was relieved that this was at least something I could deal with on my own and hopefully it would resolve itself with a change in diet. 
I visited our pediatrician at my daughter's 8-week checkup and she was just as concerned as I was, only her answer to the problem was to put the baby on formula for three days and see if there was an improvement. By this time, I already knew that it could take up to ten days for her symptoms to disappear, and that going on formula would do nothing, since it wasn't enough time to see improvement. After the three days I would continue nursing her while on my same diet; how was that going to change anything? 
I told her I wanted to change my diet and see what happened, and her response: "Well...it's been my experience that moms say changing their diet doesn't really work." I thought, either they weren't eating totally dairy-free, in all its forms, or they didn't wait long enough for signs of improvement. I knew it could take a while and was willing to wait it out if it meant I could continue nursing. I left there disgusted, but at least had convinced the pediatrician that I would do it my way, for now. 
The thing is, you don't have to stop nursing: there is absolutely no such thing as being allergic to breastmilk. Your breastmilk, designed for your baby, is Nature's perfect food. It's what's in your breastmilk, like dairy, soy, wheat or other allergens, that can cause baby a problem if they're allergic. Just like we know that alcohol and drugs in breastmilk can affect a baby, so can the food you eat. So any doctor who tells you your baby is 'allergic to your milk' is full of BS. Unfortunately, I think some doctors just don't know enough about it to properly advise a patient, because I've read a lot of misinformation out there that seems to come directly from the mouths of our esteemed pediatricians, of all people. 
The challenging part is eliminating all forms of dairy from your diet - not just milk, but caseins, caseinates, and all those other foreign-sounding ingredients that don't look like dairy but really are. Sometimes it's confusing, and the label can even bend the truth a little by saying "not a significant source of dairy." Well, maybe not to them, but it is to your very sensitive baby - so be on the lookout for these impostors. (One culprit I can think of is my flavored coffee creamers that I like so much. Darn it.) Note: lactose-free is not the same thing as dairy-free. Changing to lactose-free products will not solve the problem. 
It became more of a challenge to find products I could actually eat safely. One nearly surefire way for me to tell was by following a parve diet labeled with the OU symbol - if it doesn't have a "D" next to it, you know there is no dairy. The Orthodox Union is very strict about food labels and what goes into products, and they regularly inspect manufacturing plants and their equipment to make sure they are indeed kosher. This definitely took 90% of the guesswork out of it for me, and I recommend it to anyone who faces the same dilemma. 
There are so many things on the market today that, if you're willing and truly dedicated to going dairy free, it can be quite easy. Rice-based ingredients are usually a good bet, especially since they often don't have soy-based proteins in them that can also be allergenic as well. You can get rice milk (which I still use to this day), rice- or tofu-based ice cream and other treats (yum!) and a variety of other specialty foods that make eating less of a chore and heal your baby's sensitive tummy, too. And hopefully your child will grow out of the allergy around 9-12 months, like mine did. Thankfully my daughter tolerates cow's milk just fine now. If not, at least you know you can feed your child some safe, yummy alternatives to milk, and for the little ones, know you can still continue to nurse them safely and provide them Nature's perfect food. 
• Other great websites to check out for information and recipes:
http://www.foodallergy.org/ For info and recipes on this and many other common allergies 

Sunday, April 26, 2009

Mister Baby: The First 100 Days

It's been a month and one day since we bravely brought Mister Baby into our household. Since then, I've shed many tears, both of joy and desperation. I've had two other kids before - how can this one be so difficult? I wonder to myself. People ask how I do it, and I tell them one simple word: Caffeine. 
People also say that a woman quickly forgets how much childbirth hurts, and that's why she decides to have more children. I say we quickly forget how difficult the newborn period is, and erase the sounds of those ear-piercing wails and unpredictable spit up episodes at 4 a.m. We also forget how the baby only cries at certain times of the day, like when you want to do something important like eat, use the bathroom, or sleep. It seems like my child only gets fussy when I'm attempting any of these things, and yet, if I had nothing to do all day but sit and twiddle my thumbs, the child would sleep through a 50-piece marching band for four hours. 
I've forgotten about the "witching hour" in the early evening, where settling down to bed takes about four hours, and where no amount of holding, rocking or breastmilk seems to do the trick. Then, suddenly, Mister Baby poops out and falls asleep in an instant. After several tries, you know he's really ready for bed when the arms go up over his head and he's down for the count. Then and only then is it time for me to even consider crawling into bed - too soon, and his Baby Radar will go off and he'll smell me in his sleep, and start sputtering like an old car running out of gas. Or he'll just be settled into bed after a particularly grueling couple hours of fussiness, only to poop in his sleep. Usually this happens after I've just crawled into bed and closed my eyes, thinking only of my comfortable bed and pillow. The minute I hear the telltale gastrointestinal warning bell, my eyes fly open and I stare at the ceiling, thinking "Oh, crap." Literally. 
But then I look at my other two children, seeing how they can brush their teeth by themselves, are learning how to read on their own, and do just about everything else themselves, too. The mantra of my two-year-old is "Me! I do it!" and while her independence allows me more time to tend to the baby, it comes with a price: she's not my little baby anymore, and soon Mister Baby won't be, either. Everyone tells me to relish this time and know that it won't last, for good or for bad - we won't be getting up at all hours of the night for him to eat, but neither will he be a cute, cuddly little 10-pound bundle of joy completely dependent on me for everything. Soon he, like the others, will be riding around on his bike at top speed, waiting for the school bus, and asking me endlessly for another glass of milk or another snack. Somehow I will be ready for it, and as my children grow and change, hopefully I will with them, trying and exploring new things right along with them. I envision play forts and bunk beds, dress up clothes and camping out in the backyard, and smile. Even though something in me doesn't want them to grow up and get bigger, watching them grow and learn and change will be just as much fun. And at least until they turn 16, I might start picking up a few extra hours of sleep along the way, too. 

Saturday, April 18, 2009

Birth Day

Well, it's been over three weeks since my last post. Little did I know that the very night I last posted, I would go into labor and have such a crazy, yet wonderful, experience that would test my human strength and intuition. I was putting my faith into action, while God worked behind the scenes on my behalf!
Several hours after I blogged that Tuesday night, we ate dinner - something told me not to eat too much. I went to bed but couldn't sleep because of random, painless but uncomfortable Braxton Hicks contractions and some back ache. I think I slept for probably an hour, because I do remember having strange dreams. By the time I got up and walked around for the millionth time, the pain suddenly went up a notch - and then I lost my mucus plug. Because we didn't know what position the baby was in, we headed to the hospital about half an hour after labor started in earnest. 
We arrived at the hospital around half an hour later and headed for L & D. As I was signing the insurance papers, my water broke in a tremendous gush everywhere. For a split second I panicked, like the fact that I had made such a mess was my fault, or that now it was really gonna hurt. They wheeled me into a room and I got undressed and took a shower, which helped a bit. As I was coming out, the nurse took one look at my belly and told me she didn't think the baby was in the right position. 
While we were waiting for the ultrasound machine, they checked me - I was already 10 cm dilated! I was blown away. Here was the test to see how far I could get without pain meds and what my body could really do. I'm sure after doing the internal exam the resident could tell the baby was not in position, because it wasn't without a bit of urgency in his voice that he announced I was completely dilated. Then they wheeled the ultrasound machine in and confirmed what we had all suspected - the baby was footling breech. For some odd reason, like my last labor, I had no desire to push - which was a good thing in this case. And as soon as they told me the baby was breech, I knew it was a boy - neither of my sons could find the right way out! 
I was a bit let down, but knew in my heart of hearts - I was disappointed but remained calm while they proceeded to stick me nearly half dozen times to insert an IV line. Meanwhile, my husband was beside me nearly turning green at the prospect of another c-section. One resident shakily said he didn't know how to perform a footling breech delivery, and I almost laughed. While the nurse asked me if I wanted to attempt a vaginal delivery, I said no - I know that OB's just aren't as knowledgeable or equipped to handle such a birth anymore since they almost always do an automatic c-section. In fact, the only such people truly capable of performing such a feat are midwives. Since there wasn't one of those around for quite a ways, I decided not to take my chances and signed the release form. 
When Baby A arrived, we found his cord wrapped around at least twice - which is a testament to me, at least, that the Lord had a reason for him being in the position he was in. Perhaps the frozen Brussels sprouts encouraged him to turn in the wrong direction, we'll never know; but whatever the reason, it must have been a good one. I thought back to my months' old 'premonition' that this baby would be a boy born via c-section and kind of laughed to myself - perhaps that still, small voice was preparing me early on and I just wasn't listening? My ultimate prayer of a safe, healthy delivery was answered, and also one for a healthy child. I kind of like to think the Lord compromised with me on this one.