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.allergicchild.com/milk_allergy.htm

http://www.foodallergy.org/ For info and recipes on this and many other common allergies 

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. 

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. 

"DON'T give up!"

I received strange, yet powerful words of wisdom, from my 2 1/2-year-old daughter the other day. 

With squinched face and pointing finger, she demanded of me, "DON'T give up!" Not quite sure where she heard that. But it resonated in my head as I have been preparing for this upcoming birth journey that is really a continuation of her her birth journey. Really, all three journeys are strung together in one long, epic story over the course of five years. 

Lately we've been resting, planning, praying and praying some more as we approach "The Day," whenever that is. A bag of frozen brussels sprouts ("sprubble brouts," as my daughter calls them) and a borrowed blood pressure cuff have been my best friends. I have daily, if not hourly, talks with God, in hopes that this baby turning is His will, but ultimately that whatever happens, it goes well and I can come to terms with it. So far He has already answered one prayer in keeping my blood pressure lower and stabilized, for which I am so thankful. And I also found out last night that my son or daughter does not like having a bag of frozen food placed on its head, as the head is definitely not in the same position it was before. I've been down on all fours, cleaning my daughter's room, anything I can think of - to get this baby to turn. So we'll see ... only a last-minute ultrasound can really reveal the truth.

It would be easy to just give in and assume that the baby won't turn, my pressure will be too high, blah blah blah ... and do the c-section already. Most women would have already done that and been over and done with it and home recovering right now with their babies. But I guess I'm not most women ... I'm not sure if that's good or bad. Time will tell, though. I don't feel like this is a gamble so much as me allowing my body time to do what God intended, or at least try. In a world where we're trained to want answers now without having to wait and are awarded instant gratification, I'm hoping that the end result will be a much sweeter reward for having waited. 

Hopefully my experiences and story will make it that much more encouraging to someone else in my position. In the words of my daughter, "DON'T give up!"

"So, when's this baby going to come?"

That's what I heard at my last OB appointment yesterday. I joked, "Well, I've put in my request." "When are we going to do this c-section?" he asked, not at all joking. Now that's just not something you say to a woman hoping to VBAC and expect her to take it lightly or think it's even remotely funny. 

At nearly the 40-week mark we've had some interesting, if not startling, revelations. After my OB appointment I spent more than three hours in the hospital for observation of high blood pressure and moderate ankle swelling, only to find out the baby was transverse. Not exactly what I wanted to hear, and it definitely puts a monkey wrench in the works. 

But the good news: I'm still pregnant. Barely. 

After an animated discussion on the phone with one of my doctors in the hospital, I nearly had to beg and plead with her just to let me remain pregnant until this baby chose it's day, malpositioned or not. Her insincerity and total lack of hesitation to pressure me into an immediate c-section was surreal, considering I had the same complications with even higher BPs and swelling in my last pregnancy and was definitely not admitted for observation. I basically told her this, and was in no way going to let her scare me into making an immediate decision. I wanted to go home and rest, think about it, and do some research. 

I feel lucky, considering the millions of women who seem to get duped into taking their obstetrician's word that it's a definite emergency and worthy of panic. I've also heard women say how their reluctance or outright refusal to follow their doctor's orders can result in being treated harshly or ignored, which is inexcusable. I wanted to ask my male doctor why it's only in obstetrics patients get treated this way - as if their bodies are not their own and they are at the mercy of some stranger to make decisions for them, or are completely incapable of making those educated decisions themselves. I wanted to ask, "If you went for a prostate exam, do you think the doctor would say, 'There's a chance you could get prostate cancer. Let's just remove the prostate, and while we're at it, cut off your genitals, too.'" No way would they say that, and no man would tolerate it. Neither should women!

I'm not blaming my doctors for this baby's position, but I can't help but feel ripped off slightly in the whole process. I'm trusting in God to take care of this baby and allow it to turn if it's His will. But in the meantime, it's hard to get over the anger of being made to feel inferior, like you're an idiot, and can't make your own decisions. The lack of support is overwhelming and does nothing but tear down your confidence and spirit - which is unfortunate, considering I have done this before. One nurse at the hospital told me "Good for you!" when she'd heard I had already had a VBAC, and I told her, "You don't normally hear that when you tell someone you've had one." You find yourself clinging to that one word of encouragement in a world full cynicism, apprehension, fear and indifference: as my labor doula put it, "They don't care what happens to you after the baby is born, especially if you have to come to taking care of three children after a c-section." As I told Dr. Congeniality on the phone, 'if this baby turns, I don't want to have had to go through all that for no reason.' 

My only prayer is that women everywhere else don't have to, either. You can't expect your doctors to fully educate you on the risks and benefits and be your advocate by suggesting, "Hey, why don't you do a VBAC?," or "Let's do what we can to avoid a cesarean." Only you can do that, and you owe it to yourself to keep your rights and stop giving them away to someone who only wants you in and out in order to move on to the next unsuspecting patient. 

The Fight To Give Birth in the Age of Fear-Based Obstetrics

As I quickly approach the 40-week mark in my pregnancy, I am thankful for many things: namely the fact that my body has essentially "proven" itself to not only me but to my OB's. I am preparing for my second VBAC (Vaginal Birth after Cesarean) and while my journey has been fairly uneventful thus far (I won't say totally uneventful, because that's not the truth), it is nothing less than a tooth-and-nail fight for thousands of women to do the same all over the US. 

I am also thankful that my only reason for having a c-section was breech presentation of my first child - not failure to progress, a "small pelvis," or failed induction of labor. I went into labor on my own even then, and had already progressed well despite the fact that we knew the baby had to be delivered via cesarean. With my second pregnancy, to my OB's credit he did offer me the choice to do a VBAC initially (which I declined, knowing nothing about it) and I think he was secretly relieved when I said no. But as I approached 37 weeks, my baby was heads down - something I wasn't even sure my children could do because of a physical defect of my uterus - and realized quickly that I really didn't want to go through the painful recovery of another c-section. 

I consulted with my OB, whom I thought was going to stutter himself into oblivion at my choice. I had since done lots of research, lots of praying, and lots of reading of very positive birth outcomes that I felt was essential to the preparation process. I couldn't believe what I was about to embark on, but with God's help and my husband's support, I could get through this. And I did. Beautifully!

I'm not totally against c-sections: of course I think there are instances where they are totally necessary. Breech presentations, multiple births (although not necessarily with twins alone, as long as they present correctly), severe prematurity, dangerous pre-eclampsia, and fetal distress are all obvious red flags, at least to me. But with a c-section rate of roughly 30 percent in this country, you have to wonder if those reasons are really why women are having c-sections?

More common reasons that the c-section rate is so high is because OB's want to practice "daylight obstetrics" - they want the baby out in time for dinner, essentially. With the ability to control so many facets of our lives, why not birth? Anymore if you go one day past your due date, you seem to be a candidate for induction. Pitocin-happy doctors willingly try and induce (more like coerce) a baby out even if it's not ready. Unfortunately it seems that fewer and fewer women are sent home as a result and are almost definitely candidates for c-section. Pitocin can bring with it a cascade of interventions that can sometimes alter or stop labor completely - increased use of epidurals because of harder, stronger contractions is not uncommon, which can, in turn, stall labor - leading to an increased number of c-sections. 

Insufficient pelvis size is another common reason many women are encouraged to have a c-section. Scores of women are even told their babies are too big to deliver vaginally just by an estimate on ultrasound, which further scares them away from attempting a vaginal delivery. Sadly, there is no definite way to know how big a baby will be until they're born and put on the scales - and ultrasound measurements can be off by as much as a pound either way. Many, many petite women give birth vaginally to "large" babies (according to the March of Dimes, anything between six and nine pounds is considered average) and do just fine. Even many babies deemed to be "stuck" can be birthed vaginally provided the medical practitioner knows to instruct the woman to change positions to facilitate further widening of the pelvis (known as the "Gaskin Maneuver," named for renowned midwife Ina May Gaskin). 

Because of the high rate of c-sections in the US, many women are faced with a two-fold problem: if they want more children, do they deliver them via cesarean too? 

Not necessarily. The mantra "once a c-section, always a c-section" is thankfully being disproved by women everyday in this country, although we still have to fight for the right to do so. But unfortunately few women choose this option - whether because they're uneducated about the risks, their doctors scare them out of it, or they have no interest - which is their right. I would never advocate a woman do a VBAC if she really doesn't want to, but neither should I think women should be scared into repeat c-sections for no reason, either. 

One reason many women are scared away from VBACs is the phrase "uterine rupture." It is possible, but is rare, provided you have a low, transverse incision (bikini incision). Also, your chances of receiving Pitocin to induce labor are less - because it can increase your risk of rupture. To many women, the risks of a c-section, if they even know what they are, are somehow more acceptable than the risks of a VBAC, even though the percentage of complications is about the same. 

Risk of VBAC, with non-induced labor, include:

• uterine rupture - this is rare, and the rate is around 1 percent, depending on which source you site

• risk of needing emergency c-section, should the same complications arise as in the first birth

• if you can't go into labor on your own, induction is not recommended 

Risks of cesarean section include:

• increased blood loss and chance of infection

• respiratory complications in the infant because of spinal anesthesia

• increased risk of scar tissue adhesion, especially after several c-sections (which can cause pain and sometimes infertility)

• premature birth because due dates are off 

• risk of uterine rupture (without even going into labor) (although small, still a risk)

It all boils down to which risks you are more comfortable in taking - because don't kid yourself that a repeat c-section isn't without significant risks, too. Neither of them are decisions that should be taken lightly, but unfortunately many women shrug it off as though it's nothing. This unwittingly affects birth outcomes and choices for thousands of women they don't even know, because they either don't care or aren't willing to fight their doctor for the right to give birth. And if you don't fight it, nothing will change. 

http://www.ynhh.org/healthlink/womens/womens_11_01.html

http://www.vbac.com

http://www.vbacfacts.com

http://www.mothering.com/articles/pregnancy_birth/birth_preparation/inducing.html

http://www.buffalonews.com/248/story/573154.html

http://www.msnbc.msn.com/id/17796664/

The Dawn of a New Era: National Health Care?

The upcoming inauguration of President-Elect Obama has a lot of people excited, especially over his views on socialized medicine. Personally, I find the entire idea scary: to think, that our land of the Free and Home of the Brave could slowly be turning into an extension of another European nation?

Everyone's buzzing about "free healthcare," probably because ... it's free. At least on the surface. The idea of not having to pay for high medication costs and other procedures sounds alluring, I'm sure. But once you dig a little deeper, it becomes clear that the whole idea is a scary proposition. 

We've all read in the news in recent months and years about people hopping the border to the US to take advantage of better healthcare. To most US citizens, being put on a four-month waiting list to have a brain tumor looked at does not sound so appealing. I read not too long ago in the Wall Street Journal how death rates from prostate cancer, which is usually a relatively slow-spreading disease,  are apparently much higher than in the US, because patients don't even get to see a cancer specialist until they're in Stage Four cancer. Our rates of success and life expectancy are much higher here because we tend to treat cancer more aggressively. 

Hawaii became the first state to adopt universal healthcare for children, and it was a disaster, failing miserably after only seven months. Not only were budgetary problems a main concern, but the fact that people were dropping privatized care to opt for free coverage - which should be a warning flag to the kind of dishonesty and cheating that even this type of healthcare coverage is susceptible to. Multiply that on a national level, and it sounds like a surefire prescription for disaster. 

Nationalized healthcare looks good on paper - but let's examine some of the root causes for why so many people have high medical bills in the first place. We are considered, according to an article on Forbes.com, to be ranked the ninth-most obese country in the world, which should also not come as much of a surprise. 

Heart disease is the number one killer of men and women in this country. And most causes of heart disease are from poor diet and lack of exercise - which makes you ... obese. For the sake of argument, I won't include the killers of people that are usually beyond their control, like Alzheimer's Disease and accidents. The list includes:

• Heart disease

• Cancer

• Lung diseases

• Diabetes

Barring certain cancers like breast and lung cancer not caused by smoking, you can bet these types of illnesses are offshoots of a greater problem, most likely the explanation behind America's top ten spot in the above-mentioned poll. Obesity can cause a wide range of problems, from the obvious heart disease and diabetes, to high blood pressure, stroke, joint pain and depression. It's no wonder, then, that of the top 20 most commonly prescribed drugs as noted by Pharmacy Times, five drugs are used to treat high blood pressure or heart-related ailments. And smoking, another major factor, causes many of the same type of risk factors. 

Here, take this pill: it'll cure everything

At some point we have to ask ourselves, why should the government - and essentially the taxpayers - be responsible for footing the bill for a nation of people who can't take care of themselves? We know smoking is bad for us, but obviously we do it anyway. We know that excessive eating has led to a nationwide epidemic of overweight people, and not just adults - childhood obesity is on the rise as well. And yet, what are we doing about it? 

One can argue that you make the decision to overeat/smoke/drink or whatever and should be responsible for the outcome. But it seems that more and more Americans who cry foul over the rising costs of healthcare and how everything should be "free free free!" are ignoring the fact that they're part of the problem. 

As much as our system is flawed, it still could be much worse. Perhaps the high costs for healthcare are just another price we pay for the freedom to make choices, however bad they are.