We went to the retinologist on Wednesday. This is the doctor in Cincinnati who did Chloe's cataract surgery, but who's also checking Chloe's retinas to make sure the ROP isn't continuing to do any damage to her eyes. The good news is that she looks great! He isn't seeing any further damage. Yay!
Last week we saw my favorite doctor, Chloe's pulmonalogist. I had my plan in place. Her appointment was at 2:20 but her feeding time is 2pm. It takes 30 minutes to get to the hospital, so it would be too early to feed Chloe before leaving home. I decided to arrive at her appointment 30 minutes early and feed her there. The added bonus would be that she would have a full belly for her weigh in. Hee hee hee. I was determined to get that gold star... My mistake was that I checked in before sitting down. I hardly pulled the bottle out of the diaper bag before they called her name! Dratz! My evil plan was foiled again!!!
Dr. Sobande did his usual grams/day calculation and determined that at 13lb 7oz Chloe only gained 18g per day over the past three months. It's not bad but not as good as the last time he saw her. I reminded him that there was a cataract surgery, healing, a cold or two, etc etc in there. It HAS been three months, you know. He agreed and reminded me that it's not "bad" weight gain - just not "great." Then I dropped the bomb. "Soooo, I thought I should mention that, during the last couple of weeks, Chloe has dozed off toward the end of her bottles a few times a day. Plus, she breathes quickly when doing something strenuous - like having a fit or playing hard." I held my breath as his eyebrows went up. He thanked me for telling him because many people wouldn't tell him that. The truth is that I knew I had to tell him but didn't WANT to. How did he know that?!?
The outcome is that Chloe's back on oxygen for feedings. And we're raising her O2 from 1/8 or a liter to 1/4 or a liter. No, he said, this will not slow her lung growth or development. Her lungs are still working hard. We're just giving her a little more help. Her body will burn fewer calories trying to keep her whole body oxygenated. All right. I can wrestle her canula on a few times a day. This is not a big deal.
I also noted that she spits up frequently. It's only about 2Tbsp per bottle but it's pretty consistent. We have a super hard time getting a burp out of her. I'll pat her back for like 10 minutes and nothing. Different burping positions. Nothing. 5-10 minutes later - spitup. He prescribed Zantac. I'm not sure why, but I'm scared to give it to her. I've had it for two days now and have yet to start. The weird thing is that she hasn't been spitting up like she usually does. I wonder if the added oxygen could have anything to do with it? I asked if he thought the spitup could have anything to do with her lungs. I assumed it was just a tiny bit of reflux. He agreed. I think I'll hold off on the Zantac for now, though. I hate to give her anything she doesn't really really need.
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hey I saw ur blog, and just thought I would offer a tactic that worked for my two kids, who both have/had reflux. It sounds weird, but instead of picking her up after feeding and burping her, just leave her very still.Babies w/ reflux usually arent spitting up or "refluxing" b/c of gas, but because of an immature epiglottis. What we do/did is make use of gravity and feed the bottle while he is sitting in bouncy seat or on stacked pillows, so he is almost sitting straight up, but not quite. Then, after feeding, we leave him still as long as he will tolerate it. He usually falls asleep.. so no spit up. We tried EVERYTHING. Both of mine were on Zantac, Reglan, Axid, Prevacid, and my oldest even ending up having surgery. This always worked for us, maybe it will help you as well.
ReplyDeleteWow - thanks! I did notice that one way to consistently GET spitup is to lay her down and quickly pick her up (as in, for a diaper change) shortly after feeding her. I stopped doing that and your technique sounds like it's just taking that idea one step further. Thanks again!
ReplyDeleteSorry little Chloe is experiencing some reflux. Has it been better since the puff of O2 while eating? D's pulmo told us that sometimes preemies breathe hard and squeeze the stomach, making its contents come up. She was the first to treat D's reflux, actually. In our case, it's not so simple, her lungs are fine and the reflux is...well...not fine. In any case, my best burping technique (which is much less effective now that she can crawl/cruise away) is to stand her up and hold her still. That way, gravity helps the milk get down and if there are any air bubbles, they will come up on their own. Back patting meant vomit more often than not. By the way, she thinks her burps are hilarious now. Kisses to Chloe :-)
ReplyDeleteI used to put Ava in her bouncy seat with the vibrating feature on. It kept her in the upright position the pulmonologist wanted and Ava loved it, BONUS :)I think it did the same thing D's mom mentioned above me- gently jiggled out the bubbles without patting her back. Good luck!
ReplyDeleteCan you believe, the ONE time they race you right in to see the doc, you want them to leave you alone for a few minutes! LOL, typical :)
ReplyDeleteThat is fascinating about the possible connection with oxygen and spitting up. Keep me posted on that. It certainly sounds like you may be on to something there, at least for The Princess!