Emily: 1 month

This past Sunday my little girl turned a month old. Today she had her 1 month check up. And what a great check up it was! She is 9lbs 3.5 oz and 21 in, which puts her right about the 50th percentile. The doctor was impressed with her motor skills: holding her head up so well and bearing some weight on her legs when held like she's standing.

So how's life with a 1 month old? Great! She's nursing so well now. She also sleeps well. 2-3 hour naps are the norm and she's having longer awake and alert times during the day. That's when she likes to smile at us. She especially likes when I call her "Sweets" and when Sean talks to her. She's normally down for the night between 8:30-9:00. I change her diaper when I go to bed around 11:00. Sometimes it wakes her up enough to nurse, sometimes not. She then sleeps till 7:30/8:00...normally only wakes up twice to nurse and goes right back to sleep. Boy did I get lucky! We've said good bye to newborn size clothes which feels weird because Sean was just getting into newborn size clothes at this point. She may look like her brother but is not growing like him! She just recently discovered that she does indeed like her swing but only when she's getting tired and not hungry. She hates the carseat though. If she's awake and the car stops, she'll let you know how unhappy she is! If the car is moving and the radio is on (silence is evil in her mind), she's ok. I hate red lights! She loves baby wearing. I'm glad I invested in a Moby wrap when I was pregnant because she likes it better than the ring sling. The Moby is my go to thing for grocery shopping. She sleeps through the whole trip. This past week I had a nice old lady stop me to tell me how beautiful a sight Emily and I were because Emily looked so comfortable and content.

I can't wait to see what this month has in store for us!

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4 Weeks Postpartum

Tomorrow, Emily will be 4 weeks old. Today, I had a postpartum visit with my midwife. At 4 weeks postpartum, I'm feeling pretty normal again. The first few days this time around were really rough. Emily and I didn't really leave the bed. It was nice in one way but it got old. Recovery was much better when I was able to get up more. Nursing is getting better. Sean and Maddy were both champion nursers from the get-go. Emily, on the other hand, had latch issues...resulting in blisters on my part. But I wasn't going to let that stop us. Her latch has greatly improved and I rarely have to fix it now. But, now we're working on over supply and forceful letdown. The over supply has gotten much better but Emily still has problems at letdown. It hasn't slowed her down any! Just for the fun of it, Emily got weighed today. Fully clothed, she's 9lbs 6oz (was 7lbs at birth)!! I'm doing good on the weight issue too. I'm just a couple pounds over my pre-pregnancy weight. Then again, what do you expect when someone only has a 15lbs gain and then has a 7lbs baby. ;) The funny thing (that's not hurting the weight) is I'm craving healthy stuff. I can't seem to get enough of fruits, veggies (salads!!), yogurt, protein (eggs and peanut butter!!) and especially water. Emotionally, I'm doing better so far. Many might not realize it but I had postpartum depression after Maddy was born. I really wanted to avoid it this time so I decided on placenta encapsulation. A few days after Emily was born, someone came by to take care of the process for me. So far so good. I've had a couple weepy periods but then remembered I forgot to take a pill. PPD didn't really hit hard until a little bit later postpartum with Maddy. Fingers crossed that it doesn't sneak up later. If it does, Richard and I are both on the look out so we can nip it in the bud asap!!

My placenta pills

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4 Year and 2 1/2 Year Checkups

The kids had check ups today. Sean had his 4 year check up (yea, a month and a half late) and Maddy had an appointment mainly to talk about the constipation problem she had and us going dairy free.

We'll start with stats: Sean is 28lbs, 36in. Maddy is 29lbs, 37in.
The fun thing about having kids the same size is they have fun mixing up their clothes:


Sean is below the curve on the growth chart but keeping up with the curve. His growth in the last month or so has slightly increased..slightly faster than the curve. Given the fact that in that time he had a few vomiting spells, that's awesome!! He had labs done for iron and lead levels and hearing and sight tests. He passed the sight test just fine and refused to take the hearing test. Got to love a stubborn 4 year old!

Maddy is doing great: about 50% for weight and almost 75% for height. The doctor does not think she has an allergy to dairy because constipation was her only symptom and he doesn't think it's lactose intolerance because she would have had the opposite reaction. What he thinks it is is how her body is reacting to dairy proteins. He suggested to continue what we're doing for now; no obvious dairy and not worried about hidden dairy and dairy in things like store bought cookies and such. When she's completely potty trained he suggested to start very slowly adding dairy to see if she can handle it in small amounts: starting with 1 very small serving a day and adding more after a week and so on.

They both also had 2 shots each. Let me just say too, I love our pediatrician. He's been great with doing a delayed vaccine schedule and didn't seem phased at all that I turned down the flu and chicken pox vaccine and will be delaying MMR vaccine even further. I asked him when he wanted to see Jellybean and he asked me where I'd be delivering. Me saying home didn't phase him either. All in all, a great visit. Sean goes to see the endo tomorrow morning. I expect it to be a great visit.


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Doctor Appointments

Last week Sean had his endo followup and today Maddy had her 2 year check up.

Stats:
Sean - 3 years 5 months - 34in - 25lbs
Maddy - 2 year - 34in - 25lbs
No wonder people always assume they are twins!

I'll start with Sean's endo followup. While Sean is on the small side, he's now growing with the curve. The doc wants to still redo the bone age scan in November just to double check since it'll be more reliable than it was when it was done last time. I just have to say how happy I am with Dr Gyuricsko. He really does an awesome job explaining everything to me. He also works on gaining Sean's trust before he examines him.

Now to Maddy's check up. She's so funny. She lets the doctor examine her without a fight but she refuses to speak and gives him the death glare the whole time. I went in with a couple of things that I wanted to talk to the doctor about.

First was her poop issues. Back around Christmas she decided she didn't want to poop. She'd poop after a week because she couldn't hold it in anymore. I added more fiber and apple juice to her diet and gave her laxatives if she went more than a couple of days without pooping. It took awhile but it seemed to fix the problem. Then we worked on potty training. She could be potty trained if she wanted too. BUT she decided she would only stay dry in a diaper and just a couple weeks ago she started holding in poop again. Needless to say, she'll be potty trained when she decides to. I brought this up today. She's now going to be on Miralax or Milk of Magnesia daily to keep her regular. The doctor says it can take up to a month or so for her to realize that it's not suppose to hurt to poop and get her going on her own.

Second was her feet. I've noticed that when she walks her feet roll in and lose the arch. The doctor confirmed this but isn't concerned. It's not too uncommon at this age and could possibly fix itself. If it doesn't and her feet begin to bother her when she gets a little older, we'll have to get arch supports for her shoes.

And that is all. I take them both back in Oct/Nov for 2 1/2 year and 4 year check ups.



Not what I put them in this morning but hey, they're happy. ;)

Follow Up Endo Appointment

Sean had his follow up endo appointment this morning. (If you don't know about the first appointment read this: first endo appointment ) Today's appointment was so much better. We saw Dr Gyuricsko this time. First of all, the man has bedside manners!! He had Sean smiling and laughing in no time. Sean even gave him a high five at the end. This is big! Our last visit ended with 2 screaming kids and 2 frustrated parents. Dr G also did a very good job explaining things instead of assuming I understood why. He explained the bone age scan that was done a few months ago. He disagreed with the radiologist...but also said that it's b/c the radiologist doesn't read these as much as they read xrays for fractures and such. Sean's bone age is between 2 years 8 months and 3 years. Right on track. Dr G also mention how it's really not easy to pick up on things on the bone age scan at this age. At this age, there are still some bones in the wrist that haven't formed. It's more reliable at 5 years. So, if he's still having growth issues at 5 years old, they'll reorder the bone age.

As things would have it, Sean has had a big growth spurt. In the last 3 months he has grown 4 lbs and 1 1/4 in! That's the most he's ever grown! He's almost at the 5th percentile! The doctor is speculating that he may be trying to catch up because in the last 3 months he has grown faster than normal kids grow. On the growth rate chart, he's at the 90% mark for the past 3 months. This is a wonderful sign. Because he has no other problems right now and he has had this growth spurt, Dr G is not ordering any more tests for now. We are going to wait and see. We go back in 6 months.

Next week Sean has a follow up appointment with the G.I.

Sean's GI Appointment

Today I took Sean to see a gastroenterologist (GI) for the first time. This was the next step in finding out if there's a medical reason for him being so small. After our experience with the endo, I was very pleased to find a doctor that was caring, had great bedside manners, and explained things well.

He pointed out that Sean did grow well between 18 and 30 months. He explained that that, along with Sean's lack of other symptoms, was why he wasn't very concerned. Like Sean's ped, he did agree that it's a good idea to look into causes...better now than later. BTW he did not grow but an ounce in the last 3 months, nothing in height. He explained 3 options and then left it to me want I wanted done.

Options from most invasive to least:
Option 1- we will not do for a long time, unless there are signs that show up saying we should. Option 1 would be putting him under general and putting an endoscope down his esophagus. He didn't explain this too much because I decided that we would wait after he described how it was done. Just putting him under general is risky. He himself thought it was too invasive at this point.

Option 2- we are waiting until after Sean's endo appointment in October to decide. Option 2 would be to redo the blood tests they did in May 2009. He says there's always a possibility that something could have changed. We'll wait to see if the endo orders blood tests and maybe have them done at the same time.

Option 3- we are doing. We will collect urine and stool samples.

Urine sample will be tested for sodium, potassium, and chloride. These electrolytes can give insight into how the kidneys are working.

Stool sample will be tested for several things.
Occult blood- blood could be in the stool for several reasons.
Reducing substances- this would point to malabsorption of sugars.
Qualitative fat- this would point to malabsorption of fat
PH- this would be lactose intolerance
Fecal elastase- this would point to problems pancreas or small bowel

The doctor also suggested that we go ahead and give him a pediasure everyday instead of just when he's not eating well. He said that while his calorie counts were good, some kids just need more. He did not say that this was the reason for Sean's size but just merely a suggestion as it can't hurt.

We go back Oct. 15th for a follow up.

June calorie count

Tonight finished up Sean's first week long calorie count.

Sat 19- 1013 cal
Sun 20- 1004 cal
Mon 21- 945 cal
Tues 22- 793 cal
Weds 23- 868 cal
Thurs 24- 1369 cal
Fri 25- 787 cal
------------------------
Week total- 6779

Week Average- 968.4

Not bad!! Recommended calories for his size is 880 (AAP) or according to the USDA (the ped agreed)- atleast 1000. What we learned and what our plans are... some days he isn't even near the calorie count he should be at. Most days he's not anywhere near where his calcium intake should be. On the days that he's not eating alot and being picky, he'll get a pediasure with his bedtime snack. I'm on the search for a calcium supplement but am also going to push calcium rich foods. We'll do another week calorie count near the end of July...right before his GI appointment (30th).

Peanut update

What a week it's been! Last Tuesday (June 15th) we finally had Sean's endo appointment. What a waste!! We saw Dr Kent Reifschneider. What an idiot! I left so frustrated and with no answers. Here's a break down of the appointment:

• Asked why we were there. We had to tell him Sean’s history. It seemed he hadn’t looked over Sean’s chart at all. He didn’t know about any of the testing that had been done. (Ped even wrote a nice long letter to Dr R about Sean.)
  
• Asked if we had seen a dietitian. We said we had but she said she couldn’t help us until Sean weaned.
• He asked if there was a reason I let him nurse that long or if it was just my “belief“. I said that there are many benefits for a toddler so there was no reason to make him wean. He said “oh yes there is!”
• Asked me about teeth and dismissed hormone problems b/c Sean got his first tooth at 9-10 months.
• Asked about pooping and dismissed absorption problems b/c Sean poops fine. He didn’t ask how often or about appearance, just if I thought he was pooping fine.
• The only family history taken was Richard’s and my height. He took them, found the average and told us that that is how tall Sean should be as an adult.
• Asked about his drinking and eating habits but cut me off after I told him about breakfast. He says that Sean is small b/c he doesn’t get enough calories.
• He said that if we don’t change Sean’s diet now, he’ll never meet the size he’s suppose to be. He told me many times that I needed to count his calories and it would prove that he is right. I felt he was talking down to us the whole time; like we are bad parents and it’s our fault Sean is small.
• His suggestions were: cut out all water and only give him milk to drink…milk with coffee creamer is better. And don’t let him drink too much. The way we know how much to give him…the things to look for that would mean we’re giving him too little are signs of dehydration…he said that Sean only needs to pee twice a day and if he pees more than that, to cut back on what he’s drinking
• I did not like the way he treated Sean. He wanted to see Sean run. He didn’t tell us this and never even told us why. Sean was sitting in my lap, crying b/c he’s shy and that’s typical at a doctor visit. Dr R was sitting in front of us in a chair with wheels. He had just finished checking Sean’s back, listening to his heart, breathing, etc. Without warning, he grabbed Sean, rolled across the room and let him go. Sean, of course came running back to me screaming and crying. He was terrified!

I did a calorie count for that day. Dr R claims he doubts Sean even gets 400 calories a day. He has 1070 that day...about a normal, maybe a little less than normal day. Dr. R said he should have 700-800 a day. AAP says 40 calories for every pound the child weighs, which would be 880 for Sean. USDA suggests 1000 calories a day for 2-3 year olds.


Wednesday I called the ped and got an appointment to talk to him the following day (Thurs). The ped (Dr Dean Cauley) is awesome! Thursday he spent 45 minutes talking to me about Dr R and what we can do now. Dr C completely agreed with me about Dr R and about his advise. He also told me that I wasn't the first to complain about him. We will be going back to the endo but not to Dr R. Sean's also going to see a GI to talk about food sensitivities. Dr C wrote a prescription for the bone age scan and Sean will also be tested for Cystic Fibrosis. There's hardly a chance that Sean has CF but it's an extremely simple test so we're doing it to rule it out.

Friday morning I got a call from Dr R. Dr C had called him and voiced my concerns! Man am I impressed. I was Dr C's last appointment the day before and Dr R called me pretty early. Dr C is on the ball! Dr R had lots of excuses, mainly that it was a long day. Not an excuse!!

Where we go from here: this week we will go for the bone scan...no appointment needed. July 13th is the CF test. July 30th is Sean's GI appointment (Dr Michael Konikoff). Oct. 7th is when Sean goes back to the endo (Dr Eric Gyuricsko)

Because I can't sit and do nothing, I'm doing calorie counts for Sean and adjusting his diet. Today is day 4 of the first set of calorie counts. I'm going to do about a week worth of calorie counts every few weeks. I'm doing a week at a time because you have to look at a toddler's diet a week at a time because it changed so much.

And just as a reference; Sean's updated growth chart:

Maddy's 12 month and Sean's weight check

Maddy had her 12 month check up and Sean had a weight check today.

Maddy- 31 1/4in 20lbs 15oz
Didn't shed a tear when she had her shot or when she had blood drawn for iron/lead testing. He mentioned that if she doesn't get teeth by 15 months, he'll send up to a dentist but he can see that teeth are right under the gums and the dentist really won't do anything. lol He didn't bat an eye when I told him that Maddy wouldn't be getting the MMR this time.

Sean- 33 1/4in 21lbs 15oz
He cried more than Maddy...with just the doctor talking to him. Doctor says he looks great and was very impressed with the potty training in 2 weeks. He grew a tad faster than last time but the doc agreed that he should go see an endocrinologist mainly to put our minds at ease. I have to wait till the end of the week to call to make the appointment to give them time to get the paperwork sent over.

AND I finally have kids over 20lbs/1yr...so what did the doctor say!? Keep them rear-facing as long as possible, but at least to 2 years if I can.