Itty Bitty Happy: Update

I posted a few months ago about Vivian and how she is so itty bitty happy.
We’ve been doing a lot of things to see what is up with her petite-ness. I think where I left it was that we were giving her some formula but still nursing every 2 hours in hopes that that little bit of supplementing would do the trick.
Plot twist: It did not do the trick.
We gave it about 6 weeks with frequent weight checks, essentially zero weight gain. We were starting to see her length and head circumference affected by her lack of weight gain and that was no good.
We checked her labs, and thankfully, all of that came back normal.
That forced our hand to move to primarily formula, which by this point, I was totally fine with because sheesh, she needed to get bigger and it was obvious that something wasn’t working. So we had to get her up to 24 ounces of formula per day which was not the easiest of tasks.

We have her on between 22 and 26 ounces a day and she nurses primarily at night now. And finally we are seeing some actual gains, which is making everyone feel a little better.
At her nine month appointment we got the okay to start her back on foods as long as there aren’t any dramatic decreases in her volume intake. She has a fairly strong tongue thrust reflex which makes it hard for her to get pieces of food to stay in her mouth, but she does pretty well on purees. She doesn’t always tolerate all of her bottles the greatest and sometimes she wants to eat ALL THE FOOD and sometimes not, but hey, I can say the same for myself!

The goal is that she gets back on the curve by 15 months. She's a petite 12.5 pounds right now!

It makes me a little sad/frustrated/angry that for whatever reason breastfeeding was so hard for us in the weight gain department. Maybe I didn’t produce enough. Maybe she burned too many calories while nursing. Maybe a million things that don’t really matter right now.

Overall, she is finally heading in the right size direction.
Developmentally? She is a tiny rockstar – she has been crawling for months, but finally is up on all fours, puling up on everything, waving, clapping, and grinning from ear to ear whenever she isn’t crying or sleeping!

We often get a lot of strange looks when people who don’t know her see her – she surprises everyone and I usually just say something about her being sweet and portable. Not a preemie, not neglected, not anything but small and loved and perfect just the size she is.

Itty, Bitty, Happy

Gianna was a pretty small baby, if you go by growth charts and percentiles. She also projectile vomited after every bottle, and sometimes in between for 9ish months.

Aleesia was a really small baby, if you look at her growth stats. She also battled sepsis at 8 weeks and that little journey really set her body back on the whole growing part of babyhood.

Vivian came along and was the biggest baby I have birthed, I was so ready for some chubby baby thighs! Exceeeept that she followed in the slow gaining footsteps of her sisters, as was evident at her well visits. Thankfully her pediatrician didn't jump straight to the "she needs formula RIGHT NOW" conclusion right away, after seeing that her sisters were also slow growers. They let us work out our breastfeeding relationship, fix the problems, learn to work together, etc.

Then came her 6 month well visit. A week or so before I had a few people ask me about her size. I always made some comment about her portability and shook it off. After all, she ate every 2 hours, almost around the clock & truly never seemed unsatisfied after her feedings, with a few exceptions & those times we would give her a bottle.

Also, Vivian is the happiest baby I have ever had! She was hitting her milestones, I had no concerns about her other than just wondering how big she was getting.

So, our pediatrician told us that our itty, bitty, happy girl was seriously itty bitty. She hadn't grown in 3 months! (For the record, at 6 months she was 10#6oz) but she looked great otherwise, was hitting all her milestones, and was showing off her voice for the pediatrician! But we had let this weight situation try to work itself out for 6 months, it was time to do something else since there is no reason we could come up with why she wasn't getting bigger. Even though she was generally super happy, this weight situation needed to be dealt with as her small size would really work against her if she were to get sick for any reason & we want to make sure she keeps developing appropriately. First step was to determine (or assume) if there was inadequate intake.

For 2 weeks we supplemented with about 8 ounces of breast milk or formula on top of her regular nursing sessions. The next weight check was OK, but she'd only put on another 5 ounces when we had hoped for 8-10. We started working under the assumption that increased intake helped some but may not be the whole problem. Her pediatrician asked me to start mixing her bottles to 24 calorie since the volume she was taking was adequate at this point. So we tried that for 2 weeks and were able to move her to about 10-12oz extra a day plus nursing whenever she wanted.

Her weight check this week (at 7 months) had her checking in at 11#2oz, not a huge jump. We discussed moving to 27 calorie formula but she is already pooping so much more (apparently from the high-cal formula!) that her pediatrician didn't think that was wise. I did convince him to let her start solids, though. She has been ready to yank the food right out of my hand for at least a month so I was happy when he said we could try it. With the understanding that if her volume intake started to decrease her solids intake would have to decrease too as the higher calorie milk was more important.
We were both OK with this decision! I'll try anything to combat that pesky failure to thrive diagnosis.

(Of course, she got the touch of a stomach bug yesterday which had me a little worried about her. She's much better now, thank goodness!)

We get a month to keep doing what we are doing to see how she grows. It is tricky to time when to nurse her, give her a bottle, and food, but we will figure it out. I don't love breastfeeding like some people do, I pretty much do it because they say it's beneficial and it is really very convenient. But it is still kind of hard and she recently started to NOT be satisfied more after feeding because she doesn't want to work for it/GIVEMEABOTTLEPAHLEEZE. I am happy to have made it to 6 months exclusively, but the girl has to eat and I'm going to feed her however she needs to be fed! She's going to take the lead on what happens with our breastfeeding relationship, I'm good with whatever she wants/needs.

Let's just hope she is a little bit less itty and bitty and still just as happy in a month!

Breastfeeding: This shit ain’t easy

I made it fairly clear when I had Aleesia how difficult I found breastfeeding to be. Said difficulty did not leave a warm fuzzy feeling for me during this experience with her. Yes, there were moments that were sweet and I did enjoy the calm when she would have a good non-frustrated feeding. But as a general rule, I was doing it because I wanted to try it and then I was committed to giving it the best effort possible, which was 6 months.

When I was pregnant with Vivian I knew I would do the same thing – give breastfeeding a try, maybe it would be easier. Maybe she wouldn’t have lip and tongue ties or issues with weight gain. I was especially interested to see how things would play out since I would be working at home and not having to pump full time. (for the record, the working at home/feeding on demand thing is great!)

As soon as she was born, I checked her for ties – which she had. I even mentioned them to the lactation consultant who saw us before we left. She blew me off and told me they were no big deal. I knew they could be a big deal, but decided to use some of the tricks I learned from Aleesia to try and make things work.

We battled through the initial discomfort and it seemed that her latch was okay – not great, but she was a new human so I was giving her some slack! She then started to do a lot of things that I knew were not good including using a chewing motion v. sucking, pulling off so far that she usually had no areola in her latch, and she was getting so frustrated. Also, she did not seem to bet getting bigger. But, unlike Aleesia (and Gianna, for that matter), Vivian is such a generally happy baby! I figured I was being paranoid all that time…

But eventually I used my mommy instinct and took her to a breastfeeding group so I could do a weighted feed, have her evaluated, and validate what I already knew – her lip and tongue ties needed corrected. All of which happened . That particular day I ended up feeding her from both sides over 40+ minutes and she transferred about 2 ounces of milk. Cue all the guilt. We got her to the pediatrician for a weight check, and while both G and A were similarly small (they were all really close to the same weight at the same age!), Vivian was born the biggest and had the lowest gain over the same time period. Our pediatrician agreed with our plan to have her ties revised and thankfully a wonderful dentist much closer to us was available to do it.

We saw Dr. Milton who let me know that her lip tie was fairly bad but her tongue tie was very bad (like an 8/10 on the “this is the worst I’ve seen” scale)! He fixed her up in about 3 minutes and we could already tell the difference. She did great with the procedure, we have about a week of stretching left and then she will be REALLY happy!

before and after pictures

Along with having the ULT and PTT’s revised we started some cranial sacral therapy (CST) which she hates but is helping! We had a one-on-one consultation with an IBCLC as well – she is still not transferring much milk per feeding. The IBCLC confirmed the chewing v. sucking situation and we think that is likely the cause of the poor milk transfer at this point. So, we are trying to do some suck training, a different way to position her when she latches, and basically doing everything we can to break the bad habits she has formed/help her to learn to suck the right way.

A lot of little problems that might be a big deal on their own but are all compounding together to lead this happy little girl to maintain her portable, peanut status.

This all seems like so much to go through when giving her a bottle would be so much easier. But now I am committed to doing my part in making this work for at least 6 months, or longer. She does take bottles sort of okay most of the time when I am out of town or away for any reason, so that’s not the issue. I have enjoyed the experience with her slightly more, maybe because I feel more empowered or knowledgeable on how to maneuver these crazy situations. Maybe because she is such a happy baby? Maybe I enjoy it more simply because I don’t have to pump full time on a regular basis.

The moral of the story, breastfeeding is probably not going to be easy but it doesn’t have to (and shouldn’t) be miserable for you or your little – so go with your gut.

If you think something is wrong, seek advice/answers/help. Lip and tongue ties are considered midline defects, they can (and often do) have a detrimental affect on breastfeeding but they also affect other things, like digestion. Our pediatrician sometimes thinks I am crazy, but does support me in my efforts to do what is necessary to make this work. I would say something is helping, she had a 3 ounce gain in 3 weeks, which for her, is a lot! She is up a full 2 pounds from birth at 4 months – we’re taking this as a win for the moment (despite what that pesky growth chart says).

Also, at the end of the day, we all know that it only matters that you feed your baby in whatever way works for you and your family. I have no idea how long I’ll be able to breastfeed for, it’s up to Miss Vivian, I suppose. (and for the record, my other kids had formula and they are awesome, so obviously I have no bias there!)

Preparing for 2 under 2

I never really though much about having 2 kids under 2. I know it’s going to be tricky and a lot of things are going to be different than when I had Aleesia, for obvious reasons.  I am generally not a worrier – life has a way of working itself out and bad days don’t last forever – right? (also, I’ll be able to have wine again so that will help with the bad days)

I need to get a few things done to prepare for newborn life again – like packing a diaper bag. Right now, I don’t take a diaper bag with me anywhere – I keep Aleesia’s diapers and wipes in the car and she is really easy to entertain with some crayons and paper! I hardly ever use her stroller because she prefers to walk or “mommy hold you” so I carry her a lot of the time. Although I have a feeling that when she sees the baby in the stroller, she’s going to want to ride too. (I am still not sold on the idea of buying a double stroller) Aleesia’s schedule is fairy rock solid these days – I just pray she continues to nap well as we get into the newborn unpredictable schedule.

Other things that have been running through my head lately are: I am going to have 2 kids in cribs. And 2 kids who are basically wholly dependent on me. But mainly holy crap I am going to have 2 kids in diapers. This did not phase me until last week when I ordered 2 cases of diapers (probably a monthish worth, I figure) at the same time and almost died at the cost.

For my seasoned mom’s with two kids in diapers – how do you do it? Tricks on getting them at the best price? I prefer to use pampers swaddlers (at the very least, through size 1) or the target brand (although, I am concerned that these are contributing to Aleesia’s ridiculous diaper rash episodes). I’ve been considering cloth but am a little too chicken to bite that bullet (our awesome nanny did say she’s all for helping out there, though, so maybe this is a reasonable option??). Although NOT having to budget $100 a month on diapers/wipes would be fantastic!

Aleesia has been my best friend these days, she wants nothing to do with anyone else when I am home. I am as prepared as I can possibly be when it comes to trying to deal with this while I nurse the baby – I am sure it’s going to be tricky at first and she is going to be upset. We have a few things that she likes to do and she has been great at starting to play independently as of late so maybe that will also work to my advantage. Any tips or tricks that I should also be keeping up my sleeve for particularly difficult nursing sessions?

Gianna is like a little mother hen (who has recently been offering to change Aleesia’s diapers and help get her dressed for me!) and I am hopeful that the baby will come right before she starts her Christmas break so she can help ease Aleesia into her new big sister role. She can’t stinking WAIT for her new sister to get here – it’s adorable how excited she gets when she talks about it.

I had a freaking HARD time adjusting to 2 kids when Aleesia was born but I am fairly confident that this isn’t going to be as difficult (mostly because I won’t have a threenager at home, but a super awesome & helpful five year old) and I am sure it will be a whole different kind of difficult. Other than the diapers and the nursing concerns, I can’t think of anything that really worries me about having 2 fairly small people at home (and 1 bigger small person). But what am I being naïve about? Shoot me straight! Tell me what I need to hear.

The countdown is officially on (as in, people ask me regularly if I am going to go ahead and give birth right in front of them), nesting is in full force and THIS MONTH (please God, it needs to be this month!) we are going to bring home a new baby.

a letter to my {second} daughter: your first unbirthday

Miss Aleesia -

I have no idea how in the world your first 6 months have flown by so quickly.  It seems impossible, really that just 6 months ago I had one of the most empowering, beautiful experiences of my life bringing you into the world.

And you have been making your mark on our family ever since.   And I am happy to say that even though it has only been 6 months, you fit in like there was never life without you.  It’s magical really, how someone so new and so small can have such a huge impact on the word family and the amount of love a heart can hold.

A really good friend told me never to worry if I would have enough love for both Gianna and you – because your heart just grows to fit the new love in.  She was right.

You are a snuggler with this perfect way you fit right into my shoulder and, more commonly, the crook of my left elbow.  I enjoy just sitting with you, enjoying your sweetness all to myself, even if it is only for a few minutes.  It’s probably the only thing I miss about breastfeeding – but we still get our quiet time in.

We know it’s been a rocky six month start to life – tongue ties, reflux, problems with milk proteins, low/slow weight gain, hospital stays, kidney reflux, daily medicine, so much spit up, breastfeeding problems, colic, nap-cotting, so many tears.  We are still using alimentum, you eat anywhere from 4-6 ounces 4-5x a day and literally, every single day when I get home, you spit up on me.  I like to think it’s because you are so relaxed around me…

But there is a lot more smiling, giggling, cooing, baby talking, playing and more happiness these days.  The best thing is your recognition – when Gianna walks into the room, your face lights up and I am pretty sure your eyes don’t leave her.  When I get home from work? I get the BIGGEST smile from you and so much excitement until I am able to pick you up and get a snuggle in.  And, every time I kiss your cheek, you giggle.  Which I think is so awesome!

You love your toes the most

But also your wubanub, your lovie third and anything that makes a crinkle noise. Aleesia – you are a drool machine at the moment and you LOVE to keep your hands, shirt, my necklace, whatever you can find really in  your mouth.  You roll all over the place and are trying to sit on your own – but usually your toes distract you!  Bath time is your favorite time and you love the pool.

We have tried rice and bananas with no success. We tried peaches this week and you seemed to like them enough to take more than one bite, so that’s progress!

You aren’t a huge nap fan, but you love to be snuggled in for bed.  We either do a one arm swaddle or use a sleep sack – either way, you are comfy and that is all that matters.  And! You just started waking up so happy – it’s fun to come in to your big gummy smile first thing in the morning.

Time flies constantly but I try to soak up the little moments.  The quiet moments.  The snuggles.  The smiles.  You are our peanut with the smile that lights up the room. 

Happy six month unbirthday, peanut!

we love you much!

xoxo

Mommy

Weaning

When I decided to try and breastfeed Aleesia, I had very little expectations of the process. 

Breastfeeding is a lot harder than I imagined it would be.  And then you can add in all of Miss A’s other health issues on top of that making it harder-er than I imagined.  I didn’t ever understand all of the “low supply” woes that some of my friends experienced, until now.  Or how peaceful it can be to just sit with that tiny human and know you are giving her all that she needs to grow and thrive.

I did find some joy, or at least peaceful quiet moments, during out breastfeeding relationship over the past five months.

But probably for the majority of the time it was hard, hard work and a sincere HATE of pumping. (I give so many props to women who exclusively pump. SO MANY)

Aleesia has been supplemented with formula since I went back to work full time because I just could not produce enough during the day.  Which is just fine – she has to eat, after all.  I would just feed her when I was with her and that seemed to be okay.  Except, it really wasn’t okay.  Neither of us were quite satisfied with the relationship – she was never full and I was always feeing bad because I couldn’t give her what she needed.

And there is the spitting up issue – there is something she was reacting to in my milk – I don’t know what, but something.  And, it was clearly and visibly higher in mucous content and much lower in caloric content than you would expect.  She started doing better on days she had only formula and that was all I needed to know.

As hard as we worked together to establish and maintain this intimate part of our relationship, it just wasn’t working anymore.  I tried everything I could think of, read about, hear about, etc. to get things to work better for us to no avail.  Mike was a great supporter and dealt with my crazy emotional snippiness and frustration wonderfully.  But it still just wasn’t working.  Of course I feel some guilt around it – maybe if I wasn’t a working mom we could have worked harder or maybe I should have continued to pump for her or change my diet again or, or, or.

Ultimately, I decided two weeks ago to start weaning her because we both needed to be happy and feeling good. 

Of note: weaning is NO JOKE! 

I tried to quit it cold turkey. Which, was stupid.  So I decreased my pumping sessions first and still fed her as she pleased when I was home.  On Monday of this week, she lost interest in nursing so I stopped pumping and finally no longer feel as if my boobs will explode at any minute.

Engorgement and weaning is/was worse than childbirth no exaggeration.  I did take sudafed and motrin around the clock for 48 hours, which may have helped.  I even went to the store at lunch the other day to buy a more supportive bra because I could not concentrate on anything!

Now that I am feeling better physically and for the most part, not guilty about this choice, things are better!  We know how much she is eating, and that there is no potential allergen cross contamination going on, and while she spits up just as much and her reflux is pretty much the same she is less frustrated.  She pounds those bottles like a champ for the most part and we get good 15-20 minute chunks of HAPPY BABY!

It was a MUCH MUCH harder decision than I thought it would be to wean Aleesia – but in the end, it’s the best decision for US.

One Third {of the first year}

I have been desperately trying to figure out how to slow down time for the last four years, and that has never felt more true than the past four months.

Apparently when you add another child to the equation of life, it picks up at close to warp speed. I can’t always keep up with everything I NEED to do, let alone all of the things I WANT to do! But remember the small things is important to me, so here we go.

It has been a crazy four month. Let’s recap Aleesia’s first four months of life, shall we?

She was born after an amazing 19 hour labor/delivery. Giving birth to her without medical intervention was the most amazing thing I have ever experienced.

We hid out at the hospital for 25 hours and came home so she could meet her big sister.

We have been figuring each other out for the past few months.  We have had a busy four months, but I managed to steal some time with just her every once in a while.  We worked hard at breastfeeding at first, and are still working hard to make it work for us.  I’m back to work.  She stays home with daddy and Gianna.  Aleesia has been a bit of a challenge and Mike and I make screamy tiny people – no big deal, really – but it can be exhausting for all of us.

In general, the past four months have been a whirlwind!

We enjoyed lots of snuggling.  With mommy and sister.  Aleesia is a snuggle bug.

There were many meetings of other tiny people – mainly her cousin and new friends.

She endured plenty of goofy photo shoots with mommy.

We all experienced too many hours of crying (an intolerance to milk/soy, breastfeeding problems and a terrible infection were just a few of the culprits. and general newborn crankiness).  And despite the pictures of Aleesia sleeping, there isn’t always a lot of that going on! I just try to capture it when it DOES happen.

We had just a few very special parties to attend.

And even her first holiday - Easter!

We can’t forget to mention that she has been through a few of the most bizarre (at least to me) health issues in her short little life. (MSPI, GI Reflux, ULT, PTT, VUR, that’s enough right?)  And a little hospital stay. (thankfully everything is mostly okay now).

Aleesia figured out her lovie (lovies, if you count her wubanub!)

She has decided outside is fun! (which is a good thing considering her sister never wants to come inside!)

Despite all of the things that have gone against her in her first four months – she learned to hold her head up! and, we get a lot of smiles these days.  And if we are lucky, a giggle!

One thing is without question, somebody here has a big sister who ADORES her and worries about her all the time.  It might have only been four months, but the bond that they have is so special already.  It might be one of the most fun parts of the past few months – watching these two learn each other.

Aleesia in a nutshell is our petite, sensitive, snuggler who doesn’t always feel the best but tries not to let it show. (except, when she does let you know she feels bad – there is no question!)

I wouldn’t know what to do without this girl.  I barely remember what life was like before she came.