Soy formula

It’s been 5 days since we started on Enfamil’s Soy Formula. We saw improvement in J’s skin in just 1 day! But the switch in the formula caused a major backup in the plumbing, if you know what I mean. Poor guy struggled with every BM. Red face, grunting, the works. The Doc recommended a few ounces of apple juice – potassium to help the situation. Over the weekend, BMs were easier for J. We also tried a feeding of Similac’s Soy Formula because A read online that it didn’t cause constipation as much as Enfamil’s. Unfortunately, in just 1 feeding, we saw the redness in J’s face worsen. Hopefully, in the next few days, everything will be back to normal for Jacob. It’s times like these when I wish I were still breastfeeding. His skin would be great and no plumbing issues…

In other news, we will be introducing brown rice to Jtoday. Can’t wait to post the video and/or photos of his reaction!

Postpartum roller coaster

Many weeks after the J’s birth, when I finally felt some sort of normal again, I read in What to Expect the First Year that oftentimes childbirth classes emphasize the experience of childbirth so much that moms (first-timers especially, including me) become VERY UPSET when things don’t go as planned – which include the need for medication, episiotomies, and C-sections. I had forgotten that the most important outcome of childbirth is the birth of a healthy baby. Every one kept reminding me of this, but for many weeks I couldn’t stop dwelling on the fact that I had pushed for hours, tried all the breathing techniques and birthing positions recommended during childbirth class, and still needed a C-section. I had failed at something that should have come, as was emphasized at childbirth class, so naturally.

On the day of my discharge, the pediatrician came into my room to tell me that Jacob had lost more than 10% of his body weight since birth (3-10% loss is normal). Also, J’s bilirubin count was still high. Bilirubin is broken down by the liver, but since babies have immature livers, high bilirubin counts aren’t abnormal (which is why most babies are jaundiced/yellow). But the doctors like to see this number come down over time, and below a certain value at discharge. So…I could be discharged but J would have to (1) stay longer at the hospital and (2) be under bili-lights for several hours at a time until his number came down. Bili-light is UV phototherapy that helps to get rid of the bilirubin. Here came the tears again! Was I nursing wrong? Not enough? Praise God that the hospital let me stay too so that I could still nurse. After an additional day and a half, J was finally allowed to go home! It had felt like an eternity. We still had to take J to the hospital two more times after his discharge in order to get more bilirubin tests, but his number eventually came down.

Was the drama over? NOT YET. Before I delivered, I knew I wanted to nurse. I went to breastfeeding seminars and read So That’s What They’re For: The Definitive Breastfeeding Guide. The author instilled confidence in me that I would be able to successfully nurse J, and if I needed help, I should seek it instead of giving up like so many mothers do. Well, breastfeeding was relatively easy the first 2 weeks. J fell back asleep after almost every feeding. But then week 3 reared its ugly head, and we wondered where had our sleepy, content baby gone? Why did he cry after every feeding? We began thinking that maybe he wasn’t getting enough to eat while nursing. I was using a nipple shield, as recommended by the lactation consultant at the hospital, which I read wasn’t as effective at delivering milk as direct contact is. So after many discussions with A, we decided that I’d pump exclusively, and we’d feed breastmilk to Jacob in a bottle. Again, I felt I had failed. Every one kept reminding me that satisfying J’s hunger should be my number one priority, and that pumped breastmilk is better than no breastmilk. It wasn’t for another many weeks that I finally accepted the situation. And sadly, after 2-1/2 months of pumping, I was tired. It was challenging to take care of J (who wanted to be held constantly) while also trying to find time to pump (no matter how many creative success stories I read online). I was also starting a new job where I was uncertain about the working environment and having the ability to pump at work.

Praise God that I didn’t develop clinical postpartum depression through all of these experiences. Today I just look at J and cannot believe that I carried him for 9 months. I cannot believe that A and I survived the first 3 months! There was a point when I thought I wouldn’t be able to find the strength to keep going! Today, I can’t find any reason to be sad because J is healthy and happy. He is these things because of everything A and I have tried to do right.

More on THH

I mentioned in my previous post that Dr. Hsu was gentle with J during his examination, but didn’t include the fun details. Alan told me that Dr. Hsu would talk talk talk (to both Alan and Jacob) and then swoop-in quickly to examine, say, J’s ears without him even noticing. Dr. Taylor at PA Care pinned firmly held Jacob’s head down on the examination table to check his ears. It’s not comforting as a parent to watch.

Then (this must have been so cute!) Jacob was lying on the examination table when the nurse came in with his immunization shots. Jacob was laughing up a storm apparently. Then the nurse stuck him with his first two needles. WAAAAHHH for like 10 seconds…Then the nurse stuck him with the last two needles. WAAAAHHH for like 10 seconds, and then back to laughing again.

Finding a pediatrician (MD)

In early November, J’s eczema became really inflamed, especially on his cheeks. The skin was broken and there was a yellow discharge. We decided to take him to Pediatrics & Adolescent (PA) Care in Gaithersburg. This is the practice that one of my co-workers recommended.

First impressions: they only had 1 waiting room, and Alan thought the office was rather small. To weigh J, we had to carry him undressed from the examination room to a scale in another part of the office – I didn’t like this. Pennridge had a scale inside the exam room. We were seen by a nurse practitioner, who was helpful in answering our questions, but who still made me feel rushed. Dr. Taylor saw us briefly, just to confirm the need for an antibiotic (they said Jacob had a staph infection on his cheeks, causing the discharge). They also prescribed a steroid cream for his face and other rough spots. We were only supposed to use the steroid cream sparingly on his face, and then only for like 10 days.

After 10 days, the antibiotic was finished, and his face and body had cleared up using the steroid cream. But then it all came back again in a few days. Alan took J back to the doctor, who then prescribed a 2% hydrocortisone, which the doctor said was safe for his face. Did this mean that the other cream wasn’t safe for his face?! Alan also mentioned that Jacob had a little cold. The doctor said we could give him infant Tylenol. A also said that this visit felt even more rushed than the last. At Pennridge, the doctors repeatedly asked if you had more questions. At PA Care, the doctor only seemed to have time to address the concern that brought you into the office.

The 2% hydrocortisone cream we used on and off, but his cold didn’t seem to be getting any better. One Sunday morning we called the doctor to find out how much Tylenol we could give Jacob. The nurse on the phone said that since J had been sick for 2 weeks already, it was best to bring him in. At the office, Dr. Taylor told us that sometimes colds develop into something more serious. He checked J’s ears for infection, and they were clear. He said Tylenol was only appropriate if J had a fever (which he didn’t). So why did the other doctor tell us to give Jacob infant Tylenol?!

Over Thanksgiving, J’s cold hit its peak. His nose was very runny, and we had to use the nasal aspirator before every feeding. Poor guy – he was so uncomfortable! By the end of the weekend though, it was clearing up.

A and I decided that we didn’t appreciate the conflicting advice we were receiving a PA Care. I went on DC Urban Moms and Dads to find a new pediatrician. I read that the doctors at THH Pediatrics were affiliated with Shady Grove Adventist Hospital. And that their office had well and sick waiting rooms (yay!). We made Jacob’s 4-month wellness check up with them. I wasn’t able to go because of work, but from what Alan told me later, it seemed that Dr. Hsu at THH spent a lot of time addressing A’s concerns/questions and was very gentle with J during the visit.

They discussed J’s growth, sleeping patterns, eczema, and cold. Dr. Hsu said that Jacob being able to sleep 6 hours at night is very good for his age. He told us that we should stick with a routine each night before bed – bath, lotion (for his eczema especially), and feed. And you know what, last night Jacob slept from 10pm until at least 7:30am, when I left for work!

As for Jacob’s eczema, Dr. Hsu prescribed us 2% hydrocortisone and advised us to use it only on his body. For his face, Dr. Hsu recommended over-the-counter (OTC) 1% hydrocortisone. Dr. Hsu said that the OTC version is better for his face because the 2% hydrocortisone can thin out the skin on J’s cheeks. Why didn’t PA Care mention this?! Dr. Hsu also gave us two cans of soy formula to see if that would also help. We haven’t used either hydrocortisone cream, just switched to soy formula, and I think J’s skin is much clearer. Dr. Hsu also told us to not completely dry J after a bath and to rub Aquaphor on him before the skin dries.

And lastly, about J’s cold. Even though Dr. Taylor said J didn’t have an ear infection, Dr. Hsu mentioned that colds usually only last a few days. Any longer than that and it could be a sinus infection. Why didn’t PA Care mention this?! Argggh…Dr. Hsu prescribed Amoxicillin and told us to give it to Jacob if his runny nose didn’t clear up in a few more days. So GLAD we have and like the new pediatrician.

Finding a pediatrician (PA)

Before we moved to Maryland, we saw Pennridge Pediatrics in Harleysville. They were one of the recommendations at a breastfeeding seminar I attended given by North Penn Nursing Mothers. Many of A’s co-workers also brought their kids there. Both A and I LOVED the practice. We had a consultation with one of the doctors about a month before J was born. Their office was clean, and we liked that there was a “sick“ and “well“ waiting room. When we met with Dr. Kratz, we liked that he gave us plenty of time to ask questions. He also told us that many of the doctors in the practice still taught and did research, which to us meant that staying up to date on the latest findings in children’s health was important. Talking with other parents, it’s amazing the changes in recommendations for children’s health over the years.

Doctors used to allow parents to give their children solid food (in the form of cereal mixed in with breastmilk or formula) a few weeks after birth. Now, the recommendation is to wait until at least 4 months to introduce solids. I’ve even read that the later you wait, the less likely your baby is to develop food allergies.

Doctors also used to recommend formula over breastmilk. Now, the motto (for some doctors) is “breast is best”. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months and supports breastfeeding for the 1st year (and longer as desired by mother and child).

But then we moved to Maryland and we hoped to find a pediatrician that we liked as much as Pennridge…

Hilarious SNL Baby Spanx

Follow-up to "Birth Story"

Remember I said I was scared to push? Well...I'm not the only one!

Too Scared to Push? Fear of Childbirth Leads to Rise in C-Sections

November 16, 2010

by Melanie at Parenting.com 

Month 4 - J jumped up on the charts!

I remember a time when I'd post the progress of Baby J's growth while still in the womb. Now, here is his progress outside of it. He starts off around the median, then drops a bit...and then this month, whoa!

Birth
Height 21.5 20.5 in (above 95th percentile, which means he was born taller/longer than 95% of boys his age)
Weight 7 lbs, 2 oz (25-50th percentile)
Head circumference ~14 in (50th percentile)

1 month
Height 21.5 in (10-25th percentile)
Weight 9 lbs, 4 oz (10-25th percentile)
Head circumference 14.75 in (10-25th percentile)

2 month
Height 22.5 in (10-25th percentile)
Weight 11 lbs, 11 oz (25-50th percentile)
Head circumference 15.375 in (10-25th percentile)

4 month
Height 27 in (90-95th percentile)
Weight 17 lbs, 1.5 oz (75-90th percentile)
Head circumference 17 in (50-75th percentile)

Height-for-age

Weight-for-age

Head circumference-for-age

Source for percentiles from WHO

Birth Story

JZN

Born Summer 2010
 7 lbs, 2 oz, 21.5"

Tues, 10pm: Starting very mild contractions. Was able to sleep through the night.

Wed, 6am: Use the bathroom and discover bloody show.
6:30am: A says goodbye to leave for work. I tell him that today might be the day. He asks if he should stay home from work. I say, "No, I'll call you if anything happens."

Noon: Alan comes home for lunch, as usual. He tells me that he has taken the rest of the day off and is beginning his paternity leave/vacation.
Afternoon: Contractions are coming more regularly - every 15 min, lasting about 30 sec. I am practicing my breathing techniques. A is timing the contractions. I find a way to take a nap - don't want to be tired for labor! A texts his family and mine. I must have talked with everyone at least once. They are asking me how I feel and if it hurts ;). I leave a phone message with a girlfriend. She calls me back and we chat for about an hour. We are both in great anticipation!

Early evening: I feel better leaning on something during them. I am using the breathing techniques.
Evening, 8pm: I remember the time because that is when So You Think You Can Dance comes on. Contractions are 10 min apart, then 8, then 5 min apart. I use my exercise ball to lean on during contractions. I feel them most pronounce in my lower back. Definitely don't feel like talking during a contraction, but generally, still in happy spirits!
8:30pm: Call the answering service for my OB. She calls back a few minutes later. Just happens to be one of the doctors that I hadn't yet met in the practice I go to. She gives me the OK to go to the hospital. Alan calls his parents to come up. He makes sure all the bags are ready to go.

9:30pm: A's parents arrive at the house. I'm really nervous now because this means that we're really headed to the hospital.
 
10:15pm: Arrive at the hospital. Have to use the Emergency entrance because after 8pm. I tell the receptionist/nurse that I'm in labor. She tells me to have a seat. She'll call a nurse from the Maternity Floor to come get me. I sit down. A paces and gives me the "why do we have to wait down here?!" look.

10:30pm:  I am wheeled to a triage room on the Maternity Floor. They just want to make sure I'm far enough along to admit me. Nurse finds that I am 5 cm dilated (yay!).


I am not sure the time of the following events:

• I get strapped to a monitor every hour or so. Nurses need to see how Jacob is responding during a contraction. I have to be on my back for these. Contracting on my back is PAINFUL! I can't wait to be able to sit up again.
• Things are going good. Using my exercise ball. A is massaging my lower back. Then...
• My water breaks, which is the strangest feeling, during one of the monitoring sessions. Once my water broke, the contractions started coming on more frequent and stronger/more painful. I contemplate getting an epidural. I ask the nurse how much worse did she think the contractions would get. She lied said that they wouldn't get any worse - but THEY DID! Around 7 cm, I was asking for some sort of narcotic to "take the edge off". I don't remember it making any difference.
• Once the post-water-breakage contractions started, I wanted to lie on my side and hold A's hand. He breathed with me, and after a contraction would say, "You can squeeze my hand harder." Oh, careful what you wish for!!!!!! By the time I was 4 hours into pushing, A wished he had no bones in his hands because I was crushing them.

After every contraction, I'd ask A if he could see the head. He answered "no" every time. But he said I was doing good because he could see J get lower and lower in my abdomen. About 2 hrs of pushing (3:30am, Thurs), I keep telling Alan that I can't do it anymore. The nurse jokes with me that I can come back tomorrow to finish up. Push, push, push - a feeling that words cannot describe and no one could possibly prepare me for. I could feel J's skull putting pressure on my lower back the ENTIRE TIME because he was facing front instead of towards my back. I knew in my mind that a good push would help J down the birth canal faster, but my body was afraid of the pain, so I held back, I admit.

4 hrs into pushing and was still far from crowning (5:30am, Thursday). My OB comes in and says it's time for a C-section. I look at A, and without words, we agree. I couldn't push anymore. I ask her to give me something until they can give me the spinal block for the C-section. She gives me something to stop the contractions but it doesn't work because I'm already so far into labor. I remember the anesthesiologist coming in to give me the low-down on the spinal block and consenting to a C-section. Though I had my eyes closed, my fists clinched onto the side of the bed, I told him that I was listening and to please read faster so I could be done soon!

Thu, 6:34am:  Baby Boy Ng is born (we hadn't chosen a name yet)! He's beautiful, handsome, and has so much hair! J goes to see J in the warmer and cuts the cord. J is brought back and we get a family photo together, taken with one of the nurse's cameras (not the one you see above, sorry).

Next up...Postpartum roller coaster