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Showing posts with label growth chart. Show all posts
Showing posts with label growth chart. Show all posts

Saturday, October 5, 2013

31 for 21 challenge: Day Five. The End of an Era

The choice to breastfeed Josiah was an easy one.  It had been unsuccessful with the first, but a perfect experience with the second.  I saw no reason it couldn't be the same with Josiah.  I read all the negative reviews about breastfeeding a child with Down syndrome.  "It's rarely successful because of the low muscle tone," "...because of the common failure to thrive, these babies commonly need additional supplementation," and so on.  By all accounts, I had no reason to believe I should try.

Anyone that knows me, however, knows that I will stand up for what I believe in.  I believed it was right for me, and my child.  So, there the dream began.  While still pregnant, I made my intentions known.  I was going to do the impossible (or at least very difficult): I was planning on breastfeeding my baby with Down syndrome.

I knew right away that Josiah had low muscle tone.  Although he understood what to do, and demonstrated some interest, sucking was not easy for him.  It was obvious.  He worked hard for every sip of milk he took.  It was time consuming, exhausting, and tested every ounce of patience I had.

Josiah breastfed exclusively, for about five months.  He weighed 9 pounds at five months.  Our first weighed 15 lbs at the same age.  Our second, weighed 13 lbs.  On 3/12/12, I wrote the following in my blog:

"We took Josiah to the cardiologist today for his first office follow-up appointment, since his surgery.  His EKG was great!  Then, they weighed him.  He weighed in at 9lbs 1.3oz.  At best, given that each office has it's own scale, he neither gained nor lost weight.  At worst, he lost 2oz since last Friday (at the pediatrician's office).  I cannot begin to describe the feeling of complete exasperation, frustration, and despair.

Perhaps it seems like a small thing; perhaps it is.  All I know is this: Josiah weighed 7lbs on 10/12/2011.  Today, 3/2/12, he weighed 9lbs 1oz.  He will be five months old, in ten days.  At J1's four-month check up, he weighed 15lbs.  J2, at the same check up, weighed 13lbs.  I know the DS plays a role in the slow weight gain, but this isn't right. 

We (the professionals and family alike) believed that the heart problems were contributing to his slow weight gain.  That excuse can no longer be used.  Today's appointment confirmed that Josiah's heart is perfect (a wonderful piece of news that I cannot negate).  Is it the Down Syndrome?  Is it a feeding issue?  Is he not getting enough calories?  Does he simply need more calories than an average child?  Should we start feeding him cereal?  UGH!  The questions race through my tired mind.

The surgeon was very pleased with the outcome of Josiah's surgery.  Josiah's heart "sounds perfect."  His color is good.  "He looks like a different kid."  "He looks more mature in the way he's moving around."  However, "I expected him to come in here having gained a lot of weight so this is disappointing."  (Yeah, tell me about it!)

Up until now, Josiah has been exclusively breastfed.  He doesn't like the bottle; he won't drink from a bottle.  Since surgery, he's been eating every 2-3 hours.  It seems impossible to me that the child has gained no weight but numbers do not lie.  I don't know what to do....that's the feeling.  I hate that feeling.  I'm tired and feel I has so little left to give....

We made our way out of the cardiologists office.  I immediately walked down the hall to the pediatrician's office.  I talked to our favorite nurse M.  I voiced my frustration.  I asked if we should start Josiah on cereal.  I assured her we were doing everything we could to properly nourish our son.  She already knows that we are.  She said she'd call me later.

We did a few errands, picked up Jesse from school, and made our way home.  I was exhausted.  I left a message for our EI worker K.  I know I'll hear from her as soon as she's available.  This afternoon I fed Josiah...off and on....like usual.  I went to the store for groceries and bought a different type of bottle - maybe Josiah will drink from this one.  It's worth a try.

I talked to M from the pedi's office.  The MD said we can start Josiah on cereal.  I needed more than that.  I didn't know what I needed, but that wasn't enough.  I guess I wanted an instant fix....  I was so emotionally spent, my mind couldn't form concrete thoughts by which to gain more information.  I ended the call for lack of knowing what else to say.  Carl was very supportive of my frustration level.  He called the MD's office back again and spoke with our pediatrician.  The pedi is sympathetic to the situation and understands the frustration level.  He suggests the OT (as the cardiologist did), a nutritionist (specifically with the DS clinic), formula if possible, cereal, the new bottle, and high-calorie formula if we request such.  We'll see the pediatrician next Thursday for another weight check.

I called the lactation specialist KF and heard back from her promptly.  We chatted for some time.  It's nice to have someone who knows the frustration of breastfeeding a baby who doesn't gain weight.  She offered some great suggestions.  One by one, I'll try them all.

I talked to K for quite some time after.  She is another fantastic support.  K will put in a referral for OT early next week.  It will be, specifically, for feeding.  I've entrusted that task to her.  We'll see K on Monday and will discuss the details further.

Tomorrow, I'll email A from the DS clinic.  I'll explain what's going on with Josiah.  I'll ask her what I need to do to initiate a consult with one of their nutritionists.  I'll probably hear back from her on Monday.

It's the weekend now....two days, at home, with my wonderful family.  I'm going to try to relax a little.  I'll attempt some of the new suggestions given to me.  Hopefully something will work.  I'm going to try to not let it become all-consuming (although it already feels that way sometimes). 

In the end, everything will work out.  Even the cardiologist said "this is just another little hurdle we have to climb over."  Everything will work out.

Climbing up the down staircase isn't always easy....but it's worth every single step <3"

And so it continued...  I continued to breastfeed.  Ultimately, we added cereal and began supplementing (minimally) with formula.  Little by little, Josiah started gaining weight.  The peanut that once fell 'below the line' on the DS  growth chart, now charts on the 90th percentile.  On the 'normal' growth chart, he didn't even plot on the chart, now charts at around the 50th percentile.

I have to give credit to an unknown friend and support.  By that, I mean a person whom I have never met.  She is my friend KF.  She is a lactation specialist and has been an unwavering support during every frustrating moment.  She returned every call, called me consistently, researched, and supported my every attempt to make it all work.  Without her, I am convinced that my breastfeeding quest with Josiah would have failed.

Instead, Josiah is turning two in 8 days.  He has breastfed this entire time.  I worried about having to wean him, but HE made all the choices.  In the early part of summer, he decreased his nursing to once a day (first thing in the morning).  I could see the end coming near.  In August, he had the croup & we enjoyed what I call 'the last hoorah.'  For four days, while sick, he breastfed 4-5 times per day.  I kept asking him if this was his last hoorah.  Once well, he went back to once per day.  If he was testing me, I proved that he would get anything he needed.  If it was just for comfort, he got that too.

Regardless, yesterday he woke up and decided he was all set.  He didn't nurse.  He had no interest.  He's growing up and I know it.  I didn't push and told him it was ok to be a big boy now.  And so it was.  We went the day without breastfeeding.  Today, like yesterday, he woke with no interest in breastfeeding.  Day two and he's done it all himself.

Though I miss that certain bonding time, I have been fully prepared to see it end.  I will forever remember, and enjoy, the last hoorah that Josiah gave to me in August.  He knew I would miss it.  He, too, knew he was letting go.  And so it is.  We have reached the end of an era.  He's almost two, almost 27 pounds, and has said good-bye to breastfeeding.


“Never give up on what you really want to do. The person with big dreams is more powerful 
than the one with all the facts.” ~ unknown author

Sunday, November 11, 2012

The One-Year Check Up

October was a busy month full of birthdays (including Josiah's), Halloween parties, and outings.  This was in addition to school (K and preschool) and Early Intervention.  As is the norm, Josiah's 'one year old' distinction earned him his one-year check up at the pediatrician's office.

A few days after his birthday, we headed out in the a.m. to take him to the MD.  We arrived a few minutes early.  I felt confident that he had continued to gain weight.  I was hoping that it would be 'enough.'  Luckily for me, it's the first thing they do - weigh the child.  It was 'just what I needed.'  He weighed in at 18lbs 9oz.  He measured a long 29.5 inches.  To make matters more exciting, he plotted on the chart - the 'typical' chart.  They, apparently, don't like to use the Down Syndrome growth chart any longer, so the 'typical' chart it is.  He plotted on the chart, for weight, for the very first time ever!!!  He's in the 3rd percentile for weight; He's in the 36th percentile for height.  Our boy made the charts!!!  :) 

Of course, all the measurements were obtained by the nurse.  When the doctor came in, I was quick to share the numbers.  His smile told it all!  He said, "Josiah's just the size of a small one year old."  "My boys weren't much bigger than he his; they weren't 20 lbs at their first birthday."  Finally, I can breathe a sigh of relief.  I can finally stop being so worried about this nonsense :)

Josiah received his flu booster shot (two are always required the first year).  He received his other vaccinations and handled them like a trooper.  Before we knew it, it was time to leave.  Next visit: 15 months.

So, here we are.  One year old and all is well :)  Now, it's just time to follow up on hearing tests, etc...



Wednesday, October 17, 2012

31 for 21 Blog Challenge: DAY FIFTEEN: New Measurements

Ok....I'm a couple of days behind....I have a cold that is giving me a run for my money lol.

Monday morning, we had an appointment.  Josiah was weighed (with diaper and lightweight clothes on) - he weighed 18lbs 9oz.  Wow!  I imagine he must weigh close to 18lbs with nothing on.  That would mean an almost 1-lb weight gain since September 25th.  That's great!  He measured 28.5 inches long.  He is actually plotting on the growth charts now!!!

In early writings, I know I would talk about utilizing Growth charts for children with Down Syndrome.  Apparently, the powers that be no longer want these charts used.  In their opinions, it increases the risk that children's malnutrition won't be caught as quickly.  So, now they say to use the 'normal' charts.

K (child specialist from EI) also came out on Monday.  Josiah did very well.  The vest continues to provide him with a little extra support.  However, he seems to be demonstrating little need for it.  Rolling continues to be his favorite pastime.  He is also now showing off his ability to get up on all fours (crawling position).  He has rocked, in that position, a few times but hasn't actually crawled yet.

Big things are coming for Josiah :)....


"Success is not final, failure is not fatal: it is the courage to continue that counts."
- Winston Churchill

Tuesday, April 24, 2012

Hello Rice Cereal and Crazy Appetite

April vacation is officially over.  Jesse is back to school.  Our EI friends are back.  Playgroups are running.  Things seem back to normal; apparently in my old age, structure is a good thing :)  I already feel less stir crazy and more focused.

I talked to KF this a.m.  She was clearly not disappointed in Josiah's weight gain.  Left to my own devices, I wasn't either.  However, I still get anxiety riddled over how the MD may react to a less than ideal weight gain.  We know that the MD would like to have seen twice the gain, but given everything - we think Josiah is doing great!  He is alert, oriented, responsive, engaging, and active.  He also grew three inches in the past two months.  The MD remarked that his height places him in the 15th percentile.  His weight places him on the "0" percentile.  When asked, "of the Down Syndrome chart?," the answer was no.  The computer only charts on the 'regular' chart. 

So, at 6 months, he's 11lbs 7.5oz.  He's 25.5inches tall.  I decided to check the Down Syndrome growth chart for boys.  Josiah's weight places him in the 10th percentile.  His height places him in the 50th percentile!  I think I'll start carrying this chart with me to the MD's office :)

On Thursday, the MD had given the go-ahead to start rice cereal.  I'll be honest....I've dragged my feet a little on this issue.  I had asked the question (can we start cereal?) then, of course, regretted having asked.  I even told KF that I was probably going to delay the endeavor.  Of course, then there are time when you ask yourself "why wait?"  Last night proved to be one of those nights.

After breastfeeding Josiah, and giving him two bottles, the child seems insatiable.  It was as if he decided to make up for all of the slow weight gain, in ONE night.  So, out came the rice cereal.  I made it thicker than usual (but not as "paste-like" as suggested by the MD).  Josiah did great!!!!  Given his extremely high palette, I wasn't sure how well he would do.  As is typical for Josiah, he made me wonder why I had questioned his ability......  I lost track of how much, in all, he consumed but it was a lot for one little boy.  Needless to say, when he fell asleep - he slept soundly all night.

I had to wake him this a.m. around 7am....the breastfeeding had gone too long - he needed to eat!!!!  And so he did.  Despite the fact that my milk supply was GREAT this a.m., he proved still hungry!  So, out came the rice cereal again!  He enjoyed his bowl of cereal & the remainder of a five ounce bottle.  After a few good burps, he was in his swing & dreaming about the things babies dream about :)

James has been a crazy little person this morning.  I've somehow managed to get a few things done.  In a while, we'll pack up the little ones, pick up Jesse (and his friend) from school, and we're off to playgroup #1.  Hopefully, I can squeeze a quick errand in after playgroup. 

Tomorrow is another playgroup for James.  Thursday, EI returns for Josiah.  That will end the appointments for the week, I think.

Meanwhile, my non-smoking venture has been a complete success.  It's been three weeks as of last night!  It's been amazingly easy :)

Everyday, I continue to be thankful for everything, and everyone, in my life <3