Our day nurse today yesterday was Kim. She was great! Ive come to the conclusion that your nurse really makes a difference in how your day and your spirits go at the hospital.
Kim happened to see Savannahs projectile spit up in the morning and thought that it was definitely reflux. Brian and I took some pictures our first night of Savannahs spit-up because we keep getting asked to describe it. A picture just seemed easier.
Tuesday morning Savannah weighed 9 pounds 11 ounces--up four ounces from Monday's hospital scale weight of 9.7. Nurse Kim said that Wednesday's weight would be a better comparison because when Savannahs weight was done on Monday she didnt have the IV tubing and arm splint. Still Id like to think shes on the upswing.
Dr. Pat told us that all of Savannahs blood work came back normal. No metabolic disorders were detected.
Dr. Pat said that Nurse Kim told her about the spitting up she saw and we showed Dr. Pat the pictures we took. The diagnosis that Savannah keeps fitting the bill for is Gastroesophageal Reflux Disease (GERD)the extreme version of GER..I gues they just add the "disease" part. In the extreme cases infants lose weight, can have wheezing and even sound hoarse just like Savannah.
Dr. Pat wants to try fortifying Savannahs milk to see if it will help her Esophageal Sphincter muscle keep the food down. The Dietician has put her on a ratio of 2 ounces milk to ½ teaspoon of rice cereal.
Yesterday when Dr. Zimmer and then the Nurse Practitioner were asking me if Savannah nurses vigorously I told them, No, she really does not. Since she has been congested shes been having a hard time with breathing let alone eating.
As she has gotten progressively sicker her nursing became less strong. I have noticed without milk flowing its more painful for me since it is essentially skin being pressed against skin and pulled
OUCH!
Even though I know she latches well I feel like she doesnt hoover down the milk like she used to. I wanted someone to confirm or abate my fear that she has not been suckling productively.
So before Dr. Pat went home last night I ran down and found her at the nurses station and asked to have a lactation consultant come and evaluate Savannah today.
A Lactation Consultant named Megan came to see us late morning. First she weighed Savannah and then I nursed her on the left side. Then Megan weighed her and determined she took a mere 20 CCs less than an ounce. Next I fed her on the right--my historically best producing side. She was weighed again. Her whole intake amounted to 1.5 ounces. At her age she should be drinking around 4 ounces per feeding.
Megan kept telling me that it wasnt my faultif Savannah wasnt sucking the milk out, my breasts were not going to keep up their milk production. Even so, I feel guilt ridden that Im not making the needed four ounces.
I remember brining Savannah in to the Lactation Center when she was a couple weeks old and her being weighed before and after a feeding. At that time she took in nearly 3 ounces and I was able to pump an additional bottle out of each breast.
It breaks my heart that three and half months later shes taking in half of what she did as a newborn.
Megan also got me set up with the Medela Symphony pump I have to take home. I used it on full suction for twenty minutes on both breasts and only expressed what amounted to one additional ounce when the two bottles were combined.
We mixed this with a half teaspoon of cereal and she easily took it from a bottle. The nursing seems to be too much work for her right now.
Megan also asked me if I felt my milk let down. I really dont anymore but I attributed this to time. In the past the longer I nursed the less of that burning sensation I felt as the milk ducts filled and released.
Im glad that I asked for the Lactation Consultant to come. It was a real eye opener that not only is Savannah losing calories from refluxing but she isnt even taking in as much as she should to begin with. Combined its not a wonder shes losing weight.
After Megan left Dr. Pat gave me a little lecture about supplementing. She told me to give her some formula mixed with the cereal after the breast milk. She said that at this point every ounce of milk counts.
Im trying to emotionally prep myself that bottle feeding may be what is best for little Savannah. Its a big deal to me because Im a big proponent of breast feeding and have always enjoyed the bond that it has afforded me with my kids. I nursed Sebastian until he self weaned at 9 months and Siennah until 11 months.
Ive been giving myself a little pep talk that four months of nursing is better than none at all
Im trying not to think of it as a failure.
Tuesday evening I pumped again for twenty minutes. I was only able to get an ounce from each breast. I mixed in the rice cereal and fed it to Savannah. She drank it in no time flat.
My mother-in-law was impressed with how well she does with the bottle. Honestly, if we are to continue I hope that she doesnt become too accustomed to the ease of the bottle nipple. Otherwise I think it is going to be really hard to establish a good supply demand relationship again.
An hour later she was fussing and rooting. I didnt think my breasts were up for another round of suctioning just yet so I went straight to the Enfamil ready-to-feed 2 ounce bottle. She sucked the whole thing down while happily gazing up at me. What matters are those precious calories.
Savannah had another course of Rocephine today and went back on Prevacid. The Prevacid is stronger than the Zantac she was being given via IV. So far I think the Prevacid, which stops the production of stomach acid instead of merely blocking it, works the best. Shes being given the Prevacid as a syrup. I requested that our prescription be for a syrup as well. It is so much easier than the ridiculousness that was the soluable tablets!
I eliminated dairy from my diet and we saw immediate improvement! I also worked with a lactation consultant to make sure he was actually eating, not just sucking.
I sent her I was so happy it fit and she liked it. I hope your family are all well enough to still go on your trip like planned. I will pray for you things turn out ok.
Anyway, he had to have a bottle for a little while there, but he went right back to nursing and we got him all worked out!
Nope, I saw it too!!! 
