Wednesday, April 18, 2012

Some follow-up

Wow, thank you for all your comments on my last post.  Given how infrequently I post these days, I wasn't sure anyone was still reading.  ;-)

Reading some of the comments helped because it was a reminder that we aren't the only parents who've dealt with this issue.  (It's also good to hear that it gets better and that medications are appropriate if they are needed; MM and I went back and forth on that point, not wanting to medicate our children unnecessarily.)  It also made me realize that I failed to provide the full backstory.  (Oops.)  So allow me to do so and to also address some of the comments here to fill in the blanks.
  • Both babies are exclusively formula-fed and have been since coming home from the hospital.  (Not what I would've preferred, but breast-feeding didn't work out for us. . . a topic for an entire post of its own which I lack both the motivation and the time to write at present.  Still a bit of a sore subject for me.) 
  • They have been on Similac NeoSure from day one, apart from a very few feedings of breast milk I was able to provide for them during the first week to ten days of their lives.  I have never felt that either AJ or MJ tolerated NeoSure well.  Both have been very gassy since day one and have often seemed to have discomfort with it, even apart from the reflux issues.  (I can often actually HEAR their intestinal workings when they're struggling with gas or BMs.)  I hate that they require this higher-calorie formula, but it is what it is.
  • Although NeoSure contains both lactose and soy ingredients, our pediatrician has not wanted us to take the babies off that formula until their weights "catch up" to other babies of their age.  (Remember that they arrived almost six weeks early, which is why they are "behind" in weight.  Their birth weights were actually above average for 34-weekers.)  Just last week at the appointment where he prescribed their medication, he did say that MJ could come off NeoSure once his reflux symptoms subside and he is once again consuming appropriate volumes of formula for his weight.  But AJ still needs to stay on NeoSure until his weight gets close to the 50th percentile for his chronological age.  So while I have considered changing their formula for a while, it doesn't seem to be an option for now, at least not for AJ.
  • We love our pediatrician and trust him.  He has been practicing medicine for nearly thirty years but also obviously keeps current on the latest research; he is also very gentle with the babies and patient with us and our (many) questions.  He was highly recommended by several other twin moms in my area, and in an odd coincidence, I realized that I had met him once a few years back when he testified as an expert witness in one of my cases.  So we are inclined to follow his advice, not because we are trusting of health care providers in general but because of our confidence in him specifically.
  • Because MJ has always been a "happy spitter" ever since he was born, we had already tried a lot of the intermediate measures which are recommended to reduce reflux symptoms: frequent burping, keeping him upright for 20-30 minutes after feedings, sleeping on an incline, and using gas-reduction bottles (we've tried both Dr. Brown's and Avent and are currently using Avent).  We haven't found that any of them helped much: MJ still spit up as much as ever (sometimes during a feeding), and his symptoms (crying, rejecting the bottle, arching his back and squirming during feedings) worsened even though we were already doing all this.
  • One pediatrician in our doctor's practice suggested the possiblity of thickening MJ's formula with rice cereal, but I expressed concern about doing so because he was so young at the time (only 6 weeks old, so really zero weeks adjusted age) and also because he was/is already gaining weight more rapidly than recommended.  She and our regular pediatrician understood and shared my concerns, so that's something we have not done so far.  (If problems continue, I may consider doing it for AJ, or both AJ and MJ, if necessary, now that they are a little older.)
  • We definitely have noticed a decrease in the amount and quality of both boys' sleep since their reflux symptoms have worsened.  Both babies have been swaddled for all sleep since day one.  It seems to really comfort them, and we intend to continue it as long as they will allow us to do so, or at least until they are rolling over (after which time I understand it's not considered safe to swaddle?).
  • The babies started taking nizatidine three times a day last Wednesday evening. The pediatrician said it would take about a week to have the full desired effect.
Today will be the seventh day that the boys have been on the nizatidine, and I think we may finally be seeing some relief with it: yesterday was the best day of feedings they have had in a few weeks.  They are still not back to the volumes they were eating before their symptoms worsened--or to the volumes they should be consuming for their weights--but we've been seeing less crying, less back-arching, and less rejecting of bottles.

Here's hoping they've turned a corner with this issue.  I hate seeing them suffer.  :-(

3 comments:

  1. S...I have been away and then had a sick baby and then grandparent pass away so I missed all your previous posts. So I just caught up. Firstly, S...I am so sorry that your babies are having such difficulty with reflux/colic/fussiness/prematurity issues. Once LN10 hit 10 days old until he was 10 weeks old he was terribly fussy. He was also 3 weeks "premature"...although is considered full term at 37 weeks but still...that's 3 weeks from what nature allows! I thanked God everyday that he was not more premature as I got a real eye opener as to what parents of premature babies must go through. Yes, there were some awfully tender moments and moments that I miss dearly but it was a constant daily struggle. It was sooo hard. Honestly, for me, it wasnt until LN10 hit 4 months old that I really started to see the light at the end of the tunnel as to why parents decide to have more than one child!! And I just had ONE baby...and was at home (one of those lucky Canadians with a year maternity leave). I can't imagine twins and working full time at such a young age. All I can say is...each day is one step closer to the end of this phase. I know you do not wish these days away but at the same time you do...its such a mixed feeling. Don't feel guilty. Don't beat yourself up. Be that loving parent you ALREADY are and if you can...sneak in a few moments for yourself. I revelled in the luxury of a 30 minute bath or tv show every few days in those early days. It sounds as though you have exceptional pediatrician and husband and this makes all the difference. Hang in there...and kiss those sweet babies for me. Take care.

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  2. Sorry S. I gave W meds from 3-6 months because he went from a happy spitter to screaming banshee. R and I both have reflux so it wasn't a surprise. W still has reflux so we try to watch his diet. Not much OJ or fried food. Both kids spit a lot but Wy was horrible! Projectile vomiting large amounts until about a year old. I also think I overfed him which made it worse. Hang in there. Hope you get relief soon. That's rough times two!

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  3. I hope they are both back to normal soon.

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