Another Day, Another Diagnosis

TMI warning, before you begin reading...there will be talk of poopy...

Well, Morgan had been having a little trouble in the poopy department and hadn't gone in a couple of days. This morning she finally went and I was happy until I saw the contents of her diaper. The stool was very runny and full of mucous. She pooped a little while later and it was still light brown and mucousy. A few more hours later and she made another poopy diaper, but this time is was green and mucousy. I didn't like that at all. I googled "green mucousy stool" and found that there are usually two possible causes. One is a milk-protein allergy and the other is a foremilk/hindmilk imbalance in breast milk. I called the pediatrician's office and they said I could come in at 4:30 p.m. at their office half-way across town. I wanted to see if there was some way they could test Morgan to find out, definitively, if she had a milk allergy. At some point, she'll be on formula and I needed to know whether we'd be going down the $Nutramigen$ route or using some other formula. Also, if it was a hindmilk/foremilk imbalance, she'd be going to formula sooner, rather than later.

So, I get there early (4:10) because I left early expecting lots of traffic, but traffic was pretty light. They didn't get me into a room until around almost 5:00. The nurse had me undress Morgan and we got her weight (17 lbs. 11 oz.) and she asked the reason for my visit, which I explained. I then proceeded to wait another 30 minutes in that room. Poor Morgan is only in her diaper and wiggling like crazy and I'm trying to cover her with her clothes and burp cloth, thinking that the Dr. should be in any minute. After about 20 minutes, I open the door and one of the nurses is cleaning off the scale and I asked her what time they close and she said they closed at 5:00. I asked about the doctor and she said he just came out of another room and would be with me shortly. When he finally came in, I had been waiting for an hour. He apologized and said that he was assigned certain rooms and they did not tell him that the room I was in was one of them. *Sigh*

At that ped. office, there are several doctors and we've seen 3 of them and one nurse practitioner. I like the doctor we saw today and hadn't seen him since Morgan was a couple of weeks old.

I explained Morgan's stool situation and told him that I basically wanted to know which kind of formula she'd need to be on when the time came and I wanted to know the cause of her green, mucousy stool.

He said, "I don't have anything bad to tell you. I've had to tell other patients today that they've had an ear infection and another bronchitis, but I don't have any of that to tell you. Morgan is suffering from 'well loved/well fed/well taken care of syndrome'". He showed me her growth chart and her dots were off the charts. He said she's growing a little faster than she should be, but that's not a terrible thing. However, she is eating too much and this excess protein is disrupting her system. Her body is overloaded with excess protein and that's basically what an allergy is - a reaction to proteins. I asked if she had a milk allergy and he said that everyone does. Nobody should really drink cow's milk and that we in the U.S. are the only ones who really drink it and that other countries hardly ever drink cow's milk. I asked him why so many of the main formulas are cow's milk-based and he said he didn't know and that's just the way the American companies do things. He said she should eat a soy formula, that is lactose free. He said there's a small chance that she'll have a problem with soy, but he didn't think it was likely. I asked if she needed the $Nutramigen$ and he said no and that he only puts about 3-5 babies on that a year. (Well, he needs to talk to his colleagues, since they were just pushing it on me last week...) He said that it is true that some of the dairy I eat, passes through, but if we get her portions/intake under control that it would lessen the effects. He said to start her on rice cereal, in a bowl, and not in her bottle. I asked about allergies and he said, "do you know anyone with a rice allergy?" He said we start with rice, since it's the least allergenic. Anyway, he said we need to slowly move her towards a "breakfast/lunch/dinner" routine with a few other meals in between. He said to offer her some milk and then some rice cereal. After a while, we'd go to vegetables, then fruits, then meats. He said she could tell me when she was hungry, but I had to tell her when she was done eating. He said if I wait until she stops herself, then she will have overeaten. He said to wait until the first big pause and end that feeding. I asked how much I should feed her then and he said, "do you eat the same exact amount every day?" and suggested that I just try to change her habits. He said my husband and I should "talk up" the meals and explain to her what we're doing while we mix the cereal, so she learns that food takes time to prepare and that she'll be fed a proper amount - not too much and not too little.

That'll be interesting. Morgan is VERY impatient when it comes to her food, so I'm not sure she'll take it too well, but it is true that we'll have to try. She can't be a grazer for the rest of her life. Even though what the ped. said is different than all the other doctors, it made sense to me. If I pigged out and ate a large pizza at every meal, every day, my system would have problems, too. He said I was lucky to even be able to exclusively (over)feed her breast milk, especially being a first-time mom. She's well fed, but too well fed, I guess. He just wants to see her growth get more in line with the charts and he believes that settling her intake will improve all her issues, including her eczema. I guess we'll have to give it a try.

Well, gee whiz...

It's a good thing we waited to talk to the dermatologist before starting Morgan on Nutramigen. He said her eczema has nothing to do with what I'm eating. He said that only happens in about 1% of cases. He said the actual culprit was frequent bathing. He said water is the enemy for people with eczema, stripping their skin of its barrier protection. He said to bath her just once a week and for cleaning in between baths we could use Cetaphil and wipe it off with a cloth or paper towel - just NO WATER! I told him that the pediatrician suggested a Nutramigen formula trial for her eczema and possible reflux and he said not to do it for the eczema. That's fine with me, because that Nutramigen would be like $2,000! The ped. gave us Zantac, so our newest plan-of-the-day is to wait and watch her and see if she still exhibits the symptoms of reflux. If so, we can give her the Zantac. That is, of course, if the Tucker Sling we ordered, doesn't help. We want to try and exhaust our physical and behavioral options, before using the medicinal options. I'm glad to know that what I'm eating isn't bothering her. I was thinking/hoping that might be the case, especially when I had added diary back to my diet and her face cleared up, instead of getting worse.

I am still worried about my milk supply, though. It has peaks and valleys and I don't know what's going on or what has changed. I know the normal reasons for a drop in supply and none of them apply. Well, stress can drop your supply and I have been stressing. I want to keep feeding her breastmilk up until 6 months and then try to fix my overactive let-down. I don't want to fix it now, for fear of dropping my supply even more. If it drops after 6 months, I won't feel as bad, since 6 months was my original breastfeeding goal. If I can get her back to breastfeeding directly, I won't have to hassle with pumping and I could just pump the occasional bottle or use a bottle or two of formula. She'll be starting solid foods by then, so there should be other feeding options, should I need to be away from her for a few hours to run errands or something.

Well, I do feel better...now I just need to figure out what's up with my milk supply...

My baby is 4 months old!

Morgan had her 4-month pediatrician appointment today. I had so many things to say and questions to ask and I was talking a mile a minute. She weighed 17 lbs. 5 oz., which put her past the 95th percentile for weight. Her head circumference was 43 cm, which is past the 90th percentile and her length was 25 inches, which is in the 75th percentile. Her eczema is still present on her body, but her face really cleared up today. We have no idea why, since I have been eating cheese (dairy) and she's back on my breastmilk. Oh, that's right, I didn't blog about what we did last week.

We thought we'd do a trial of formula, but we weren't very smart about it. We used a Walgreens Gentle brand, which is equal to the Enfamil Gentlease formula. I wanted to see if it would help her reflux/tummy issues. Well, what I failed to think about is that we're trying to see if any milk proteins are coming from my diet into her milk and this formula is definitely milk-based, so what exactly were we testing. We did that formula for 2 days and I continued to pump to keep my supply up. I tried to drop down to 5 pumps a day and it caused my supply to drop somewhat. At 4 a.m., on the second night of the formula trial, it occurred to me that this wasn't a true test of anything and she wasn't improving, so she'd be better off back on my milk until we figured things out. When she pooped out that formula the next morning, it was the most vile, horrendous thing I'd ever seen or smelled. My poor, sweet baby had to pass mixing cement through her body.

So, she was back on my milk for 2 days and I was thinking I was going to cut out dairy, but it's just not possible. My diet is already so restricted. Her face was still red, but then today, it really started to clear up. Baffling... Here is a picture of my cutey-baby from today:

The only thing on the side of her cheek is the collection of small cuts and scratches that she inflicted on herself when scratching at her face. Her forehead and cheeks are otherwise all clear. Her body does still have spots, though.

I was telling the pediatrician about her reflux symptoms and he said both the eczema and reflux might be caused by a milk-protein allergy. He said this is not to be confued with a lactose intolerance, which I understood from my research. He gave us a prescription for Zantac, though, and said they've been using it for over 10 years on babies with great success. He also suggested using a hypoallergenic formula, like Enfamil Nutramigen, if an elimination diet wasn't possible. He didn't want to discourage my breastfeeding, though, but it was something we could try. I told him I was pumping, so I could keep my supply going, while we gave the formula a 10-14 day trial. He gave us 3 sample cans, which is great, because that formula is EXPENSIVE. If I were to feed it to her at 40 oz. a day for these next 8 months, it'd cost about $2,000! I'm looking into seeing if our insurance will cover it under "enteral formulae", which I know we have coverage for, but only for certain diagnoses.

Anyway, we've (for the moment) decided to hold off on the Zantac and give the formula a try, since it might help both the eczema and the reflx issues. We're going to wait until after tomorrow's dermatologist appointment, also, to see what they have to say about it. We also didn't want to make any changes today, since she just had her shots.

After she had that one awful cement diaper, all her stools have been running and mucousy and that's bothering me. They also smell different and haven't gone back to their normal consistency. I don't know if this is a residual affect of the formula, or if it's caused by my milk, which I have noticed has become more watery. Even though I've gone back to 6 pumping sessions a day, my supply hasn't fully recovered and that's making me nervous. Maybe I'm stressing out too much.

I'm glad that her face cleared up today, but it does make things very confusing. If I ate dairy and she's recovering, does that mean it's not the dairy? She still has reflux symptoms, so is it just that the dairy allergy causes rotating symptoms and she isn't going to have all the symptoms, all the time? *Scratching head*...

Well, it'll be interesting to hear what the dermatologist has to say. Oops, I better get to bed!

What to do, what to do...

*Sigh* I still don't know what to do about Morgan's eczema and acid reflux. I just don't know if it's something in my breastmilk or what...I keep debating whether I should do a formula trial. I could try regular formula and see if she has an allergy that's not dairy (eggs, wheat, etc.) and if that doesn't work, I can try the hypoallergenic formula and see if it's a dairy allergy, after all. I will continue to pump on my normal schedule and freeze the milk to maintain my supply, should we need to switch back to breastmilk. Honestly, I'm hoping the formula doesn't help, since I'd rather she get the benefits of breastmilk. I do, desperately, want to find a way to relieve all that ails her, though. My poor baby!

Her eczema flairs up out of nowhere. She was taking a nap and woke up like this:

(She was asleep in the crib and this picture was taken after I had moved her to the car seat. I had put vaseline on her face, so that's why it's shiny...)

I put the steroid gel on the side of her head. Here she is later in the day, looking a little better:

...and another picture even later in the day...

So, it does get better, but I can't figure out what makes it flare up, aside from heat.

On top of the eczema and reflux, I think she may be teething. :( She drools rivers and chews on her fingers and rubs her bottom gums. I see two white patches, but they've been there since she was about a month old. She is just so sad and uncomfortable sometimes, but she still spends a good amount of the day smiling and "talking", for which I'm very thankful.

A Decent Night...

I had put some steroid gel on Morgan's really red spot and they've cleared up quite a bit. She took a really long nap (almost 3 hours) in the afternoon and I was worried that she wouldn't sleep last night. She woke up from her nap and was so hungry. She went through all the milk I had waiting for her and after I pumped later, she chugged that, too. I was trying to get her to bed a little after 9, but she was still so very hungry. I was feeling extra tired and exhausted and asked Greg to finish feeding her, so I could pump and hopefully get to sleep. I finished pumping and was able to get to sleep at the same time as Morgan. This was about 10 p.m. She (we) slept until about 2 a.m., so I got a nice 4-hour stretch of sleep. After putting her back to bed at 2:15, I had to pump and didn't get back to sleep until about 3 a.m., but she slept until 5 a.m., so I got another 2 hours. After feeding her at 5 a.m., we fell asleep in the glider for another hour or so. That gave me 7 total, albeit interrupted, hours of sleep. I went and bought her a humidifier yesterday and we're thinking that may have helped. It hopefully helped her skin and helped her not have such a dry mouth all the time. She often wakes up making a "kah" sound, like her throat is so dry and parched. She didn't do that last night. Little by little, we'll get this stuff figured out.

Evil Enigmatic Eczema

When Morgan was born, she had the typical "cradle cap" and "baby acne" skin conditions. About 3 weeks ago, however, her baby acne had cleared up, but she was getting these red, scaley patches on her cheek and forehead. One night her forehead was looking very red and irritated and I decided that it needed to be looked at, by the pediatrician. The ped. took one look and said, "she has eczema," which is what I had suspected. I was given a prescription for a low-dose steroid gel for the bad spots and told to put vaseline on her face/eye area. I can't put the medicine on her face because she scratches her cheek and then puts her hand right in her mouth. The ped. said that we didn't have to bathe her every day, but if we did, to use a non-soap cleanser (Cetaphil) and keep the bath brief. We're to slather her in a dye-free/fragrance free lotion immediately out of the bath, to lock in the moisture. Three times a day, I reapply the lotion and keep her arms and legs covered to keep her from scratching. I asked what causes it and she said that it's fairly common in babies and some just have sensitive skin. It can also be a sign of food allergies, but it's hard to tell. I also mentioned that Morgan appears to have acid reflux and she suggested that I do "thickened feedings" where you add some rice cereal to her bottle, using a special "Y-cut" nipple. I asked if she was too young for that, but she said it was only recommended for issues like reflux, and not normally suggested until they are older.

The steroid gel cleared up the patches on her forehead by the next day, so that was good, but her cheek was slower to heal, because she constantly wanted to scratch it. She then started to develop patches on her arms, upper thigh and the back of her legs. It was getting worse and I wanted to know if we could find out if it was a food allergy, so I took her back to the pediatrician's office. They said at 3 months of age they can't tell, since the tests might come back showing no allergies and then, if run a few months later, they might show all kinds of allergies. She didn't think it was food-related, she said she just has sensitive skin and to keep up the regimen and that if I was slathering her in lotion 2-3 times a day, to step it up to 3-5 times per day. I asked her if I should try switching to formula for a bit, to see if her symptoms subside, and she said I could, but then Morgan wouldn't be getting the immunological benefits of my breastmilk.

So, back home we went with no real answers and no idea what to do. I kept doing what they told me, but it just seemed to be getting worse. I really worried that it was something I was eating that was bothering her, so I started researching the "elimination diet" where you stop eating all of the allergy-causing foods (eggs, dairy, wheat gluten, soy, tree nuts, etc.) for a couple of weeks and if she improves, then you slowly add back foods to find the culprit. I made a list of foods, mostly containing rice and went to HEB to read a thousand labels. There is just no way to cut out eggs, dairy and wheat gluten AND soy, at the same time! I ended up with a cart full of rice products, many with small amounts of soy. I had cream of rice, brown rice, rice puffs, rice Chex, rice "puffins", etc. I also got various types of fresh fruit. So, as of noon I switched over to just eliminating eggs, dairy, and wheat gluten. For lunch, I had a bowl of rice puffs, mixed with rice "puffins", rice Chex and raspberries. That was quite a dry lunch, even with the berries. I has forgotten to get rice milk when I was at the store. :P I pumped my breastmilk at 5 p.m. and I believe that was the first "batch" under the new menu plan. For dinner, I ate organic chicken with squash, zuchini, onions and green onions, seasoned with a salt-free seasoning and sea salt. I also ate a corn tortilla.

After dinner, Greg said I should go take a nap and he would feed Morgan. A little while into my nap, I hear her crying and crying and crying. I can't sleep when she is crying like that so I get up and we have no idea what's wrong with her, but real tears are coming out. I took her to the changing table to see if she needs a diaper change or if something is poking her and when I pull up her top I see that there are some spots on her belly, which were new. I thought she might want a change of clothes, so I took her to the crib to put her in her pajamas and I took her clothes all the way off and realized that her entire side was red and covered in slightly elevated patches. It looked so painful and I almost started crying right then. I turned her to the other side and it, too, was very red and splotchy. I called Greg in to look at it and we tried to think of what to do. Just earlier I had spoken to my friend, Christine, and she suggested chamomile tea to soothe the rash, so I brewed some up while Greg prepared a bath for Morgan. I got out the gauze from the first aid kit and watered down (and cooled down) the tea and made dressings for her most affected spots. We gave her a quick bath and she looked a lot more comfortable, although I think she was a little cold. She was "talking" to us, saying, "goo goo ah goo, gee" and I think she was trying to explain what had happened to her.

We got her out of the bath and I switched out her jammies for some 100% cotton ones, since I had her in a polyester outfit. She was calm by this point, but Greg and I were trying so hard to figure out what in the world happened.

This is my theory. Back when the ped. suggested the rice cereal for Morgan's reflux, I gave her small amounts in her bottle with the new nipples. She seemed to tolerate it well and it appeared to help somewhat with her reflux. However, it then constipated her and she didn't poop for days. So, it helped one thing and caused another problem. When she finally pooped, it was very thick and smelled worse than normal. I decided to stop with the rice cereal after that. Anyway, I've been told, and have read, that introducing rice cereal too early can sometimes cause a rice allergy. One thing I read said it was a smaller chance than getting hit by lightning, but it could happen. So, perhaps she doesn't have a full blown rice allergy, but I "over-riced" my diet that afternoon and it might have caused the big flare-up in her eczema. Of course, this is all speculation and I have no way of knowing for sure what happened. I've now abandoned the elimination diet, because on top of the effects on Morgan, I was starting to feel weak and we can't have that. Morgan is almost 17 pounds now and I need my strength!

I looked at Morgan's skin this morning and it's still red and splotchy, but not as bad. I've dressed her in a 100% cotton outfit. I'm thinking those "organic" outfits from Babies-R-Us, that I used to roll my eyes at, might now be a necessity when she has a big flare-up.

She slept fairly well, last night, considering her discomfort. She fell asleep in Greg's lap at around 9:30 p.m. and I took her to the crib at 10 p.m. She slept until 1:05 a.m. and awoke at 3:55 a.m. and 6:15 a.m. It makes me sad that she sleeps better when she has had a rough day. I wish she didn't have to go through anything to get a good night's rest.

She has her 4-month appointment on 3/16 and an appointment with a dermatologist on 3/17, so we'll see what they say, then. I need to get going to my eye doctor appointment. Morgan takes after her mommy's frequent doctor visiting...

It's March already?

Time is starting to fly by a little more quickly, now. Morgan is 3 1/2 months old! Last week, she rolled over (from tummy to back) for the first time since she was 5 weeks old. She did it a second time for the camera, but I haven't been able to get her to do it, since. She holds her head up really well, but she doesn't seem to want to roll over any more. I guess she figures, "OK, that was interesting, but I'm done with that for now."

Anyway, after the fiasco that was the Ferber method, I finally received The No-Cry Sleep Solution book in the mail. I feel so much better about what I'm reading in this book, although I can tell that it won't be easy. She weighs 16.75 lbs. now, so I know she's not going to starve if she doesn't eat 3 times at night. Part of this process involves finding her ideal bedtime, which means watching her, starting at 6:30 p.m. and putting her to bed at the first signs of tiredness. This, in turn, means that I can't do anything in the evenings for the next several days. They say it takes about 10 days to get things figured out. I get the feeling that things will get harder before they get easier. Right now, Morgan wakes up 2-4 times a night and with this method, I may need to tend to her 10 times, to avoid having her cry. I feel sleepy just thinking about it.