Supplemental Nursing System

Sometimes I feel that we make one step forward and two steps back. Sigh. After being so excited that Cerise finally gained weight last week, I feel we're back to square one. The medicine that the pedia-cardio gave to relieve the pressure from the lungs is a diuretic. Meaning, Cerise will be urinating more often and consequently may lose weight. Since she is peeing more often, this is suppose to make her want to feed more also. But as it is, she takes the same amount of milk and maybe even less now. Sigh again.

I bought her these Breast Flow bottles that's suppose to mimic the breast. It has two nipples that regulates the flow of the milk. Only when baby sucks can the milk come out. At first, she readily took to it and was taking enough milk in a day. I think she gained weight already when she started taking this bottle. Then all of a sudden, out of the blue, she just rejected it. No warning, no symptoms. Just no bottle. I tried the Evenflo bottles. I tried Avent. I even went back to the Pigeon bottles that she used to drink from with breastmilk. Still no progress.

I was able to feed her with a sippy spout that Alyssa used to take when she was an older baby. The spout is closed and liquid will only flow when sucked. The beauty of this is that the baby is able to regulate her milk intake. Cerise took to that and can drink in it but only in small amounts. She refuses to drink more than half an ounce in that cup. Frustrating, really!

I'd like to monitor the quantity of her milk intake so I can see how much she's drinking in a day. For her age, infants usually take in 3-4 ounces in a 4-5 hour period. That's about 20-24 ounces a day. I checked the Dr. Sears book and it says that 2-2 1/2 ounces per pound is a better way of quantifying a baby's milk intake. Since Cerise is 3.5kg, she should be taking 15 to 20 ounces a day. As it is, she barely reaches 10 ounces although we can't really quantify the breastmilk she gets from direct breastfeeding.

Then I thought of researching about the Supplemental Nursing System of Medela. I wasn't sure if this would help but I was thinking since Cerise preferred feeding directly from me, this would enable her to get more milk without jeopardizing also my breastmilk production. Good friend, Jen Tan of Next9 slings was able to hook me up with Medela Moms and I was finally able to get this:

This works by attaching a tube (connected to supplemented milk) right beside your nipple to allow baby to suck on the breast while getting milk. This is usually used by adopting mothers who wish to breastfeed. It is a good way to relactate and to feed preemies or slow weight gaining babies. I thought this would be perfect for Cerise! Good thing Medela Moms has this in stock!

I tried using it tonight. Not easy! It takes practice for you to shoot the tube into the baby's mouth. Cerise was getting frustrated at first. But we were able to manage and she was able to take in one ounce of milk. I tried using the medium tube at first but will try the bigger tube tomorrow for faster milk intake. I hope that this would enable Cerise to take in more milk so she'll gain already.

We'll be seeing a pedia-endocrinologist when we go to Manila. Cerise's pedia here in CDO recommends it. My friend, Dr. Zeka Tatad-To also suggested the same thing and mentioned that most failure to thrive babies is an endocrinological problem. I hope that we finally find out why Cerise is not gaining weight so we can address it right away.

However, amidst all the trials she is facing, Cerise remains to be an alert and active baby. She loves looking at her play gym friends and talks to anyone who would listen to her, usually mommy or her sisters. :-) I hope that she'll be ok soon for her sake and for my sanity.

Small Steps

Cerise had her 2D Echo yesterday. The holes in her heart (PDA, 2 VSD's and 1 PFO) are still there but have reduced in size already. Praise God! I also weighed her in the pedia's office and she has gained another 100 grams. I am so relieved! 100 grams in 2 days! Things are looking brighter for her and I am so happy! I know that things will be better soon.

The pedia-cardio said that the condition of her heart is not bad enough to be the reason for her failure to thrive. Honestly, I think it is all a combination of problems in her health that caused it. Her heart, anemia and the sepsis. She was given an additional medicine to help relieve the pressure from her lungs which consequently can help her gain more. Slowly, these problems are being addressed and I think Cerise is on her way to recovery. :-)

Hopeful

It has been quite a hectic week and a roller coaster of emotions for us. Cerise went to see her pediatrician again last week to assess her growth and if she has improved with the steps that we have undertaken. It was disheartening to find out that again she did not gain weight. Her weight two weeks ago was the same as last week! How can that be? It was so frustrating. I could feel the pain in my heart boring a deep hole. I've sacrificed and worked hard in helping her gain and yet it was all in vain.

Her doctor suggested to supplement my breastmilk with formula. If he asked me that a month or a week ago, I might have said no and let me work on her weight gain through breastmilk. But right then and there I felt that I needed to give her formula too. I wanted her to gain weight so badly already before it's too late, before I regret it, before something happens that might be detrimental to her health.

He also recommended that Cerise be checked by a pedia-gastroenterologist when we go to Manila. And since we'd be going to Manila on the 18th pa, Mier and I decided that Cerise and I should fly off for a few days to have Cerise checked immediately. We were able to get in touch with a pedia-gastro from St. Luke's Hospital and bought tickets right away.

Thank God the pedia-gastro cleared Cerise from liver and abdominal problems. She said that she believes that this isn't a metabolic problem and that Cerise expends too much energy breastfeeding. She suggested that I quantify her milk intake by pumping milk and giving it to her through a bottle. Cerise should be taking 8oz of milk aside from breastfeeding.

Honestly, I don't think I can pump 8oz of milk everyday. Although I do have stored milk at home, this won't be enough and it would be a struggle for me to reach that goal. Pumping takes time. As it is, I am taking too much time with Cerise already. I need to be able to bond with the other girls too. Thus, with a heavy heart, I've decided to continue to mix feeding. My goal is for Cerise to gain weight as soon as possible and if formula is the key for that then it is so. I tried my best and did what I could.

I went to have Cerise checked again yesterday, this time by a pedia-cardiologist. It was great to find out that Cerise finally gained! 100 grams. Not much but something. I am hopeful that things will get better soon. We are scheduled for a 2D Echo tomorrow and I pray that I will hear good news.

I forgot to mention, on our way home from Manila, Cerise was crying in the plane. She refused to feed either from the breast or the bottle and I was feeling really down. But when I looked out of the window, there was a rainbow among the clouds. Not a full one, just half a rainbow and I wasn't sure if it was visible only to me. But I felt God's presence and his assurance that all will be well. I am hopeful.

Babywearing Festival

Yoga Baby Bliss in Facebook is having a Babywearing Festival. They have very exciting prizes to be won by the entries with the most likes. I sent in a photo not to win but to support this event.

I am proud to say that I have been a babywearer since 2001 when my oldest daughter, Nadine, was born. At that time, babywearing wasn't the norm yet. In fact, I've never even heard of the term "babywearing". All I know is that Nadine hated her stroller and loved being in our arms all the time. I used a Baby Bjorn carrier to wear her.

My first sling was from my friend, Buding Aquino-Dee, who lent me her Kindersling from Canada. At that time, I would see slings in US magazines and thought that this would be a good way of bonding with my baby Raya while caring for my toddler Nadine. It was an answered prayer because I was able to do just that.

So when I gave birth to my 3rd girl Alyssa, I knew right away that I would be babywearing her too. Same with my baby now, Cerise. :-)

I love babywearing because it makes my babies calm, content and secure. I wear my babies anywhere and everywhere. Plus, it makes breastfeeding a breeze! I currently have 6 slings, 2 pouches and 1 SAYA. Hahaha! Like I said, I don't need to win this contest. I just want to show how much babywearing means to me!

The photo I submitted was taken in 2007 during my sister, Marla's wedding. Alyssa, was only a month old then. I had a sling made to match my breastfeeding dress and that of Nadine and Raya's dresses who were both flower girls. My 4th daughter, Cerise, who is now 2 months old, loves the slings just like her sisters before her. :-)

The Golden Sling during my sister's wedding.

Wearing 3-month old Alyssa in Enchanted Kingdom using a Next9 sling.

My first sling, the Kindersling, with my 2nd daughter, Raya, in it.This was in 2003.


Alyssa in a Blissfulbabes pouch from Buding Aquino-Dee

My husband, Mier, with Alyssa.

My 2-month old baby Cerise in the pouch.

Proud of my Schoolgirls

We had the quarterly parent-teacher conference last week and all three girls brought home highly satisfactory grades. I am so proud of them because I know that they had a lot of adjustments to do last quarter --- I gave birth to Cerise and was busy caring for a newborn, then Cerise got sick and was hospitalized for a week. But despite all these obstacles, they were able to do well in school with some grade subjects even going up.

Their teachers are all praises for them. Yes, they see that the girls were struggling with the changes at home but obviously, they were able to surpass those. Both Nadine and Raya have subjects whose grades went up dramatically. Some grades went down but not very low. Both are second honors and have very good conduct grades.

I was brimming with pride when Raya's teacher commented how Nadine would watch over her sisters in school. Nadine would go to Raya's classroom to check on her and see if she packed her lunchbox properly or if her things are all in order. She has been a very good "ate" to them and I am so proud of her. :-)

Alyssa could have been accelerated to the next level for the 3rd quarter but her teacher and I agreed that it might be too much of an adjustment for her. She can do it academically but emotionally she might have difficulty since there are also adjustments at home. I don't mind leaving her in the Toddler level and wait for her to be ready for Nursery next year. I know she will ace the Nursery level as well.

I think I owe all these also to our yaya Anie who has been great in filling up my shoes in times when I cannot do the things I usually do for my girls. She is really a gem and I thank God for giving her to us.

God's Way

Have you ever tried to collect urine from a baby girl? It is not an easy task. You will have to position the plastic collector in just the right place so that the urine will not spill. Since Cerise needed a urinalysis I was bent on collecting this by hook or by crook.

It took awhile for her to pee. Right before lunchtime, there was a little in the plastic. Just in time! Mier was about to go downtown for a dental appointment. I instructed the driver to send the sample to the hospital's Lab 2. But an hour after, the driver texted that the lab technician refused to accept the sample because it wasn't enough. How disappointing!

The 2nd time we collected by mid afternoon, the urine was even less than the first collection. Much was spilled in the diaper. I didn't even try to submit it. By the 3rd try, I carefully positioned the plastic making sure that it covered most of her labia. At 530pm we were able to get a good amount of sample. Hooray! Since the driver left already for the day, I instructed my Yaya Anie to take a cab down to the hospital. The urine needed to be in the lab in less than an hour or it will stale.

She rushed down in vain. Again the technician said it wasn't enough. They needed 20ml to do a urinalysis, according to her. WHAAT??? Did they expect a 2 month old baby to excrete 20ml? What stupidity! I texted our pediatrician but she didn't reply at that time. I told Anie to just come up. The next day I called up my pedia and told her the situation. "That's crazy!" she said. She told me she will ring up the lab to check it out. I also told the neonatologist and he looked at me incredulously and said that if they are able to get a urinalysis from a premature baby, why not a 2 month old.

I put the urine collector for the 4th time at around 3pm the next day (We went to see the neonatologist that morning) and was able to collect a sample by 430pm. I was hellbent in bringing the sample down myself but since the driver wasn't back from an errand, I was willing to drive downtown myself with all the kids and Anie holding Cerise. But as we exited the subdivision gate, Cerise started wailing. I knew I wouldn't be able to make the drive hearing her cry at the backseat the whole time.

I suddenly just thought of calling up my friend, Yen, who lived in the same subdivision. Her husband was a medical representative and had flexible time although I doubted that he would be home at that time. Lo and behold, he was home! And he was about to leave to go downtown! I asked if Anie could hitch a ride to the hospital and he was more than willing to give her a lift.

Right before he arrived to pick Anie up, I made a spur of the moment decision to go to the lab myself with Cerise in tow. I could just take a cab on my way up afterward. In the car, Dan and I talked and he said that he usually doesn't go home at that time. But Yen was concerned that their water dispenser was leaking so he had to go home even if he wasn't done with his work. I called just in time because he was about to leave for downtown. It was a blessing from God!

When we got to the hospital, only then did I realize that one of the orders of the neonatologist was a blood sugar test for Cerise. It was a good thing that I decided to bring the urine sample myself so I could have Cerise's test done too!

Both the urinalysis and the the blood sugar test came out negative. But I am amazed how everything just came into place. Dan was right there at the right time and we were able to go down to have all the tests done. I think this was God's way of saying that all will be well, that He is in control, that He will take care of us, especially of Cerise. :-)

Anemic

I brought Cerise to see a neonatologist yesterday. Mier and I were so bothered by her condition and we just wanted peace of mind. The visit was very enlightening as he explained to me the basis for Cerise's problem and the steps we are taking to address that.

The probable reason for her failure to thrive is that she is anemic. The neonatologist explained to me that newborn babies cannot produce their own red blood cells until the 3rd or 4th months. That is why they store red blood cells from the mother's last trimester into their system until they are able to produce their own. It is natural for the red blood cells to go down. But in Cerise's case, she also had sepsis (a blood infection) when she was a week old and that deterred her bone marrow to work on the red blood cells all the more. Hence, the anemia.

Right now, she is taking iron supplements 3x a day and a medicine that will help her absorb the proteins and nutrients into her system. Her urinalysis is normal and so is her blood sugar. We will go back to see the neonatologist after 10 days to see if she has improved. He was humble enough to say that they are not 100% sure that it is the anemia that caused the failure to thrive but since that is what is evident now, that is what they will treat. And hopefully it is nothing more serious.

Thank you, everyone, for your prayers. It breaks my heart to see Cerise so fragile. But she is such a happy baby --- always smiling and cooing and never really fussing except when she's hungry or sleepy. She is a fighter and we will all fight alongside her with God's grace. I pray that this episode in our lives will soon pass.