Reflux Redux

After my last post, Olivia slept through the night again two nights in a row.

Then last night? Our entire house was up at 11:30, 12:40-2, and 4:10. So that was fun.

I really do have a point, and it is that I am reaaaaaly tired. And so if this post doesn't make sense, or takes a turn for the bizarre, or ends abruptly? You know why.

Milk and/or Soy Protein Intolerance

Olivia has Milk Soy Protein Intolerance (MSPI). She cannot digest milk and soy protein without lots of abdominal discomfort, and sometimes? Bloody poop. Lots of people have success with Similac Alimentum, or Enfamil Nutramigen, and even Nestle Good Start. These formulas break the proteins down so that they do not need to be fully digested and pass through your baby easily. Like a tidal wave from mouth to diaper, if you want to know the truth. We had shoulder blade high blowouts when we first started Alimentum.

Babies with MSPI can have reflux. And once you get the right formula, you might notice an improvement in reflux issues. You might, but we didn't.

Alimentum and Nutramigen are pretty expensive - I am usually a Similac girl, and to give you a ballpark: Similac Advance was about $14 for a can of powder, and Similac Alimentum was $27.

Being the diva that she is, Olivia still couldn't tolerate Alimentum. And the gastroenterologist recommended Nutramigen AA because it would be easiest on her delicate little guts.

Let's talk about Nutramigen AA Lipil. By those dirty whores at Enfamil.


It is the same type of formula as Neocate and Elecare - elemental, broken down to amino acids. And if you think back to freshman year science class, you will remember that amino acids are the building blocks of proteins.

They are...Very Expensive.

Olivia: Come on...How Expensive Can Baybee Food Possibly Be? Surely You Exaggerate, Mother. You do have a flair for the dramatic.


Heh.

Without going on eBay or Craigslist, the best deal I have found is directly from Enfamil. For $155 a case - a case being 4 cans. So... $38.75 a can? And a can lasts less than a week.

Olivia: Excuse me while I pass the hell out!



But hey! Free Shipping!! Isn't that so very nice?!

I can't believe what people are charging for this stuff on Amazon and eBay. The retail price of this formula is significantly higher - the Walgreen's price was $25 dollars (per can!) higher. People online are selling it for $260 per case! Plus shipping!

If your insurance won't pay, ORDER DIRECTLY FROM ENFAMIL!

I tried to get my insurance company to cover the formula, and I believe their exact words were, "Don't hold your breath." I love their subtle approach. Always so caring about my feelings, those people.

The combination of Freaking Expensive Formula and Prevacid seem to be really helping Olivia. The Ped Gastro just informed us on Friday that she will need said Lexus Formula for an entire year. *gulp*

If you switch to this formula, be warned: it tastes like shit. And that is an understatement. I tasted it, and it tasted so bad that I felt like my taste buds would shrivel up and die forever. Disgusting.

Now, if I may make a swift change in topic, I'm going to post some good links for reflux information:

Infant Reflux.Org Click here.

This is the best place to start. Because if you go to your pediatrician and say "My baybee cries all the time and won't sleep," then you are begging for a diagnosis of colic. Write everything down - what your baby does when - and don't leave that office until someone pays attention to you.

The post linked has all kinds of useful info, but the entire message board is awesome for information about medicine, sleeping, eating, everything.

The Baby Whisperer Forums Click here.

Lots more sleeping and eating information, and a reflux forum. I read this book (two of her books, actually) and have mixed feelings. I will try to review it later because I'd like to see what other people think.

(Review in a nutshell: The author talks about a sleep training method that I have found to be complete bullshit. But I love her routine method, so it's worth a read.)

Marci-Kids Click here.

This website is great - it is the Midwest Acid Reflux Children's Institute. Pretty much the only place doing research on the treatment of GERD in infants and children. They have a dosage calculator and even a memo that you can take with you to your pediatrician or gastroenterologist if you think your child's dose of PPI is too low.


I think someone asked me to talk about how I got Olivia to sleep, and basically the answer is that I AM MAGIC. These are the things I tried to transition her from her car seat (which we were putting inside her crib) to laying down in her crib.

First, I tried inclining the mattress and rolling up a big towel and putting it under the crib sheet to hold Olivia's butt up. She has a tendency to slide down her mattress as if she is at the playground.

Thank you to everyone who recommended this. If I was trying to get Olivia to slide down the mattress and turn sideways onto the towel under the mattress? I would call it a success. (I put this in the FAIL category, but maybe it will help someone else.)

Then, I busted out the Snuggle Nest. I put a giant blanket over it, then rolled towels all the way around it so that the sides came up like the car seat. The Snuggle Nest has a wedge, so she was at an incline.

This worked for about a week, but we still had the scooting problem. She would end up sideways at the bottom of the incline. Laying flat on her back, looking up at me with a mocking smile.

The latest: I have the mattress inclined again (using rolled blankets and towels under the mattress), with a soft blanket on top (tucked in all around so she can't pull on it). We lay her on her side, swaddled. She usually wakes up partly unswaddled and way at the bottom of the mattress. BUT, it seems to be working well for us.

I need a nap.

Reflux for Dummies

I had heart burn almost the entire time I was pregnant.

It started at 6.5 weeks. I was on vacation, and really thought that I may have caught some sort of Mexican fire breathing disease while on our cruise.

After that? I started sleeping in the big comfy chair in our living room. Sitting up like the elephant man. For the next thirty weeks.

No amount of Tums Smoothies could tame the fire breathing dragon living in my uterus (but those things taste like candy and sometimes I still eat them because they don't have very many calories and my thighs are YOUGE and don't really fit in pants).

So I'd like to think karma is biting Olivia in the ass with this whole reflux thing. And normally I'd be really excited to see someone Get Theirs. You know, like when someone rides your ass for 20 miles, passes you, then gets pulled over. Stuff like that.

Knowing what it feels like to have a burning in your chest and throat as soon as you lay down? Makes it so sad to watch your baby writhe in pain while eating or trying to sleep. Many desperate visits to the pediatrician with little to no sympathy left me shaking my fists at the heavens and swearing like a trucker.

And threatening to shove a bottle of Mylanta directly up the pediatrician's ass.

It is possible that you have landed on my blog via Google (and Oh.My.Sweet.Baby.Jesus people come here from the CRAZIEST google searches. I need to do an entire post on that soon - an example? Big Clown Underwear). Perhaps you have searched for one of the following:

-My Baybee Breathes Fire: HALP!
-Why Does My Baby Have Reflux, Does God Hate Me?
-Is It Weird To Be Sexually Attracted to My Pharmacist?
-Will I Ever Sleep Again, If Not Can I Main Line Coffee Straight From My BUNN?
-Mylanta is Bullshit
-My Pediatrician is Useless
-Silent Reflux Is A Stupid Name Because It Makes Babies Scream
-I'm Getting Drunk, Who's With Me?
-Why Can't Dr. Google Prescribe Me Some Prevacid?

I did all sorts of desperate Google searches and found all kinds of really great information. And since I have so many important things that I don't feel like doing, I will sum it up for all you lazy whores out there...

Reflux doesn't necessarily mean ungodly amounts of spit up.

Olivia has silent reflux. She rarely spits up. Instead, the acid comes up her throat and then she swallows it. Because she loves to burn her throat twice?

So. If your baby arches her back and cries while eating (and for hours after), and refuses to sleep laying flat, but doesn't spit up? Be suspicious.

You know how you barf in your mouth sometimes? Olivia would kind of do that, make a sour face, then scream her freaking head off.

Get Thee to a Pediatric Gastroenterologist!

Much to my disappointment, I've found that doctors aren't really brilliant and caring. I mean, if you expect to go to your pediatrician and encounter some person who agonizes all night long over your babies issues? You're stupid. I know this, because I am stupid.

Your pediatrician is probably useless.

Pediatricians know the basics about reflux. They can give you limited solutions, and then will most likely give up, claiming that they've done everything and that it will pass when your baby starts to sit up or eat solids. OR TURNS ONE. And you will just have to deal with the crying (your baby's and yours) until it passes. (Vodka, anyone?)

My experience with my pediatrician ended when I was told to let my 3 month old cry it out because there were no other treatment options outside of Zantac or Pepcid. I had been asking for a prescription for something like Prevacid or Prilosec for over a month and was repeatedly told NO. "NO! Those aren't any more effective than Zantac!" Sensing my rage and fearing for his very life, he then made a call to a pediatric gastroenterologist and got me an appointment the next day.

If loving the pediatric gastroenterologist is wrong? I DON'T WANT TO BE RIGHT. More on my infatuation later...


Zantac is an Asshole.

There are a few ways to treat reflux.

1. The first line of defense: Mylanta and Rice Cereal. The Mylanta is supposed to coat your baby's throat, the rice cereal is supposed to hold the food down.

(Psh. Whatever. I'd like to know if this ever worked for anyone. It gave Olivia HORRIBLE stomach cramps.)

2. Next! Zantac or Pepcid.

These types of drugs are H2 blockers - they are supposed to block the acid from shooting up your baby's throat and causing Screamapalooza.

I've found that this is a temporary solution to a somewhat permanent (in the short term) problem. They are really weight sensitive and need to be increased with weight gain. And they tend to become less effective when your baby takes them for an extended period of time.

Olivia was on Pepcid for a week with ZERO improvement. We switched to Zantac, because we love futility, and that worked for a week, then quit working. Then we'd up the dose, which would sort of work for a week, then stop working. When we finally quit using Zantac, her dose had quadrupled over a month. Stoopid.

3. FINALLY! Prevacid or Prilosec.

Mmmm...the good stuff. Like tasting Grey Goose after living on the $3 bottom shelf vodka.

These are Proton Pump Inhibitors. They mean business. They stop the production of stomach acid altogether. Which makes sense, right? Just shut that shit down! Nip it in the BUD!

We've been giving Olivia Prevacid for a few weeks now, and things for her have dramatically improved. We did have to up her dose once already, but she has gone from eating 13 ounces of formula per day, to 18-20. And she almost never screams and arches while/after eating.

We have also been trying to transition her to sleeping on her back. And I'd write about that now, but I think that it would be better with pictures, which I don't have because I am too busy and important to have taken them already. Plus it's so much more fun to write blogs with impossibly long sentences.

(She was also switched to Nutramigen AA Lipil formula - AKA The Lexus of Formula - and that helped too. More about that later, too, because if this post gets any longer, people will probably come set my house on fire.)

**Next post will finish this up, and will have lots of linky goodness.**

Daycare, Because She Asked So Very Nicely.

I'm not sure if many of you know this, and maybe this will knock your sox off, but I had a baby and then went back to work 9 weeks later!

Crazy!

Since this blog has taken a turn toward the Mommy Blog category, it does seem kind of unusual that I didn't post about my return to the land of the gainfully employed.

Do you know why?
Because it all went down without incident. That's why.
But someone asked for me to write about this to ease her anxiety about her upcoming return to work. And since she asked so nicely...

The expected thing to feel, I think, is misery upon return to work.

You are supposed to cry the entire drive, and run to the restroom periodically throughout the day to wipe your snot and reapply mascara.

You should call the daycare provider no less than four thousand times to check on your baybee.

Your drive home should be no slower than fifteen miles above the speed limit (because the speed limit is lame anyway and doesn't apply to new mommies returning to work).

I really wasn't miserable about returning to work. Was I excited? HELL NO! I was not excited at all. But the fact of the matter is this: We love my paycheck, and since I have to work to get said paycheck, then I need to go to work. There is no option in my mind. So it was kind of inevitable - like going back to school in the fall, or getting a urinary tract infection after drinking too much pop.

Don't get me wrong here. I am not one of those If I Won The Lottery I Would Still Be Doing This Same Job type of people.

Because you know what? If I won the lottery? I'd be on my big fat ass, in Hawaii, drinking something alcoholic out of a coconut and watching the baby play in the sand while a handsome muscular man fed me fresh grapes.

So. Anyway. I have to work and I don't feel bad about that. I don't aspire to stay at home, ever. Which tempts me to go off on a tangent about the way that people address each other regarding the work/stay at home choice. But that is way over done and so I will skip it.
(You are welcome.)

(But I can't promise that I won't write about Jon and Kate.)
(Seriously, Jon Gosselin. You are a douche.)
(And: Team Kate!)

On my first day back to work, I was lucky enough to have my lovely mommy come to my home and watch Olivia. So I suppose having her there made the transition much easier. I simply handed Olivia to her grandma and went merrily about the rest of my day.

The first time I took her to the sitter (we decided against the daycare center because of all of the reflux issues she was having), it was all very uneventful. The sitter picked her up, and Olivia smiled at her, and I left feeling pretty OK about the whole thing.

Work ZOOMED by. When I walked into the office, my first thought was, "OMFG, I have no idea what I am supposed to do." It took that entire first week to get back in the groove. But much like Stella, I did get my groove back, and fell into a comfortable routine with baby, sitter, work, baby, husband, zzzzzzzzzz. Rinse, repeat, until I've wished away my entire week for the weekend.

I don't really feel guilty for saying that it is nice to have my hour lunch break every day. It is nice to return emails and phone calls without feeling guilty about everything I would be putting off at home to do those things.

Do I miss Olivia? Well. Does a bear shit in the woods?
(Yes, a bear does shit in the woods. And yes, I do miss Olivia.)

I suppose I could sit here every day at beat myself up over all of the time that I miss with Olivia when I am at work. But I simply choose a different way of thinking. I think of all of the fun things that we can afford to do for and with Olivia because of my work. And the big fat college fund we will have for her some day. And the big fat retirement fund. And the awesome medical insurance. The ability to take vacations, and have girls day out, and whatever else we want to do.

Without worrying about money.

So, since you asked so nicely, I will tell you my opinion: it is only as bad as you make it.


**insert clever segue here**

Thank you for the sleep advice! Don't you fret - I plan a lengthy post of woe and heartache. And PHOTOS!
As soon as I load the 360 pictures on my camera onto the computer.
Olivia might be, like, 7 by then. But at least you will know what happened!

Need Sleep Advice

Warning: this post will suck and only serves the purpose of me asking for advice for Back Sleep Bootcamp starting tomorrow. I could have posted it earlier, but I am a busy whore.

Olivia is on Prevacid and hasn't had any reflux pain episodes in two weeks (YAY!). She is not comfortable in her car seat anymore - this morning I went in her room to find that she scooted her head all the way down by the butt part of the seat. And I was all "I'm totally the Mother of the Goddamned Year." She twists and fusses in the car seat now.

But for special added fun? She isn't a fan of sleeping flat, either. She will sleep on her side for an hour and a half, which is just fine for naps. But my ass does not want to get up every hour at night. I've gotten used to her sleeping through the night.

Here's what I need, Internet friends:

If you were in a similar situation - a carseat/bouncy/swing sleeper transitioning to side or back sleep, how did you handle it? If you have any advice or tips, I'd love to hear them. The Internet is always way smarter than I.

I am kind of following the Baby Whisperer method. We are still using shush pat, but if it doesn't work, I bust out my Happiest Baby on the Block moves. If she cries after she's laying down, I try to calm her in the crib and only pick her up if she is really upset. She is a stellar night sleeper - 11-12 hours every night - but her naps are kind of rocky. Some days good, some days bad.

I am off Thursday and Friday this week and am hoping to focus on the back/side sleep all weekend. Cold Turkey Carseatless, if you will.

Halp!


**Edited to add stuff**

The elevation of the mattress has been a colossal fail thus far. She is a wiggly sleeper and ends up scooting all the way down. We even have one of those little Snuggle Nest things, and she scoots down that, too.

I'm not opposed to belly sleep, but Olivia is. She hates being on her belly and since she's learned to roll over, she's all "screw this" and just rolls to her back. Believe me, I've tried, because she has great neck control.

I do not strap her in the carseat, because she requires a swaddle for sleep and that doesn't work. And why do the SwaddleMe's even have that butt hole? USELESS!

The Happiest Baby on the Block

This book could also be called: The Most Sane Mommy on the Block

Seriously? This book should be required reading before you are allowed to leave the hospital with a baby.

I'm pretty sure that I was vaguely aware that babies cried sometimes. That is, babies other than mine. My baybee was never going to cry. And if she did? I would need to just pick her up and that would calm her. Other people's babies cried and fussed all day and night, but not mine.

Anyways.

The reality is that I had no idea how to calm a baby. I had no idea that babies, after the first few weeks, need help calming and falling asleep. I didn't understand what people meant when they said that the first six weeks suck. It wasn't until I started referring to Olivia as an Asshole in casual conversation that I truly understood the suck that was the first six weeks.

I spent a lot of time rocking, bouncing, pacing the floors. Begging. Reasoning with my 5 week old...PLEASE JUST SLEEP, GAWD!

At the recommendation of my pediatrician, I turned to my best friend in the entire world: Google. The 5 S's search hooked me up with this:



I read the book in one day. I watched some You Tube videos of the method and some interviews with the author, Dr. Harvey Karp.
And then my life changed for the better.

Dr. Harvey Karp - Jennepper's Pick for Sexiest Man Alive



He does have nice teeth, doesn't he? I love him. Like fat kids love cake. More than that even.

The whole point of this book is to calm your fussy baby using The Five S's:
Swaddle
Side/Stomach
Shush
Swing
Suck

I'm sure that you've tried at least one or two of these with little to no success. ME TOOOO! But the thing is, you have to do it a certain way for it to work, and you pretty much have to do all of those things at once.

Let me describe it to you New Kids On The Block Style:

Step 1: We Can Have Lots of Fun!

Wrapped up like a delicious baby burrito, that is!
Your baby will scream at you like you are the Satan himself. Just keep going. Swaddle that screaming little shit, really really tight, and then move on to step 2.

We use the Swaddle Me blankets, because we need Velcro to keep Olivia in burrito prison. No matter how tight we swaddled a receiving blanket, screaming Houdini would bust free. Whatever you do? If you want sleep? Make that swaddle tight.

Step 2: There's So Much We Can Do!
While laying on our side/stomach!
After you strap your baby into its straight jacket, turn her over on her side - all the way on her side, almost so her belly is leaning forward. When Olivia was little, I could do this standing up using one arm. Now that she is a 10 pound heifer (ha!), I put my thighs together and lay her down with her butt against my belly and her legs on my side.

Step 3: It's Just You And Me

Or so your baby will think since you will now shush in her ear so loud that it's impossible for her to hear anything else! You shush as loud as she is crying. You get get softer as she calms down, but keep it up for as long as it takes for her to be completely calm for a significant period of time.

Step 4: I Can Give You More

So this lyric doesn't really follow the method, but too bad because I'm too far in to back out.
The next S is for Swing. Sway. Shake. Stuff like that. There are a few different ways to do this. You can calm the baby with swaddle, side, shush, then plop them in a swing on the fastest speed. Or you can shush and sway.

Or, my favorite, you can jiggle the baby's head. Really light and quick, like you had too much caffeine. Or, as Dr. Karp says, "like jell-o on a plate."
Now that you think I'm crazy, here's a YouTube video I found. And interview with Dr. Karp, where he demonstrates this entire thing...



Step 5: Don't You Know That The Time Has Arrived

For you to suck it!
Or, more accurately, for your baby to suck it.
Once you have the baby all calm and jell-o-on-a-plate-y, you can give them a pacifier, finger, or delightful nipple to suck on.

Here is another video that I found, and I thought these people were funny. Plus, they actually calm a crying baby, and not some well-behaved fame whore like on the talk show in the first video.



So. Do this.
Live it, love it, and dream about it when you actually GET SOME SLEEP.


The happiest baby on my block:

This post is brought to you by: obligation.

Or: In which I brain fart in your general direkshun.

Or: Things I was thinking about when Olivia woke up at 2:30, 3:30, and 4:30 a.m.

A wise man once said, "Happy Wife, Happy Life."

And I know what you're thinking - there's no such thing as a wise man.

But I read this book one time, and I bet you won't believe this, but in this book there were THREE wise men! In the same place at the same time!

And if you think that is crazy, get a load of this: these guys knew enough to get gifts when a baby was born!

Now, I'm not sure if the author(s) left the part out about how the wives of these three wise men actually did the shopping because seriously? Don't the women always have to do the shopping? Because I never see men in Bath and Body Works around Christmastime picking out hand soaps for their mothers. Or scouring the aisles at Target trying to find baby registry items.

(Seriously, Target? What is UP with your registry? It blows. And it pains me to say that because I love you, Target. I do. But your registry (and your return policy) blows a big fat fatty.)

Another possibility is that they knew they needed to bring gifts for the baby but didn't have time to shop, so they totally regifted at the last minute. "Hmmm...what should I bring? I have that old frankencense from Aunt Edith, I suppose I could just take that."

There are so many more believable things in this book, like a talking fire bush and a dude who lived inside a fish for three days.

But a man who brings baby gifts? I'm not buying that.

(It is quite possible that I will post a real, not ridiculous entry somewhat soon.)
(Possible but not definite.)