Reflux Theory.

Alright, I'm not going to make any friends with this post, but so far, despite any efforts on my part, I've made few friends with my opinions. This blog is not for anyone else. It is for me. To chronical my days, help me make better sense of my experiences and if it can help others BONUS. If it make you angry then it is your choice not to read it. 

Reflux.

Over the last five years I've encountered 500x more reflux than I did during my first five years of nannying. This makes sense as reflux cases are on the rise. There are literally more cases of reflux now than there were ten years ago. 

Right now, I'm taking care of twins, Jackson and Tabitha. Both born at 25 weeks, both the same size at birth and both adorable. Only one has reflux. Jackson spits a lot.  Tabitha spits the normal amount but it never affects her eating, attitude or growth. Jackson is smaller because of the amount that comes back out. He has trouble with some feedings and at time refuses to eat at all. 

This was also the case with Madison and Addison. Little Miss Madison is tiny, she spit a lot and ate significantly less. Food was always an issue with her, bottles were a struggle and weight gain was slow.

Before them there were another set of twins, just like Jackson and Tabitha, where the little guy had pretty bad reflux. A set of identical twins that also had tough reflux without the weight gain issues. And a sibling pair, not twins, Ethan and Ava who both seemed to suffer from reflux.

Of course after seven children with reflux issues, all different gestations, locations, different people, I've seen similarities. I see one particular stereotype with Jackson regularly. I've verbalized this to Roger and Sara to be poo-poo'd and have it forgotten/disregarded. Yesterday though, it was pretty blatant.

The more tired Jackson becomes, the more he spits. I've noticed this on many occasions. Roger believes the spitting comes from quantity, position, activity, excitement, many other things, but that it isn't predictable and/or avoidable. Because Roger is Jackson's father, we get to go with his theories first, always. Fine. I'm a rather patient person.

About a month ago, Jackson was spitting quite a bit. He was also overtired and having trouble sleeping regular, long periods. But don't think about that, his numbers were up. For me he was taking 220 - 240 mL. Roger decided, convinced Sara, this was the problem. They told me to cut Jackson off at 200 mL. Above that was just too much for him. I did and the spitting continued. Because my theory was just that, we continued limiting Jackson's bottles to 200 mL. After two weeks he visited the pediatrician who said that he wasn't getting enough total volume for the day. We needed to increase his over-all quantity. Sara thought about it and decided the only way we could do that would be to let him eat as much as he wanted at each bottle. About a week ago I was allowed to increase his per bottle volume again.

Surprisingly enough, his spitting didn't increase. But on the nights it was huge, he was really tired. Now, the original decision to limit his volume was based on this late evening spitting. Just a side note. There were no large spits during the day when he was well-rested. 

Alright, now you have the background.

Yesterday Jackson decided that I needed to know when he was ready for bed. Apparently I hadn't been responsive enough on his schedule. After his breakfast he played for a few minutes then let out this terrible screaming-cry. It was awful! I told him it was too early for bed and tried to distract him. He wasn't having it. After almost five minutes of trying, I gave up. This cry was truly awful. I took him to bed. He was asleep within seconds and slept for almost two hours, rather unheard of for this morning nap. 

He woke up, hung out, played, got annoyed, but didn't use that painful cry again. He ate his lunch, played more and BAM! there it was again! So, so awful. I looked at the clock, figured this was late enough and put him to bed. Exactly as before, he snuggled in and went to sleep immediately without complaint. 

He slept another two hors and forty five minutes! While a long nap isn't out of the ordinary for my tomatoes, two long naps, right after each other, are. Jackson woke up happy, relaxed and calm. We had a great time playing. He ate and played for another fifty minutes. 

Of course after two amazing naps he was hungry. He took 240 mL twice, also unheard of for our little dude. But no spits. Even dry burps. I'm not sure if you know anyone with reflux, but dry burps and spit-free post bottle sessions are pretty rare. Then, at five o'clock, he did the screamy-cry. It was so bad! But it was five, too late for a nap. I told him, apologized, but I couldn't put him to bed, it was too late. 

Then, it happened. And happened. And happened. He spit and spit and spit. He'd eaten an hour before and hadn't spit at all, but as soon as he'd become over tired, he started spitting. The spitting continued the rest of the night, well, it had lessened just before I left, but it's likely it continued after I left. He took a bath and fell asleep almost immediately. He was so tired.

Ethan, my other little guy with terrible reflux, never slept. Seriously. This little boy broke his leg as a young toddler and spends most of his life sick. He never sleeps. His diet was outstanding but his growth slow and stunted. He was breastfed well into his first year, actually he was closer to two when his mom weaned him, and fed on demand. But he had the worst case of reflux. Then his sister, also breastfed, had trouble with reflux too. 

From my experience, reflux increases as sleep decreases. As the number of average reflux cases has increased the average amount of sleep has decreased. 

Obviously just having a good sleeper doesn't keep your kid from having reflux, but my best sleepers have had the least trouble with reflux. Sleep increases their growth potential, increases mental health and stability, improves their appetites, refreshes and rejuvenates their bodies, improves and increases their attention spans and brain power plus allows their bodies time to just be, what's wrong with just trying?

Mursday

Yep, it's true. I had to do it. I've created a new weekday name, couldn't help myself. It fits perfectly.

This morning was tough, super tough. It was a Monday morning. Cranky, yelling babies, short naps, over-tired fuss-pots who weren't pleased with anything. Of course we just had to deal, so I pushed their bottle a little later and took them for a walk. Both fell asleep immediately and slept soundly the duration of our walk.

Still tired and hungry when they woke up, we plodded through the feeding and off the little tomatoes went for their second naps of the day. After some strong and loud protests both were sound asleep.

And BAM! it became like a Thursday afternoon. 

Both took beautiful naps and woke up in the best moods. 

Better yet, they woke up 25 minutes apart so I actually had the opportunity to enjoy their awesome moods with some relaxed one-on-one. Giggles, smiles and cuteness prevailed and the afternoon was wonderful.

My first Mursday, I love it.

Evening Excitement

We had quite an even this week. A neighbor tried to make a fire in her fireplace and smoked us out! It was pretty rough. I called Roger and Sara to ask about their location and Roger seemed to be trying to tell me that things weren't as serious as I was suggesting. The funny part of this is that I'm at least 60x more relaxed about emergencies than most. Honestly. I approach things calm, cool and collected because if I were to freak out everyone around me would too.

Roger ended up calling me back a minute or two later to try and learn more. Apparently when he'd hung up the phone Sara told him exactly what I just explained to you. She said, "If Samara is calling it's probably pretty serious."

A few minutes later they arrived home and Sara freaked out. Her babies were born pretty early to be risking the health of their lungs over someone's stupidity. 

Apparently this neighbor has done this before. She knew she'd screwed up and unplugged her fire alarms. Our place was full of smoke and she didn't think she should even check on us our mention it. She knows there are two babies here. And I kept telling myself to relax because there wasn't a smoke alarm, it must have been a neighbor using a wood burning stove. 

Sara called 911 while Roger talked with the neighbor. There was a lot of excitement and a lot of drama. The entire place reeks of smoke. They opened everything up despite it only being in the thirties and colder overnight. We had three fire engines here and at least five fire fighters came tromping through the house. There wasn't a fire just lots and lots of smoke. The babies were tired, it was the end of their day, but held up pretty well. Because we visited with another neighbor while the house was aired we got to see something we probably wouldn't have otherwise. Jackson is developing some stranger anxiety. Tabitha not so much. We'll see how it develops. 

For now though, we're all fine, the smoke smell is decreasing and we're all looking forward to a quiet remainder of the week. Hope yours are equally calm, relaxed and uneventful.

 

Shots, weights, sleepy-ones.

Me, I'm one of the sleepy-ones. I'm unbelievably tired today. 

The tomatoes are fine. Both are a bit of today because of their shots. For all of it's benefits, RSV vaccines can really take it out of them. I'm not complaining, I'm just telling you, both Jackson and Tabitha are feeling it today.

They weighed in at 15lb 6oz & 17lb 13oz, Tabitha being the heavyweight champion. She is also taller 27" to Jackson's 25 1/4", both have perfect weight to height ratios though so they are each perfect for themselves. Exactly what we like to see. Jackson still isn't on the chart for his actual age, eight months, but just below, maybe in the 1st percentile, maybe. Tabitha on the other hand is just below the 50th percentile for weight and just above for height. She's measuring up to other eight month olds even though they spent nearly fifteen weeks longer in the womb. Go Tabitha!

Another week almost over, another month of RSV shots and we're all doing great.

Early Intervention

EI came this morning to check up on Jackson and Tabitha. They came early because it is best for Roger and Sara and only interrupts Jackson and Tabitha's sleep a little. Both the PT and our EI nurse were impressed with the progress the tomatoes have made. Jackson was a little cranky, sleepy this morning but still did an acceptable job. He is a baby so we can cut him some slack, right?

We need to continue working on tummy time, floor time in general and some specific suggestions included side play, to encourage the separation of top and bottom, seated positions, to increase trunk strength, and putting toys in their hands, to increase grasping, opening of fists and toy transfer. Tabitha transfered a toy between both hands while they were here, I was very proud. Roger and Sara haven't even seen her do this yet! Jackson seemed stronger on his tummy, more of his chest and stomach were off of the ground. He was also infinitely more verbal but Tabitha saw plenty opportunities to share her raspberry-type spitting that I so loathe. Much as Sara and our EI nurse thought it was cute. I don't think either Roger or PT agree and I surely don't think it's cute in any way.

Tomorrow morning will be a weigh in and RSV for each baby. I'll come into work late but Norah will join me because she's on Christmas break from school, as of this past Monday, and today is her last workday before she gets a break from that too. I was telling her how the housekeeper received a Christmas bonus yesterday and hoping that meant I'd get one too, she was saying how she definitely won't get a bonus as her work is an unpaid internship. As she gets a three week break I told her, that is a pretty good bonus! Looking at it from that perspective she had to agree!

Wednesday before Christmas!

Yesterday's most exciting news - and I forgot to blog it!!!

Eating together used to be a regular occurence around here. Two babies, two bottles, my two arms and a nice big lap - no problem! But with Jackson having all of these issues with eating, it hasn't been an option in a very long time. I missed it very much. I love those two little sweeties snuggled into my lap, looking up at me with those four bright eyes and holding onto my hands (okay they weren't doing this before but they are now!). It also cuts bottle time in half which leaves more time for playing together before they are both ready to go back to bed. And yesterday it happened! We did it! It was AWESOME!
They were starving and I told them,
"It isn't fair for Tabitha to wait to eat because Jackson has decided he needs to be held just so."
I turned to them, looking Jackson in the eyes, and stated,
"You can wait until Tabitha is finished or we can all eat together."
He looked up at me, screaming what I can only imagine was,
"Just FEED ME!"

And we did it! The three of us sat together with both of them eating, just like in the old days. Tabitha finished first, she'd actually eaten half of her bottle while Jackson and I discussed the situation, after she burped I put her down and finished Jackson in his regular position.

Today? Today was BETTER! Both babies took ALL of their bottles, did all of their burps and enjoyed snuggles together, the whole time! It was great. After we finished we tried, Sweet Potatoes for the first time. They both really enjoyed them. I just baked a sweet potato, skinned it and mashed it with a fork. I thinned it a tiny bit with formula but left it a tad thick to see how they'd do. Sweet potatoes are naturally a little stringy, but they didn't mind at all. I think they liked them more than pears. Hooray! We'll have them three more days then try something new.

Is it really Monday?!

Can it really be Monday?! It feels like Friday. Jackson and Tabitha have napped impeccably today. I'm not sure what to do with myself. All of my well-rested-weekend-energy hasn't been drained from reinstating regular naps. It feels surreal. Talking with Roger and Sara on Wednesday of last week actually made a huge difference and I'm so HAPPY!!! And the babies? They are relaxed, happy and hungry! All of this sleeping, awesome tummy-time and enjoyable social interactions have increased their appetites!

We're getting exceptionally productive tummy-time that I hope continues all week. On Thursday EI returns with the physical therapist (PT) to give us more suggestions and evaluate our progress. Then Friday will take us back to the pediatrician for our second round of RSV shots.