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State of the Menagerie - Karen's Musings
Random Rambling
State of the Menagerie
So far, things are going pretty well, though we do occasionally have nights in which we wish we were able to sleep more. Last night I was up from 2 until 5am which would have been fine, but at some point, Ellie's heart monitor started beeping incessantly and I finally figured out it was because it had come unplugged from the wall and the battery had run down. I couldn't get it plugged back into the wall and Seth was so out of it it took a long time to get him to figure out how to plug it back in (he needed to get behind some furniture to make it happen). It was all kinds of fun. Yeah. Eventually the infernal beeping stopped and I went back to feeding babies and Seth went back to sleep. Fortunately, last night was not a normal night.

The days are all pretty much the same as the next... I basically feed the babies, change the babies, sometimes bathe the babies, pump, feed the babies, change the babies, do laundry, pump, feed the babies, change the babies, pump, eat, feed the babies, change the babies, pump, etc. Some days a pediatrican appointment is thrown in there just for fun. Last Tuesday I took all three babies to the pediatrician all by myself for the first time. The catch was that I couldn't bring a stroller because I had a rented van (my van had been hit by a drunk driver on Halloween while it was parked on the street and was in the shop) and the triplet stroller wouldn't fit in the van I was renting!! (Nevermind that the triplet stroller wouldn't have fit through the hallways in the doctor's office anyway) So I wore one baby in the Moby Wrap that arosoff gave me and carried the other two in their car seats. This was totally manageable until you added in the diaper bag and Ellie's monitor, which made the balancing act slightly more precarious, but that's okay... I still made it work.

The appointment went well. The appointment was ostensibly a weight check for the babies, but the rest of the appointment was with the nurse practitioner/lactation consultant to deal with some of the feeding issues they've been having, which was really helpful. They had all grown, but Ellie less than the others. Sam was up to 6lb, 2oz (up from 5lb, 4.5oz two weeks prior), Ellie was 5lb, 12 oz (up from 5lb, 6 oz), and Abby was the winner at 5lb, 7oz (up a whole pound from 4lb, 7oz!!). Ellie had only gained 6oz in 14 days. Babies at this age are expected to gain about an ounce per day, but the minimum acceptable weight gain is half an ounce per day and she was just under that rate. So the NP wasn't worried yet, but definitely wanted to keep an eye on it. By Sunday I was sure she still wasn't growing, so I called in during call-in hours and brought her in to be weighed. Sure enough, she was still 5 pounds, 12 ounces. Since she was hungry (FINALLY...she tends to go on hunger strikes) I fed her there in the office and weighed her again just to make sure that she really was actually nursing effectively. She definitely does nurse well, because she ate almost 4 full ounces! So that's not the problem, but we don't know what the problem is. We'll go back on Thursday for their already-scheduled appointment and check again. If she's still not gaining weight, we'll talk about other options. Sigh.

In other weird news, Abby was approved for Synagis, the RSV vaccine. Sam and Ellie, however, were still denied. This is a bit weird and troublesome, because it's a monthly shot for the season, which means dragging two non-vaccinated babies into a doctor's office with sick children and germs for Abby to get her vaccination. Even the doctor wasn't sure what the best course of action was. Ultimately, we decided that the babies will be there so often anyway for their regular check ups that it's worth the risk since Abby does have a slightly higher risk of getting RSV, but it's still a phenomenally stupid decision on the part of the insurance company.

I have to go... Ellie is crying and that's not normal. She's normally my quiet one. Later I'll try to update about how Julian's doing.
21 comments or Leave a comment
From: proudestmom Date: November 13th, 2007 08:09 pm (UTC) (Link)
you are amazing! mazel tov and a lot of nachas from them!
estherchaya From: estherchaya Date: November 17th, 2007 11:51 pm (UTC) (Link)
Thanks! Things are going well so far.
rlitterst From: rlitterst Date: November 13th, 2007 08:38 pm (UTC) (Link)
It's good to hear how things are going. Keep up the good work!
estherchaya From: estherchaya Date: November 17th, 2007 11:51 pm (UTC) (Link)
Thanks. So far, so good.
kressel From: kressel Date: November 13th, 2007 08:52 pm (UTC) (Link)

Does this mean that your son DID have a bris?
estherchaya From: estherchaya Date: November 17th, 2007 11:51 pm (UTC) (Link)
Yes, on October 26th: http://estherchaya.livejournal.com/362365.html

He is Shmuel Mendel, named for Seth's grandfather Samuel (we don't know his Hebrew name) and Seth's father Yerachmiel Mendel.
(Deleted comment)
estherchaya From: estherchaya Date: November 17th, 2007 11:45 pm (UTC) (Link)
Thanks. She had gained a few ounces by her next appointment on Thursday. Hopefully she'll continue to gain. Her weight gain (or lack thereof) seems to be specifically influenced by her hunger strike pattern... she has periods where she simply refuses to eat and there's no convincing her otherwise. Fortunately, she seems to be out of one of those cycles right now.
mrn613 From: mrn613 Date: November 13th, 2007 10:33 pm (UTC) (Link)
How much does Sam or the pump usually get from that breast at a sitting? Some LC's have digital scales you can borrow. If she drinks adequately but isn't gaining weight, I'd bet she isn't getting enough calories/ounce. Too much foremilk, not enough hindmilk.
estherchaya From: estherchaya Date: November 13th, 2007 11:33 pm (UTC) (Link)
I alternate which breast I put her at, and I don't consistently get the same amount pumping ... it depends on the time of day. At that time of day, I probably would have gotten about 3 ounces from that breast if I'd been pumping. I've never weighed Sam after eating, because his growth has never been an issue, so I don't know what he gets.

I think Ellie's issue is less about foremilk vs. hindmilk and more about the number of feedings. She goes on hunger strikes where it's very difficult to convince her to eat for hours on end. On Sunday when I took her to the doctor, I hadn't been able to convince her to eat in about 6 hours, though I'd been trying to get her to eat every two hours through the night. When she doesn't want to eat, she won't take either breast or bottle. You can't even prop a bottle in her mouth and let it dribble into her... most babies will instinctively swallow even if they are sleeping...she won't; she chokes (the lactation consultant had recommended trying the bottle propping thing since she was sleeping through feedings, but it obviously didn't work).

The question I have is WHY does she go on hunger strikes? She'll eat normally (not ravenously) for a day or so, and then go on hunger strikes for two days where you can't convince her to eat more than every 6 1/2 hours or so. That's not nearly often enough for a baby of her size, but no matter what I've tried, I can't get her to eat when she doesn't want to.

Sam is her polar opposite. He NEVER stops eating. Ever!
mrn613 From: mrn613 Date: November 14th, 2007 02:25 am (UTC) (Link)
One of my children is/was like that... we are still dealing with the ramifications of it until this day (literally today). She weights 26.5 lbs at 4.5 years old. I suggest you nip it in the bud because once they develop a tolerance for hunger and/or develop food aversions it is a hard cycle to break. If I had to do it all over again I would definitely have tube-fed her.

When she was an infant we fed her 26 calories/ounce formula.

We still don't know exactly what is wrong with her. A lot kids with that eating pattern have Russell Silver Syndrome. It is still possible she has this, sometimes it is a diagnosis of exclusion. Another common cause of this eating pattern is CF, even heterozygous CF can sometimes cause it.
estherchaya From: estherchaya Date: November 17th, 2007 11:43 pm (UTC) (Link)
We give Abby 22 calorie fortifier added to expressed breastmilk. I've heard of 22 and 24 calorie, but never 26 calorie.

Ellie did improve by her appointment on Thursday. She was 5 pounds 15.8 ounces (rounded up to 6 pounds even). Admittedly, she had just eaten half an hour before that, so I take that number with a grain of salt, but still... The doctor wasn't worried about her growth because although she's slower than the other two, her growth is consistent with her eating pattern and her head circumference has grown consistently which he felt was far more indicative of how she was doing. If she had lost weight, he would have been far more worried. Fortunately, she's also been much more consistent in her eating pattern and hasn't been having so many hunger strikes which makes me happier.
gishmak From: gishmak Date: November 13th, 2007 11:34 pm (UTC) (Link)
wow! may they continue to grow & strive!
I would have loved to see a picture of you taking all 3 to the dr. how you described! Sounds like great exercise!
estherchaya From: estherchaya Date: November 17th, 2007 11:33 pm (UTC) (Link)
It was definitely good exercise... I used the double snap and go last the next time I took them and wore the third baby in a sling. That was a much easier way to do it!
skatured From: skatured Date: November 14th, 2007 02:27 am (UTC) (Link)
So good to hear everything is going so well. :D You make having multiple babies look easy.
estherchaya From: estherchaya Date: November 17th, 2007 11:32 pm (UTC) (Link)
I think I just have lower standards. ;)
rquintilian From: rquintilian Date: November 14th, 2007 05:08 pm (UTC) (Link)


You ROCK. I finally got around to adding you as a friend after bugging Jeanne on a weekly basis asking how you were doing :o) If you remember me, we met at Jeanne's a while back, then I saw you at Jacob's birthday party.

Congratulations on your birth, and I'm SO delighted to hear you're breastfeeding is going well. Amazing!
estherchaya From: estherchaya Date: November 17th, 2007 11:31 pm (UTC) (Link)

Re: *Wave*

Thanks! I've been meaning to add you all summer, but never got around to it... so now I've added you as well. :)

Breastfeeding is going just fine for Ellie and Sam, but Abby still won't latch on. She did fine in the NICU and got home and decided she wanted nothing more to do with it. I haven't given up though. We'll see. She was my tiniest one (2 pounds 11 ounces when she was born) so it's not shocking that she's had the hardest time. They still all only get breastmilk anyway, so that's the important part, even if it is more of a pain in the neck to give her expressed milk. Sigh. (I should get used to it though, because I have to go back to work eventually and that'll be the deal with all three of them!)
kalki From: kalki Date: November 16th, 2007 01:25 am (UTC) (Link)
aww, I'm so happy to read a post from you! I hope that things continue going well. I love reading your updates :)
singwa From: singwa Date: November 17th, 2007 11:19 pm (UTC) (Link)

Missed You!

I haven't been able to get onto this site at home cuz my koshernet blocked it and I decided not to pursue it cuz I don't have too much time anyway these days but I sure do miss all your entries-- all of you!!!

Anyhow-- cld u fill me as I have like 25 more seconds on this computer (FIL's!) What did you have and when?????!!!
estherchaya From: estherchaya Date: November 17th, 2007 11:26 pm (UTC) (Link)

Re: Missed You!

I had two girls and a boy.... Avigail Nechama (Abby), Eliana Miriam (Ellie), and Shmuel Mendel (Sam) on September 19th at 33 weeks. They are all home and doing well, B"H. You're welcome to email me directly for more details. :) estherchaya@livejournal.com works.
greenquotebook From: greenquotebook Date: December 21st, 2007 07:55 pm (UTC) (Link)

A bit late, but...

If you still haven't gotten the RSV shots approved for Ellie and Julian and want to try, email me at the address in my profile. Getting insurance companies to do things is a specialty of mine. In case you're wondering, yolen pointed me in your direction.
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