Well after a week of no vomiting on the formula, Gabrielle started it back again. At least once a day she will throw up a good portion of one of her bottles. She has taken a few oz awake which is a start, but it is not consistent. Mom and dad were really hoping she would be better so that she would not need the endoscopy. No luck. She is scheduled to have it done Wednesday, Dec 5th. Hopefully it will give us some answers so we can get Brie eating better.

On a positive note, Brie is making forward motion. It is more like an army crawl, but she is getting better at moving forward every day. Of course just in time for the christmas tree. Looks like I am going to have my hands full keeping her away!

Visit at Chop's feeding clinic

Well today we went to chop. After evaluations with the nurse practitioner, speech therapist, occupational therapist, and nutritionist they all agree that there is some medical reason why she is not eating. The think an endoscopy is the way to go. This is a test where they put Brie to sleep and look at her stomach with a camera. They can take biopsies to see if she has an allergy to milk or if there is any inflammation. After talking to the GI doctor on Monday she is scheduled for the test Dec 1st. We also switched her to a hypoallergenic formula. Since we have made the switch she has not vomited and seems pretty happy. I think the taste is quite different then breast milk, but she seems to be getting used to it. Yesterday for the first time in a week she actually took 24 oz. Prior to that we were averaging about 16 oz. I also weighed her last night and she was 14 lbs 10.5 oz so she is back where she was a week ago. Hopefully this new formula does the trick and we can get our little girl feeling better. We are going to progressively make it 24 calories per oz rather then 20 so hopefully that will help with weight gain.

Well after many weeks of slow weight gain, Gabrielle lost weight this week. She was 14 lbs 6.5 oz yesterday. Maybe the doctors will start listening now. Every doctor we see says she is gaining weight so she is doing okay. The last few days have been really bad. She has not been sucking on the bottle at all. She has also been vomiting at least once per day. The vomiting is an entire bottle at time. All day since Wednesday she has been gagging and trying to make herself vomit. It is so frustrating. Otherwise she seems well and is playing with her toys and has completely perfected sitting independently. She loves to sit and pull all of her toys out of the basket.

We did try to give her a new formula, alimentum at the GI doctors suggestion. She would only drink 2 oz at a time and that is when this gagging started. It smelled horrible so I can understand why she did not like it. We abandoned it after one day. On Wednesday we go to CHOP to their feeding clinic. Hopefully they will have some help for us. I am afraid if we keep going like this she is going to get a feeding tube.

Yesterday was the day for doctors. Gabrielle got her second synergist shot which went well. She had to get two because of the amount. She was a little bit fussy yesterday, but it may have been all of the running around to appts. We also went to the GI doctor. Her feeding is no better and it has been getting harder to feed her during the night. She just refuses to suck on the bottle. So the new plan is to switch her to a hypoallergenic formula and see if she is allergic to her milk. The doc said that there are generally 4 reasons babies refuse bottles: pain from reflux, milk allergy, uncoordinated suck, and behavioral. We want to rule out the first 3 before we just try and stop the dream feeding. The GI also suggested that we contact our local early intervention to have a speech therapist come out and evaluate her suck and swallow. She does choke often while drinking so maybe there is something to that.

Today will be the first day of the new formula. Hopefully she will take to it. I am still going to keep pumping for now and freezing my milk in case she does not tolerated it or it doesn't help. I have been getting pretty tired of pumping and would like to transition her to just formula. It is nice to give her the antibodies in breastmilk, but pumping every 3 hours for the last 8 months has gotten old.

At last weigh in on Friday Gabrielle was 14 lbs 9 oz. She is slowly gaining so we are getting enough calories into her. She is gaining in length and her head as well. At the doc yesterday in 6 weeks she grew 6 cm! I did not ask what her measurements were, but i can tell she is getting longer. Her 3-6 month clothes are getting short. Also her head is in the 25% for her actual age.

Gabrielle had a nice weekend. Aunt Shelley and Grandma Bert came for a nice visit. I think everyone had a great time. Daddy even had off on Monday because of the holiday so we got to spend the day together as a family.

RSV

Just thought I would post so info about RSV. Many of our friends and family wonder why we are so careful about bring Brie out in public. Well this is why:

Some facts about RSV and prevention:

The Season: In the northern hemisphere RSV outbreaks begin in November, peak in January or February and end at the end of March but may last through April In the Midwest US, the RSV season tends to last through April
The infection: RSV is highly contagious After RSV infection, many children will have recurrent wheezing which usually diminishes in later years Almost all children are infected at least once by age 2 and re-infected throughout life RSV infection in older children and adults manifests as an upper respiratory tract illness such as the common cold, runny nose, etc In high-risk infants and immunocompromised patients, or elderly in can be a much more serious infection involving the lower respiratory tract
The epidemiology: It is the leading cause of lower respiratory tract infections in infants and children worldwide It is the most common cause of hospitalization in the US in children 1 yrs of age Majority of children requiring hospitalization are 6 months of age leading to almost 2,500 deaths per year National hospital costs annually from RSV are $400 million
Risk of infecting others: RSV can persist on environmental surfaces such as furniture for many hours and for a half-hour or longer on hands The incubation period ranges from 2-8 days (so if you caught it and don’t have symptoms yet, you don’t realize you have it, but can still pass it on especially to high-risk infants) Viral shedding may continue for 3-4 weeks especially in young infants and immunocompromised patients
Prevention: Careful hand hygiene, avoiding sick contacts, avoiding crowds, avoiding public places such as grocery stores, limiting visitors and avoiding school aged children are the most effective methods in preventing infection All high-risk infants and ALL CONTACTS should be immunized against influenza (don’t forget to get your flu shots) Synagis does not prevent infection, but it reduces the severity of infection

Gabrielle slept in her crib in her own room for the first time last night, without incident. Previously she slept in the pack-n-play in our room. Gabrielle is also sitting now--10-20 seconds at a time before she topples over. She's especially successful at sitting when watching TV--something we stive to avoid--and she loses balance more easily when manipulating a toy. Jen and I were both home today--a rare occassion. We took the Peanut for a walk in the park.

Well the new medicine is a flop. Gabrielle has a very sensitive tummy it seems. With every dose of the medication she vomits it back up. We tried giving it to her on an empty stomach, on a full stomach and even mixed it in a bottle. After 45 minutes of fighting with her I finally got her to take a bottle tonight and about 5 minutes later she gave the entire thing back to me right down the front of my shirt. So after 3 days of vomiting we are finished with the medication. We did not even get to the recommended dosage!
Brie's weight tonight was 14 lbs 5.5 oz. She is up 3.5 oz from last week. I am actually surprised she gained anything with all of the vomiting. Hopefully now that the medication was stopped she will at least be able to keep her bottles down.

Gabrielle was cute as can be in her little caterpillar costume for Halloween. She met a few of our neighbors when she went trick or treating. Last week we tried to get some professional pictures taken in her costumes and she wanted nothing to do with that. I did take some at home which are pretty cute. They are up on snapfish for all to see.
As for her eating we are doing no better. On tuesday we went back to the feeding clinic. They added another medication, erythromycin, to help with gastric emptying. It is typically used as an antibiotic, but in low doses it causes the stomach to empty. The theory behind it is that her stomach is never empty so she does not get the cue that she is hungry. Hopefully it helps. I do think she gets hungry, but is still afraid of the bottle. We have also started on solids. She seems to like eating with a spoon. So far she has had bananas, squash, avocado and sweet potatoes. Right now our goal is to get her to take enough solids so that we can cut out at least one of her bottles and we are working on a sippy cup.