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.

Finally some good news

Gabrielle finally had a good test result today. She was able to get her hearing screen today. They sedated her for the one hour test and she came out smiling. Her hearing is 100% normal in both ears. Marcus and I were not really worried about it because she responds well to sounds, but it is nice to have the test to confirm it. She is still a bit sleepy from the medication, but hopefully it will wear off soon.

As for her eating, she still refuses to eat while she is awake. I am waiting for the doctor to email me back. They are likely going to start her on a medication that decreases the amount of time food is in her stomach. It is getting more difficult to feed her while she is sleeping. Brie is difficult to get to sleep and now she just stops sucking on the bottle. She did not gain anything this week she is still 13 lbs 2.5 oz. We added the fortifier back to her milk. We were trying a lactose free formula, but she really disliked the taste. We do see the local GI doctor on Friday. I really hope we get this straightened out soon. I hate that the reason she refuses to eat is because she is in pain. I feel so helpless.

Gabrielle has had a busy few weeks. Last weekend Aunt Shelley and Grammie Smithgall came to visit. We all went to a pumkin patch and Brie had a good time on a hayride. She got her first pumpkin picked out by daddy. This weekend Aunt Cindy, Linda and Grandma Bert came to visit. I think everyone had a good time. Brie entertained everyone for many hours.

As for her eating, Brie is doing no better. We went to the feeding clinic last week. They increased her dosage of Prilosec and we got a new prescription of it from a special pharmacy. It cost $170 so hopefully it helps. We also increased her Mylanta to help with any excess gas and breakthrough acid. Thirdly, we changed her formula and I stopped adding formula to the breastmilk. It is less calories now, but the hope is that she will more to make up for the decreased calories. So far we have not seen a change. The doctor wants me to call or email this week to let her know if there is any change. If we see no improvement we are going to try a medicine that increases the emptying time of the stomach and is also an appetite stimulant. At her last weigh in she was 13 lbs 2oz so she is still gaining on the little he is eating, but it has slowed down.

Finally, Gabrielle will be getting synergist shots starting this friday. They are helpful at preventing RSV, which is a virus that can cause serious illness and even death for premature babies. Now that winter is almost here we will be keeping Brie inside alot more in attempts to prevent any illness. She has come so far, we do not want illness to set her back.