GI Visit
Greetings to everyone.
Late yesterday we got a call from Children's Hospital. The reason was to set an appointment with the GI specialist. Dr. Abbey had, on Monday, made an urgent request that Children's see Xavier as soon as possible. Surprised by the call, Rebecca and I took the opening on Thursday morning.
We visited with the same GI doctor we saw in August, Dr. Shikha Sundaram. We answered many of her questions and explained what brought Xavier to see Dr. Abbey.
Dr. Sundaram told us the white stool is common with babies fighting an illness. Rebecca and I felt a bit of relief. Though we didn't think we held any angst about this, apparently we held a little. Dr. Sundaram also repeated that his growth rate is not where it should be.
The doctor suggested a number of issues for Xavier's slow growth. Several tests were suggested, including X-Rays of Xavier's stomach and upper intestinal tract. During all of this, Xavier was happy, cheerful and flirting with Dr. Sundaram.
We mentioned how Xavier grows distracted while eating, that we generally have to feed him in a dark room, like a sensory deprivation chamber, for him to concentrate long enough to down a whole bottle. When Xavier got hungry, Rebecca pulled out a bottle and he took it. Dr. Sundaram, after tying in some notes, looked up and asked another question. Her voice immediately pulled Xavier's attention away from eating and onto her. "I see what you mean," the doctor stated, then was quiet while Xavier finished.
Near the end of his feeding, Xavier began arching his back, something he does a lot. Dr. Sundaram asked "does he arch his back like that a lot?" That is a sign of an acidic stomach, a condition which puts babies off their feeding. Out (for today anyway) went the X-Rays and in came a prescription of Zantec to see if that will help.
Further, the caloric concentration of Xavier's formula was increased from 26 calories per ounce to 28 calories per ounce. I asked my standard question about having too high a caloric diet, but learned Xavier is past the need to worry about his body getting programmed for high-calorie intake. And, we learned, preemies often need higher calorie mixtures for growth. Because of their early delivery, they generally develop how to use lower calorie milk (like breast milk) some months later than term babies.
After reviewing the lab results Dr. Abbey sent over, Dr. Sundaram told us his liver results look normal. The elevated numbers on some of the metrics are most likely due to Xavier not eating enough. Apparently, it's common to see those particular metrics elevated when a baby is not eating enough.
So, our take-away today was
- Feed him every three hours whether he indicates he is hungry or not (except during his night to morning sleep; it's better for him to sleep a few extra hours)
- Offer him more formula. He has been having four ounces per feeding, now it's four and a half.
- Feed him a 28 calorie per ounce mixture
- Feed him Zantac twice a day
- Have him weight and growth checked in two weeks
Of course, you can't just walk into the doctor's office and not get weighed. Not only weighed today, but length measured and head circumference also. Here are the numbers:
- weight: 11 pounds 3.9 ounces; a 2.7 ounce increase over last week
- length: 24 inches; that is 1.25 inches longer than early December
- Head circumference: 17 inches, an increase of 1.05 inches since November 15th
Xavier plays in his Johnny Jump-up, a new toy he scored from he God parents. He enjoyed it for a few days, but he does not like being confined to it. "Give me the open floor and a scattering of toys," is his cry more often than not these days.