October 16, 2013

Underweight

Tomorrow we're heading to Columbia, the state capital, to meet with an oral surgeon who will revise Noah's upper lip and tongue ties. I like that they call the procedure a "revision" and not a "fix" - I didn't break him or make him wrong, he just needs some additional help.

I'm very, very nervous. I know it's a simple procedure and all, but still, he's my baby, and in case you haven't realized in the three years of this blog ... I'm tend to worry a lot.

We're lucky that we got an appointment this week - there are no classes this Friday and I was excused from the meetings I was supposed to attend to give Noah the full attention he's going to need. Bottles may be uncomfortable for him at first, so it'll be great to be able to nurse him as he needs.

After the surgery, Matt thinks we should try and see the city since we're driving all that way to get there, but honestly, I'm hoping to just come home and help my baby convalesce a bit - he will likely bleed a bit, and nursing will be a new challenge. He basically has to relearn how to suck all over again since he's never properly used his top lip or his tongue. We'll see the lactation consultant for some physical therapy after - just some simple exercises and stretches for his mouth.

Once it gets fixed, nursing will be a bit uncomfortable at first, but then it should get easier and my milk supply should increase dramatically - the sources the lactation consultant offered said an increase of at least 30 oz per day can be expected. That's more than twice what we figure I'm making now.

And it can't happen too soon.

Since we moved so quickly back in August, I didn't have time to get Noah's medical records from the clinic where we went for his checkups. This proved to be a big problem when we went to find a pediatrician here in South Carolina. We finally got an appointment and saw a doctor yesterday - so, his 4 month appointment took place when he was 5 1/2 months. Frustrating, but better late than never.

He's a tall boy - 26", up from 19 1/2" when he was born. The only concern the pediatrician (and the lactation consultant) had was about his weight. At his 2 month appointment, Noah was in the 48th percentile for weight - perfectly average. This week, he measured below the 15th percentile. He has gained weight, but not enough. He should be a bit bigger by now - a little more than double his birth weight. At 14 lb 4 oz, he's about a pound and a half shy of where he ought to be.

The concern is low - it's not that he can't grow, because he did get taller. He's just not eating enough, and that's something we kind of already knew - the issues with his mouth affect how much he eats, which in turn affects my milk supply. The doctor's suggestion was to up solid foods to twice a day instead of just once, and we'll see how it goes.

I know the lip tie isn't my fault, and that I'm not a bad parent because my baby needs a little special attention. Still, I have an awful feeling over the fact that Noah is struggling with his weight.

I'm not underfeeding him on purpose, of course not. We feed him as much as he wants, whenever he wants. The kid loves food - so far, he really has only shown a dislike for peas, and even those, when mixed with other fruits or veggies, he's fine with. He gobbles it down like a little champ. Nursing has absolutely not been easy, especially with my transition from staying at home with him to being a working mom. But we've made do, and he isn't being deprived, not at all.

But I know long-term, this is something I'm afraid of. As someone with my fair share of food issues, and as someone married to someone with his own food issues, I'm absolutely terrified that Noah will inherit our food-related neuroses and disordered habits. I've struggled so much with my weight and with my eating habits, both on the too-much and too-little sides of the spectrum. I don't want my son to suffer the same way. I wonder if, for him, it will be "just food," the way I wish it were for me, rather than an obsession or something that I am constantly aware of and compelled to binge on or restrict.

The debate goes on whether nature or nurture has a greater influence on this kind of thing. I can't take back what we've already given Noah genetically. All we can do now is offer is a positive environment and an example through our own healthy relationship with food. It's going to take a considerable effort on our part - he's still quite young, but you'd be amazed how quickly he picks up on things. How small things get noticed - little actions, little behaviors. He's a sponge. So, we need to offer him a positive model. It's not just about losing weight now, but about maintaining a healthy lifestyle for ourselves and for our son.

In the meantime, he just needs to keep being a happy, healthy little boy - and likely the only one in either family who's ever been told "you really should try and eat more."