Well Visits

Freddie at 2 years, 8 months:
Stats:

• Weight: 27 lbs (15th percentile)
• Height: 34 inches (5th percentile)

Vaccinations:

• Hep A, 2nd dose
• Influenza

Right on track with growth, with the 1 inch growth in about six months!  Dr. G said to expect about 2 inches per year.


Also, the child DID NOT CRY for either shot.  And he watched the needle go in both times!  I was amazed.  We have been talking about going to see Dr. G for the past week and told him he was going to get a shot.  We also told him that shots hurt.  He went with Charlie to get his allergy shot and he's seen Hans get his shots.  He knew what he was in for and this morning he was actually *excited* to go to the doctor to get a shot.  It was if he was getting initiated into the club.  I told him it'd be ok if he cried because it does hurt.  Not a tear. 


No concerns.  Development looks great.  She was impressed with his toileting, vocabulary, and imagination. 

Mama at 37 years 4 months:
Stats:

• 3 lbs from prepregnancy weight and nowhere near fitting into my prepregnancy pants.  Sigh.

Vaccinations:

• Influenza

I asked if she thought my OB had the vaccinations and would administer one to me, and she offered to take care of it.  She said I had too much other stuff to worry about and didn't need to schlep into the city with two babies for a vaccination.  I agree!  I didn't cry but man my arm is aching!

Hans, 4 month well visit at 4 months, 5 days:

• Weight:  12 lbs 5 oz (2nd percentile)
• Length:  25 inches (40th percentile)
• Head circumference: 41.5 cm (35th percentile)

Vaccinations:

• Rotovirus, 2nd dose
• Hib, 2nd dose
• DTP, 2nd dose
• IPV, 2nd dose
• PCV, 2nd dose

Well, can you spot the problem?  Hans is only in the 2nd percentile for weight.  A drop from the 22nd percentile at his last visit.  And even thinner than Freddie at the same age.  All of his percentiles dropped, actually, but the weight is the most significant.

We began the visit with my concerns, where I brought up the issue of his bowel movements being infrequent, once every 7-9 days.  Although there have been a few days of daily bowel movements here an there, he continues to go long stretches.  And she said this was normal, even if he is showing some signs of "discomfort."  I've been doing some weight checks on the scale at home and knew he was not gaining a significant amount of weight and had a feeling she might change her opinion of the "normalcy" of his infrequent bowel movements once she saw his weight.

Sure enough, she's concerned about his weight.  The fact that he's not pooping as often in addition to the weight supports her concern.  "As much as I hate to say it, I think you should supplement with formula," she said.

And I said, "I really don't want to do that."  So we talked about why: 

• Supplementing often results in the baby refusing the breast and at the very least means I will produce less with the baby getting (some) nourishment elsewhere.  
• I breastfeed to pass on antibodies.  Charlie suffers with allergies, and I want to take whatever steps necessary to prevent Hans from having allergies.  The recommendation is a year, and I want to nurse for a year.  She, as a pediatric allergist, wholeheartedly agrees with nursing for this reason. 
• Freddie was (is) small, and he's fine.  I think it is completely in the realm of normal for both boys to be similarly sized.

So she gave me the name of a lactation consultant who may have some suggestions.  She said she wouldn't dare recommend waking him during his 9 hour slumber to nurse, and hoped the lactation consultant might have some other ideas.  I sure hope those other ideas don't include the pump.  Sigh.

She checked his urine, for what I don't know, and it was "normal."

She talked about the expected drop in weight for babies around the 6 month mark because of their increased activity, but still thought this drop at 4 months was a little premature and quite severe.

She thought starting solids might help and gave me the go ahead, although she said her typical recommendation is to wait until 6 months.  At the very least, she wants me to come back in a few weeks to check his weight.

His development was normal, cooing and babbling, smiling, wiggling, and lifting his chest and head off the table nice and steady. 

My general feeling is that he's doing just fine, but I do feel it necessary to follow through with the next few precautionary steps just to be certain.

Next appointment:  November 9th with Dr. G.  Appointment pending with lactation consultant