domperidone – Keeping up with the Hoffmans

I’m three weeks late on posting, but Emmett is officially a year old. The day came and went pretty uneventfully. We’ve decided to celebrate the anniversary of his homecoming in August this year instead of his birthday, so we’ll do a cake, presents, party, etc. at that time. I did put him in the same “Uno” shirt I got for Theo’s first birthday and sent him to daycare in that, and I posted something on Facebook to commemorate the day. Mostly I’m happy to have it behind us. I had mentioned in my previous post that it’s been a little surreal to see photos pop up on my Timehop app of my pregnancy, and I’m happy to not be seeing those anymore, but now I’m seeing NICU pictures, so there’s that. Actually, I’ve started re-reading my daily blog posts from last year each day, and while it does bring up a few feelings of anxiety still, I’m also finding it a little bit healing.

He really has come so far.

Adjusted age: 9 months

Stats: 16.2 lbs and 27 inches

Milestones: Clapping! Walking with a walker!

Sleeping: All night, most nights! Still wakes once a couple times per week. Naps are pretty predictably and hour mid-late morning and another hour early-mid afternoon. I’m thankful we didn’t have to do any sleep training this time around and he kind of figured it out on his own. I hated sleep training Theo but we were desperate, with him waking every two hours!

Eating: He’s doing three solid meals per day now, plus an afternoon snack. Not as interested in nursing these days and is pretty easily distracted, but we’re still trying to get bottles/nursing sessions in him every 3 hours since he needs the calories and breastmilk is more calorie-dense than the solid food he’s getting. Still adding avocado, butter or full-fat yogurt to his purees. Gotta fatten this peanut up!

Personality: The two words I’d use to describe him are happy and busy. So busy. He’s into everything these days. I thought Theo was a busy kid, but Emmett is insatiable when it comes to exploring and getting into stuff. I think he may be my wild child.

Likes: Getting into stuff and exploring, above all else. Also loves his brother so much. He lights up whenever Theo walks into the room.

Dislikes: His inhalers, the Nose Frida and being away from mom. Separation anxiety has officially arrived. I used to be able to drop him off at daycare without much fuss. He’s so intent on exploring and getting into things that he’d crawl over and empty the toy bin as soon as I set him down and hardly even noticed I left. Recently, though, he cries and grabs my legs if I try to leave the room. Breaks my heart.

Mama: Still obsessing over milk supply, though the Domperidone has helped a LOT. I’m still not up to full supply, but I’m usually only 2-3 oz short of what I need to send with him to daycare each day, and there have been a handful of days where I actually pumped enough! I started on the lowest recommended dose of 60 mg per day, though, and have recently increased to 70. I can go as high as 160, I believe, if needed. I’m so close to making enough, that I’m hesitant to increase much more since I’ll need to wean slowly. As of now I still have enough freezer supply to make up the difference and I think E is pretty close to dropping a bottle at daycare now that he’s eating more solids.

In other exciting news, I’ve just begun the process of becoming a volunteer at the NICU where Emmett stayed. There’s a parent advisory board that meets with NICU parents to help them through their journey and I found this resource to be so valuable when we were there. It just really helps to talk to someone who gets it; who’s been there and come out the other side. I know it may be tough to be back there, and I’m sure it’ll bring up a lot of emotions, but I also think it will be healing and a good way to give back. More to come on that — it’s quite the process to get ramped up and approved to volunteer (both by the board and by the hospital) and they don’t like you to officially start until you’ve been out of the NICU for a year, so I wouldn’t start doing any work for them until August, anyway.

Still can’t believe we have a one year-old. I don’t think it’ll really feel like we do until he’s a year adjusted. Right now he just feels like your typical 9 month-old.

Here are some photos from the past month, including some professional shots we had taken.

It’s been an interesting month, health-wise. As I mentioned before, we’ve been seeing a pulmonologist at Children’s Hospital, due to E’s chronic breathing issues. After chest x-ray and echocardiogram results came back normal, the pulmonologist decided to refer us to a feeding therapist to check for silent aspiration as a potential cause for his wheezing and coughing. She didn’t think it would be the culprit, but wanted to “rule it out.” Unfortunately, we weren’t able to rule it out because it turns out that is the culprit. Or at least part of it. Emmett is aspirating as he’s eating. So now we have to add thickener to his bottles. As of now I’m still allowed to continue breastfeeding morning, night and weekends as I have been, as long as I keep him upright and give him breaks, but we have a swallow study coming up May 2 to assess the severity. Depending on how badly he’s aspirating, we could end up having to go to all bottles. After working so hard to breastfeed this kid, now this.

I suppose I shouldn’t be surprised by anything at this point. Eveyone had warned me that prematurity doesn’t end when you leave the NICU, and that the consequences of being born early can follow kids for quite a while — sometimes a lifetime. But I’ll admit that a part of me had hoped he would be the exception. He is such a strong little boy, though, and I know we will get through this. And as frustrating as it is to keep encountering hurdle after hurdle, I am also acutely aware of just how much worse things could be. Perspective is so important.

With that said, here’s what’s going on with our 11 month-old:

Adjusted age: 8 months.

Stats: 15.6 lbs and 27 inches. We have growth finally! He is still a peanut, just barely clinging to the charts around third percentile for his adjusted age and nowhere near the charts for his actual age, but it’s nice to see progress. Thank you, butter.

Milestones: Finally reliable at sitting (without feeling like I need to spot him), pulls up to standing, and even lets go briefly.

Sleeping: Getting much better! He sleeps through the night about half the time, and the times he doesn’t he’s only up once. But a good friend told me to never trust a baby. So there’s that.

Eating: This kid loves to eat, and he’s getting much more efficient about it. In other words, more is finally ending up in his belly than on his belly. He also doesn’t appear to be picky at all, and will even eat any green veggie (could have something to do with the fact we’ve been instructed to add butter to everything, though!). We’re experimenting with some dissolvable finger foods like puffs, yogurt melts and mum mums, but haven’t made the leap to real table food yet. I’m still terrified of choking and he also still doesn’t have any teeth yet! I know I need to get over that fear and start giving him stuff soon, though.

Personality: So happy and very curious and determined! He gets into everything, but is also very good about responding to me correcting and redirecting him when he gets into something he shouldn’t. He seems very socially aware, if that’s even possible for an eight month-old. It will be interesting to see if this trait of his continues as he develops.

Likes: Bathtime, big brother, getting into stuff.

Dislikes: Still hates his inhalers.

Mama: Still stressing about my milk supply. Interestingly, when we took E in for his feeding evaluation, the OT, who is also an IBCLC (lactation specialist), confirmed what I’ve known deep down for quite a while — I’m not making enough milk. I knew I was only pumping about half of what he needed, though everyone kept telling me babies are more efficient than the pump and if he was really hungry he would let us know — so I had just continued to dip into my freezer stash to get him though the day at daycare and continued to exclusively nurse on the weekends. But the OT reiterated that while yes, babies are more efficient than the pump, nursing is still supply and demand, and by the time I got to the weekend my body was already adjusted to what I was pumping all week — about half of what he needed. On the weekends he was probably nursing just enough to take the edge off, but there’s no way he was getting enough from me alone.

I cried on the way home from the appointment, feeling like a shitty mom for basically starving my baby on the weekends. Thankfully, the OT/IBCLC and I worked out a plan, and I’m feeling good about what we have to do to move forward and get him enough food without losing any more of my supply. So now after nursing, I’m supposed to offer him an extra ounce or two via bottle, and ideally pump too, though she acknowledged that wasn’t very practical with busy schedules. She also said I was a good candidate for Domperidone, which is supposed to be very effective at increasing milk production. In fact, it’s so effective that adoptive mothers sometimes take it so they can actually induce lactation. I just started it and am hoping to start seeing results soon. If it doesn’t work, I think I’m probably ready to throw in the towel on nursing once we reach the end of our freezer stash, knowing I’ve tried everything I could. And depending on the results of the swallow study, that may be the direction we’re headed anyway. I had hoped to nurse to a year adjusted, but I may have to settle for a year actual.

A year. How is that possible it’s been almost a year?