Tough Cookie

**This post was written Friday September 7th**
You know that song from The King and I "Getting to Know You"?  I believe it could be the theme song for the first few weeks of life with a newborn.  Some things you figure out right away...other things take a bit of time.  We're learning our little lady is one tough cookie just rolling with the punches.  Often I'm surprised at how durable she can be, por ejemplo (for example): her stomach had to be pumped in the nursery after delivery because she swallowed too much amniotic fluid-she faired well so I'm told; has acid reflux but seems to cry no more than your typical baby; when they pricked her heel for her second PKU she gave one little whimper and then took it like a pro (even the nurse was impressed); I once clipped her fingernail too close (drew blood close) and she only flinched; then there was a little incident with her face and a seat belt buckle...but we won't get into that, suffice it to say that she only cried for about 10 seconds and it didn't leave a mark (parenthood seems to have its moments of guilt and apologies).

We've known since her first week at home that Leone has acid reflux.  It's not difficult to figure something is awry when your baby deposits everything she just ate all over you, your furniture, and her cute outfits.  You start using receiving blankets as burp cloths, because those little white burp cloths are mere child's play against what she's dishing out, and you stop putting clothes on her (and yourself) unless it's absolutely necessary.  The sound of a burp makes you cringe and spring into action because something else is sure to follow.  The hardest part is knowing she's in pain and all she wants is to eat but you know that as soon as she does it will come back around only seconds later making her more upset...and still hungry.  Apparently infant acid reflux is much more common than we knew because we've hardly spoken to someone with multiple children who hasn't had at least one child with reflux.  We were finally able to get her a prescription for infant Zantac by her second week and the change was as obvious as night and day. There's still spit up...lots of it...but some days are fairly 'normal' and some days are better than others.  Speaking of some better than others...

Sunday morning her breakfast went down like normal but came up looking very different.  It was be-speckled brown with a yellow brown tinge.  The first spit-up was little the second was large and the rest of the morning varied but always with brown flecks until they seemed to be fairly normal again. When I first saw the 'coffee grounds' I immediately thought "internal bleeding"...what else can you think when you see that?  I called to Spencer to take a look and although I saw the same thought wash across his face he remained calm and started thinking of completely rational possibilities (a dry/bloody nose, something I ate...).  We decided to wait a little and see if it kept happening.  I mentioned earlier as the day went on it lightened up, she seemed to us her normal self and she wasn't running a temperature so we decided it was probably gone, but kept an eye on her.  Monday and Tuesday went by without incident but then it was back just like before on Wednesday.  I called the pediatrician as soon as they opened and scheduled an appointment as soon as possible (late that afternoon).  Once the pediatrician took a look at her he said he was concerned, it was very curious and he couldn't really figure out what would make a baby as young as Leone produce this.  Admitting there's a chance it's really something or possibly nothing at all he scheduled an abdominal ultrasound and blood work at Primary Children's immediately following our office visit and made us an appointment with a gastroenterologist  for the following day (in case she needs an endoscope).  I felt I had been appropriately concerned through everything.  Not over reacting or getting carried away with "what ifs" but when the pediatrician said it was curious and he started talking about Primary Children's Hospital I admit my heart leapt in my throat.  Only for a moment though and then I was in go-mode, whatever needed to be done let's do it.

The ultrasound was mainly to look at her pylorus to make sure she doesn't have pyloric stenosis.  It took a bit of looking to find it because her stomach was full but we did see it and everything else along with it and all seemed fine.  They did keep mentioning that her duodenum was very dilated but nothing seemed to come of it.  She was a champ through the ultrasound, only starting to fuss because she was hungry.  The blood work....that was the biggest little needle I've ever seen (ok, that's a little dramatic).  She definitely cried  while they were drawing blood but they did it right in her elbow and she was still hungry and tired of being poked and prodded during the ultrasound.  As soon as the needle was out she was fine and easily consoled. Meeting with the gastroenterologist yesterday was informational but no real answers yet.  He spoke with us about all the possibilities and about reflux.  He decided we didn't need the scope right now he thought we should try other things like testing my breast milk for blood and cutting out dairy and soy completely.  When I mentioned that I haven't had any dairy or soy since she was one week old he said "Oh..........well it could still be in the breast milk so let's keep testing that and now I'm curious.  Let's schedule a UGI (upper gastrointestinal series--another ultrasound but this time she has to drink barium to highlight the upper gastrointestinal area).  Seems like we're all a little curious.  We left with the test strips to see if there are any traces of blood in my breast milk (so far 2 out of 3 are negative) a prescription for a stronger antacid and an appointment for a UGI back at Primary Children's this afternoon.  From all of this we know two things:
 1) she has acid reflux (but of course we already know that) and 2) she doesn't have pyloric stenosis.  Hopefully the UGI will shed a more light on what we're working with.  It's very likely it's nothing at all but there's always a chance....oh that chance.

Leone turned 7 weeks old yesterday and without-a-doubt smiled at Spencer and I this morning.  It made our day.