Merry Christmas and Happy New Year

Merry Christmas to all. We have truly appreciated all of the support and interest that Jac has received. I have learned of so many people who read this blog regularly and keep up with the goings on of our precious little boy.

Please continue the positive thoughts for Jac's continued good fortune and development in the coming year. Please keep on reading as we will keep on writing!

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Winding down the year

Well - we have finished 2007. Jac is asleep in his swing, I have just pumped and am now sitting, alone, in the bedroom I grew up in. Hmmm...

All of the health problems of the last week have taken their toll. I am feeling worn out. I now have a yeast infection to add to my troubles (not uncommon when taking antibiotics).

Joseph is back in Boulder. He spent the day at work - where I could not reach him and started to get worried. The dogs are happy to have him home.

So I think I am going to ring in the new year asleep.

Ah, the life of a parent.

Daddy back in Boulder

Joseph is back in Boulder. He is going to be working to get ready for CES. He will be then be traveling to CES (the Consumer Electronics Show) in Las Vegas from Jan. 6 - 11. On the 11th he will fly to LAX where we will meet him and take the same flight back to Denver together.

3rd Synagis injection

Jac had his 3rd Synagis injection today. After all of the negotiations I thought I had done with my friend to get the injection done at home she and I had misunderstood one another. She thought I was going to tell her how much he weighed and I thought she was bringing a scale. D'oh!

Fortunately my father has a friend who is a pediatric cardiologist in Pasadena. He kindly opened his office and allowed us to weigh Jac and then gave Jac his injection. Jac cried for the injection but then took 50 ml from a bottle and then happily fell asleep in the car on the way home.

Jac now weighs 7 pounds and 12 ounces - much less than I had hoped for. I am hoping that is weight gain is going to pick up now that I am getting a bit healthier. We should be able to have a fairly settled next 2 weeks.

A Christmas Roundup - or - What happened to Christmas?

12/24 10 pm - Joseph & Jac & I drive in to Pasadena to do some last minute shopping at Target (which turned out to be closed) and have a late night dinner at In-n-Out.

12/25 1 am - I wake up with diarrhea and vomiting which continues unabated until 7 am. Grandma & I spend the night on the floor of my bathroom while Joseph takes care of Jac.

12/25 8:45 am - 911 is called. About 20 (seemingly) firefighters and paramedics come and take me to the hospital. Joseph comes along and Grandma and Grandpa stay home with Jac. Jac has been unaffected by this episode and is happily at home. Before I leave for the hospital Joseph purchases Nutramigen Lipil since I have not pumped since 8 pm the night before and have not been storing milk since arriving in LA.

12/25 10 am - Christmas is canceled. Family is called.

12/25 11 am - I pump in the ER for the first time in 14 hours. Major pain and milk that has to be dumped.

12/25 1 pm - I am released from the hospital with 3 liters of fluid having been pumped into my veins and some meds to stop the squirts.

12/25 The rest of the day - I try to drink, eat a little, and pump. All in a haze and while feeling like I have been run over by a truck. I am making very little milk but Jac only has to have 2 bottles of formula.

12/26 - This is where things start to get really hazy (they were only a bit hazy up to this point). At some point in here I have developed mastitis in my left breast. This is the breast that makes 2/3 of my milk so this is a big problem. I am making very little milk and it is quite watery since I have very little nutrition in me. I am finding it almost impossible to eat. I have NO appetite. I am drinking but that is very hard also. It turns out that the mastitis has given me a fever. It turns out it is as high as 104! My OB in Boulder is called, I am given Tylenol and Ibuprofen and fluids and food and finally antibiotics. I am dazed but still pumping. My left breast is 2/3 blocked and making a very small amount of milk (an ounce at each pump if I am lucky) and my right is doing yeoman work to make enough milk for Jacie which I am still doing by the skin of my teeth.

Time passes.

I pump and Jac eats and I sleep and more time passes with Joseph and Grandma and Grandpa taking care of Jac.

I continued to have diarrhea throughout this entire time and Thursday night I started to get scared again. I had finally eaten a bit and my diarrhea had gotten worse and I was very worried that it was not going to stop. I had really not been able to get any proper nutrition.

I started to have a sense of the world again Friday morning - sort of. We went to the see the doctor. He told me to drink - just drink - until my appetite came back. Good advice. And take Immodium.

The diarrhea stopped.

My left breast blockage started to clear today after a great deal of work with heat etc. I had my first solids in a few days this morning - chicken soup and I have had oatmeal and cereal the rest of the day in sparing amounts along with lots! of water.

I am not pumping anywhere near my normal amount but I am staying ahead of Jacie which is enough for now.

I will post more later - pictures etc.

Pre-Christmas at the Chiu's

We spent the afternoon at the Chiu's house. They invited all of the family from Southern California and we had a very nice afternoon with great food and lots of pictures and talk.

There were many, many pictures taken today with many different cameras. I have uploaded to flickr some pictures from my Mom's camera. I will upload more when I get them. Enjoy!

Jac playing with the breast pump cords

When I am pumping sometimes I hold Jac on my lap and play with him. Today I was holding Jac on my lap and he started to play with the cords that lead from my flanges to the pump. He was having such a good time I called my Dad in to take a movie.

Peter Potty Urinal for Toddlers

Joseph told me about a product that is going to be a must-have when Jac starts standing. I can't wait!

Joseph is always telling me that boys pee all around the toilet - not necessarily in it [like this --Joseph] - and I always mule and puke about the seat being up, etc.

So - when Joseph told me about the Peter Potty Urinal I got so excited! Jac can have his potty and we can have ours.

Jac can't stand to have a wet or dirty diaper so we are hoping this means he is going to potty train earlier than usual. The last few days when I have gone to change his diaper because he was crying - he had not peed yet and peed when I opened his diaper. This is kind of a problem because I get wet but might be a good thing for potty training - at least we can hope!

Quite a trip

We made it! Jac and Jen and I made it to LA successfully and are now ensconced at the grandparent's house.

Thursday night: Call Frontier Airlines to "inform" them that Jac will be traveling with oxygen. We are told that oxygen tanks are not allowed on board. D'oh! Now what! We are told that if Jac needs oxygen on the plane we have to get a POC - Portable Oxygen Concentrator. So I called our medical supplier (Lincare) for Jac's oxygen and left a message that we needed a POC and called the pediatricain to ask for a prescription for the oxygen.

Then we slept.

At 8 am we got up when Lincare called and said that they did not have a POC available - that if we needed one it would take 2 weeks! D'oh! We needed to leave for the airport at 1 pm!

So I went online and found a local company that offers POC rentals. I called them and they said that they had one and that we could come down and rent one - for $450! So I pumped and then left Jac with Jennifer and went off to get the POC - in Denver - 1 hour away!

I arrived at American Medical Sales and Repair, Inc. in southern Denver and they were awesome! They had the POC ready when I got there. Nick showed me how it worked, got me the contract and the invoice to sign, got me the form I needed for Frontier Airlines, faxed it to our pediatrician's office, got it back signed and got me out of there in 20 minutes! Amazing! Our trip was made possible by American Medical and I can't thank them enough!

Back in the car and back to Boulder in Denver traffic (sometimes I think Denver traffic is worse than LA! Hard to imagine!). Arrived in Boulder to finish the last packing, pump, and get on the road to the airport (45 minutes late for our plans but really early since we had padded our time so much (we left at 1:45 pm for a 5:10 pm flight and the airport is 40 minutes away).

We get to the airport and I park in the most expensive parking - right near the Frontier entryway. We get Jac out of the car, Abbey out of the car, all of the luggage out of the car and loaded onto us - and then Joseph calls and mentions that we could use WallyPark - and I was like "oh my gosh no!". He didn't realize we had already unloaded the car and were NOT going to reload it!

Jennifer travels handicapped - and so once we got to the front of the special check-in line we were in like sin. Jen was wheeled to the front of the TSA security line and we tagged along and went through with her. We temporarily lost the POC but located it quickly and then after a little drive for Jen and a walk for us we were at the gate!

Jac really enjoyed the airport. He looked around and played with Jen while I got food etc.

Then I had to pump. I looked around for a private place to pump and the bathroom seemed to be the only place that was not in full view (not that I care - I have lost all modesty when it comes to pumping). I decided to ask the Customer Service for Frontier if they knew of a place I could pump - and they let me use their office! Amazing! I pumped and when I got back it was time to board the plane.

Jac did really well on the plane. Because of Jen we had the front most seats in the plane - and Jac had a really good view of everyone boarding as we had boarded first. He watched everyone board and then I fed him as the plane took off. He cried a bit but was soothed pretty easily with the bottle and his paci.

He had a couple of diapers while we were on the plane and he seemed to throroughly enjoy having them changed on my seat. After I changed them and had him closed back up he seemed content to stay lying in my seat!





He ate for the landing and didn't cry much for the descent.

Grandfather Johnson met us outside security, we got the bags and headed home to La Canada.

New plan - fly

Okay - we have a new plan. We are going to fly to LA. Our friend Jennifer is going to take the same flight so it will be Jac, Jen and me. Jen has a service dog so we are supposed to be in the bulkhead seats which will hopefully make things a bit easier.

Our flight leaves tomorrow late afternoon so we are trying to repack and re-organize to get ourselves to LA by plane. This means, of course, that the dogs will be staying here in Colorado. I don't think Knutson will be unhappy that he does not have to make the drive. After we got home last night he seemed really happy to be home and not cooped up in the car with Paula and Abbey.

The dogs will get visits three times a day from their dog walker - which we hope will be enough. I have never left Knutson without somebody to spend the night so I am a bit worried but I am sure it will all be fine. They love the dog walker - Haley - and she loves them so I know they will get the best care she can give them.

We are going to stay in LA for 10 days so we are going to have to change some of our plans but this way at least we will see everyone (and give them a chance to see our little boy) and be home for Christmas!

Still off dairy and caffeine and still happy

Jac is a pretty happy little boy (as long he is not in a car seat!). He seems SO much more comfortable then he did just a week and a half ago! He still spits up occasionally but they mostly seem to be a result of trapped air that we didn't get out through burping rather than reflux! Yeah! Yeah! Yeah!

Return to base!

The drive ended up being too hard. In 6 hours, they only made it down to Pueblo, about 140 miles from Boulder. There was a lot of stoppage time from Jac's crying; the dogs (Knutson, in particular) were uncomfortable, and the overall situation was just too unpleasant. They are returning home now, and should be back around 2 am.

Southern route

It's a good thing that Taj is taking the southern route to L.A. (I-25 south to Albuquerque, and then I-40 west to I-15)...

There is really bad snow forecast for the mountains/high elevation for the more direct I-70 approach to L.A.

Click on the map to see the full, animated image of the road conditions for the next 4 days.

Off to a rough start

Taj, Jen, and Jac hit the road at around 4 pm, and have spent much of first two hours in Denver rush-hour traffic. Jac woke up a little while ago, and he has been screaming for food.

With the car packed full of stuff, and since I did much of the loading, they had a hard time finding the bottle warmer to heat up the milk.... making for a very frustrated mommy.

They have pulled off the road at a restaurant to feed Jac. I have asked Taj to familiarize herself with the contents of the main cabin (all the non-essential stuff are in the 20-cu.ft. cargo box up on top). Hopefully, it will be much smoother from here on out...

Milestone: Head turning

Three days ago Jac started turning his head from side to side. Back and forth, back and forth - like he is looking for something. It is very funny to watch and he really seems to enjoy doing it when he does it. I have tried to take a video of it several times but when I point the camera at him he looks at the camera and stops turning his head!

Drive to California for Christmas

Jac and Jen and I are going to drive to La Canada for Christmas! We are leaving today (Tuesday) and we shall see how long it takes us to get there! We have purchased a car top carrier off of craigslist so we can take a few more things along.

It is going to be Jac, Jen, me and 3 dogs - Knutson, Paula and Jen's dog, Abbey! Wow! This should be quite something! We are going to take the southern route avoiding the mountains. Without Daddy I would prefer not to deal with any winter storms.

Joseph is going to be leaving for Beverly Hills on Wednesday and will be joining us in La Canada when we get there.

Wish us luck, a quick trip, and good sleeping by little Jacie.

I will keep the blog updated with trip updates by iPhone as we go.

Happy Baby

No milk and no dairy make a happy baby! Yeah!

I have not had any dairy or any caffeine and man is little one happy! He is having many newer reflux symptoms, is spitting up far less (seems more in the range of "normal" spitting up), is sleeping and EATING better!

His feed volumes are gradually increasing - and hopefully he is starting to gain weight at a more rapid pace again!

YEAH!

Jac looking cute on the couch

Daddy put Jacie down on the couch in his bedroom and took some very cute pictures.

Auntie Jen is here

Our friend, Jennifer, is here to visit and to help Jac and me drive to California.

Appetite comes back

I haven't looked at the numbers to back this up, but it sure seems like Jac's appetite has come back in the last few days; and he's a lot calmer at feedings.

For a while, it seemed like he was simultaneously wanting to eat and afraid to eat.

Last night and this morning, however, he seemed quite happy and eager to take the bottle. He practically smacked his lips opening and closing his mouth, anticipating the bottle, and flung his head forward to catch the nipple when it was close!

Happy 3 and 5 month birthdays

Jac is now 5 months old (on 12/10/07) and 3 months old adjusted (12/12/07). He is really growing up and it is so fun to watch (and a little easier now that his reflux seems to be getting a little better!).

No thickening for us

After some reading on the internet I have decided not to thicken Jac's feeds. The evidence to support this as an effective way reduce his reflux are thin and the downsides are fairly high. There is a potential to cause problems with allergies later in life and also Type I diabetes if Jac is introduced to solids this early (he is only 3 months old adjusted.) See Kellymom for more information. This would also in all likelihood complicate our attempts to start breastfeeding.

I would prefer to avoid these complications and stick with breast milk and meds (which we would need to continue even if we started thickening his feeds.)

Reflux medications illuminated

We have now started Jac's new reflux medication - Axid. With all of the changes I have made to my diet it is hard to know if the medication is helping (he was feeling better before we started the Axid). One thing I saw yesterday was that he had many more poopie diapers. I must have changed 10 of them - rather than the usual 4 or 5. We shall see how things go today. He did not seem unhappy about that much pooping - he just needed his diaper changed more.

I also discovered something very interesting and in its own way disturbing. I found a website called Marci Kids - Midwest Acid Reflux Children's Institute. On their website they say that they have found that compounded Prevacid (which is what Jac gets) loses its effectiveness about a week after it is compounded. They also explain that Prevacid is not approved by the FDA to be compounded.

Well - his explains a lot. It seemed like the Prevacid starting working better each time Jac's dosage was upped - but he also generally got a new bottle each time his dosage increased! D'oh! I spoke with his pediatrician about this yesterday and she said she would review the information.

Marci-Kids states the following (link to original page):

"If you are currently giving your child a compounded suspension of a PPI such as Prevacid made by a pharmacy, you should know that there is a good potential for the medication to become inactive (and therefore ineffective) in a much shorter time period than your pharmacist may be aware. The loss of activity is related to the effect of the flavorings added by the pharmacies. The flavorings cause the PPI to become unstable and break down so it can no longer inhibit acid secretion. Laboratory testing has shown that the majority of such compounded, flavored preparations become inactive within a week.

In addition, many pharmacies do not add enough buffer in their suspensions to protect the drug from degradation by stomach acid. This is particularly a problem if the child is receiving a very low-volume dose—less than 3 mL, for example—because the amount of buffer likely won't be enough to protect the PPI from degradation by stomach acid.

For these reasons, we recommend the use of FDA-approved Zegerid® powder for oral suspension over the use of pharmacy-compounded suspensions, which are not FDA-approved. The Harriet Lane Handbook, a trusted source of pediatric dosing information for more than 50 years also states "The extemporaneously compounded oral suspension product may be less bioavailable owing to the loss of the enteric-coating."

His pediatrician indicated yesterday that she would not be willing to give Jac a medication that she is not familiar with - Zegerid. It seems like it may be necessary to change her mind about that or find a doctor that would be willing to prescribe it.

In the meantime we are going to give Jac single dose Prevacid dissolvable tablets which we will dissolve prior to each dosing along with Axid. If he seems to be doing well perhaps we will drop the Axid and go back to just Prevacid but use the single dose tablets instead of the compounded version.

VLBW growth chart

Our pediatrician has been tracking Jac on a full term, full size baby growth chart. On that chart Jac is still below the 3rd percentile in every measure. When the public health nurse came last week they brought a VLBW (Very Low Birth Weight - defined as children born at less than 1500 grams) chart on which Jac's height and length are still below the 3rd percentile but his head is at the 5th percentile!

I found the VLBW (defined as children born at less than 1500 grams (Jac was 698 grams)) chart online and I am going to bring it to our next appointment so our pediatrician can use that chart - it only seems fair!

Off the cow and the can

Okay - kind of a corny title - but my way of saying that I have stopped all caffeine and all dairy. Augh! I love cheese pizza and really anything dairy. I am fortunate not to have any lactose intolerance so I am used to eating dairy with impunity.

I also love Diet Coke. Such a silly thing to love but it is a habitual thing with me - calms me down. Hmmm... Not such a good thing. So thanks Jac!

On the positive side. Our boy feels better! We can already tell a difference. He is eating more easily again. He is grabbing the bottle and rooting for it and lunging like he did before. Yeah! He seems to be more comfortable and is eating more during each feeding. His feed volumes are going up again (I have only been off dairy for 4 days and caffeine for two). It is amazing how quickly these changes have affected him.

So thanks Jac! The no Diet Coke thing is good for Momma anyway and maybe no dairy will help me lose the last of the baby weight so I can get back to soccer!

I have been participating in several online groups discussing premature babies, babies with reflux, pumping and many other issues of special needs babies and moms that pump for a variety of reasons. They have all been very elucidating and through one of them I found the kellymom website which has all sorts of great information about breastfeeding. After I found their article about Spitting Up & Reflux in the Breastfed Baby I decided I had to quit both dairy and caffeine. I have decided not to try a full elimination diet at this point. If Jac's reflux seems to get worse again I will try a full elimination diet but at this point it seems we may have found part of the problem.

The problem with dairy is not lactose intolerance (since breast milk has lots of lactose!) but is an allergy to proteins in the cow's milk.

I had been eating more cheese (pizza!) when it seemed like Jac's reflux was getting worse so my instincts tell me that that may be a good portion of the problem. Ah, Christmas without dairy but a happy baby! I can do that!

Company Christmas Party

Last night Joseph's company had their Christmas party. We got ourselves cleaned up and off we went. We were a little late - but made it before dinner. Oh man did Jac get a lot of interest. So many people at Joseph's company have been following Jac's progress through our website and through Joseph - so a lot of people were very excited to see him for the first time.

I ended up in the downstairs ladies room with Jac (looking for a quiet spot) feeding him. I missed dinner (not the first and for sure not the last time I will not eat while Jac does) and most of the speeches. It was way too warm in the room where the party was being held (20 degrees outside - must have been 85 degrees inside) and so Jac and I hung out downstairs in the foyer of the restaurant where Jac also got a lot of attention. He is so small - but looks so old - everyone asks how old he is.

Some of the ladies on a few of my newsgroups that have preemie babies have commented on how many times they have to explain how old their children are and how it gets tiresome after a while. I know people are just curious but it does get tiring the 30th time you explain it in one evening. They also comment on how cute Jac is which is nice!

How to extract milk with your feet

Another title for this post might be - Jac massages Momma while she pumps!

I have started to pump hands free. I use my bra to hold the flanges of the pump and I can type (as I am doing now) while I pump. At this moment Jac is asleep with Daddy but during the day I have been getting by with less and less help since I figured out how to pump this way (again thanks to those internet groups!).

Sometimes Jac will sleep while I am pumping but a lot of times my pumping and his eating coincide. So I feed him while I pump. It seems very ironic but there it is.

While I was feeding him today he was sitting propped on my knees with his feet near my hips and he was kicking me. Not hard - just moving his feet as he ate - and his feet were hitting my breasts - while I was pumping. It felt like he was trying to extract the milk with a little breast massage. I tried to explain to him that he had other ways of extracting the milk but he did not seem to understand ;)

Five month checkup

Jac had his five month checkup today (normally babies have four and six month checkups but because Jac is special he had a five month).

He weighed in at 7 pounds 5 ounces. This is up 15 ounces from his four month checkup - which is a significant slowdown in his growth rate. Since he left the hospital he had been gaining weight at a rate of about an ounce a day (so 2 pounds a month) and this month he only gained 1 pound. He is now 20 inches long and his head is 37 cm.

You can see in his weight graph that his weight gain has flattened out. Jac has been off of his oxygen since Nov. 20th. His oxygenation is fine - but it is possible that this is influencing his weight gain. Going back to sea level for 3 weeks at Christmas should help us figure out if the thin air here in Boulder is influencing his growth (we will have a weight check in the middle of our visit).

My instincts tell me that the real problem is his feeding. His feedings have gone down in volume even as he has grown. It is possible this is related to oxygenation but I think it has much more to do with his reflux which as I have mentioned seems to be getting worse.

The doctor has suggested some possible things to help. She has suggested thickening his feeds with rice cereal. The idea is that this helps his food stay down in his stomach rather than coming back up into his esophagus and burning. I am not so sure that I really want to do that. I am consulting some of the listservs that I am on to see what other Mom's experiences are with this sort of thing.

The other possibility is to add another medication to treat the reflux. This one is called Axid. It works in a different way than Prevacid and could potentially help with the reflux.

We are going to try some combination of the rice cereal and the Axid and see if his reflux and feedings get any better. If by January his feedings have not improved his doctor wants us to see a gastroenterologist.

So - all in all - not the best checkup he has had. We shall hope that by the time of his six month checkup things will have looked up a bit and he will be a lot bigger! It feels weird sometimes to have a baby that is almost five months old and is the size of a newborn.

Aunt Mary and Uncle Mike come to visit

Aunt Mary and Uncle Mike (Joseph's Aunt on his Father's side) came through Boulder on their way from Florida back to Los Angeles where they live.

I was out shopping during most of their visit but I made it back for the last part of the visit and it was very nice to see them. We also met Mike's daughter and son-in-law who live in Denver.

Mom and baby bonding

Jac and I spent some Mom-baby skin-to-skin bonding time this morning. It was very nice!

More white days

It started snowing yesterday but it was too warm to stick - except on the grass - but yesterday evening it cooled off and now everything is coated in white. It looks very pretty. This is so different than living in Pasadena. It is a bit shocking to see snow covering things. It is not exceptionally cold though (upper 20s) and it looks like the snow is going to melt in a few days when it warms up into the 40s again.

Dairy-free

I am going to try cutting dairy out of my diet and see if this helps Jac's reflux. I have to have no dairy for 2 weeks and then try adding it back and see if we can see a difference in his reflux and/or his behavior. Part of me hopes it helps and part of me doesn't but we shall see. I love dairy so much ...

More fun whacking things

Jac has some new toys that Momma has been ordering from Amazon and some of them are a real hit! (literally).

I bought him this Lamaze Freddie the Firefly and he really likes it. I hung it from his Baby Einstein play gym and he had a really good time whacking it around. I also got him Mind-Shapes by Manhattan Toy. This is the toy on the right of the movie. He seems to like the sounds that this one makes, it sounds like a bell.



It has been tough though these last few days to find a time when it is safe to lie him down to play. Tonight he wanted to play so I laid him down and he did a semi-up-chuck so I picked him up to burp him some more and he checked through his nose - a lot. Augh.

Tough couple of days

So - Daddy was gone - and Mommy was left home alone with a newly very fussy baby. Argh. I had Grace to help during a bit of the day (which did make a difference) but it was still very tough.

Daddy came home last night at 1:30 am and had an appointment near Denver (read 30 minutes away) at 7:30 am this morning. Not good. At 5 am when Jac was hungry but fighting eating and I couldn't keep my eyes open I woke Daddy up and asked him to feed him. He did and I went to sleep. He thought I had gone to pump. First misunderstanding of the day. This evening I was trying to help Daddy type something while he was trying to feed and comfort Jac and he got irritated with the way I was doing it and semi-snapped at me and I snapped right back. Two strikes. It is almost midnight so hopefully we can avoid a third strike for the day!

Jac is really having a tough time of it right now. It seems that the reflux has gotten worse - he is not spitting up more - but he seems much more uncomfortable. Previously I could always say that he did not cry unless there was a clear reason he was crying and I could find and fairly easily correct the problem. This is no longer true. I spoke with a member of the NAP team and she and I talked about what has been going on. Babies between 3 and 4 months switch from having a reflexive suck to having a voluntary suck - meaning they start to have more of a choice about what they suck on and they have to be good at sucking to coordinate it as they don't have the reflex running the show anymore. I don't think he is having a problem with his coordination as he is not gagging or choking. He is showing us he can make choices though. It seems to me like eating is not fun - because it hurts with the reflux - and he is starting to not want to do it. Not good!!!! Augh! The NAP team member suggested that we sit on the exercise ball and bounce him in an attempt to change his state - and then try to feed him. We can also bounce him standing up but the ball is easier on the legs. Hopefully this to shall pass. We were told repeatedly that the reflux would get worse before it got better and perhaps we are at that worse stage.

Mostly at night - he cries while we are trying to feed him. He is clearly hungry - rooting around - and yet he cries and fights. We have to be supremely patient to get the bottle into his mouth by encouraging him to open his mouth and waiting until he does. All while he is crying.

This is of course not helping with the breast feeding efforts. We went to see a different lactation consultant on Thursday and it didn't go very well. I have to say that by the end of the session I was just happy to be away from her. Most of the people that I have worked with at BCFH have been great - but I did not like her.

We will try some of her suggestions for how to work on breast feeding though. She suggested that we stop using the nipple shield - if he was going to take to it and make progress he probably would have by now. She says he is not too old to learn to breast feed. She told me about the daughter of a LC (lactation consultant) that started successfully breast feeding at nine months! She suggested that we try spending the day in bed together - him laying on me or next to me - and offer him the bare breast every 30 min. to hour when he is awake. Not to push him but to offer it - and stay this way for 24 hours - only getting up to pump and eat and use the restroom. She suggested that I keep him skin to skin the entire time. She also suggested co-bathing.

On another gloomy note he has not gained much weight. On Nov. 30th he was 7 pounds 4 ounces and yesterday (Dec. 6th) he was only 7 pounds 6 ounces. A very small weight gain for 6 days. Augh. We have an appointment with his pediatrician on Monday - we shall see what she says. His feed volumes have not been great though - especially given his previous weight gain - so I am not terribly surprised - but worried.

Our first night without Daddy

My lovely husband bas left me - okay - not quite - he has gone on a business trip to Beverly Hills! And just when Jac has started to get fussy! After cursing him a bit I hired Grace (my regular daily helper) to spend the night and help out.

She was able to help earlier in the evening when Jac was really fussy around 10 pm and I REALLY needed to pump. She wandered around the house with him and was able to get him not to cry for a few minutes ;)

But this morning (read 3 am) Jac woke up - I fed him 10 ml - and then he went back to sleep! Yeah! So I put him in his new Graco swing (read my new best friend for pump time) and he is still sleeping in it 1 hour later and I pumped - without waking Grace up! And loaded the dishwasher and am blogging! Yeah!



So - all is quiet on the Jac front - for now! We have another lactation appointment at 1 pm - wish us luck!

Fussy baby

Jac is going through an interesting new period - which seems to involve a lot of crying - especially in the late afternoon and evening.

We are hypothesizing that he is going through a growth spurt because his feed volume has increased again (which is good). He cries and wants to eat all of the time - but he cries during the feeding - a lot - and he is getting LOUDER!

Hopefully this will not last too long and we will get our calm little baby back soon!

Who are we to complain I know ;)

Milestone: Purposeful grabbing

Jac has been enjoying playing in his Baby Einstein play gym for quite a while. Today he was quite fussy in the afternoon and after what I hoped was a sufficient amount of time I placed him down in his gym - and off he went.

His play today seemed a bit more purposeful - in terms of his grabbing of the toys. He seemed to be working to really grab a hold of them - particularly the round rattle toy. He managed to grab it quite a few times - he doesn't close his hand on it very well yet - but he seemed much better able to aim at it and hit it and grab it sometimes.

The breast feeding trials continue

The trials continue. After a break for Thanksgiving we have again been practicing breast feeding at least once a day. The attempts are emotionally and physically trying for all involved so we rarely do more than once a day.

Pre-Thanksgiving Jac had gotten up to 38 swallows in one session - and last Friday we got him back up to 30 swallows in one session. We feel like are making good progress in refining our positioning and Jac now seems to understand that my breast has milk - a major accomplishment as far as I am concerned.

We now think that we have hit a wall - because of the use of the nipple shield. The nipple shield is not designed for long term use and is recommended to SLOW breasts that are too fast for a baby. So - we think we have gone as far as we can with the nipple shield. It seems clear that Jacie is getting frustrated with the breast because of the slow flow - because when he is not upset he is quite willing to latch on and suck. we think the slow flow is what makes the subsequent latches harder - and we almost never get past 3 separate latches - and with his bottle he routinely latches on 10 times - although he does get mad with the bottle also - it depends on his mood and how hungry he is and what time of day it is.

So - we have an appointment on Thursday with the Lactation Consultant at BCFH to see if we can learn how to get latched straight on to the breast! Wouldn't that be something!

Jacie sitting on Daddy's lap

Here is Jac sitting on Daddy's lap sporting a bib as a cape as usual!

More Diet Coke

Jac weighs approximately 7 pounds 5 ounces in this new Diet Coke pic and video!

2nd Synagis injection

Jac had his second Synagis injection on Thursday. He cried as expected during the shot but I got him eating very quickly and he calmed right down. He did not seem to have any reaction to the injection that day but last night (Friday) we think he developed a fever. He was very unhappy for several hours - crying and eating on and off. Jac is a very calm baby and generally does not cry much - as long as he is held and comforted - so this was very unusual for him. Around midnight we figured out that he was too warm (we had swaddled him to calm him - which usually works) and gotten him to warm in the process. So we made a semi-naked baby and gave him Infant Tylenol. It took a while to kick in - about 1.5 hours later he finally crashed, asleep on Daddy and we all slept for a couple of hours.

When people tell me about their babies that cried all of the time I can hardly imagine. I am tired and Jac just cries when something is wrong and we can almost always quickly figure out what it is and fix it.

Milestone: Here comes the tongue

A few days ago Jac started sticking out his tongue - all the time! At first I thought this was from the reflux (he did this when he was in the hospital when he was having bad reflux) but this looked a bit different. We had a public health nurse in today and she told me that the "tongue thing" is a natural reflex - and usually newborns do it - but because Jac was born prematurely his reflex may have just kicked in. It is very cute and he does it most of the time when he is awake now.

He has a very expressive body and face to begin with and this just adds to the effect. He is smiling more and more and making more and more noises also.

Proud baby

picture1
picture2

Yesterday when I was changing Jac in the afternoon he decided that he would pee on me! Not once, but four times! And not a little pee, a lot! The first one hit him in the face as I had my hand in the way - the other 3 got me and his changing table and various other objects. He looked so pleased with himself the entire time I had to take a few pictures.

Great Thanksgiving

We had a wonderful Thanksgiving with the entire clan (Alexis and Chris arrived on Saturday morning). It was so cool to have the entire family together - 3 generations in their entirety!

We had several nice outings - one to Nederland which is at 8600 feet! It is about 30 minutes from Boulder and the drive reminded me of driving up Angeles Crest Highway in LA. Jac did very well in the car except for a little bit of crying and we had a nice lunch with the fam at a cute little restaurant up there. We put Jac back on his oxygen for the trip since we would be going up into the even! thinner air.

We spent a good amount of time at our house and at the rental house in Erie. The rental house was very large and gave us plenty of room to spread out. We brought a bunch of our cooking stuff over to the house and we made Thanksgiving dinner there as a group affair on Saturday.

On Sunday 6 of us went to see Beowulf in Real D 3D. The 3D was great! Go Joseph!

Jac is really growing up! He is moving his arms and legs a lot and his eyes are really starting to track and lock on. It is so exciting to see him change and it feels like he changes every day!

Playing in his Baby Einstein play gym

Jac really likes to play in his Baby Einstein Play Gym. We have mentioned this product before but it deserves mentioning again. He loves to bat at the toys and it is easy to switch them around so he can look at different things. The star is nice but I only play it once or twice in a row and then give him a break from it. He can go as long as 15-20 minutes playing in it, just batting at the toys.

Here he is having a grand old time!

Jac playing on the changing table

Jac really likes to play on his changing table. He will go from being mad about a dirty diaper to wanting to play as soon as it is changed. If you leave it open and his clothes off his legs he will kick around and wiggle. It is pretty fun to play with him like this as he seems to enjoy it so much. I wonder if he is going to want to be a naked baby when he can choose!

Jac in his sweatsuit

We pulled this sweat suit out of the closet today (a present) and dressed our little Jacie in it. Oh man did he look cute!

He wore this (plus another pajama underneath) when we went out on a walk with the whole fam later in the day. It was barely above freezing but he was nice and cozy. He was attached to Momma in the Moby Wrap and then inside two jackets!

Jac and Daddy having a snooze

I have been sick since Wednesday and this morning I took a nap in the bed while Dadddy took a nap with Jacie on the couch in his room.

The Johnson/Murray Fam are here for Thanksgiving

The Johnsons (Bill and Toni) and the Murrays (Matt, Ali, Madeline, Caitlin and the girls' nanny Linda) arrived yesterday (Thanksgiving) to celebrate. Alexis and Chris are coming tomorrow (Saturday) to join us. We are going to be celebrating Thanksgiving on Saturday at a house that the rest of the family is staying in nearby to our house.

It was very exciting to have Madeline and Caitlin meet their cousin. Madeline seemed very interested in Jac and was very excited to give him all of the presents that they brought for him! Caitlin seemed much more interested in Knutson!

Grandma, Madeline and Jac



Grandpa, Madeline, Caitlin and Linda

:-| :-p :-/ :-( :-)

Recently, Jac has started to figure out how to smile. About a week ago, Mommy started to notice his mouth starting to form the beginnings of a smile. I started to notice the same about two days ago.

This morning, as I fixed his diaper, Jac smiled off and on for about two minutes, responding to my coos and happy-talk. And, his eyes seemed to brighten in unison. Pretty neat!

When I took care of Jac tonight, he began to get restless and started sticking his tongue out -- a definite sign that he was getting hungry. As the milk was heating up in the warmer, he started to cry out loud, and there was quite a bit of tears in his eyes (also a recent development). Then, as soon as the readied bottle was in front of him, Jac made a wide smile!

So far, we haven't been able to capture his smiles on camera. It seems like the camera distracts him from smiling... We'll keep trying!

Update from Momma (11/24/07 12:48 AM)

This evening Jac was giving me lots of smiles. I asked Daddy to get the camera and as soon as I did Jac stopped smiling! Daddy did manage to capture an almost smile!

Brrrrr!

Things started to chill down quickly yesterday afternoon. By midnight, snow and frozen rain had started to fall. Then, after feeding Jac at 4 am, Taj noticed that there were people outside our condo clearing snow! There's at least an inch or two of snow out there now! Weather.com says it's 25 degF outside right now. It will be 14 degF tonight!

Latched on!

We practiced breast feeding again tonight and man did Jac ever get it! He latched on 3 separate times and swallowed 29 times we were able to count but I think there were a few swallows we did not hear. This is the first time he has just looked at my boob, taken the nipple shield and started sucking like he has always known how to do it.

He fussed a bit - but he does that when we are feeding him from the bottle all of the time! He had a diaper in the middle and after Daddy changed it he was able to get latched on again and get more sucks.

We don't know how much milk he transferred but it was enough to soften my boob a bit!

I am so happy! Daddy has always known Jac would do this but I was always not always so sure in my heart of hearts. Daddy has pointed out to me that we are not done learning - and there will be good days and bad days. I am equating this to when Jac was learning how to eat from the bottle. We would have a feeding where he took the entire bottle and then the next feeding he would take 2 ml or none. I am sure the process with the boob will be the same. When we were teaching him to eat from the bottle we would tube feed him when he couldn't take the bottle and now we will bottle feed him when he can't take the boob.

Until we get this down we will just do it in the evening when Daddy is home for support and to feed him after the breast feeding. Yeah!

Thanks for all of the encouragement that everyone has given us! We are getting there! Our goal is to be totally breast feeding by Christmas. Hopefully we will be able to go back and forth to the bottle (this would be ideal) so I can sleep a little! (selfish Mommy!)

Healing nicely

While changing Jac this morning, I noticed that the SteriStrip had fallen off the left incision (hernia surgery). The incision healed up pretty nicely -- there is a faint scar, but it looks pretty good. There are two tiny spots where it's still dark red, but the rest of it has returned a healthy skin color.

Big boy!

Jac had the last of his 4 month immunizations today. 2 shots and an oral one. I think the oral one was more upsetting to him than the shots!

He weighed in today at 6 pounds 14 ounces! Wow! We thought after having surgery last week Jac would only have a small weight gain this week but he gained 6 ounces in 7 days!

Here is another Diet Coke can picture and a link to all of the previous Diet Coke can pictures on flickr.com



He now has a fever which is not so good. Darn these immunizations. I know they need to be done but they are a little tough!

We have also been having some more problems with spitting up. On Sunday he spit up about 6 times in one day! Not good! 3 of them were through his nose. This is upsetting for him and us - much easier to deal with when you have two people around though. We have gotten pretty good at the drill to deal with the through the nose spit up and we can handle it in under 30 seconds usually if he is eating in his room.

Jac on his changing table

Jac likes to play some while he is on his changing table. Sometimes if he is upset and we set him down on the changing table he will stop crying and hang out. Also, after he has his diaper changed sometimes he will hang out and look very happy to wiggle his arms and legs around.

Jac has really made a lot of progress in terms of his control of his arms and legs. He is very able to move them around in space with some pretty good control. He is not really pruposeful all of the time with them yet though. He hardly shakes any more and he has really started to enjoy playing with objects hanging in front of him. Sometimes he grasps them but for the most part at this point he likes to look at them and swing his arms at them.

P.S. Karen I think you sent him this suit!

Jac sitting on the couch

Daddy likes to take pictures of Jac sitting on the couch which are very cute and very funny all at the same time!

Doing well

Jac is doing well and growing up so quickly. He spent 20 minutes tonight playing in his Baby Einstein play area. He was whacking his toys and having a grand old time.



We also did more breastfeeding tonight. He took 34 swallows in 2 times on the breast! This is a record. Daddy is very confident that he is going to take off now and we are really going to make good progress from this point on. I am feeding off of his confidence and we are all getting better at it!

Jac is now sleeping pretty well during the night - usually waking up once or twice and he seems to have recovered completely from his surgery. Mommy and Daddy are tired but otherwise doing well.

We are looking forward to having all of my family (including Jac's cousins) visit for Thanksgiving.

Jac grabbing his diaper bag

Jac has been using his arms more and more in the last week. While we were getting ready to leave the hospital yesterday I changed his diaper while he lay in his hospital crib. His diaper bag was right next to him and he started grabbing the handle.

Home from surgery and doing very well

Momma and Grandma had a long night last night in the hospital. Once Jac came fully around from his anesthesia he wanted to eat! and eat! and eat! He ate every 2 hours all night - tiring out Momma and Grandma! He then continued to eat all day - 13 times in total for the day! He is near his all time high for feed volume!

We made it home from the hospital with a bit of crying in the car but without much incident and we have settled back in at home. Grandma is currently holding Jac and I am about to take over.

Here is a picture of Jac in his car seat in the red wagons they use at the hospital to wheel the kids around!



Jac's incisions don't seem to be bothering him too much (he is taking Tylenol every 5 hours) and his bowels seem to be moving a bit better without the hernia causing problems.

I am glad this is over and he can recover and get back to the important business of growing!

Recovery is going well

Jac and Grandma and I have all settled into our room in the PICU now. The new TCH has all private rooms in the PICU - nice and quiet.

We have all settled in nicely and Jac is now asleep in his really large crib.



After some initial setup issues with his oxygen he has settled in and woke up around 7:30 pm wanting to eat! Really eat! He took 90 ml (3 ounces) in about half an hour and I think he would have taken it a lot faster if I had let him!

Daddy came to visit this evening (he had to leave around noon to do work!). Around 8:30 pm he took another 60 ml (2 ounces).

His incisions look really good. They are fairly small and in the creases of his legs. The stitches are dissolvable and on the inside and will dissolve on their own and the steri-strips will stay on for a few weeks and then just fall off. (I had the same sort of thing for my c-section but I had staples rather than stitches!)

He seems much more comfortable in terms of his digestions and general comfort level without the hernia to bother him. This is all preliminary though. The caudal block has worn off now but he is taking Tylenol which is pretty good pain meds for a little one like him.

We shall see what the night brings but for the moment he is resting very comfortably.

Jac has moved to the PICU for the night

Jac stayed in the PACU (The Post Anesthesia Recovery Unit) until 3 pm or so when he moved to the PICU. The doctors decided that he should spend the night in the PICU (Pediatric Intensive Care Unit) so he could be monitored closely to make sure if he has any A's & B's (Apnea and Bradycardia) that he has nurses and doctors right there.

He had a bit of a hard time for a few minutes when his sats went down into the 50s. I! realized that the problem was that his O2 had been cross-threaded so the cannulae was actually acting as an occlusion to his breathing rather than providiving him oxygen. We got that fixed and he has been resting comfortably since then. He is now sleeping on Grandma and I am about to take a little nap and hope he wakes up and wants to eat.

He has only eaten about 30 ml since his surgery - hopefully he is going to wake up and ask for food! He did a twice earlier but then he fell back asleep quickly. As the full effects of the anesthesia wear-off he should start to ask for food!

Jac is still asleep after surgery

Jac has been asleep ever since he came out of surgery. He was awake for a few minutes after surgery but then he went back to sleep and has been asleep ever since.

Here are a few pictures to enjoy while we wait for him to wake up.

Pictures from before surgery

Jac and Daddy with the nurse before surgery


Jac and a worried Momma

Successful hernia surgery!

Dr. Moulton (surgeon) just came out and told us that the hernia surgery went well. In addition to the hernia on the left side which we knew about, he found and corrected the hernia on his right side.

As I write this, Jac is getting transferred to the recovery room, and we should be seeing him in another 20-30 minutes!

Dr. Campanini (anesthesiologist) also gave us an update -- his IV went in on the first try (into the right arm), and the caudal block worked well.

During the surgery he had a breathing tube for general anesthesia which was removed after the surgery. After the surgery the anesthesia was affecting his breathing a bit -- he was holding his breath a bit -- so the doctors had to put him back onto the breathing tube for a few minutes after the procedure.

He is breathing out his anesthesia, but he now can be aroused to wake briefly. As the anesthetic gases come out of his system, he will get to a point where he will be awake, mad, and hungry!

We are now waiting for the nurses to confirm that he cries, wakes up, and clear his secretions. When that happens, it'll be time for his big breakfast! He has not eaten breast milk since 12:30 am and Pedialyte since 5:20 am!

We can't wait to see the babes!

Weekend lounging

Here's Jac, relaxing on a Sunday morning, after a nice drink of the good stuff!

"Wassup, Ladies!"

Jac and Taj's Little Black Book

We have a little black journal to log Taj's milk production, and Jac's milk consumption...

As you can see, they are constantly pumping/drinking throughout the day!

Inguinal hernia repair tomorrow morning

We are all getting ready for Jac's hernia repair tomorrow. Grandma Johnson is coming in late tonight and we are going to all stay at a hotel near the hospital. We have to be at the hospital at 7 am (with a baby that has not eaten since 2:30 am - only pedialyte or water from 2:30 am - 5:30 am and nothing after 5:30 am until surgery at 8:30 am) so we decided it would be best to not try to drive from Boulder to Aurora at that time of the morning on a Monday.

So - I am trying to get all of our stuff together to go tonight - amazing how much stuff you need for a baby - especially when we are pumping and feeding!

Think positive thoughts for little Jacie and nervous Momma.

Video: Jac wiggling his feet

In this video Jac is all swaddled up with just his feet showing and he is wiggling them around. It makes me chuckle and coo every time I see it

Happy 4 month birthday

Happy 4 month Birthday Jacie Boy!

In the last few days I have taken to calling Jac "Wackie Jacie" and Daddy is calling him "Cutie Jacie"! Oh man! Alexis will hate this!

Daddy has also told Jac that he is beautiful several times - which is of course undeniably true ;) but still!

Jac breast feeding with an SNS

Jac and I tried to breast feed again tonight (we did not try last night because I was attending a Infant/Child CPR class in Denver). This time we used both a nipple shield and an SNS (Supplemental Nursing System). Jac seemed quite content to suck while Daddy worked the SNS and I held him and my breast. Unfortunately I think we were a bit aggressive priming the SNS and Jac spit-up a huge amount while he was at my breast. Not pretty. We got him cleaned up and stopped the breast feeding and then fed him some from the bottle to clear the acid from his throat.

The SNS is giving me hope that we can get him used to eating at the breast and transition him from the bottle. The SNS supplies milk from a bottle attached to me through a small tube that sits right at my nipple so when he sucks on the nipple shield he causes milk to come from my breast and from the SNS. This way he gets the immediate gratification from the SNS but he gets used to eating from the breast.

Oh please let this and a lot of hard work get us to breastfeeding! Please!

Jac and his Diet Coke can

I took another picture of Jac with his Diet Coke can today - not the greatest picture but it does give a good perspective on how big he is getting.

He and I took a nice walk today. We walked to the hospital where he was born (and where his pediatrician and my OB have their offices) and delivered a milk donation to the Mother's Milk Bank and picked up his Prevacid prescription. It was a nice day for a walk but the sun is so brutal here that when it is 70 out I get hot! I always wear a hat when we go out but I am getting sunburned anyway - even with SPF 50 lotion on! I am going to buy a better hat! I keep Jac nice and protected from the sun so he is fine! Today I wore the Moby Wrap and he was very comfortable. It is about a 30 minute walk one way - and he slept all the way there. We took the milk donation and then visited with a few of the NICU nurses that took care of him. Then we got his prescription and headed home. He woke up just before we got him eand he was hungry.

He has spent the day today making up for how little he ate yesterday (he was feeling punky from his vaccinations yesterday). He has spit up quite a bit (once through the nose this evening) but all in all he has had a pretty good day and he is currently sleeping on Daddy.

Jac in his pontiff's hat

We took Jac out to dinner at a Mexican restaurant in Louisville. We packed him up and took him. We had him off of his oxygen for most of the day and he did just fine. The restaurant was great for Joseph and not as good for me - but c'est la vie. Jac wanted to eat while we were there also!

It was difficult to feed him in the restaurant because I am so used to being able to hear him and judge his state from his sounds. I am used to hearing his tummy and his farts and his burps and I couldn't hear any of those things. I was a little surprised how huge a different this made in my comfort level with feeding him.

When we got him home he looked so cute in his pontiff's hat we took some pictures!

4-month check-up

Jac had his 4-month check-up today (he will be 4 months in 3 days). He had two of his 4 month vaccinations today. We are waiting on the rest of them until after his surgery.

They also measured his weight and his height and head size and he is doing well on all of them!

His weight is now 6 pounds and 6 ounces. That is a gain of 7 ounces in 8 days!

His head is now 35.5 cm - which is up from 32.1 cm on 10/1/07! We have really been noticing how much bigger his head is!

He is now 18.5 inches tall which is up from 16.5 inches on 10/1/07. He was 12.5 inches tall when he was born!

Growing baby! His pediatrician is really happy with his growth - and she is amazed that he is doing it on pure breast milk!

He is still below the 3rd percentile for all of his measurements but we expect that. It is going to take him a while to catch up.

Developmentally he is doing well. He is tracking things with his eyes - side to side and up and down. He is grasping things. He is gazing directly into people's eyes. He is starting to react to our voices. He is occasionally smiling. He is occassionally making cooing noises.

Yeah!

Now we just need to get this darn hernia fixed. It is pretty clear that it is bothering him. Last night he was fussy for about 5 hours which is just not like him. Whenever we would check his diaper his hernia would be out. The doctor said she has seen this and she is glad we are getting it fixed so soon.

To see his growth chart click here.

Big Day

Jac had a big day today. Jac, Knutson, Paula and Daddy and I went on a walk around noon. We found a shady spot by the East Boulder Rec Center and ate some sandwiches (Daddy and I ate). Knutson walked so far and then walked all the way back! I carried Jac in his Moby Wrap. He fell asleep shortly after I put him in it at home and he slept for the entire walk!


This evening we had our first social outing with Jac! We went to our friends house and had dinner with them and their daughters. We had homemade sushi!

Jac in his papasan

Jac is sleeping in his papasan on the dining room table. The blue blanket was made by his Great Aunt Judy. It is very warm and cozy and soft and he really seems to like to sleep under it.

Spitting-up

Jac has been spitting up a lot lately. There are usually good days and bad days - once it starts it usually continues all day - and then he will have days where he does not spit-up at all. The doctor has explained that a lot of the spitting-up is caused by reflux.

He takes prevacid for his reflux seems to help - but the dose needs to keep on changing as he gains weight - which is of course constant. At the beginning of last week we upped the dose and it does not seem to working as well as we might hope. Everyone! warned us that his reflux is likely to get worse before it gets better - and perhaps that is what is going on! The estimate is that he will have reflux until he is at least 6 months (adjusted) and possibly as long as 1.5 years! Oh man! Let's hope he grows out of it sooner rather than later!

Here are some pictures taken by Daddy after a particularly bad spit-up which came shooting out his nose. This has happened about 4 or 5 times in his life and it has been dramatic every time. We have to put saline drops down his nose and then use the bulb to suction it back out. This is to try to clear the acid from his stomach our of his nose quickly enough that it doesn't really burn his nasal passages - how effective this is I don't know. We also almost always feed him again right after. This seems somewhat counter-intuitive but it seems to help. I think it helps to coat his esophagus and calm the burning down.


When he does a normal spit-up out of his mouth he is frequently not upset at all and if you happen to turn your head when he does it you don't always even know he did it until you see it.