Because they are so hungry!

I now understand why they eat garbage. And people. I would too, if this diet continues. I am literally starving (and nuts and berries only go so far, and no, I am not willing to have ground beef for breakfast).

This diet sucks. And I think it's affecting milk production. I've seen a serious drop in amount collected, and I think it's because I literally have nothing left. My body is using everything, leaving one very tired, cranky Kim.

And no, I don't think we are any closer to figuring this breast milk v. formula thing out. Is it GERD? Is it colic? Is it general fussiness? I haven't a clue. I talked to my sister today and she said that baby Ben was diagnosed with reflux. Not severe enough to warrant medication, but enough that they should do more frequent feedings with smaller amounts, and keep the baby upright for 20 minutes after feeding. His fussiness had nothing to do with Kelly's diet.

Um...that's what we've been doing. Frequent feedings, 20 minutes, blah, blah...and we've seen a positive change, so is it me, or is it GERD? Or both? Really the only reason I'm asking is that I'm mad for a Starbucks right about now and would kill to have a slice of cheese. I had no idea my diet was so heavily focused on caffeine and milk-based products.

I honestly don't know what to do. If this continues, I won't have any milk and then my options will only be one: formula. Or, I can keep pumping, keep trying, and know that will every new feeding, Brian and I close our eyes and pray this isn't the one that turns Scotty into 'Crazy Baby.'

We had our pediatric neurologist appointment this morning (more about that later) and as I was driving home, the food options that were going through my head almost caused me to start drooling. My breakfast was a  horrible mess of toast with jelly (no butter) and apple juice. All simple carbs that I'm sure I digested in about 3 minutes. So after 4 hours, I was ready to chew my arm off and possibly start pawing through garbage. I ended up going through the McDonald's drive-thru (only b/c the thought of lifting  the car seat out, along with the diaper bag was too much for me to bear - haha, no pun intended) and getting 10 chicken nuggest (4 extra since I'm lactating). I ate them in the car, fearful that Pork Chop would wake up, and then came home and ate two granola bars and a turkey sandwich. I *think* I might finally be full.

This cannot go on. But I don't know what to do - add more foods and run the risk of Crazy Baby? Just stop all together? The thought of no coffee until 2010 (which I am hoping to do, breast-feeding wise) seriously depresses me. But I also don't want Scotty to think that I traded his health for a Pumpkin Spice Latte. He does know that PSLs are seasonal, right? I mean, if I don't strike now, I won't get another one for almost 12 months...that's a lot to ask out of anyone.

Anyways, the appointment went really well. The neurologist said that Scotty is "perfect" and developing fine with no side effects from the high bili levels. We have a follow-up in three months, and she said that if everything looks fine, we can stroll into the sunset with no more worries. All great, great news.

And FYI: getting to this appointment on time was seriously like planning a major event. The official planning started last night as Brian and I cleaned the house (the maids were coming today). I prayed Scotty would sleep well so I wouldn't be completely out of it as I drove this morning. I was up by 8am and in the shower; Brian fed the baby as I packed the diaper bag. I left the house at 9:45am for our 11am appointment. I arrived in the very busy, very germy waiting room at 10:25 only to find that my appointment was really at 11:30, and I was supposed to start paperwork at 11am. Um, okay. So I filled out the paperwork in 12 minutes and sat there and prayed my child wouldn't wake up for another 53 minutes. By the time I left at noon, I was so exhausted that I got my nuggets, ate, and then came home, only to find the maids still here. I'm sure I looked fairly crazy as I lugged the baby in, said hi, and promptly went upstairs to pump and then collapse on the bed. Parenthood is hard, but it's so much harder when you are carting around a 30-lb carseat and 45-lb diaper bag. (I exaggerate...just a little).

There were some kids playing tag in the waiting room (it was a ped neurologist...I'm guessing they see a lot of ADHD kids). I was fairly proud of myself for not losing it and yelling at them, especially with my sleep deprivation. Instead, I was able to organize their game to include 'safe zones' (i.e. don't cross this line and step on my child) and 'free zones' (i.e. have at it - run around to your heart's content.) It seemed to work well.

And now I know why most new parents feel like rock stars when they are in public - with all of the little 5-6 year olds running around, my 6 week old baby was the highlight. Everyone wanted to see the baby (see, not touch), including a little girl who was in charge of the tag game. Everyone ooh'd and ahh'd and made me feel all-over awesome. My little Pork Chop was quite the superstar. :-)

Brian just brought home Bobbies (turkey, cranberry, bread, and mayo - all safe, no?) and I'm feeling less grizzly-like. Whatever we are doing seems to be working - we've had two excellent nights (up at 1:30, 3:30, 6, and 8) and the little guy is up, feeds, and down within 45 minutes. Naps are getting more "scheduled" - he takes a long one from 1-4, and then from 6-8, so keep your fingers crossed. I'm sure now that I've put that in print, he will change everything. Oh, well.

So the formula v. breast milk debate continues in our household...

We are on Day 4 of the GERD challenge. We started Scotty on formula (the RS Sensitive one, can't remember the full name) on Saturday afternoon. Like the chow puppy he is, he gulped it down happily. And then Brian and I waited for the wailing...and then...nothing. We had a drowsy, happy baby on our hands. Silence is truly golden.

And this has continued to present day. We've had a few bumps in the road - one 2am cryfest that was more attributed to me than the little pork chop (inadequate swaddle + overtired little baby = 90 minutes of hysterics). But for the most part, Scotty is doing really well on the formula, making me think he does not have GERD.

Also, my diet is going well. I am eating like a grizzly bear - fruits, nuts and meat. I told my mom this and she suggested I dig in the backyard for some grub worms. If you see me leaning over a shallow stream, fishing salmon out wtih my insanely-long post-partum nails, please call the local mental hospital.

I added wheat back in, mainly b/c I was going crazy without bread. I mean, it's like I was attempting some version of the Atkins/South Beach/Perricone diet all at the same diet, WHILE lactating. I can only handle so much, people. And bread is delicious.

Scotty has had two bottles of breast milk (brewed yesterday around 3pm) and so far, so good. He is sleeping soundly right now and I hope our good fortune continues. Now I just need to figure out what is (are?) the true culprits - caffeine, alcohol, all of those veggies, citrus fruits, and dairy. My money is on dairy, to be honest - everything I've read (minus the blood in the stools) seems to point to a slight lactose-intolerance. Brian is slightly lactose-intolerant (amazing, considering the amount of cheese he eats) so I'm blaming him for this.

And in other (weird) news, Sunday afternoon was quite interesting. After my Target run, we were all sitting around watching football when there was a knock at the door. Everyone looked at each other (thinking the same thing: It was She-Who-Shall-Not-Be-Named), when I decided to be bold and answer it. Turns out, it was Ganster Boy from two houses down. (Remember, the drug dealers are next to us - aka Tent City - the gangsters are the house next to them, and the drug users are across the street). GangstaBoy was dressed head-to-toe in Green Bay Packer gear and looked rather eager to see me. Well, see Brian. Turns out, they had exchanged pleasantries while wearing their respective green and gold wear.

And now GangstaBoy wanted to talk to Brian. They chatted for a few moments at the door, and then next thing I know, Brian invited him inside and offered him a beer. Okay, this was getting interesting.

What lead him to our house? The new Direct TV satellite, festooned on our back wall. Thank you, my husband. Like a jackal smelling a fresh kill, GangstaBoy was lured to our home by the idea of Direct TV. He woefully told Brian how he had to watch the Packer game on his computer, and looked more than happy to plop down and watch more football on our 54' LED flat screen.  Brian is like the Pied Piper of Direct TV.

He was a virtual fountain of information, however. He told us he hates the drug dealers and feels as though they are doing bad things (especially with the Tent City). He said that the middle boy (aged 16) isn't even at home - "He's in some camp, somewhere." I about choked. Say, my former job? Holy crap, that's lovely. He also told us that they will not be in the house for longer than 3-4 months (pleasepleaseplease) since the mom has another job. Maybe that's why they are saving all of the boxes on the side of their house?

GangstaBoy was also kind enough to tell us about his daughter, aged 2. He proudly told us he just celebrated his 21st birthday last week and is trying to get a job at the Bellagio. He also likes to counsel the drug dealers on their life choices, exclaiming, "I don't do none of that sh*t anymore...now, I just drink and smoke, that's all." Great...

After Scotty was done with his bottle, he started to fuss a little. GangstaBoy looks over at me and says, "I think he needs to be burped." I ignored him. He says again, thinking that I didn't hear him, "Um, Kim, you need to burp him." I almost lost it (I was carb-less at this point, too, making me especially cranky) and shouted something about how I am TEN YEARS OLDER than he is but managed a quiet, "We think he might have GERD so we are trying to prevent spit-up by giving him more time to digest his food before he burps, so thank you, but we're fine." Pushy little gangsta. He's going to offer me advice on raising my child? I thought I had seen it all...

He literally sat in our house for about an hour, with all the rest of us exchanging glances like, "Um...how are we going to get him out of here?" I also didn't buy the idea that he was just stopping over for a freindly visit - my paranoia is so strong that I assumed he was casing the joint to figure out what to steal when the whole gang breaks in. 

I then had the inspired idea to change Scotty's diaper...even though it didn't need to be changed. Viola. In three minutes, we had a screaming baby on our hands, and one flustered GangstaBoy making a break for the door. He claimed he was taking a smoke break but never returned. Scotty: 1, GangstaBoy, 0.

I thought that was the end of our neighborly-ness until last night when Brian got home from work. I heard him pull in but then he didn't come inside. I finally walked outside with the baby to find him talking to both GangstaBoy AND DrugDealer. Turns out GangstaBoy told DrugDealer that Brian is a lawyer, and DrugDealer wanted to talk to Brian about a ticket he got regarding some stuff he shop-lifted. He needed legal counsel.

Fan-freakin-tastic.

We need to move. Now.

I went to Target today for the first time in literally months. I was all excited to buy a new lipstick (to wear...when? But that's not the issue) and just lose myself in the makeup aisle for awhile.

But then as soon as I walked in, I saw all of the Halloween decor and was reminded the big holiday is only a few weeks away. I thought about what we should dress Scotty as this year, and headed to the costume section.

But then I realized - I headed  for the pet costume aisle instead. I didn't know where the children's costumes as I had never shopped in the kid's setion before. I inadvertently landed amid kitty litter, cat chow and fuzzy mice.

It made me so sad. :-(

Emma was a ghost last year. I'll try to post a picture when I can.

Seriously, I'm not kidding. I just can't figure out if I should sell it on eBay or Craiglist.

And my other working title for this post (that I crafted in my head while at the grocery store) was "Over-feeding, over-producing, and overwhelmed."

Yes, folks, it has been a rough couple of days.

So it all started last Thursday when we went to see the new ped. Love her - very thorough, very calming, and she even managed a small giggle when I told I would be requiring a lot of hand-holding through this process.

Her first order of business during our exam was to press on Scotty's stomach and watch him vomit. "You are over-feeding this infant, no?" she asked in her light Indian accent. I immediately looked at my mom (accusingly, I admit). Grandma "You Can't Over-feed An Infant" Karen blanched slightly, and we turned over the food journal with some reluctance, eyes downcast. Yes, you CAN actually over feed an infant. Five to six ounces of milk per feeding is a ridiculous amount of food (please refer to the post where I ponder if Scotty had a hollow leg) and that's (allegedly) why he was spitting up. But again, per Dr. Awesome, it wasn't just spit-up, it was full-on vomit.

Oh.

So, Grandma Karen (who is clearly more mentally flexible than I am) immediately adapts to the new info, while I stewed, cried, and fretted for about six hours. At the next feeding, when Scotty did better with less spit-up, I relented and so, the three-ounce feeding was born (again).

So that was like 10 days ago. Where are we now? Oh...no better place.

The fussiness started on Monday. After the miracle that is the Happiest Baby on Block, Brian has the crying at night under control. Except Scotty continues to spit-up. And fuss. And cry.  Not at every feeding, but at most. Monday was horrible, Tuesday was great. Wednesday was horrible, Thursday was fine. Friday was horrible. Wednesday, in fact, was so horrible that when Brian told me he had to go to storage (our massive, cramped and roach-infested storage) to find our damn cable box (that I packed in 2007, and now that we are Direct TV consumers, the good people at Cox Communications were threatening bodily harm if we didn't return the damn box), that I offered to go digging through our massive, cramped, roach-infested storage because quite frankly, it was better than hanging out with a five-week old baby. (and miraculously, I found the damn box within about 10 minutes and without having to move great amounts of stuff. I drove around for 20 minutes and told Brian it took me 30 minutes to find the box.)

I saw Dr. Awesome again on Thursday (she looked at me pleasantly and said, "Back again?" with a smile. I had called her Saturday, Monday, and now it was Thursday. Yes, I am medically needy.) She listened patiently as I described his symptoms (arching of the back after feeding, crying, some spit-up, and increase in fussiness.) It could be the dreaded "5-6 week peak" of fussiness, but since he's not waking up crying (in the middle of the nap), he's gaining weight, and there is no coughing or gagging going on, she thought it might be a response to something in the breast milk. I.e. something I've eaten that is getting to him.

Now, I know there are two camps on this - the one camp that says, "Eat away! Babies are NOT affected by flavors in the mom's breast milk," and the other camp that says, "Eliminate everything - caffeine, chocolate, alcohol, spicy foods, cabbage, broccoli, curry, cauliflower, beans, citrus foods, wheat, eggs, and dairy" in order to rule out possible allergies and/or gas-producing foods. I don't know what camp to believe, as most things in Motherhood (yes, capital M) are confusing, contradictory, and generally, a quadmire of misinformation. One day I will write a post about all of the contradictions, but since I'm discovering more and more on a daily basis, I'm waiting for the list to slow down a little.

I also want to point out that once again, it's me. All through the pregnancy, the baby was always fine - it was just my damn body that was doing something funky. (fibroids, fluid, pressure, oh my). And now, it is me, once again, that is hurting the baby (allegedly). I'm trying really hard to not beat myself up over this, but it's really, really hard. I will likely be in therapy in the next few years (months) and we're already saving for Scotty's therapy in about 24 years. If I sound horribly self-depreciating, it's because I am.

Anyways, I am plugging ahead with the conviction of a terrier puppy and I WILL figure this out. As of today, we are going with only-formula for the next 48 hours, to rule out me as a possible cause of this. If Scotty shows no spit-up, no arching of the back, and no general fussiness, I take full blame (and change my diet asap). If he doesn't, we'll proceed with the testing required to determine if it's GERD. We are officially 3 feedings into our experiment, and I'm happy to report: no spit-up. No fussy baby. In fact, we have a lovely, alert baby that progressed into happy sleep cycles. Motherhood: 2, Kim: 0. 

And so, I went to the grocery store to stock up on new foods. My cart looked like I was joining a new religion that had dietary restrictions: green grapes, apple juice, organic chicken, soy milk, bottled water, almonds, an avocado, bananas, and two cucumbers. I know, this probably sounds healthy to most, but let's just say it's not my normal shopping list. Even the woman at check-out looked at me strangely. She was probably wondering where the Doritos were. I wanted to tell her, "I'm lactating," but I figured that might freak her out. As if she couldn't already guess based on the size of my boobs.

All of this leads me to the title of this post: we're got some breast milk for sale. I have been so proud of my pumping - I've been very committed to getting production back up to par - and now, per Brian, "The milk is bad." He uttered those five words yesterday and it nearly broke my heart. There were 9 3-ounce bags (i.e. single serving size) in the fridge, and almost 40+ ounces in the freezer. And all are tainted with the flavors of caffeine, chocolate, onion, garlic, and hoppy beer (only one per day! I showed such restraint).

If our experiment works out and it IS me, I'm not sure what to do with the last two weeks of my hard work. How should I phrase my ad on Craiglist? "Rich, full-bodied 60 ounces of breast milk available. Aged two weeks, light garlic flavor with a hint of dark chocolate. Pair with recently-sterilized binky and Mylicon drops for a satisfying meal."

::sigh::

I probably should have waited 24 hours before posting my last entry.

Today was crash and burn.

I hate to say it, but I hate getting off of our schedule. We had a friend from out of town come over last night for dinner, and it was a great time. Except I forgot to record Scotty's feedings and when and for how long he slept. And then before I knew it, it was 10pm (I'm supposed to be in bed by 8pm, since Brian has the night shift and I pick things up again at 2am).

I finally fell asleep at 11pm only to be awoken by Brian and a screaming baby at 11:30pm. Got the little guy down by 12:15am, and he was up again at 2am. Fed until 2:35, pumped, washed bottles, and I was back in bed by 3:15. Scotty was up at 4am. And he then was up at 5:30. And 6:35. And then 7:30. And then 9:15am. You see where this is going.

I swear, I swaddled, I shushed, I put him in the side position.I promised him a puppy (another one) if he would please just go to sleep and allow Mommy to go to sleep, too. He finally passed out at 10am, on my chest, and I just laid there, afraid to move him. We both groggily got up at 12pm, fed (well, he fed, I fed him. I just ate my first meal of the day right now, and it is 6:50pm. And yes, it was a Whooper Jr.), and then he was alert until 2pm. I tried to get some stuff done (like washing bottles - only the necessary stuff, trust me, I've learned) and was back in bed by 3pm. He was up at 3:30pm. Brian called and my frantic tearfulness gave him the impetus to come home early, and finally, by 5:15pm, I was off of baby duty for the day. Complete insanity.

Is this normal? He wasn't fussy today (normal crying), but OMG, how am I supposed to get anything done? How am I supposed to even do happy baby stuff, like take a walk, when I am so completely sleep deprived and exhausted? Why would I want to walk and expend energy right now? I want someone to push me in a stroller so I can nap.

The hardest part, I think, is trying pump while he's awake. I put him in his bouncy chair, hook my toe in there and try to keep him bouncing while I sit there doing my best moo-cow impression. He usually lasts about 15 minutes before he starts screaming, and then I attempt to jostle him, the binkie, the pump, and my moo-cow boobs. It's messy, to say the least.

After Brian came home (and I hightailed it out of the house to salvage the last bit of sanity I have left), I came home to find a blissfully happy SLEEPING baby and a rather proud Brian. I give up. I don't know what he did, but I need to find out.

Motherhood: 1, Kim: 0.

The greatest moment of my life (so far) has been the birth of Scotty. The moment he came into the world - seriously unbelievable. It made 9 months of pregnancy totally worthwhile (and immediately made me want to do it again, much to Brian's horror. Poor guy was still thinking about wheelchairs, bed rest, and back pain while I bathed in the glow of new motherhood.)

And now, I present the second greatest moment of my life: tonight, around 7pm. I had spent a horrible day yesterday with a very fussy infant that screamed for 3.5 hours in the morning and another hour when Brian got home. I googled reflux.I googled GERD. I looked up 'spit-up' and tried to figure out if my baby was normal. I posted my situation on Facebook, seeking advice from other mothers. I steeled myself for another 7+ weeks of this, telling myself I could do it. I might get a lot of lines around my eyes and mouth from the stress, but I could do it.

It was so bad yesterday morning that I actually had to step outside. I was crying so hard that I don't think Scotty could hear it over his crying. We were both a mess. The thought that I had to deal with a fussy, screaming baby for almost another two months seriously depressed me but this motherhood, I told myself. Buckle up and deal.

And then today, Brian showed me how to work the PlayStation so I could play a DVD. Our DVD player doesn't work (not sure why) so we play things through the PlayStation, a contraption I have zero experience with. A few months ago, one of Brian's co-workers gave him 'The Happiest Baby on the Block' DVD but I never watched it since I don't know who to work the damn PlayStation thing. After yesterday, I begged Brian to please set it up for me since I was desperate for any new ideas.

I had read the book (even reviewed it) but the book, like most books, is nothing like the movie. The DVD is 100x better - and gives real and actual descriptions of HOW TO swaddle, shush, side-position, swing, and suck. Scotty had a great day this afternoon, so I didn't get a chance to put my new skills into action until tonight.

And then, right on cue, around 7pm, Scotty began to fuss. We did our usual 'talk to the baby,' 'snuggle the baby,' 'walk with the baby' routine. And then I busted out my new swaddling technique. Scotty still screamed. I did the side-position move and in 30 seconds...silence. Blissful, lovely silence. I looked at him to make sure we weren't hurting him, and he looked absolutely content. Wonderfully content. Like a switch in his brain had been turned off, and now he was happy. I was so happy I started crying (again). BEST DVD EVER, PEOPLE. This man, Dr. Sears, needs a Nobel Prize or something.

When Scotty got fussy again in two hours, we repeated our behavior. And you know what? IT WORKED!!!!! Again. Phenomenal! Scotty is now blissfully asleep, growing and developing, without having to waste all kinds of useless energy on screaming and fussing. I now have so much time on my hands that I can blog, talk to friends, write a book, maybe even make dinner. Brian will have a hot meal waiting for him? Truly a blessed event.

Anyways, I HIGHLY recommend this DVD. An A+++++ on my rating scale. Don't get the book; get the DVD. Much more helpful.

And let's keep our fingers crossed that our good luck/baby wrangling skills continue to improve. :-)

So, I just have to dedicate this blog entry to my good friend Courtney.

She managed to do what few people have been able to do in recent weeks: she made me feel like a human being again. I spent the afternoon at her house and I don't think I've laughed that much since...well, July.

I'd like to think of us as modern day Betty and Francine - a more sane, smokeless version.  For those of you who don't know, Betty Draper is Don Draper's stay-at-home wife/mother on 'Mad Men," the best drama on TV (thank you, Emmy voters). Betty has her hands full raising two kids (and pregnant with a third) while Don traipses around Manhattan, but her good friend Francine is ever present, sitting at Betty's kitchen table, sharing gossip. The two smoke (while pregnant), drink (while pregnant), and talk about the neighbors. I'd like to think we've learned a thing or two since 1962 (like, don't drink or smoke while pregnant), but female friendships have remained the same.

Courtney and I have a lot in common. We're not really neighbors, but grew up only 20 miles apart on the south side of Chicago. We didn't meet until Las Vegas, but our husbands work together and share a secretary. And they share a lot of information, too. I called Brian to tell him I was headed over to Courtney's, to which he replied, "I know. I just talked to Jason [Courtney's husband.]"

My mom is a teacher and named Karen. Courtney's mom is a teacher named Caryn. We were born two weeks apart and are both Virgos. And, interestingly (and sadly enough), baby Scotty was born on the same day Courtney's dad passed away. We' like to think they passed each other on their way in/out of this world and maybe high-fived.

So today, we watched as Courtney's toddler son played with his toys. She is almost 33 weeks pregnant with whom we both believe is Scotty's future wife, baby Samantha. We talked about pregnancy, pediatricians, baby slings, and pork chops. She brought over this great chicken dish after Scotty was released from the hospital, and I'm planning to make my mom's tamale pie for her family when little Samantha joins them (sorry to ruin the surprise, Court, if you are reading this). I drank a decaf pumpkin latte while she sipped water. We watched 'Dora the Explorer' and read a few children's books. All in all, a great afternoon.

I'm not sure who is Betty and who is Francine, but I'm fairly confident that everyone needs a Betty/Francine relationship in their life. After all, this motherhood stuff is tough, and would simply be that much harder without the support of good friends.

Okay, this is a serious post. I want everyone to know what Brian and I didn't know three weeks ago.

As we all know, Scotty's bilirubin levels at the hospital were 28.9 at admit, and it dropped within 36 hours to 12.8. While initially we thought he was a fairly straight-forward case of dehydration and jaundice, what I didn't know is that we will not know if there are any long term effects to the high bili levels until he is 4 months old. Some cases are diagnosed as late as 18 months. We really won't know until Scotty starts hitting (or missing) his developmental milestones.

Kernicterus is a disorder that results from high bili levels. What is considered high? It all depends on the baby. Kernicterus happens once the bili crosses the blood barrier in the brain, causing PERMANENT NEUROLOGICAL DAMAGE. PERMANENT. Let me say it again: PERMANENT. Once that toxic bili seeps in, there is no going back. Resulting conditions include auditory processing problems, athetoid cerebral palsy, gaze and vision abnormalities, mental retardation and even death.

What I found most interesting is that kernicterus was labeled as a "Never Happen" Event by the Centers for Disease Control in 2000. A "Never Happen" Event is just that - it should never happen. Kernicterus is 100% avoidable and preventable - as long as it is caught in time. And it is not up to parents to catch it - it is up to hospital professionals and pediatricians. Bili levels MUST be taken in order to determine what level of treatment is necessary. Phototherapy (the lights) is one treatment, as is the bili blanket, and exchange transfusions (swapping out the baby's blood with cleaner blood) are also used.

Also found in my research: many cases of kernicterus are under-reported or not reported at all (making it seem much more uncommon that it is) due to the HIGH LEVELS of litigation that ensue after a kernicterus diagnosis. Ligitation - i.e. someone is getting their pants sued off of them. Based on what I found, we're talking about $5 million dollar settlements and up.  The money is necessary for treatment, therapy, and ongoing services for the affected baby. For the rest of his or her life.  Once again, I want to highlight - this is a totally preventable disease. And if it happens, it appears to be the result of malpractice. Doctors and hospitals did not order the appropriate tests, bili levels spiked, and a little baby's quality of life was lost forever.

The reason I am writing about this is because I don't want anyone else to ever experience one ounce of the panic Brian and I have felt since August 26. For anyone that is reading this, please tell every pregnant woman you know: insist on bili checks. Insist on it. Tell your hospital/post-partum nurse/pediatrician that you want bili levels checked frequently (daily, hourly, if necessary). You want blood tests (it's just a prick on the heel of the baby) to confirm that levels are normal and not rising. Insist on this for the first few days, and follow-up frequently.

Perhaps the scariest thing I read is that the majority of kernicterus cases happened within 3-4 days of life. These little babies never had a chance. With hospitals discharging mothers within 24-36 hours after birth and relaxed attitudes toward jaundice, these babies' levels spiked on Day 3 and the families were back in the hospital on Day 4. Because much of toxicity of the bili depends on the baby's weight and age, younger babies don't stand a chance. I found that the determination of doing the exchange transfusion is based on the baby's weight in grams divided by 100, and then compared with the bili level. So, for example, Scotty's admit level was 28.9. His weight at the time was 7lbs, 6oz (or 3400 grams). 3400 / 100 = 34. If you remember, the neonatologist told us upon admit that "34 was the number of no return." That's how she came up with it. So, a little baby that is only 1200 grams (about 3lbs - premature, low-birth weight) only needs a bili level of 12 to be extremely dangerous. Your average 6lb, 12oz baby (2772 grams) only needs a bili of 27.7 to be at serious risk. Combine that with the fact that the baby will probably lose weight in the first week of life (common), perhaps down to 6lbs (2376g), and all of a sudden, 23 is the magic number.

That's why it's tough to predict what babies will be affected by kernicterus and which ones will not; it's all relative. And younger babies have a less developed blood barrier in their brain, putting them at even greater risk.

Babies that are exclusively breastfed are also at greater risk, since breast milk contains the mother's bilirubin. What is interesting is that I have 5 books on breastfeeding - and not a single one of them mentions kernicterus. All five books mention jaundice, but all five claim that increased breast-feeding is the way to get rid of jaundice. Technically, yes, but in my case - no. Breast feeding simply contributed to the problem. Scotty wasn't getting enough milk to help him pee/poop out the bilirubin, and so it built up in his system. The higher the level of bili, the more lethargic Scotty became. The more lethargic, the less he wanted to feed. And so, the less he peed/pooped. Had I used formula, it would have hydrated him, giving him more food to pass through his GI, and pushed more bili out.

Not surprisingly, all five books are currently in my 'burn' pile and will likely be used as kindling later this winter. As will every business card related to a lactation consultant who told me "formual is poison."

There is a fantastic online support group out there called PICK - Parents of Infants and Children with Kernicterus. www.pickonline.org.  Please check it out - they have all kinds of great info listed, including what babies would be considered high risk for jaundice. Some of those risk factors include:

- boys
- born via induction
- moms with gestational diabetes
- babies that lose a lot of weight right after birth

Also at risk for jaundice:

- if there is a sibling that was jaundiced at birth
- if bruising happened during delivery
- pre-term babies (born before 37w)
- feeding problems (baby is unable to latch on, has problems swallowing)
- Blood incompatabilities (Mom is O, baby is not)
- early jaundice (yellowing within 24 hours after birth)
- heredity, mainly Mediterranean or Asian families, since it is harder to see the skin color correctly.

All of these risk factors warrant a HIGH level of supervision and monitoring. Looking back, Scotty was a boy, born via induction, lost a lot of weight right after birth, had early jaundice, and had serious feeding problems. My milk also didn't come in until Day 5, putting him behind the 8 ball almost immediately. Again, all of this was reported to our pediatrician at the first visit, and yet she did nothing. No blood work, no two-to-three day follow-up - nothing. And four days later, we were in the ped ER, practically hysterical. Four weeks later, I am still trying to calm my mind and not fall to pieces everytime he doesn't wake for a feeding or has a weird look on his face.

I grilled our new ped yesterday about the likelihood of Scotty having long-term effects as a result of all of this, and she said that had she not known his history, she would have thought he was a normal one-month old infant. He passed his auditory brainstem response test prior to discharge from the NICU, and is showing appropriate head control during tummy time. He also is tracking objects with his eyes and is making grasping motions with his hands.  Thank you, God. Brian and I feel insanely lucky that we may have managed to avoid this colossal pit-fall. She also suggested I consult with a pediatric neurologist for more peace of mind, and I plan to follow-up on Monday. I can't believe we will not know for certain until he is almost two years old, but as for right now, things look okay.

I cannot even describe the roller coaster of emotion that I have felt since the word 'kernicterus' came into my vocabulary. Please do not let this happen to your child or anyone else's child that you know. Please talk about this with your friends and family. As I told our first pediatrician (when I asked her why this info is NOT listed in jaundice pamphets), she said, "We don't like to scare our new mothers." Well, what is scarier? Hearing about a potential neuro-toxin or having to monitor your child for developmental delays? Seriously.

And interestingly enough, when I initially posted about kernicterus at the end of August, my sister (mom to Ben) read the warning signs and became concerned. Ben is a boy and lost a lot of weight after birth. He appeared yellow even at 13 days old (when I posted the info), and Kelly took him in that day to have his level checked. It was 14.7. High. Not high enough to be admitted , but high enough to warrant monitoring and possible formula. He's doing great now, as is Kelly, but again, knowledge is power.

Please share this with everyone you know. If any of my facts are wrong, please let me know so I can correct them. I am not a doctor and am just trying to summarize the enormous amount of information I found on this topic. And please continue to keep our little bear in your prayers, along with every child affected by this disease. It is truly a tragedy (and abject failure of our medical community) when kernicterus happens.

I don't want to toot my own horn around here, but...

guess who pumped 10oz last night?

Woot! Toot. :-)

I did it. I fired our pediatrician.

I feel much better. Brian and I aren't sure what we will do next - if a complaint to the medical board is warranted, or even a possible law suit - but I am glad the office will no longer be a part of our - or Scotty's - life. The original ped (not the one who so grievous erred) has been treating us like "Oh, everything's fine! Let's put this little snafu behind us, shall we?" and it really bugged  me. I wanted to tell her (and I did, at our last appointment - oh, me and my mouth) - that 1.) what happened was a REALLY BIG FREAKING DEAL and 2.) we have lost trust in her and her collegues. And do NOT minimize our situation in order to make yourself feel better. She also couldn't guarantee me that the other doctor would never see Scotty again. In her words, "I need to have a life, too." I understand that (and as a former practitioner who had to deal with emergency calls from patients, I'm well aware of how this works), but as I told her, "You are only as strong as your weakest member."

And so, the interviewing began. We found a lovely woman with a solo practice who assured me she never takes vacations. We are meeting with her today for Scotty's one month check-up.  I feel the need to cram in as much tummy time between now and 2:30 as possible, almost like in college when you sat there and read the whole text book in anticipation of the quiz in class. Nothing like procrastination. I'm so glad I'm passing on my bad habits to my son.

And in other news...

I am pumping almost 7-8oz at night! This is very exciting. My production is down during the day (about 4-5oz per pump) but really skyrockets at nighttime. Scotty, however, is an eating machine (his nicknames vary from Chumley, Pork Chop, Piglet to Chow Puppy) and has taken to eating four ounces every two hours. Where is he putting this food? I'm planning to work up his chart for the new ped today to make sure he is developing appropriately. Does this child have a wooden leg? Seriously.

I am only 8 pounds above my pre-pregnancy weight. This is insane. I've fought a long, hard battle against my body (and weight) the majority of my life, and I'm hoping this is perhaps my body's way of saying, "Sorry, Kim...we'll be nicer to you in the future." A silver lining to the past month? Either way, I'll take it. And, just in case you are curious, it's not like I was skinny pre-pregnancy. I was fattening myself up in anticipatino of pregnancy ("Onion rings? Sure! That's sounds great!") so I really have about 20 more pounds to lose to fit into my favorite pair of jeans. Body, did you hear me? Start metabolozing.

And finally, in non-baby news, our neighbors (yes, those neighbors) are right back up to their old tricks. Not only have they piled about 60 cardboard boxes on the side of their house (right in front of our window), but they have set up "Tent City" in their backyard. There are two huge tents amid the cat litter, potting soil bags, and flattened cardboard boxes. There is even a fire pit carved into the rocks.   It's like we're living next to a homeless city. I called the Fire Marshall yesterday but they seemed wholly unconcerned. Great. Because our house burning down will just the cherry on top of an otherwise stellar month.