Mrs. Peter's Birthday Cake

A favorite book at camp was The Seven Silly Eaters by Mary Ann Hoberman. This delicious picture book tells of a rapidly growing family, a child a year and a set of twins until there are seven children, where each child will eat only one food: warm milk, homemade pink lemonade, applesauce, non-lumpy oatmeal, homemade bread, eggs fried, and eggs poached. As the mother approaches a nervous breakdown and her birthday, the children decide to make their favorite foods for her. They can't, end up with a big mess, some of which they hide in the warming oven, and in the morning a "pink and plump and perfect cake" is discovered. It turns out to be the one meal they can all agree to eat, and -- even better -- they can all help make.

I had to read this about three times a day. Monkey1 did admit, when I asked, that she was trying to memorize it. Monkey2 insisted I write down all the ingredients so we could make this cake. 

So we tried for the occasion of Monkey3's five-month birthday. (This first year, she gets a birthday every month.) Referencing my best baking recipe, I included everything in the story and served it hot out of the oven. So hot in fact that the candles melted. So then I had to cut holes in the cake so we would not eat the wax. But with ice cream on top, the Monkeys thought it was delicious. However, I was puzzled that it had not risen at all. I got the pink part, red sugar added to the lemon juice for the pink lemonade, but not the plump part. My husband pointed out that the "quick bread" recipe I was working off of used baking soda and baking powder to rise, but this had been rendered useless by the acid of the lemons. So next time I'll have to try my luck with yeast for achieving that "pink and plump and perfect cake."

A Pint is a Pound

The one month later weigh-in appointment for Monkey3 showed that she had gained one pound. "Are you happy with that?" the doctor asked me.

I looked at her in confusion. I had not been unhappy with Monkey3 until I was told she was steadily dropping down the growth chart percentiles. Actually, that had not been very upsetting. It was the "You have to come back in a month for a weight check... and you may have to start solids early" comment that had made me unhappy. I felt like saying, "Are YOU happy with that?"

Yes, for the medical chart minders, a pound in a month was satisfactory. The baby had stabilized on one growth curve. A continuation on this trajectory will mean she's a peanut, a tiny baby, but at the moment that is acceptable news to the white coats. 

Should a pound be a victory? It doesn't feel like one to me. A pound in a month is what she has been averaging. A friend who is also taking her baby to frequent weight check appointments remarked, "I'm just trying to buy time until my baby matches their chart... because he will eventually." We got lucky it happened so quickly. Still, I am reminded of the medical disregard for individuality that I encountered from doctors during pregnancy, causing my husband and I to seek out a midwife and skip the hospital. 

I wonder if this discontent will also lead us on another path...

600 Miles to Memory Lane

Ever since I heard about my high school graduating class marking twenty years, I was alternately eager to attend the reunion, mildly curious, or revolted by the amount of money I might spend to travel. My high school was almost six hundred miles away. I had a nursing baby. I would have just been in the area exactly a month before for my annual family visit -- mom, sister and family, aunts and uncles. I had not seen most of my classmates since our six-and-a-half-year reunion. (Yes, my class had a six-and-a-half; things did not get organized in time for a five-year gathering.) How important was this anyway? I consulted with some of my friends in my current city and home of six years. One had missed her twentieth and later heard it was terrible, all cliques and old high school stupidity. Someone else advised me to find out if my BEST friend in high school was attending. And a third said, "Oh you have to go! Everyone just wants to talk about their kids!" 

Then our family visit happened, Monkey3 proved a good traveler, and my mom was sick half of our visit and didn't dare hold the baby. I decided to give her another opportunity and attend my high school reunion, and I would drive, and bring all the Monkeys. 

Was I crazy?

The first day we logged over 350 miles, stopped four times, and checked into a hotel with a pool at seven in the evening. The Monkeys had been looking forward to the promise of a pool all day! It was small, and they only stayed in it for fifteen or twenty minutes, but it helped settle them down for the night.

The next day we completed our journey by mid-afternoon, into the welcoming arms of my mom. 

I don't think I have ever driven so far on my own before. Ever. And I did it with three kids! I wonder if my level of daring has increased since Monkey3's arrival? Or perhaps my estimation of what I am capable of? 

The next day was reunion day, with a family friendly beach  lunch -- a pavilion was rented as a meeting spot and catered by a classmate who owns a restaurant -- and an evening adults-only buffet dinner. It was wonderful! The Monkeys loved the beach. Monkey2 made a new best friend in about two minutes. Monkey1 did not quite find a quick companion, but she enjoyed playing tag in the water with a sweet eleven-year-old girl and she thought the chef was hilarious. Monkey3 was along for the ride in the wrap, and she slept about half the time. The rest of the time she was staring at people with her big blue eyes and showing off her big toothless baby smile. I did not have a lot of time to talk to people, but all of us with kids were being pulled every which way -- filling water cups, finding forks, getting two bites eaten, making sure a parent was down at the water while someone else did bathroom escort, greeting a classmate and answering the "Where are you living now?" question before being pulled off to open a yogurt. (And where did those Sponge Bob yogurt tubes come from anyway?) But the evening afforded more talk time as we mingled and ate fajitas and shared cell phone pictures of our kids and talked about the transition to kindergarten. People did seem to clump into their high school groups at first, but as the evening wore on, people moved about. We were not the smallest class to graduate from my high school, but close to it. At one point we had been 92 students, remarked upon because we were the class of '92, but families move and change schools, so we graduated with a few less. Unlike some schools in the area, we had all known each other's names. The organizers did not deem name tags necessary. 

When I first arrived at the beach, I did not recognize anyone. Someone welcomed me by name, and in introducing herself, I was suddenly reminded of her mother. Then I recognized her. ("Oh geez," I thought, "We've reached the age of looking like our moms looked..." This was particularly true of my classmates that I had attended elementary as well as high school with.) Then I started recognizing faces, and by the evening it all came back in a flood and names were fast floating to mind. 

I stayed on the periphery, nursed my baby, shared her off while I ate, went outside to re-wrap her in the quiet with two classmates for company, and returned inside the restaurant, staying to the quieter spots mostly, so I did not get to talk to everyone I wanted to, but my baby slept as I listened and chatted, enjoying my evening out. 

It was worth it. Driving almost 600 miles to touch the past and present at the same time, to give a nod to history and to our lives that have radiated out from the crucible of high school, it was worth doing. 

Her Best Nap

I can do a lot of things with Monkey3 on my back -- laundry, emptying the dishwasher, sweeping the floor, reading or emailing as I walk around the house -- but seeing what she is doing requires either a mirror or a camera.

A Leg to Stand On

If I visited the lactation consultant in hopes of hearing that growth charts are rubbish, the peditrician is a complete nincompoop, and as a third-time nursing mother I'm doing everything right, then I was disappointed.

The lactation consultant said that as far as dropping percentiles, I needed "to continue to watch the situation." So the pediatrician's request for a weigh-in in a month was reasonable.

I said something about weighing all Monkey3's diapers for the last few days because in terms of volume I have no idea how much she is getting, and the lactation consultant chuckled, pointing out that the human race did survive before scales were invented.

Watching me nurse Monkey3, the lactation consultant helped readjust our positioning for a better latch. We talked about my Monkeys' (all three of them) habit of nursing on one side. She encouraged me to offer the second side. This took some patience, as Monkey3 was very interested in looking around and showing off for her new audience. We turned down the office lights, the lactation consultant stopped talking, and after Monkey3 finished oogling the emergency exit sign -- red, her favorite color right now -- she returned to business. The baby scale used before and after each feeding indicated she consumed 2.4 ounces per side. A good meal for a breastfed baby.

Now while a dark and quiet room is out of the question for every feeding of the day because I have two other children to keep track of, offering the second side and trying to reduce distractions, such as wearing a nursing cover-up cape, may help. Monkey3 will only eat if she's interested, but trying to minimize how interesting the environment is may help her focus on eating. Also, a little massage after the initial let-down, which is quite strong, could encourage Monkey3 to stay attached, as the lactation consultant noted that some babies will "coast" on the initial let-down of milk and lose interest when they have to work a bit more. "Help her get to the cheesecake at the end," were her words, as the hind-milk, end of feeding milk, can be richer.

We discussed initial foods, for when the time comes, and how nutrient dense things like avocado, sweet potato, and banana would be a better start for her than the classic rice cereal and breastmilk.
"I've never ever pumped," I told the lactation consultant, "It would be rice and water... and that's not a great idea."
"You are amazing!" she said. In her job, she usually deals with pumping mothers.

So I have a few little things that I can work on with Monkey3, but really, what will it do? I doubt that nursing her more will move her back up the percentiles to 75th, where her at-birth weight initially put her on the chart. Maybe she is just going to be petite. Somebody has to be at the bottom of the chart!

"I don't mind standing up to a doctor," I have said to another mom, "I just want to know I have a leg to stand on."
"You do!" she retorted, "You're the mother! You are around your baby all day... these doctors breeze in for five minutes..."

The other mothers I have spoken to who also have, or have had, babies that do this percentile drop thing either have "a peanut," as a tiny kiddo is commonly referred to, or have something drastically wrong -- but the mom knows that! When the baby is happy, shouldn't mom also be? Not when doctors start taking an extra look at their papers and asking questions about how many times a day the baby eats and how many diapers are used. Not when doctors bully supplements or mention Child Protective Services (not my experience, but yes a mom I know). "Failure to thrive" really is different from failure to stick to the average growth chart.

If the doctors would only get their noses off the tiny ink spot on a graph, maybe they would see... I have more than a leg to stand on. And my baby has two chubby legs she's kicking to stand on.

A Rainy Afternoon

A cute family of girls and umbrellas were out this afternoon... Oh, that was my family.

It was lightly raining. Dad was gone for the afternoon, and will be again tomorrow morning, so I knew that a rainy day inside our house, which is still all pulled apart awaiting the last of the bug treatments on Tuesday, would be just Trouble. So out we went, umbrellas in hand, and walked to the library. At their short-legged pace, and without heat to make us dawdle, it is about a forty-minute walk.

Monkey1 didn't actually use her umbrella that much.

Monkey2 kept hers up the entire time and somehow got wet to her knees walking through the cut grass.

The library was busy. I guess I've never been on a Saturday before. Monkey2 quickly stacked up a pile of books, while Monkey1 spent her time studying some graphic novels of a steampunk Rapunzel. She was also brave enough this time to ask the children's librarian where the first Harry Potter movie was. (We know the book by heart, having listened to the audiobook beyond countless times.) The librarian pulled it out of a stack of just-returned, ready-to-shelve items. I guess tomorrow's no-Dad morning is taken care of!

See? Happy Monkey1 after a walk to the library and back in a light rain. Fortunately light because my umbrella has a hole. Monkey2's energy must have been flagging because she held my hand most of the way home, though she kept up a steady cheerful stream of chatter. As usual, Monkey3 just hung out for the ride.

Mystery, or How to Make a Mom Feel Inadequate

Monkey3's four-month well check up.  Scale, measuring tape, questions about what she is doing developmentally and how long she sleeps at night, ... same old stuff. Except, "she dropped percentiles in weight. You need to bring her in for a weight check in a month. That way if there is a problem, it can be addressed before her next well visit (in two months). She might need supplements, or you might think about starting solids early."

What?
Wait, what!?

She gained weight. In two months she gained 1 pound, 12 ounces, but her weight gain has slowed dramatically from the previous curve she has been charting.  Pediatricians have growth charts, and each  well visit, the baby is weighed and measured (length and head circumference), and these numbers are plotted on a graph. Out of a hundred babies, some will be big, 90th percentile, some will be average, 50th percentile, and some small, 10th or 5th percentile.  It simply means that compared to a hundred other babies, this baby is, say, bigger than 90 other babies, or perhaps 5 other babies. These are the percentiles. Generally, a baby will grow on a curve, sticking approximately to one percentile. When there is a large jump from one percentile, or growth curve, to another, this is a red flag of a problem.

Except there are no other symptoms.

Monkey3 is a happy baby. She is not colicky, does not spit up much, outputs diapers, sleeps well, is alert and interested in people around her, is meeting her milestones such as smiling, rolling over, holding up her head, grabbing things, etc. I had no idea she was "not getting enough."

For two days I wandered in a frightened haze. What would happen if she was not charting correctly in a month? I breastfeed her, as her sisters before, and I do not want to supplement formula. As for starting solids before six months, that just sounded absurd to me. Monkey3 can't even sit up on her own yet! What is going on? How could I be so clueless? She is such a happy active baby! How can anything be wrong? Don't babies tell you if they are hungry?

A week before, at a baby shower/moms' evening, a mother of five was commenting on how she had extra weight checks on her baby, who is two weeks older than my Monkey3. I accosted her for a few minutes one morning at Vacation Bible School.
"Yeah, he "failed" his weight check," she said, rolling her eyes. "I'm feeding him avocado. Who feeds their four-month-old avocado? I do, because it keeps them off my back. He has another weight check in two weeks."
He's her happy baby too. We take our children to the same pediatric practice.

After supper I thought of La Leche League. They would know. They would have answers. They would have suggestions, tips, sympathy, and support. I looked up the area meetings. There was one that night, 65 minutes from now. I called my husband at work. His office voicemail answered. Hopefully he was on the bus home. He was, because ten minutes later he walked in. I immediately told him I wanted to go to a LLL meeting.
"When is it?" he asked.
"7:30."
He looked at the clock. "I wasn't going to go running because my heel still hurts, but I guess I can walk.... Monkey1, Monkey2! Get your shoes on! Go to the potty! You're running with Dad tonight!" A local running store has weeknight training fun runs, typically a five mile loop, though there are also walkers who do a three mile loop, and then a social hour. The wine shop a few doors down has figured this out and holds wine tastings late evenings post-run.
So, all five of us were out the door.

La Leche League is a wonderful resource, both as a source of information and help for breastfeeding moms and as a source of fellowship during what can be a bewildering time for women becoming mothers. After the customary round-the-circle of introductions, as each introduced herself and her baby and briefly described why she came that evening, the leader, who scribbled notes during the introductions, furrowed her brow, and said that as there were so many different issues, and she would try to address all of them, but she'd start with the most concerning problem.

That was me. And Monkey3.

Dropping percentiles is potentially a sign of a very serious issue; inadequate weight gain could signal a host of nutrition problems. However, since she is a happy baby (and Monkey3 was with me, taking in the room and people, snuggling down to nurse, babbling when done, and otherwise pleasantly carrying on), and so plainly "getting enough," the LLL leader was hesitant to suggest a course of action. She encouraged me to find a lactation consultant, preferably one with an International Board Certified Lactation Consultant accreditation. Another person, a mother of a two-year-old, pulled out her cell phone and gave me the number of the IBCLC lactation consultant who had helped her.

Feeling so much saner, the next day I contacted the lactation consultant. We spoke on the phone at length, and she was plainly baffled. She had not run into this -- a drastic drop in weight percentiles and lack of other symptoms -- before. She's on it though, and will research and consult with colleagues. At her request, I sent her all of Monkey3's height and weight numbers from the well baby check ups, birth onward.

I still don't know what to do. I try to nurse Monkey3 more, and when she's not interested, she certainly lets me know!