福娃6个月例行体检体重88% - 18 .2磅,身高77% - 67.5 厘米,头围92%。事前,我怕忘记问题,就整理了一页半纸的问题单子,省了医生不少时间,毕竟读纸条比口述要快得多。去体检之前,乐爸就说,医生肯定说都正常,基本上问不出什么所以然来。果真这样,对于我提出的,问题医生都说正常。关于湿疹,她建议我们用Hydrocotisone,说不用担心皮肤变薄这个副作用。
最近福娃吃奶减少,从医院回来后我又开始使劲喂,结果全盘吐了两次- 4点半一次,11点半一次。乐爸和我痛下决心,还是顺其自然吧,爱吃多少吃多少。看来福娃还是比较脆弱,不知是不是胃有些刺激。王阿姨喂的时候很少吐,她一般不想我们这么心切,主要是顺其自然。
把给医生的条子贴子这里,留个纪念吧。还附上开妈湿疹经验谈,谢谢了。
Discussions Points with Dr. Carlo
1. Breast milk intake has reduced from 35 ounces to 30 ounces, from 5 ounces per intake to 3-4 ounces. I understand that at 6 months, normally babies drink about 40 ounces. This has been going on since around February 1, 2011. We don’t know what caused this sudden change. She had to take antibiotics around early Feb to fight infection caused by bleeding and discharge on her face which was caused by scratching.
When she takes the bottle, she can stay still for like a few minutes. Then she starts to get fussy – either pushing away the bottle using her hands, or closing her mouth tightly, or crying.
In the past, she used to take 4-5 ounces every time. Nowadays, the intake is irregular, sometimes 3 ounces and sometimes 6 ounces. She still feeds about 8 times a day, including about 3 times at night.
What caused this change? How much is enough? What should we do?
2. Introducing solid food. We started rice cereal last week, but she doesn’t seem to be interested, also pushing the spoon out from her mouth. I have a feeling that she will not like solid food for some period. What should we do?
3. We started multivitamin with iron last week, as we are afraid she may be lack of iron or some type of vitamins which cause her to wake up frequently at night and shake her heads when falling asleep. Your view on multivitamin with iron? Did we start late?
4. She has been having green poops for over a month. The poops look mucous. I called the nurse once. She said it is not a problem. So I went on to do my own research. One source says green poop can be a sign of too much foremilk and no hind milk.
Symptoms that baby may exhibit:
• Fussiness and/or gassiness
• Frequent stools, often green, curdy and mucus
• Gulping, gasping and choking while nursing
• Excessive weight gain
• Apparent lack of "comfort" nursing
• Discomfort when breastfeeding, sometimes so intense that baby goes on strike
• Possible early weaning (often close to the first birthday, sometimes sooner)
My questions – the above seem to be related to oversupply. I don’t have over supply issues, just pump about enough every day.
5. Eczema – had bleeding and discharge about 3-4 weeks ago, but now under control. Have very dry skin. We applied Aquaphor ointment and Aveeno lotion on her face throughout the day. We applied Hydrocortisone when it appears very itchy. But we haven’t used it for a while given the side effect of the medicine.
We don’t use soap when we wash her. We wash her quickly. When will she outgrow Eczema? Could it be food allergy? Nobody in the family had Eczema.
Eczema has been causing lots of problems other than itching. We constantly have to keep an eye on her, so that when she scratches her face, we can stop her. Also at night, we have to move her to the big bed, so that when she wakes up in the middle of the night, we make sure she doesn’t scratch. It is very tiring for everybody.
6. Sleeping pattern has changed since the Eczema breakout. Night sleep – on a good night, wakes up every three hours. On a bad day, she has 30 minutes nap, waking up still feeling very sleepy. On a bad night, she keeps scratching her face or rubbing her eyes. Neither the parent nor the baby can sleep well. Sometimes, it is hard to tell whether the scratching/rubbing is due to the Eczema or sleepiness or something else. When she is sleepy, she tends to rub herself more frequently.
In addition, she shakes her head from side to side when trying to fall asleep.
7. Overall – she doesn’t seem to be as calm or peaceful as her sister when she was this age.
Then I followed up with a question on throwing up milk...
From: RF
Sent: Wednesday, February 23, 2011 05:57 AM
To: Carlo, Vanessa
Subject: quick question about Claire
Dr. Carlo,
I forgot to ask you one question during yesterday’s visit. Recently Claire has been throwing up the whole breast milk intake after the feeding (normally 5-6 ounces). For example, yesterday, she threw up the whole thing at the 4:30 pm feeding and 11:30 feeding. This never happened before she was 5 months old, but happened frequently during the past month (every 1-4 days, sometimes twice a day). Does her stomach feel irritated? We suspect this may have something to do with the reduction in milk intake.
Responses from Dr. Carlo:
It may be some reflux. Does she seem uncomfortable or in pain? Most babies with reflux do ok without treatment. We know she's gaining weight well so the only reason to intervene would be if she shows signs of pain and in that case she would need medication, like Zantac. Based on the visit yesterday I don't think she needs it but if you feel differently let me know.
开妈湿疹经验谈:
这是当年开的湿疹的记录:http://tigtagpnb.blogspot.com/2008/05/tigtag_5382.html
我现在记得清楚的是:
1. 每周洗两次澡,不要每天洗澡;洗澡用温水,越凉越好,不要用热水;洗澡水不
放任何东西,就用白水洗(开一岁以前一直这样洗);洗澡要快,越快越好。
2. QV cream是主要的擦皮肤用品,用来防止皮肤干燥,因为皮肤干燥会导致瘙痒,
湿疹。湿疹严重,比如发红瘙痒,就要用hydrocortisone的药膏,如Sigmacort。如
果有真菌感染就要用hydrozole,包含hydrocortisone和antifungal agent的药膏。
3. 贴身的衣服被子都要100%棉,不要接触化纤,羊毛衣物。
4. 要防止穿盖过多。湿疹遇热容易加重。一定要保持孩子凉爽。
现在就能想起这么多。湿疹是开当年让我非常头疼的毛病,现在还有一点点,基本
上可以控制。当年我花了大量的时间和精力来咨询,调查研究和治疗,所以开基本
上勉强能控制得住。开爸的同事的孩子因为父母不知道该怎么办而湿疹到脸都抓烂
感染,需要抗生素。做父母的看到孩子这么受罪真的是很难受。希望我上面的经验
可以帮到乐妈。我知道美国可能情况不一样,因为我法国的好朋友说她们那边需要
保持皮肤干燥而不是湿润,所以上面的经验只是给乐妈参考,需要乐妈根据视情况
采纳。
儿科医生开给天的eczema management plan供你参考:
1. short bath
2. no soap
3. no woollen clothes
4. not to play on a woollen carpet
5. qv bath oil in the bath
6. qv wash instead of soap
7. novasone ointment daily to rash(据说这个药比较强,我用含hydrocotisone的
sigmacot就可以了)
8. glycerine 10% sorbolene cream twice a day to body and limbs
9. orabase protective paste to nappy area with each change of nappy for
nappy rash
现在天湿疹已经很轻,每天抹一两次sorbelene就可以了。
乐妈,上回没发成留言,也是要说我们给开用了很多Hydrocortisone,看不出任何副作用。我知道很多Hydrocortisone的副作用,但我觉得不能因噎废食,需要用的时候还是要用,医生开药,会给用量,药的说明书上也会有使用限制,只要在限制之内用应该没问题的。
看了你的问题单子,交流一下。第一个帮不上忙,我是胸喂,从来不知道天吃多少。第二三个,我们家是顺其自然,我从来没有加维生素的想法。第四个,天拉绿poo也拉了好久,医生护士都说只要体重正常看起来健康精神,不需要担心。我想也许很多宝宝都会有这么段拉绿poo的阶段吧?天精神很好,体重很好,所以我不担心绿poo的问题。第五个湿疹问题,我们看过的所有的医生都说一般两三岁之后就会outgrow,开的确是三岁以后就很少了,偶尔会有爆发,但是很容易用hydrocortisone控制,平时就是很完美的皮肤。我们给她做过过敏原测试,要按照单子上写的她过敏的东西排除,基本上没什么她能吃的了。我们试着排除过一些,没有明显变化,而且排除食物给我们带来的麻烦远远outweigh了对她的湿疹的控制,我们就懒得排除了。不过我们开爸家是有eczema的历史。换做我,一定要保证宝宝的湿疹得到控制,然后再考虑副作用。第六个,天想睡觉的时候有时也会趴在床上来回蹭头,可能就是代替揉眼睛吧。如果是湿疹影响睡觉,我还是会先用药,控制下湿疹再说。第七条,还是那句很多人都说的话,每个宝宝都不一样,不能横向比较。。。像我们家开到现在4岁多了还要爸爸哄着睡觉,5个月的天只要扔在床上自己就睡了。
吐奶,天也吐。。。她吐那么多拉那么多,我都不知道她体重怎么长的。。。
还有,福娃的头发耷拉下来顺眼多了,乐乐长的真漂亮,哪像我们开到现在人家见了还觉得她像男孩子。背带很不错,大人小孩都舒服。
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