Puke patrol

13 Feb
What, me vomit?

What, me vomit?

When I wrote the other day about how sleep deprivation was the most difficult part of parenthood, I neglected to mention the other issue that constantly keeps me on my toes: vomit prevention. When you have a baby with reflux and a hair trigger gag reflex, a lot of energy and strategy goes into feeding the baby enough so she’s full, but not so much that she projectile vomits her entire stomach. And not to over-share, but we are talking about an Exorcist-like situation when we get it wrong.

We first started to think that our baby may have reflux (or GERD) when she was only a few weeks old. After some trial and error, it became clear that this was one of the central reasons why she continued to scream at the breast every time I tried to nurse her. Her tongue tie meant that she could only latch on if I laid her on a pillow and leaned my boob into her mouth (a disastrous position from an ergonomic perspective). This was probably the worst position for her GERD, as babies with reflux should be kept upright while feeding whenever possible. The switch to bottle feeding (with her sitting up on my lap) helped dramatically. But then she began eating with such gusto, that we had a serious Vomit Management Issue on our hands. We got good at slowing her down, using slow-flow bottles and offering her small portions more frequently. And generally speaking, she lets us know when she is full. But when she is tired, her instinct is to drink and drink until her tummy is over full. And that inevitably leading to mega vomit, which is so frustrating on so many levels.

After a major uptick in the puking after the holidays, we switched Daphne to a soy formula. It appears that some sort of dairy or lactose intolerance was exacerbating the situation. But the situation is certainly not resolved. She is still on medication (the highest dose allowed for her current weight) and we are constantly doing this careful calculation, to make sure she doesn’t eat too much or cry too hard and trigger the vomit reflex.

The addition of solid food into her diet has complicated things as well. I originally had visions of practicing baby-led weaning — offering soft chunks of solid food from the beginning and allowing the baby to feed herself. But as my friend Caro jokes, this baby has very retro sensibilities. Not only does she gag on soft solids (we’re talking over-ripe avocado here — nothing that’s not developmentally appropriate), she often rejects my lovingly-made purees in favour of bottled baby food. It’s definitely a texture problem. No matter how much I blend steamed sweet potatoes, I will never approximate the texture of commercially strained and blended pears. I spoke to our trusty lactation consultant and apparently tongue tied babies often have a problem swallowing solids. The sensitive gag reflex is quite common. This leaves me wondering if we should suck it up and take her to have her tongue operated on again. I am just loathe to traumatize her at a stage when she is already struggling with teething and separation anxiety.

So once again, we muddle through. Last night, I got the calculation dead wrong and ended up covered in puke, along with the baby, the rocking chair, the entire floor of her nursery and a couple of board books. It’s always so distressing, because it makes me feel like I somehow failed at motherhood and made it happen. “I should have known that she was eating too much … I ignored that first cough and made her eat another spoonful … I wasn’t fast enough to distinguish fussing from crying and didn’t intervene in time to prevent it.”

Rationally I understand that I am being too hard on myself. My friend Pam’s son was a puker for years and nothing she did could make him stop — until he did on his own. And as much as I am loathe to admit it, this is largely a laundry problem and not a major medical one. Daphne is thriving and putting on weight like a champ. I would just love to get through a couple of days without suffering the indignity of being covered head to toe in regurgitated formula. Wishful thinking.

3 Responses to “Puke patrol”

  1. cathy February 13, 2013 at 7:27 am #

    will doesn’t have nearly the problems that daphne does, but even i can overfeed him by a half spoonful and face the dreaded gag noise. it’s a very narrow grey area between worrying about him not eating enough and eating too much!

  2. Janet February 13, 2013 at 9:04 am #

    I hope this gets better for you all. ((HUGS)) Thinking of you.

  3. Sarah February 13, 2013 at 2:17 pm #

    I hope Daphne’s GERD improves soon. Lior’s digestive problems were largely solved when I went off dairy, but I totally get the feeling of ‘bad mother’, no matter how much you know it isn’t true. Hugs!

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