12 Month Appointment (updated)

Update 2.13.09: Apparently Juliana has roseola. At her appointment Dr. Sarah mentioned that roseola was possibility. Roseola is characterized by high fever with few other symptoms. With roseola you break out in a rash about 12-24 hours after the fever breaks. Sure enough... the fever broke last night and the spots came on today. The rash isn't bothersome and it means she is pretty much over it. As of tomorrow she shouldn't even be contagious.

We had Juliana's 12 month appointment this morning. Actually, it was her 12 month appointment plus "lets check out this really high fever she's been running."

Juliana seems to have gotten the virus I had last week. High fever (up to 103 degrees) and no other real symptoms (besides being crabby, clingy and fussy... just like I was last week. Ha!) Dr. Sarah said there have been some viruses like that going around. We'll need to call again tomorrow if she is still way up there, but mostly Tylenol has been pretty effective in keeping the fever in check.

As for the regular 12 month stuff... Juliana is doing awesome developmentally. Her iron levels are great (no anemia.) She weighed 22lbs and 13oz. which puts her in the 75th percentile for weight. She is 31" so that puts her in the 90th percentile for height. I went to check out Gabriella's baby book to see how that compared with Gabriella at 12 months only to find that Gabriella didn't have a timely 12 month appointment. We were in the middle of a 2,000 mile move so that one kinda fell by the wayside. Oops.

Juliana's 6 Month Appointment

Yesterday we had Juliana's 6 month well child check. Here are her stats....

19lbs.4oz.... 90th%
27".....90th%
44cm head.... 85th%

She certainly is proportional. I can't even believe my tiny baby is that big. Pretty hard to imagine she was ever in the 3rd percentile for weight! Otherwise, she is doing very well. We did talk about her continued struggles with reflux and upped her prilosec per her new weight, but otherwise she is a very happy healthy little muchkin. She thought the paper on the exam table at the doctor's office was the best toy ever and managed to completely demolish it in the time we were there.

After her visit with Dr. Sarah we had an appointment with the allergist. They did skin prick food allergy testing and she tested positive to.... nothing. It was pretty great news and the allergist said that it hopefully means she just grew out of whatever she was reacting to. However, he gave us a 70% accuracy rate for the test so we'll still proceed with some caution. I'll be re-trailing milk soon and then soy (in my diet- her reactions have all been via breastmilk) and hopefully the reactions we got from milk a few weeks ago will just prove to have been a fluke and she can go on as an allergy free kid. If she reacts a second time then the allergist said we would call it a "positive" and just continue to avoid milk. She may be "MSPI" or simply, "Milk Soy Protein Intolerant" which is a more general term for kids that react to milk and/or soy proteins but don't have an IgE mediated allergy (skin tests look for reactions mediated by the IgE antibody, but your body produces many different antibodies that can be responsible for reactions. IgE is responsible for the traditional hives/wheezing kind of allergy). This type of allergy/intolerance is usually outgrown pretty early, sometimes even within a few months. So anyhow... the hope is that food allergy chapter in Juliana's life is simply coming to an end.

Gabriella's Allergist Appointment

Hanging out at the mall play place after her appointment

Today was a doctor visit day. After Juliana’s appointment we headed across town to see Gabriella’s new allergist. We saw an allergist last summer shortly after we discovered Gabriella’s life threatening peanut allergy. I wasn’t impressed with that allergist and so our pediatrician recommended this one. This guy is a Board Certified pediatric allergist and asthmaologist. Ok, so "asthmaologist" isn't really a word, but he had all sorts of credentials.

I liked this guy quite a bit. We discussed not only food allergies, but environmental allergies and asthma. Gabriella’s asthma has been reasonably easy to keep in check. Mostly she gets upper respiratory infections that lag on and the wheezing accompanies those. We use the nebulizer about every other month, on average. The allergist told us that they no longer give an official asthma diagnosis before three years old. He said that for her age he wasn’t too concerned with the amount that we need to use the nebulizer, but if next winter goes about the same way then they will officially diagnose her asthma and they will possibly want to treat it a bit more aggressively.

I did ask the allergist questions about Juliana’s food reactions (via breastmilk) and he said it did sound like allergy issues. He said he would be happy to skin prick test her as well so that we have more answers. If it is food allergies, then he said I’m doing the right things. He also advised sticking with the very conservative food introduction guidelines when it is time for her to start solids. He also said that with babies they re-test at 6 month intervals because they can outgrow these things so quickly. I guess I’ll need to talk to the pediatrician again about getting a referral for Juliana. I’m not sure if I want to do it soon or wait until she is six months and possibly get a slightly more accurate picture. Juliana may just have MSPI.. Milk/Soy Protein Intolerance and that won't show up on allergy testing (and usually goes away on its own.)

Oh and the Allergist earned brownie points with me by praising my ring sling. He noted how Juliana’s leg’s were spread apart at the hips and asked me if I knew that this positioning was good for her hip development (I did know this and it is one reason why I am not a fan of the Baby Bjorn and other similar front packs) He said that she will never have hip development issues (like hip dysplasia) and noted that in places like India and certain African counties where moms carry their babies in cloth carriers they don’t see the hip development problems that we do here. Chalk one up for the cloth sling.

OK… back to allergy testing…

He did three panel skin prick tests with eight items each that included basic food and indoor environmental allergens. It was surprisingly quick and easy. He just pressed each panel to her arm and it did all eight tiny pokes at once. I think it was a bit irritating, but not truly painful.

For food allergies- He did test peanut, despite the history of anaphylaxis. I was a little surprised they would give her the exposure and questioned him a bit, but he assured us it was fine to test. This one was obviously a blaring positive. Milk was the only other positive and it was “barely” positive. This was pretty exciting to us because last year when she was SPTed for milk (and only milk) it was a huge positive. They don’t test shellfish or tree nuts before age three.

For environmental allergies- Cat was the only positive. Dog, dust, mold, cockroaches and I can’t remember what else were all negative. I thought this was pretty great news. Outdoor environmental allergies (pollen etc..) will be tested after she is three.

Because the milk was such a “barely” positive we were given instructions for a “food challenge.” She was to get 1 tsp. (watch for reaction) then increasing amounts in 30 minute intervals. We were given a sheet that told us what amounts to give at what times and had places to record any reactions. The allergist told us she had a very excellent chance of passing. We went home excited and nervous and decided to just go ahead and start the trial. I gave her the first teaspoon of milk and she said it was tasty. Less than 10 minutes later she was scraping her tongue and said that she didn’t like cow’s milk because it made her tongue feel funny. The hives and just a tiny bit of lip swelling followed that. We gave her benadryll and things cleared up. So much for that hope! We’re keeping an eye on her and we’ll call the allergist back in the morning. She'll go back in six months.

Juliana's 4 Month Well Baby Check

Everyone knows that the first thing they do at a well baby visit is weigh and measure the baby. Juliana measured 24.5 inches and then weighed in at…. 15lbs 8oz. Seriously. I knew that she had a growth spurt. I knew that some cute baby rolls had appeared on her sweet little legs and I knew that she had jumped percentiles, but I still can’t believe she is that big. At two months old she was 9lbs 3oz and in the 5th percentile for weight. Two short months later she has picked up more than six pounds and is in the 75th percentile for weight. Can you see why I was astonished?

We talked with Dr. Sarah about acid reflux a bit because it hasn’t been very well controlled on either axid or zantac. We asked about her nasal “snorting” that she has had since she was a newborn. Dr.Sarah said her nasal passages were indeed inflamed from the reflux coming up into her nose. We’ll be moving up to the next level of reflux meds, a PPI. They are very safe and should give Juliana some relief. However, we will have to go to a special compounding pharmacy to get them.

Developmentally Juliana is on track and then some. Dr. Sarah said she was rather advanced with gross motor skills. She can already roll and scoot around the floor to get her sister’s toys. Hopefully she’ll stay content with that mode of (slow) transportation and not be an early crawler.

Food allergy/sensitivity and breastfeeding wise I’m still avoiding soy protein, milk, eggs, nuts and seafood. I tried eggs and it seemed to make her react considerably, but I also ate a plain burger at a church BBQ the same day… so it could’ve been cross-contamination of that. I am successfully eating soy oil now (the protein is the offending part of the food. Refined oils have the protein removed and most allergic/sensitive people can have them.)

We’ll get the food thing figured out eventually, but for now Juliana is healthy, happy, growing insanely fast and on the move!

Two Months

Juliana turned two months old on Tuesday and she had her two month pediatrician appointment today. Here are her stats....

Head Circumference: 38cm (16th percentile)
Length: 22.5 inches (34th percentile)
Weight: 9lbs 3oz (5th percentile)

So she is still a tiny thing, but making gains now that I've adjusted my diet to exclude the common allergens. Eventually we'll figure out exactly what she wasn't tolerating, but for now she is healthy and happy.

We talked to the ped about her reflux since the dietary changes haven't seemed to help that at all. It isn't a huge surprise that she has reflux troubles since I have reflux and so does my Dad and sister etc... the ped started her on Axid two times a day. Hopefully that will help her be more comfortable.

I also had a long talk with the ped about vaccinations. I was really nervous to give Juliana the five vaccinations she was lined up for today considering she is just now finishing healing from the food protein allergy related colitis. In plain words, her poop just got back to normal and I didn't want to shoot her up with goodness knows what (really, you should never read a vaccination ingredient list). I had done some research beforehand and I was very concerned with the potential for allergic reactions to vaccinations given that my kids apparently like to be allergic to things. Anyhow, the ped was so great about talking this through with me. As a breastfed baby that doesn't go to daycare Juliana is at pretty low risk for contagious diseases at the moment. Our doctor pointed out the three vaccinations that she thought were most important so we are starting with those and only administering them one at a time for now. That way, if she has an adverse reaction we'll know exactly what it was. Things like Hep B can wait a bit. I'm pretty sure we have awhile before she starts becoming promiscuous or using intravenous drugs. Did I mention that I LOVE our pediatrician? "Dr. Sarah" is so wonderful and talking to her about vaccinations really proved that she is willing to work to treat our children according to their individual needs.

Dr. Sarah noted today that Juliana is a strong little girly. While was checking Juliana for developmental milestones she put her on her tummy on the exam table. Juliana of course started pulling her legs up to her tummy and digging her toes in so she could attempt to scoot herself across the table. Dr. Sarah looked at her and said, "If you are crawling before I see you at four months I am going to cry for your parents." Should I be concerned by that? With the second one you aren't exactly quite so enthusiastic for them to gain mobility. I'll admit I was a bit wary when Juliana starting rolling over from tummy to back at three weeks, but when your pediatrician says "This one will be your mover" you start to envision a very busy future for yourself.

Juliana is smiling and cooing now. She is very interested in this business of talking. She watches our lips very intently and then tries so hard to move her mouth the same way. Eventually she'll get some good noises out and be rather pleased with herself.

It is hard to tell in pictures, but Juliana's hair is a rather strawberry blond color, with more or less gold/red tones depending on the light. The last few days I've been asked several times, "So where does she get the red hair from?" I wouldn't call it red myself, but I do love her hair color (which could certainly be subject to change at any time.) I assumed the blond was from Jonathan, but it does seem to be a different tone than his in his baby pictures. Jonathan's biological grandmother has strawberry blond hair, so maybe Juliana will get to keep her pretty hair color. Right now we joke that it is our Scottish roots coming out in her (Jonathan's maternal biological family has some Scottish ancestry and now that my brother has taken up genealogy he has discovered a lot of Scottish ties in our family as well.)

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