Difference of Opinions

Archer's first appointments have confused Mom and Dad regarding Archer's health because they have heard various opinions. Archer's pediatrician said that Archer was not on a growth chart but he is following a good growth curve. Archer's growth has to be adjusted, just like his age. It is unfair to compare Archer to other four or five month old babies. The pediatrician was very relaxed and was not concerned about Archer weighing just over 6 pounds. Archer's milk or caloric intake was not changed after this appointment.

A few days later Archer had an appointment with a pulmonologist. This doctor was very concerned about Archer's growth. This doctor explained that Archer was in the 1 to 3% range and he needed to be in the 50% range in order to be considered healthy. This doctor also said that Archer's fussiness is not due to his hernia, but rather his reflux. This opinion is the opposite of what NICU doctors and nurses had told them about Archer's fussiness while eating. Mom and Dad thought he was always uncomfortable because it was difficult to process food past the hernia. After this appointment, Archer's caloric intake was increased from 22 to 24, with the order of increasing it to 27 if he is doing well. 

Some of Archer's medications were also changed to help with reflux. 

Mom and Dad had tried mixing Mom's milk with a 24 calorie fortifier, though Archer did not tolerate it. In fact, he ate much less of what he normally ate, and he was still fussy. Mom and Dad then tried straight milk, which he seemed to eat more of and was less fussy. They made a call back to the pulmonologist about Archer not accepting a 24 calorie fortifier and a suggestion was made to change the brand of fortifier from Neosure to Enfacare. After a couple of days on Enfacare, Archer seems to be doing much better during feedings and is eating close to his requirements. Archer's reflux issues were still noticeable, so his reflux medication prescription was just changed and the results of this are yet to be seen. 

The pulmonologist also said that if Archer is gaining a healthy amount of weight (roughly 1 pound every 2 weeks) then the order could be put in soon for Archer to be off oxygen during the daytime, and then progress to no additional oxygen at all. Archer's weigh-in today by the visiting nurse was 6 pounds 7 or 8 ounces, as the scale is a little inaccurate. 

Archer has two more appointments tomorrow. The first is a consultation with a surgeon regarding Archer's hernia, the other is with the ophthalmologist to check the progression of Archer's eyes.

Archer has been enjoying spending time with grandparents and keeping Mom and Dad busy and awake. He likes to attempt to crawl during tummy time (he mostly just squirms on the floor) and climb up Dad's chest to his shoulders. He also had his first couple attempts of poo shooting at Mom and Dad during diaper changes.