Thursday, September 16, 2004

Making Foie Gras

Traditionally, making foie gras is a pretty grim practice that involves force-feeding a goose until its liver is ripe for making pâte. Despite that, making foie gras is the best analogy I can think of for what it's like feeding Celeste.

Because of the jaundice, the doctors want us to feed her at least 1 fluid ounce of formula on top of what she gets nursing. The goal is 4 to 6 fl. oz. of formula each day. There are two reasons for this: first, she still needs to get her weight up and, second, the formula can help expel the bilirubin more efficiently than breast milk will.

As for her weight, Celeste fell from her birth weight of 5 pounds, 9 ounces to a low of 4 pounds, 14 ounces. That was early in the morning on Friday, after we'd checked her back into the hospital. As of Tuesday, she was back up to 5 pounds, 5 ounces (but we'd just fed her, so her actual weight may have been an ounce or two lighter). The next weigh-in is on Saturday when we go back to the pediatricians for another bilirubin check.

All in all, she seems to be doing well with the formula. There's no hesitancy about nursing, nor any confusion about the bottle vs. the breast. After all, the formula isn't nice and warm like Evelin, and when I give her the bottle we can't snuggle the way she does when breastfeeding. For the most part, she sucks down the formula pretty greedily, but there are times — particularly if she's sleepily after a good nursing session — when she has to be cajoled into finishing the bottle.

It is those times that I feel like I'm practically force-feeding her. Wait for a yawn, and move in with the bottle. Tickle her toes and/or belly, and move in with the bottle. Strip her down to her diaper and when she complains, move in with the bottle.

Although at times she'd rather sleep, she doesn't seem to mind the bottle (and often she'll take the ounce and then look around for more), but the foie gras image sticks in my mind. Of course, we're looking to fatten up her cheeks, not her liver.

Thinking of Bottles

We'd been planning to exclusively breastfeed Celeste, so Evelin and I never talked about bottles. Once we got home from the hospital, I found myself running out to the grocery store to see what I could find. We needed at least one bottle (although we've since bought more so we can have the formula measured out and ready to go on a moment's notice), but I had no idea what sort of system to get.

We ended up with Playtex Original Nursers. Since they use disposable drop-in bottle liners that don't need to be sterilized (we don't have a microwave and boiling bottles would seem to take forever), it seemed like a good choice for us. So far, it seems to be going well, but hopefully we'll be able to go back to exclusively breastfeeding once Celeste's weight is back up and the jaundice scare is finally resolved.

Thinking of Formula

Outside of anecdotal comments online, everything I've read online seems to say that all brands of formula are pretty much identical, so long as like variations are compared to like variations (i.e., Similac Advance vs. Enfamil Lipil, both are milk-based and have iron and DHA and ARA, and differ primarily in color and maybe a little in taste). But those anecdotes about babies having a bad reaction to switching formulas strike true after last night.

While at the hospital for jaundice, we were giving Celeste ready-to-feed Enfamil Lipil, but at home we had samples of Similac Advance powder, so we have been using that. We had one bottle of the ready-to-feed Enfamil left over from the hospital stay and we decided to give some of that to Celeste last night instead of mixing up more Similac. Big mistake.

First off, let me note that Celeste had no troubles with Enfamil while in hospital, and I can't say with certainty that it was the formula that caused her troubles, but it is the big variable I can point to as maybe having an effect.

The Enfamil feeding happened around 10:00 p.m. Pretty much from 11:30 on, Celeste was inconsolable. She would breastfeed intermittently, and would stop crying every now and then if she was walked around or if I did some kangaroo care with her, but most of the next six hours were spent crying. And most of today, she has been out cold. We went for a little outing to Brookside Gardens in Wheaton; Celeste never opened her eyes. She is feeding well, and greedily sucking down the Similac formula as well as the breast milk. Hopefully, tonight will be much less eventful.

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