I suppose I should start with the bottom line, the good news, what really matters. I have a healthy 9 week old. He is going to be ok.
Wednesday I took Toby for his 2 months well baby check up. I expressed concern about how skinny he was at the start of the appointment. He's never been a big baby but over the last few weeks, the comments have been becoming more frequent; "He's awful small isn't he?" or "Look at those tiny legs."
You read on all the breastfeeding pages to nurse on demand and to allow the baby to end the nursing session instead of timing, to make sure he is having a normal amount of wet and dirty diapers. Breastfed babies just weigh less than formula babies they all say. I kept telling myself it was fine. This is the third child I've nursed and I tried my hardest to shrug off the comments, my confidence lying in the fact that I would know if something was wrong, that I had to knowledge to make the call.
I didn't know. I didn't know until the weight came up on the doctors scale. 7 lb, 14 oz., one ounce less than the day he was born. I felt my heart hit the floor and I looked at the nurse. "Something's wrong. That's under his birth weight." And then I saw it, that look that medical professionals get when they don't get their Calm-The-Patient mask on fast enough. She made a non-committal noise and ushered me back into our little room. I started to cry. She was whispering in the hallway and the doctor came in, much quicker than it usually takes. It's a blur now, but he seemed angry with me. "Why haven't you brought him in sooner?", he asked. "He's starving", and he pinched the loose skin on Toby's rail of a thigh and stretched it out. "Can't you see he's starving?" And I did. I saw completely for the first time and in the horror of the way I felt, I could only shake my head. I texted Jeremiah, who had Asher at the salon getting a haircut. "Miah, they are going to take him away". It's all I could think. Of course they would take him away! I felt like nothing more than a mother who had blindly been starving her precious son.
We drove directly to Arkansas Children's Hospital's emergency room. They were waiting with our information. Doctors came in, nurses came in, hours passed. Jeremiah told me to stop apologizing. He told me that our trust is in God and He is bigger than this. But I wasn't listening.
They took blood, they put in a catheter. They came in to start an IV because he was dehydrated and the nurse kept blowing his tiny veins. She kept repeating, "He's just so dry" and I wanted to hit her because he was screaming and being angry with her gave me momentary reprieve from being angry at myself.
After 10 hours in the ER we were admitted and moved to a room to stay. The nurses fed him a bottle of formula, the first in his life. We didn't sleep much. He woke up hungry and wouldn't latch so I gave him pumped milk. At 3 a.m., a hispanic family with no english was moved into the other side of the curtain in our semi-private room. Her baby was crying and she was too. She was saying over and over "Leche para mi bebe?" The nurse talked to her like she was a child and when the translator came, she told the woman that doctor had ordered that her baby could not have anything until morning.
The baby kept crying and I took Tobias from his crib, brought him to the pull out bed with me, and curled my legs up, encircling his little body, swaddled tight to keep the IV arm from being pulled or snagged. He slept peacefully in my arms, but I laid there dozing and being awoken again and again by a hungry child that wasn't mine until morning.
He gained 3 oz. the first night. We met with doctors through out the next day, but mostly we just fed him while people came in, took his vitals, and recorded his intake and output. He continued on an IV and continued to spit up the bottles of pumped milk. We tried more formula and he kept it down. They said it's heavier, so if he was refluxing it wouldn't come up so easily. He started looking different, his color changed and I realized how palled he had been. In the evening, we were successful in getting him to hold down expressed breastmilk by feeding him completely upright and stopping for burping after every ounce. He ate 3 ounces then almost 3 of formula and fell into what we call a "milk coma" for the first time in weeks. And I realized I should have noticed the absence of that sign of sated tranquility.
In the morning he had gained 6 more ounces. I fed him after the weigh in, another feeding of a couple of oz. of pumped milk followed by a couple of formula. They came in and unhooked his IV from the bag. I kept dissolving into tears, replaying the thought "I've been starving my baby" in my mind. The grotesque image of my childhood pet cat feeding her kittens, licking them all the same and not realizing one had died, kept haunting me. I beat myself with the blunt edge of how blind and stupid I had been.
Our friends and family were overwhelming us with love while texts and facebook messages poured in. It felt like the entire world was praying for us and for Toby and he was improving drastically before my eyes. Yet I could not fight the waves of despair and the shame of my mistake. I couldn't bring myself to answer the phone calls or update on my facebook wall. Because my son was labeled failure to thrive and I just wanted to tell everyone, "I promise, I thought he was ok. I didn't know."
Then he woke up, and he smiled. Not just a weak little smile but a smile that changed his whole, healthy face. And he made this loud, happy noise and the volume of it startled him so he smiled even bigger.
In that moment, I tell you, the grace of our almighty Father filled our little hospital room so fully that I started to laugh. And so Toby smiled more. He cooed again, louder and happier and I laughed and it went on for the most refreshing 10 minutes I think I've ever known. It was as if God showed me the truth on the face of my precious boy and my guilt was gone.
Last Sunday, I led our youth kids in a study of Nehemiah chapter 2. One of the main points was that when Nehemiah met his opposition, armed with the blessing and the military guard of the king of Persia, they attacked him with accusations of not honoring the king. "Their accusation was weak and clearly untrue," I told my high school students, "the only weapons that satan really has against us are untruths and despair."
It's easy to say these things, to teach them to people younger and say, "Trust me, I've been there", but it's so much easier to fall short when faced with the real life application.
The first morning in the hospital, a good friend sent a text to Jeremiah and me from his morning bible study. He quoted Daniel 6:22, telling of the morning after Daniel's night in the lion's den and how he came out unscathed because he trusted in the Lord. He asked, "What den do we find ourselves in today? If we are in what seems like a den of lions, what kind of attitude do we have about it, and what's our attitude about God? Psalm 18:30- As for God, His way is perfect; the word of the Lord is flawless. He is a shield for all who take refuge in Him." When I first read the message I responded with thanks, and acknowledgement of the truth of it, but I did not let it break down the wall of my desperation as I should have. However, after Toby's smiles had turned on the lights for me, after I had realized the truth of the situation and given the reigns back to my big, powerful, heavenly Father, I read that message again. I was able to see so clearly how uselessly self serving I was being, how my lack of faith was crippling me into ineffectiveness. I recognized the contrast between myself, capable yet too pitiful to be proactive, and the poor spanish speaking mother on the other side of the curtain. She was in the big, scary hospital with her sick baby too, but lacked the ability to communicate that I had been taking for granted. I prayed for her.
I started to ask questions. I requested a meeting with the lactation consultant and I started asking WHY Toby wasn't gaining because I knew I had been feeding him frequently and for as long as he would eat.
After multiple consults, it was determined that between his worsening reflux, my overactive milk letdown and forceful flow, he was in pain trying to nurse. He was drinking just enough to no longer feel hungry, but it wasn't enough for normal growth. That, combined with the amount he was spitting up, led to the dehydration. He was sleeping so much not out of contentment, but due to a lack of energy. The solution I was given was to continue to pump, supplement only what is necessary and follow up with weekly weight checks.
It really was the best diagnosis we could have hoped for. The tests for metabolic issues came back negative. He has no absorption problems. He is a perfectly healthy little boy with a healthy, milk-making momma and we just had a feeding issue that needed a resolution.
We came home last night and slept in our own bed. I can tell already how much he has grown in these incredibly LONG few days. I like to think I grew a bit too, as has my trust in God and my thankfulness that when I get off track, He will always lead me back.
Thank you all for caring so much about our son. We named him Tobias, which means "God is good." Turns out, it suits him well.