Sunday, June 21, 2015

Teething: For or Against It?

The only natural way for a baby to acquire teeth is for them to poke their way through the baby's gums. This is not Andrew, by the way, but the baby in the picture bears an uncanny resemblance to him,  blue eyes and all. Even Andrew's grandmothers believed it was an actual photograph of him.


Baby Andrew is teething. At least we hope that's all it is. His father checked him out and said nothing other than diarrhea (which pediatricians will tell you has no clinical connection whatsoever with teething, but every mother who has ever raised a child will insist that the two almost always accompany one another), drooling more than usual, gnawing at everything within his reach, and crying a lot. He has no fever.

Andrew's father has to operate early in the morning (it's a semi-emergency but can wait until 6:00 a.m.) and knew it woulld be a rough night, so he took a sleeping pill and went to sleep in a bedroom in the farthest part of the house from the master bedroom. Scott and Jillian deliberately put a comfortable Westin bed in that room for nights such as tonight, when the father (or perhaps mother later) really needs to sleep and a baby really needs to be fussy.  

The room can be reached by intercom in an emergency, and of course i'm also here to walk down the hall and get the baby's father if it becomes necessary, but that's unlikely.  We can also call the baby's mother's parents, who are an MD and a pediatric nurse practitioner. We could call my parents if we needed to, also, or the next-door neighbors, a childess couple who are MDs. The baby has two other MD uncles living within ten minutes, and I have an uncle and an aunt five minutes away who are medical doctors. Teething, however, is not a medical emergency. as long as the baby is not feverish, we'll tough it out  with Ora-jel, acetaminophen, Motrin, and cold things on which the baby can gnaw.

Becca, do you remember Bennie's teething phase? Did he have an especially hard time? do you have any tricks?

If I could, I'd take the baby to the living rooom to let the mom get some sleep, but the baby wants his mother now. I'm here because the baby's mother is not supposed to get out of bed, so I change him as quickly as his diaper gets messy so that he doesn't get a rash. The stool from the diarrhea (TMI) tends to be very acidic and can give a baby a rash very quickly if the baby is left in the diaper for much longer than a minute. We're going through scads of diapers. It's a good thing the family is not strapped for cash.) I keep Andrew well-coated with A & D ointment for added protection from the acidic mess until i can get the messy diaper off of him. That's at least something useful I can do. In a real pinch Andrew's mother could change him on her bed, but it's more hygienic to carry him to his changing table.

I already called Andrew's pediatrician, who happens to be my uncle, to make sure we're doing everything we should be. He said everything sounds good, and to give Andrew cool teething rings until a tooth pops through, after which he can have cold damp cloths. Both of those two bottom teeth look as though they could burst through the gums any minute. (One of my favorite baby looks is when they have just the two bottom teeth sticking up. I think babies look so incredibly cute at that stage.) My uncle said to check Andrew's temperature if he feels warm, as babies are less resistant to other illness when their bodies are weakened from teething. He also said to go a bit light on formula/breast milk  and to try to replace it with Pedialyte if Andrew will go along with it, but only if Andrew will drink enough Pedialyte because the very last thing he needs is to become dehydrated, and to give him bananas, which have recently been introduced to his diet and which he seems to like. There are advantages to being related to half the doctors in the county. I feel as though I can call any of them whenever I feel like it.

Jillian told me that when I become an MD and an intern and am dealing with teething babies, I must not forget that no matter what pediatricians say about there being no connection between teething and diarrhea, there really is;  it's not an urban legend.  Sometimes, she said, when people become formally educated, they lose common sense they formerlly had before they completed their education, and that I should not let that happen to me. Diarrhea and teething often accompany each other, period, whether the text book authors admit it or not.

I'm sure there's some study that babies born to pygmy tribes in the rain forests of South America don't experience teething issues because they supplement the babies' diets (or the mothers' diets and breastfeed exclusively until the children are 8.5 years old) with coconut water or guava seed puree or some other such thing, but at the moment, I'm not all that interested. Coconut water and guava seed puree are not on Andrew's list of approved foods. He just barely made it past rice cereal to bananas. Food allergies in children are less of a problem if parents wait a bit later before introducing babies to solid foods. This is especially true if the baby is breast-fed. Andrew receives almost 3/4 breast milk donated from lactating aunts who froze extra milk so that he wouldn't need quite so much formula. His mom could only breastfeed him for a month. So far it's been good for him. He's a not-even-eight-month-old preemie and he weighs sixteen pounds and is starting to walk. 

Nanny Helen won't be here tomorrow (today) because she doesn't ordinarily work Sundays although she has said she will anytime she's needed. Jillian's mom will arrive just before 6:00 when Scott leaves. Andrew actually likes me more than he likes her (sorry, Grandma) but she's a nurse practitioner and knows far more about how to make him comfortable than I do. She can probably get him to sleep so that Jillian can get some sleep. I'll go to sleep as well as there will be no point in my staying awake when grandma is here.

Jillian said she hates to see Andrew get his days and nghts turned around because it's a tough cycle to break, but for her personally it's actually good to be awake a bit more in the night and less in the day. She subsxcribes to a theory that because babies sleep more when there mothers are up and around and are awake when the mother is still and resting in bed, a mother can shift a baby's sleep cycle in utero by being awake at night so tha baby has developed the habit of sleeping at night while the mother has been up and around. This would work a lot better if she were actually up and around as opposed to being on bed resr, but she showers during middle-of-the-night hours and sits up more during that time.  

It worked to some degree with Andrew, who quite quickly took to doing the majority of his sleeping at night. He's not much of a sleeper, but he did well at night from the very beginning. 

At thirty-three weeks, which is in exactly two weeks since it's  now officially Sunday, Jillian will be given walking papers if she hasn't delivered yet, meaning she'll be released from bed rest. That's still early for the baby to be born, and taking her off bed rest increases the chance she'll have the next baby soon after that point, but Jillian will recover from her surgery more quickly of she's had even a few days on her feet before she goes in for the C-section. She said she plans to reverse days and nights as much as possible, although she'll ned to be awake during the day to some extent for Andrew. She says she'll get by with just naps.

My prediction is that the next baby is about 2 1/2 weeks away. If I were to pick a date, I'd go with July 8. That's still quite early, but everyone's expecting this baby to be early. With everything Jillian has going on, the baby is lucky to have stayed in place this long.  The baby's weight, relative strength, lung maturity, and other factors will determine the length of her NICU and hospital stay, but i seriously doubt it will be more than a couple of weeks. This kid will be home  by mid-to-late July according to my uneducated prognostication. 

Time for another diaper change. I hope all of you are slumbering blissfully without a teething baby  or anything or anyone else interfering with your sleep.

Update: the baby's father has given up on sleep. He has called the hospital and told the team to prep the pateitn for surgery and to alert the anaesthesiologist.  An anesthesiologist is supposed to be in the hospital at all times, anway, but he or she was probably in the sleeping quarters dreaming about cotton candy clouds or San Francisco Giants' victories or some other such thing and expecting a full night of sleep. That's the way life often works out, though. You don't always get what you want. 

The surprise  is that immature  Alexis is being allowed to stay with a pregnant woman on bed rest and a teething infant  (and the dog, who is for real a major playor in this equation and probably would bark until a neighbor showed up if anything truly out of the ordinaty were to happen) without a real adult [sarcasm font]. Scott's not even calling anyone to alert them to the fact that Jillian is at home with just the baby and me. He's assuming I'll have the presence of mind to call someone if either Jillian or the baby has an issue beyond the ordinary. 

Silly as it sounds, this is a milestone  of epic proprotions. Someone is trusting me to conduct myself as a competent adult in the event that an unforeseen complication should arise.  This place is armed with "I've fallen and I can't get up" alarms, video surveillance, and just about every other technological fortress imaginable, bit still it's the first time in my life I've been entrusted in the middle of the night with any amount of responsibility even close to this.  Could it be that someone has finally deduced that I'm not a complete freaking moron? 

8 comments:

  1. If Andrew Really looks like that baby, he will break hearts!

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    1. He is a pretty boy. Eventually his parents may give me permission to send a real picture.

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  2. Hmm I have never noticed any diarrhea with my kids and teething. Sort of makes sense I guess with all the drool they are swallowing. I also have a really easy time with breast feeding so I'm guessing that helps.

    I liked the trick of freezing a damp washcloth and letting the baby chew on that. My kids seemed to like it.

    I will say that the delayed foods to prevent allergies has recently been disproven. Pediatrician were saying to delay possibly allergenic foods for years and severe food allergies were increasing. A recent study on peanut allergies was based on the fact that Israel has the lowest rates of peanut allergies in kids anywhere and babies there apparently eat a peanut puff snack. A study found that introducing the peanuts around 6 months (I don't remember the exact timing) actually reduced peanut allergies vs kids who didn't get them until after 1. I think the most recent research still says that kids shouldn't have solids before at least 4 months but introducing foods, including potential allergens early actually reduces allergies. The blog science of mom has a great write up of all the studies done so far. Obviously we don't know exactly when each food should ideally be introduced, and some kids will still develop food allergies but the idea of wait till they are 1 or more is outdated (very recently though, it was still the advice when my 3 yr old was a baby). Not that you probably have any sway over what Andrew is eating because you aren't the parent so not trying to say he should be eating differently (and if he was a preemie he is probably a bit behind anyway). I will say that bananas are great for helping loose stools. We have to limit them with my toddler because he has issues getting constipated (he probably has the same connective tissue disorder as me which also affects your gut).

    Good luck helping out! It sounds like you are doing everything right! Sometimes teething babies just want to be cuddled all day!

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  3. If Jillian were to leave the house and you were snowed in with Andrew and yourself alone for a few days, I am confident that you would be able to handle almost anything.

    Also we can apply science to the idea of teething and diarrhea. So wouldn't anyone admit that teething is stressful for the baby? Or would people say that teething is not stressful at all for the baby? There would be no need to drug a baby if it were not stressful.

    Then webMD says "Everyday things such as food, medication, or stress can cause diarrhea." People have trouble since it is a 2-step process. So possibly the teething does not cause the diarrhea directly. It causes the stress and the stress causes the diarrhea.

    Calmclinic.com says "For example, the stress of anxiety will put a considerable amount of physical stress on your stomach and organs as well, and that pressure may lead to your body not processing food well. All of these can lead to diarrhea, as well as other gastrointestinal issues like irritable bowel syndrome (IBS)."

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  4. As far as drugging the baby, acetaminophen (mentioned above) is a popular pain killer that is in Excedrin. I was talking to an MD that had just graduated medical school. I said that about 40,000 people a year need liver transplants but most will not get them. He said that he believes the reason why so many need liver transplants is due to so many people using too much acetaminophen.

    Maybe pain is better than pain killers. I hear that many get injured and get powerful pain killers. Then when they can't get them anymore, their addiction causes them to seek them elsewhere. Since heroin is cheaper than the opiate-based pain killers like morphine and oxycodone I hear that heroin is making a comeback.

    A 2012 article says: Federal Prosecutors Crack Down On Addicted Doctors: "Doctor Keith – he doesn’t want his last name used – was once a board certified anesthesiologist. Today he’s a convicted felon, stripped of his license to practice medicine.

    His crime: using deception, subterfuge and misrepresentation to feed his addiction to powerful painkillers like Vicadin, Percocet and Demerol."

    I saw a recent James Bond movie with Daniel Craig. The bad guy was torturing him to get his password and he was not using pain killers. Instead James Bond was making jokes about the guy torturing him and laughing at him while also yelling from the pain. So Andrew can be like James Bond instead of Dr. Keith.

    Make sure to wish your father, Happy Father's Day! He sings cool songs like Time of Your Life and Leader of the Band. His nickname could be the singing doctor.

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  5. Ben did well with teething, surprisingly. He really liked his teething ring. He seemed to prefer it warm instead of cold, so we'd run it under warm water before giving it to him.

    Also, regarding the diarrhea ... maybe the loose BM are related to the increase of saliva leaving more free fluid in the intestine? That might be a bit of a stretch, because theoretically the bowel should still absorb fluids, although maybe there is a bit of a change that happens within the bowel, as well. Ben's eczema used to get worse when he was teething, too. The ped. always said it was unrelated, but he would get patches of dry skin right around the time a new tooth would break through.

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    1. PS; I was talking to the judge the other day. He proposed the idea of the 3 of us meeting up for lunch in New York someday. I can't say that I am entirely opposed to that idea either :)

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    2. Wow, Becca. That would be an amazing trip.

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