Off on holiday...

Heading to the airport for our first long distance flight with Doof. Not off to the greatest start as he was up every hour overnight - I think teething - so his dad and I are exhausted already! Although Doof has the right idea catching a quick nap in the cab on the way to the airport... (Pic to follow)

I'll post an update about how it went when we're back and also details of some websites I found useful when deciding what to pack (and not pack!) for the flight.

Happy Easter in the meantime!

Being a pushy parent?

Doof needed a blood test done this week. So I took him up to the hospital (coincidentally where I worked up until having him) and went to the children's day unit.

The background: unfortunately Doof has already needed several blood tests - this was going to be his 8th - and everyone comments on how difficult he is to get blood from. I've even looked and can't see many obvious veins. Often the doctors or nurses have to have several attempts before being successful.

So when we arrived I suspected it might be a difficult procedure but didn't want to be one of these super-stroppy-and-pushy parents who refuse to let anyone except the most senior doctor near their child. So when the junior doctor introduced herself I was happy for her to take the blood but did warn her that it might be difficult and if she couldn't see anywhere to go then I was very happy to wait for as long as needed for a more senior doctor. She said no problem followed by the fateful words... "I'll just give it a go".

I've heard lots of medical professionals saying this in the past. I'm not sure why it is said. To lighten the mood? A nervous joke gone wrong? For the record it is not something patients or parents want to hear.

Anyway, so she "gave it a go", dug around with the needle and completely failed. Meanwhile poor Doof was inconsolable. So then the registrar was called (who happened to be one of my old colleagues) to finish the job. Even she, a very experienced and good registrar, did not succeed on the first attempt - making me feel even worse that I'd "let" the junior doctor ruin a potential vein.

I *think* Doof is too young to remember any of this - I really hope so. But I won't forget his helpless anguished cries as the needle was repeatedly and blindly stabbed into his arm. So I have learnt several valuable lessons...

1. Don't let juniors practise on my child - if he had been my patient I would have said no he was too difficult for a junior - why did I feel unable to say that as his parent?

2. I should have trusted my instincts - I think sometimes medical parents can be the worst for this. You so don't want to make a fuss that you don't when you actually should

3. You can't be too pushy a parent where your child is concerned

Dispelling myths 3

There is no such thing as "just" a cold in babies. Babies are obligate nose breathers and don't understand to open their mouths if they have a blocked nose. Doof had a cold last week and it was so sad listening to him snuffling and struggling to breathe through all the snot.

A blocked nose to an adult is an easily solved problem - blow your nose or sniff hard. To a baby it represents:

- disturbed breathing

- disturbed feeding

- disturbed sleeping

And last but not least...

- disturbed parents who also suffer from the disturbed sleep, being kept awake by the disturbed breathing and the frequent feeding...

Later I will write about the thing-I-thought-I-would-never-use-but-was-actually-really-useful-in-this-situation.

Tongue tie

At work it seemed that every baby with a not-so-perfect latch or feeding technique was immediately labelled by midwives as having "tongue tie". As the number of affected babies seemed to rise exponentially every year we remained skeptical (dubious?!) -not that the condition existed, but that it was having such an impact on feeding.

Well, let me just say... Tongue tie does exist and has a massive impact on feeding! 

After 6 weeks of agonisingly painful breastfeeding, 2 episodes of mastitis, 1 hospital admission and Doof's weight falling from the 50th centile to the 2nd... He had a frenulectomy

Oh wow. The difference - immediately pain free. A proper latch that he could maintain. And best of all - his weight has gone up to 25th centile. No longer a "famine baby" thankyouverymuch!*

At 17 weeks now I wonder if it is returning as recently his latch has started to slip again and feeding has once again become painful. Not agonising yet, but definitely different... 

We shall see...

 

*this refers to a comment a fellow healthcare professional made about Doof’s appearance during a routine check up when he was not gaining weight well. Rather harsh in my opinion – luckily I took it as a joke and did not worry too much. Said to the wrong person or to someone more insecure about their child’s weight… could have not gone down as well! 

So...

The last few days have been crazy (Doof's had some tests in hospital, grandparents been visiting etc etc) so not had time to post anything.

Will write something later but just wanted to share my newest revelation... Breastfeeding necklaces are great for entertainment when baby-wearing.

I bought one from http://www.breast-buddies.co.uk/ to try and stop Doof pulling at my hair/eyes/ears/lips/bra strap. Sadly he is completely uninterested in it when feeding (preferring the aforementioned entertainment) but when front- wearing him in the Ergo today I put the necklace on and he loved it. He played with it until he fell asleep and even then he clung onto it as you can see below.

Dispelling myths 2

Giving medicine to children can be difficult. Yes, I know I am bigger/stronger/should be in charge etc etc but there is very little I can do if he spits or dribbles the liquid out... 

I tried when he was awake, when he was asleep, when he was happy, when he was crying... I think he just didn't like the taste of that particular drug. It's strange - how does a 3 month old know not to like something? But most definitely true!

Dispelling myths 1

Getting a clean catch urine is NOT easy. It should not just be done "just in case", especially at home. Boys particularly are prone to high-velocity far-reaching fountains and everyone involved will need a change of clothes...

The downside of baby wearing...

Dribble.

We got our Ergobaby accessories this week - namely the rain cover and teething pads as still waiting for the backpack to arrive from the States.

I love our Ergo carrier, Doof loves our Ergo carrier. Since we got it 3 weeks ago we have used it everyday and I have never heard him cry in it - if he is over-tired and fussing beforehand I pop him in and then he happily watches the world go by before falling asleep. Perfect.

Anyway so back to the dribble... 

Doof is starting to teethe (I think - although as he's still breastfeeding I'm hoping teeth are a long way off...) so dribbles a lot. At the moment we are still using the heart2heart insert - I know lots of people don't like it but I love it. It's like a mini duvet which keeps him warm and in the right position. He is so snug in it that even when it's cold enough for me to wear a coat he is fine in just his babygro. Anyway, using the insert means his mouth doesn't reach the teething pads so he sucks on the insert instead. Imagine a soggy duvet. Yuck. 

So today I tucked a muslin around the insert thinking that would be better for him to suck on. I was surprised (but pleased) when instead of sucking he fell asleep straight away...  However when I arrived at our destination (luckily a coffee group of other mums) I unstrapped him only to find a large pool of drool all down my jumper. And sort of smeared around. Was that his way of telling me he didn't like the muslin? Hopefully this will not end up being a permanent switch and he will go back to sucking the insert tomorrow!

As an aside - I found this video super helpful when we first started using the Ergo and always use this method to put Doof in safely:

https://www.youtube.com/watch?v=SB2FSe8Tc0M

Waking a sleeping baby

Why? Why would you ever intentionally do this - especially to someone else's baby?! 

On every ward round I have ever been on we have started at one end of the ward and worked our way methodically through to the other end, making sure everyone gets seen. This meant when we (which could be a solo doctor or up to 8 people if a consultant-led teaching round) descended on the child's bedside there was no time to wait around or faff when examining them - otherwise the round would be delayed - potentially for hours (10 minutes faff per patient in a 20-bedded ward = 2 hour delay...).

However (and this is the bit I am going to struggle with when I go back to work)... This meant any babies on the ward were also examined in turn - regardless of whether awake, asleep, feeding, you name it - we probably interrupted it...

Now I'll be the first person to stand up and say doctors are hard pressed for time and so cannot afford that 2 hour delay. Equally sometimes patients are unwell and need to be examined regularly in case they are deteriorating.

BUT (and its a big one) having now struggled and struggled and struggled on occasion to settle Doof to sleep... I would lose my mind if someone woke my baby up to do something that could have waited half an hour. Indeed I will be forever grateful to the nurses who, when Doof was admitted to hospital at 4 weeks of age, would delay his examinations until he was awake - thank you!!

I never before appreciated:

1) how important baby's sleep time is to mums

2) how cranky overtired babies are

3) how long it can take to get even a-not-overtired baby to sleep

So massive apologies to the mothers of any babies I have previously woken unnecessarily... Future ward rounds will be very different!

The start...

When I was pregnant everyone used to look at me enviously and say “you are so lucky that you’re a doctor as …[insert some variation of]… you’ll never worry about your child/will always know what to do”. I admit, I am lucky that there are lots of things that don’t phase me, such as handling a newborn or holding my baby for immunisations.

However there is a whole host of parenting skills that being a doctor does not prepare you for... And, to be honest, may even hinder you.

Over the last few months since “Doof” was born I have been slowly collating things I wish I had known when at work and have now decided to write them all down and share them with whoever wants to read. I have no doubt the list will get longer and longer as time goes on! So as well as sharing stuff I find interesting/important/entertaining, this is a record of all the things I wish I'd known before while working (but didn't!); think all paediatricians should be taught or on which I have radically changed my mind (very different when it's your own child!) and will do differently when back at work...