Food battles

In the effort to get food into Ruby, we have had our share of ups and downs. Initially, it was a struggle to get milk into her when all she wanted to do was sleep. Then we had a few months of relative ease, when breastfeeding was going smoothly, and Ruby was drinking more or less her daily recommended amount of milk. Then at 6 months we introduced solids, and her reception to it was so bad that it seemed like she would subsist on a breastmilk-only diet forever. Finally around 8 months old, Ruby began taking to her vegetable and fruit purees. She even seemed to enjoy some foods, in particular broccoli, sweet potato, peas, and avocado. Encouraged by this, I began to introduce lean proteins such as chicken and tofu. This too she gobbled up, and for a time it seemed like there were no foods that she didn't like. However, in keeping with the cyclical nature of kids' eating habits, we are once again in a food slump.

As Ruby is now 9 and a half months old, she is reaching the transition point where solids overtake breastmilk as the dominant source of nutrients. During the week that she was sick and had trouble breathing through her nose, she showed less interest in nursing, as she had to constantly stop and come up for air, and more interest in solids, which seemed like a step in the right direction. However, now that she is better, she has regressed to preferring to nurse. Even certain foods that she used to enjoy are now greeted with an crinkly face and a swat of the hand.

It has become a daily mission of mine to get the recommended 10 oz of solids into Ruby each day. Over the last couple of months, her weight gain has plateaued, so while she was still in the 95th percentile for height at her 9 month check-up, she dropped from the 50th to the 30th percentile for weight. Her pediatrician assured us that this was common for babies of her age, but recommended that we introduce some higher calorie foods into her diet such as cheeses and yogurt. Unfortunately, cheese seems to make Ruby gag. I have discovered, however, that I can sneak many things into her morning cereal without her noticing, so nowadays her cereal is always mixed with either an egg yolk or yogurt and fruit. I've also discovered lentils, which I had never eaten myself but are packed with protein and other important nutrients.

Ruby's favorite food of the moment is tofu, which I cut up into little cubes so that she can shove it into her own mouth hand over fist. She is becoming quite adept at finger foods, which has made family dinners a lot easier. I know that one day it will probably be to her advantage to prefer tofu and vegetables over fatty foods and sweets, but as a baby I think it's ok to be fat. Of course kids go through so many phases with foods that in a couple of years, she may be living on cheese and buttered rolls. Although I'm sure she will be fine in the end, I guess it's part of a mother's job to fight the food battles.

Pediatrician

For Ruby's 9 month check up this week, she saw a new pediatrician in a new practice. We decided to change pediatricians because we never loved our former doctor, and I've had some reservations about the practice from the beginning. However, the main impetus was a serendipitous conversation I had with another mom from Ruby's playgroup.

At the beginning of our last mommy book club meeting, we were all discussing pediatricians, and I was just about to ask the group if anyone else was considering changing doctors when another one of the moms started telling this horror story about her son's former pediatrician. Basically her son was in the doctor's office because he was sick with a fever, and she asked the doctor to take a look at his diaper rash. So the doctor (not wearing gloves) looks in his diaper and says that he has a bit of a yeast infection. Then she notices that one of his eyes is a little goopy, so she decides to massage the tear duct for him (without first washing her hands). The mom (who is herself a nurse) is dismayed by this but doesn't say anything at the time. A few days later they are back in the doctor's office for a follow-up, and the mom asks the doctor to take a look at her son's eye which has been a bit swollen and red. The doctor takes a look and says, "That's funny, that looks like yeast!" Needless to say, the mom was horrified and could not get her son out of that office fast enough. When I asked what practice this was, she said Stonestown Pediatrics (which was our practice), and then when I asked which doctor it was, she said Dr. Janet Sollod (which was OUR doctor)!! Although nothing this egregious had ever happened to us, it was enough to convince us to find a new pediatric practice by Ruby's 9 month appointment.

Once we made the decision, I regretted a bit not listening to my instincts the first time I considered leaving the practice, when Ruby was only 5 days old. However, at the time, we simply did not have the time, energy, or access to resources needed to research and find another practice. Our initial newborn visits at Stonestown Pediatrics were not with Dr. Sollod because she was temporarily on leave getting treatment for breast cancer. Therefore, the day after we came home from the hospital, we went into their offices to see Dr. Nanci Tucker. Since Ruby was a very sleepy baby who had trouble breastfeeding, we were told to return in two days for a weight check.

When we returned with 5-day-old Ruby, we were told that Ruby weighed 6 lbs 13 oz, which was already 10% less than her birthweight of 7 lbs 9 oz. Without asking any questions, Dr. Tucker told us that what was happening was that my milk was too slow to come in, so every other feeding, we should feed Ruby formula while I pump to stimulate milk production. This did not sound right to me because there were many signs that my milk had come in such as extreme boob soreness on day 3 post-partum, Ruby spitting up milk, and intermittent milk leakage. Even though I cited all of these experiences as evidence of milk production, the doctor was very dismissive, as if she was assuming that I was either lying or mistaken. The worst part, the part that still makes me cringe to think about to this day, was the patronizing way she spoke to us, like she was saying we have NO BUSINESS taking care of a newborn.

We scheduled an appointment to return the following day for another weight check. After a harrowing night of pumping, bottle-feeding, and meticulously recording Ruby's milk intake and pee output, we returned to the doctor's office first thing in the morning. Since the previous appointment had been in the late afternoon, only about 16 hours had passed since Ruby's last weight check. This time we were informed by the nurse that Ruby weighed 7 lbs 6 oz, or 9 oz more than 16 hours prior. Considering her total milk consumption during those hours totalled LESS than 9 oz, clearly something was awry! When Dr. Tucker came in, she bumbled about and offered a few nonsensical explanations. However, when I asked her how it was possible that Ruby could have gained more weight than the total amount of matter she consumed, thus violating the Law of Conservation of Mass, she gave no response and quickly changed the subject.

So, basically it was after this that we seriously considered changing practices, but due to Ruby's problems with breastfeeding, we needed to return for weight checks and follow-ups several more times in the coming week, and we didn't know of another practice who could see us so quickly. Therefore, we stopped seeing Dr. Tucker and began seeing Dr. Sollod, who had returned from her leave. While we liked Dr. Sollod a little better, there were still things that didn't quite mesh, for instance how quickly she gave up on Ruby's ability to learn to breastfeed and how insistent she was that we Ferberize the baby even when it was clear we were not ready to let Ruby cry it out.

This time when we decided to find a new pediatrician, we had the vast knowledge network of the Golden Gate Mothers Group at our disposal, so it was a much less daunting experience. I noticed that there was one practice, Getzwell Pediatrics, founded by Dr. Julia Getzelman, that consistently received rave reviews from GGMG moms. Getzwell Pediatrics is definitely not your ordinary pediatrics practice. It is known for its holistic approach to healthcare, its openness to alternative medicines, and its focus on nutrition. The practice does not accept insurance, so everything is paid out of pocket, and then it's up to the patient to seek out reimbursement from their PPO provider. There's also a yearly membership fee for which you get the doctor's personal email and telephone number, which you can call at any time. Basically it's a hippy San Francisco mom's dream, and by joining I've once again surprised myself by how hippy dippy I've become. A few years ago, I would have scoffed at a natural childbirth, had no idea what a doula was, and thought that Getzwell Pediatrics was just an overpriced practice for hippy moms who didn't want to get their kids vaccinated. However, after one visit to their immaculate, state-of-the-art, brightly decorated office full of happy, friendly people, I knew it was the right place for us.

My only reservation was that our primary care physician would not be Dr. Getzelman, as she was not accepting new patients, but the new doctor in the practice, Dr. Aarti Nasta. However, I took it as a good sign when I read in her online bio that she is fellow Brown alum. We met Dr. Nasta at an "organic milk and cookies open house" hosted by the practice. She seemed very nice, and she has a 12-month-old daughter of her own, so she could relate to many of the things we were going through. Our first appointment with her this week was a refreshing change from the interactions we've had with our former pediatrician and made me wish we had been with the Getzwell practice all along. What sold it for Steve was the fact that the office is located very close to Mitchell's Ice Cream, the best ice cream shop in the city, so when Ruby is older, we can take her to get an ice cream cone after getting a shot.

If you're happy and you know it

The germ factory

In addition to proficiency at being snugly and cute, babies are also great incubators of germs. Ruby just got her first cold. It started with a mild runny nose a couple of weeks ago which didn't seem to bother her at all. However, after last weekend, her snot became a lot thicker, causing her nose to be stuffed. The last several days have seen a nasty cough add itself to the list of symptoms. Overall, we've been fortunate since most of her little playgroup friends started getting sick months ago and have been sick several times already. However, we knew the good times couldn't last forever.

Shuyi and I have been fairly sickness free since childhood. I think the last time I had the flu was during my first visit back to China when I was 12. But, despite our mature, proven immune systems, inevitably, both Shuyi and I have caught whatever Ruby has been incubating. In addition being consistently exposed to her sneezes and coughs, her discomfort has also caused us less rest and sleep along with more stress and anxiety. The latter may even be the greater factor.

Ruby's stuffy nose has become the most problematic symptom, as it prevents her from being to breathe while sucking on the pacifier, which in turn, prevents her from falling asleep. It also makes it much harder to soothe her back to sleep when she wakes up in the middle of the night, which in turn, prevent yours truly from going back to bed.

Since babies aren't able to blow their own nose, the standard way to clear their sinuses is to use a nasal aspirator. Most look something like a round bulb with a syringe coming out of it (see below).



We have something similar that came in a baby first aid kit. However, we discovered that it wasn't particularly effective. After some research, we bought a NoseFrida snotsucker, which is basically like a syringe connected to a tube with a mouthpiece. You basically use your mouth to suck out their snot. Mmm. Ruby seems to enjoy it even less than the baby below.

9 months old

Last Sunday Ruby turned 9 months old! I used to look at 9-month-old babies and think that they were so grown-up and that their parents were so seasoned. And here we are on the other side.

As a baby of 9 months, Ruby has made advancements in some areas and not so much in others. Perhaps the most dramatic advancement has been in eating solids. Whereas one month ago we were acting like fools trying to elicit a momentary smile whereby we might sneak a spoonful of food past an otherwise clamped jaw only to elicit the crying and the gagging, Ruby now eats with great gusto and has been receptive to a wide variety of foods.



In the past week, she's begun to try proteins such as soft tofu and chicken. I prepare the chicken by poaching and then pureeing chicken breast and mixing an ice cube worth of chicken with about two ice cubes worth of veggies. Who knew broccoli and chicken mush could be so delicious?

Ruby has also started experimenting with Baby Puffs, which are similar to Cheerios and are meant to serve as practice for finger foods. They are supposed to dissolve on the tongue, but Ruby usually slobbers all over it before it ends up in her mouth, so it dissolves in her hand. Although messy, they seem to be a good exercise in hand-mouth coordination and mastering the pincer grasp.



Speaking of mouth-related advancements, Ruby is finally teething! She is definitely the last in her circle of friends to be toothless, but I can now feel the tippy top of one tooth through her lower gums. Teething doesn't seem to bother her too much during the day, but it might be the cause of more frequent night awakenings, which has cut into Steve's sleep.

The area in which no real progress has been made is that of mobility. Ruby still does not crawl and barely rolls. I am almost certain that she will walk before she crawls because she is nowhere close to crawling. She also has never pulled herself up to sitting, so her crib remains in the newborn position. However, she has become a very proficient sitter and can reach quite far to grab something and then sit back up. Even if you push her, she can usually regain her balance and sit back up like one of those bobble dolls.



At 9 months, we can now tell for sure that Ruby is learning and understanding things. While she can occasionally make the baby sign language sign for milk, her favorite all-purpose sign is to flap her little arms, meaning "pick me up," "I want that," and "general celebration." She also now initiates her own games of peek-a-boo by pulling something over her head, waiting a few seconds, quickly pulling it off, and waiting for me to say "peek-a-boo!"

Although it was always clear that Ruby has a sweet and happy disposition, we are now getting an even better glimpse into her personality. We can tell that Ruby is a thinker. There are often times when we can hear the wheels turning. It takes her a little bit of time to warm up to new environments, especially those that are somewhat loud and overwhelming. She will sometimes silently observe the situation for 30-45 min. before relaxing and joining in on the play. When handed a new object, she will examine it carefully for several minutes before deciding to put it into her mouth. I have yet to see her decide something is NOT good to put in her mouth.

Even though Ruby is becoming more and more like a little person, we still have many nice baby moments.



Don't grow too fast, Ruby!

Ruby signs "milk"