Developmental Paediatrician

Today Tiddler had an appointment with the Developmental Paediatrician. I went on my own with T, unsure of what it would entail but reckoning on a 15mins with possible immediate discharge.

2 hours, several Braxton Hicks and a few more grey hairs later, we emerged from the appointment with T beyond tired and me fighting back the tears.

Ironically, the appointment went quite well...it was very detailed, with the Paediatrician taking a lot of history and then observing her accomplish various tasks: drawing, identifying objects, building block towers etc etc

She more or less hits the spots that she should, finding herself in the 15-18mth bracket for most aspects apart from communication which she was a bit more advanced, and cognitive and personal care or something like that which she is more like 12 mth level. It was a very interesting process to observe, she casted objects like a trooper, totally refused to build a brick tower.. It was reassuringly typical behaviour...

They did express concern as to her attention span... Which is woeful and incredibly incredibly exhausting so I was glad that this was picked up on as I felt validated. I have been trying to tell people how difficult it is to manage her as she will not stay on a task for more than 2 minutes, if you are lucky!

Her head banging and casting behaviour was also picked up on again and the basic upshot is she is getting referred to our Local Authority Educational Psuchologist to be assigned a pre school teacher. I have been trying to get T into this system and had been told before that because she was without a diagnosis this was unlikely. Thankfully, now she has been seen by the Paediatrician they have a Statutory duty to notify the local authority.

So a positive appointment all in all but there is no way I am flying solo with appointments like that again. It's impossible to manage bump, bags and very wriggly non walking toddler without a pushchair... Again... Not allowed in the building... We have heard that somewhere before...

Reflux and Weaning

After several intrusive tests and intravenous antibiotics, Tiddler's "dusky episodes" during the first 8 days of life were put down to Reflux. I remember the first time a Paediatrician said this I was very cynical and I will admit highly irritated. My newborn baby had stopped breathing for God's sake- how can that be Reflux? She had nothing in her tummy the first time it happened, how can that be Reflux? Anyway I was of course thankful it was nothing more sinister. We were "finally"* discharged with a diagnosis of "Silent Reflux" and a very daunting cocktail of medication at a user-unfriendly every 4 hours, 4 hours, 6 hours and 6 times a day.

We have always kept Tiddler's crib tilted (waste of a bloody good John Lewis glider crib, that!) and until very recently always kept her upright for an hour after every feed. I dont jig her about. She misses out on a lot of silly Mummy / Tiddler dancing :( Her medication has been tinkered with over time and she is now on a fairly strong medication once a day. (Omeprazole)

The thing about reflux is that its a condition that varies wildly but does seem to be exacerbated by teething / colds etc. Frustratingly it can seem that you are turning a corner and things are getting better and then you can be brought down to earth with a bang and whole lot of vomit!

Our Paediatrician had said originally we should wean at 4 months but due to Tiddler's low tone and inability to sit, as well as suspected Cows Milk Protein allergy we were then advised against this. Tiddler has had a rough couple of months health wise and so weaning has taken a back seat until now.

She has been doing really well with purees in the last couple of weeks, certainly enjoying an unprecedented hunger and desire to eat. However, she does seem to have a very strong gag reflex. This emerged in the first few days of weaning a while back and she gagged and vomited on a very thin puree of carrot. Since then, she has mainly coped with puree and we never gave her milk just before solids so as to make sure she keeps the milk in her! I am now attempting to introduce lumps and am finding that reflux is rearing its nasty head again :( This evening I gave her 1/4 of a tiny tiny Annabel Karmel pasta shell... she managed three quarters but the 4th made her gag and she threw her entire feed up. Now the saving grace is that Tiddler hardly seems bothered by this- its a silent evacuation rather than lots of tears and retching- just realised this is quite graphic, hope there are no vomit phobics/ people eating while reading this ! It is hard for me though- I spent quite a while preparing her dinner and then feeding it. To then see it all come back up again is dispiriting, feels like Reflux is back. I dont know how much slower we can wean her though as the lumps were tiny. Puzzled. Bloody Reflux.


* we had a lot of "final" discharges...