M's Follow-Up Appointment

This morning we went back to the pediatrician to reassess her breathing and weight gain.

Her current stats:
15lbs 5oz  (off the full term growth chart; 3% on preemie growth chart)
26 1/2" (3-5% on full term chart; 10-25% on preemie chart)

She's putting on weight again, which is the good news.  But, it's not as good of a gain as the pediatrician would like.  She's not concerned, but said to still push the high fat foods and try to get her to drink as much formula as possible.  I also have to start giving her a vitamin D supplement since she's not drinking as much formula as we'd like in a day.

Looks like at this point we still have a long and lean kid.  She must take after my mom.

As for her breathing, despite having another cold (thanks daycare), she's looking pretty good.  Her breathing is still on the fast side, but not out of the normal range.  No coughing in quite some time.  Haven't noticed any retractions in a while.  Her pulse-ox today was 97 which is good.  There was no evidence of wheezing (and I haven't noticed any at home either).  So, our plan of action is to keep her on a low dose of the inhaled steroids for the duration of cold and flu season (read: until spring).  This should help keep all of the colds from settling in her lungs and having to go thru what we did the last month and a half.  I asked about consequences of long term steroid use.  Obviously we have to keep them out of her eyes (which we do now) because it can cause cataracts later in life.  She said there really shouldn't be anything for our course of action.  However, a study did just come out recently that children who were on moderate dosing of steroids for long term (i.e. several years) had a loss of 1 cm of height, or about a half inch.  But, M will be on a low does (not moderate) and it shouldn't be for years...it should just be for the winter this year.  The hope is that when she gets a cold in the spring (and is off steroids) that it won't settle in her lungs and that would be a good indicator that she's grown out of whatever this is.  Fingers crossed that's how this goes.

What else?  Oh, she got her 2nd and final dosing of the flu shot.  So, in 2 weeks she should be completely immunized against the strains they are predicting for this year.  She was a real trooper with her shot today.  She only cried for about a minute and then was a-ok.  Definitely one of our better shot experiences.

She does not qualify for Synagis this year.  I'm not really sure how I feel about that.  On the one hand with the breathing issues, RSV scares me even more.  But, on the other it'll be nice to save her several shots this year.  I looked at the criteria already and knew that was going to be the answer.  There's absolutely no category that she fits under to qualify.  We'll just have to be careful this year again.  But, I'm hoping that the daily steroid treatments will keep things in check even if she does end up catching something nasty. 

So, all in all, it was a pretty good appointment with encouraging news.  Maybe M will gain a ton of weight during the holidays like everyone else does ;)