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Oh, baby! A scare, but baby gaining weight

Wellness
Dr. Monica Selander's oldest daughter Nora, 2, enjoys some time with her baby sister, Luna.

Dr. Monica Selander's oldest daughter Nora, 2, enjoys some time with her baby sister, Luna.

The team at Tidelands Health Women’s Center helps families navigate pregnancy and childbirth every day. Now, one of the practice’s physicians – Dr. Monica Selander – has invited us to be part of the journey as she and her husband, Tidelands Health orthopedic surgeon Dr. Earl Han, welcome a second child to their family. Follow us on Facebook, check out our Twitter feed and stop back here often to get the latest updates.

Weight is often a hot topic when a baby is born. At birth and during a child’s early months, people often ask how much baby weighs.
Curiosity about pounds and ounces is more than a polite pleasantry. Weight gain is an important indicator of baby’s health and development.
As a physician, Tidelands Health OB-GYN Dr. Monica Selander knows the importance of monitoring an infant’s weight, but she also has personal experience as a mother. Weight gain is something she’s had to pay especially close attention to following the birth of her second child, Luna, on June 24.
Only weeks after birth, Luna was diagnosed with laryngomalacia and mild to moderate acid reflux.
Laryngomalacia is the softening of tissues of the larynx, and is the most common cause of noisy breathing in infants. The larynx isn’t formed correctly at birth, which causes the tissue to partially block the airway. Reflux occurs when food backs up from the stomach, causing the baby to spit up.

Common, but a concern

While both conditions are relatively common and will likely rectify as Luna grows, Dr. Selander has had to keep a close eye on her baby’s weight gain.
Dr. Selander says Luna is an efficient nurser who seems full even after brief nursing sessions and to this point, Luna’s weight gain has been appropriate. She has consistently been in the upper 60th percentile on the growth curve, but that could change if the laryngomalacia doesn’t improve.
“It’s important for me to determine if I notice any abnormalities with her nursing that seem to be due to her breathing. If she starts to have issues like that and her weight gain drops off, then this would indicate her condition is worsening,” Dr. Selander says,

Baby Nora is happy and eating well.

Since babies can’t tell us what’s wrong, weight gain is a key indicator that can point to a problem, says Dr. Lauren Munck, a resident physician at Tidelands Health Family Medicine at Holmestown Road.
“Weight gain is one of the ways that we as physicians can help ensure that babies are getting the appropriate nutrition,” she says. “Changes in growth may be the first signs of chronic congenital conditions such as inflammatory bowel disease, thyroid concerns, adrenal issues and the like.
“If a child has a significantly low growth curve, it might also raise flags about problems at home or signs of malnutrition. Over time, poor weight gain and poor nutrition can lead to developmental and behavioral problems.”

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Full-term babies can lose up to 10 percent of their body weight after birth but should regain their birth weight within two weeks, Dr. Munck says. By four months of age, infants should double their birth weight and by a year, infants should triple their birth weight.
“If an infant isn’t gaining weight appropriately, we first evaluate for potential issues with feeding such as latching, swallowing difficulties or feeding cues,” Dr. Munck said. “For women who are struggling with breastfeeding, lactation therapy can help.
“Dietitians are also important in making sure infants are getting the appropriate caloric intake to sustain growth. Labs may be drawn to look for causes of malnutrition such as genetics or malabsorption, as well as conditions such as anemia.”

A return to normal

Now that Dr. Selander and her husband, Tidelands Health orthopedic surgeon Dr. Earl Han, know Luna’s diagnosis, they’re back to their regular routine.
“The period of time between when we decided to bring Luna in to be seen for the noisy breathing and when we received the diagnosis was very stressful,” Dr. Selander says. “We were lucky with (our first daughter) Nora that we never had to bring her to the doctor for anything other than normal routine well-child visits. This was a different experience for us.”

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Luna is sleeping for longer and longer stretches at night, and getting lots of attention from her big sister, 2.
“Nora almost has ‘mom hearing’ as she hears Luna cry or fuss from across the house and asks to ‘check on baby Luna.’ She wants to hold her and give her hugs and kisses,” says Dr. Selander, who is on maternity leave from her role at Tidelands Health Women’s Center. “She hasn’t indicated any jealousy as yet, and I’ve also noticed her getting better at playing by herself instead of always asking me to play with her.
“Since I am taking care of the two of them myself when Earl is working, this is helpful since sometimes my hands are full taking care of Luna.”
Family members have also visited to help lighten the load, and the couple has developed a daily routine and shared tasks.
“We definitely have our hands full, but the more we fall into a routine, the easier it gets,” Dr. Selander says. “More sleep will help, too.”

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