Anemic.

The doctor's office called back, and Peeper is a little bit anemic.

The nurse said that, according to the full lab test her hemoglobin is 10.4 and they want it to be around 12, and her hematocrit is 31.6 and they want it to be around 35.5.

I asked about those numbers, "I thought the nurse told me yesterday that the hemoglobin should be between 10 and 12? Or was that for the screen, and it's a little different when the lab does it?"

(Sometimes these things change from lab to lab.)

She said that, "The in-office screen was right on, it was 10 and the lab said the same thing."

Um, no. Because I'm sure I didn't make up, "She needs to be at least 10 and she's 9.4" but whatever.

Point is, they say she's a little low and want us to give her 1 ml/day of PolyViSol with Iron.

As it turns out, we actually had an unopened bottle of that. I do not know why. Maybe we bought the wrong kind before?

Anyway, Shrike got the call from the nurse (and I called back later for details) while I was tutoring, so she found the vitamins and gave her a dose and it went down just fine.

She didn't fight it or complain or anything - although Shrike did bring her in for some goody right afterward, to wash the taste out of her mouth.

(Shrike tasted the vitamins before giving them to Peeper and confirmed that they are still nasty.)

So, sigh.

I supposed that, especially if she's not going to fight us and make a scene about it (or she might, now that she realizes what we're giving her!), we'll give her the damn vitamins.

The nurse said it can take a couple of months for the iron level to come up, so we'll just recheck it at her 12 month (!) well-baby appointment.

I really hate this.

It's not about giving her the vitamin drops - although I do hate that, too, because they taste so bad - but I hate that she needs them.

You know, just today, I was teaching a student about deductive reasoning and syllogisms.

Here's an example:

Given
All dogs bark.
Big Galoot is a dog.

Therefore
Big Galoot barks.

Easy enough, right?

Okay let's try another one:

Given
Nutritional deficiencies are caused by receiving inadequate nutrition.
Babies get all their nutrition from their parents.
I am Peeper's parent.
Peeper has a nutritional deficiency.

Therefore
It is all my fault and I am the Worst. Mother. Ever.

See how that works?

How about another:

Given
Premature and low-birth-weight babies are at increased risk for anemia.
Peeper was premature and low-birth weight.

Therefore
I should have seen this coming, so it is all my fault and I am the Worst. Mother. Ever.

And one more:

Given
Most people feed their babies iron-enriched rice cereal.
I decided that Peeper don't need no stinkin' rice cereal.
Therefore
Well, I think you know were I'm going with this one.

In my defense . . .

(I said that to Shrike earlier, and she said, "It's not a trial . . . I was going to say 'you're not a witch,' but I just couldn't get my tongue around that one.")

. . . Peeper's hematocrit was just fine when she was discharged from the hospital after her surgery, at 4.5 months old.

Immediately after surgery, it was low, but then they gave her back that was in the bypass machine when she came off of it.

(She'd already gotten a unit of donated blood to up the volume enough to fill the machine; that amount was then left over.)

So, whether she started off okay that morning, or if she was already a little depleted before surgery (possible, because she probably started with less of a reserve than normal) it seems like they got her spiffed up to normal before sending her home.

So, I guess I assumed that we were starting with an appropriately full iron-tank at that point, despite her prematurity and low birth weight.

Perhaps I was wrong.

I feel like we feed her iron-rich foods pretty often, as well as vitamin-C rich foods (which help the iron to absorb), but I guess we have been slacking a bit on the meat lately.

I suspect it has more to do, though, with how little of what we offer her actually ends up being swallowed.

Which, for the most part, is fine, because she gets (I thought) everything she needs from breastmilk and "food's for fun until they're one," but I suppose that doesn't apply to iron.

Especially if she was less tanked up than she ought to have been, from the get-go.

Looking at it objectively, I can see that it's really not that big of a deal. She's only a tiny bit low, and this is just when they start even checking it, so she's not likely to have been low for long, so it's doubtful that any actual damage has been done, and it's not a big deal to take some vitamins and make sure she's getting enough.

But, of course, it's hard to look at it objectively.

It's hard to look at it any other way than, "I decided to feed her this weird way, and now she's anemic and (all together now, kids) it's all my fault, and I am the Worst. Mother. Ever."

Shrike did her best to rein me in and make me stop making myself crazy about it.

She pointed out that "nobody eats like they should," and that we both take vitamins - including iron - so what's the big deal if Peeper needs to, as well.

In fact, back in January, when we were in Texas, we stumbled upon a Red Cross blood donation truck, and Shrike was going to make a donation, partly because she's just a good person but also to get us "blood insurance" in case Peeper needed some with surgery.

They wouldn't take her blood because the initial screen showed her to be a little anemic.

She was nice enough this afternoon to try to convince me that perhaps it's some sort of genetic malabsorption issue, and therefore all her fault, but I'm not really buying that.

(She is now taking a daily multivitamin which contains the full recommended daily allowance of iron for a woman her age.)

I, on the other hand, do malabsorb lots of stuff because of my gastric bypass surgery, but everytime I've been tested, I've got plenty of iron - sometimes it's even a little on the high side.

So, at least it's likely that I've been putting all that I can in my milk.

Well, I suppose that's something.

(Or, at least I was high on iron when I was very conscientious about my protein intake. I'm more willy-nilly with it now. Although I'm quite sure I was tested for anemia at some point during pregnancy and nobody ever told me there was a problem, so I suppose I was fine.)

(Interesting note, if you've not already read LadyKay's comments on my earlier post: Pregnant women need a lot of iron, but lactating women need much less - more like the levels required by men or post-menopausal women. I'm assuming it's actually matter of menstruating women needing more than everybody else in the world.)

So, I guess if we were introducing solids the way "everyone" else does (mumbling: and the way our doctor recommended) it's possible she wouldn't have this problem, and if she did, at least I would feel like "Well, watcha gonna do?"

On the other hand, as Shrike also pointed out, if we were to be shoveling a bunch of rice cereal down here, she might not be anemic - but would she be as happy as she is with picking up fruits and veggies and meat and gnawing on them?

She also pointed out that it's a lot easier to get a milliliter of nasty liquid down her than a bowl of blechy mush.

Also, LadyKay tells me that (25 years ago, at least) Cheerios have as much iron as the rice cereal does, anyway.

(Now, she just needs to perfect that pincer grasp so she can get more Cheerios into her mouth and less in her lap!)

So, I suppose it's nasty vitamin/iron drops for now and we'll see how she's looking when she's a year old.

At that point, she should be actually eating a lot more solid food, and taking in a lot more iron in her diet, so hopefully we can ditch the vitamins and she'll be able to hold her own.

But I'm still sure that it's somehow all my fault.