Friday, April 25, 2008
The Fourth Trimester
They say that the first three months of your baby's life are like a fourth trimester, and I whole-heartedly agree. It's no coincidence that my maternity leave was three months long. If there's one thing we can thank Bill Clinton for, it's the family medical leave act. I came back to work and now Ben is home with Megan for his leave, as it applies to moms, dads, adoptive parents, or anyone coping with a family medical emergency or ailing aging parent. Maybe Bill was looking forward to Chelsea's turn at coping with his future hospice care! Whoa, dark, Val. Sorry.
Speaking of sorry, I'm sorry I haven't kept up with the blog through those three months. I can say a little bit here. I did have some post partum depression but it would come and go and eventually faded. Physically I felt great. I didn't tear, so it was no time before I felt up and about and good about it. Despite this, I was not 100% in the romance catagory, as far as bouncing back! Ahem! My biggest physical problem was my back. I felt as if it no longer really worked. It hurt, and I had a big lump where the epidural had been. I slumped over a lot and would have to work to sit up straight, it was like my back just didn't work anymore. I begged numerous back rubs from Ben, and struggled to support my back while I worked on getting nursing down (that's another subject altogether). Also, I kept getting odd cold touches on my body, mostly my legs, which my doctor said was a sign of spinal irritation. It felt exactly like a small dog had put a cold, wet nose on my leg for a moment. Then I would feel it and nothing would be there. It has faded to being almost entirely gone, so I don't need the neurological tests he said I might need if it didn't clear up on its own. Tho I still get it sometimes.
Megan also had a rough first few days, (tho not as rough as Tyler had it). She was jaundiced from the hematoma and from her slow start at nursing, altho she was never deprived of milk, we made sure of that. The first week saw daily and then weekly visits to either doctor or hospital for blood bilirubin level testing and weight measuring, and poor thing, you should see her feet (that's where they prick to draw blood). She got dangerously close to a measure of 20, at which point they would've had to put her under lights, but she backed off from that, and by 9 weeks her hematoma and most of the jaundice were gone.
Mommy-baby yoga is great, and Megan is the most active, vocal, hungry, and needs the most diaper changes, than any other baby in class. The idea is, you bring your baby to yoga, and you can stop and nurse or walk or change diapers anytime during class. It's a very gentle way of getting back to the outside world. The first session was a class of all girls! The one I'm in now, all the moms have two kids like I do. All the other moms are so nice and friendly. At first, with how active Megan is, I felt frustrated that I couldn't do many of the yoga poses. After time passed I began to see some of the other babies wake up and be more demanding, so that was good. At least then I wasn't the only one. Now she is still the most active, I don't know why. But I make a play/roll area for her next to me and she practices rolling and grabbing things and puts stuff in her mouth and watches the instructor. It's a real pleasure. It's a special time for me and for being just with her too. It's really my only time getting out on my own.
Speaking of getting out, during maternity leave I had terrible cabin fever. At first it was rough. Tyler would get stirred up, trapped inside with terrible, freezing weather outside. I was always it seemed "stuck under Megan," as Tyler and I say, on the couch, and felt just so frustrated to be unable to do anything in the home or with Tyler or effect any positive change in my own environment. I lived for the time when Ben would come home, and he often came home to poopie diapers waiting for him to change or an overtired boy who needed bedtime, and me with a very demanding baby. My Aunt Sharon came to stay and help, and that was a highlight of this early time. She was entirely nonjudgemental about my attempts and sometimes failures to nurse, and the messy condition of the house and my own unshowered state. She cooked for us, and brought me a happy ally and confidant during those early days. She also brought a DVD of the Disney/Pixar movie Cars as a gift for Tyler (my suggestion--he liked the movie when he saw it once at daycare as a treat on Luka's birthday). So I have "watch car tv" multiple times, sometimes once or twice a day. While I'm not proud to have used TV in this way, it has saved my sanity. Luckily it's a great film with great music (we've since got the soundtrack and "play car music") and great messages. We have weaned him from watching it so often now, btw.
Tyler is a great big brother. He was still watching Cars when Mike and Madalen came to visit and meet Megan, and I was still on leave, but things were better by then. I was nursing successfully then, for one thing, without all the accoutrements. Tyler has his ups and downs, but then again he is 2 and a half. At first he was thrown by the introduction of the new baby, and he gave me some heartbreaking looks of betrayal sometimes. Going back to Sheila at day-care got him back on track to normalcy, but then she quit to go be a nanny and earn more, so we now share a nanny with a boy from day-care, Luka, and his parents. A very expensive playdate, kind of like. Tyle had some bad days in there, poor thing, but he is really changing in the right direction now. He grows and blossoms in spurts and jumps, and amazes us all the time. He likes to hold Megan (supervised, on the couch), and grab her and poke her if he can get away with it, and has even brought her a car toy once or twice. He talks about her and announces when she's crying, and protectively tried to defend her by pushing away the pediatrician on one visit! (Dr. Mercola seems to really like him.) Only sometimes he will want her off my lap to make room for himself, but that's an issue less and less for him.
Throughout I have tried my very best to memorize as much of these moments as possible. Megan is very special, and I will never have a baby like this again (that's the plan anyway). She's nothing like Tyler was. She's much more spit-up-y, and poopie (is she ever!), and in general messy and wet. She's a loud talker as she sqawks like an angry cat when she's excited. She's chubbier than Tyler was, and sweetly so. She has round rosebud lips. She's clingy where he was independant, and she's accepted a sling, and wants to sleep on me all night if she can. She doesn't want to be put down, ever. But she does like the swing, and her tummy-time.
I can't get enough of her, I'm so in love. After a period of estrangement--it was subtle--from Tyler, I am back to kissing his cheeks as much as I can again, and also hers, which are nice and soft and chubby. I had such baby hunger (that's what they call it) toward the end of my pregnancy, it feels so good to fulfill my desires to hug her as much as I can. To touch her little toes, to hold her as her head wobbles around and she looks around the room with a look of "wow." Those quick little breaths babies do when their excited, or when they're trying to do something and are flailing their arms around trying to control them and grab something. It was hard to come back to work, but as everything else a necessary transition to make. So I rush home to her every night and enjoy my kids as much as I can. Kiss her and hug her and breathe her in, try to memorize her, these moments. And never take them for granted.
* * * * *
These Are Days by Natalie Merchant
these are days you'll remember
never before and never since, I promise
will the whole world be warm as this
and as you feel it, you'll know it's true
that you are blessed and lucky
it's true, that you are touched by something
that will grow and bloom in you
these are days you'll remember
when May is rushing over you with desire
to be part of the miracles you see in every hour
you'll know it's true, that you are blessed and lucky
it's true, that you are touched by something
that will grow and bloom in you
these are the days
that you might fill with laughter
until you break
Speaking of sorry, I'm sorry I haven't kept up with the blog through those three months. I can say a little bit here. I did have some post partum depression but it would come and go and eventually faded. Physically I felt great. I didn't tear, so it was no time before I felt up and about and good about it. Despite this, I was not 100% in the romance catagory, as far as bouncing back! Ahem! My biggest physical problem was my back. I felt as if it no longer really worked. It hurt, and I had a big lump where the epidural had been. I slumped over a lot and would have to work to sit up straight, it was like my back just didn't work anymore. I begged numerous back rubs from Ben, and struggled to support my back while I worked on getting nursing down (that's another subject altogether). Also, I kept getting odd cold touches on my body, mostly my legs, which my doctor said was a sign of spinal irritation. It felt exactly like a small dog had put a cold, wet nose on my leg for a moment. Then I would feel it and nothing would be there. It has faded to being almost entirely gone, so I don't need the neurological tests he said I might need if it didn't clear up on its own. Tho I still get it sometimes.
Megan also had a rough first few days, (tho not as rough as Tyler had it). She was jaundiced from the hematoma and from her slow start at nursing, altho she was never deprived of milk, we made sure of that. The first week saw daily and then weekly visits to either doctor or hospital for blood bilirubin level testing and weight measuring, and poor thing, you should see her feet (that's where they prick to draw blood). She got dangerously close to a measure of 20, at which point they would've had to put her under lights, but she backed off from that, and by 9 weeks her hematoma and most of the jaundice were gone.
Mommy-baby yoga is great, and Megan is the most active, vocal, hungry, and needs the most diaper changes, than any other baby in class. The idea is, you bring your baby to yoga, and you can stop and nurse or walk or change diapers anytime during class. It's a very gentle way of getting back to the outside world. The first session was a class of all girls! The one I'm in now, all the moms have two kids like I do. All the other moms are so nice and friendly. At first, with how active Megan is, I felt frustrated that I couldn't do many of the yoga poses. After time passed I began to see some of the other babies wake up and be more demanding, so that was good. At least then I wasn't the only one. Now she is still the most active, I don't know why. But I make a play/roll area for her next to me and she practices rolling and grabbing things and puts stuff in her mouth and watches the instructor. It's a real pleasure. It's a special time for me and for being just with her too. It's really my only time getting out on my own.
Speaking of getting out, during maternity leave I had terrible cabin fever. At first it was rough. Tyler would get stirred up, trapped inside with terrible, freezing weather outside. I was always it seemed "stuck under Megan," as Tyler and I say, on the couch, and felt just so frustrated to be unable to do anything in the home or with Tyler or effect any positive change in my own environment. I lived for the time when Ben would come home, and he often came home to poopie diapers waiting for him to change or an overtired boy who needed bedtime, and me with a very demanding baby. My Aunt Sharon came to stay and help, and that was a highlight of this early time. She was entirely nonjudgemental about my attempts and sometimes failures to nurse, and the messy condition of the house and my own unshowered state. She cooked for us, and brought me a happy ally and confidant during those early days. She also brought a DVD of the Disney/Pixar movie Cars as a gift for Tyler (my suggestion--he liked the movie when he saw it once at daycare as a treat on Luka's birthday). So I have "watch car tv" multiple times, sometimes once or twice a day. While I'm not proud to have used TV in this way, it has saved my sanity. Luckily it's a great film with great music (we've since got the soundtrack and "play car music") and great messages. We have weaned him from watching it so often now, btw.
Tyler is a great big brother. He was still watching Cars when Mike and Madalen came to visit and meet Megan, and I was still on leave, but things were better by then. I was nursing successfully then, for one thing, without all the accoutrements. Tyler has his ups and downs, but then again he is 2 and a half. At first he was thrown by the introduction of the new baby, and he gave me some heartbreaking looks of betrayal sometimes. Going back to Sheila at day-care got him back on track to normalcy, but then she quit to go be a nanny and earn more, so we now share a nanny with a boy from day-care, Luka, and his parents. A very expensive playdate, kind of like. Tyle had some bad days in there, poor thing, but he is really changing in the right direction now. He grows and blossoms in spurts and jumps, and amazes us all the time. He likes to hold Megan (supervised, on the couch), and grab her and poke her if he can get away with it, and has even brought her a car toy once or twice. He talks about her and announces when she's crying, and protectively tried to defend her by pushing away the pediatrician on one visit! (Dr. Mercola seems to really like him.) Only sometimes he will want her off my lap to make room for himself, but that's an issue less and less for him.
Throughout I have tried my very best to memorize as much of these moments as possible. Megan is very special, and I will never have a baby like this again (that's the plan anyway). She's nothing like Tyler was. She's much more spit-up-y, and poopie (is she ever!), and in general messy and wet. She's a loud talker as she sqawks like an angry cat when she's excited. She's chubbier than Tyler was, and sweetly so. She has round rosebud lips. She's clingy where he was independant, and she's accepted a sling, and wants to sleep on me all night if she can. She doesn't want to be put down, ever. But she does like the swing, and her tummy-time.
I can't get enough of her, I'm so in love. After a period of estrangement--it was subtle--from Tyler, I am back to kissing his cheeks as much as I can again, and also hers, which are nice and soft and chubby. I had such baby hunger (that's what they call it) toward the end of my pregnancy, it feels so good to fulfill my desires to hug her as much as I can. To touch her little toes, to hold her as her head wobbles around and she looks around the room with a look of "wow." Those quick little breaths babies do when their excited, or when they're trying to do something and are flailing their arms around trying to control them and grab something. It was hard to come back to work, but as everything else a necessary transition to make. So I rush home to her every night and enjoy my kids as much as I can. Kiss her and hug her and breathe her in, try to memorize her, these moments. And never take them for granted.
* * * * *
These Are Days by Natalie Merchant
these are days you'll remember
never before and never since, I promise
will the whole world be warm as this
and as you feel it, you'll know it's true
that you are blessed and lucky
it's true, that you are touched by something
that will grow and bloom in you
these are days you'll remember
when May is rushing over you with desire
to be part of the miracles you see in every hour
you'll know it's true, that you are blessed and lucky
it's true, that you are touched by something
that will grow and bloom in you
these are the days
that you might fill with laughter
until you break
Thursday, April 24, 2008
My Nursing Journey
Because I was never able to nurse my first baby, Tyler, I came to the hospital prepared for disaster. Breast pump, nipple shields, bottles with various nipples, a breast-shaped bottle I’d special ordered, and 2-oz travel bottles of premixed formula, all came with me.
Tyler never latched, apart from a first latch a nurse helped achieve immediately after his birth. The first night nurse brought him to the breast twice, waking him up from the initial newborn slumber, and insisting I try the lie-down position (the most difficult at first) and shoving him at the breast, where he just screamed. I don’t know if that’s where it started, but the next day he just slept the hours away and screamed at the breast. West Sub had just the day before fired their in-house lactation consultant and new-mom breastfeeding classes were canceled. Every nurse had a different position and advice. Tyler quickly became lethargic, jaundiced, and dehydrated, and landed in the ER with a high fever not 12 hours after we were released from the hospital.
A lactation consultant was brought in (he was admitted) and taught us how to revive him from lethargy and get him to eat. She ordered a hospital pump and supplies, and came up with a feeding schedule and a plan for how much formula and how much pumped colostrum he should take. I’m cutting out a great deal of detail and other difficulties brought on by the hospital (West Sub), and some high drama involving firing our first pediatrician, for brevity’s sake. This is Megan’s story, after all. Suffice it to say that we nursed Tyler back to health in a very expensive, uncomfortable, and unhelpful hospital room. Once back home, he drank lustily from a bottle and screamed at the breast, and it was possibly the most painful time of my life. Determined to give him the benefits of breastmilk, I pumped for seven and a half months. So, yeah, I was a little paranoid heading into this second birth!
Under our doula, Tanya’s, care, Megan’s first latch was a good one, right after birth. I had called ahead and spoken to a lactation consultant at Prentice and requested, per her advice, to see an LC on the first day in the hospital. We asked and we asked, but an LC did not come on that first day. Megan’s latch was poor, and painful, and when she cried I could see her tongue tie was tight. Taking matters into my own hands, I pumped colostrum and tried the breast-shaped bottle and a bottle with a nuk nipple, neither of which did she like much, tho she did take some. One of the nurses gave us some syringes for mouth feeding, and that was our best bet. We began to track her intake in a chart, much as we had learned to do for Tyler before. Trying to avoid the confusion of each nurse giving different advice and positions that had happened before, I insisted on trying to master just one position, the basic cradle hold, which was most comfortable. Our doula came back the next day and assisted, and supported me in this decision, which I really appreciated.
Right away that day, I could tell that Megan was sticking to the effort. I was impressed by how she kept trying and trying to latch, no matter how many times I asked her to try again, and tho she might cry she did not scream. When the LC thought she wasn’t getting enough, we supplemented with the formula I’d brought, and she took it without complaint. I figured Megan’s cooperativeness was a good sign that we could work this out.
The LC came on our last day, and she was like a friendly, if hurried, drill sargeant. She came in with a trolly of supplies and slapped on latex gloves and got to work, her pager going off constantly and barking commands and questions in rapid fire. Cradle and reverse cradle no longer worked, she said. I was already getting big with transitional milk, and I had trouble with the positioning of my hands, so she ordered the football hold. (Yes, ma’am!) She examined Megan’s tongue tie and tried her latch and sucking strength with a finger, and declared that she was capable. After many tries, I got the football hold down. She felt Megan wasn’t getting enough and that she’d have to make up for not getting enough the days before. How frustrating for us, when we’d prepared way ahead of time and I’d pumped and made sure to supplement the latches! Not to mention our repeated requests for LC help! In any case, she got us started on the SNS (supplemental nursing system), which is a bottle attached to your shoulder with a tube coming down that you tape to your breast or finger, along with a nipple shield, which is like a fake one you put over your own when yours are too flat, to help the baby draw it out and teach her the proper shape to draw it out to.
Let me tell you, this combination is a mess. The first week at home, I was red from hospital tape holding on the SNS tube, and the formula/breastmilk (after one initial bottle, it was all pumped milk) dripping out of the tube filling up the shield and causing it to lose suction and slip off to the side and the tube coming out from under it spilling all over, all the while I’m trying to position baby and my hands in the football hold with a pillow for support, and then trying to get her to open up enough and latch on to all this mess, which took repeated tries. I mean, this is chaos!!!
Our doula Tanya came when Megan would be hungry, at a moment’s notice phone call, and helped me with the mess. After dealing with the whole big mess and tiring Megan out, I’d feed Megan with the SNS on the finger to make sure she’d had enough, which was relaxing for her. After a while Tanya and I figured out that if she has a little bit by finger first, she would be calm and not panic-starving when trying the latch. Tanya taught me how to recognize what they call a “nutritive sucking pattern,” which is what you look/listen/watch for to know your baby is getting what she needs. We would have a great feeding session, then the next one would take a step back and not work again. One day I’d decide Meg and I needed a break, and we’d do all finger-feeding, and start again the next day afresh. I don’t have proof but I feel that really helped us. (Only did it twice.) Nighttimes, when she and I and Ben were half-asleep, were just finger feeding. (For finger feeding Ben was glad to participate, too.)
It helped having Tanya come over for feedings. It was just a support, as well as good instruction. I wish all new moms could have a doula or full LC for the first few weeks of their baby’s life. Otherwise I have been very internal with this process, unwilling to share much with others or have friends and family come over to watch me try. It was so painful last time, I wanted to be very private this time. One new friend, tho, asked me about it. Kristin, the mom of Tyler’s day-care best friend Luka, asked me how it was going. I gave her a headline, and it turns out she had the exact same problem! Her firstborn never latched, her second (he’s just 6 months older than Tyle) had the same problems as Megan and I! She also did the SNS and shield combo and the nighttime finger feeding. She said it took a month to work it out. I thought, wow, that’s a long time. I excitedly told Tanya about this, and she said to be prepared for it to take two months! Anyway, Kristin said, after the initial difficult period, she had a great nursing experience. I really took heart at that.
I don’t know what kept me going, but sheer determination. Kristin’s story gave me hope. Breastfeeding isn’t easy, and most everyone I know has had trouble, except my mom who was a natural. Cousins and friends all had difficulties with various outcomes, and one friend ended up pumping for all three of her kids! It’s not just enough to know that “breast is best”—it’s the doing that’s sometimes impossible. I used to get looks for giving Tyler a bottle in public, and I’d want to say “Hey! It’s breastmilk! Give me a break!” Now I’m worried about looks for nursing in public! Anyway, I wanted to get that end result that Kristin got, and a good year of happy nursing.
What really kept me going was Megan. Every time I asked her to try a new latch or a relatch, she would do it. She was a real trooper. I would feel really down, and I would announce to Ben that I was quitting. And he was a great support, even tho he was as anxious as I was to keep her healthy and hydrated. He would say he’d back me on any decision I might make, it was okay if I quit, he’d support me. But then when Megan was hungry again, I would just wordlessly put her to the breast again. And we kept on that way for a while.
Once my milk came in fully I did not need to tape the SNS to “the girls” and they were grateful, ha ha. Then the SNS was finger-feeding only. After awhile I got good at working with the shield, and carried it in my bra where my cleavage would keep it warm and it would be ready at a moment’s notice. Soon she was big enough to go back to the cradle hold, and I found it worked! I even nursed her, w/ the shield, for the first time in public, in the pediatrician’s office, I was so proud. I began to wonder if I’d have to use the shield all the time.
Then the law of diminishing returns set in. First, the SNS finger feeding wasn’t 1) big enough to deliver enough, or 2) fast enough to satisfy her. The pediatrician, Dr. Mercola, said she had outgrown it. Away it went. Next, the nipple shield. My first clue was that Megan began to get fussy during feedings. My next clue was that I was getting sore and red from its use. I opened my many trusty breastfeeding books and they all warned against long-term use of the shield. It restricts the nipple ultimately, and slows down the milk delivery making it inefficient. Whoops! So one day I tried without it, and while the latch hurt, Megan seemed much happier, and continued to thrive. So, away it went. We were officially back to basics. Megan was six weeks old. Six weeks, a month and a half, to do away with the accoutrements. Not bad!
After a week of latching and relatching, Megan stopped slipping off down to the tip, which really hurts, and seemed to have the hang of it. My greatest concern at that point was that more often than not she didn’t open her mouth wide enough to get more in and it would hurt. I kept on asking her to relatch, hoping that she would eventually grow big enough to fit better. I think now that she has. I began to practice other positions, mainly side-lying position, which is excellent for nighttime because you can doze while she eats at leisure and as sleepily as she likes. It’s lovely, and has saved my sleep-deprived sanity.
It was hard for awhile to tell whether I had pain because of her latch or whether we had a low grade yeast infection/thrush or even a type of mastitis. I perused my trusty books and found the symptoms overlap they are so similar. Eventually it cleared up, and they can clear up on their own if they are not serious. One weekend I spent helping a friend move and did not pump often enough, and I developed a low grade mastitis that spread from one side to the other. Again, back to the books for home treatment options. Luckily it cleared up on it’s own again with home treatments. They say if it doesn’t clear up w/in 24 hours you need antibiotics. Whatever the case, I was okay.
Recently, at about three months old, I was nursing her when I suddenly realized that it didn’t hurt! That mostly it doesn’t hurt usually. I sat there trying to remember when it last hurt. You see, it would hurt initially and then fade away and I’d be fine for the rest of a feeding. I’m sure it was latch related, that she was taking in more of the areola gradually. And let me tell you that idea of “toughening them up” is a myth. I began to think that I was one of the lucky ones who is naturally sensitive and no way around it. But at three months, I think we’re finally nursing happily. Yay!
Now if we could get her to take the bottle a little more readily while I’m at work, that would be a good thing. We had a great rhythm by the end of my leave, she and I, and our supply and demand was perfectly set up. Now I have a private room at work for pumping and I try to approximate the timing of her feedings while I’m away. It’s working out pretty well. Except that sometimes she just doesn’t want the bottle. So I worry about her. But she continues to grow fat and tall and to laugh and coo, roll around and grab her feet, and do what babies do. And you can’t ask for better than that.
caption: This photo, added to this entry months later, shows a thriving and healthy Megan enjoying a "meal." She's become an old hand at it! I feel so lucky, it's like a gift. Isn't she, and nursing too, just so beautiful?
Tyler never latched, apart from a first latch a nurse helped achieve immediately after his birth. The first night nurse brought him to the breast twice, waking him up from the initial newborn slumber, and insisting I try the lie-down position (the most difficult at first) and shoving him at the breast, where he just screamed. I don’t know if that’s where it started, but the next day he just slept the hours away and screamed at the breast. West Sub had just the day before fired their in-house lactation consultant and new-mom breastfeeding classes were canceled. Every nurse had a different position and advice. Tyler quickly became lethargic, jaundiced, and dehydrated, and landed in the ER with a high fever not 12 hours after we were released from the hospital.
A lactation consultant was brought in (he was admitted) and taught us how to revive him from lethargy and get him to eat. She ordered a hospital pump and supplies, and came up with a feeding schedule and a plan for how much formula and how much pumped colostrum he should take. I’m cutting out a great deal of detail and other difficulties brought on by the hospital (West Sub), and some high drama involving firing our first pediatrician, for brevity’s sake. This is Megan’s story, after all. Suffice it to say that we nursed Tyler back to health in a very expensive, uncomfortable, and unhelpful hospital room. Once back home, he drank lustily from a bottle and screamed at the breast, and it was possibly the most painful time of my life. Determined to give him the benefits of breastmilk, I pumped for seven and a half months. So, yeah, I was a little paranoid heading into this second birth!
Under our doula, Tanya’s, care, Megan’s first latch was a good one, right after birth. I had called ahead and spoken to a lactation consultant at Prentice and requested, per her advice, to see an LC on the first day in the hospital. We asked and we asked, but an LC did not come on that first day. Megan’s latch was poor, and painful, and when she cried I could see her tongue tie was tight. Taking matters into my own hands, I pumped colostrum and tried the breast-shaped bottle and a bottle with a nuk nipple, neither of which did she like much, tho she did take some. One of the nurses gave us some syringes for mouth feeding, and that was our best bet. We began to track her intake in a chart, much as we had learned to do for Tyler before. Trying to avoid the confusion of each nurse giving different advice and positions that had happened before, I insisted on trying to master just one position, the basic cradle hold, which was most comfortable. Our doula came back the next day and assisted, and supported me in this decision, which I really appreciated.
Right away that day, I could tell that Megan was sticking to the effort. I was impressed by how she kept trying and trying to latch, no matter how many times I asked her to try again, and tho she might cry she did not scream. When the LC thought she wasn’t getting enough, we supplemented with the formula I’d brought, and she took it without complaint. I figured Megan’s cooperativeness was a good sign that we could work this out.
The LC came on our last day, and she was like a friendly, if hurried, drill sargeant. She came in with a trolly of supplies and slapped on latex gloves and got to work, her pager going off constantly and barking commands and questions in rapid fire. Cradle and reverse cradle no longer worked, she said. I was already getting big with transitional milk, and I had trouble with the positioning of my hands, so she ordered the football hold. (Yes, ma’am!) She examined Megan’s tongue tie and tried her latch and sucking strength with a finger, and declared that she was capable. After many tries, I got the football hold down. She felt Megan wasn’t getting enough and that she’d have to make up for not getting enough the days before. How frustrating for us, when we’d prepared way ahead of time and I’d pumped and made sure to supplement the latches! Not to mention our repeated requests for LC help! In any case, she got us started on the SNS (supplemental nursing system), which is a bottle attached to your shoulder with a tube coming down that you tape to your breast or finger, along with a nipple shield, which is like a fake one you put over your own when yours are too flat, to help the baby draw it out and teach her the proper shape to draw it out to.
Let me tell you, this combination is a mess. The first week at home, I was red from hospital tape holding on the SNS tube, and the formula/breastmilk (after one initial bottle, it was all pumped milk) dripping out of the tube filling up the shield and causing it to lose suction and slip off to the side and the tube coming out from under it spilling all over, all the while I’m trying to position baby and my hands in the football hold with a pillow for support, and then trying to get her to open up enough and latch on to all this mess, which took repeated tries. I mean, this is chaos!!!
Our doula Tanya came when Megan would be hungry, at a moment’s notice phone call, and helped me with the mess. After dealing with the whole big mess and tiring Megan out, I’d feed Megan with the SNS on the finger to make sure she’d had enough, which was relaxing for her. After a while Tanya and I figured out that if she has a little bit by finger first, she would be calm and not panic-starving when trying the latch. Tanya taught me how to recognize what they call a “nutritive sucking pattern,” which is what you look/listen/watch for to know your baby is getting what she needs. We would have a great feeding session, then the next one would take a step back and not work again. One day I’d decide Meg and I needed a break, and we’d do all finger-feeding, and start again the next day afresh. I don’t have proof but I feel that really helped us. (Only did it twice.) Nighttimes, when she and I and Ben were half-asleep, were just finger feeding. (For finger feeding Ben was glad to participate, too.)
It helped having Tanya come over for feedings. It was just a support, as well as good instruction. I wish all new moms could have a doula or full LC for the first few weeks of their baby’s life. Otherwise I have been very internal with this process, unwilling to share much with others or have friends and family come over to watch me try. It was so painful last time, I wanted to be very private this time. One new friend, tho, asked me about it. Kristin, the mom of Tyler’s day-care best friend Luka, asked me how it was going. I gave her a headline, and it turns out she had the exact same problem! Her firstborn never latched, her second (he’s just 6 months older than Tyle) had the same problems as Megan and I! She also did the SNS and shield combo and the nighttime finger feeding. She said it took a month to work it out. I thought, wow, that’s a long time. I excitedly told Tanya about this, and she said to be prepared for it to take two months! Anyway, Kristin said, after the initial difficult period, she had a great nursing experience. I really took heart at that.
I don’t know what kept me going, but sheer determination. Kristin’s story gave me hope. Breastfeeding isn’t easy, and most everyone I know has had trouble, except my mom who was a natural. Cousins and friends all had difficulties with various outcomes, and one friend ended up pumping for all three of her kids! It’s not just enough to know that “breast is best”—it’s the doing that’s sometimes impossible. I used to get looks for giving Tyler a bottle in public, and I’d want to say “Hey! It’s breastmilk! Give me a break!” Now I’m worried about looks for nursing in public! Anyway, I wanted to get that end result that Kristin got, and a good year of happy nursing.
What really kept me going was Megan. Every time I asked her to try a new latch or a relatch, she would do it. She was a real trooper. I would feel really down, and I would announce to Ben that I was quitting. And he was a great support, even tho he was as anxious as I was to keep her healthy and hydrated. He would say he’d back me on any decision I might make, it was okay if I quit, he’d support me. But then when Megan was hungry again, I would just wordlessly put her to the breast again. And we kept on that way for a while.
Once my milk came in fully I did not need to tape the SNS to “the girls” and they were grateful, ha ha. Then the SNS was finger-feeding only. After awhile I got good at working with the shield, and carried it in my bra where my cleavage would keep it warm and it would be ready at a moment’s notice. Soon she was big enough to go back to the cradle hold, and I found it worked! I even nursed her, w/ the shield, for the first time in public, in the pediatrician’s office, I was so proud. I began to wonder if I’d have to use the shield all the time.
Then the law of diminishing returns set in. First, the SNS finger feeding wasn’t 1) big enough to deliver enough, or 2) fast enough to satisfy her. The pediatrician, Dr. Mercola, said she had outgrown it. Away it went. Next, the nipple shield. My first clue was that Megan began to get fussy during feedings. My next clue was that I was getting sore and red from its use. I opened my many trusty breastfeeding books and they all warned against long-term use of the shield. It restricts the nipple ultimately, and slows down the milk delivery making it inefficient. Whoops! So one day I tried without it, and while the latch hurt, Megan seemed much happier, and continued to thrive. So, away it went. We were officially back to basics. Megan was six weeks old. Six weeks, a month and a half, to do away with the accoutrements. Not bad!
After a week of latching and relatching, Megan stopped slipping off down to the tip, which really hurts, and seemed to have the hang of it. My greatest concern at that point was that more often than not she didn’t open her mouth wide enough to get more in and it would hurt. I kept on asking her to relatch, hoping that she would eventually grow big enough to fit better. I think now that she has. I began to practice other positions, mainly side-lying position, which is excellent for nighttime because you can doze while she eats at leisure and as sleepily as she likes. It’s lovely, and has saved my sleep-deprived sanity.
It was hard for awhile to tell whether I had pain because of her latch or whether we had a low grade yeast infection/thrush or even a type of mastitis. I perused my trusty books and found the symptoms overlap they are so similar. Eventually it cleared up, and they can clear up on their own if they are not serious. One weekend I spent helping a friend move and did not pump often enough, and I developed a low grade mastitis that spread from one side to the other. Again, back to the books for home treatment options. Luckily it cleared up on it’s own again with home treatments. They say if it doesn’t clear up w/in 24 hours you need antibiotics. Whatever the case, I was okay.
Recently, at about three months old, I was nursing her when I suddenly realized that it didn’t hurt! That mostly it doesn’t hurt usually. I sat there trying to remember when it last hurt. You see, it would hurt initially and then fade away and I’d be fine for the rest of a feeding. I’m sure it was latch related, that she was taking in more of the areola gradually. And let me tell you that idea of “toughening them up” is a myth. I began to think that I was one of the lucky ones who is naturally sensitive and no way around it. But at three months, I think we’re finally nursing happily. Yay!
Now if we could get her to take the bottle a little more readily while I’m at work, that would be a good thing. We had a great rhythm by the end of my leave, she and I, and our supply and demand was perfectly set up. Now I have a private room at work for pumping and I try to approximate the timing of her feedings while I’m away. It’s working out pretty well. Except that sometimes she just doesn’t want the bottle. So I worry about her. But she continues to grow fat and tall and to laugh and coo, roll around and grab her feet, and do what babies do. And you can’t ask for better than that.
caption: This photo, added to this entry months later, shows a thriving and healthy Megan enjoying a "meal." She's become an old hand at it! I feel so lucky, it's like a gift. Isn't she, and nursing too, just so beautiful?
Wednesday, January 16, 2008
Megan's Birth Story
Today is Megan's 1 week birthday. Thought I'd take the occasion to recount her birth for the blog...
We were an hour late getting to the hospital for the induction, we were tired and a little weirded out and excited about it. We entered the big, fancy lobby that makes Prentice look like a fancy hotel, and went on up to the 8th floor to L&D. Dr. Arof met us in the waiting room and talked about what to expect. Tanya our doula was finishing up with another birth and would join us in a bit.
Things went pretty leisurely at first. I put on the gown and we scouted out our fancy L&D room. The view was all city, no lake, but still nice. The bathroom was huge. We were visited by two nurses who introduced themselves and a couple of anesthesiologists. One took a drug history and another signed me up for an epidural study, which was a mistake. More on that later.
They got the I.V. in my left hand and started w/ 2mm (or is that ml?) pitosin, then broke the waters. Once they broke the bag of waters things went quickly and picked up pace. Tanya arrived just after that just in time for the contractions to hit. She talked me thru them, holding one hand while I squeezed the heck out of Ben's hand. I paced the room with my IV pole, visited the bathroom, sat on the birth ball, and stood and swayed. I never wanted to lie or sit. If allowed to I likely would have stood for the entire thing!
Tanya had to ask repeatedly to reduce the pitosin b/c she was worried about hyper stimulation, and my contractions which were suddenly and consistently less than 2 minutes apart, about 1 and a half or so. We finally got them to reduce to 1mm of pit. I was trying to clear my head and think was it time for the epidural when Ben started to say, if Val can't think, then she needs the epidural now. I really wasn't getting breaks between contractions all the sudden. Dr. Arof checked me and I was 4cm dilated and he also agreed on the epidural, and turned off the pitosin. So from here on out, it was just me. He said he was going to be in a C-section for the next hour but he didn't think I'd be having the baby before he got back. Famous last words!
This is when it got bad. The gal doing the epidural study came in with her kit and kicked out Ben and Tanya, said it would be just 20 minutes. West Sub had let Ben stay, so this was a surprise. If I had known what would happen I might have skipped the epidural. To get my spine straight they laid me on my side and she jabbed around a bit, which hurt. The study was to give a little medicine and take pressure readings, give more, take another reading. I did not realize that is what it would be. They tried to get me to lie still. I seemed to lose all control of my body at this point, and the pressure to push, or what feels like you desperately need to poop, was immense. I started yelling things, like first I begged for Ben back. Then I was yelling that the contractions still hurt and why wasn't the epidural working. Then when they kept telling me to lie still I was trying to say I couldn't help it and a lot of "oh god" and "help me" and stuff like that. Finally I yelled somebody hold my legs still. And I told this young nurse trying to hold the monitor on my abdomen to stop it because it hurt. They called more and more people in, and there were all these voices and no single person helping me. They couldn't get the heart rate, the baby's heart rate had slowed and they couldn't find it anymore, so without asking, they put in the internal monitor. They kept lifting my leg to check me, to put the monitor in, then to check me again, and it seemed no time had gone by and it was "she's 6 centimeters" "she's 8" "she's dilated to 9" Then they were telling me to stop pushing. Well, I wasn't doing any pushing on purpose. My body was doing whatever it wanted. They flipped me onto my other side for some reason to do with the epidural. A nurse finally came and peered down into my face and took off her face mask and told me to breathe and did some coaching, blowing in my face. I have no idea who she was, but I swear she was the only one in the room over 25 (maybe 40ish) and I just remember her brown eyes. Thank you, whoever you are.
This little crisis was of their own making. Why they would kick out labor support during the epidural for a second pregnancy, which notoriously go faster, when I'm alredy 4cm and no breaks between contractions which is transitional labor (the last stage before pushing), is beyond me. It is not wise. But I got through it, because what else do you do?
Finally Tanya was there, and suddenly Ben, and the back-up doctor, Dr. Katz, appeared at the base of the bed, and they were telling me to push. It was like they were speaking a foreign language, I was very confused. I could move my legs and feel beyond some surface numbness on my legs, and the anesthesiologist put an alcohol swab on my belly asking if it felt cold, which it did, then on my leg, where it did not, altho I could still feel it. I could feel that "ring of fire" when the perenium is stretched. The doc said "just one more push" and I must say I just didn't believe her. I managed a couple of pushes at most, and suddenly the baby was out!!!
(Ben's side of the story is also interesting, and he was feeling insane being locked out. He recalls it as nearly an hour while he repeatedly sought permission to return. Then when he got in it was chaos around me and he was very upset. I focused on him and gripped his hand while I tried to push.)
So I was already in the mode where I announced some insane request to the room repeatedly until I got help, so I switched to "I want her" as my mantra--the baby, which was a girl. She was red and her fingers were purple, and the cord was blue and she was doing that newborn cry. I got her, and she was amazing. This little thing! They switched out towels around her to dry her and prevent cooling of and Ben and I just focused on her.
Tanya had to repeatedly tell the nursing staff to hold off while we had bonding time. They asked maybe 6 times, and the doctor backed us up, which really helped. They just wanted to weigh her, do the apgar, and admit her to the system. But those first 45 minutes of alert time are key. We got a good latch and she drank, with Tanya's help. It was wonderful.
Meanwhile the doc was in and out of the uterus because the placenta would not disengage. They found it had fused membranes. I pushed most of it out with her help, then Dr. Arof joined Dr. Katz and she did a cuterage (like a d&c)--I could feel pressure and hear the snick-snack like scissors! Creepy, but apparently taking care of it then prevented hemoraging and hospitalization later. Also I was already dilated (tho they said I was already contracting). Excellent news was that I had no stitches!!! Just a scrape. They say the placenta did not look 100% healthy, and it was good that they induced when they did.
I know the whole thing sounds crazy, but I'm glad it's over and I'm so glad to have this beautiful girl in my arms. Coming down so fast did give her a cephalo hematoma, however, which is a giant bruise like a pocket of blood on her head. It will resolve in a few weeks. They x-rayed her and there was no skull fracture. She's fine. Breaking down the old red blood cells does create billirubins (sp) as a byproduct, however, so there is jaundice. That and some latch difficulties added to jaundice, but it is already going down and she's eating, pooping, and gaining weight like a trooper!
We were an hour late getting to the hospital for the induction, we were tired and a little weirded out and excited about it. We entered the big, fancy lobby that makes Prentice look like a fancy hotel, and went on up to the 8th floor to L&D. Dr. Arof met us in the waiting room and talked about what to expect. Tanya our doula was finishing up with another birth and would join us in a bit.
Things went pretty leisurely at first. I put on the gown and we scouted out our fancy L&D room. The view was all city, no lake, but still nice. The bathroom was huge. We were visited by two nurses who introduced themselves and a couple of anesthesiologists. One took a drug history and another signed me up for an epidural study, which was a mistake. More on that later.
They got the I.V. in my left hand and started w/ 2mm (or is that ml?) pitosin, then broke the waters. Once they broke the bag of waters things went quickly and picked up pace. Tanya arrived just after that just in time for the contractions to hit. She talked me thru them, holding one hand while I squeezed the heck out of Ben's hand. I paced the room with my IV pole, visited the bathroom, sat on the birth ball, and stood and swayed. I never wanted to lie or sit. If allowed to I likely would have stood for the entire thing!
Tanya had to ask repeatedly to reduce the pitosin b/c she was worried about hyper stimulation, and my contractions which were suddenly and consistently less than 2 minutes apart, about 1 and a half or so. We finally got them to reduce to 1mm of pit. I was trying to clear my head and think was it time for the epidural when Ben started to say, if Val can't think, then she needs the epidural now. I really wasn't getting breaks between contractions all the sudden. Dr. Arof checked me and I was 4cm dilated and he also agreed on the epidural, and turned off the pitosin. So from here on out, it was just me. He said he was going to be in a C-section for the next hour but he didn't think I'd be having the baby before he got back. Famous last words!
This is when it got bad. The gal doing the epidural study came in with her kit and kicked out Ben and Tanya, said it would be just 20 minutes. West Sub had let Ben stay, so this was a surprise. If I had known what would happen I might have skipped the epidural. To get my spine straight they laid me on my side and she jabbed around a bit, which hurt. The study was to give a little medicine and take pressure readings, give more, take another reading. I did not realize that is what it would be. They tried to get me to lie still. I seemed to lose all control of my body at this point, and the pressure to push, or what feels like you desperately need to poop, was immense. I started yelling things, like first I begged for Ben back. Then I was yelling that the contractions still hurt and why wasn't the epidural working. Then when they kept telling me to lie still I was trying to say I couldn't help it and a lot of "oh god" and "help me" and stuff like that. Finally I yelled somebody hold my legs still. And I told this young nurse trying to hold the monitor on my abdomen to stop it because it hurt. They called more and more people in, and there were all these voices and no single person helping me. They couldn't get the heart rate, the baby's heart rate had slowed and they couldn't find it anymore, so without asking, they put in the internal monitor. They kept lifting my leg to check me, to put the monitor in, then to check me again, and it seemed no time had gone by and it was "she's 6 centimeters" "she's 8" "she's dilated to 9" Then they were telling me to stop pushing. Well, I wasn't doing any pushing on purpose. My body was doing whatever it wanted. They flipped me onto my other side for some reason to do with the epidural. A nurse finally came and peered down into my face and took off her face mask and told me to breathe and did some coaching, blowing in my face. I have no idea who she was, but I swear she was the only one in the room over 25 (maybe 40ish) and I just remember her brown eyes. Thank you, whoever you are.
This little crisis was of their own making. Why they would kick out labor support during the epidural for a second pregnancy, which notoriously go faster, when I'm alredy 4cm and no breaks between contractions which is transitional labor (the last stage before pushing), is beyond me. It is not wise. But I got through it, because what else do you do?
Finally Tanya was there, and suddenly Ben, and the back-up doctor, Dr. Katz, appeared at the base of the bed, and they were telling me to push. It was like they were speaking a foreign language, I was very confused. I could move my legs and feel beyond some surface numbness on my legs, and the anesthesiologist put an alcohol swab on my belly asking if it felt cold, which it did, then on my leg, where it did not, altho I could still feel it. I could feel that "ring of fire" when the perenium is stretched. The doc said "just one more push" and I must say I just didn't believe her. I managed a couple of pushes at most, and suddenly the baby was out!!!
(Ben's side of the story is also interesting, and he was feeling insane being locked out. He recalls it as nearly an hour while he repeatedly sought permission to return. Then when he got in it was chaos around me and he was very upset. I focused on him and gripped his hand while I tried to push.)
So I was already in the mode where I announced some insane request to the room repeatedly until I got help, so I switched to "I want her" as my mantra--the baby, which was a girl. She was red and her fingers were purple, and the cord was blue and she was doing that newborn cry. I got her, and she was amazing. This little thing! They switched out towels around her to dry her and prevent cooling of and Ben and I just focused on her.
Tanya had to repeatedly tell the nursing staff to hold off while we had bonding time. They asked maybe 6 times, and the doctor backed us up, which really helped. They just wanted to weigh her, do the apgar, and admit her to the system. But those first 45 minutes of alert time are key. We got a good latch and she drank, with Tanya's help. It was wonderful.
Meanwhile the doc was in and out of the uterus because the placenta would not disengage. They found it had fused membranes. I pushed most of it out with her help, then Dr. Arof joined Dr. Katz and she did a cuterage (like a d&c)--I could feel pressure and hear the snick-snack like scissors! Creepy, but apparently taking care of it then prevented hemoraging and hospitalization later. Also I was already dilated (tho they said I was already contracting). Excellent news was that I had no stitches!!! Just a scrape. They say the placenta did not look 100% healthy, and it was good that they induced when they did.
I know the whole thing sounds crazy, but I'm glad it's over and I'm so glad to have this beautiful girl in my arms. Coming down so fast did give her a cephalo hematoma, however, which is a giant bruise like a pocket of blood on her head. It will resolve in a few weeks. They x-rayed her and there was no skull fracture. She's fine. Breaking down the old red blood cells does create billirubins (sp) as a byproduct, however, so there is jaundice. That and some latch difficulties added to jaundice, but it is already going down and she's eating, pooping, and gaining weight like a trooper!
Tuesday, January 15, 2008
Thursday, January 10, 2008
It's a Girl!!!
I'm sitting in bed at the hospital typing on a little keypad attached to the nurse caller thingie--you know, the device by the bed that you call the nurse with (Ben says, the device you push to make the nurses not come, heh). I'm seeing the blog entry on a big, wide-screen TV. Cool,huh? We've just ordered room service and the food is fantastic. Ben is reading what I write and making sarcastic comments from the dad-bench. Oh, sorry, he says they are "snide or snarky." I sit corrected. "And the bed is an uncomfortable couch that folds out into an even more uncomfortable bed." Little Megan is in her hospital bassinette by the bed. Ben describes this as a "deluxe petri dish." We are tired and a little slap happy.
Megan Hillary was born yesterday, January 9th at 1:21 in the afternoon after a bizarre labor I'll have to describe another time. She was 7lbs 12oz, and 18 inches. She's amazingly tiny. I can't believe Tyler was ever this small. Getting a latch on is again a problem, but we are working through it best we can with our doula
helping. We haven't seen the lactation consultants rumored to work here yet, despite numorous requests and orders for them written into our records in the system here. But she will not be dehydrated like Tyler was. I've brought my breast pump and whenever she doesn't get a latch (it's hit and miss) I pump and she takes colostrum by syringe now. She dislikes two different kinds of bottle nipples already, one of which I had special ordered b/c it is shaped like a breast. She wants the real thing.
Megan looks like no-one I know, but she's really beautiful. Ben adds "in a squishy baby kind of way." Her newest nickname is "scrunchy face." This is in addition to Megalon and Megaweapon, the earlier Scumby of course, and, since Tyler is "boogie boy" we've decided she will be "disco girl." She has a round face, very dark eyes, wisps of brown hair, little rosebud lips, and mini Mobley ears. She has a pink complection and is a little rashy around her face which is already fading. We are both really into her.
...Megan is smacking her lips. Gotta go. Wish me luck!
Megan Hillary was born yesterday, January 9th at 1:21 in the afternoon after a bizarre labor I'll have to describe another time. She was 7lbs 12oz, and 18 inches. She's amazingly tiny. I can't believe Tyler was ever this small. Getting a latch on is again a problem, but we are working through it best we can with our doula
helping. We haven't seen the lactation consultants rumored to work here yet, despite numorous requests and orders for them written into our records in the system here. But she will not be dehydrated like Tyler was. I've brought my breast pump and whenever she doesn't get a latch (it's hit and miss) I pump and she takes colostrum by syringe now. She dislikes two different kinds of bottle nipples already, one of which I had special ordered b/c it is shaped like a breast. She wants the real thing.
Megan looks like no-one I know, but she's really beautiful. Ben adds "in a squishy baby kind of way." Her newest nickname is "scrunchy face." This is in addition to Megalon and Megaweapon, the earlier Scumby of course, and, since Tyler is "boogie boy" we've decided she will be "disco girl." She has a round face, very dark eyes, wisps of brown hair, little rosebud lips, and mini Mobley ears. She has a pink complection and is a little rashy around her face which is already fading. We are both really into her.
...Megan is smacking her lips. Gotta go. Wish me luck!
Wednesday, January 9, 2008
I'm at the Hospital!
Check this out! Free Internet access! I'm just getting settled in for the induction at Prentice Women's Hospital. I've been having contractions all night/morning, too! They do hurt.
Will report back when possible! This place is so hi tech. Hee hee hee!
P.S. Turns out in the exam yesterday the doc did what they call stripping the membranes, which is separating w/ finger the bag of waters from the uterus lining around the opening. That's why it hurt so much! Angry that they didn't tell me. It's very common, and is supposed to release hormones to bring on contractions. Did it work? Hmmmm...
Will report back when possible! This place is so hi tech. Hee hee hee!
P.S. Turns out in the exam yesterday the doc did what they call stripping the membranes, which is separating w/ finger the bag of waters from the uterus lining around the opening. That's why it hurt so much! Angry that they didn't tell me. It's very common, and is supposed to release hormones to bring on contractions. Did it work? Hmmmm...
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