I just realized the name of my blog is "The Next Adventure." Can this still be classified as an adventure? Can I somehow spin heart surgery to mean adventure? I don't know.
Today we were at the hospital for 6 hours doing pre-op stuff. We met with nurses, surgeons, social workers and met a mess of hospital staff. I won't go into all the hairy details, but here are the highlights (wrong word...stand outs, maybe?)
Two separate hospital staff cried with me. The cardiologist NP and the Child Life Services Worker who gave us the ICU tour. They didn't cry hard, but both got noticeably choked up when I cried. I almost couldn't take it. The empathy was overwhelming. But I was touched.
Aleida had to get blood drawn for testing and whatever they do with it before surgery. The regular nurses decided not to try, so they called in the specialist team (called PANDA- but I'm not sure what it stands for.) They had to poke my baby 4 times before they got the flow they needed. 3 times on her hands and arms and once on her head. She cried harder than she has in her life. I had to cry too, so I didn't have a more physical reaction to her cries. Again, I am amazed by the way her crying makes me feel. She seems no worse for the wear and surely has forgotten about it by now. I, however, have not.
The surgeon is British. He used the word "untoward" which I have only ever heard in movies of Jane Austen adaptations. Needless to say, I like him. He apologized for making me upset (yes, I cried with him, too), but admitted that he often said things that upset people. I am confident he knows what he is doing.
I am thankful that just about every view from every window is scenic. Even through the shimmer of tears, Mt. Hood looks awesome. Dave and I, while having a sad and heartfelt moment together, broke the gloom and tension by realizing how glad we are that we're not going through this in New Jersey. (Sorry, NJers.)
Finally, the biggest highlight- and this is a highlight- was my daughter. She smiled as much today as any other day. She sat completely still through her EKG (which requires a tech to put about 10 stickers onto her chest, hook wires to them, take a reading of her cardiac output, then unhook everything and pull all the stickers off). She took a 1.5 hour nap in Dave's arms. She melted the hearts of everyone we met in the hospital. I am sure they will all do their best to make sure everything goes smoothly.
Wednesday, September 9, 2009
Monday, September 7, 2009
Contrast
I spent the last 3 days doing wedding-related festivities for my good friend, Erin. I was in the wedding party, so we spent lots of time celebrating and preparing and just having a great time. The ceremony was beautiful, the girls a lot of fun, and the weekend altogether enjoyable. Of course, in the back of my mind I kept thinking about Aleida's surgery coming up on Thursday. This wedding was always the event before the surgery, and it was a nice distraction. But now, I have no other place to focus my thoughts. My mind is spilling over with thoughts of the operation.
Truthfully, I think I would be less scared if I was about to have open-heart surgery. But I'm not and I can't take my daughter's place. I can't even explain to her what's going to happen. So, while I'm enjoying these few days with her, every one of her smiles has the sad outline of ignorance, and I feel guilty knowing more about her future than she does. Maybe it is better, her not knowing. There is anxiety in knowing and waiting and just thinking about something. And maybe that is where most of my fear is coming from- the thinking.
What am I most afraid of? It's hard to pinpoint because there are so many things. Here's a list of just a few.
1) The most obvious fear, that something will go wrong with the surgery. Let me just put it out there...that she won't make it. It's open heart surgery, afterall, and all surgeries have some inherant risks. I do not know what I would do if the worst happened. I do not know what I would do.
2) I'm afraid of seeing her taken away from me, knowing where she is headed. I don't like saying goodbye when I leave her with Dave to go to the grocery store. I know the hours she is in surgery will be agony.
3) I'm scared to see her directly after the surgery. She's going to be hooked up to machines and tubes. She'll be pale, drugged. I don't think I'll be able to hold her for several hours- maybe not even touch her. I'm not sure.
4) I'm afraid of the recovery. She's getting sturdier every day. She's working on standing up and crawling. We play airplane and she loves it. She loves baths and smiles through diaper changes. How fragile she's going to seem after such a major surgery. When will we feel comfortable handling her again? Is she going to be in pain? Will this delay her milestones like rolling over and crawling? When will we be back to normal, back on track again?
5) I'm a little afraid that they won't be able to fix her, that this will be a "wait and see" or "wait and try again" situation. I don't think this is likely, but this thought wormed its way into my brain a few days ago, and now it's leaving tracks up there, moving around and around in my head.
6) I'm worried about the scar. Honestly though, this may be the least of my worries. I'm not a vain person, and I can already tell that my daughter's lovely face, sweet temper and just that shine in her eyes will overshadow any cosmetic blemish. This scar will give her a story to tell, will make her aware of her own mortality, will help her feel lucky and blessed, will give her an appreciation for the human mind and modern science. She will hopefully embrace this as part of her life story, something that sets her apart from other girls. Still, this is a big procedure. I look at my daughter and she looks so PERFECT, that it hurts me to think about what they must do to her. But, she is not perfect. She has a whole in her heart, and the scar will be a visible reminder that she has been mended.
7) I think my biggest fear is that this will change her in some profound way. She is such an easy-going, adaptable, cheerful little creature. She is wholly unspoiled by any trauma or hardship. She is well loved and regularly cuddled. She's warm and full and comfortable most of the time. She smiles a lot. I am afraid that this surgery and the pain and confusion that accompanies it will change her. I don't want her to become fearful or suspicious or wary. She is too young to realize that life is not all warm milk and swaddled blankets. I don't want her to lose her innocence before she's 4 months old.
Truthfully, I think I would be less scared if I was about to have open-heart surgery. But I'm not and I can't take my daughter's place. I can't even explain to her what's going to happen. So, while I'm enjoying these few days with her, every one of her smiles has the sad outline of ignorance, and I feel guilty knowing more about her future than she does. Maybe it is better, her not knowing. There is anxiety in knowing and waiting and just thinking about something. And maybe that is where most of my fear is coming from- the thinking.
What am I most afraid of? It's hard to pinpoint because there are so many things. Here's a list of just a few.
1) The most obvious fear, that something will go wrong with the surgery. Let me just put it out there...that she won't make it. It's open heart surgery, afterall, and all surgeries have some inherant risks. I do not know what I would do if the worst happened. I do not know what I would do.
2) I'm afraid of seeing her taken away from me, knowing where she is headed. I don't like saying goodbye when I leave her with Dave to go to the grocery store. I know the hours she is in surgery will be agony.
3) I'm scared to see her directly after the surgery. She's going to be hooked up to machines and tubes. She'll be pale, drugged. I don't think I'll be able to hold her for several hours- maybe not even touch her. I'm not sure.
4) I'm afraid of the recovery. She's getting sturdier every day. She's working on standing up and crawling. We play airplane and she loves it. She loves baths and smiles through diaper changes. How fragile she's going to seem after such a major surgery. When will we feel comfortable handling her again? Is she going to be in pain? Will this delay her milestones like rolling over and crawling? When will we be back to normal, back on track again?
5) I'm a little afraid that they won't be able to fix her, that this will be a "wait and see" or "wait and try again" situation. I don't think this is likely, but this thought wormed its way into my brain a few days ago, and now it's leaving tracks up there, moving around and around in my head.
6) I'm worried about the scar. Honestly though, this may be the least of my worries. I'm not a vain person, and I can already tell that my daughter's lovely face, sweet temper and just that shine in her eyes will overshadow any cosmetic blemish. This scar will give her a story to tell, will make her aware of her own mortality, will help her feel lucky and blessed, will give her an appreciation for the human mind and modern science. She will hopefully embrace this as part of her life story, something that sets her apart from other girls. Still, this is a big procedure. I look at my daughter and she looks so PERFECT, that it hurts me to think about what they must do to her. But, she is not perfect. She has a whole in her heart, and the scar will be a visible reminder that she has been mended.
7) I think my biggest fear is that this will change her in some profound way. She is such an easy-going, adaptable, cheerful little creature. She is wholly unspoiled by any trauma or hardship. She is well loved and regularly cuddled. She's warm and full and comfortable most of the time. She smiles a lot. I am afraid that this surgery and the pain and confusion that accompanies it will change her. I don't want her to become fearful or suspicious or wary. She is too young to realize that life is not all warm milk and swaddled blankets. I don't want her to lose her innocence before she's 4 months old.
Saturday, August 22, 2009
Why I am crying...
I'm sitting in the nursery rocking chair, AJ swaddled and close to sleeping in my arms, and I am doing what new moms are prone to do, just staring at my child. We had a long, fun, stimulating day at Mt. Tabor's Adult Soapbox Derby with friends. Aleida slept fitfully in the Bjorn, but had no real nap. Consequently, she had a bit of a melt down when we got home. I am still surprised by the physical reaction I have to my daughter's cries. This connection I may never understand.
It took a while, but now we are rocking peacefully. Suddenly, I have tears running down my face. One splashes on Aleida's chubby cheek and she flinches, but does not waken. But why am I crying?
I'm crying because that is my default reaction to any overwhelming emotion. Too happy...I cry. Too sad...I cry. Too mad...yep...tears-a-streaming. It's inconvenient sometimes, but cathartic always. But which emotion is the most overwhelming to me right now... I don't know.
I'm crying because AJ is sleeping with her mouth slightly ajar, head tilted back, reddening hair askew. When I was a child, my family would take road trips. Without fail, my mom's turn in the passenger seat would result in her sleeping like this. We used to laugh at the predictability of her mouth falling open, her head lolling back and forth against the head rest. My daughter, born on my mom's birthday, named after my mother, looks like her in this moment and I can't help feeling squeezed by the closing of the generation gap between June, my beloved mother, and Aleida June, my dearest daughter. That they will never physically meet still pains me, but I am comforted by this connection they have that is greater than I am as the obvious link between them.
I'm crying because I feel as if my heart might explode with the maternal love that was so abstract and unknown until about 12 weeks ago. I have heard it said that the love you have for your kids is stronger than any other love in the world. To say that is not entirely fair, because it is not an apples to apples comparison. To say parental love is different than any other would be true, however. It is love mixed with a great and overwhelming responsibility to a small, helpless, dependent creature.
I'm crying because we have scheduled Aleida's heart surgery for September 10, and I cannot think about that fast-approaching week without anxiety. She is so small. Deep down, I know she will be okay. I am thankful she has a condition that can be fixed so she can lead a normal, vibrant life. But, I also know that when they take her away from me to the operating room, I will feel a physical, emotional schism that will not mend until I am able to hold and feed her again. Fortunately, she will not remember a thing. So though I am worried about her and how she will handle the procedure and recovery, most of my anxiety is selfish. I simply don't want to suffer.
I'm crying because having a child is amazing. Full of challenges, full of insecurities, full of changes, but all the difficulties are eclipsed by the love and wonder and beauty of this new relationship. And I know, from what others have told me, that is only gets better from here.
It took a while, but now we are rocking peacefully. Suddenly, I have tears running down my face. One splashes on Aleida's chubby cheek and she flinches, but does not waken. But why am I crying?
I'm crying because that is my default reaction to any overwhelming emotion. Too happy...I cry. Too sad...I cry. Too mad...yep...tears-a-streaming. It's inconvenient sometimes, but cathartic always. But which emotion is the most overwhelming to me right now... I don't know.
I'm crying because AJ is sleeping with her mouth slightly ajar, head tilted back, reddening hair askew. When I was a child, my family would take road trips. Without fail, my mom's turn in the passenger seat would result in her sleeping like this. We used to laugh at the predictability of her mouth falling open, her head lolling back and forth against the head rest. My daughter, born on my mom's birthday, named after my mother, looks like her in this moment and I can't help feeling squeezed by the closing of the generation gap between June, my beloved mother, and Aleida June, my dearest daughter. That they will never physically meet still pains me, but I am comforted by this connection they have that is greater than I am as the obvious link between them.
I'm crying because I feel as if my heart might explode with the maternal love that was so abstract and unknown until about 12 weeks ago. I have heard it said that the love you have for your kids is stronger than any other love in the world. To say that is not entirely fair, because it is not an apples to apples comparison. To say parental love is different than any other would be true, however. It is love mixed with a great and overwhelming responsibility to a small, helpless, dependent creature.
I'm crying because we have scheduled Aleida's heart surgery for September 10, and I cannot think about that fast-approaching week without anxiety. She is so small. Deep down, I know she will be okay. I am thankful she has a condition that can be fixed so she can lead a normal, vibrant life. But, I also know that when they take her away from me to the operating room, I will feel a physical, emotional schism that will not mend until I am able to hold and feed her again. Fortunately, she will not remember a thing. So though I am worried about her and how she will handle the procedure and recovery, most of my anxiety is selfish. I simply don't want to suffer.
I'm crying because having a child is amazing. Full of challenges, full of insecurities, full of changes, but all the difficulties are eclipsed by the love and wonder and beauty of this new relationship. And I know, from what others have told me, that is only gets better from here.
Wednesday, August 12, 2009
Careful what you wish for...?
So, after my breastfeeding saga, I'm glad to report that we've gotten it down. I am even comfortable nursing in public (with one of those fashionable cape-like covers) Furthermore, AJ's 2-month check up revealed that she continues to gain over an ounce a day. Makes me feel like I have magic boobs.
I remember reading posts out in the breastfeeding blogosphere about women whose babies were so "good" at breastfeeding that they didn't want to take anything but mommy's nipple. As a mom who was experiencing quite the opposite, I felt anger toward these braggarts. So what if you your baby just wants to suckle all the time? Stupid jerks. I remember reading one blog comment that said something like, "My baby will only take directly from my breast! I guess she knows what she likes!!!" and absolutely hating those extra exclamation points. With throbbing nipples and 6 pumping sessions a day, I despised the cheerful b-word who gloated about her picky baby.
Well, last week, I was in the park- having a girls' outing with some friends. I'd pumped and packed a bottle to avoid whipping out the boob during the picnic. When AJ acted hungry, I grabbed the bottle and sat her down. She took the bottle nipple into her mouth, spit it out and dribbled milk everywhere. She fussed every time I tilted her back and offered the bottle. She refused the bottle! My friend, Georgia, who had her 2nd child in late June said, "You'll probably have to hand her off to someone else if you want to feed her from the bottle. She knows you have the real thing." I ended up sitting under a tree and nursing her; she ate with no hesitation.
Since then, she's refused bottles every day from me, daddy and even grandma. We will continue to offer her the bottle in the hopes she will pass through this phase. Part of me is flattered that she seems to want the intimacy and warmth of breastfeeding. Another part of me is panicked that I have cursed myself to a year in which I will not be able to be away from my daughter for more than a few hours at a time. This week grandma is visiting, and I would like to take her up on her offer to give us a baby-free date night, but don't want to stick her with a baby that gets pissed every time she's offered a bottle. Also, there's a bit of terror that comes with realizing your 2-month-old is already proving to be extremely opinionated.
In the end, I think it's kind of hilarious. And I feel confident that Aleida will re-learn to take the bottle eventually. I do value the nursing relationship we have established and her refusal of the bottle feels like an odd kind of victory. Still, I can't help thinking of the saying, "Be careful what you wish for..."
I remember reading posts out in the breastfeeding blogosphere about women whose babies were so "good" at breastfeeding that they didn't want to take anything but mommy's nipple. As a mom who was experiencing quite the opposite, I felt anger toward these braggarts. So what if you your baby just wants to suckle all the time? Stupid jerks. I remember reading one blog comment that said something like, "My baby will only take directly from my breast! I guess she knows what she likes!!!" and absolutely hating those extra exclamation points. With throbbing nipples and 6 pumping sessions a day, I despised the cheerful b-word who gloated about her picky baby.
Well, last week, I was in the park- having a girls' outing with some friends. I'd pumped and packed a bottle to avoid whipping out the boob during the picnic. When AJ acted hungry, I grabbed the bottle and sat her down. She took the bottle nipple into her mouth, spit it out and dribbled milk everywhere. She fussed every time I tilted her back and offered the bottle. She refused the bottle! My friend, Georgia, who had her 2nd child in late June said, "You'll probably have to hand her off to someone else if you want to feed her from the bottle. She knows you have the real thing." I ended up sitting under a tree and nursing her; she ate with no hesitation.
Since then, she's refused bottles every day from me, daddy and even grandma. We will continue to offer her the bottle in the hopes she will pass through this phase. Part of me is flattered that she seems to want the intimacy and warmth of breastfeeding. Another part of me is panicked that I have cursed myself to a year in which I will not be able to be away from my daughter for more than a few hours at a time. This week grandma is visiting, and I would like to take her up on her offer to give us a baby-free date night, but don't want to stick her with a baby that gets pissed every time she's offered a bottle. Also, there's a bit of terror that comes with realizing your 2-month-old is already proving to be extremely opinionated.
In the end, I think it's kind of hilarious. And I feel confident that Aleida will re-learn to take the bottle eventually. I do value the nursing relationship we have established and her refusal of the bottle feels like an odd kind of victory. Still, I can't help thinking of the saying, "Be careful what you wish for..."
Monday, July 20, 2009
On Breastfeeding
If you don't want to read my long personal story, scroll down to the bottom for my list of advice on breastfeeding.
A couple weeks ago, I wouldn't have been able to predict if this entry would be called "On Breastfeeding" or "On Bottles." I was pretty close to giving up on doing things the "natural" way.
Funny, how misleading the word "natural" can be. Yes, breastfeeding is natural. But so is walking...and it takes a lot of time and development and strength to be able to do it. Babies have to learn how to walk. They have to take small steps with a lot of help. They have to fall down many times before they can do it properly. Yet there is no denying that it is, in fact, natural.
Breastfeeding...ahhhh...breastfeeding. How confident I was telling people, "Yes, I'm going to breastfeed." Just saying it seemed natural. I heard it was painful at first, but most accounts seemed to limit the discomfort to the first few days. No problem.
How cute I was with that confidence. LIttle did I know what was ahead.
As you know, my daughter was born a month early. The hospital had a "protocol" for premature babies. They offered her my breast right away, but she was too small and sleepy to nurse. The pattern was this: Breast, bottle, pump. Offer her the breast. Supplement with the bottle. Pump for 15 minutes to stimulate your milk supply. Let me tell you: 15 minutes is a long time to have something tugging at your knockers.
While we were in the hospital, Aleida didn't do much with my breasts. So, we started off giving her formula (I heard the collective gasp from all the La Leche Leaguers out there). It was nice because both Dave and I could feed her. Daddy liked that. Not what I wanted or expected, but I knew she needed nourishment. And the nurses assured me that she would be able to breastfeed eventually.
I used to see breasts as a feminine, sexual thing. That's why women wear necklaces and low-slung tops, right? To flaunt the boobage. To showcase the tatas?
Cue the breast pump. If you've never seen one, it's like this: A funnel shaped piece of plastic is placed over each breast. You have to hold it there- no handsfree contraptions. I've heard they exist, but the hospital did not offer... These funnels are connected to a splitter. One end goes to a collecting bottle. The other end connects to a tube which runs to the pump. Turn it on and you get a nice "whirrr, slump, whirrr, slump, whirrr."
In essence, I became a cow. Hook me up to a milker and collect. At first, it's a painful tug that for me brought not a drop for almost 24 hours. Once the milk started, the yield was little drops and trickles of milk. After a couple days, I was getting a stream. I had extra milk. More than AJ needed. By day 3, she was on nothing but breast milk, but not from the breast. Had I been more informed, I would've been more proactive in getting her to latch. But I had lots of other things on my mind, and the lactation consultant was clearly not aggressive.
Jump ahead 7 weeks. Today I'm going to my 4th appointment with a lacation consultant. These appointments will outline for you the general points of difficulty that I've encountered on the journey.
1st Visit: Aleida 1 week old. Routine Visit to Kaiser's Mother-Baby program. She was weighed. Lactation consultant watched her try to latch. She gave us a "nipple shield." It's a plastic dome that covers your nipple. It's usually used for flat or inverted nipples. I don't have this problem, so I think she gave it to us as a transition from bottle to nipple. I was advised to try the shield, but continue to pump and supplement with the bottle.
2nd Visit: Aleida 3.5 weeks old. Back to Kaiser's Lactation Specialist. Originally, I made the appt b/c we were really struggling at the breast. Aleida would cry and pull away from my breast, but happily finish off a bottle. Feedings often ended in frustration, sometimes tears. Aleida was still small, still premie, so my expectations might have been a bit unrealistic. Still, I just wanted to breastfeed her. I didn't want to struggle with it. Between making the appointment and going to it, things improved dramatically. Aleida was taking more from the breast. We were still using the nipple shield, but I was okay with it b/c it was better than the bottle. At this appt, Aleida was again weighed and still gaining like a champ. We also did a before and after weight. Weigh her. Feed her. Weigh her again to see how much she was getting. AJ proved to be efficient. In about 14 minutes of nursing, she took in close to 3 ounces- more than her nutritional need. Everyone was happy and I thought the worst was over.
3rd Visit: Aleida 5.5 weeks old. I wanted to wean off the nipple shield. Though my husband continues to warn me away from the blogosphere, I continue to turn to it for advice. I saw that nipple shields have been shown to decrease milk supply and can be very hard to wean off. So, I started nursing without the nipple shield, and started having some pretty major pain. I'd heard breastfeeding caused pain in the early days, so I suffered through, thinking that this was my equivalent of the early days. I started to have anxiety associated with breastfeeding, b/c I wasn't sure how she was going to latch on, and I anticipated pain. I would often have to give myself breaks from nursing. Even when I wasn't nursing, I would have intense soreness and even acute pain in my breasts. I started to worry about infection and I had no idea if this was normal. I called a different lactation consultant under my new insurance, and made an appointment. I was skeptical that anything could be done, and worried that I would be giving up shortly after the visit.
Fortunately, Aleida was still gaining weight. And this consultant was much more knowledgeable than the last. She showed me that with some very minor technique changes, I could get AJ to take more of the breast in her mouth. Before, she was really just nursing off my nipple and I thought "latching on" referred to her grip on my nipple. What "latching on" really means is that the baby's lower lip is latched on below the nipple, towards the bottom of the areola, taking much more into her mouth. She again did the before and after weight, and again we saw that Aleida is an efficient sucker. I felt good. I was equiped with good information.
I asked about the pain. My consultant did suggest that I might have Reynaud's Syndrome. This is the same syndrome that causes people's fingers to turn white when they are cold. Apparently, you can have it just in the breast, and that could be a cause for pain, especially when your nipple is already traumatized. The blood vessels in the area actually constrict, so it feels like a spasm. Yep, I was having nipple spasms. I often referred to these episodes as "nipple attacks" and affectionately described them as "cheese-grater nipples." Lovely, no? Don't worry, this is an outlier symptom- not among the scope of "normal" breast-feeding adjustment.
**24 hours have elapsed since I started this entry**
4th Visit: Aleida 7.5 weeks old I made this appointment because while my pain has greatly diminished, Aleida is inconsistent with nursing. Sometimes she will be on and off in 5 minutes and I can't convince her to go back on. In the last few days, she's been fussy at the breast, squirming around like she's uncomfortable and sometimes crying. Since she's not a fussy baby by nature, I'm worried that something's wrong. And I'm worried that she might not be getting enough milk with her quick feeds. Again, the blogosphere has me worried about foremilk/hindmilk inbalance, insufficient weight gain, etc.
Good news from the visit- Aleida now weighs 8 lbs 14 oz which means she's been gaining about an ounce a day since birth--over an ounce a day since my last appt. She's also a total Hoover- sucks down 2 ounces in about 5 minutes on my boobage. The consultant said I'm doing everything right. She said AJ's latch is great, I make it look easy, I'm a good mother. Shucks...I thought...keep going... The only question is the fussiness. 6-8 weeks is one of the more fussy periods across the board- so it could be that. She also said the buzz word in lactation circles is acid reflux in babies and they are actually treating babies with antacids. She isn't buying into it, and neither am I. I checked the blogosphere and most babies suffering with reflux have many more and much worse symptoms than my AJ.
So, I'm trying new positions and just in the last few feedings, I've noticed a big improvement. Part of the problem could be my overabundance of milk and therefore my fast let down. I think it's probably just creating gas. So, I'm trying more upright nursing positions. I prop AJ up beside me- almost in a sitting position, and offer her the breast that way. She hasn't fussed this morning, so I think it's working. And there's validation in her weight gain and the words of the consultant. So this time...fingers crossed...I do feel like the hard part is over, though I still hope to get more consistent feedings, and I want my milk to regulate so I don't feel so swollen.
In summary...here's my advice to anyone attempting to breastfeed:
1. Lower your expectations. This is a difficult process for a lot of moms. Some lucky people transition w/out much trouble, but from what I'm hearing, it is totally normal to have a bumpy start.
2. Do what's best for you! For me, pushing through was the right decision. The disappointment of not breast-feeding would've outweighed all the pain and frustration. On the other end, I'm glad I suffered through. But this is not true for everyone. If you need to pump and bottle, pump and bottle. If you need to go to formula, go to formula. Don't let frustration hurt your relationship with your baby, or your body. In the end, a happy bottle-feeding mom is going to be much better for a baby than a miserable breast-feeding one.
3. Forget your cans as anything but functional milk-makers. They are as big and pretty as they are going to be, but they are not your boobs anymore. Nor are they your partner's. They are your baby's. It's temporary.
4. Use lactation consultants. The minute you feel frustrated, call and schedule an appointment. I wouldn't be breastfeeding now if it wasn't for the help I got.
5. Beware the blogosphere. Keep reading my blog...of course...but watch out for the info out there. Every baby is totally different. So when I was reading that babies should nurse for at least 15 minutes on each breast, I was totally insecure. My baby gets what she needs in under 10 minutes (that's right, suckas). But advising others to stop at 10 minutes could be harmful. You will learn what works for you and yours.
Breastfeeding is hard, but I must say, there are few things more precious than my daughter nursing. It's a beautiful, amazing thing that our bodies can be the sole producers for our offspring. Oh yeah, and you burn 500-800 calories a day breastfeeding- that's more than during pregnancy- so eat away!
Final piece of advice: Be gentle and patient with yourself, your baby, and the process. Remember, it's all temporary.
A couple weeks ago, I wouldn't have been able to predict if this entry would be called "On Breastfeeding" or "On Bottles." I was pretty close to giving up on doing things the "natural" way.
Funny, how misleading the word "natural" can be. Yes, breastfeeding is natural. But so is walking...and it takes a lot of time and development and strength to be able to do it. Babies have to learn how to walk. They have to take small steps with a lot of help. They have to fall down many times before they can do it properly. Yet there is no denying that it is, in fact, natural.
Breastfeeding...ahhhh...breastfeeding. How confident I was telling people, "Yes, I'm going to breastfeed." Just saying it seemed natural. I heard it was painful at first, but most accounts seemed to limit the discomfort to the first few days. No problem.
How cute I was with that confidence. LIttle did I know what was ahead.
As you know, my daughter was born a month early. The hospital had a "protocol" for premature babies. They offered her my breast right away, but she was too small and sleepy to nurse. The pattern was this: Breast, bottle, pump. Offer her the breast. Supplement with the bottle. Pump for 15 minutes to stimulate your milk supply. Let me tell you: 15 minutes is a long time to have something tugging at your knockers.
While we were in the hospital, Aleida didn't do much with my breasts. So, we started off giving her formula (I heard the collective gasp from all the La Leche Leaguers out there). It was nice because both Dave and I could feed her. Daddy liked that. Not what I wanted or expected, but I knew she needed nourishment. And the nurses assured me that she would be able to breastfeed eventually.
I used to see breasts as a feminine, sexual thing. That's why women wear necklaces and low-slung tops, right? To flaunt the boobage. To showcase the tatas?
Cue the breast pump. If you've never seen one, it's like this: A funnel shaped piece of plastic is placed over each breast. You have to hold it there- no handsfree contraptions. I've heard they exist, but the hospital did not offer... These funnels are connected to a splitter. One end goes to a collecting bottle. The other end connects to a tube which runs to the pump. Turn it on and you get a nice "whirrr, slump, whirrr, slump, whirrr."
In essence, I became a cow. Hook me up to a milker and collect. At first, it's a painful tug that for me brought not a drop for almost 24 hours. Once the milk started, the yield was little drops and trickles of milk. After a couple days, I was getting a stream. I had extra milk. More than AJ needed. By day 3, she was on nothing but breast milk, but not from the breast. Had I been more informed, I would've been more proactive in getting her to latch. But I had lots of other things on my mind, and the lactation consultant was clearly not aggressive.
Jump ahead 7 weeks. Today I'm going to my 4th appointment with a lacation consultant. These appointments will outline for you the general points of difficulty that I've encountered on the journey.
1st Visit: Aleida 1 week old. Routine Visit to Kaiser's Mother-Baby program. She was weighed. Lactation consultant watched her try to latch. She gave us a "nipple shield." It's a plastic dome that covers your nipple. It's usually used for flat or inverted nipples. I don't have this problem, so I think she gave it to us as a transition from bottle to nipple. I was advised to try the shield, but continue to pump and supplement with the bottle.
2nd Visit: Aleida 3.5 weeks old. Back to Kaiser's Lactation Specialist. Originally, I made the appt b/c we were really struggling at the breast. Aleida would cry and pull away from my breast, but happily finish off a bottle. Feedings often ended in frustration, sometimes tears. Aleida was still small, still premie, so my expectations might have been a bit unrealistic. Still, I just wanted to breastfeed her. I didn't want to struggle with it. Between making the appointment and going to it, things improved dramatically. Aleida was taking more from the breast. We were still using the nipple shield, but I was okay with it b/c it was better than the bottle. At this appt, Aleida was again weighed and still gaining like a champ. We also did a before and after weight. Weigh her. Feed her. Weigh her again to see how much she was getting. AJ proved to be efficient. In about 14 minutes of nursing, she took in close to 3 ounces- more than her nutritional need. Everyone was happy and I thought the worst was over.
3rd Visit: Aleida 5.5 weeks old. I wanted to wean off the nipple shield. Though my husband continues to warn me away from the blogosphere, I continue to turn to it for advice. I saw that nipple shields have been shown to decrease milk supply and can be very hard to wean off. So, I started nursing without the nipple shield, and started having some pretty major pain. I'd heard breastfeeding caused pain in the early days, so I suffered through, thinking that this was my equivalent of the early days. I started to have anxiety associated with breastfeeding, b/c I wasn't sure how she was going to latch on, and I anticipated pain. I would often have to give myself breaks from nursing. Even when I wasn't nursing, I would have intense soreness and even acute pain in my breasts. I started to worry about infection and I had no idea if this was normal. I called a different lactation consultant under my new insurance, and made an appointment. I was skeptical that anything could be done, and worried that I would be giving up shortly after the visit.
Fortunately, Aleida was still gaining weight. And this consultant was much more knowledgeable than the last. She showed me that with some very minor technique changes, I could get AJ to take more of the breast in her mouth. Before, she was really just nursing off my nipple and I thought "latching on" referred to her grip on my nipple. What "latching on" really means is that the baby's lower lip is latched on below the nipple, towards the bottom of the areola, taking much more into her mouth. She again did the before and after weight, and again we saw that Aleida is an efficient sucker. I felt good. I was equiped with good information.
I asked about the pain. My consultant did suggest that I might have Reynaud's Syndrome. This is the same syndrome that causes people's fingers to turn white when they are cold. Apparently, you can have it just in the breast, and that could be a cause for pain, especially when your nipple is already traumatized. The blood vessels in the area actually constrict, so it feels like a spasm. Yep, I was having nipple spasms. I often referred to these episodes as "nipple attacks" and affectionately described them as "cheese-grater nipples." Lovely, no? Don't worry, this is an outlier symptom- not among the scope of "normal" breast-feeding adjustment.
**24 hours have elapsed since I started this entry**
4th Visit: Aleida 7.5 weeks old I made this appointment because while my pain has greatly diminished, Aleida is inconsistent with nursing. Sometimes she will be on and off in 5 minutes and I can't convince her to go back on. In the last few days, she's been fussy at the breast, squirming around like she's uncomfortable and sometimes crying. Since she's not a fussy baby by nature, I'm worried that something's wrong. And I'm worried that she might not be getting enough milk with her quick feeds. Again, the blogosphere has me worried about foremilk/hindmilk inbalance, insufficient weight gain, etc.
Good news from the visit- Aleida now weighs 8 lbs 14 oz which means she's been gaining about an ounce a day since birth--over an ounce a day since my last appt. She's also a total Hoover- sucks down 2 ounces in about 5 minutes on my boobage. The consultant said I'm doing everything right. She said AJ's latch is great, I make it look easy, I'm a good mother. Shucks...I thought...keep going... The only question is the fussiness. 6-8 weeks is one of the more fussy periods across the board- so it could be that. She also said the buzz word in lactation circles is acid reflux in babies and they are actually treating babies with antacids. She isn't buying into it, and neither am I. I checked the blogosphere and most babies suffering with reflux have many more and much worse symptoms than my AJ.
So, I'm trying new positions and just in the last few feedings, I've noticed a big improvement. Part of the problem could be my overabundance of milk and therefore my fast let down. I think it's probably just creating gas. So, I'm trying more upright nursing positions. I prop AJ up beside me- almost in a sitting position, and offer her the breast that way. She hasn't fussed this morning, so I think it's working. And there's validation in her weight gain and the words of the consultant. So this time...fingers crossed...I do feel like the hard part is over, though I still hope to get more consistent feedings, and I want my milk to regulate so I don't feel so swollen.
In summary...here's my advice to anyone attempting to breastfeed:
1. Lower your expectations. This is a difficult process for a lot of moms. Some lucky people transition w/out much trouble, but from what I'm hearing, it is totally normal to have a bumpy start.
2. Do what's best for you! For me, pushing through was the right decision. The disappointment of not breast-feeding would've outweighed all the pain and frustration. On the other end, I'm glad I suffered through. But this is not true for everyone. If you need to pump and bottle, pump and bottle. If you need to go to formula, go to formula. Don't let frustration hurt your relationship with your baby, or your body. In the end, a happy bottle-feeding mom is going to be much better for a baby than a miserable breast-feeding one.
3. Forget your cans as anything but functional milk-makers. They are as big and pretty as they are going to be, but they are not your boobs anymore. Nor are they your partner's. They are your baby's. It's temporary.
4. Use lactation consultants. The minute you feel frustrated, call and schedule an appointment. I wouldn't be breastfeeding now if it wasn't for the help I got.
5. Beware the blogosphere. Keep reading my blog...of course...but watch out for the info out there. Every baby is totally different. So when I was reading that babies should nurse for at least 15 minutes on each breast, I was totally insecure. My baby gets what she needs in under 10 minutes (that's right, suckas). But advising others to stop at 10 minutes could be harmful. You will learn what works for you and yours.
Breastfeeding is hard, but I must say, there are few things more precious than my daughter nursing. It's a beautiful, amazing thing that our bodies can be the sole producers for our offspring. Oh yeah, and you burn 500-800 calories a day breastfeeding- that's more than during pregnancy- so eat away!
Final piece of advice: Be gentle and patient with yourself, your baby, and the process. Remember, it's all temporary.
Saturday, July 18, 2009
a matter of the heart
Pregnant women (and I speak for all of us here) can't help but worry that their children will turn out okay. We hear enough about Downs Syndrome and Cystic Fibrosis and Fetal Alcohol Syndrome to freak anyone out. I worried about the careless 2 doses of NyQuil I took after conception but before my knowledge of it. When my dad joked that he would be happy with a "grandson, granddaughter or friendly alien," I laughed, but had nightmares about giving birth to something that looked like an extra terrestrial. You worry about the missing toes, the cleft palate, the hair lip, the deafness, the blindness, the deformation. Once baby is born and you count the fingers and note the proper placement of her nose, you breathe a sigh of relief. All that worrying for naught, you think.
So, on day 2 in the hospital, when the pediatrician came in to check my perfect daughter, I was confident. Even after she told me she heard a heart murmur, I didn't despair. "Lots of babies are born with murmurs that go away in a day or so, so I'll be back to check her tomorrow," she'd said.
Dave listened to her heart, heard the murmur, but didn't seem worked up, so I calmly waited for the next check up.
On day 3, the pediatrician still heard the murmur, so she ordered an echocardiogram. The technician came in with a big machine and ran a wand over my darling as she lay sleeping on my chest. Dave was watching intently; he had some training in these mysterious images, after all. I just watched my daughter and occasionally glanced at the screen or my husband to see if I could make sense of anything. I couldn't.
The technician, knowing Dave was a doctor, said, "I can't really tell you what I'm seeing. You'll have to wait until the doc looks at the images," but he proceeded to point out major landmarks anyway. Words were tossed around between the tech and my husband that made little sense to me, but piqued just enough worry to raise my own heart rate. When the procedure was over, I asked my husband what he knew.
"Nothing really," he said. "It could be *insert gibberish words* and it could not be, we'll have to wait and see what the doctor says." I know now, he was protecting me. He knew that our little baby had a hole in her heart.
Those gibberish words can now be defined as "tetralogy of Fallot." For a while, I thought they were saying "tetralogy of flow" which made sense since we're talking about the heart. But no, Fallot is the guy who defined the condition. Tetralogy refers to 4 key anatomical features of the condition, but my understanding is that only 2 of them matter. 1. A hole between the left and right ventricles. 2. A narrowing of the pulmonary valve. In a nutshell, oxygenated blood can mix with deoxygenated blood, meaning that not enough oxygen gets taken throughout the system. In an even smaller nutshell, this means babies can turn blue.
Our baby is not blue. She's not even purplish. She's pink and rosy and beautiful. She's currently considered "mildly affected." She has the same oxygen levels in her blood as any other baby. You look at her and you have no idea that she has a congenital heart defect.
In the end, she's going to need surgery. Open heart surgery. Probably before she's 6 months old. Right now, we go to the cardiologist every 3 weeks to check her stats. We watch for "blue spells." We wait and let her grow and get strong. We enjoy her and forget that there is anything wrong. Truly, as far as heart conditions go, this is a best-case scenario. She's otherwise perfectly healthy. We discovered the condition via the murmur- not a "blue spell" (can you imagine how scary THAT would be if you weren't expecting it?). We have the means and resources and attitude necessary to get her the required care. We have good health insurance. Once she has the surgery, she'll be fine. Follow up with the cardiologist throughout life- but no limitation to her activities. Shaun White- the Olympic snowboarder- had this condition. So AJ can be an Olympian if she wants to.
Still...open-heart surgery on a baby. My baby. You can imagine what it's taken for me to come to terms with this. But I have. I had to accept a few truths to get there. First, this has nothing to do with her being a month early. Second, there is no known cause of this. It is congenital, but not hereditary. Dave and I are no more likely the have another child with this condition than any other couple. Third, this doesn't define her. She is beautiful and healthy. We'll fix this, but until then, she's just a normal (well...exceptionally adorable and smart and perfect) baby.
Finally, I've accepted that this is not my fault. Of course, I could go into how I've wracked my brain to come up with something I used or did or ate that could've caused this. If I was a religious person, I might see this as God's punishment to Dave and I for having premarital sex. The most spiritual I'm going to get about it is this: Balance. I have a fairly charmed life. This is a challenge, an obstacle, but I can handle it. We can handle it. AJ won't even remember it.
Dave summed it up best. We were still in the hospital. I'd been crying as I realized what had to happen to fix my baby's heart. "Now that I've met her, I wouldn't exchange her for a baby without this problem." I said. "I mean, she's pretty perfect, except for this hole in her heart."
Dave looked at her, then looked at me. "She's pretty perfect with it."
So, on day 2 in the hospital, when the pediatrician came in to check my perfect daughter, I was confident. Even after she told me she heard a heart murmur, I didn't despair. "Lots of babies are born with murmurs that go away in a day or so, so I'll be back to check her tomorrow," she'd said.
Dave listened to her heart, heard the murmur, but didn't seem worked up, so I calmly waited for the next check up.
On day 3, the pediatrician still heard the murmur, so she ordered an echocardiogram. The technician came in with a big machine and ran a wand over my darling as she lay sleeping on my chest. Dave was watching intently; he had some training in these mysterious images, after all. I just watched my daughter and occasionally glanced at the screen or my husband to see if I could make sense of anything. I couldn't.
The technician, knowing Dave was a doctor, said, "I can't really tell you what I'm seeing. You'll have to wait until the doc looks at the images," but he proceeded to point out major landmarks anyway. Words were tossed around between the tech and my husband that made little sense to me, but piqued just enough worry to raise my own heart rate. When the procedure was over, I asked my husband what he knew.
"Nothing really," he said. "It could be *insert gibberish words* and it could not be, we'll have to wait and see what the doctor says." I know now, he was protecting me. He knew that our little baby had a hole in her heart.
Those gibberish words can now be defined as "tetralogy of Fallot." For a while, I thought they were saying "tetralogy of flow" which made sense since we're talking about the heart. But no, Fallot is the guy who defined the condition. Tetralogy refers to 4 key anatomical features of the condition, but my understanding is that only 2 of them matter. 1. A hole between the left and right ventricles. 2. A narrowing of the pulmonary valve. In a nutshell, oxygenated blood can mix with deoxygenated blood, meaning that not enough oxygen gets taken throughout the system. In an even smaller nutshell, this means babies can turn blue.
Our baby is not blue. She's not even purplish. She's pink and rosy and beautiful. She's currently considered "mildly affected." She has the same oxygen levels in her blood as any other baby. You look at her and you have no idea that she has a congenital heart defect.
In the end, she's going to need surgery. Open heart surgery. Probably before she's 6 months old. Right now, we go to the cardiologist every 3 weeks to check her stats. We watch for "blue spells." We wait and let her grow and get strong. We enjoy her and forget that there is anything wrong. Truly, as far as heart conditions go, this is a best-case scenario. She's otherwise perfectly healthy. We discovered the condition via the murmur- not a "blue spell" (can you imagine how scary THAT would be if you weren't expecting it?). We have the means and resources and attitude necessary to get her the required care. We have good health insurance. Once she has the surgery, she'll be fine. Follow up with the cardiologist throughout life- but no limitation to her activities. Shaun White- the Olympic snowboarder- had this condition. So AJ can be an Olympian if she wants to.
Still...open-heart surgery on a baby. My baby. You can imagine what it's taken for me to come to terms with this. But I have. I had to accept a few truths to get there. First, this has nothing to do with her being a month early. Second, there is no known cause of this. It is congenital, but not hereditary. Dave and I are no more likely the have another child with this condition than any other couple. Third, this doesn't define her. She is beautiful and healthy. We'll fix this, but until then, she's just a normal (well...exceptionally adorable and smart and perfect) baby.
Finally, I've accepted that this is not my fault. Of course, I could go into how I've wracked my brain to come up with something I used or did or ate that could've caused this. If I was a religious person, I might see this as God's punishment to Dave and I for having premarital sex. The most spiritual I'm going to get about it is this: Balance. I have a fairly charmed life. This is a challenge, an obstacle, but I can handle it. We can handle it. AJ won't even remember it.
Dave summed it up best. We were still in the hospital. I'd been crying as I realized what had to happen to fix my baby's heart. "Now that I've met her, I wouldn't exchange her for a baby without this problem." I said. "I mean, she's pretty perfect, except for this hole in her heart."
Dave looked at her, then looked at me. "She's pretty perfect with it."
Saturday, July 11, 2009
80/20
It is hard to justify writing in my blog with so many other things to do. But my goal is to complete at least one entry--however short--a week. We'll see.
This morning was a bit rough. My mellow angel baby who sleeps well and rarely cries has been super fussy. She's refusing to nap- though I can see she's tired. She's crying more, and I'm a little scared that this is the beginning of a trend- though there is no logic considering the past 6-weeks have been suprisingly fuss free. Everyone has bad days. This is one of hers.
Couple that with one of my bad moods and you get a mess. Baby crying. Mommy crying. Daddy confused. A bit of a wasted morning.
Here's what it comes down to. 80% of the time, I feel so privileged to be the mommy. I get to breastfeed her (though this comes with challenges and frustrations too- but that's for a later blog). I am the sole care-taker, even though my husband is more involved than 99% of dads out there. But, he works full time. AJ is my full time job. And I spend probably about 6-8 hours a day just feeding and changing her. Usually, I love it- even the poopy diapers. She's beautiful, pleasant, interesting and a part of me. In fact, most of the time, I'll tell you this is easier and more fun than people say it is.
This morning was part of the other 20%. As I work to feed a fussy baby and my husband goes outside to work out and play around in the garden, I start to feel sorry for myself. This is my life, and my first responsibility. On days when she doesn't nap, I don't get a chance to work out or even shower when I want. It's hard to fit in meals some times. Dave's trying to help me. "Let me take care of her while you go workout."
I'm in an unreasonable mood and frankly, a bit too tired and frustrated for working out to sound like a good idea, though I'd just complained about not having time to work out. "Well, do I work out? Eat breakfast? Shower? Which of these important things do I choose, because I don't have enough time to do all three? And what about you? I was hoping to spend some quality time together."
Dave throws out several logical options that hit at least 2 of the 3 activities, but I shoot them all down. I'm just set on feeling sorry for myself. This is my life now. Catering to the needs of a small little human being with moods and demands and a personality that I'm still trying to figure out. I love her, but I don't always get her.
Truth is, I'm ashamed of these moments of self-pity. I want to be the always on, always happy mama bear that has no trouble putting the needs of her young above all else. And believe me, I know this is a privilege and most of the time it feels like one. But occasionally, I have a little pity party. I envy my husband the part-time nature of his role. He gets a kick out of her when she's fussy, because then he goes to work and sees much more fussy people in the ER.
A pregnant friend asked me for my best piece of advice after a month of motherhood. Here it is: Expect the 20% moments. Roll with them. Know they will pass. Forgive yourself for being a little selfish. Your life is about to change in a major way. It is amazing, beautiful, meaningful. But it's hard and at times scary and frustrating. No relationship is perfect- so you're bound to have down moments with this new little person at the center of your life. But the ups much outweigh the downs. 80% to 20% at least. Maybe more like 90% to 10%, now that my little angel is napping. And after a successful, long feeding, I got a smile. Totally worth it.
This morning was a bit rough. My mellow angel baby who sleeps well and rarely cries has been super fussy. She's refusing to nap- though I can see she's tired. She's crying more, and I'm a little scared that this is the beginning of a trend- though there is no logic considering the past 6-weeks have been suprisingly fuss free. Everyone has bad days. This is one of hers.
Couple that with one of my bad moods and you get a mess. Baby crying. Mommy crying. Daddy confused. A bit of a wasted morning.
Here's what it comes down to. 80% of the time, I feel so privileged to be the mommy. I get to breastfeed her (though this comes with challenges and frustrations too- but that's for a later blog). I am the sole care-taker, even though my husband is more involved than 99% of dads out there. But, he works full time. AJ is my full time job. And I spend probably about 6-8 hours a day just feeding and changing her. Usually, I love it- even the poopy diapers. She's beautiful, pleasant, interesting and a part of me. In fact, most of the time, I'll tell you this is easier and more fun than people say it is.
This morning was part of the other 20%. As I work to feed a fussy baby and my husband goes outside to work out and play around in the garden, I start to feel sorry for myself. This is my life, and my first responsibility. On days when she doesn't nap, I don't get a chance to work out or even shower when I want. It's hard to fit in meals some times. Dave's trying to help me. "Let me take care of her while you go workout."
I'm in an unreasonable mood and frankly, a bit too tired and frustrated for working out to sound like a good idea, though I'd just complained about not having time to work out. "Well, do I work out? Eat breakfast? Shower? Which of these important things do I choose, because I don't have enough time to do all three? And what about you? I was hoping to spend some quality time together."
Dave throws out several logical options that hit at least 2 of the 3 activities, but I shoot them all down. I'm just set on feeling sorry for myself. This is my life now. Catering to the needs of a small little human being with moods and demands and a personality that I'm still trying to figure out. I love her, but I don't always get her.
Truth is, I'm ashamed of these moments of self-pity. I want to be the always on, always happy mama bear that has no trouble putting the needs of her young above all else. And believe me, I know this is a privilege and most of the time it feels like one. But occasionally, I have a little pity party. I envy my husband the part-time nature of his role. He gets a kick out of her when she's fussy, because then he goes to work and sees much more fussy people in the ER.
A pregnant friend asked me for my best piece of advice after a month of motherhood. Here it is: Expect the 20% moments. Roll with them. Know they will pass. Forgive yourself for being a little selfish. Your life is about to change in a major way. It is amazing, beautiful, meaningful. But it's hard and at times scary and frustrating. No relationship is perfect- so you're bound to have down moments with this new little person at the center of your life. But the ups much outweigh the downs. 80% to 20% at least. Maybe more like 90% to 10%, now that my little angel is napping. And after a successful, long feeding, I got a smile. Totally worth it.
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