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Catharsis

By Goddess in Progress · Comments (9)·   June 23rd, 2008

(noun) elimination of a complex by bringing it to consciousness and affording it expression.

I feel the need to write one (hopefully) last entry on breastfeeding.  Mostly because I have a few lingering things that I just need to let go.

I do not regret our decision to go to 100% formula when the kids were eight weeks old.  At that time, in those circumstances, with that experience, it was the right decision.  And it has afforded some notable advantages. Other people can help with feedings, for instance, which allowed me to be better-rested than many new moms.  And at this age, when they hold their own bottles, it’s pretty sweet to just hand them bottles in the stroller and run an errand.  It’s expensive as hell and I can’t wait to move on to whole milk, but it has had its benefits.

But breastfeeding was something I had really wanted to do, something I prepared for, something I felt confident I was going to be able to do.  And it just didn’t work out.  Maybe it was meant to be that way, and maybe no matter what, that’s how it would have ended up.  But with hindsight being 20/20, and all that I know now, I can’t help but think I could have done some things differently.  And as I may not have any more kids and be able to benefit from my own experience, maybe this will resonate and help someone else.  Or maybe not, and maybe this is just for me.  That’s OK, too.

Before I launch into my list, let me be clear.  I am not sad and in need of consolation or advice, I am not bemoaning the way my life turned out.  I think things have turned out rather well, in fact.  I just have had these ideas bouncing around my head for a while, and I want to get them written down so that I can let them go.  Breastfeeding (or not) is such a loaded, emotional issue, it’s not the easiest thing in the world to get over if it doesn’t go the way you hoped.

So here you go, the things I’d change if I had it to do all over again.  Would all of these have been realistic?  Would they have made the critical difference? Who knows, and it doesn’t really matter.  They’re just ideas…

1. Nurse more in the NICU.

This is a very hindsight kind of thing. Because when you have a baby (or two) in the NICU, your only goal is that they will be able to come home. And one condition of coming home is to take all feeds by mouth and gain weight. Daniel was pretty slow to transition after he was born, and would fall asleep before finishing his whopping half-ounce, and the rest would go down the little nasal tube. I didn’t want to tire him out at mealtimes, so I didn’t nurse. Bottles were always easier. Guess who had the seemingly incurable latch issues? Rebecca and I tried more, and were more successful, but she was just so darn tiny.  In hindsight?  Be aggressive about trying to nurse as much as possible, nasal tube be damned. It probably wouldn’t have meant more than an extra couple of days in the hospital, which seems like no big deal right now, but of course would have felt awful at the time.  Ah, the fantasy of hindsight.

2. Throw away the schedule, at first.

We came home from the NICU with the kids on a predictable 3-hour rotation, and they were supposed to get high-calorie formula every-other feeding. In my attempts to nurse, of course, sometimes they would want to eat again after an hour or two. Because the 3-hour schedule was so concrete in my brain, it made me nutty when they wanted to eat more often, as well as convinced I couldn’t possibly make enough milk for them. So I’d give them a bottle of formula, which stayed in their tummies a bit longer, and didn’t actually tell my body to make more.  I wish I had been able to just let go of the 3-hour idea and just sit and nurse all the damn time for the first couple of weeks to actually get a supply going.  Maybe do a bottle of the high-cal stuff every 6 hours, just to do what the doctor said, and pump those times, but you get my idea. Save the schedule for a little later, nurse constantly for the sake of establishing milk production. By the time someone told me to do that, I was so married to my 3-hour schedule that I couldn’t handle letting it go.

3. Throw away the pump, sort of.

From day 1, my life revolved around the dreaded pump.  The seeming lack of results, combined with the milliliter-counting that is life in the NICU, was really demoralizing.  And the whole pumping-then-bottle-feeding is an absolute nightmare.  You prep bottles, you feed bottles to slow-eating babies, you burp babies, you put them down and go pump for 20 minutes… you label and refrigerate bottles, you clean the pump parts… leaving you with approximately 15 minutes to do things like, say, hang out with your babies. And while I didn’t feel like my body responded well to the pump, I probably was, in fact, producing enough at the time for one baby.  But if I wasn’t nursing two babies, my body was never going to learn to produce for two babies.

The pump can be a useful tool, of course.  It was good to have in the hospital when my babies were not in a position to nurse, and it would have been good as a supplemental tool to help boost supply.  But while I was sent home with instructions to pump every 3 hours, I do not feel like I had any idea of how to get off of the pump.  Hindsight verdict: chuck the pump and nurse all the time, only use the pump maybe at the times that I did the high-cal formula bottle.

4. Get better nursing attire.

This may seem like an odd one, but I think it would have been helpful.  One of my big stumbling blocks was that I was very uncomfortable nursing in public.  Less for reasons of exposing the boobs, but more for fear of exposing the belly. I’ve always been overweight and self-conscious… add in a big, squishy, stretch-marked postpartum belly, and do you really think I wanted to lift up my shirt?  But getting out of the house was really important to me, and I’d just end up bringing bottles and not staying out long.  What I wish I had done was gotten some of those nursing tanks to wear under my shirts (so the belly would remain covered, even if I had to lift up my regular shirt), or those pull-aside nursing shirts, or something.  I really had no nursing clothes, save for two sort of transitional nursing bras and one non-functional nursing tank (there are better kinds out there.  I think the right attire would have made an enormous difference in my ability to nurse while not at home.  Also… a hooter hider! I knew about these things at the time, but as nursing was looking questionable, I didn’t want to spend the money in case it didn’t work out.  Alas.

– — –

There you have it, my woulda, coulda, shoulda list.  Would I have been able to do them in my post-partum hormonal state? Would any of it have made a difference with Daniel’s weird-tongue-thing and hideous latch? Would doing all of these things have saved breastfeeding at the expense of losing my mind?  Who knows. Maybe not, and I’ll never know.  But now I can stop bouncing these things around in my brain when I can’t sleep, I will know they’ve been written and not lost, I can come back and reference it or link it for someone, or add to it if I think of something else.

It’s done.

Comments (9)
Categories : Infants, Mommy confessions, Newborns
Tags : Breastfeeding, Formula

One-month checkup

By Goddess in Progress · Comments (1)·   September 7th, 2007

Today was the twins’ weekly weight check and one-month well-baby appointment. Both have continued to put on weight well. Daniel is up to 8lb14oz, and Rebecca is 6lb9oz. For those keeping track at home, in five weeks they have posted a net gain of 2lb12oz and 2lb1oz, respectively. Not too shabby.

As for percentiles, since parents love to compare their babies to one another, their weights are in the 76th and 15th percentiles (you can guess which is which!). So for two babies who spent the same 36 weeks in the same belly and were born in the same minute, they are awfully different sizes. Oh, and those are their “adjusted” percentiles, taking into account the fact that they were technically 4 weeks premature. So, yes, Rebecca is only bigger than 15% of one-week-olds. Compared to the average five-week-old, she has finally climbed into the first percentile. Whew.

When I expressed to my pediatrician that I’d like to take Rebecca off of the high-calorie formula, she had no problem with that. She’s clearly eating and growing well, and this will allow me to attempt to breastfeed her more, which is a good thing for both of us. For today, I’m attempting to pretty much just breastfeed her on demand, and we’ll see how it goes.

I asked her if she had any ideas about Daniel’s terrible suck, I finally got a new suggestion! She said that, since they were officially premature, I would qualify for a visit from the Early Intervention folks. The thought being that they might set me up with a pediatric occupational therapist who might be able to help out. It may or may not be the answer, but at least it’s something to try. She also gave me a prescription for Señor Fussy-Pants, thinking it’s possible he might have reflux, and that’s what is making him grunt and fuss some of the time. We’ll see if it helps.

Thanks to all those who offered support and suggestions about my breastfeeding woes. As you can tell, I was in quite a state when I wrote that last post. Not only have the suggestions been nice to have more things to try, but the support has helped me to let myself off the hook a bit. I’m backing off a little, and allowing myself to just say I’ll do my best, and it’ll be alright.

In the meantime, we now await the arrival of Grandpa Jack, Abuelita Cha-Cha, and Auntie Desi. Should be a fun weekend!

Comments (1)
Categories : Feeding, Newborns, Pediatrician appointments
Tags : Breastfeeding, Formula, growth check

First Pediatrician Appointment

By Goddess in Progress · Comments (3)·   August 13th, 2007

Today was our first outing with the twins, and their first trip to the pediatrician’s office. Our new pediatrician is a very nice woman, about our age, and pronounced the babies in great shape. When they were discharged from the hospital on Friday, Rebecca weighed 4lb4.5oz and Daniel weighed 5lb11.5oz. They want them to gain an ounce per day. Well, they did even better than that! In three days, they were up to 4lb9.5oz and 6lb5oz (if I remember correctly, things are blurry these days). Both have regained and surpassed their birth weights! Hooray! And on an even happier note, no shots today. This practice prefers to wait until the babies are about a month old to start some of the routine vaccinations (as the doctor said, how exactly do we fear they’ll get Hepatitis B in that time, sex or blood transfusion?), so they’re safe for now.

We go back in one week for another weight check to make sure they continue their good work. I asked when she might suggest weaning down on the 24-calorie formula they currently get every other feeding, and I was surprised to hear it might be a matter of months, not weeks as I somehow suspected. Alas, we’ll just have to see how they do. In the meantime, I’m looking forward to my lactation consultant appointment on Wednesday, in the hopes that I can at least transition the breastmilk feedings to direct breastfeeding, instead of pumping every single time.

Speaking of pumping… off I go. Moo.

Comments (3)
Categories : Newborns, Pediatrician appointments
Tags : Formula, weight gain

Birth Story, Part 3: Postpartum

By Goddess in Progress · Comments (4)·   August 12th, 2007

Within one short minute early last Friday morning, I suddenly went from pregnant to not. It would seem like such a monumental change should take place over a longer period of time, but as my husband would say (quoting from an episode of West Wing), pregnancy is a binary state. You either are, or you aren’t. And now, I’m not. Whew.

So, after the c-section, I was groggy but happy for a while. Since I had felt some pain during the surgery, I had been given a little extra dose of happy juice while they put me back together. They also used something called duramorph. Instead of having a morphine pump for pain after the surgery, they injected a long-lasting dose/form of morphine with the spinal. For a solid 24 hours, I can honestly say I felt no pain, and I noticed no negative side effects. For that period of time, they also gave me pitocin to help contract my enormous uterus and IV fluids. I had inflatable cuffs around my calves, not unlike alternating blood pressure cuffs, to keep circulation going and avoid blood clots. It was a little odd at first, but not terribly uncomfortable.

At this point, I hadn’t slept in a good 24 hours. But as there were new babies and it had reached somewhat reasonable hour of the morning, there were phone calls to be made. Excited grandparents were weepy, aunts and uncles (real and honorary) were cheering us on. I was sleepy, but the adrenaline (and frequent checks by the nurses) would keep me up for a while.

The first day saw me confined to bed, but no shortage of visitors. My dad arrived directly from a business meeting several hundred miles away by 2pm. Our only local relatives (my aunt and my sister-in-law) came by as well. I smiled sleepily at them and assured them I was feeling no pain. They got to go with the new daddy to see the babies in the nursery. I was jealous.

By Saturday morning I was unhooked from my various tubes and wires and was able to slowly start moving around. I finally was able to go to the nursery to see the babies for myself. It was really the first time I’d seen Daniel at all. My first thought was how small he looked. I knew he was bigger than Rebecca, so I figured he’d be huge. But no, he was a little six-pound newborn. It’s only after spending time with or holding his sister that he suddenly looks like a linebacker.

Since I knew I wanted to breastfeed the twins, and they were not really in a position to be directly nursing, I was started on the pump. You can’t help but moo the first few times you get your boobs into the suction cups. Though I likely wouldn’t produce much of anything at first, I was instructed to pump for 15 minutes, every three hours, to help my milk come in. Fun times.

Sunday I was able to walk to the nursery on my own and not require a wheelchair or assistance from the nurse. I started going more frequently, realizing I was welcome there, and tried to make it to as many feedings as I could. I learned what it took to “stay on top of the pain.” Motrin and Percoset became good friends. The pain was quite manageable, but my elevated blood pressure and swollen extremities would not abate. I was instructed, yet again, to spend more time on my left side, and keep drinking plenty of water. And here I had been so excited to finally sleep on my back again. Ah well.

In the meantime, we had scrapped our original plans of hubby spending nights with me in the hospital. Since the babies weren’t rooming in, we decided we’d both have a better shot at a good night’s sleep if he went home and took care of the dog and kept his snoring to himself. I’d not only be able to sleep instead of yelling at him to roll over every 10 minutes, but he’d be able to rest up instead of being on an uncomfortable cot, waking up every time the nurses came in. We both liked this plan.

Sunday night, as he got ready to go home, I got my first case of what I refer to as “the weepies.” Hormones combined with a huge emotional life change are a really special cocktail. I assured my husband I was just fine and insisted he get home and get some rest, and then proceeded to cry for 30 minutes. No particular reason. Just the weepies.

By the time Monday came around, I was feeling a lot more human again. I was more comfortably mobile, able to shower and wear something other than the hospital gown and a robe. As much as I missed being home, I was also getting anxious about being discharged. Not that I was concerned for my health, but rather because I wanted to keep being down the hall from the babies. Not across town lines. I was additionally stressed because the pumping was coming to absolutely nothing. Three solid days of dutifully pumping every three hours, and I had nada to show for it. I don’t mean “not much.” I mean nothing. Every time I went in to feed the babies, someone asked if I wanted to put one to breast, or if I had any pumped milk I wanted to feed them. I tried one of them at breast at least once a day, just for the sake of practice, but there was nothing for them to get.

Monday night, the weepies came on with a vengeance. I cried at the thought of leaving the babies at the hospital. I cried out of the guilt of having someone else take care of them, even if it wasn’t a matter of choice. I cried at the feeling of not being able to take care of them myself. I literally woke up three times during the night, bawling. Tuesday morning was no better. I had finally gotten a hold of myself when the nurse came in to take my blood pressure. Unsatisfied with the results, she told me to lay down and rest and she’d recheck me in half an hour. I once again burst into uncontrollable tears. I wanted to get to the nursery to be with my kids, and I had to lie down again for my stupid blood pressure. I was a wreck.

Just before I left for home that afternoon, I finally got my first measurable amount of breastmilk from the pump. I kid you not, it was two milliliters. Total. Both breasts combined. And I brought it right over to the nursery so someone could eat it. The nurses were great, and proudly combined it with formula so the babies could have it. We came back to the hospital a few hours after leaving to feed the babies, but I was running on empty. I couldn’t stop crying, no matter what. The kind SCN nurse insisted that it would be a good idea for me to just go home and rest, and I could come back in the morning.

It was nice to be home, but again, very mixed. After being unsure how “connected” I would feel to them since they were in the nursery all the time, the prospect of being further separated positively broke my heart. I ached from missing them. I couldn’t even look at the polaroid of the three of us from two days earlier without sobbing.

Wednesday and Thursday, however, were improvements. We were at the hospital for four feedings a day, and all the pumping was FINALLY starting to produce something. The first time I got a full ounce, I nearly jumped for joy. It wasn’t enough, but it was finally progress. The babies were doing well, and it looked like they would come home. I was having minimal pain from my incision, and was able to keep it at bay with only ibuprofen, maybe a single percoset at night.

And here I am, the end of day two with babies at home. My in-laws were here the last two days and were more helpful than I worried they’d be. It was good to have the extra set of hands. I still burst into tears with minimal provocation, but it’s getting better. My belly is a big, stretch-marked bowl of jelly and my feet and legs are still determinedly retaining lots of fluid, but I’m trying not to worry about it. The pumping is yielding 1.5-2.5 ounces at a time, which is enough to keep up with their current needs (doctor sent them home alternating breastmilk with high-calorie formula to help gain weight).

I’m pretty tired, and I haven’t got the foggiest idea what I’ll do when my husband goes back to work in a couple of weeks, but I can’t possibly think that far ahead. Tomorrow is our first full day by ourselves, so we’ll see how that goes. I think we’ll make it.

So, that’s the story. This is now, officially, a “mom of twins” blog. Hard to believe, but it’s really true. I have two babies. Yipes!

Comments (4)
Categories : Feeding, Hospital, Postpartum
Tags : blood pressure, Breastfeeding, c-section, emotional, Formula, NICU, pumping

Birth Story, Part 2: Special Care

By Goddess in Progress · Comments (5)·   August 10th, 2007

After being born, Daniel was whisked directly off to the hospital’s Special Care Nursery. It’s technically a “level II” unit, which means they can care for all but the sickest and/or most premature infants. It’s got 16 beds, and is staffed ’round the clock by a neonatologist and 4-6 nurses.

So, there went Daniel, who was grunting quite a bit, indicating he was working somewhat hard to clear his lungs and breathe freely. Rebecca, though smaller, was breathing well and came back to recovery with us. On the way over to my postpartum room, they wheeled me in to see Daniel, though all I could really see were his feet. He was lying in a warming bed attached to monitors and an IV, but they were letting him try to work out his breathing issues on his own. No extra oxygen, no CPAP, just letting him work it out. And by later in the afternoon, he had.

Daniel with IV

Around lunchtime, Rebecca and I were hanging out in my room (as I managed to spill jello on both of us), when my nurse noticed her feet and hands were looking a little too blue. It’s not unusual for newborns to have poor circulation to their extremities, but hers were looking a little too dark. They took her off to the well-baby nursery to get watched, and a little while later they moved her to a warmer in Special Care so that someone would be able to keep a closer eye on her.

Rebecca in warmer

By Saturday morning I was unhooked from my various wires and tubes, and was wheeled over to see the babies. They were in separate warmers, but both looked good. Rebecca was taking some food by mouth and some through a tube in her nose, and Daniel would start doing the same shortly. I was even allowed to hold them for a few minutes. By Sunday morning, Rebecca’s tube was out as she proved to be a voracious eater. We even tried putting her to breast a few times, and for such a teeny thing, she has a pretty decent latch. Daniel would take about half of his feed and get tired. The rest would be pumped down the tube so he could get the calories without having to work too hard.

Sunday evening, Daniel was fussy in his warmer and they decided he didn’t need it anymore. He was off of the IV, as he was able to take his feeds and infection had been ruled out, so antibiotics were stopped. They swaddled him up and put him in an open crib, and he happily settled down. At the next feed, Rebecca joined him in the crib.

DSC_0002

Monday was spent improving on feeds, which were formula since all of my pumping was coming to naught. Tuesday was my discharge day, and a difficult one for me. Rebecca’s bilirubin levels were slightly elevated, so she had to leave the crib for an incubator with lights. Daniel was still not taking his feeds as well as we wanted. And I had to leave the hospital.

By Wednesday, though, things started to turn back around. Rebecca came off the lights and back to the crib, and Daniel pulled out his own feeding tube in protest and started taking his feeds better by mouth. They even had us bring in a carseat so they could do their carseat test that night (must be able to spend 90 min. in the carseat without respiratory or cardiac troubles).

DSC_0004_2

All tests came back good on Thursday, and they started to really seem confident that Friday would be discharge day. We were going to the hospital to do four of their feeds every day, and though the hospital is less than 10 minutes from home, the back and forth was really getting tiring. We learned how to give them a quick sponge bath, and got a lot of safety tips and instructions from the nurse. I didn’t want to get my hopes up too high, in case anything happened overnight, but Friday seemed like it would really be the day.

Indeed, all was well when we went for the 8AM feed this morning. No one had any feeding, breathing, or circulation trouble overnight, weights were good, bilirubin levels were down. We got some brief instruction in Infant CPR, and the nurse told us we could go disconnect them from the monitors and get them dressed to go home, one week exactly since they arrived.

Excuse me?

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That’s when we got a little nervous. You mean, there will be no screen we can look at to make sure they’re still breathing? No 24-hour RN keeping a watchful eye over us? Are you sure this is wise?

But we made it. We got them dressed and safely buckled into their carseats and secured into the van. We drove a little more cautiously than usual on the way home, but it didn’t take the 30 minutes we predicted to go the three miles to the house.

There was a small part of me that was even a little sad to leave the SCN. It was tiring to go back and forth, hard to grasp the reality of having babies when someone else is taking care of them and you only visit and do what they say. But the nurses and doctors were nothing short of wonderful. They were not just skilled and efficient, but also caring toward the whole family, happy to help the new parents take on additional tasks when possible. They were very supportive of efforts to breastfeed, and would be the first to call in the Lactation Consultant to come help. They were funny and personable. I’m looking forward to my first of the annual SCN reunions around Labor Day.

But nothing beats sitting at my computer and looking over at my two babies, sleeping snugly in the Pack n Play in our den. This is the best.

Comments (5)
Categories : Feeding, Hospital, Newborns, Postpartum
Tags : Breastfeeding, Formula, NICU, pumping
   

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