Thursday, July 28, 2011

A Good Trend!

Elizabeth was weighed at the doctor's office today, and she came in at 8 lbs and half an ounce. That's a gain of 2 and 1/2 ounces since Friday of last week, which isn't bad (especially not for a newborn who wasn't gaining at all), but I still want to see bigger gains.  I'm still supplementing her feedings with 3-4 ounces of either formula or breast milk.  So far, I've been able to give her breast milk for most of the supplements, which makes me pretty happy. I'm definitely getting more used to the pump. 

I realized that as fussy as Elizabeth can be sometimes, we're actually very lucky because she sleeps through most of the night. She usually falls asleep around 10:30 or 11:00 P.M., and she'll wake up at 2:30 or 3:30 for a small feeding, then again at 5:30 or 6:00 A.M.. That's a very manageable schedule, and pretty awesome for a newborn!  Slowly but surely we're getting to know her and figuring out how to keep her happy. 

Sunday, July 24, 2011

One Month Old!

Elizabeth is four weeks old today!  I have decided to make a new page within this blog called "Tracking the Tot", and on that page I will put up pictures of Elizabeth at each of her monthly birthdays so we can watch her grow month-by-month.

Here is the official first-month picture:


And here are two extras, because she's just so cute:


Here are a few things I've learned about my daughter, thus far (wonderful idea shamelessly stolen from my friend Debra to list out facts about her loved ones on their birthdays):

  • She hates sponge baths and baths in the little tub thing the hospital sent home with us, but she doesn't mind them in her larger tub because we can constantly pour warm water over her belly.
  • She is pretty much conditioned to calm down whenever we turn on some white noise.
  • The prime time to get a smile out of her is right after a morning nap or just after her first morning feed.
  • She does not like to smile for the camera.
  • She does not like to sleep in her crib. 
  • She doesn't seem to like tummy time that much. 
  • Most of the time, she'll sleep right through the dogs barking. 
Though she is a grouchy little thing most of the time right now, I love her so much!  

 

Friday, July 22, 2011

Success!

As you can probably guess from the title, my Elizabeth finally put on some weight!  Gentle readers, I cannot tell you how relieved I am that something is finally working.  Elizabeth weighed in at 7 lbs, 14 oz. today.  I also made a point to learn the name of the lactation consultant--her name is Sophia. Sophia said that the three or four ounces that I was supplementing per day shows that it didn't take much to edge Elizabeth's calorie count into the gaining territory, and that meant that my milk supply was probably fine to begin with.  She thinks I probably haven't even experienced the increase in milk supply from the fenugreek yet, and once that happens she thinks it won't be any trouble at all to keep up with Elizabeth's consumption.

So here are the things I've been doing to build up my milk supply and get Elizabeth to her fighting weight:
  • Feeding Elizabeth at the breast every two hours during the day, almost without fail (before I'd let it stretch to 2 & 1/2, or sometimes 3 hours between feedings).  Overnight, I just let Elizabeth tell me when she's hungry (we are co-sleeping, even though I never, ever planned to and it still scares me that we're doing this--Elizabeth simply won't sleep in her crib right now, and it makes it easier to breastfeed her in the middle of the night).
  • Pumping 3 times a day (new goal: pump at least 4 times a day), after feedings.
  • Supplementing her feedings with 3 or 4 oz. of either formula or breastmilk (if I can pump enough) per day.
  • Taking fenugreek (3 pills 3 times a day) and drinking Mother's Milk tea (3 times a day).
  • Drinking lots and lots of water, and making an effort to take in enough calories.
  • I also try to eat oatmeal at least once a day--it's rumored to help with milk supply.
Pumping is a very strange thing, and I'm really glad that I started trying to pump a few weeks before going back to work.  It takes a bit to get used to, and trying to be relaxed while it is going on is a bit of a challenge.  I was lucky enough to be able to borrow a friend's Medela Pump in Style Advanced pump (an electric double pump), and I just had to purchase the other parts (tubes, breast shields, connectors, membranes, and collection bottles).  The first time I pumped, I only got a few drops.  When I pump after Elizabeth has fed on both breasts, I get a total of about .05 oz. right now.  I once pumped after Elizabeth only fed from one breast and got one full ounce, but I try to let Elizabeth feed off both before pumping because she's always going to be better at extracting the milk than the pump (and I'm more concerned about getting her weight up right now than getting a good freezer stash of milk).  Those paltry amounts aren't unusual for mothers who are breastfeeding full time.  Once I go back to work, if all goes well I should be able to get a lot more during the day when I'm away from her.

Sophia said that I could go ahead and introduce Elizabeth to bottles, since she's almost four weeks old now.  I think I'm going to try to do this through the amount I have to supplement--maybe by giving her two 2 oz. bottles per day of either formula or breast milk.  I can try to do most of the supplementing at night while I'm still home on maternity leave, so that I have all day to try and pump enough breast milk to round out the bottle, or just give her formula if I don't get enough.  This is also nice because I can let Michael feed her these bottles--this should make it easier for him to keep her calm and happy when I'm taking a shower before bed.  Not to mention, this will give us some time to get Elizabeth used to bottles before I go back to work. Finally, it's awesome because using and washing that supplemental nursing system is a bit of a pain, especially when I have to do it on my own during the day.

We go back to the doctor next Thursday just to make sure that she's still gaining weight--here's hoping I can get her back up to her birth weight, or very close, by then! 

Tuesday, July 19, 2011

Underweight

Today, Elizabeth was still 7 lbs, 10 oz.. Right after the appointment, I went back to the Women's Center in the hospital to talk to a lactation consultant.  I knew that Elizabeth would want to feed soon, and I wanted the lactation consultant to see her feed so we could diagnose any problems.

As soon as I was seated in the lactation consultant's office, I started crying. I couldn't help it--I'd been holding back tears ever since we'd left the doctor's office. Without even blinking, she handed over a box of Kleenex, and said, "That happens a lot here." The stress of it all just wouldn't be kept back anymore--I'd read tons of breastfeeding information and watched lots of instructional videos and dealt with the sore breasts and nipples and I was following all the advice I could grab and trying to do it all on very little sleep yet none of it was working.  My little girl was still underweight, not thriving.


The lactation consultant (I can't even remember her name, which is so sad--she was wonderful) calmly listened as I told her about my feeding schedule and got me set up to feed Elizabeth.  I started feeding her and felt immense relief when I was told that her latch was fine--I'd been convinced that somehow I wasn't doing that correctly. The issue is that Elizabeth is a sleepy, non-assertive sort of eater: she attacks the breast like a shark, but after getting the initial edge off her hunger, she's happy enough to just sit there and sip. Basically, she falls asleep before completely draining the breast at most of her feedings.

She said that I probably had a decent milk supply, but that to boost it she was going to recommend that I start taking fenugreek (an herbal supplement that boosts milk production) and pumping after feedings three or four times a day. She also suggested that I go ahead and start supplementing my milk with a few ounces of formula a day to get Elizabeth's weight up while we're waiting for my milk supply to increase. She gave me a supplemental nursing aid that administers the formula right at the breast (because using a bottle right now would result in a loss of stimulation, which could decrease my milk supply). Once I've pumped enough to get a few ounces, I can start using my breastmilk to supplement at feedings instead of the formula, and the lactation consultant thinks this abundance of milk will train Elizabeth to get a bit more assertive at feedings and take in more each time. 

The lactation consultant thinks this is an easy issue to resolve. She told me that I have 98% of what I need to do this successfully, and that edging up the milk supply and getting Elizabeth to eat more at each feeding will provide the last little bit that I'll need. In the meantime, supplementing with formula will also help because I won't be as stressed about Elizabeth's weight.

I'm hopeful that this will work. At the very least, I know that I'm doing everything I can to make this work--so if it doesn't, I shouldn't feel bad because I tried really, really hard. Elizabeth goes back in on Friday to see if she's gained any weight, and I go back to the lactation consultant then as well. We'll see if there's any improvement then.

Thursday, July 14, 2011

Argh?

On Tuesday, Elizabeth and I went to the doctor again for another weight check...and she's still coming in at 7 lbs, 10 oz. 

Sigh.

The doctor thinks this is still fine.  Elizabeth is alert, she isn't dehydrated, she's having an acceptable number of wet diapers per day, etc.. But of course, I'm worried. I'm getting more worried each time we go and there's no significant gain. I've read so much stuff on breastfeeding and watched so many videos online over the last week or so that it's a little insane. I have also started to try to feed her every two hours instead of every three hours during the day. Either this next week or the week after, I'll start pumping. From what I've read, that can be pretty discouraging--I might be lucky to get half an ounce, at first.  I hope I can build up enough of a stock before I go back to work.

I keep trying to keep Michael's words of encouragement in mind. He tells me that I'm doing all I can, and that she's fine--that everything is being supervised by a doctor and that we're following the doctor's instructions. It's hard not to feel like a bit of a failure, though. For something that has been done for so long throughout the ages without any real instruction or guidelines for most of that time and that is supposed to be so natural, it is remarkably difficult to breastfeed.  Or maybe it is just remarkably difficult to breastfeed in today's world, even with all the advantages afforded by our technology and information.  Mothers of the past were probably not on the same timetable as some of the mothers of today--get the baby feeding ASAP because you need to go back to work and you need to have enough milk for a caregiver to give the baby through a bottle.  Mothers of the past were also blissfully ignorant.  There were no weight charts or online forums about what was ideal or normal or desirable in their baby. They just fed their babies and hoped they wouldn't get sick. 

We go back on Tuesday. So I'm going to feed my baby and hope that she doesn't get sick.

Sunday, July 10, 2011

A Calm Baby

A wondrous thing happened today: Michael was able to calm a very fussy Elizabeth and put her in the swing to sleep. This is something that doesn't usually happen for us. As I mentioned in my previous blog post, Elizabeth is pretty much never a happy camper unless she's attached to one of my breasts. My friend Tina, who just had a lovely little baby girl named Sofia, recommended a book to me: The Happiest Baby on the Block, by Dr. Harvey Karp.  Michael was able to find a video online that was made by Dr. Karp and that covers the same techniques discussed in the book and we watched it this afternoon. You can also see a very quick rundown of his 5 S's in this YouTube clip from a morning show.  Michael's success in calming Elizabeth was pretty amazing. Here is a pic of him using two of the 5 S's: swaddling and side-holding:


If you have a fussy baby, you should try these out--we were able to start using these techniques within minutes of learning them. So thank you, Tina, for recommending the book/video, and thank you, Dr. Karp for taking the time to develop this approach and to teach it to us bleary-eyed, harried parents.

Saturday, July 9, 2011

Keeping Abreast of Things....

So breastfeeding is hard. For me. Seriously.

 Note the design on her onesie. Michael thought it was particularly fitting for this blog post.

My little Elizabeth loves to be at the breast all the time. Apparently, breasts are good for food and for use as a pacifier, and it is the latter use that is especially difficult to endure. I know that this is actually a good thing--that it will stimulate my milk production and help when it comes time to pump--but it's hard to be so positive about it when I can barely find time to shower or use the bathroom or brush my teeth without causing her to wail.  Add the soreness that comes from having a baby latched onto your boobs most of the day (and the fact that you stupidly used a nipple shield in the hospital, so you had to wean your daughter off of it once you got home--meaning you had to go through the whole re-toughening of the areolae again) and you have a situation that is so not fun.

As hard as it is on me, I think it's even worse for Michael. He wants so much to help, and he feels helpless when she's crying for something he can't provide. He's even said that he would support me completely if I wanted to start using formula instead, because he had no idea that breastfeeding would take so much time and effort. He just wants time with his daughter that doesn't involve her screaming in his face and trying to nurse on his shoulder or hand or elbow.  He really, really wants to be able to feed her. Elizabeth's quiet (but alert), cute times are few and far between right now, and usually happen in the wee hours of the morning--he doesn't get to hold her when she's peaceful all that often, and he feels like he's missing out.

I'm not giving up yet. If I can keep this up for two more weeks, then my milk supply should be fairly well established and I can start pumping. I think things will get better once I do that, and we can start using bottles. Elizabeth really liked the use of the nipple shield, so I think she'll take to bottles rather well--she might even prefer them, once she sees how much easier it is to get to the good stuff.

Another factor in all of this is Elizabeth's weight. Babies lose some of their birth weight just after they're born, but ideally it will be regained within two weeks. The day we left the hospital (Tuesday, June 28th), Elizabeth weighed 7 lbs, 15 oz., and at her first check-up on Thursday, June 30th, she weighed 7 lbs, 9 oz.. That weekend, I broke her from using the nipple shield out of concern that it was restricting my milk flow, and we had our first gain this last Tuesday, July 2nd--she was 7 lbs, 10 oz.. Her next weight check is this upcoming Tuesday, so I'm hoping to see some major gains by then.  If she isn't gaining, then I'll visit with a lactation consultant...but if that fails, then I'll have to seriously rethink the use of formula. I go back to work in the second week of August, so I don't really have the luxury of letting the feeding situation go for much longer without knowing for sure that she'll have enough food to get her through the day and keep her on track for weight gain.

Sometimes this is so scary, because now we're responsible for a little human being whose survival and ability to thrive depends on us and the decisions we make concerning her care. Luckily, we have a lot of support and encouragement from friends and family, and from our healthcare providers. They all say we're doing everything we should, and that we're doing well. Sometimes we actually believe them.

Saturday, July 2, 2011

Meeting Elizabeth

Gentle readers, it has been quite a week.  My daughter, Elizabeth Jeanette, was born on Sunday, June 26th, at 11:55 A.M., and she was 8 lbs and 7 oz, and 20 inches long.

My birthing experience was very different from what I'd expected, but in a mostly good way.  For one thing, it was a much faster labor than anyone expected--the nurses and doctors included. Most first-time mothers have a rather long labor and delivery, and when I checked in it was determined that I really was only 3 centimeters dilated.  I didn't go into anything approaching active labor until sometime between 3:35 AM and 6:30 AM.  The doctor had tried to start off labor by giving me something to ripen my cervix that would take up to 8 hours to take full effect--thus, I spent most of the first night in the hospital sleeping (thanks to a sleeping pill that the nurse highly recommended I take, even though I was a little hesitant to take it).  When contractions didn't start, they gave me pitocin around 3:35 AM. Once the contractions began, I only felt them as a bit of pressure. Around 6:30 AM, the doctor came in and checked me, and broke my water to speed things along. He estimated that I would deliver sometime on Sunday afternoon or early evening, given my dilation and effacement, etc..

The contractions started coming much faster after my water broke, and I was definitely feeling them by 7:30 AM.  I had always planned to get an epidural, but I was trying to hold out as long as I could so that I wouldn't slow down the labor. My contractions were coming pretty quickly--about 2 minutes apart. I caved and asked for some IV pain meds in the meantime, and I received some Staydol around 8 AM.  In hindsight, I should have asked them to check me at 8 AM, and I should have taken the epidural then--because I'm almost certain they would have found that I was dilated at least to 6 cm.  By 8:30 AM I was requesting my epidural be given as soon as the Staydol wore off (it only lasts about an hour), and I received it a little after 9 AM.  When the doctor checked me some time after I received my epidural, he was shocked--I was already at 8 cm dilated, and he asked the nurse to confirm. She said, "Oh my God, she's nearly complete!" (Completely dilated, completely effaced--in other words, nearly ready to start pushing).  I immediately felt like less of a wimp when I heard that, because when I'd started caving in and taking the pain meds, I was convinced that I was probably only dilated to 4 or 5 cm.  Women who go through labor and delivery without any pain relief have my respect--it's not something I'd want to do, and I nearly did it quite by accident.  

The nurse spent most of the time between 10 and 11 AM getting the room ready for the delivery.  By 11 AM, she had me start some practice pushes, and I was given the task of pushing with the contractions. I was determined to deliver quickly--I didn't want to spend a lot of time pushing.  I felt very focused, and I followed the nurse's coaching and I was able to deliver with just under an hour of pushing--yet another surprise to the doctors and nurses. The relief and joy that came with Elizabeth's arrival is impossible to describe.  She was placed on my chest after Michael cut the cord, and that is where we finally met her.  She was wailing her little head off, but I was just so happy that she was safe and healthy and finally here!  We were absolutely thrilled with her, and everything else simply melted away as we looked at her little face and her fingers and toes and knees and listened to her cry. Our baby had finally arrived, and a circus could have come through the room and we wouldn't have really noticed or cared.

So that is the story of the events that led to the time we met Elizabeth. Yes, it was uncomfortable and at times painful.  But look at what I got out of it:



Absolutely, totally worth it.