Tuesday, October 27, 2009

Suggested Items for New Parents

I thought I'd make a list of specific items we have found extremely valuable in the first 7 weeks at home with Sidney. They have supplied welcome relief as we embark on the journey of parenthood. Not an exhaustive list by any means but my favorites.
  • Bibs: At first, I thought they were just cute accessories. But for a baby that gets fed from a bottle, it can help minimize the wet collar that inevitably happens as milk runs down their chin. And for both formula and breastfed baby, they are the first line of defense against spit-up and hence decrease the number of outfit changes.
  • White board: As a new parent, you're constantly keeping track of feedings, diaper changes, pumping schedule, dr. appts, medicine dosages (if app) and stuff like that. When one is majorly sleep deprived, your memory is questionable so write it down and if you want to relay something to the other caregivers in the house (but don't have them right in front of you) this is an invaluable communication tool.
  • DVDs to view: "Happiest Baby on the Block" & "Dunstan Baby Language" Both of these are extremely helpful in giving guidance about how to help your baby feel comforted and understood. "Happiest" gives 5 solid ways to soothe a baby and "Dunstan" interprets 5 distinct cries and what they mean. Rent or borrow first and then decide if you need to own a copy.
  • Books to own: "Baby 411" & "What to Expect in the First Year" My bible was "Baby 411" in the first days/weeks. I was constantly referring it. I love the way it is organized by topic and the layout is easy to read with lots of bullet points (my favorite way to intake information). In contrast, "What To Expect" is organized by months of age, so you can see everything that should be happening within the monthly intervals. It's nice to be able to cross reference by topic and time frame.
  • Drying rack If you bottle feed and/or use a breast pump, there are parts that constantly need washing. There are cages you can put certain parts in for the dishwasher but if you aren't running the dishwasher multiple times a day, you'll still need to hand wash a bunch of things. A rack will also be invaluable for storage and minimizing the impact to your counter space.
  • Kiddopotamus Swaddle Me Wraps (cotton or fleece depending on season) New babies like to be swaddled and while you can do this with a blanket, these wraps are better because they contain the arms and legs separately. That means you don't have to undo the entire swaddle to change a diaper--this is key.
  • Burp cloths shaped like a peanut, like THESE. For a spitty baby like ours, we use lots of burp cloths and these stay on your shoulder better.
  • VIPP Diaper Pail This is a totally indulgent item that most people could do without, but if you've ever smelled the diaper of a formula fed baby--oh yeah--we needed this. In the book "Baby Bargains," (one of the best resources for baby things) they actually gave the VIPP diaper pail an "F" because 1) it's expensive and 2) the reviewer had some trouble getting the bag of used diapers out of the can. But I don't agree with this. It's not that hard to pull it out and honestly for the foot petal, soft close top, minimal use of plastic and *no* odor--that's pretty much why we bought it. Feel free to get something cheaper or just use the kitchen trash but since we still use disposable diapers enough of the time, it was worth it to us.
  • Medela Symphony Breast Pump (as a rental): It's a hospital-grade unit and called the "Cadillac of Breastpumps." It's modulated by a computer that mimics the rhythms of a baby's suckle and it's quite powerful so you can spend half the time attached to it as compared to a consumer grade pump. Even though I owned my own home pump, I had to rent this one to increase my milk supply (when I was briefly trying to breast feed) and relieve engorgement that neither the baby nor my pump were able to. Regarding the rubber membranes that make this pump work--buy extra ones because they are fragile and use a teaball to wash them so they don't get lost down the drain.
  • Cloud and Stars Crib Zipper Sheets: Simply the fastest & best solution for changing crib sheets--ever.
  • Robe and slippers: Get some warm, comfortable ones. You'll be spending lots of time in them and need something wear as you shuffle into the baby's room for late night feedings. A robe can also act as a body-sized spit-up shield in a pinch.

Sunday, October 25, 2009

Pumpkin Carving (3rd Annual)

After you do something three years in a row (Year 1 & Year 2), it seems like you then have a tradition. We could not have been more delighted to have the Testas over for pumpkin carving. (This time with Ms. Sidney and Grandma Joyce to add to the fun.) The soon-to-be-born baby boy Testa was kicking it in utero but next year I suspect he and Sid will be giving us a run for our money. After some hard work carving and drilling into the jack-o-lanterns, we had some delicious burgers from Hamburger Harry's in Ballard. They came highly recommended by Grandma Joyce who had sampled them earlier in the week. Fun times, great conversation and a little preview of baby handling 101 for the soon-to-be-parents.

Tuesday, October 20, 2009

New Parents need a Warning Label

Allow me to throw out a warning: new parents (less than 4 weeks) should not be allowed to speak to pregnant or potentially pregnant folks. This became very obvious to me as we were receiving guests in Sidney's first few weeks of life. Well-wishers would come over with food and eagerness to see our spawn but naturally we were dazed and sleep deprived. I was lucky to string a sentence together and hold my fragile hormone-addled emotions in check. That alone should immediately disqualify a person for parenthood evangelism and giving advice because invariably our pregnant or potentially pregnant friends would ask us what was the "best thing" or "most magical thing" about being a new parent. Ken and I would look at each other blankly, struggling for an honest yet positive answer. At that point, the most magical thing about Sidney was how much poop she could generate. But that didn't seem like a good answer.
I'm fraking magical!
So we hope our pregnant friends will forgive us. Because now, oh now, things are quite delightful. We are just a hair shy of 6 weeks and each day we see great changes. The feeding situation has settled down so that the source of her food (formula) and the timing of her eating intervals is predictable. She does not yet sleep through the night or go any longer than 4 hours maximum without eating, but we have high hopes that will happen soon. Her interactivity and eye contact is much increased. She takes in the world with wide-eyed wonder and is on the verge of smiling socially (with cause, not just involuntarily or because of gas). Recognition of who Momma & Daddy are when we are in her field of vision is distinct. She is starting to lift her head up and gain more control over her wildly flailing limbs. It's starting to get really fun AND we can appreciate it. Two very important things.

Friday, October 09, 2009

Sidney's Birth Story

One month ago today, Sidney was born. So I think it only fitting to finally compile her birth story. Ken was taking notes as the event unfolded so all of his words are in blue. The rest is me. 9/8/09
6AM Kali's water broke! We scrambled to pull our stuff together. (Kali's bag was already packed, mine was quick thanks to her list & prep). Three weeks early, but full term & we're excited to welcome The Wetus to our world. We're in the hospital getting checked up initially--there's a possibility of natural birth if the placenta has moved...something we weren't prepared for! Getting ready to do an ultrasound to check. Cindy is nurse attending to us, very nice. 9AM Unexpected turn--Kali's showing all signs of preeclampsia, so we won't be able to use Anna (our doula) and they'll likely give Kali magnesium sulfate to help keep her calm & prevent seizures. We can possibly choose between natural or Cesarean, but we haven't prepped for natural birth, so Kali's a little reluctant to go that path w/o a doula. Contractions ~7 minutes apart. Kali is falling asleep. Dr. Foltz will deliver the child--she recommends natural birth (vaginal) and will allow Anna to doula--Kali's blood work apparently checked out fine and her blood pressure is coming down some. Getting ultrasound now to see if placenta has moved away from the cervix...technician thinks so, but need doctor's assessment. Lights are low, no phone/computer/stimulating devices, needs to be quiet for concern of preeclampsia/seizures.
(Kali's note: These concerns were never founded and were the over reaction of our nurse. It was actually more stressful to envision these limitations and then after the blood work came back within normal limits, we realized that clearing everything through the doctor first was the only way to go.) 10AM Contractions ~2 minutes apart but not so strong. 11:45AM I went to get a World Wrapp & stuff my face, and bought a cord to connect the mp3 player to the speakers...Kali is sitting tight, just had a mildly strong contraction. Waiting for Dr. Foltz to come give a word. Kali is really hungry, poor thing. Listening to Prokofiev's Concerto 1 in D Major.
12:30PM Dr. Foltz came in--the placenta previa has totally cleared so rather than a c-section we're going to go with natural vaginal birth (!). We're going to get full use of our doula now :) Kali is able to eat a bit, which makes her very happy. 4:10PM The labor/delivery nurse is encouraging us to get Pitosin going to induce labor. Kali called Anna who suggested trying nipple stimulation...trying that now. 5:20PM Kali spoke with Dr. Foltz and agreed to a little Pitocin to get the ball rolling. She's having it added to her IV now. Anna is on her way...things are going to get going soon I suspect! I've been watching "Who's Afraid of Virginia Wolf" on Netflix, good movie. 11:30PM Anna is here--very comforting. She knows just what to do to help Kali cope with the contractions, which are about 2 minutes apart now and difficult for Kali. She has had 2 half doses of Fentanyl and will get an epidural eventually. The pain spikes are bringing on some nausea. But next she'll do a few contractions on the toilet, then some time in the tub. Dr. Foltz says the baby will come at about 6AM. Cool beanz! I'm a little tired, but happy all is well so far.
(Kali's note: I wanted to try everything and get dilated to at least 5 before the epidural. We got to use the ball and the tub which I was very happy about. But by the time we hit the tub I was almost at my pain threshold limit and that turkey salad that I had so badly wanted earlier came back up. Aside from vomiting on my husband and doula, the transition from the tub to getting an epidural was smooth. I can see why women swear by them--it was a gigantic relief and to know that I had waited long enough on the dilation part also made me feel very good.)
4:10AM We've slept some since Kali's epidural (on & off for ~3 hours)... Kali is at 10cm and ready to go!!! Anna's going to come over and we'll do this thing. :)
This is where Ken stops writing. Baby's head hasn't molded to get through the pelvis so we're waiting another few hours to see the progression.
Checked again and head has molded so baby can come down through the birth canal. Real pushing to begin before the end of the hour.
Hard labor with major pushing. Ken and Anna on each side holding a leg. Dr. Foltz pops in and out to see progression. Fingers being placed at the opening so I can focus on a place to push and a 10-count are very helpful since there is a lack of feeling and after 24 hours of dilation--I'm very tired. Also lamenting the lack of core strength due to no exercise during pregnancy and the suspension of yoga due to "placenta previa" concerns.
~8AM Crowning
Touched baby's head. Intense stretching at the opening--they call it the "Ring of Fire." No shit. Haven't taken any labor/delivery prep so I am doing whatever the doula & the med staff say. Since I'm tired, there is a lot of pausing during the pushing which doesn't make it very effective in pushing baby out quick but it is stretching so there will be less chance of tearing or an episiotomy. At one point, they asked me if I wanted a mirror to "see" what was going on down there--"No! Let's focus people and get this baby out!" I said. I request them to tell me when contractions are coming (via the monitor) because the epidural interferes with me being able to feel them yet I can intensely feel the Ring of Fire--how is that possible? In my mind, I'm wishing the doctor would just pull the baby out--feels stuck. Finally one of the pushes gets baby's head clear which is a major relief to the Ring and to me since I am utterly exhausted. In the final pushes, Anna says to be "fierce" but my first thought is of Christian Siriano.
But that didn't quite do it. So I then thought of a great white shark and that seemed to do the trick. Never have I felt such relief as when the baby exited my body. Whew.
It was surreal as they pulled her out and Ken cut the cord. He had to double-check then announced what I had suspected the whole pregnancy, that we had a girl. "This is Sidney," he said. We had decided on the girl's name years ago (like on one of our first dates) but we had a list of 40 boys names--nothing really standing out above the rest. So that was a relief. They placed her on my chest and vigorously rubbed her and got her bundled up. She had a long cone shaped head and her face was sort of swollen. Ken cried and I would have too if not for the exhaustion. So I just gazed at her and just couldn't believe that I had given birth.

Sunday, October 04, 2009

Got Milk?

I’d say 99% of my conversations these days with fellow mothers hit on the topic of breastfeeding. As a new mom, your life can be consumed by it. The schedule, the technique, the accessories, the whole process...

As they say “breast is best” and any breastfeeding you can do is highly encouraged. Enough medical evidence and social pressure exist to support breast milk as the best food for baby which is a shift from a generation or two ago, where formula was the modern and best way to go. We certainly agree that breast milk is optimum but why do so many women find it unintuitive and confounding to breastfeed? To put this in perspective, think of the most frustrating experience you’ve ever had where you didn’t accomplish your goal--now multiply that feeling by 10. That’s breastfeeding for team Moore-Sakai.

Sidney and I just could not even get out of the starting blocks on this one. Here’s the full story on our experience of breast feeding.

When I gave birth, the 2 mounds of flesh on my chest finally had a purpose and I was looking forward to this ability to produce something within my own body that could completely and efficiently nurture our child. And that’s where my enthusiasm for the process began and ended. Several issues contributed to our consummate failure at nursing/breastfeeding…

  1. Because Sidney was born 3 weeks early, she was very tired so her sucking was under-powered. This didn’t allow her to get the hang of how much effort she’d need to put out to get milk from the breast.
  2. We used nipple shields (plastic sheaths that go over your nipples that have holes in them) to give her something more defined to latch onto since her lower jaw was slightly recessed and limited her range of opening. From the outset, her latch was bad.
  3. As the days went on, we found out she needed to be treated for jaundice and the amount of hydration she was getting from the scanty colostrum I was stranded with before my milk came in was not flushing the bad stuff out. Not only did she have to be put on a light box to help dissipate the toxins, the doctors also recommended that we give her formula to start flushing out her system. So within days of her arrival and well before breastfeeding was established, she was sucking down formula from a bottle.
  4. Since breast milk works as a supply & demand phenomenon, the fact that she wasn’t adequately demanding meant my body wasn’t supplying so the amount of milk I was creating was not keeping pace with her need for it. We had to supplement with formula anyway.

But we soldiered on. We consulted a lactation specialist, our doula, rented a hospital grade pump and attempted to use SNS (supplemental nursing systems) which mimicked feeding from the breast. This included a tube and syringe that was precariously placed within the nipple shield that pushed liquid into her mouth or “finger feeding” where Ken would use that same tube and syringe but use put his finger into her mouth to ensure that she was sucking and latching somewhat correctly. So it took 2 of us to feed her every 3 hours and it was so tedious yet we hung in there.

At her 2 week check up, she gained back her birth weight plus 4 extra ounces so the doctor suggested we try removing the supplemental systems at SOME of the feedings. I, in my sleep deprived and eager state, heard “let’s cut over to nursing for all of the feedings.” At the time, she needed 2 ounces at each feeding so we supplemented ½ oz. of formula just to give her a safety net. We assumed she’d get the other 75% of her meal from the breast herself. We started this on a Tuesday night and noticed that while she would be fussy after most feedings, she seemed to be “doing it.” (Note: For the night feedings, we straight up gave her 2 oz of formula from a bottle per the doctor’s recommendation.)

We decided to be on the safe side and rent a highly calibrated scale where we could weigh her before and after feedings to see how much breast milk she was actually pulling. The scale did not arrive until Saturday, 4.5 days after we switched over to Sidney-powered nursing. You know what I said in the previous blog about her “latching and nursing pretty well”—yeah, not so much. To our horror, we realized that Sidney was only pulling .1-.2 oz. of breast milk on her own. That’s well below what we assumed she was doing and as a result she lost a total 6 ounces in those 4.5 days from her 2-week checkup. We immediately began giving her a bottle of 2 full ounces at all feedings from then on to get the weight back up.

I was traumatized by this turn of events. Despite our best efforts, there were so many obstacles in our way to make nursing successful. Our pediatrician was very empathetic and supportive of us. She commended our dedication to try to make breastfeeding work but glad that we had discovered & corrected the supply problem. She said many families would not have stuck with it as long as we had or gone to the lengths we did to try to make it work. So at that point, we decided we were done. Done struggling with a process that was supposed to be natural but was anything but for us. With my supply stagnating, her demand per feeding increasing and so much of her feedings being formula any way, we decided that we’d be weaning from breast milk entirely around 5 weeks.

She would already have received the vital antibodies at the 3 week mark which our pediatrician advised us was important and we’d know that for all of our efforts, we had really tried. It would also eliminate a huge piece of anxiety that surrounded all feedings. I know there is a very adamant and vocal community who would condemn our decision. Perhaps they would call us selfish or not committed enough to our daughter’s well being and welfare. But we really tried and it was heartily disappointing. Ultimately though you have to do what is best for everyone involved. Being raised on formula isn’t the end of the world though. So many of our generation were and thankfully there is that option when the breastfeeding just doesn’t work.

My advice to all soon-to-be and new moms who want to breast feed is to line up resources and contacts as soon a possible. Don’t be afraid to reach out immediately when you have questions or things don’t seem to be going right. Hospitals usually have programs that can assist and there are doulas & consultants ready to help in-home as well. If you want to try to make breastfeeding work, there are the tools and folks out there. I will say the breast feeding is definitely worth trying even if it doesn’t become the long-term feeding solution.