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.

Tuesday, September 22, 2009

What's new

The long silence on the blog can only mean one thing and I apologize for the delay but we've been uh...busy.
Ken and I are pleased to announce the early arrival of our daughter Sidney Katsuko Moore back on 09-09-09 @ 8:17am. She weighed in at 6lbs. 8oz. at 18 inches long.
She was originally due on 9/26 and was actually scheduled to arrive via c-section on 9/21. However, upon arrival at the hospital on Tuesday 9/8 in the early morning after my water broke, we were told that the complication that prompted our scheduled c-section was no longer present. So natural childbirth was back on the table. It's funny because Ken and I had been told since week 24 that we were having a c-section so we skipped all the chapters and classes on labor/childbirth. But thankfully we have the best doula in the world, Anna, who guided us through the experience and really empowered us to have the best birth possible. (I will write specifically about the birth experience in a separate blog later.)
Since being home...
My mom was here from 9/10-9/15 and we couldn't have survived those first days without all of her dutiful assistance and just ensuring that the household had food, clean dishes, clean laundry and moral support.
My dad and brother came up on on the weekend 9/11-13 for a previously scheduled WSU exhibition game.
Then my cousin Angela (who we neglected to get any pictures of while she was here) came up for this last weekend 9/18-20. Her help was instrumental in giving us some opportunity to get rest and to spend more quality time with our daughter instead of tending to household chores.
We are hanging in there but the sleep deprivation is ridiculously taxing. Sid likes to be alert and awake from 1-4am. We call it the "witching hour". Thankfully we reviewed the Happiest Baby on the Block DVD the other day so we have tricks to calm her down but she won't necessarily sleep during that time. But the doctor says it will get better when her circadian rhythm gets righted. That will take awhile.
She had jaundice initially and was diagnosed with a high enough level that we had to get a special bed with lights in it to help dissipate the toxins. In addition we had to give her formula since my milk hadn't come in yet. She had to be on this light table 24/7 except when changed and fed. It was so sad because we really couldn't interact with her and she was so lethargic due to the jaundice. It was quite trying. Everyday a nurse would come here, weigh her, examine her and take a blood sample to see if the levels were improving. Finally four days later the level dropped enough to take her off the box. It was so weird being able to have her in the living room and hang out with us. But we were very glad for it.
Breastfeeding has been difficult for a number of reasons: Sidney being 3 weeks early (not having the jaw strength initially), the jaundice, my nipples being flat and her jaw is slightly recessed. Milk finally did come in and I got engorged--hurt so bad. We made an emergency call to a lactation consultant and now I have a hospital grade Medela pump---within 24 hours it has made a world of difference--boobs are nice and happy again. Because it was so critical to get her ample nutrition and irradiate the jaundice, we had to supplement her big time with formula.
Gaining a decent milk supply is a multi-faceted puzzle with lots of interdependency. It can get really complicated and frustrating really fast. The milk supply is best stimulated by the baby herself--but the baby needs to latch/suck to do this. In order to latch/suck, you need a properly shaped nipple. If you are not born with this, a nipple shield (plastic sheath that goes over nipple) will suffice but it is not as efficient or effective as the real boob. We were told to use a tube & syringe that feeds into the nipple shield to deliver the supplements of breast milk (~40ml) & formula (~20ml) while simulating the act of nursing for Sidney. This way she would get used to the experience when she could do it for real. This equals about 2 oz of liquid a feeding x 8 feedings daily.
At first, the syringe business was excruciatingly awful but we rose to the occasion and Sidney responded well. Maybe a little too well. When we went in to the doctor Tuesday to get her 2 week exam, she had gained 8 ounces in 4 days for a weight of 6 pounds 12 ounces which is 4 ounces over her birth weight. It was suggested we get moving off of the syringe feedings and solely onto nursing with/without the nipple shield. We are actively trying to make this transition which also throws our formerly very strict feeding schedule of every 3 hours into a freestyle watch-and-wait feeding cycle which makes Mama & Daddy very tired. It sure is complicated but the good news is, Sidney is latching & nursing pretty well. When she hits her expected due date of 9/26, we are hoping see an increase in her energy level and feeding prowess.
But things change on a moment to moment basis. We learn things and observe patterns. Life is cut up into 3 hour segments. It's unlike anything I've ever experienced and I can't believe I'm some body's mom...

Sunday, September 06, 2009

Preparing for Baby: Classes

To have a baby these days, it seems preparation is the key. You can read books and watch DVDs but if you are fortunate to have access to classes, by all means take them. Because Ken and I are nerds at heart, we took and are taking as many classes we can. After all, there is something to be said about having the wisdom of others passed on, have the benefit of a live session where you can ask questions and being around other people in the same boat as you.

The hospital system where we are delivering (Swedish) has an extensive "curriculum" that soon-to-be-parents can attend. They even have a grandparents class that sadly none of the Wetus grands will get to take. (But I know the Testas are going to do this so perhaps we will get a report...) If you are eager to learn and interact, it's best to get the Welcome package for a lump sum of $250/couple. That let's you sign up for almost all of the flagship classes and keeps the transactions quite easy. Once you sign up and pay your fee, you just use a code to register online for the classes/times of your choice.

We've taken:
  • Childbirth Preparation class--Planned Cesarean Birth w/Hospital Tour: It's good to know what to expect and some of the nitty-gritty details of this type of deliver. Though they don't tell you "everything." You have to consult close girlfriends for those gems.
  • Postpartum Preparation: How it's normal to feel overwhelmed and under the control of "aliens" right after baby is born. But really it has to do with hormones, sleep deprivation and a brand new creature who relies on you for its very survival. Coping skills.
  • Newborn Care: Swaddling, diapering, bathing, warning signs and more.
  • Breastfeeding: There is a lot more to know about this than you may think. Especially if you want to do this with some level of success.
  • Infant Safety & CPR: A very empowering class. To know how to do CPR-- and on an infant even, you feel pretty tough and prepared.

Still to take in the next few weeks:
  • Conscious Fathering (Ken only): We've heard many dads enjoyed this one.
  • Car-Seat Installation and Safety: 80+% of car seats are installed incorrectly. I know we both have college degrees and astute minds but this is something we have to get right.

But one of the most rewarding classes which is not included in the Welcome package is a 2-day workshop designed by John & Julie Gottman of the Gottman Institute @ UW. It's called Bringing Baby Home. It's taught in the Swedish system and is more about how your marriage or relationship is affected by the new baby. You work on tools and skills to help you stay connected with your partner when you are both sleep-deprived, emotionally drained and vulnerable to high relationship dissatisfaction--all of this due to the new addition. Even if you have rock solid relationship, it's a good way to arm yourself with tools and understanding that the challenge of parenthood will place a strain on a marriage. How you deal with that affects not only the couple but the children. We highly recommend it.

While I did an entry on books earlier, I want to plug a book that just came out that I REALLY like. It's called Baby 411, by the same folks who wrote Baby Bargains. Based on good science, it is straight-forward on all the 1st year topics and very easy to read/retain with no-nonsense chapter about vaccines. Again, it's based on actual scientific evidence, which we respect and will uphold.

H1N1 Outbreak @ WSU


This does not bode well. With WSU in town next weekend for an exhibition game @ Qwest and some get togethers with folks from there, I'm a bit nervous.

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Right now as a pregnant lady, I am a member of one of the highest risk groups for serious complications from the H1N1 (Swine) Flu. The vaccine will not be available until mid-October (after I deliver) so then my newborn will be at highest risk with no chance for a vaccine until 6 months of age.

From www.flu.gov:
Videos on what to do regarding H1N1
Page for pregnant women about H1N1