Monday, March 29, 2010

Our First Well Child Visit

I had Bebe on a Sunday afternoon, and I think our first well child visit was on Friday. I may not remember the day of the week, but I do remember the visit. We were at the doctors office a little early, and we waited for what seemed like an eternity. I fed her before we left the house, but I was nervous about making it back home for her next feeding. We had a fifteen minute drive to the doctors office, I was worried that I wouldn't be able to find the building,and we had been told that if we were not there ten minutes ahead of our appointment time we were late. We were there fifteen minutes early, and we had to wait another fifteen minutes past Bebe's scheduled appointment time before we were called back. So by the time we got into the office it had been about an hour since her last feeding, time was rapidly running out. A very nice nurse took us into a room, I changed Bebe into a clean dry diaper, and we headed to the scales. She weighed 6 lbs.,13 oz. I was very pleased with this not only had she stopped losing weight, she had gained an ounce! This had to be good news right?
We went back into the little room, and I happily wrapped Bebe in her blanket, and waited to met Bebe's Nurse practitioner. We waited, and waited, and waited. Finally Nurse H. walked through the door. She was a tiny little cute as a button woman. She had short curly hair, big blue eyes, and a lovely reassuring smile. I felt very comfortable around her. She looked directly at Bebe, and Said,"Hello Miss Bebe. I'm very happy to meet you. Look at you! Your just a beautiful little peanut!" Then it was my turn, she lovingly interrogated me for about twenty minutes, then she said, "We are having a big problem with this little girl. She isn't eating nearly enough, and if your accounts of her feedings are correct it is taking her way to long to eat. It should only take her five to ten minutes to drink a two ounce supplement. We need to speed that up, I'll get you guys a bunch of different sample nipples to try. The other problem is that you need to increase your milk supply. I see that you are drinking a lot of water already, and Kaysie's Mama, is she eating an extra 1000 calories each day?" My mother verified that I was. Then Nurse H. continued, "Alright, then it is time for a supplement for Kaysie. I want you to drink three cups of herbal fenugreek tea everyday. Also be sure that nothing disrupts Bebe's feeding routine." I was thinking to myself not even waiting an hour to get into see you at the doctors office, but I held my tongue. I did have to ask,"Isn't Bebe doing a little better since the home visit? She stopped losing weight, and she did gain an ounce." She answered me, "Oh yes, it is great that she has stopped losing weight, and I am very happy that she gained an ounce, but the problem is that she lost so much to begin with, and most children this age gain at least an ounce a day, and it has been two days since she was weighed last. Now normally I wouldn't need to see her for a month, but I would like you to bring her in at least twice a week for weight checks. You just drop by between 7:30 and 9:30 A.M., or 1:00 through 3:00 P.M. You don't make an appointment, you just show up, and we squeeze you in when other people are late. I would like you to come in next Monday, and Thursday. Then if possible bring her by on Saturday too." Now I had one more question, "How do I get her to eat faster." Nurse H. answered,"She might prefer a different nipple, but other than that I don't know I'm not an occupational therapist. Maybe you could show me how you are feeding her the supplement, and I could tell you how your supposed to feed her. It's almost feeding time why don't you try giving her the supplement first this time, and I will help you." I said that would be fine, but again I should have said no. I should have said, 'No. I don't want anything to disrupt her normal feeding schedule.' and left, but I didn't I fixed Bebe's two ounce supplement, and Nurse H. watched her drink, and gave me tips,"Try holding her upright a little more, pull back on the bottle, hold her closer to you, push her away, dangle her by her feet, flip her like a beach towel......." Alright so Nurse H. never said those last two, but you get the point it was exhausting, and none of her helpful hints were helpful. I had once more trusted someone else when I should have listened to the voice in my own head, and I had squandered yet another opportunity to breast feed my child. I felt like the stupidest woman on the planet. What could be easier than feeding a hungry baby? I didn't think that my child might be very hard to feed. I didn't think all these people that feed babies everyday can't feed my child either. I just thought if I can't even feed her enough or fast enough how am I going to handle the big stuff. I didn't realize that for Bebe, and me this was the big stuff.

Tuesday, March 23, 2010

Dairy Production

Later that evening my husband and I went to the hospital to see the lactation consultant. My mother and Bebe came along too, but they decided to stay in the car. The lactation consultant explained the process of pumping, and gave me some information to read. She then showed us a few pumps, and said that we could buy a pump, or rent one. If I used the pump for more than two months rental was the same price as the pump. We decided to buy it out right. We figured that this was our first child, and that it would be a good thing to have.
Then we were off to the store to buy all the things we needed for the pump; bottles, storage bags, microwaveable sanitizing bags, and just about everything else you can imagine.
Then back to the house. Time for another feeding, and now I got to add yet another step to the feeding routine. As it turned out adding the pump didn't add any time to the routine. At least not while my mother was around. The new plan for me was feed one side, then the other. Then I would hand Bebe to my mother for her supplement while I pumped for ten minutes. At first this was actually much faster for me.
After using the pump I decided to read all of the information. As I was reading I came to a chapter that I was very interested in. This chapter talked about special eating problems. The very first section was devoted to babies with jaundice. It talked about all the problems we had been having. It talked about how tired the child would be, and that because they were tired they would have trouble latching on, and that the baby would eat very slowly. It also said that establishing a good milk supply without a pump would be very difficult. Yes, this information was valuable to me. I only wish I had known this sooner.
*An interesting side note, six months after the fact I was talking with my sister-in-law about Bebe's feeding issues, and the fact that she was jaundiced, and she told me that jaundiced babies should drink only formula, because the molecules are bigger, and they will draw the jaundice out of the body faster. She said that a nurse told her if you want to breast feed a jaundiced baby, you should pump, and store, until the jaundice is gone.*
In the first day of pumping I was so surprised that I actually had milk in my body. It seemed so strange to me. I kept thinking this was so amazing. I had actual milk in my body. I was producing a dairy product. It even had cream on top! Then I noticed that I had very little milk. In one 24 hour period I was able to pump six ounces of milk. I know most women can get more than six ounces every time they pump. It wasn't much, but at the end on each day I had enough milk for one feeding. The lactation consultant said that if I could do this I could sleep through one night time feeding, and someone else could just feed her.
This seemed like heaven. I could sleep for one four hour block each day. You might be wondering if I woke up when the baby cried or was hungry. No, I did not, because she didn't wake up in the night. She would have slept straight through. We had to wake her, and now that I could sleep through one feeding waking her for one of these feeding was no longer my problem.

Friday, March 12, 2010

Trouble

I think it is funny that everyone tells you to get all the rest you can, to sleep when the baby sleeps, and all of that. In the very next breath they are telling you that you need to go to the lab for blood work, You need to swing by the hospital and visit with the lactation consultant, you need to get a prescription filled, you need to stuff your face with food, and drink a few gallons of water. Then it is time to feed the baby again, and after that you find out that you have to return all the diapers you just bought(the baby can't wear huggies or she breaks out into a terrible rash). Then you remember that you need a birth certificate, and a scocial security number, and when you get the card they have spelled the baby's name wrong,and you get to start all over again,and blah, blah, blah......
Our hospital offered many wonderful programs, and we took advantage of all of them. Two days after leaving a nurse is sent for a home visit. We were not sure when the nurse would be coming, but we thought it would be best to go about our normal feeding schedule. Every two hours, just like clock work, we would feed left side(15 minutes), right side(15 minutes), then a two ounce supplement. She always took her time eating, and still she would only drink about an ounce of the formula.
The nurse came about ten minutes after we fed Bebe.
She checked me out first. I was doing fine, and healing nicely. No trouble at all. Then it was Bebe's turn. She looked her over, and checked her jaundice. I think she was at an eighteen, but leveling off, so she wasn't too worried about it. Then she got out her scale. I wasn't worried. After all, what did I have to be worried about. The baby had done nothing but eat. It took her nearly an hour to eat, and she was fed every two hours. so about half my day was spent feeding her. Before putting the baby on the scale, the nurse warned us that the baby had probably lost a little weight. She told us not to be alarmed. Then she placed Bebe on the scale. The scale read 6 lbs. and 12 oz. My mother and I looked at the nurse anxiously. She read it again, and said,"There must be a mistake. How much did she weigh at birth? The chart says 7 lbs. 10 oz. Is that correct?" We said yes. She asked us to give her a few minutes to calibrate the scale again. We waited. Then we put Bebe on it again, and again the scale gave the same reading. The nurse called Bebe's doctor to let him know the situation. She was unable to get Bebe's doctor directly, but she spoke to his nurse practitioner, Nurse H.
She said that my milk still might not be in, and advised me to go see the lactation consultant yet again, and buy a good breast pump. Then she asked if she could watch the baby eat. By this time it had been about thirty minutes since her last feeding. I told the nurse this, but she didn't seem to care. Bebe was always exhausted after her hour long eating marathon, so waking her up was pretty difficult. We had to undress her, and change her diaper. Still she was not fully awake, and she wouldn't latch on. My mother kept saying, "I don't think she is hungry. She just eat before you came." Still we tried to wake her and feed her. Then the nurse asked me about the routine we had established. She was shocked, "It takes her an hour to eat! Why?" We explained how the lactation consultant had told us to feed her, and she said that it should never take more than thirty minutes to feed a baby. I wasn't sure how to respond to that.
Then she asked us how we were giving the baby her supplement. We said that after feeding her on both sides we gave her a two ounce bottle of formula. She was appalled, and said that she shouldn't have a bottle if I was going to breast feed her. Then she went out to her car, and came back with a crazy elaborate contraption. It was a bag that we could put formula in, and a tube that had to be taped to my body and fed through my breast guard. Still Bebe wouldn't latch on, and this terrible thing I was hooked to was impossible to use, unless I had six hands, which unfortunately I do not have.
I asked again,"Is it possible that the baby just isn't hungry right now?" The answer was,"Even if she isn't hungry she should want to eat." Why? Why should she want to eat when she isn't hungry? I just didn't understand. I know that I don't want to eat when I'm not hungry.
Finally the nurse gave up on the breast feeding. I thought the home visit was over, but I was wrong. More torture was just ahead. The nurse then insisted that I feed Bebe her two ounce supplement.
We put the formula in it's usual bottle. She wouldn't eat. We tried all different types of bottles, and many different nipples, and still Bebe wouldn't eat. This woman had now been in my house for two hours. The same amount of time that typically lapsed between feedings.
Finally Bebe opened her big, beautiful eyes, and took the bottle into her mouth. She took her sweet time, but she drank the whole two ounces. While she was drinking the look on her face was priceless. In my mind she was looking at the nurse as if to say, "Look lady, I'll drink this bottle on one condition. You leave after I'm finished!" The nurse felt like this was a huge success. I did not. It was her scheduled eating time, and I didn't even get a chance to breast feed my baby. How was I ever going to get my milk in if these types of things kept happening? I felt like it was a huge waist of time.
The first thirty minutes of her visit was just fine, and really nice. I wished that I would have been firm with her, and said,"No, you may not watch her eat, unless you want to come back in two hours when she might actually be hungry."
All told, it took three grown women about two hours to try to convince a four day old child to drink a two ounce bottle of formula.

Sunday, March 7, 2010

Going Home

That night as I drifted in and out of an uneasy sleep, I heard a little coughing sound. I was startled to a completely nervous state. I looked over into the bassinet, and saw that Bebe's mouth was covered with formula. I, being a first time mom, freaked out just a little bit. I jumped to my feet, and walked around to pick her up. I grabbed the bulb syringe, and began removing the rest of the vomit from her mouth. More was coming out. She was like a slowly flowing fountain of slightly soured formula. I tipped her on her side, and then I noticed that she was also laying in a pool of vomit. What? She had only drank at most an ounce of formula. How could so little going in look like so much coming out? I called the nurses station, and told them the problem. A very sweet nurse came in to help me clean Bebe up. I remember that I was talking really fast, and I asked her why she was throwing up, and if there was something wrong. I then felt all the blood drain from my face, as I had a new thought. What if I hadn't heard her tiny little cough? She surely would have drowned in her own vomit while her mother was sleeping only 12 inches away! I voiced my concern, almost before I finished having the thought. I was in full panic mode, when the nurse said with a very sweet smile, "Kaysie, do you see that she in laying in some of the spit up?" Yes, of course I showed her that. "O.K. So that means that she did throw up while you were sleeping. And look what Bebe did. She just turned her head, and let it roll out of her mouth." Then she said, "Relax, and I'll tell you a little secret about babies. First they want to live, and second babies are much smarted than people think. Everything is alright." Then she smiled and left the room. This Mother Thing was going to be tricky.
The next morning while the nurses were busily working to prepare for my departure, I decided to drag myself into the shower. I am the first to admit that I am a vain woman. Yes, I dress up to go to Walmart. I know it is an illness, but admitting it is the first step to recovery. Right? However, I went into the hospital with a completely naked face, and during my stay I did not fix my hair. I did not wear any makeup. I did nothing to beautify my appearance. I did brush my teeth four or five times each day, and I'm not sure why I was doing this. I didn't care how I looked, but I just couldn't seem to get rid of that dirty mouth feeling. I had taken a very brief shower, and washed my hair the day before, other than that I had done nothing vain during my stay.
I climbed into the shower, and took of my hospital gown, and made what I feel was a crucial mistake. I looked down. There I saw the shattered remains of what had once been my glorious flat nicely sculpted stomach. Now it was in flabby ruins. My belly button was a wide yawning hole seeming to cry out,"What have you done to me!" I took a breath, and said,"It is worth it." I vowed then and there that I would not look down, or think about the state of my body for the next six weeks. I would not go anywhere near a scale, and I would not exercise until my doctor gave me the O.K. at my six week appointment.
I got cleaned up, brushed my hair, and of course my teeth. Then I got dressed, and put on my makeup. With eyeliner securely in place I felt a bit more like myself. I relaxed, and waited to see Bebe's doctor.
He came into the room, and checked everything out. her jaundice was at a higher level than the day before. I might be wrong, but it seemed like she was at a fifteen. He said that if it got up to 19 she would have to come in to the hospital, and may have to stay for treatment. He also said that he wasn't too worried about that, and said the we would have to take her to the lab for blood work the next day. I told him that we had scheduled an appointment with Nurse H., his nurse practitioner, for a well child visit on Thursday. He said that was great, and that he was looking forward to having Bebe as a patient.
For anyone who knows my husband you also know that he is not the type of person who waits for anything. We were supposed to check out at noon, but at 11:15 he began to get restless. I was able to keep him calm, and quiet by saying that I wasn't ready to go, because the baby wasn't dressed yet. With the help of him, and my mother we got the baby ready to go. She was not a preemie or a small baby. She was not low birth weight, but my aunt, the same one who had witnessed Bebe's birth had also given her an adorable tiny preemie out fit to wear home form the hospital. It was a little white top and pants with little pink, and yellow flowers, and ruffles on the bum. My husbands sister had sent her the most adorable little pink booties, they looked like maryjanes, and although they were so tiny Bebe's feet were lost inside them. We brushed her hair, and put a little cap on her tiny head. Then we swaddled her in a pink and white checkered receiving blanket. After she was all dressed and wrapped she looked like a little caterpillar with enormous eyes, and so she was given the nickname of Bebe Bug.
Now it was 11:30, and my husband no longer distracted was ready to go again. He went and got the car, and brought it to the loading zone. Then he came back, and said to get all my stuff we were going. I took my time packing things up, and he and my mother took everything down to the car. He was ready to go so we headed to the nurses station. When we got there they were surprised. One nurse laughed and said,"Most of the moms have to be dragged from their rooms, and you guys are telling us to stop dragging our feet." Then they explained that we needed to sign a few more papers, and then we would have to wait for a wheel chair. My husband thought this was really silly. He said,"Kaysie is tough she can walk." Then they explained that yes, I could, but I had to be the one to carry the baby, and I had to carry her in her car seat, not in my arms. My husband quickly answered,"That's O.K. She can do it." I was stunned. Did he not realize what I had just went through? Did he not witness the birth of our child? I was exhausted form the walk down the hall, I was about ready to pass out just from standing there signing papers! I told the nurse that I would gladly wait for the wheel chair. She walked away to get it, and my husband said,"How do you think you are going to take care of the baby if you can't even walk to the car?" I calmly said,"Why do you think my mother is here? Why do you think she is staying for a week? I need help right now." We waited for the wheelchair, and he apologised for thinking I was super woman.
After being wheeled down to the car, and strapping the baby in we were off. We took Bebe home for the first time. It was so strange. Just a few days earlier my husband, my mother, and I drove to the hospital in the dark still night. Now we drove home, my husband, my mother, my baby, and I in the light of day. It seemed like an eternity since we left for the hospital. We Got to the house, and took a few pictures of her homecoming. Then we entered the house, and took her to the room which we had prepared for her. She met her kitty brothers, and we settled in for the ride of a lifetime.

Monday, March 1, 2010

Quiet Time

The time went by quickly. That is to say except for the twenty minutes of terrible pain that came every two hours. It was clear to me that I was not toughening up as quickly as I had hoped. I am sure the nurses felt the same way, because I continued to bother them by asking for help every time I had to feed the baby. I continued to think that someone would say,"Hey, wait this isn't right let me help you." That didn't happen. My doctor came, and asked if we would be going home that day. I laughed and said no. I planned to stay until we got the breast feeding thing down. She breathed a sigh of relief, and said that she really felt that it was best especially for first time mothers to take their time, get the help they needed, and not rush right out the door.
My mother, and my husbands parents were at the hospital early that day. My husband had to work, so he was in and out. The hospital schedules two hours of quiet time for mothers and babies each day. There are to be no visitors, and really they prefer that the father, isn't there either. Quiet time started at 1:00 and was over at 3:00. My husband decided that rather than sit around silently he would spend some time with his father. Our mothers decided that they would go shopping together. I was all set.
Until this point Bebe had been silent. I was looking forward to having her all to myself. Everyone left. A nurse came into the room with magazines and snacks. As she left she closed the blinds, and turned down the lights. Bebe was in her bassinet quiet, but with eyes wide open. I settled in and began to eat my snack. As I took the first bite, the baby seemed to be watching me, and she let out a little squeal. How odd. I took another bite, and again Bebe cried out. I stopped what I was doing and picked her up thinking that she just wanted attention. I brought her back to the bed, and sat down with her. Then I grabbed my snack, and with every bite the baby became more irate. By the time I had finished my cookies Bebe was in full blown fit melt down mode. I didn't know what to do. I wanted her to be quiet. I felt like she would ruin quiet time for all the other mothers, and I didn't like the idea of everyone thinking, 'I really would have enjoyed my quiet time if the baby in the next room would have stopped screaming for a few minutes!' I began to walk around the room with her in my arms. This was no good, the screaming seemed to escalate. I sat in the rocking chair with her. Still she was not going to calm down. I had never been around babies this small, and my arsenal of ideas was quickly used up. I looked at the clock. Bebe had been screaming for an hour! Then I had one more thought, I began to sing in a small soft voice,
"Smile, though your heart is aching.
Smile, even though it's breaking.
Though there are clouds in the sky you'll get by.
If you smile through your pain, and sorrow.
Smile and maybe tomorrow, you'll see the sun come shining
through, for you.
So light up your face with gladness.
Hide every trace of sadness.
Although a tear maybe ever so near.
That's the time when you keep on trying.
Smile what's the use of crying.
You'll see that life is still worth while.
If you just smile."
It worked. She was asleep. Now everyone could rest. I lay there thinking. Why was she so inconsolable. My milk hadn't come in yet. She was hungry. I know that it takes about forty-eight hours for most women to get their milk, and I know that all the books say that the baby isn't hungry until then, but I heard my baby crying, and that was one very painful cry. She was hungry. Then in the quiet I had an epiphany. Yes, I had called the nurses every time I had tried to breast feed, and yes, they had come into the room, and told me everything was alright, but I knew it wasn't. I knew it was seriously much too painful, and nothing was the way the books had said it would be. Yes, the nurses had looked, but they had not really stayed long enough to see what I was talking about. I had to appeal to a higher authority, and I had to do it quickly. As soon as quiet time was over. I was going to call the lactation consultant. She would be going home at five. My mind had been so cluttered that I had forgotten about her existence.
I took a little nap, and soon I heard voices in the hall. The visitors had been allowed to come back. My visitors were not there yet, and I thought I might have time to get help before they got back. This would be great, because it was something I would rather take care of in private. I called the nurses station, and asked them to send the lactation consultant. The the person I was talking to had no doubt helped me, because she said,"Are you sure? Because you already saw her yesterday, and she is very busy. I think you just need some more time to practice, and we would be happy to help you." I said no. We had already tried it that way, and I knew that things were not working they way they should, and they were not helping me. She said that the lactation consultant would be there as soon as she could.
In the mean time I met with a pediatrician who took the baby for some testing. When they brought her back the doctor stayed to tell me how she was doing. Everything seemed to be just fine, but she was slightly jaundiced, probably because my milk hadn't come in yet. I really liked this doctor, and asked if he was taking on new patients. He said that he was. He also said that most people saw his nurse practitioner, or physicians assistant, unless there was a real health problem. after he left I called and set up a well child visit with his nurse practitioner.
Soon my guests came back, and I was still waiting for the lactation consultant, and it was just my luck that she didn't come until I had a room full of people.
She was a large, loud woman, and when she entered the room she announced that all men needed to find something else to do because,"We have a little mama who needs help, and the breasts are coming out." Wow, right to the point. She said that she needed to check my breasts first. As she looked them over she had a very concerned look on her face. She said,"Oh Honey, you are really damaged. This isn't right at all!" Finally, I was right! But my happiness was short lived. She asked me, why I hadn't called the nursing staff for help. I lost it. Until this point I had had tears in my eyes on many occasions, but I only count it as crying if the tears spill out of my eyes, and this was a massive break down. I told her about all my troubles. I told her how I had called the nurses every time I tried to feed the baby. How I told them that it was much too painful. How they told me to toughen up, and rolled their eyes. She was shocked. She could not believe that anyone paying any attention at all would allow me to continue to put myself through this. She said that I was right to call her. She told me that the damage was so bad that if I was still interested in breast feeding I would have to use a breast guard until I was able to heal, and that I might have to wear it for the rest of my breast feeding life, because once introduced the baby and I would become reliant upon it.
She left to get one for me, and I was so embarrassed by the way I had broken down. My mother-in-law came over to the bed, and hugged me and said that she was so glad to see me cry. She had been worried that I hadn't done this yet. I said that I was always planning to cry, but just in the privacy of my own home, and I really didn't want to do it in front of a complete stranger.
In the hall I heard the lactation consultant talking to the nursing staff. It was very professional, but I knew that she was going to have words with them in private. Then she was back, and She helped me learn to use the breast guard. It worked! It was no longer painful, and I actually felt like I could do this, but I still didn't have any milk, and Bebe was getting very irritable. I asked it there was anything we could do she quickly brought her a supplement, and said that she would be much more agreeable if she had a two ounce supplement after each feeding until the milk came in. She told us that Bebe should drink it in five to ten minutes, and that if she didn't finish it in a half hour we would have to throw it away. She said that it really should be gone long before that. I started to feed her the bottle, and she wasn't very interested, and no she did not finish the bottle in thirty minutes. She was very sleepy, and only drank about half an ounce. I didn't know it at the time, but this was the beginning of a very ominous pattern.