[setting: a dimly lit living room, with the TV on in the background]
Mama: (to sleeping baby in her arms) [Tearful mushiness about how much he’s loved and what a life-changing miracle he is. Blathering continues about how beautiful he is, and how Daddy is going to be his best friend]
Kieran: [faaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaart]
Oh the joys of having a boy. I’ve tried to explain to him that the time wherein farting and burping are encouraged is finite, so he better enjoy it while he can.
This week has been kinda rough for us all. Kieran’s sleep patterns changed to naps of an hour or less. His usual little bit of fussing after feeding increased to nearly an hour or more of arched-back screaming. He started spitting up, not just directly after feedings, but an hour or more later, and while he was asleep.
Kieran has always been gassy – literally from birth, but this was more than his usual gassiness. (I’m starting to notice that the tummy part of his sleep & play outfits is slightly more worn and pilled than the rest of the outfit from where I rub in firm circles for 20 minutes or so after every feeding.) I was really starting suspect Acid Reflux, which is really quite common in infants. (More and more pediatricians are thinking that what was diagnosed as “colic” in years past really was acid reflux.)
On the advice of the lactation consultant on Thursday, I made an appointment with the pediatrician to check Kieran out for reflux. I was able to snag a cancellation appointment at 3:45 yesterday afternoon, thank goodness. I didn’t want to go through the weekend with Kieran crying in pain after every feeding. (Talk about feeling helpless!) Dr. Alazard was pretty open to the idea of reflux when we presented all Kieran’s symptoms. He made a couple of suggestions for isolating the problem:
We came home after a long afternoon of the doctor’s appointment and then a trip to Walmart to actually purchase the Pedialyte and oat cereal and whatnot. Kieran got his bottle of unflavored Pedialyte and acted the same as he had been, but worse. I’d never heard him scream like that before. He was bordering on frantic, which is just heartbreaking to hear. Knowing that he’s in such pain and there’s nothing we can do to take the pain away.
I decided to break the rules and give him the medicine then. I’m more interested right now in preventing my child from being in pain than figuring out what kind of formula to give him. The meds are supposed to be administered three times a day, 15 minutes before a feeding. It took until a third feeding for them to kick in, but when they did it was blissful. The 2:30am feeding was peaceful, with Kieran calm and relaxed, with nary a back-arch or squawk.
We are also making sure we keep him vertical for at least 15 minutes after a feeding. Paul put bricks under the far side of the crib, so Kieran sleeps on an incline now too.
So while we’re thrilled to have the meds in our arsenal, we’re kinda stuck now for checking out other kinds of formula or possibly altering my diet. We don’t want to stop giving him the meds, because we KNOW we’re dealing with reflux – so regardless of what he eats after we stop the meds, he’s gonna have pain and spitting up. We’d prefer not to have to change his formula, and REALLY prefer not to have to change my diet – especially cutting out dairy. We’re HUGE milk drinkers in this house, so cutting out dairy would be akin to cutting out water.
I’m pumping as much as I can right now (a proper-fitting hands-free bustier thing is helping SO much with that) to build a several-feeding supply of breastmilk so that we can try to ‘reset’ Kieran from one formula to another in another day or two.
We’ve started another tactic this evening with thickening Kieran’s bottle with some oatmeal cereal. OMG, if it’s possible for a baby to be drunk, we think we achieved it this evening. The nipple had to be enlarged so that the thickened formula could come out, and Kieran (Mr. LAZY nurser) loved just having this amazing elixir thrown down his throat! Here’s hoping the combination of Zantac and thickened formula will keep everything down – cuz Kieran has been urping formula all afternoon. (Maybe soy isn’t the best for him, huh? We’ll be switching back to the regular Similac formula on Monday or Tuesday.)
So we’ve joined the ranks of parents of reflux babies. Here’s hoping the solution stays simple. We just don’t want our baby to be in pain.
This has been an amazing couple of weeks at home. Paul and I have found a rhythm that seems to work for us, and we just go with the flow as much as possible. Kieran sets the pace and timing of our days.
Life right now is a series of 3-hour cycles consisting of waking up, changing a diaper, feeding him (breast, bottle or both), burping, changing diapers again if necessary and then getting him back to sleep. Sometimes this whole reboot takes 45 minutes. Usually it takes a good two hours. Just depends on how fussy Mr. Kieran is feeling and how gassy he is (it’s worse in the evenings.) Kieran needs to eat every three hours or so, so the length of the nap is dependent on when his little tummy starts growling again. We get a longer nap out of him when he’s only had formula, since it takes longer to digest. (As opposed to a breast milk bottle or a mixed bottle of EBM and formula, which is what he gets most often.) He’s now starting to have longer awake and alert periods after a meal, which is really cool to get to interact with him for a while before he passes out.
Paul and I mostly stay awake together during the day (hopefully catching a nap during the day too) but at night we tend to trade off a bit on who gets up. I tend to cover the midnight-ish shift, Paul catches the 3:00am-ish shift, and I’ll be up with Kieran around 6:00am or 7:00am when he’s back up, since the 3:00am shift tends to be a longer one these days. I let Paul sleep in as late as I can, usually to the 10:00am-ish cycle. Then we’re both up from there to do it all over again. But we’re both flexible and frequently get up together in the dark of the night to keep each other company or at least to help make a bottle while the other one changes Kieran. Once Kieran gets good and going at being hungry or wet, it’s hard to ignore, even if you are still in bed. We both find it easier to deal with being up (again) when we’re not doing it by ourselves. We’re watching a lot of NCIS and Law & Order these days.
Kieran has two main nicknames these days: Pumpkin (cuz that’s just what I call him) and SquirmBot, because holy cats, this child was built to SQUIRM and he’s an expert already. He has two best friends: Mr. Hand and Mr. Hand. He chews on his hands all the time and always has them in his face. He’s constantly trying to poke his own eyes out. (Yes, we keep his fingernails trimmed because of this… he came out with a big scratch under his eye and we want to avoid that in the future, plus he claws the hell out of my boob while he’s nursing.) Feeding is fun because we constantly have to explain to him that while his hands are undoubtedly fun, they provide no nutrition and thusly won’t help his grumbly tummy. We’re getting better at prying his hands out of his mouth and quickly jamming in the bottle or boob. But it’s incredible to watch him play with his hands – it’s like he’s conducting some symphony that only he can hear.
Kieran is starting to really fill out his newborn clothes and diapers. We’ve had him in newborn sized disposable diapers because his cloth diapers were too big when we brought him home. The preemie-sized cotton inside parts fit fine, but the outer waterproof covers were too big. Now the preemie-sized cotton inside parts are getting a little snug, but the next size up are HUGE on him. We’re using cloth and disposable now – and will be making good use of the various-sized partial packages of diapers that Caroline and Jamila gifted us from their growing babies. We’re thinking that maybe we can strap Kieran into a size 1 diaper this weekend and it maybe won’t fall off his little bottom.
But yeah, cloth diapers are in effect!! Paul and I are both very happy about this. They’re easy to use (not any harder to apply to SquirmBot than a disposable) and honestly Kieran seems more comfortable in them. He truly squawks less during cloth diaper changes. And for Paul and I: not seeing weird little moisture absorbent chemical crumbs on our baby’s little junk is comforting. Disposable diapers are a necessary evil as far as we’re concerned, so we’re happier all around when we don’t have to use them.
I’m positive that all parents feel this way, but Paul and I marvel at how beautiful Kieran is. He’s just so FREAKING CUTE. The looks he gives us when we’re trying to burp him, with his little forehead all wrinkled up… I can only imagine that as a toddler he’s going to glare at us for something and it will be all we can do to keep a straight face.
It still doesn’t seem real that we have a baby. I am in awe of myself that I was pregnant and gave birth to a healthy child. It almost seems like a dream now that I was ever pregnant. Other than occasionally leaking boobs and a few new stretch marks, I’d never know that 24 days ago I had a 6lb4oz baby inside me. Oh, and the 8″ incision across my bikini line… (For the record, total weight gained during the pregnancy was 18 pounds. I walked out of the hospital back at the same weight I was at my first OB appointment at 5w4d, and as of last week’s checkup with Dr. Schwartz I was 9 pounds under my 1st appointment weight. I’m not trying to lose anything, but between breastfeeding and forgetting when I ate last, it’s coming off anyway. Mind you, I’m not complaining – but I don’t expect it to last either.)
My life is absolutely not what I thought it would be a year ago. It’s like the slate has been wiped clean for me. I didn’t have a “five year plan” or anything specific for myself, but there were certain assumptions I had about how things would continue for Paul and I. Now all that has changed. I can’t see very far into the future now, and that scares me a little. (OK, a lot.) But I’m confident that Paul and I will make it good for our little boy, regardless. It’s all about him now.
I am enjoying this time with my husband as much as I’m enjoying my baby. Paul and I are really working together as a team – as I knew we would. We’ve always been good at that. But now we’re …. more. It’s hard to describe, but Team Us is even stronger now. I’m finding all new reasons to love Paul. He’s taken SUCH good care of me during the pregnancy and afterwards, even with the gross after-Cesarean stuff. He’s still always trying to make me take it easy and has been constantly reminding me that I did just have major abdominal surgery. He’s been incredible as I struggled with Baby Blues and hormones and the breastfeeding troubles we’ve had. (SO.Much.Crying.) The hugs in the kitchen as I’m cleaning bottles and breast pump attachments and he’s making more formula. The forehead kisses and slurred “I love you” as we both pass out in bed, nearly asleep before our heads hit the pillows. The laughter as Paul gets pee’d on AGAIN. (Eventually he’ll get the timing down of covering the teeny peeny with the clean diaper faster.) But most of all: seeing Paul with his son. It takes my breath away and chokes me up every time. I know that look he has on his face when he’s talking with Kieran – I’ve seen him look at me that way. I love him all the more for giving me my son.
Breastfeeding isn’t going as well as we would have hoped. There are several factors at play here:
Kieran just isn’t good at breastfeeding. He isn’t “tongue tied” but the connecting tissue at the base of his tongue is thicker than normally seen, and it is a little farther forward than normally seen. Not enough to need medical treatment, but enough to make it harder for Kieran to nurse. He “snacks” instead of really sucking. The Lactation Consultants say that he is “inefficient” with his nursing. This isn’t a good thing because his nursing never truly empties my breast, so the signal to make more for next time isn’t/wasn’t being sent. (Having to give him formula from a bottle starting in the hospital didn’t help matters, because Kieran got a taste of what a bottle is like, and he doesn’t want to have to work for food like he needs to work for breast milk.)
My medical issues (Hypothyroid and PCOS) are two big strikes against me for creating a sufficient milk supply. These are the same issues mostly responsible for me not being able to get pregnant for so long. I’m taking a ton of herbal supplements right now and am adding things like flax seed, oatmeal and brewer’s yeast to my diet (in the form of Peanut Butter Oatmeal cookies) to try to boost my supply; with limited success so far.
I’m using a rented hospital-grade pump instead of fully nursing Kieran now as well. The hospital pump is much better for creating and maintaining a supply as opposed to the pumps you can purchase in the store which are intended to maintain and eventually gently reduce a well-established supply.
Kieran is offered the breast most of the time when I feed him, and he’s offered “comfort boob” often in the evenings after he’s had a bottle. “Comfort boob” isn’t for nutrition purposes; it’s just to give Kieran and me a chance to snuggle together, skin to skin and gives him an outlet for his need to suck. Also, when he’s being fussy and fighting falling asleep, nursing him for a bit puts him right out.
We’re seeing Lactation Consultants weekly for help with positioning, latching, supplementing, and as cheap psychotherapy for me. I had so much pinned on exclusive breastfeeding that the reality of it not working was something that was incredibly hard for me to accept. Crying in frustration as Kieran fussed and cried at my breast, weeping in sadness watching as Paul fixed yet another formula bottle for our baby, and feeling big hot tears of guilt and rage roll down my cheeks as the guilt and shame of not being able to provide all my baby needs washed over me again and again in those first two weeks. Paul had to put up with so much crying initially, from both Kieran and me. I was having panic attacks several times a day. The feelings of fear, dread, anxiousness and being completely overwhelmed were awful. I really thought that Postpartum Depression was setting in with a vengeance. I couldn’t sleep even though I was exhausted, and was starting to have nightmares again.
But one of the LCs confided that even though she’d lose her license for saying it: formula isn’t the devil. Breastfeeding isn’t the end-all, be-all of everything for the baby. SOME breast milk is better than NO breast milk. Kieran will still get all the benefits of breast milk with my pumping and supplementing with formula – plus he’ll get the weight-gaining benefits and sleep-inducing benefits of the formula itself. Her earnest exhortations to calm down and just focus on giving Kieran what I *can* give him helped immensely. I’ve been *MUCH* better in the brainmeats department since then.
Currently we’re using the Similac formula that the hospital sent home as well as the free samples we got in the mail. But within another week or two, we’ll have to make our first purchase of formula. Something I never, ever thought we’d do. I’m going to investigate the differences between the name brands and Costco brand formula. I want to cut our costs, but I won’t do it at Kieran’s expense.
So that’s where the whole breastfeeding thing stands. Formula supplemented with breast milk, as I’m lucky to get a third of what Kieran eats every three hours out of a pumping session. I’m averaging just over an ounce every time I pump. I was hoping the “Mother’s Milk Plus” pills would help, but they’re not. I’m going to switch to just Fenugreek pills when the Mother’s Milk Plus runs out this week.
Paul has been (of course) just fabulous during all this. He wants breastfeeding to work as much as I do, because he understands all the great benefits to be had if exclusive breastfeeding were an option. But he’s seen how hard it’s been, and sees that exclusive breastfeeding just isn’t in the cards. He assures me that he’s proud of me and that we’ll figure out a way to make this work for us. His support and acceptance have made all the difference in the world. I am so blessed in him.
We’re hoping as Kieran continues to grow that maybe nursing will come easier to him. We’ll keep trying and I’ll keep pumping regardless. The pump has been rented for three more months at least.
This morning saw us at an unscheduled appointment with Dr. Schwartz to check on my stapled-up incision. Things got a little scary last night with some significant, unexpected drainage. Turns out that some of the concerns about someone of my size and shape having a Cesarean are coming true, but things aren’t as bad as they could be. The staples are all out now, and the wound *is* healing – so close monitoring is in order, but no further interventions were needed.
Dr. Schwartz wants me to be extra vigilant (and Paul too) about feelings of depression, anxiety, and being overwhelmed. He reminded us that we’re going through A LOT just in the general scheme of life and having a baby – in addition to my medical stuff and Kieran’s weight-related challenges. So feeling tired and overwhelmed is to be expected. But with my personal history, and my family history – he wants to be on the lookout for issues to be proactive.
Kieran and I have an appointment with the Lactation Consultants this afternoon at 3:00. They were so incredibly helpful in their daily visits while we were in the hospital. (The LCs are truly one of the things we miss about the hospital.) I’m hoping they can get us back on track with breastfeeding, as Kieran seems to have forgotten everything we learned and had working before we had to start supplementing. It’s getting to the point where his lack-of-latch is hurting me pretty badly. But because his immediate need for nutrition trumps properly learning breastfeeding technique, things have suffered. (We can’t be spending an hour on getting him latched when we have to be making sure he gets a given number of milliliters of EBM [expressed breast milk] every two hours…)
Supplementing: Babies are expected to lose a little bit of weight before they leave the hospital. Usually on the order of 4-7% of their birth weight. They gain it back by their 2-week pediatrician check-up and everyone is happy. Red flags happen though, when a baby loses 10% or more of their birth weight. Kieran hit the 10% mark of weight lost at Day 3. My milk hadn’t come in (which isn’t uncommon since MILK doesn’t come in until day 2-5 after birth) and the colostrum apparently wasn’t enough. There’s a smaller window too, with such a little baby: 10% of 6lb 4oz is smaller than 10% of 8lb 6oz.
There’s a WHOLE LOT of backstory to tell here (and it was a helluva couple of days/nights) but right now the upshot is that I have a rented hospital-grade breast pump at home am using it after every feeding. Kieran gets offered one or both breasts for as long as he’ll nurse, and then he’s offered a bottle to make SURE he’s getting 30-45ml of nutrition every 2-3 hours (closer to two is better.) We have bottles of formula from the hospital, but we do everything possible to not use them – only what I pump. He’ll be weighed today and tomorrow to see how we’re doing to make sure there’s really nothing else wrong.
Prayers for his continued progress and our getting back on track with nursing are greatly appreciated.