Thursday, February 28, 2013

Molly - 1 month old

So, my freshly baked newborn babe?  Turned 1-month-old nearly a week ago now.

I can't believe how quickly that first month went!

But, then again.  Jack turned 3-years-old just today and WOW!  Did 3 years go by quickly!  I've definitely found that time seems to go by a lot faster now that I have kids.

Miss Molly has been very, very kind to us.  I don't think we could have asked for a better transition to a family of four and I owe that ease to both of my kids.  First, Molly is a dream baby.  I thought Jack was an easy to average baby, but Molly is definitely in the easy category.

First bath - 2 weeks

Tummy time!

Most importantly to any newborn parent - she sleeps!  She never seemed to have her days and nights confused (surprising!) so has always slept for decent stretches at night.  She's getting up 1 to 2 times overnight and has since she arrived home from the hospital, but she has always just wanted to eat and go back to sleep.  I don't think it gets much better than that starting out!

 Overall she just has a very sweet, content disposition and I can't wait to see how her little personality develops over time.

Jack is doing wonderfully as a big brother.  For the first few days he was certain that Molly was actually his 3-month-old cousin Rilynn.  Then he realized that no, this was a different baby and that she was staying at our house permanently, but thankfully he took it in stride.  90% of the time he completely ignores her, which I don't blame him for.  It's not like a weeks old baby has much to offer a 3-year-old little boy!  But the other times, when he does acknowledge her as a person, he's pretty sweet with her.  Obviously we're still undergoing this whole transition, but so far it has gone very smoothly.  He hasn't seemed jealous, or really effected by it too much overall.  I think it really helps having Mark home.  Although there are times when he wants to sit with me or something when he'll say, "please put Molly down".  It's pretty cute, and at least he asks nicely!

First social smiles - 5 weeks

Of course it's still very early, but I have to say I feel like, for me, the transition from 1 to 2 kids was easier than going from no kids to 1.  Not that the first one was especially hard, but it certainly turned my world on its head!  I feel like we've eased right in to having 2 little ones.  Obviously we're still exploring our new normal, but overall I just think it's been easier because I'm already a mom.  We still have a long road ahead of us though so we'll see how it all shakes out! 

For now, I'm very much enjoying all the baby snuggles.  I'm all too aware of how quickly this sweet little baby stage flies by!  

1 month stats:

     Weight: 9lbs 1oz (50th percentile)
     Length:  21 inches (50th percentile)
     Head Circumference: 15 inches (75th percentile)

Of note this month:

Molly lost her umbilical cord 1 day shy of 2-weeks-old and had her first real bath soon after.  She cried during her first bath, but didn't cry for her 2nd!  She also stopped crying during diaper changes a week or so ago.

We did have some trouble with her belly button healing.  As I said, she lost her cord around 2 weeks, which is totally normal.  We put her into cloth diapers once she lost her cord (which come up over her belly button unlike the disposable diapers we were using) and we noticed that her belly button just seemed to not have healed all the way.  It was oozing a little bit of liquid and was poking out quite a bit, kind of like an outie, but it didn't look like a healed outie belly button would.  Because it didn't seem infected or anything we decided to put her back in disposables for a little bit to see what her belly button would do in case the cloth diapers covering it were irritating the situation, and it definitely wasn't allowing it to stay dry. 

Over about a week's time her belly button healed up on its own.  I don't know why it didn't heal in the first place, but the cloth diapers rubbing it and keeping the area damp definitely didn't help anything.  It was totally healed up by her 4th week and the pediatrician checked it out at her 1 month appointment and says it looks just fine, thank goodness!  And she's back in cloth :) 

Breastfeeding is totally done now.  We were trucking along doing both breast- and formula-feeding, but when Molly hit 3 weeks she just stopped latching.  I assume drinking from a bottle so often just undermined her natural instinct to latch.  I had mixed feelings about it.  I was sad that it was over, but at the same time I expected it. 

I was also kind of glad to just move on because even though I was glad to give her breastmilk while I could (and to the extent that I could) it was pretty stressful because every time she latched it was like, is there milk there?  Is this the last time we'll nurse?  When she didn't latch (because even while things were going well with her going back and forth between breast and bottle there would be an occasional feeding when I just couldn't get her to latch for whatever reason.  I assume to a certain extent she already knew that the bottle was coming if she bypassed the breast.) it was really sad because I didn't know if it was just over at that point or if it would work the next time we tried.  Plus it's just hard knowing that I couldn't provide what I needed for her and every short nursing session we had that had to be followed up with formula was a stark reminder that I wasn't able to get the job done.  I really wish that we had been able to continue nursing for longer, but I am at least glad that we were able to do it for 3 weeks.  Now we start down the very long path of exclusive formula-feeding :/

Wednesday, February 6, 2013

Breastfeeding 2.0

Oooh, breastfeeding.  You and I, we're not friends.

It's no secret that Jack's and my breastfeeding relationship did not go well.  I went into it thinking that breastfeeding was a totally natural process and it just happened.  Well, it doesn't quite work like that.  I quickly discovered the learning curve involved, but then real problems developed when I didn't produce milk like I was supposed to.  It never even entered my mind that we would have problems, I didn't realize it was possible, to be honest, so it was a big surprise when it didn't work.  After struggling for 2 weeks and dealing with Jack needing to take formula, but not wanting a bottle, we switched exclusively to formula feeding when it was apparent my milk supply was never going to "come in".

This time, we went into breastfeeding with eyes wide open.  We were very hopeful that my experience last time was isolated and it would go differently this time around.  I REALLY wanted breastfeeding to work for us and part of the reason that I was working so hard for a VBAC, and hopefully an unmedicated one, is because I wanted the best start possible (well, in general too) to kick off our breastfeeding relationship.

In the hospital, right from the start, we did all the right things.  Molly latched on and nursed less than an hour after birth.  During our hospital stay I literally had her skin-to-skin or latched on nearly the entire time.  The only time she wasn't was if someone else was visiting with her or if they took her for a quick test.  Other than that, snuggled on my chest or nursing.  Luckily, she has a very strong sucking reflex (she's much more into sucking than I remember Jack being.  Her hands are constantly in her mouth and she's already sucking on her thumb quite a bit) so she was perfectly content to nurse, nurse, nurse.

I know she got colostrum the first couple of days.  We saw a lactation consultant each day we were in the hospital and she was able to manually express some colostrum (she's magical!  I wasn't able to do this.  I am not skilled in the ways.) so I know it was there.  Molly had way more than the required number of wet and dirty diapers the first day she was born.  The second day she was still ahead of the game with wet and dirties.  The third day she drastically slowed down.

Her birth weight was 8lbs 11oz.  By day 2 she had lost several ounces... I'm thinking she was down to just over 8lbs, but I don't remember specifically.  She had lost less than 10% of her body weight, so it was still within the realm of normal (I *think* at that point she was at like 9% lost).  By day 3 she was down a full pound.  Her discharge weight was 7lbs 11oz (down ~11% of birth weight).  The nurses were in contact with our pediatrician to see what they thought about the weight loss and unlike last time (where we were advised to start supplementing with formula in the hospital.  Although, the circumstances were a little different.  The weight loss was similar, but Jack was not happy at the breast.  He would latch-unlatch-cry-latch-unlatch-cry.  Molly was content to just continue to suckle even if she wasn't getting much of anything) they advised us to wait through the weekend to see if my milk would come in (it was still early, both my OB and the lactation consultant at the hospital had said it could very well take 5-7 days for my milk to come in post-surgery) and then come in for a visit with them Monday morning.

Hearing that she had lost a full pound was really hard for me.  I cried.  I was so frustrated because at that point I just knew we were headed down the same road.  It was the same experience as last time and there was nothing additional I could do about it. 

Over the weekend we nurse, nurse, nursed and hoped that one morning I would wake up and the breastmilk fairy would have visited.  Again, if she was willing to latch on, she was there.  She would constantly fall asleep at the breast so we were trying to keep her awake and actively suckling for 20 mins per side.  Still no increase in milk.

By Monday I still hadn't had any noticeable changes with my breasts.  We went to our office visit and Molly weighed in at 7lbs 6oz (at this point she had lost ~15% of her birth weight) in addition to lacking adequate wet and dirty diapers.  At that point the pediatrician recommended formula supplementation.  So we nursed and supplemented with a little syringe and that day I made an appointment to meet with another lactation consultant.     

Last Wednesday we went back to the pediatrician's office for a weight check and Molly was back up to 7lbs 10oz.  Yay!  They want at least a 1oz gain per day and she was doing great at 2oz per day.  The doctor said, "so I take it your milk has come in?".  Nope.

Later that day I met with the LC.  She checked out my technique and Molly's latch, both were great.  Molly latches well, sucks well, doesn't have a tongue tie or anything else that would cause problems with breastfeeding.  I physically look fine.  We discussed my past experience and my experience this time.  We went over possible red flag circumstances which could cause milk production issues (things like breast surgery or PCOS, etc.) and I don't fit any of those factors.  We stripped Molly down to a dry diaper and the LC weighed her with a special, sensitive scale, had me nurse on one side, weighed her again, nursed on the other side, weighed her again and found that she got 2/3 of an ounce after she emptied my breasts.  That's not enough milk :/  AND this is my milk production on the maximum recommended amount of Fenugreek supplements per day and drinking Mother's Milk Tea. 

All things considered the LC believes that I either have insufficient glandular tissue or the hormones aren't working properly.  Either way it's not something that can really be "fixed" and bottom line, I'm not making an adequate amount of milk even though I'm doing everything right.  GAH!  So tired of hearing that things aren't going to work out despite doing everything the way it's supposed to be done! 

We discussed a plan of action and the LC recommended that for a week we nurse (and during that time I only nurse for the time when she's actually getting milk rather than comfort sucking because I'm to the point where my nipples are cracked and bleeding and we have to get them healed!  She showed me what to look for and also how to massage the ducts to make sure she's getting everything.  I was surprised to discover that non-productive/comfort sucking actually doesn't stimulate additional milk production the way productive sucking does.), then supplement with formula, then I follow each feeding with pumping for 10 minutes to make sure I'm definitely empty and to hopefully stimulate additional milk production.

We've been doing this, but unfortunately I haven't seen any improvement.  Frustratingly enough, it seems that I'm making even less milk.  I could be wrong about that, but Molly seems to be productively nursing for less time and sometimes I end up just pumping instead of actually nursing (the way we're feeding her takes quite a bit of time so sometimes it ends up that the amount of time that has passed by the time I get a chance to pump ends up with a missed feeding, if that makes sense) and I'm getting less and less from the pump now.  I know that nursing is far more effective than pumping, but I can't see a reason that I shouldn't expect to see the same/more milk if I was continuing to make the same amount of milk or more.

I don't know.  We're going to stick with it and see what happens after a week.  I said that because Molly doesn't seem to mind going back and forth between breast and bottle the way Jack did that I would try to do a hybrid of breast- and formula-feeding if I could produce milk on my own.  I can't keep up with the nurse-bottle feed-pump routine for obvious reasons, but if I can just put her to breast and she'll get something that's okay, but I feel like it's not even looking like that's going to happen at this point.

So frustrating.  My body just isn't cooperating with anything right now.  Also, something like 5% of women can't produce milk.  WHY do I have to be part of that 5%?!  I mean really...

I wrote this post last week and I'm just getting around to posting it now so I thought I would update with how things have played out so far.  

We did the nurse-formula feed-pump thing for about half a week.  After that I was just so sick of the whole process (it's just so involved.  Basically, to feed my kid, I was utilizing every technique out there.  Most moms either bottle feed, nurse, or pump.  I was doing all of them, all day long.  With a newborn.  And a toddler.  And while healing from surgery.  Do you know how much time that takes?  All of it!  Oy, it was just too much and was enough to make me want to throw in the towel on breastfeeding completely and just switch exclusively to formula-feeding.  

When I met with the LC last Wednesday she had said not to drive myself crazy with this protocol and if it got to the point where I was starting to hate the whole thing to stop.  I was getting to that point so I stopped.  I don't regret it because it didn't seem to be making a difference.  It's obvious to me at this point that I'm never going to have a full supply regardless of what I do so I need to simplify if I'm going to be able to continue our breastfeeding relationship at all.  It's already incredibly frustrating not to produce enough milk, I just can't deal with the demand of nursing and bottle feeding AND pumping around the clock.  I would rather spend that time snuggling my sleeping newborn than hooking myself up to a pump to try to slightly increase my sad milk supply.  

So anyway at this point we've decided to do a combination of breast- and formula-feeding to get the job done.  This was something that the LC and I talked about during our meeting - that unfortunately the reality may be that I may never make enough milk to provide for all of her nutritional needs, but that doesn't mean that our breastfeeding relationship has to end completely.  That doing a combination of breastmilk and formula is an option as well and for some women, this is just how it has to be and that's okay.  I'm really glad we had that discussion.  Some breastmilk is better than none and I still have some so I start by nursing Molly and then we give her a bottle of formula to finish it up.  For the most part this is going okay.  Molly still seems to be fine with taking both breast and bottle.  I have had a couple instances where I just couldn't get her to latch on.  I don't know if she was just too hungry or if it was nipple confusion or what, it's like she forgot what she was doing, but then the next time she latched just fine :shrug:  

The other problem has been that she's a snacker.  Feeding a newborn takes a good amount of time even when they're actively participating the whole time because you have to stop and burp them frequently and make sure that they don't over-indulge their tiny tummy (I'm talking about formula-feeding in this instance).  But Molly likes to take a little bit of food, then fall asleep for a cat nap, then wake and eat more, fall asleep... and so on.  It can easily take a few hours to get a single feeding completed.  She's especially sleepy at the breast (not surprising, I think this likely has to do with the slow flow of the milk.  I know it's comforting to her to nurse and added to that she's a sleepy eater anyway and on top of that because I have such a low supply the flow is even lower than it would be otherwise.  All of these things combine so that at least half the time I latch her on and she's asleep very soon thereafter and I have to work to keep her going so that she actually drains the milk from my breast as much as possible.  Lucky for me, it doesn't take all that long.   

So a combination of nursing and formula is the plan for now.  I do enjoy nursing her (it's become much more enjoyable the last day or two now that my nipples are doing better!  Before that it was like torture to nurse knowing that it wasn't even necessary considering my supply is crap and she's getting the vast majority of her nourishment from the formula.  It's still not a totally pain-free process, but I think we're over the hump and headed that direction!) and it makes me happy to know that she's at least getting some breastmilk and the benefits that go with it.  

It's hard to say how things will play out with my supply, or if she will continue to be content nursing from the breast when she knows that the instant gratification of a bottle is coming shortly, but for now we're just taking things one feeding at a time.  

Tuesday, February 5, 2013

Introducing Molly!

Molly Elise is here!

Well, she's been here actually :)  But I'm just now getting a chance to talk about her arrival nearly 2 weeks later!

Molly arrived via scheduled C-section at 10.21am on Wednesday, January 23rd weighing 8lbs 11oz and measuring 21 inches in length!

Everything went very smoothly and I have to say we had a much better experience with the C-section than last time and for that I'm very thankful.

We arrived at the hospital early in the morning on Wednesday and went through the checking in process.  I had slept surprisingly well the night before.  I was worried that I would be awake the whole night worrying and although I didn't sleep as soundly as usual I still got a decent night's sleep.

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Waiting to meet Molly

I was worried that after we got to the hospital there would be a lot of waiting around.  We were scheduled to arrive at 8am and as long as we didn't get bumped by any emergency C-sections my surgery was supposed to start at 9.30am.  I thought with all that time in between there would be a lot of waiting, and I was sure we'd end up getting bumped which would cause more waiting and I just knew I would be worried and anxious the whole time.  Thankfully it wasn't like that at all.  They were pretty much doing things to get me ready for surgery the whole time so there wasn't a lot of down time and it kept me pretty distracted.  We didn't make it to the OR right at 9.30am because I think the previous surgery had run over, but it wasn't too much later.

Something that was really great about our experience this time around is that my midwife was there with us the majority of the time.  For my prenatal care I rotated between 3 midwives and my favorite one happened to be on call the day of my surgery, which was great!  I had hoped all along that she would be the one to attend Molly's birth and although it went differently than I had envisioned I still appreciated that she was the one who was able to be there.

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Molly, minutes old, holding Daddy's finger

My midwife was with us before we went to the OR and she was also in the OR with us the whole time and then came back to recovery with us as well.  I found the best part about her being in the OR was she was able to be with me for the beginning stuff like when they placed the spinal block.  That is a scary process (to me at least!), and one that the support person isn't allowed to be present for, so it was really awesome to have her there for support.  She was the person who stood in front of me and helped to instruct me what to do, kept reminding me to relax and breathe, etc.  Very helpful and comforting to have a familiar presence there for that process.

We also had a great OB performing the surgery.  It should have been the OB that was with my practice that performed the surgery, but he happened to be out on vacation that week so he had a backup doctor acting in his place.  I had never met either OB so it was all the same to me.  The OB we had really had a great bedside manner, seemed to be on top of everything, and just seemed to really care more than my OB last time.

So anyway, after 2 attempts they finally got my spinal block in place (I guess my body just doesn't do well with spinal anesthesia between the 2 failed epidurals last time and then this.  It could be worse, but ugh... the whole process is very uncomfortable and unsettling.  I'd like to have to only do it once thankyouverymuch.  Not to mention, a huge difference I was worried about between last time and this time was that last time I was SO ready for the spinal block because I knew it would take the pain away.  This time I wasn't in any pain.  They had me walk down to the OR and hop up on the table myself and then I have to sit there while I know they're messing around with my spine.  Icky.  Obviously I knew it needed it, but I wasn't looking for instant gratification like last time, you know?) and got me settled on the table.  The OB brought me a warm blanket and the spinal block started to work instantly.  Before I even got laid down I was going numb and in a very short span of time I was numb from the chest down.  It's an incredibly weird feeling and not necessarily a good one, but it did the job so I'm thankful!

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Skin-to-skin on the operating table

After that they brought Mark in and got to work.  It seemed like a very short time later that I was able to hear Molly's first cries!  They took her over to the little warming table and I was so surprised when I saw 8lbs 11oz pop up as her weight!  I was NOT expecting her to be that big!  Jack was born at 41 weeks, 1 day weighing 8lbs 2oz and I had been on IV fluids for an extended period of time before that which probably slightly inflated his weight.  Molly was born at 41 weeks, 2 days so I was guessing she would be slightly under 8lbs.  I was wrong!  She came out pleasantly plump with squeezable cheeks and arms and thighs!

Something else that made our experience better this time is instead of them wrapping baby up like a little burrito and putting a hat on just to bring them over for a brief snuggle against my cheek like last time they quickly did what they needed to do and minutes later brought Molly over to rest on my chest while they completed the surgery.  While we were still waiting to go back to the OR my midwife cleared it with everyone so that we could do the skin-to-skin.  The nurses seemed pretty excited about it and said they hadn't done that before.  It was a really great experience!

We hadn't decided on a middle name before Molly's birth.  We had narrowed it down to a short list of contenders, but nothing was really speaking to me.  As soon as they put Molly on my chest the name "Molly Elise" popped into my head.  Elise was on our short list, it wasn't at the top, but when it randomly popped into my head like that I decided it was meant to be!  We talked about it and sat on the decision as long as possible (we didn't fill out the birth certificate paperwork until the afternoon that we left the hospital) and then decided it was the right choice! 

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Nursing for the first time

After they finished the surgery the OB told me that there was a lot of amniotic fluid (which was surprising to me because I always measured right on track throughout my pregnancy) and that's probably why Molly was able to flip so late.  He also said that she did have the cord wrapped around her neck.  While it's not unusual (or a problem in most situations, as long as it's handled properly at time of delivery) for a cord to be wrapped around the neck it could definitely have caused problems if we had somehow managed to attempt a version.

Once back in recovery we were able to keep the lights nice and low, get baby latched on for her first feeding, and do lots of skin-to-skin snuggling.  This was so much better than last time when Jack and I were separated for nearly 2 hours after he was born for "mandatory observation" even though there was nothing wrong with him.  Another benefit to our experience this time and probably the most important to me.   

After awhile we transitioned up to our postpartum room and got settled in.

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Sweet baby snuggles!

I was feeling pretty good after the surgery.  I was able to get up and go to the bathroom at the 12 hour mark.  I think they had me up moving around at the same time last time, but I remember it being much more painful.  I think I may have had better medication this time because they added Morphine to my spinal block that gave 18 hours of pain relief.  I didn't have this last time.

Day 2 was probably the hardest, but I recall that being the same last time.  Overall, I think I felt better this time around.  Don't get me wrong, I was taking 2 different pain meds round the clock on a schedule and it was still extremely painful to move around, but I just felt better overall and I also seemed to get around a little better.  I also wanted to sit in a chair every so often, which I definitely did not do when I had Jack.  My recovery overall has seemed to go more quickly this time and I think it's likely because I didn't labor leading up to the surgery like I did with Jack.  Also, my OB gave me a compression wrap to wear around my torso and OMG!  I wish I had known about this last time!  It was really helpful to keep things in place and provide just a little bit of pressure to help with the pain.  Last time they had me holding a pillow to my tummy when I moved around and this is essentially the same idea, but so much better!  WHY didn't they do this last time?!

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Molly meeting big brother Jack and cousin Kylie

We stayed 2 nights at the hospital and then I requested to be released.  We had assumed we would only be there 2 nights, but I guess the first day when you have the surgery doesn't actually count so I was supposed to stay at least 3 nights.  I was ready to go home though.  Those hospital beds are SO uncomfortable (it hurt my butt and it's not like I could lay on my side or tummy!) and Mark's accommodations were worse than mine.  I knew that we would both be far more comfortable at home!  So, after talking things over with my doctor, they released us Friday evening.

We're settled at home now and every day is a little easier.  I definitely turned a corner and started feeling like myself right around the 1 week mark.  It took more like 2 weeks last time.  Molly is doing wonderfully and has been a dream baby so far.  I'm slowly starting to feel more like myself, just looking forward to the day when I'm totally pain free and can start getting back to living life more normally!