Tuesday, November 13, 2012

The First Weeks

I keep trying to force myself to write my birth story, but every time I stop to think about it my mind keeps wandering to writing about how these first two weeks have been going. I will get to the birth story soon—I really want to before I forget—but for now this is where my attention lies.

There's so much to say, where to start? I think I need to open with what I am thankful for since this post is probably going to end in a dialogue about the issues we are having.

As I said, Lola's birth story will be coming soon. But for now I can tell you that it was an amazing experience. I've actually become really thankful for the two weeks of early labor that I had to go through. It was such a quiet and restful period—albeit an anxious period too—that I know I won't get again for a long time now that we have a kiddo. I even went into labor on my original due date. How very textbook! My active labor and Lola's vaginal delivery (HUGE blessing!!) was long and  challenging, but I look back on it with really fond memories. I can't wait to share more.

The Physical and Emotional

Healing is going pretty smoothly. I ended up with no perineal tearing, but had a pretty hefty internal tear that needed stitches. I am 12 days postpartum as I begin writing this (17 days pp as I finish!) and am feeling about 80% 85% back to normal. Way better than I would have ever imagined. We even went on our first family walk yesterday on Wednesday with very minimal discomfort. I would say around day 10 pp was when I started to feel an improvement. I seriously can't throw up enough "Thank you, Jesus'!" about having a vaginal delivery. I know the healing process would be completely different if I would have needed a c-section. It's crazy how normal I feel for going through the most physically traumatic event of my life just 12 17 days ago.

Emotionally, I've been a big weepy mess. Those hormones are no joke. For the first few days I was a big soggy crying mess all day long. I would just cry over nothing and everything. I'm grateful we were warned about this, otherwise I think it probably would have freaked us both out.

I was doing okay at the hospital, but once we started packing to leave I couldn't stop crying. Part of me was scared about leaving the safe cocoon of the nurses and hospital amenities, while another part of me was baffled that this new season of our life was really happening and that this pregnancy is over with, and a big part of me was thinking, "what the crap do we do now?" As we walked back to our car over the skybridge with Lola in the carseat, I sobbed and blubbered about how crazy it was that the last time I walked through there I was in labor with a baby in my belly. Now we were walking out with a baby in our arms and a deflated belly. It was too much for me to process.

Otherwise, I haven't noticed too many other physical changes. I do have a zit on my face, which isn't an issue I've had to deal with for nearly nine months and I'm hoping is just a fluke from lack of sleep and stressors like that. I think I'm also starting to notice a change in my hair. I've been warned that the postpartum hair loss is wild and you think you're going to go bald, but so far I'm just seeing a few strands falling out after shampooing or running my fingers through my hair. No big scary clumps yet!

But maybe the most bizarre of all is the night sweats and crazy dreams. Almost every time I wake up at night I am drenched in sweat even though I feel cold and am bundled up in sweats and a sweatshirt. I remember learning that this is one of the ways my body might get rid of the extra fluids, but it's still so strange. And the dreams! I am constantly dreaming that I fell asleep pumping or holding her and have to shoot up to look in the bassinet to make sure she's there and not tangled in the sheets. I've never fallen asleep holding her or pumping once, so I'm not sure where this comes from. Arthur said he has the same dream about falling asleep holding her too. New parent jitters!

As far as pregnancy weight gain and loss goes, I ended up gaining 37 pounds from pregnancy. So far I am down 22 with 15 left to go to reach my pre-pregnancy weight. Admittedly I wasn't in the best shape of my life when we got pregnant from working a job that forced me to sit all day and being so busy that I wasn't exercising or cooking enough whole food based meals, so I'd like to shoot for losing a bit more than 15. I'm in no hurry to do this, but it's in the back of my mind. I am really looking forward to exercising once I get the go-ahead from my midwives. I also can't wait to get back in the kitchen.

The Placenta

I'm sure some of you are dying to hear about how the placenta pills are going. Thankfully my placenta came out in good condition and was able to be encapsulated. I never caught a good glimpse of it—I didn't care to at the time—but I was told it was on the smaller side. Our doula and encapsulation specialist, Matilda, took and packed up the placenta shortly after the birth to take home with her. I think I remember her saying that she just took it home in a plastic bag.

Since it was smaller, she offered to use a technique called "raw prep" that would skip the steaming portion of the process and just go straight to the dehydrator. This would bypass the shrinkage that would happen from steaming and allow us to get more pills. The end result is exactly the same, I guess, as steaming is just part of the traditional chinese way of preparing a placenta, but not essential. I think we were able to get somewhere around 140 pills.

She delivered the pills three days postpartum and I took my first set right on the spot. I was most nervous to smell them, but they really do smell like ginger and nothing more. They are also far less intimidating to take than you would think. It's no different than any other supplement if you get over the mental hump of eating an organ ;) I will admit that I tend to avoid tasting them while they're in my mouth since I notice a tiny bit of an iron-y flavor, but it's not bad.

So what's the verdict? I think they are working! Like I mentioned, my postpartum emotions were wild. But honestly once I started taking the placenta pills I wasn't crying at the drop of a hat anymore. There isn't any way we can truly know if it was them that broke my baby blues so early or not, but I am inclined to think it was. I wasn't waiting for them to kick in either. They are just part of my huge lot of supplements I'm shoveling down all day long and I wasn't thinking about them at all—no time to think with a newborn, just keep moving. But after a few days I realized I wasn't weepy anymore and that my turn in emotions happened to coincide with the inauguration of my placenta pills. I'm a believer!

I'm planning to take the pills until I either run out or feel ready to stop them. Matilda mentioned that often people will keep them in their freezer for later. I hear they do wonders for menopause and PMS! Even though the encapsulation was a bit pricey at $155, we both are really glad we made the choice to do it. If you're in the Seattle area and interested, Matilda does encapsulation for people who aren't her doula clients (at a slightly higher fee). Here is more info!

Life with a Newborn

How can it possibly be that we are over two weeks postpartum?! I want my 4-hour old Lola girl back and to keep her there forever. She is so tiny and cute, I cry everyday thinking about her growing up. I know we have so many fun times to look forward to, but time is flying so quickly. She's not the wrinkly little raisin that came out of me two weeks ago, she's actually starting to fill out like a "grown up" baby. Sniff. Arthur says he's excited for her to grow up so he can talk to her, but this totally makes me break down into a weepy mess.

Slowly but surely we're figuring things out. It seems like we're steadily getting into a routine, but I'm sure that could change at any second. So far Lola—or Baby Coco, as she keeps getting called (which I adore)—is a great nighttime sleeper. Unfortunately on my end it means going to bed around 7/8pm and sleeping in very broken 1.5/2 hour chunks until about 8am. Arthur and I are trying to figure out a system where we operate in shifts, but because I'm pumping full time...I have to get up every two hours around the clock.

It's helpful though when he takes the feeding/changing/putting back to sleep duty every other cycle so I can just pump and go back to sleep. Sure he's getting way less broken sleep than I am when he's off duty for one cycle, but that's important with him going back to work soon.

I also realize that this nutty newborn schedule is very short term and will be over before I know it. So I'm trying not to fret over the insane sleep deprivation. I might have muttered, "I feel like death" once or twice last night though.

While she's a great night sleeper, it's a bigger challenge to get her to sleep during the day. She tends to fight sleep and fuss during the hours when the sun is up. At this point I'm completely terrified of Arthur going back to work and baffled at how I'm supposed to take care of her by myself during the day without going crazy. I think it starts with me accepting that her life right now is eating and sleeping, so that's what my days are going to revolve around and I need to just embrace it.

Getting out of the house seems to be our biggest hurdle right now. Aside from the fact that we've forgotten the diaper bag a couple times, or failed to pack necessary items when we do remember the diaper bag, just getting out the door is an act of God. She's usually crying or hungry (total parent fail) when we're running to make it to an appointment. And we're pretty much late for every appointment, which sends me into a crying panic over not having a clue how I'm supposed to do this on my own.

Even a casual walk takes military-like coordination to pull off. By the time I've pumped, she's fed and soothed and in the carseat, we've gotten the BOB out of the car and put together, and we're on our way, it's nearly time to do it all over again. And then there was that one time in Target when she was so upset and hungry that we had to feed her a bottle of formula in the men's clothing section. I cried.

I've been encouraged by so many ladies to have grace with myself during this season, which is a word I've been meditating on this past week. I also think having grace with Lola is a huge factor as well. After all, she's just a tiny new baby figuring things out herself! Accepting this facet of my new role and figuring out a routine with her is definitely my number one prayer request, if you feel inclined.

Otherwise, we are totally smitten with her. This is so cliche, but it really is so magical to consider how she grew in my belly from the size of a poppyseed to a full grown baby. Boggles my mind every time I think about it. Her sweet smell, little squeaks and baby cuddles make all the hard work worth it. And just one glance from those big dark blue eyes melts our hearts into a puddle of goo.

I've been really lucky to feel bonded to her right away—I think the immediate skin-to-skin time was so incredibly important—but I also look forward to continuing to get to know each other and all the fun times we will have as a family. She's honestly the most perfect little blessing we could have ever asked for.


Ugh. This is where the tides turn. I had heard breastfeeding could be hard, but never imagined it to be this difficult. For the sake of not droning on, I'll try to sum up our past two weeks of breastfeeding quickly. Warning: it's not quick.

We started our nursing relationship probably a little over an hour after birth. Lola was rooting pretty quickly after being put on my chest, but I was getting stitched up for around an hour and really wanted to have our first feed be relaxed and enjoyable, so I just let her bob around but didn't encourage her fully to latch. I was so exhausted after getting stitched, but Matilda was really encouraging with getting Lola to the breast as quickly as I could muster. She understood my beyond-tired state of mind, but also didn't want me to miss out on such an important time. She eventually talked me into it and we tried a few different positions. I've written about how nervous I was to breastfeed, but it ended up feeling pretty natural and not as bizarre as I had anticipated.

Over the course of our hospital stay we had a new nurse every 12 hours, each with a different technique. I found this really confusing and got a lot of conflicting advice of what to do and how to do it. At one point we had a night nurse that was trying to teach me side lying nursing at two in the morning. I couldn't see what I was doing, my nipples were so tender, and nothing about it felt right. I got so frustrated and cried the whole time. It was experiences like this that left me feeling so unsure of what I was doing.

Thankfully we ended up having the same day nurse two afternoons in a row. She got me set up with a nipple shield, which was SO helpful for my ailing nipples and also helped me figure out a couple nursing positions that worked at the time. This was a turning point because she actually took the time to look at Lola's latch and how she was flattening my nipple even though she looked like she was on the breast just fine. She said she had done all she could, but left us with some lactation support resources to call when we left the hospital. Arthur called to schedule an appointment that day.

Another piece of the puzzle is that when we were in the hospital, Lola wasn't producing enough wet diapers. While she was pooping up a storm—seriously, like eight poops in the first few hours—her first wet diaper wasn't until hour 30 and she didn't have another for a long while after that.

The on-call pediatrician was concerned and urging us to supplement with formula to get her wetting more frequently. I was totally taken for a loop and not in a million years expecting to have to feed my baby formula right out of the gate, but we didn't know what else to do, so we took the hospital samples home with us and fed her just half an ounce at each feeding. I was totally devastated and really confused about what was going on. Arthur urged me to accept that this is what was best for our baby and that the first priority was to get her hydrated. I needed to look at the formula as medicine. I reluctantly obliged.

We went home on Sunday, and were able to get into our [AMAZING] pediatrician Monday morning. She agreed that we did the right thing by feeding her the formula and that getting her to pee was definitely the first priority. She gave us the name of a lactation consultant (lc) and suggested we head to PCC to pick up a higher quality organic formula (Earth's Best organic, specifically). We called the lc on our way to pick up the formula and she was at our house within a couple hours.

I was anxious about her coming since I figured she would just take one look and tell me everything I was doing wrong, but this was so not the case. She also agreed that getting Lola peeing was the first priority, even if that meant supplementing with formula since my milk hadn't come in. So she set us up with a supplementer device called an SNS that is basically a bottle with thin tubing that I tape to myself so it ends up at the nipple. With this, Lola is able to nurse at the breast and while taking in the supplement at the same time.

Betsy, our lc, had warned us that we would love the supplementer for a while, but would want to throw it out the window in a matter of days. This was so, so true. The thing served its purpose and we got her wetting more frequently with formula, but it took both of us to feed her, lots of tears each feeding session, bandaids stuck all over my boobs to secure the tubing, and eventually Lola just learned to suck out of the tube like a straw. That was when we really "threw it out the window"—er, or on the kitchen counter.

It wasn't all bad though. I started pumping that same Monday after our visit with the Pediatrician and Betsy and was able to see that I actually was producing a bit of colostrum. I had doubted anything was coming out since day one because I could hardly express anything with my hands when I tried. It wasn't a lot, but there was something and I wasn't about to let it go to waste. So we used an IV syringe that our pedi gave us and I fed her the teaspoons of colostrum with that. Eventually I was producing enough to put a half an ounce or so in the supplementer, so we would feed her the rich colostrum first and then supplement the rest of the way with formula. This seemed like the best way we could get her at the breast, taking in my antibody-rich colostrum, and also full of formula. It wasn't ideal, but I was thankful for what we had going on.

Because the SNS was such a pain, we were also bottle feeding her to give me an emotional break, and also so we could get some sleep. The SNS took so much time from beginning to end that we were barely sleeping in 1.5 hour chunks. Unfortunately, over the course of that week she was getting too used to the fast flow of the bottle nipple, even though they were slow flow nipples, and losing interest in anything else. Betsy advised us to order some Dr. Brown's bottles with premie nipples so she would have to suck harder. We did, and this is currently what we use to bottle feed her. A bottle feed now takes around 10 minutes instead of 5 and forces her to suck harder, as she has to do at my breast.

Slowly my colostrum began showing signs of shifting to mature milk and also increasing bit by bit. However, it was taking me nearly 40 minutes of pumping to get enough milk for Lola to drink—around 1.5–2oz. I was exhausted and suspicious of a low milk supply, but determined to feed her pure breastmilk, so I pumped and pumped. Thankfully, she was able to wean off the formula completely sometime around one week. I praise God for providing us with formula, but I also praise Him for getting her off the formula and allowing me to produce enough milk to sustain her.

Betsy came back that same week on Friday to finish our appointment that she had to cut short on Monday. This ended up being such a blessing because things had changed so drastically in those few days and we didn't have to pay for another session with her. By Friday my milk had come in, I guess. I never experienced much of an engorgement period, which was alarming since everyone had told me it would happen. There was a day of sort of lumpy breasts, which I think was when my milk arrived, but my supply wasn't seeming all that plentiful.

With Betsy we were able to have a nursing session and weigh Lola before and after to see how much she was getting. And after 30 minutes of feeding, it appeared she had only taken in about half an ounce. Not good. The next few hours were all about getting quizzed on my personal history and discussing a plan of action. We talked about how part of the issue seemed to be my supply and how drained my breasts were after a feeding. Betsy said she would like to see my supply be enough that I had something leftover after I was done nursing. But we also talked about how on Lola's side she didn't seem to be sucking very efficiently. Her latch wasn't ideal with a bit of a clenched lower jaw, and she would tend to fall asleep immediately at the breast. What a dynamic duo we are. Ugh!

There are lots of herbs that are supposed to increase milk supply, but before beginning any of them, Betsy wanted to get my thyroid level checked to make sure it could withstand their effects. Unfortunately, I couldn't get into our naturopath until Monday, so I had to wait the weekend. We eventually got my labs back and everything looked fine. I immediately started on a high "dose" of fenugreek, the most common galactagogue (milk stimulator), at 3 capsules, 3 times a day. I have been taking this for about a week now and have seen a definite increase in my supply, but I wonder if it's just my body naturally increasing my supply or if the fenugreek is to credit. It's not something that is advised to take long term since it could become less potent to my body, so I am anxious to know.

As of now I am pumping every 1.5–3.5 hours anywhere from 1.5–3oz at a time, which seems to be enough for her most feeding sessions. I try to put her to the breast throughout the day, but she has developed an affinity for big plastic nipples (i.e. the nipple shield and the bottle) and an aversion to my actual nipple. It takes a bit of wrestling to get her to latch on, but I've had some success the past few days. The remaining issue seems to be that she just doesn't get enough milk from me when we nurse. I have nursed her for hours on end and it will still take a bottle of an ounce or so afterward to get her sleepy enough take a nap. At her last weight check, she was gaining weight steadily at over an ounce a day, so we know my milk supply is sufficient for her right now.

I've researched a lot and found some great resources such as this and this. So much of what I read says that by putting baby to the breast whenever she wants, my supply should adjust. I also think that by letting her practice, she's bound to figure it out at some point. Right? So today—day 17 pp—I am having a nurse-in. A nurse-in is where you camp in bed for one or more days and just nurse. But so far she has nursed since about 9:30am nonstop. It's 2:30pm now. She seems to be swallowing, but I just don't understand if she's getting enough. I'm happy to nurse around the clock if it's actually productive, but I'm doubtful right now. She's napping in about 10 minute intervals, whereas if I were to give her a bottle she would go to sleep for a couple hours. I'm at a loss.

Thankfully we have an appointment tomorrow with an Occupational Therapist at Seattle Children's Hospital. At this point our pedi and lc have done about all they can do to help us and we're needing some specialized advice if we're to figure this out. Part of me questions if all this work is worth it just so I can breastfeed her. It feels a bit selfish on my end. Because the reality is that I can give her breastmilk, it just has to be pumped and bottle fed. I've asked Arthur if he thinks this is too self-focused, but he feels adamant about figuring this out as well.

Regardless of what I'm deeming our issues right now, I realize how small all this is in the scope of our lives. Lola is healthy and happy. Mama is healing from birth and capable of caring for the babe. Arthur is supportive and calm. We are all a family. We are very blessed.

I have been given the word this week that I need to ask God to increase my faith. I need to trust that Lola is his daughter before she is mine and that he will care for her even more than I ever could. He has allowed her to thrive since birth on one form of milk or another, and I am thankful for that. So, so thankful. It's been a challenge for me to seek God above my desire to breastfeed. Much of it is about pride. Pride in wanting to be a perfect mom. But the truth is that I'm not a perfect mom, and I'm never going to be. I can be the best mama to Lola by seeking our perfect father for both of us and asking for greater faith in God's sovereignty and goodness.

I think God sees becoming parents as good for us because it teaches us selflessness. This role of mother is like nothing else I've ever experienced. All of my attention, time, energy, finances, and so much more are focused on caring for this little person, not myself. I have no time or capacity for myself. She occupies all of me, mind and body. I knew this was coming, but couldn't really comprehend it without living it. But I'm growing stronger as a woman of God. I can feel it deep inside. I haven't had much time to reflect yet, we're in survival mode after all, but I know God is doing big things in my heart. I can't wait to find out what those are.