Thursday, July 30, 2009

I've been mentally writing several different posts on our breastfeeding situation here as it has changed, but I think it has finally come down to this: without really intending to, I've wound up back with exclusive pumping, and I don't have a lot of confidence that that's going to change.

Initially, I had to pump because my supply had gone way down after a rocky start to breastfeeding and then a two-day separation when I had to go back to the hospital. So I would breastfeed him, then finish the feeding with a bottle and pump as much as possible. And it worked - he's almost completely on breastmilk for the past three weeks. But even after my supply was where it should be, he was still breastfeeding for over an hour, then requiring at least two ounces from a bottle. When you find yourself spending that much time breastfeeding and still having to bottle feed and pump as well, it starts to get really easy to just skip the breastfeeding and pump, especially when it means you can hand the baby off to someone else for a while.

Initially, I blamed myself, that maybe I had brought this on myself because I just wasn't dedicated enough. Then as I did more research, I discovered that it's just not normal for a baby to feed for over an hour and only take in an ounce or less. To take over an hour to drink a bottle, even with a slow-flow nipple, is even less normal. What it was adding up to is that Alec has a weak suck.

I added up weak suck to baby who started life at the 75th percentile and has dropped to the 20th by one month, who hovers at the lower bound of acceptable weight gain and eats the lowest amount of the average range of milk intake for his age. Then I switched him to a fast flow nipple and discovered that suddenly, the boy could eat, to the tune of increasing it by 25 percent. He also stopped constantly pulling away from the bottle and crying, a behavior that had me panicking over reflux but now is clearly because he was hungry but upset at how hard he had to work to get milk.

From the research I've done, dealing with a weak latch involves a lot of work and stress, preferably in close consultation with a lactation consultant. Well, our insurance doesn't cover a lactation consultant and we can't afford the cost of even one session, let alone an ongoing relationship.

I've decided I'm not ready to give up yet. I bought a cheap supplemental nursing system off of Ebay today, which will hopefully get Alec used to getting milk at the breast while still getting enough food. And if it doesn't work, I'm surprisingly not as bothered by that as I would have thought. I've pumped for a year before, so I know I can do it again. Alec is also not showing any sign of K's milk allergy, so if we have to switch to formula, we won't have the prospect of $30 cans of formula to pay for. I think it upset me a lot more with K because we had a working breastfeeding relationship that just completely fell apart. I really had hopes that things would be easier with Alec and even cherished hopes of extended breastfeeding into toddlerhood, but I'm finding it easier to let go of expectations of how things should be with him.

Pumping isn't fun, but the baby is getting fed, which is what counts. And if anyone wants to start waxing rhapsodic about how you can only bond properly at the breast or quoting me that stupid hierarchy of baby feeding where pumping comes in third after feeding from the mother and then using a wet nurse (as if that were remotely practical in our society), they're cordially invited to bite me.

Monday, July 27, 2009

Take two

Wednesday alone with both children went much better, with absolutely no property damage. We even survived a trip to the mall with sanity and limbs intact.

I've been pondering lately how much of when things go dysfunctional is my fault. Well, fault isn't really the right word. It's more accurate to say that things tend to go badly when I allow my expectations to become unrealistic. K is four, and as such, it's a given that she's going to throw tantrums, be defiant and experiment with how much obnoxious behavior she can get away with. That's the stage of development her brain is at, and I shouldn't expect anything different. I can and do try to respond to all of these undesirable behaviors with gentle but firm discipline. But it's easy to lose patience and instead of turning things into a game or pointing out what she'll be missing if she doesn't cooperate, resort to a stern voice and barking orders in hopes that she'll just do what I ask without nonsense or dawdling. This almost never works, of course. The stern voice works well in dog training, but usually has exactly the opposite effect I want when dealing with a child who is trying to push my buttons with defiance. It's so easy to slip into yelling when I'm tired and trying to juggle groceries and a crying baby and just want her to GET OUT OF THE CAR ALREADY. But while it's entirely understandable for me to lose patience in those situations where K is behaving in a provoking manner, ultimately what I can control is how I respond, which will hopefully result in better behavior on her part.

Changing my expectations has definitely made Alec's newborn days more pleasant than K's were. He is genuinely a better sleeper than she was at this stage, and it helps a lot that she had started getting reflux at this age which he doesn't seem to have (I think. It's becoming apparent to me that I have a bit of PTSD when it comes to K's reflux, and it makes it hard for me to tell how much I'm overreacting when he shows any reflux symptoms). But part of why he's a better sleeper is that I've recognized that he will only sleep well if someone is holding him. So that's what we do - stick him in the sling and go about our day. But with K, I put myself through a lot of stress wanting to be able to put her down and have her stay asleep, which rarely happened. I also didn't know how much sleep to expect from her at which age, so I went through stress over her not sleeping when it was that she was simply starting to wake up. With Alec, I don't have any expectations for his sleep at this age, so I enjoy when he's awake and interactive, and do my best to encourage him to sleep when he seems sleepy.

Mind you, it would take Yoda levels of zen to actually maintain the levels of patience I'm talking about about. I'm going to lose it with K, and just want Alec to go to sleep already or stop being so freaking fussy so I can just put him down for two seconds. But life goes better when I remember that it's changing my attitude that can make all the difference in a bad situation.

Thursday, July 23, 2009

Alec at one month

Alec is one month old today. It's horribly cliched to say this, but it simultaneously feels like no time at all and surprising that he hasn't been part of our family forever.

He is 9 pounds, 6 ounces as of today, which is adequate weight gain. I'm trying to remind myself that even though K was a full pound heavier at this age, she had spectacular weight gain, and Alec is more on the normal end. Our feeding issues are a topic for another post, but I'm fairly confident that he's getting enough food, or at least as much as he wants. He's pooping and peeing copiously, so it seems like he's more destined to be long and lean.

He sleeps. He's usually good for at least one long stretch during the day and a six hour stretch at night, with other decent naps as well. I know from painful experience that when it comes to infant sleep, past performance is not a guarantee of future returns, so I'm just enjoying it while we have it right now.

He also has increasing alert periods, where he admires his toys or examines contrasts. He's in the sophisticated artist period of infancy, where he's entranced with the play of light and shadows. He's making eye contact and even has started deliberately catching my eye. He shadowboxes extensively, and often needs to have those mean arms and legs firmly swaddled to be able to calm down and sleep.

He has excellent head control for his age, and can both hold his head up when we hold him up and can lift his head enough to turn his head when on his tummy.

Let's face it, one-month-olds aren't terribly accomplished. But they're awfully cute.

(More pictures here)

Monday, July 20, 2009

An inauspicious start

My first day alone all day with both children did not go as well as I hoped. And Mount Vesuvius caused a little bit of property damage.

It started out so well. B was working late tonight, so I dropped him off at work at noon and decided to take K out to lunch. It was going just fine - Alec slept angelically, I got K a cookie as a treat and she happily ate her lunch,* and we made plans to go to the park and feed the ducks and play Pooh sticks. But then I got up to get K more to drink, and I'm not entirely sure what she did while I was gone, but by the time I got back, she had woken Alec up. I was displeased, to put it mildly.

I packed us up in the car, and amazingly, Alec went back to sleep. This was K's cue to keep playing with him - putting her hat on him, tickling his feet - no matter how much I told her not to, until she woke him up again. I was livid. But then, miraculously, Alec fell asleep again. Only to be woken up a third time by his hellspawn of a sister.

Fortunately, we were very close to home, or she may have gotten punted out a window. Instead, we arrived home, and I got our stuff and Alec to take inside and opened K's door so she could get out. At this point, she decided to pull her supremely annoying trick of climbing into the back of the car instead.

I know the solution to that trick is to just open the back to let her out and she'll stop thinking it's a great trick to pull. But when I'm already angry it's very hard to do that. However, I held it together and just left a door open while I took a howling Alec inside and changed his diaper. I was a bit calmer when I went back out to get K out of the back of the car, when she told me she had wet her pants. Which of course wouldn't have happened if she had just gone in the damn house instead of fooling around in the back of the car. At that point, I hauled her out of the car and growled at her to go in the house and change her pants. I was working up a lecture on the theme of not fooling around and leaving her brother alone when I told her to as I closed the back door a bit harder than normal.

It wasn't really that hard, but since I wasn't paying much attention to what I was doing, I had my hand on one of the panes of glass in the window as I closed the door. Which then proceeded to shatter.

Thankfully, K was about ten feet in front of me, so she was nowhere near the glass. I was able to stay surprisingly calm, as I told her to stay back and checked Alec for glass shards (none, thank goodness), then carefully brushed myself off. I went upstairs, put Alec down and went to deal with the small cuts on my hand.

The one positive aspect of this is that the breaking window cowed K into obedience. So she readily obeyed when I asked her to go play in her room for a while. Then I put Alec in the sling where he calmed down quickly and sat down for a few minutes while I contemplated dealing with the broken glass. Then I asked B to come home. And ate K's cookie.

So I made it about three hours on my own with both kids today. K has blessed, wonderful preschool tomorrow so I have a day to recover before I face the gauntlet again on Wednesday. I've been thinking about how I can start the day better so hopefully I can deal with the horrendous behavior K's been favoring us with lately** with a bit more grace. Things like getting dressed as soon as I get up and making breakfast for myself before I give Alec his morning feeding, so I don't find myself still in my pyjamas and starving two hours later, feeling trapped and unable to cope. As for K, I'm hoping a combination of working really hard on keeping my patience, ignoring the button-pushing and mainntaining firm consequences for the defiance will help. And of course, a cattle prod could work wonders too.

*Behold the power of not restricting sweets: K took one bite of her cookie, then demanded my apple and happily ate it all. This is because cookies aren't anything special to her, so she doesn't feel the need to gorge herself on them when she gets one.

** I never thought I'd say this, but oh my hell, I've found an age I hate more than 21 months. We've seen a return of the same delightfully piquant blend of hair-trigger tantrums and oppositional defiance, only now she's smarter and has a better vocabulary, so she can press our buttons with fiendish accuracy while mouthing off and hurling insults when she gets mad. Ah, the wonder years.

Thursday, July 16, 2009

Genetics and geekery

I'm continually fascinated by the ongoing genetics experiment we're conducting by having children. It's pretty easy to see where some traits come from. I have my father's long, narrow fingers and feet, so it's not hard to see where Alec's absurdly long fingers and monkey toes came from, for instance. But although I have a lot of my father's build, I look nothing like him in the face. But K has his mouth. And Alec has his nose and ears, and I would not be surprised at all to see a big resemblance as he gets older. Apparently my father's face has been hiding in my genetic code, just waiting for the opportunity to be expressed.


We finished watching Torchwood: Children of Earth last night, and I don't think I've watched such a depressing five hours since the time I made the mistake of watching Schindler's List and Life is Beautiful in the same week. It was just so unrelentingly awful, in ways that I'm really sensitive to right now. Which is not to say that it was badly written, acted or produced. It was just a good telling of a story I really didn't want to watch.

Hey, remember when Captain Jack was likeable and fun? I miss that.

B isn't working tomorrow but we're still shipping K off to daycare, so hopefully we'll be able to go see Harry Potter tomorrow. This is all dependent on the baby cooperating with a nice long nap, but given that there are showings about every half hour tomorrow, we should be able to find some point in the day when he'll sleep long enough. We might as well take advantage of the sleep like the dead phase of infancy while we can.

Sunday, July 12, 2009

2 1/2 weeks

I went to the doctor Friday to have my incision inspected and everything is looking good. The bacteria causing the infection turns out to be MRSA, which would explain why it didn't respond to the first antibiotic, as that it was one that MRSA is resistant to. It makes me really glad that we decided not to circumcise Alec, because the last thing a baby with a MRSA-infected mother needs is an open wound on a sensitive place just waiting to get colonized.

Life is starting to settle into a new normal. Alec is developing not so much a schedule as a pattern. He likes to spend 2-4 hours cluster feeding, interspersed with cat-napping and alert periods, then sleeps for six hours. It's a bizarre schedule for a newborn, but he seems to be eating well, producing as many dirty diapers as he should and is gaining weight, so we're just going with it. Such long sleep periods do make me have hope that he'll sleep through the night early, or at least earlier than K did at 22 months.

It's been 2 1/2 weeks, and he's already changing:
- He's having more alert periods and spent a good ten minutes in the bouncy seat last evening, admiring the dangling toys.
- Diaper changes are improving, in that the mere act of having his clothes or diaper taken off is no longer cause for him to demand intervention from Amnesty International. He would still like having a cold wet cloth applied to his genitals be declared a violation of human rights however. I can't say I blame him, but we have to get the poo off somehow.
- In slightly less positive changes, the infant acne has arrived. Our poor little pizza face. Time will tell if he also gets the cradle cap his sister had. I love my children, but I have to admit this is not necessarily the phase of infancy where they are at their most physically attractive.

Sunday, July 5, 2009

Home again

I was sprung from the hospital yesterday morning. The antibiotics worked pretty quickly to make things look visibly better after the first dose, and three more have gotten things down to the point that they were willing to let me go with oral antibiotics. So I'm back home with my babies.

Thankfully, Alec has gone back to the breast like he never left, and if you were to point out to him that he spent his first week of life refusing to latch, he'll deny it while looking at the sky and whistling nonchalantly. Whistling while spending two hours sucking desultorily away is quite a trick, but he's talented.

If you ever find yourself in the situation of needing to use a bottle early in a breastfeeding relationship, I highly recommend the Breastflow bottle. It's designed to mimic feeding at the breast, both in requiring the baby to latch correctly and having an incredibly slow flow. We barely ever have to burp Alec with these bottles either. Given that he had only been reliably latching for about a day and a half before I had to go back to the hospital, I really think having to use a different bottle with a faster flow would have been disastrous for getting back to nursing. As it is, my supply has definitely taken a hit, but that's fixable. We're supplementing a bit as needed and he has no problem switching back and forth, often in the same feeding.

Friday, July 3, 2009

Not how I intended to spend the holiday weekend

So! I'm back in the hospital. What looked like irritated skin around my incision earlier this week turned into a spreading redness that kept going even after my doctor put me on antibiotics. So I earned myself a stay in the hospital for iv antibiotics.

I feel fine physically. The infection isn't in the incision, it's just the skin above the incision. I'm receiving an iv bag of antibiotics every 12 hours, which makes this feel like the biggest waste of money in the world for me to lie around in a hospital bed just to receive medication twice a day. Fortunately, it's working pretty rapidly, so it's hopeful that I'll be able to go home tomorrow.

Children aren't allowed in the building I'm in because of the swine flu, so you can imagine how I'm doing emotionally. It's bad enough leaving K again after being gone last week, but there's a special sort of hell involved in being forced to be away from your ten-day-old baby when you're filled to the brim with hormones telling you you need to be taking care of him. Intellectually, I know that he's fine and well-taken care of, that my health is more important than what havoc this might wreak with the breastfeeding that was just starting to go well and given that he's been sleeping 20 hours a day, he probably barely knows I'm gone. But my body doesn't care.

On the plus side, being on the "Women's Health Pavilion" floor instead of the maternity unit has resulted in much better accommodations that most significantly don't include a roommate who leaves the tv on all night (not that there's any good time for this, but waking up at 6am is way too damn early to be confonted with Married...with Children). And although we were told last week that the hospital doesn't have wi-fi, when B brought my laptop in so I could watch dvds, I discovered that in fact they are "happy to provide our patients and guests with free wireless internet access."

Thank goodness B's parents are still here. And while I feel like a terrible hostess for having to go to the hospital the day my mother arrived for a visit, it was nice to have her here to keep me company most of the afternoon.

But I just want to go home, dammit.

Wednesday, July 1, 2009

One week

One week ago right now, I was lying in a hospital bed, admiring my most marvelous newborn son. Our hospital stay was surprisingly decent for a crowded inner-city hospital, but we were all very happy to come home. Here's our status so far:

Alec: Right now, he's in the eat-sleep newborn cycle where he basically wakes up to eat and to object to the horrific state of his diaper (apparently he poops hydrochloric acid, given his vociferous reaction to it), then cuddles back down in our arms and goes back to sleep. He has the most amazing menagerie of animal noises when he's expressing his woe, with squeals that start out like a horse whinny and escalate up to pterodactyl shriek, and deep piggy grunts. I'm remembering some of the things I had forgotten about newborns, like the difficulty of diapering a violently kicking, crying little being without letting them get their feet in poo and stamping it all around.

He looks quite a bit like his sister did at that age. They have the same round cheeks, velvety dark hair (although he has quite a bit less than K did), Wolfman pelt of dark hair on his ears, shoulders and back and dark grey eyes. I expected K's to turn brown, but they surprised me by just turning a lighter grey. I'll be very interested to see what Alec's do. He has my father's nose and ears (or ear, I should say, since my father had mismatched ears and Alec's are mostly the same. But they're very much like one of Dad's ears). When I look at him, I see a lot of my father and brother.

Although he was nearly nine pounds, he was 95th percentile for height and only 75th for weight, so he isn't a fat baby yet. We started using the cloth diapers that were technically supposed to fit an 8 pound baby, but decided that since they went halfway up to his armpits and extended down to his knees that we should wait a couple weeks.

Me: I'm feeling pretty good, all things considered. Part of it is that they gave me much better drugs than I had last time - I was started out with a PCA pump of morphine and then given a nice combo of perc0cet and industrial-strength ibuprofen. As a result, I've felt much more mobile this time around. Things seem to be healing well, although the skin surrounding my incision has developed a nice case of cellulitis that earned me a round of antibiotics.

Breastfeeding got off to a rough start, which was starting to make me a bit neurotic and panicky, but tonight, the simple introduction of a nipple shield produced a lovely productive nursing session and a baby that has been sleeping contentedly for the past hour. Given that on Sunday, I was forced to switch to bottles because of a quite dehydrated baby who was refusing to latch, this is quite a relief. I don't feel like we'll be out of the woods until this becomes a consistent performance and he does well at his weight check on Thursday, but I'm a heck of a lot more hopeful.

K: is absolutely THRILLED with her baby brother. She loves holding him, and when I put her in bed with her last night while we read bedtime stories, she was in seventh heaven. On the downside, I found her in a pullup when I picked her up from preschool yesterday because she wanted to be like him (although she was still using the toilet, so I guess it doesn't really matter) and she spent part of today drinking milk out of a bottle.

She's definitely feeling pretty attached to me. Part of that is that she wasn't allowed to go see me in the hospital, which I felt just awful about. I agree that protecting tiny babies from swine flu is important, but every time I talked to K about what would happen when I went to the hospital, it ended with "And then you'll come see me and baby brother." Instead, she didn't get to see me for three days. I'm trying to make up for it by being as available as I can given that I'm often pinned under a baby. Thankfully, B's parents have been wonderful at distracting her with activities, bless them.

I'm sure life will get a lot harder as the extra help leaves and the honeymoon ends, but right now, life with a new baby is going pretty well.