Tuesday, June 29, 2010

Our Breastfeeding Story

I'm sorry it's been so long since I've blogged. So much has happened and I really want to share it all, but things have also been so busy I haven't had time!

Here is a picture I took the other day that shows off Lillian's fabulous hair. It's probably my favorite picture of her so far.

So, now it’s time for me to blog about our breastfeeding saga. I knew in advance that breastfeeding would be hard. However, I didn’t expect it to be this hard.

Now, I knew that things do not always go as planned, but I didn’t expect to have as many obstacles as we did. I expected long nights, latch issues, sore nipples, a sleepy baby, etc. I didn’t expect NICU. I didn’t expect supply issues. I didn’t expect the vacuum extractor.

Things got off to a rough start in the hospital. I had always planned to breastfeed immediately after birth, but that wasn’t an option because Lillian had to be taken to NICU right away. And I wasn’t able to see her for about seven hours because I had problems of my own. Everything I’d experienced during labor and delivery, (getting only six hours sleep and not eating in 48 hours, the fever, the hemorrhaging), left me extremely weak. I could barely sit up in bed without help. And I had to be on two different IV antibiotics, one every six hours and one every eight hours, which really limited my availability to leave my room.

The NICU’s policy was that all babies were fed every three hours, so, by the time I got to see her, she’d already received two bottles. Despite this, when I tried to breastfeed for the first time, she latched right on and I was so moved by the experience that I started to cry. However, the longer she stayed in NICU and continued to receive bottles, the worse things got. Greg and I tried to attend all of her feedings, but that wasn’t always possible because of my antibiotics schedule. And, when we did attend, she often wasn’t hungry. I was sooooo frustrated because everything I had been taught said that newborns don’t eat much those first few days, and they were feeding her up to an ounce at a time. So, when Greg and I showed up, we’d spend over and hour trying to get her to nurse, and she would just sleep. We even asked the nurses to call us if she woke up hungry, which meant sometimes they would do, and sometimes they wouldn’t do, which infuriated us. At one point, it was about two o’clock in the morning and we both broke down in the NICU because she just wouldn’t breastfeed due to getting so many bottles and we felt like people weren’t listening to us.

Some of the NICU nurses just seemed unconcerned with our struggles to breastfeed. I’m sure this was because they were used to dealing with much bigger problems, but it was still extremely frustrating to have our concerns minimized. One told us that we should be grateful we are taking our baby home with us (which we were). Several told us that “there is no such thing as nipple confusion.” Greg wishes he had asked them why the literature the hospital hands out specifically talks about nipple confusion and not introducing a bottle or pacifier during the first two weeks. By the time we got home from the hospital, the only way we could get her to latch on at all was using a nipple shield.

The other extremely frustrating part was that we could not get a lactation consultant to meet with us until our last day there, and she only met with us for about 15 minutes (they were simply understaffed). We met with another LC when we got home, who thought it was so ridiculous that we should send a letter of complaint to the hospital CEO.

Oh, and the other ridiculous part was regarding the antibiotics schedule: As I mentioned, part of the reason I couldn’t always breastfeed Lillian was because I would be due for a dose of antibiotics at the same time she was due for a feeding. (On top of that, it was extremely annoying to have to lug around an IV pole everywhere I went, and it was really hard on Greg that first day when I was too weak to walk to NICU and he had to push me in a wheelchair along with the IV pole.) This went on for about a day and a half. Then, when my OB came to my post pardum room to see how I was doing, she asked why I was still hooked up to an IV. WHAT?????!!!??? It turns out she had ordered ONE MORE DOSE of antibiotics, not for them to be continued for two more days! Somehow the message got lost and I was on them unnecessarily!

The NICU nurses kept telling me that Lillian would breastfeed once my milk came in and she was getting something for her efforts, so I was banking on that. When we got home, I was producing a little more milk and pumping eight times a day, so we were “triple feeding:” First I would try nursing. Then we would give her a bottle of pumped breast milk. When the breast milk was gone, we’d give her formula.

My first goal was to pump enough milk to get her off formula, and I accomplished that in about four days. However, over that time, she was willing to take the breast less and less and it got to the point where she would just scream when I tried to nurse her. I remember trying to nurse her and breaking down in tears. I had trouble sleeping and had a constant knot in my stomach because I was afraid I wasn’t going to be able to breastfeed. And I was sooooo angry at the hospital.

However, I am extremely stubborn and wasn’t going to give up without giving it a really good shot. Greg and I decided to call a lactation consultant, and, oh my God, she was fabulous! Anna came to our house for two hours on a Saturday, (six days after Lillian was born), and we learned soooo much about why we were having such a hard time breastfeeding. Apparently my supply was slow to come in because:

a) I had hemorrhaged during delivery.

b) The medication they administered to stop the hemorrhaging (methergine) lowered my supply.

c) I had extreme swelling due to the normal course of pregnancy and labor plus the added affect of being on an IV for three days (seriously, my feet looked like sausages and I couldn’t even get them into my flip flops). Apparently the water was taking up space in my breasts that milk should have occupied.

And, apparently Lillian was not nursing well because I was trying to use the cradle hold, which involves holding the back of her head, and her head was sore because of the vacuum extractor! (Whhhhy people at the hospital couldn’t have shared this information with us, I have no idea.) So, Anna had me lean backwards so that Lillian could nurse on her tummy, and, OMG, she started nursing instantly!

Anna said my primary goals should be to keep Lillian well-fed and boost my supply. This meant I had to continue pumping 8-10 times a day for 20 minutes each time, which was sooo time consuming and exhausting, especially in the middle of the night! She also wanted me to call my OB on Monday and ask for her thoughts on prescribing me Reglan to boost my supply.

Greg and I spent the next several days thinking all breastfeeding all the time. We had a spreadsheet where we tracked everything. We called it “Captain’s Log.” Before and after each nursing session, we would weigh Lillian on a scale, (rented for $90), so we could record the amount of milk she drank. Then I would pump (with a hospital grade pump we also rented), and we would record the amount of milk I pumped. And, it seemed like half the time she would decide she was still hungry right after I finished pumping, so we’d have to give her if she was still hungry, we would give her a bottle of pumped milk and record the amount she drank.

It was a bit maddening, because I felt defeated each time we had to give Lillian a bottle. I would think she was done nursing and start pumping, and then she would want to eat again and I would stop pumping and nurse some more. This would be extremely frustrating at four o’clock in the morning when I just wanted to sleep! Or, she would want to nurse again right after I finished pumping and my breasts were empty, so we’d have to give her a bottle. I was managing to give her about 60-80 percent of her milk through breastfeeding and the rest was pumped milk. Luckily, I was producing more and more milk each day and actually started to make a small freezer stash.

Lillian wasn’t a big fan of bottles, which helped out with breastfeeding, but it drove Greg crazy because he usually fed her and it would take forever and she would spit up a ton. And we went through so many bottles. At first we were using Avent bottles I bought because they were recommended by Baby Bargains. I had only bought two, so, on the second day back from the hospital, Greg ran to Babies R Us and bought four more. Then the LC said she hated those and recommended Breastflow bottles. So Greg went off to Target to buy three of those. Then Lillian decided she wasn’t a fan of the Breastflow bottles, so we called the LC and she told us to use the nipples that go on the Enfamil containers that Lillian used in the hospital. So Greg went back to Babies R Us to buy more nipples! However, after more patience, Lillian did eventually start to take the Breastflow bottles and we are planning to continue using those when she needs a bottle.

After I started pumping three ounces at a time, the LC gave me permission to cut pumping down to five times a day and go longer between pumping sessions at night. That was a nice little reprieve. But we were still suffering the problem of Lillian not getting enough milk from my breasts because they were never full enough, (she would usually only get ½ to one ounce after nursing for 20 minutes), and it was extremely frustrating. Greg always wanted me to hold off on pumping, but I was afraid of hurting my supply. And I was always a little resistant to giving her a bottle of pumped milk because it felt like a defeat. But then I felt really, really guilty because the doctor said her weight gain was a bit on the slow side.

Greg and I had several late night arguments, I cried several times, and Greg even once said he wanted me to give up on breastfeeding and just use formula because I wasn’t getting any sleep. Even my Aunt, who was staying with us for the week, made a point to sit down with me and tell me it would be okay if I fed Lillian formula. I knew this was true, but I just wanted to breastfeed SO BADLY and I wasn’t ready to give up.

Finally, about two weeks after Lillian was born, the LC said I could try a going a day without pumping. She said that, if Lillian had at least 6 wet diapers, 3 poopy diapers, and 1/2 oz weight gain that I could go another 24 hours without pumping, and, if we met the goal again, I could consider our breastfeeding established. Lillian nursed like a champ during those first 24 hours of no pumping and no bottles. And we've exceeded the goal - at least 8 wet and 6 poopy diapers, and she gained 3 ounces! The LC was so thrilled that she said we didn’t even need to go another 24 hours and that we were officially “graduated.” OMG, I was sooo happy! I am feeling happy as I type this, just thinking about how hard we worked!

I couldn’t believe how much more sleep I was able to get not having to worry about pumping, weighing, or bottle feeding, Lillian was so much less fussy, and I had so much more free time during the day. And we haven’t looked back since! I am still exhausted and feel strapped for free time, but it is so.much.better. I still pump every morning so I can build a freezer stash, (in case I ever need to go on some nasty antibiotic or something), and also so someone can give her a bottle if I decide I want to leave the house for a few hours, (or so I can sleep in a bit).

Now my goal is to wean her from the nipple shield. So far she fusses every time I try to nurse without it, but I am not going to stress over it. If I have to use a nipple shield every time I nurse for the next year, that’s okay. It’s not ideal, but it’s still better than having to use formula or pump all the time.

So that’s our breastfeeding story (so far). It’s been two weeks since we “graduated” and things are still going well, and I am sooo happy that we stuck with it!

Sunday, June 13, 2010

Lillian's Birth Story

This is going to be very long, but I want to write everything down so I don't forget it.

We went into the hospital Friday evening at 5:00 for my induction. Cervidil was in place by 8:00. The placement of the Cervidil was actually a bit painful, mostly because the string attached to it was flat and textured, kind of like sandpaper, and the nurse was super rough with it. Sandpaper to the lady bits = not so fun :/ Other than that, though, I didn't notice any bad side effects from the Cervidil.

I spent the night connected to an IV so they could administer penicillin every four hours - that was needed because I tested positive for Group B Strep. I was also hooked up to blood pressure, fetal heart rate, and contraction monitors.

Having the IV placed, however, hurt like hell! I almost hyperventilated when the nurse put it in. I didn't expect that – I had gotten an IV several other times in my life and didn’t remember it hurting. The nurse didn't even numb my vein and was like, "Yeah, this is the biggest IV needle we use, so it hurts." WTF, thanks for numbing me first.

We didn't get much sleep that first night because the medical equipment was constantly beeping. The blood pressure monitor kept screaming that my blood pressure was too low, (it wasn't), then the battery was running low on the IV pole, and then the contraction monitor ran out of paper. So, I'd say Greg and I got about four hours of sleep. And I even took an Ambien :P

The next morning is when things started to pick up. The Cervidil was removed at 8:00 and I was still only 1 cm dilated. The nurse started the Pictocin around 9:00, and the doctor attempted to break my water around 10:00. Wow, having my water broken sucked! Apparently my cervix was still facing posterior and the doctor had a hard time getting her giant crochet hook in there. She made one attempt and I almost hyperventilated (again) because her fiddling hurt so much. When that didn't work, she said she needed to be more aggressive and told me that it was going to hurt MORE and asked me if I wanted something for the pain. "Um, yes, please." She let me choose between the epidural and Stadol. I chose the Stadol because I wasn't ready to be chained to the bed for the day. HUGE mistake. The pain was still horrible and I flipped out and got really hot and almost passed out, the medicine make me soooo dizzy, and it took everything in my power to keep from vomiting, despite getting IV Zofran. I spent the next hour trying to stop the room from spinning and trying not to vomit while I waited for the Stadol to wear off.

After all that, my OB wasn't sure if she had gotten my water with the hook, because nothing happened, but she wanted to give it some time to see if maybe she snagged it just enough for it to break on it's own.

The next few hours were not bad, although I don't really remember them. My contractions became regular, (three minutes apart and lasting one minute), around 10:00 (the same time my OB tried to break my water). Around 11:30, my water broke while I was in the bathroom. Whooohooo! My contractions steadily picked up from there, but they were very manageable. I thought they were similar to severe AF cramps that wrapped around my back, except I got a break in between them. The breaks are what made them so manageable. I stood up and did gentle side to side lunges during the breaks (I couldn't really walk around because I was attached to too much equipment). And I sat on the bed and did breathing exercises as Greg massaged my back with each contraction, (and I would whisper things like "Sons of Bitches" and "Mother Effer" at the peak of each contraction). One of the nurses even said I was doing so well that I should considering going natural. However, I had no desire to keep that up for hours and hours and hours. I wanted to be able to rest and chill out. So, at around 2:00, I requested the epidural.

It took over an hour for me to actually get the epidural, so I'm glad I asked for it when I did. While I was waiting, I lost my mucus plug, (I always wondered if I would notice it - Um, yeah, there was no denying it). And, at some point, I lost all sense of modesty with my husband and was handing him my used pads to throw in the trash :P - moving around was just not easy with ten thousand cords and IV pole attached to me.

Getting the epidural freaked me out but really didn't hurt too bad. It wasn't as bad as the IV. Still, I am not a fan of people "doing things" to me, especially sticking a needle in my back, so I was holding Greg's hands saying "Sweetie, sweetie, sweetie" over and over again.

I'm so glad I got the epidural. It made me very shaky for a while, and I was bit nauseated, but other than that it was great. I could still move my legs a little bit, but I was able to sleep a bit. And watch TV, talk to my family, read some magazines, and write a lot of this down here :)

Shortly after I got the epidural, I got my sixth dose of IV penicillin for Group B Strep. That medicine burns! And I guess my vein had enough. A few minutes after the nurse started the medicine, my arm started to hurt so badly that I thought I was going to lose my mind. She tried turning down the flow rate and it did nothing. I was laying in bed holding Greg's hand and crying out, "It hurts! I can't take it! It hurts so badly! Oh my God it hurts! What am I going to do????" It was the worst pain I’d ever experienced, including all of labor and delivery. Finally, my OB gave the nurse permission to turn off the medicine and I didn't get it again.

Around this same time, the contractions really picked up - they were really close together and to the point that the baby was showing signs of distress. So, they turned off the Pictocin and had me lay on my side wearing an oxygen mask for an hour. The baby looked much better after that and they started the Pictocin back up again at a lower dosage.

This is where I stopped writing stuff down during labor, so things are much less clear from here. I remember being unable to sleep and watching Star Wars. And I remember starting trembling soooo badly around 1:00 AM on Sunday morning. I had to put my mouth guard in to protect my teeth from all the trembling. I remember getting that undeniable urge to push around 3:00 AM and having to breath through the contractions, and I asked for a booster to my epi because it wasn't time to push yet.

At some point around here I also got a fever of 102 degrees. I think this was the scariest part for Greg, because I was so hot and he was just constantly going back and forth from me to the sink giving me cool washcloths for my face. Then the nurse joined in and was putting washcloths everywhere on me. My doctor got called in and gave me Tylenol suppositories.

My doctor then informed me my fever could potentially be caused by a uterine infection, and, because I had tested positive for Group B Strep, our baby would have to go to NICU to receive antibiotics until the results of a blood culture, (for GBS), came back, which would take 48 hours. I was disappointed by this news, but accepted what was best for our little girl.

Soon after that, it was time to push, and I got a freaking migraine at the same time! I was like, "Are you effing kidding me???" because I didn't want to be disoriented when I met our daughter. I am soooo thankful to our nurse because she got the anesthesiologist, who put something in my epi that stopped the migraine in its tracks.

So, then came the pushing. My contractions were about four minutes apart, and I pushed three times with each one for three hours. It wasn't too bad - I got to relax in between pushes and Greg and I chatted with the doctor and nurses. I did not find it more exhausting than anything else I’d experienced during labor and delivery. Unfortunately, the baby got stuck in the birth canal when she was almost out! We could see her hair, but she just wouldn't come any further, no matter how much I pushed.

The doctor told us that we would have to decide between a c-section and using the vacuum extractor. There were risks to the baby associated with both, and Greg and I were had a hard time deciding which route to choose. So, while we were deciding, I pushed for another half hour. Greg called his brother (a doctor) for advice. My doctor and the nurses left the room for a while so Greg and I could talk it over. We finally decided to go with the vacuum, because the baby was almost out and they would have to pull her back up through the birth canal in order to perform a c-section, which had its own risks, and because, as everyone knows, a c-section is major surgery.

Once we made that decision, the room filled with people. It only took three sets of pushes for the baby to crown, (which hurt, BTW, but it only lasted for a few seconds, so it was not as painful as the penicillin). After that, the doctor told me to keep pushing whether or not I was having a contraction, and she guided the baby the rest of the way out.

During this time, someone asked Greg if he was okay, and he said he was just trying not to cry. I will never forget the look on his face when she was born - he looked at me and there were tears in his eyes. It was the first time I ever saw him cry.

Unfortunately, this is where things started to go not as I planned them. I always wanted skin to skin contact and to breastfeed immediately after birth. Someone asked Greg if he wanted to cut the cord, and I heard the doctor say, "No, I am just going to do it." Lillian was then whisked away to another table in the room while the NICU people took care of her. Once they started cleaning her, she let out a wail and started crying. I started crying at the sound of her voice because I couldn't believe that was my daughter and I was so happy. I told Greg to go over to her, so he did, and then he got to hold her once she was cleaned up and swaddled.

In the meantime, I heard something about me having a lot of bleeding and needing medication to stop the bleeding. At the time I didn't realize this was a big deal, but afterward I learned I was hemorrhaging and the doctors were worried. I also had a 2-1/2 degree tear that needed sewing up. I spent the entire time watching our daughter across the room.

Finally, they let me hold her for a few minutes. She was screaming and I could tell she was hungry, but they wouldn't let me breastfeed her and it broke my heart. She was then taken away to NICU pretty quickly.

I was trying really hard to be okay with all of this NICU stuff, but I lost it when a nurse told me I wouldn't be allowed to see her until she was released from NICU because I had a sinus infection. I sobbed and said how I wanted her to know I was her mother.

After that, I still had to spend quite a bit of time in the labor room while the post-pardum nurse cleaned me up and put me on more IV antibiotics (not penicillin this time, thank goodness!). However, someone disconnected my IV at some point, so the nurse had to flush the port to reconnect it. Well, my vein had enough. It hurt so freaking bad that I yelped and jumped and start bawling. That was definitely part hormones, part exhaustion, and part being sick of being in pain. So they placed a new IV (and numbed my vein this time!).

Then, I thought I was going to pee myself, so the nurse helped me to the bathroom and I couldn't go, which meant I needed a catheter. The epi had worn off by this time, so this meant that it was going to have to be placed without pain medication. And I was very sore and swollen. It hurt so badly that I kept crying out, and it took the nurses three tries to get the freaking thing placed! A few hours later, I started cheering when I was able to pee on my own because I was so afraid they were going have to place a catheter again!

During all this, I remember getting a call from NICU asking me if there was any type of formula we wanted Lillian to have. My heart absolutely sank. This is not what I wanted. I wanted to breastfeed. I hadn't even bothered to read the chapters of formula feeding. I was so taken aback by the whole thing that I just told them it didn’t matter – honestly, I had no idea what kind of formula I would have wanted her to eat.

After my torture was over and the nurses just had to finish cleaning me up, Greg went to NICU to see Lillian. I got transferred to postpartum, and Greg came back glowing and said, "She is awesome!"

During all this, I kept crying over not being able to see Lillian. Then, it turns out there was just a communication issue and I would be able to see her, and nurse her, I just had to wear a surgical mask.

The next 48 hours were some of the most stressful and wonderful of my life. I was so in love with Lillian, and holding her was the most amazing thing I'd ever experienced. However, the fact that she was in NICU and receiving formula meant that breastfeeding did not get off to a good start. I will blog more about our breastfeeding saga in a separate post - I knew it would be hard, but it's been harder than I ever anticipated and is a long story in itself!

Thankfully, Lillian’s blood culture came back negative and we were able to take her home from the hospital with us! As hard as it was to not have her with us during those first two days, I kept reminding myself how lucky we were that we had the healthiest baby in the NICU and got to take our baby home.

And all of the pain of labor and delivery was soooo worth it. It’s so funny, because I’m sure this post seems like a lot of complaints, but I already look back at those 40 hours in the labor room with a lot of fondness. It made me love my husband even more, and seeing him glow over our daughter makes me such a proud wife. And, of course, I already can’t imagine our lives without Lillian. I can’t believe how perfect she is, and how much I know I would do anything for her. I know that we are so lucky and blessed to have her!

Wednesday, June 2, 2010

Lillian Mabel

Our sweet baby girl, Lillian Mabel, was born at 8:35 Sunday morning! She weighed 7lbs 12oz and was born after 12 hours of Cervidil, 19 hours of active labor (w/ Pitocin), and 3-1/2 hours of pushing. We named her after two of her great grandmothers.

Greg and I are so incredibly in love with her. Things have been crazy busy, but I am looking forward to writing a birth story soon. There were a few hiccups along the way, but everyone is doing well, and we came home from the hospital yesterday! I can't believe we got to take her home and that she is ours. Here are a few pictures:

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