Breastfeeding, Take Three

I know I still need to post a birth story.  It's coming, but I'm still working on processing everything mentally.  Until then, I'm going to post some post-birth stories.  I'm going to start with my experience with breastfeeding this time, because it wasn't what I was expecting.

Not much has been, really.  And I'm getting to the point where I think that's okay, but, as I said, I'm still processing.

I had many high expectations of what would come out of having a natural childbirth.  One of these was an easier time with breastfeeding than I had with the other two.  Not that I a particularly difficult time with either of them, but I figured after an unmedicated delivery, it would be even better.

First, there would be no medications in my system to keep me from being able to nurse right away, as happened with the Birdie's birth.  I wasn't able to nurse her until several hours later, after the medications wore off.

Second, there wouldn't be any medications in my Bumblebee's system, thus making her more alert than babies born during medicated deliveries.  She was very alert right away.  But, then again, so were the Birdie and the Imp.

Third, waiting for her to come on her own (instead of being induced) might - I speculated - help my milk come in faster.

Fourth, having natural oxytocin in my system instead of synthetic oxytocin might also help my milk come in faster.

But guess what?  There was one factor I didn't consider, and it was probably the most important one with relation to breastfeeding:  hydration.  It's quite possible that the things I listed above would have made my breastfeeding experience better...if I had kept myself hydrated.  But I didn't.  It never even occurred to me that I needed to.  After all, it was never that big of a deal with my other two.  Oh, I knew it was important, but I never went out of my way to make sure I stayed hydrated, and I had plenty of milk for both of them.

But guess what else I had with them:  IV hydration during labor.  Something I didn't want and didn't have during my labor with the Bumblebee.  I was pretty dehydrated afterwards, and I didn't do anything to take care of it.

And it made a big difference.  Huge.  So big that, for a couple of days, I didn't think I was going to be able to breastfeed my Bumblebee long-term.


Everything started off well.  Immediately after delivery, although I was pretty shell-shocked from what I'd just gone through, I was able to nurse my Bumblebee for about an hour and a half.  I was never pressured to hurry things up.  They let me stay there and nurse her until she was finished.

She was 7 lbs, 8.5 oz. when she was born.

She nursed well in the hospital, although it wasn't as frequently as it should have been.  I'd planned to have her room in with me the whole time, but I was exhausted that first night, so I asked them to take her to the nursery for a while.  They brought her to me when she seemed hungry, which meant she went for some fairly long stretches in between feedings - becaues newborns are sleepy like that.  I should have been feeding her every two hours, and I knew that, but I hadn't slept in more than 48 hours and I didn't have the willpower to choose nursing her over snatching a few hours of rest.

They weighed her that night around midnight, and she was 7 lbs, 5.3 oz.  We left that day, the 20th, so that was her discharge weight.

On the afternoon of the 21st, we went to the pediatrician for her first weight check.  Most breastfeeding moms are familiar with the horror of the weight check.  After a mostly sleepless night spent trying to figure out what in the world you can do to placate your newborn who will only sleep if you are holding her, which of course you are told you absolutely must not do, you stagger in to the pediatrician's office, only to have them tell you your baby has lost too much weight, or is on track to losing too much weight, and (if they are supportive) inform you that you and your baby are sleeping too much (What?  Seriously?) and that you should be waking up every two hours to feed her (if they aren't supportive, they start talking right away about supplementing with formula).

So, we had our first weight check.  Since this is our third baby, we really weren't too worried about it, especially since everything went really smoothly with the Imp.  He only lost about 7 oz. total - about 7% (the "danger cutoff" is 10%) - before he started gaining.  During our weight checks with the Birdie, Craig and I developed a bit of a tradition.  We'd choose a weight, and then we'd bet on whether she'd be over or under it.  Loser had to buy at Starbucks after the appointment.  So, on the way to the appointment, we joked about it, and settled on 7 lbs even.  If she was 7 or more, Craig won; if she was under 7 lbs, I won.

Except, of course, if she was under 7 lbs, I was really losing.  After all, the Imp never dropped below 6 lbs, and the Bumblebee was a pound heavier than he was - so I didn't really expect her to drop below 7.  Even though that's what I bet on, 'cause I'm pessimistic like that.

And, as it turned out, the pessimist in me won.  6 lbs, 14.2 oz.  Then, to make me feel even better about it, they had me nurse her in the exam room, then they weighed her again to see how much she gained with a feeding.  The result after I fed her?  6 lbs, 14.1 oz.  All right!  I actually must have sucked some milk back out of her!  Great job, Mommy!

Of course, the pediatrician's lactation consultant was ever-so-encouraging.  "If she drops below 6 lbs 12 oz, we'll be concerned, but I don't expect that to happen.  This is your third baby;  I'll bet your milk comes in in the next 24 hours."

Oh, yes.  I'll bet it does.  Just like, "This is your third baby.  I'll bet your labor goes fast."  And, "This is your third baby.  You're already at 6 cm - she'll be here in no time."  Also, "This is your third baby.  I'll bet she slides right out with you barely even having to push."

But I'm getting ahead of myself.  We'll get to that part in another post.

Back to the milk - have you guessed it?  Nope, as a matter of fact, it didn't come in "within the next 24 hours."  7/22 (Day 3), weight: 6 lbs, 13 oz.  Only one ounce lost away from, "Danger, danger, supplement NOW!"  As before, I nursed her, they weighed her again - and she was still 6 lbs, 13 oz.  I started to panic.  Someone remarked, "At least she didn't lose any [after being nursed]."  Ohhh, yes.  Thanks ever so much for that.  I started to cry.

7/23 - we went to the hospital for the weight check because we had some routine tests that needed to be run since we left the hospital early.  This time, we received a little bit of hope:  6 lbs, 14 oz.  I nursed her, and it actually went up - 6 lbs, 14.7 oz!  Not much of a gain, but I'd just nursed her shortly before we weighed her, so she'd already mostly drained me.  So this was somewhat encouraging, but the pessimist within reminded me that Craig and I are pretty sure that the scale at the pediatrician's office is not reliable - we think it's consistently low, so it was possible that 14 oz. on the hospital scale would still be 13 oz. on the pediatrician's scale.  However, it was enough to get us out of the weight check cycle.

7/25 - I'd been feeling pretty encouraged, but overnight, I accidentally went for about 5 hours without feeding her.  I should have been ready to explode, right?  Nope.  I barely felt full after that.  So I knew things were still not where they needed to be.  Completely discouraged, that evening, I spoke on the phone with my doula, who agreed that things didn't sound right and suggested I spend a few days of strictly nursing every two hours (or more often) and otherwise keeping the Bumblebee skin-to-skin with me and doing nothing else.  She also helped me realize I hadn't been drinking enough water to make up for the fact that I hadn't had IV hydration during delivery, so I was very dehydrated, which was probably the main reason my milk was being so stubborn about coming in.

Unfortunately, the timing of me needing to focus 100% on the Bee coincided with my mom going back home for a few days (she had been with us since the day before the Bumblebee was born);  fortunately, I have an amazingly supportive husband who never once questioned or argued about my need to do this, and took on either caring alone for our two small children or arranging for someone to help him out with them.  I was able to settle on the downstairs couch with my Bumblebee and three travel mugs that I kept full of water on Sunday evening and stay there or in bed with her constantly until Tuesday evening, with only a few breaks.

And guess what?  It seems to have worked.  On Wednesday morning (7/28, 9 days old) I had to take her to the pediatrician for an unrelated issue, but of course they weighed her.  I went in, half-fearful and half-hopeful.  This time, the hopeful side won out.  Weight:  7 lbs, 4.2 oz. - a gain of 6 oz since her last weight check, 5 days earlier.  Since the average rate of weight gain for a breastfed baby is 1 to 1.5 oz. a day, that was enough to let me know we were on the right track, finally.

What a relief.

We have a little over 4 oz. to go to get her back to her birth weight, so I expect she'll hit it by Monday, if not sooner.  Her next visit is on Monday (two weeks!  Wow!) so we'll find out then whether we made it or not.

Regardless, I've learned a very important lesson for next time, if I decide to have another natural birth:  drink way more water than I think I need, because my tendency is to not drink enough.  I guess this should be obvious, but since I was probably over-hydrated after my first two babies' births, it didn't matter nearly as much whether I drank enough during those early days (which, of course, I didn't, but as I said, it didn't matter).

So, now I know.  That's one item to go in the "Lessons Learned" list.

One of many.  Very, very many.  I'll get to those other ones soon.

Au Naturel

I haven't posted about the Baby Bee in a while (or about anything, for that matter, but that's beside the point), so while I sit here waiting and dreading a couple of approaching thunderstorms, I'll see if I can organize my thoughts enough to say a few things.

First, about the baby.  Not much to say there...everything is normal, as far as anyone can tell.  I am just past 35 weeks, so only a little bit longer to go.  (For those who aren't used to counting pregnancies in weeks, I'm expecting her to be born between 39 and 41 weeks, so I have another 4-6 weeks to go.)

An aside.  Does anyone else still think of six weeks as a "grading period?"  A throwback to elementary school days.  We got our report cards every six weeks, and to this day, when I think of six weeks, I think of it as a "grading period."

But really, it's about a month-and-a-half, so that's what I've been telling people who ask me how much longer I have.

After doing quite a bit of research, I've decided I would like to have an unmedicated delivery.

What?  Really?  Me?

Yup.

Anyone who knows me will know that this is a surprise.  I've never been much of one for pain, and I've always been of the "if there's a good way to avoid it, then why the heck not?" mindset.

So how did I come to this startling decision?

It started out with a single motive:  to reduce my risk of a c-section.  No, I have never had one, and odds are, I'm a pretty good candidate for not having one in a future delivery.  But, every labor is different, and realistically speaking, it could still happen.  Since we are planning to have another little bundle within the next two years or so, God willing, a c-section with this one most likely would mean a repeat c-section with my fourth.

And scheduled c-sections don't make good stories.

At least, you hope they don't.  If they do, then it's probably not a good story, or at least not a pleasant one.

But if all goes well, and Mommy and Baby are healthy at the end, then it's likely not a good story.  And, oh yes, I thought of that.  In fact, that was my first reaction when the idea crossed my mind.  No, not a good reason, but there's a good reason that trumps it, even in my mind.  Three words for you:  Major Abdominal Surgery.

Don't get me wrong.  If it were a question of a c-section or my baby's health and safety, I'd take the c-section in a heartbeat.  But just because...?  (Just because my labor isn't progressing fast enough?  Just because I had one the last time?)  No, thank you.

My first decision was, in order to avoid the increased risk of a c-section, I'd skip the induction this time.  Inductions worked well with both of my others, but why take the chance?  As much as I love the doctor who delivered both of my babies (I scheduled so I could ensure she delivered them), I figured I could stand to wait it out this time.

And I was okay with that.  But I still planned the epidural.  After all, epidurals don't increase your risk of c-section, right?  Right?

But then I started stumbling across comments...birth stories...anecdotal evidence that maybe an epidural does increase your risk of c-section.  Stories of epidurals slowing down labor so much that the doctor orders on the pitocin, which leads to more interventions (some necessary, others possibly not), which eventually would lead to a c-section.

Really?  So I asked around a little, and found some literature, and did some research (admittedly secondhand - I just don't have the time to read the studies for myself at this point).  And there is actually quite a bit of evidence that an epidural can lead to an increased risk of c-section...and that it might not be best for Mommy and Baby in a vaginal delivery, either.

(Yes, I just used the word "vaginal."  Sorry, Dad, and any other men who might read this.  That's just how babies come out, at least 67% of the time.  Yes, you read that right, 67%.)

There are other reasons.  I know that the odds of the epidural slowing down labor enough to lead to a c/s in a third-time mom are fairly slim, but that was just where the research started, the tip of the iceberg, to use an overused cliche.  I'll get into some of the other reasons in a future post...but as I'm not trying to start a debate, I don't want to go into too much detail.  Just know that I have researched this, and I've found enough additional reasons to labor unmedicated that I feel very comfortable with my decision.

I'll admit, however, that I wasn't too happy about this at first.  I didn't want to skip the epidural.  I mean, hello?  Pain?  We are not friends.  We have never even been what you might call semi-close acquaintances.  But the more I looked into it, the more I felt convicted that that was the best route for me and for my baby.  It's not the best choice for everyone, but I feel clearly that it will be best for us.

So if I was going to do it, the next step was to figure out how to do it.  Which meant even more research.  And I learned that it's not always excruciatingly painful.  That it doesn't have to be scary...it really is a natural process!  Natural contracting and releasing of muscles, pulling up and out, to open up the...opening...(I'm trying, Dad) -- That doesn't sound nearly as frightening as I always imagined it.

I do realize it is usually painful, and I am not expecting it to be painless.  I know childbirth isn't easy, and it's not going to feel good.  I don't think I have any unrealistic expectations (but then again, who ever thinks they do?)  But I am trying to not have any specific expectations about how it is going to feel.  I'll plan on taking it as it comes.  I'm researching, and exercising, and preparing myself for what my body will go through, but trying not to have expectations beyond the knowledge that it is going to be a lot of hard work.

(Aaaaaaaand....the first storm is here.  It seems to have broken up a little bit as it hit the "Ohio River Triangle," where many storms seem to get lost, never to be seen again, but for the most part, this one made it through, and I'm going to try to remain calm until it passes.)

To my surprise, though (going back to the original discussion), I am finding that I am looking forward to the experience.  It didn't start out that way, and that was never and will never be my primary motivation. I'm not wanting to be one of those people who is "doing it just so I can say I can."  I think it's the best choice for me and my little Bumblebee, and I will continue to think that as long as no new, substantiated information comes along that tells me otherwise (specifically, from my caregiver; otherwise, I'm not going to change my mind).

There is a lot more to this story, but I realize this has gotten long and rambling.  I wasn't joking when I questioned my ability, at first, to organize my thoughts into something cohesive and coherent.  I think I've gotten my point across, but I think I could have said it much better, too.  So I apologize for that, and will try to put my thoughts in better order before I write the next installment.

(Incidentally, the storms are over now, unless something else pops up tonight.  The second storm that was headed our way pretty much did die on the Ohio River.  And I have no problem at all with that!)

Birth Story: The Imp

Today I am joining Mama M.'s Birthstory Blog Hop with the story from when my son was born.  Sadly, I can't find my daughter's birth story (although I am still looking), but if/when I find it, I will share that also.

My Imp was born on June 4, 2008, at 6:13 p.m. He was 6 lbs, 9 oz. and 19.5 in. long.

I was scheduled for an elective induction on June 4th. I chose that date because it was past 39 weeks (39w2d) and my doctor was on call. Interestingly, the Imp was due on a Monday and induced and born on a Wednesday, exactly the same as his sister, a year-and-a-half earlier.

As with the Birdie, I was told to call Labor & Delivery at 5-in-the-morning (yuk) to find out when they wanted me to come in. With the Birdie, they had me come in right away, and that was what I expected this time. Much to my disappointment, the girl I spoke to told me they were having a "computer glitch" and to call back at 7. I was not happy, and there were a few tears.

At 7:00, I called back, certain they'd tell me to come in within the next couple of hours. (By 9:00 at the worst, I figured.) The nurse told me, "Yes, you're on hold for a room, and we'll call you when one is available." What?! That was not what the first nurse had told me. There wasn't a room for me at all? Now there were a lot of tears.

I called again at 9:00 because I didn't like being at their mercy for a phone call, and the (same, sigh) nurse told me that I was still on hold, but that I was "next on the list," which meant I was going to get in that day (at that point, I had been certain it wasn't going to happen). So I waited a bit more, and just before 10:00, the nurse called and told me to come on in. Yay! (When I got there, the same nurse that I had been bugging with phone calls was the one who checked me in, but at least she was nice about it.)

They got me hooked up to an IV around 10:45 and started pitocin around 11:15. Right after that, my doctor went ahead and broke my water. I was still at 3-4 cm at this point. I'm not sure when I got the epidural, but it wasn't long after that, probably at 12-something. That wasn't fun. Since my contractions really weren't all that bad at that point, I was focused entirely on the sensation of a catheter being put into my spine, which was NOT pleasant. And yes, you CAN feel it going in. I whined a lot, although the doctor did commend me for doing a "good job" (meaning I held still). My response was, "Like I'm NOT going to hold still when you're putting something into my spine!" It did feel like it was off to the left a little bit, and I think that I was right about that because my left side ended up being MUCH more numb than my right side the whole time. Truly, I HATE the epidural, but I wouldn't dare go through labor without one.

The entire afternoon was spent waiting, and waiting and waiting. Starting around 4:30 or so, I could feel the Imp really low. It didn't feel like I needed to push, but it seemed like he was getting close. The nurse checked me at 5:00 and I was 7 cm. The nurse said things could go quickly from there because his head was pretty low, but I was pretty much expecting him to be born fairly close to 8 p.m. because of the whole 1 cm/hour once you’re in active labor thing. She told me to call her back in there if the pressure got worse.

Ten minutes later, the pressure got worse. I knew I was crazy for calling the nurse back, but I did, anyway. She checked me at 5:15 and said, "Your cervix is almost gone, and his head is right there!" I was shocked – I had gone from 7 cm to ready to have a baby in 15 minutes. How scary is that? I mean, if for some reason I wasn't ready, or I if told Craig, "I'm only 7 cm, why don't you get dinner now while there's still time?" Which, of course, I didn't, but still - it was very eye-opening.

My doctor and I had decided ahead of time that we'd let him "labor down" on his own instead of having me push right away. Turned out I didn't have a choice because she had just started someone else’s c-section at 5:15 so she wasn't available to "catch" him, anyway. The nurse said the timing would be "just right," that my doctor would do the c-section then come in and deliver the baby.

So we waited for her, and waited, and waited some more. It felt like an eternity, and I could feel him getting lower and lower with each contraction. Finally, around 6:05 the nurse came in and checked me again. She said something along the lines of, "Oh, yeah, he's right there!" I asked her how far in he actually was, and she measured it on her finger - about the distance to her first knuckle, roughly an inch. Again, I was shocked. And WHERE was my doctor?

At this point, the room became a blur of nurses setting up stuff for the Imp's imminent arrival. My mom took away my cell phone (yes, I'd been texting updates to people this whole time) and the L&D nurse got me ready to push. She had Craig get on one leg and, to my surprise, my mom get on my other leg (at that point, I was beyond being uncomfortable about it – but it was a shame because Mom had been going to take pictures of the Imp coming out, although from a less graphic angle than straight-on. Since they were digital pictures, I figured I could delete anything that made me uncomfortable.) The nurse had me do a "practice push," I guess to see how things were going to work, and right after that, my doctor came in. I pushed for one contraction, and she said he was close, and then on the second contraction, I started pushing and she said, "Okay, he's out!" Amazing. And I guess because of the way the epidural was working, this time I actually felt him come out of my belly - not the pain, but the release of pressure as he came out. It felt really weird, but in a good way because the pressure was causing some nausea that stopped when he came out.

Unlike with the Birdie, they immediately put him on my chest, before he'd been cleaned up, and I got to hold him right away. I was shocked that he was blue-ish, although I guess this is normal because he was crying and he pinked up right away when the nurse rubbed him. It was amazing to get to hold my little boy right away. After I got to hold him for a few minutes and everyone got some pictures, they took him off to clean him up, measure him, and weigh him (he was actually 6 lbs 8.8 oz), then gave him back to me and everyone except family cleared out and I got to nurse him. That, also, was amazing. I didn't get to nurse the Birdie right away because I was shaking/nauseated and I had to be drugged up immediately. He nursed so well right from the start, and he's been good at it ever since.

Oddly, I started having the shaking and nausea right after I finished nursing him and they took him away. I threw up a couple of times, and they gave me phenergan and carted me off to the mother-baby unit. I was in a lot of pain that night overnight, I guess from him being in the birth canal for so long (the pain was in my butt) so they gave him a bottle overnight because I didn't feel like I could sit up to nurse him. I was better by that morning, though, and the bottle didn't hurt breastfeeding any.

We went home on Friday morning, and his weight was still good at 6 lbs 4 oz. At the pediatrician the next morning, he had dropped to 6 lbs even (my guess would be that he didn't pass most of the meconium until Friday because I didn't change any dirty diapers until then, and that caused his weight to drop more after we went home than before). On Monday, he was back up to 6 lbs 4 oz, and by the following Friday, he was 6 lbs 10 oz, so he did a great job of making up for what he lost!

The last paragraph was from when I wrote this up, I guess when he was a month or so old.  I'm leaving it in for nostalgia's sake.

He has been an amazing baby. So far, he rarely cries - just during some diaper changes or if he gets hungry and someone other than me is holding him. He's very easy to calm - usually if I pick him up he will quiet right down. And he has been really good on me with sleeping. He sleeps in a little glider beside my bed and as long as I don't doze off while I'm nursing him overnight, he'll let me sleep for several hours at a time lying down in my bed.

I am so blessed to have my two beautiful babies, the Imp (6/4/2008) and my Bitty Birdie (12/13/2006)!

First photo (or one of them):

First kiss from his sister:

3 Months Old:

6 months old:

9 Months Old:

1 year old:

18 Months Old: