Diagnosis

Ok, 2 great things to report. I got Elliott into the sling! Yesterday (after some fussing) he allowed me to put him in, and took an hour long nap, and again this morning he allowed me to put him in it again, while he napped. It is a glorious day.

I also went to see a lactation consultant. She came at the recommendation of several people, all unrelated to one another. Gratefully, I was able to get a same day appointment. Aside from the let down issue, and the clamping that is a symptom of the let down...I learned a new position to feed in that will assist with both. I am also supposed to pump a couple times each day, after feeding on the opposite breast. This will help me two fold. It will allow me to start building a supply-for when I go back to work (or for when I just need a break). And it will also take some of the pressure off, and help Elliott latch on better, and prevent him from clamping down to slow the flow. And as another pleasant side effect...less laundry due to less milk spillage and less spitting up due to gas resultant from having to guzzle to keep up. Woot!

But, most important was the diagnosis of the awful nipple and breast pain I have been having. Today I actually started to cry while I was feeding Elliott. Previously, I thought it might be Thrush, but it is apparently Raynauds Phenomenon. The unfortunate part is that to alleviate the pain, I have to take a ton of herbals pills and it may take up to 6 weeks to see results, or I can take medication. In either case, they both have their pros and cons. I am going to take a multi-pronged approach and do both.

First thing tomorrow, I am going to see my Midwife and hopefully get a confirmed diagnosis. The LC can only suggest what she thinks it is, but your doc must diagnosis you formally (for meds anyway). I will keep everyone posted on the results, but for now we are hopeful of the possibility of getting some relief.

Do you have help at home?

I have been asked this question about 25 times since I delivered my son-the OB, Midwife, Lactation Educator, Nurses and Pediatrician. Everytime I answer the same thing. My husband took 3 weeks off of work to help at home, but NO I dont have any help at home currently. But, it doesnt matter what my response is. They dont seem to care what you answer is, they just want to ask the question. Like, the obligatory greeting, "How are you"? Does anyone really care about the answer?

I suspect that a memo went out saying something like this...

Dear Medical Staff:

Here at UCSD Medical Center we want our patients to think that we care about them and their recovery. In a world of ever increasing disassociation with patients, increased lawsuits, and a decreased amount of interpersonal relationships between doctor and patient--we feel it is critical to give the sense that we are a different kind of hospital.

Henceforth, please ask every L&D patient if they have help at home. The questions should be positioned in a way that sounds as if you care. If should be asked with an air of concern. It doesnt matter what the patient answers, since we dont actually care about that part.

Regards,

UCSD Medical Center

Blips and Beats

Excuse the randomness of each item here, but I am sleep deprived, kinda depressed at my lack of success with breastfeeding and have a major headache.

• thank you to those who have posted comments and suggestions, as well as friends who have emailed or called with advise. I really appreciate hearing your thoughts, and can use all of the options and variables that are out there. Often times I know that the answers are out there, I just need to explore all of the variables and being a new parent, I am treading new ground daily.
• I think I have set myself up for personal failure (the worst kind, in my opinion). What I mean is that I thought that parenthood would consist of XYZ (see below for examples), and I had a plan of attack for what I wanted. What I neglected to understand was that children are human beings with their own ideas and plans for what they want. Duh!
• For example, I thought I would have a vaginal, natural childbirth. Apparently Elliott had a different path in mind (or I wasnt strong enough...that is another post).
• I thought I would baby wear (my kid wont go into any sort of sling for me (we have 4 to chose from)...and will only go in for my husband. I still try almost every day). This makes me sad, because I think that he wants to be held more, but since he is sleeping so much, I often put him down and try and get things done around the house. This is a catch 22 of course...if he wants to be held and comforted and I am putting him down all the time, we arent bonding in the way I hoped and he in turn doesnt get the confidence and feelings of love that he needs. But, if he wont let me sling him, I am forced to put him down occasionally at least. Again, I need to forgo my own needs in favor of his more often. Guilt over being too selfish...it never ends.
• I wanted to breastfeed for as long as possible. But, the way it looks I might not last 6 weeks, and may resort to part-time pumping. (heartbreaking and of course, I feel like a failure for not being strong enough to persevere and find a solution). Elliott gets so much comfort while at the breast. How can I take that away from him? But, how much more pain do I have to suffer, when there is another option. Again, more guilt over being selfish.
• On top of my own personal feelings of failure, I feel horrible for thinking ill of people who didnt do all of the things I mentioned above. Before I had Elliott, in my head, I judged people who didnt breastfeed, baby wear, etc. Dont I feel silly now.
• Parenting is hard. How in the world do women have a gaggle of kids? I can barely manage one.
• I stole the title of this post from a CD my husband put together while he was in a CD Club.
• Could this breastfeeding problem I am having be Thrush? His tongue doesnt look white, but the other symptoms are spot on for me.
• I dont have time to talk on the phone for long periods of time, and I think I am alienating myself from friends and family who are far away. When Elliott is sleeping, I want to sleep or do chores, or use the restroom, or check email, or eat. I dont want to talk on the phone. Which doesnt help my relationships that are far away. Please dont take it personal. This time I have home with Elliott is so short, that I want to make sure I am present with him as often as possible. I dont want to be on the phone, and not give him my undivided attention.
• In spite of all the parenting woes, I still want to stay home from work full time. I cant imagine leaving my little man in the hands and care of anyone else. I dont even like to let anyone else hold him for very long. I feel very protective over him. But, financially know that it is impossible to stay home. I dont even know if my employer will let me work part-time.
• By not staying home and I prioritizing correctly? After reading this post, I wonder if we need to bite the bullet and realign our priorities more in favor of what is most important (our family unit) to us. The fact that the decision is so difficult, makes me bitter again. Prioritizing a family shouldn't be so difficult especially when $$$ is the motivator for our decisions.
• Elliott is thriving, in spite of my boob blunders. He weighed in at 12 lbs and some change yesterday at the BF Support Group. He is gaining about a pound a week. I am very grateful to have a baby who is gaining weight so well. It is a mixed blessing.
• I thought I may have torn my incision. It was red, leaking some fluid and had a couple of drops of blood. I had it checked though, and the midwife said it was healing nicely, and she thought that a piece of skin just grew lightly over it, and tore back.
• My good friend had to put her 3 year old dog to sleep over the weekend, and I am very sad for her and her hubby.
• Sorry to any of those who I have depressed or whose day I ruined with this rambling depressed post.
• Have a great Hump Day.

Food, Sleep and Closure

When I went into Labor on 6-30-07 at 8:30am, I got a pretty good night sleep the previous night. That is to say that I sleep on the couch, in the upright position for a few hours at a time. In between the 2-4 hour bouts of rest, I was up and around the house. Usually thirsty, or having to use the bathroom. But, occasionally just wandering around the house, or reading. The last months of pregnancy were like this.

I have said in previous ruminations that this was a prep for parenthood, or so I thought while I was pregnant. What I wasn't prepared for were the hours and days immediately following the birth of my son. From the time I went into Labor on Saturday until I left the hospital on Wednesday July 4th, I slept about 15 hours in total.

Saturday night while I labored, I of course didn't sleep. My husband and my Doula took turns taking cat naps (which I barely noticed). I delivered on Sunday evening, and was put on Percoset, and moved to L&D to recover. That night and subsequent day, I couldn't sleep and barely noticed the difference between day and night. I was so afraid that if I closed my eyes my son would stop breathing or choke to death on his lung fluid (when you have a c-section, even when you labor first, the child doesn't fully benefit from traveling down the birth canal and getting the fluid squeezed out of their lungs, in the same way). Every little noise he made had me up, checking on him. This was coupled with the nurses coming in every 2 hours for stats, and every 4 hours for meds, housekeeping, food service (see below), and my doctors and the pediatricians. My doc started rounds at 5am, and I was apparently first on the list. Oh, and since UCSD is a teaching hospital, you see a student and a doc--2 separate visits.

Since I had a C-section, I couldn't co-sleep with Elliott as I had planned and he in turn slept in a little plexi-glass crib next to my bed. The inability to co-sleep was due to a variety of valid, although frustrating reasons. The first was that I was on pain meds, the second was the bed was sooooo small, and the third is that I could barely move without assistance (the surgery, the IV, the catheter...). Had I delivered him vaginally in the Birth Center, both baby and husband all can sleep together. They have normal beds (not mechanical hospital beds), that are Queen size. They encourage baby and Mom to sleep together. UCSD is also a baby friendly hospital, and as such they don't have a nursery. If you need to take a break from your baby, you can ask the nurses to watch them. At this point they will wheel them into the nurses station and keep an eye on them in there. I never opted for this.

I ate lunch on Saturday, at the Bar Mitvah. But, the remainder of the day I just wasn't that hungry. Maybe it was nerves due to wondering if this was "IT", or not. The evening only brought nausea and lack of appeal for anything food related. I did manage to eat a few lolli-pops and a bite of fruit. But, mostly I was thirsty and drank a ton of water. By the time Sunday afternoon rolled around and my labor had basically slowed to a snails pace, I was hungry! However, since I was going into surgery...there would be no food for me.

I wasn't allowed to eat on Sunday night, nor Monday. All they gave me beginning with lunch was liquids. Broth, jello and juice. Plus, vicodin, gas pills and stool softeners. Yummy!

By the time I was allowed to eat, and I was begging the nurses for food by this point (sometime on Tuesday)-the meal that the food service people brought in was mostly wheat products (lasagna, a dinner roll, etc.), of which I am allergic. So, I was foiled again.

How are you supposed to function/parent/nurture on so little sleep, without food, and all doped up on meds? It seems counter intuitive to me. There are a lot of things about pregnancy and labor that are backwards in my opinion. Let me give a few examples.

When you get pregnant, usually you take a home pregnancy test to confirm. And if you are like me, I knew on day one of my missed period. Once you confirm, you are sooo excited (lets assume this is a planned pregnancy), that the first thing you do is schedule a doctors appointment. If you have an HMO, they wont schedule your first appointment until you are somewhere around 8-10 weeks along. Now, isn't the first trimester the most critical as it relates to development of the baby? Why would you leave a newly pregnant person on their own, without advise or guidance during the most sensitive part of their pregnancy?

The second situation/example is during your post-partum period. Since I had a c-section, I spent 3 nights after the birth in the hospital (although they wanted to release me on the 2nd night, I declined). They removed my staples (13 of them), on the third day, and gave me instructions for caring for my incision. They also instruct you to schedule your follow up appointment for 6 weeks later. Now, I just had major abdominal surgery and a baby...wouldn't you want to see me sooner than 6 weeks? Apparently not.

The sleep has improved since I have been home. And I suspect we are faring well compared to some. Elliott on most nights, sleeps from 9-12 or 1, eats, and then sleeps again from 1-4 or 5 am. Then he eats again, and occasionally will sleep again from 6 to 7:30am. Although, when we are struggling with the let down problem, he is less likely to sleep for such long periods, and is awake for longer time periods in between. So far I am OK with the sleep patterns, and feel good most days. I can see how the lack of sleep can be impossible to handle, especially if you have more than one child, or have to go back to work sooner rather than later, or don't have a lot of help or support from your spouse.

Well, after all of that typing...I am not sure what the summation of my thoughts are. But, I wanted to share what was on my mind anyway. I am all for closure, but for this post, there is no closure... to my dismay.

Breastfeeding Woes

I am having a really hard time breastfeeding (and think that by pumping those few times in the beginning sabotaged myself), and have thought about giving it up completely over the last week. It is causing me serious amounts of pain and tears, and making me upset at Elliott (when I clearly know it isn't his fault).

My problem is that I have an over-active let down. The milk flows out too fast for the baby to handle, and he has taken to clamping down on my nipples (often times not letting go even with my finger totally inserted into his mouth), fighting me when feeding, and has a serious amount of gas. The large amount of foremilk that he is forced to ingest has a lot of lactose, that his system has difficulty digesting effectively. He is spitting up often and fussing due to the substantial amount of gas and intestinal discomfort caused by the over abundance of lactose.

I feel horrible for him, and want to comfort him. But, it seems the very thing that would give him comfort (the breast) is the thing that is causing him (and me) the most grief. This hurts my heart to no end, and the guilt associated with not being able to give him what he needs is eating away at my innards.

I went to a breastfeeding support group last week. I called La Leche League twice and didn't get a call back (and their schedule is posted on-line but with no address or email address), I called UCSD to speak with someone and didn't get a return call. I am thinking about contacting a lactation consultant. But, at $60/hour...it seems a little pricey. But, I am desperate. I don't want to sabotage our breastfeeding relationship.

The best website and info I found so far was below and on the WIC site. I bought some contraption to help heal my nipples. I am going to try nursing on one side for several feedings and try the modified feeding position as well. If all else fails, I am going to contact a lactation consultant. I promise not to give up at least for another couple of weeks.

Summary of Strategies to Reduce Rate of Milk Production and Force of Milk Ejection:
Nurse on one side for a each feeding, continuing to offer that same side for at least two hours until the next full feeding
Gradually increase the length of time feeding from one breast if necessary
If this strategy is not effective, try the method of thoroughly pumping breasts and then feeding on one breast until unbearably full (described in detail above)
If the other breast feels unbearably full before you are ready to nurse on it, pump or hand express for a few moments to relieve some of the pressure
Use cold raw green cabbage leaves or a bag of frozen peas to reduce discomfort and swelling
Feed baby before he becomes overly hungry to minimize aggressive sucking
Try alternate nursing positions
Mother leaning far back
Side-lying (letting milk dribble out)
Use scissors hold or the side of your hand to compress ducts to reduce the force of the milk ejection
If baby chokes or sputters, unlatch him and let the excess milk spray into a towel or cloth
Allow baby to come on and off the breast at will
Burp frequently if baby is gassy
Certain herbs and drugs, used judiciously, may be helpful in reducing milk production