Tuesday, April 29, 2014

Beauty sleep

should have been this week

Daniel's birth should have happened this week.  He is 37 weeks 2d gestation today.   He is doing very well out of the uterus, but I am pretty sure he would have preferred things to happen differently, and so would I...differently better, that is, not differently worse, as that is always another option that I have to keep in the back of my mind :) lest I forget to be thankful!

I am profoundly happy still, I don't know what exactly happens to me when I have a baby, but I am ecstatic. In addition, I am falling more and more in love with little Daniel, who is so cute when he looks at me, and tries to punch me when he wakes up so that I give him milk, and makes all sorts of funny sounds...he even sings with me and Emma at bedtime.

The only thing that I am working hard on and not seeing any results yet is weight loss.  I am doing a 1500 calorie intake/200 cal exercise/breastfeeding, and from the point of view of calorie intake/expenditure, I should be losing about 2 lb a week, but so far nothing happenin' over here.  I am a bit impatient because I only have one pair of mommy jeans in size 12, and don't really want to spend more money on a second pair, rather I have several pairs of skinny jeans in size 10 that are waiting for me to lose about 5-6 lb to fit into them.  I am going to look at this store today and see if I can find a tight fitting pair in size 12 that I might be able to take in at the seamstress when I lose the weight.  I am not going to drop to 1300 calories until about two months post partum, when the milk supply is well established.  At this point, I have about 30 lb to lose to get to my pre-Emma pregnancy, and about 16 lb to get to pre-Daniel pregnancy weight.

Breastfeeding is going extremely well.  He gets tired and wants to sleep after about 3/4 of a feed, but I use the SNS to push him a bit to take in a full feed, and yesterday when we went to the paediatrician, she said he gained 36 g per day on average, which is extremely good (they expect 15-30 g a day).  Obviously the system is working.  I seem to be making enough milk, which is such a relief.  I have rented a breastfeeding scale, and it is so much peace of mind, I highly recommend it to all mothers of preemies that are breastfeeding, as it is very unreliable to go by baby's clues before their "due date" age, since most of the time they would rather sleep than eat.

The one other thing I wanted to mention is that being in a big city is full of shopping temptations.  I went into l'Occitane and walked out 160 $ poorer.  I buy the bum cream there (I use the mom and baby balm, which is pricey but works very well with cloth diapers), and also the hand cream which has been my favourite beauty product for the past 10 years in a row.  This time, my mom was with me, and she was very excited about the Divine serum, which promises to get rid of my melasma spots (yeah, right) so we decided to give it a try.  A 110$ try, that is.  Huh.  Also, Craigslist is not helping my case any.  I needed a camera flash and am meeting this photographer who is selling his used canon flash for half the price that I would pay in the store.  Unfortunately, he is also selling a fabulous zoom lens that I want want want.  There is NO END to wanting in this city.  How do you guys living in big cities not go broke?  In my small town, I go for months not buying anything other than basic food and some books/toys for Emma to spice up her life a bit.  Crazy.  I think I am going to succumb to the zoom lens charms in the end...wish I were made of stronger stuff...

Monday, April 21, 2014

so far, so good

We seem to be doing quite well at home.  He is eating even better than he was at the NICU, and peeing up a storm.  He got a mild diaper rash on a very small area, from a tiny poop made in his sleep.  His skin is very, very sensitive.  I am more paranoid than ever to keep on changing him very often, usually hourly, unless I am sleeping, in which case it goes to two hours max.  We are using cloth diapers, the G-diapers brand, which I have used successfully with Emma.  They now came up with newborn sizes, and they are incredibly cute and well built.  Because of the change in diapers from disposables to cloth, I am hyper vigilant about the skin.  If I see any other areas that are getting red other than the above mentioned one, I am going to change back to disposables for another few weeks, until his skin thickens.  The main advantage of the disposables is the ability to smear Penaten cream on, which one cannot use with cloth, as it alters the absorbability of the cotton.  I am using an organic cream called Bum bum, with calendula, which is supposed to be diaper friendly.  I will report on how it is working for us so far in a few days.

Today I have lifted Emma for the first time in 4 months, and I was shocked by how heavy she is.  I have weakened considerably during my bed rest/no activity time.  I did some lunges, about 16-20 on each leg, and felt like I tore my quads for the subsequent two days.  I have a long road ahead as far as regaining my previous fitness level.

My little man Daniel is starting to get stronger.  I feel like he is holding his head quite a bit better than he was a few days ago.  I am reassured by the fact that he seems to be thriving at home, as yesterday I was debating whether I am doing the right thing by bringing him home. Now I know.

Sunday, April 20, 2014

Day 23-guess who's home?

Happy Easter everyone!  We had an especially happy Easter in my family, as today I have brought home Daniel.  It happened a bit fast, and this is how it went:  after I decided to do the exclusive breastfeeding, I started with three feeds a day, then after about two days he started rooting and waking up at night wanting to suck.  I came in at 2 am to do a feed, and stayed in the parent room until 8 am for another feed, but the nurses woke me up to do the 5 am feed as well, so on Friday I ended up with six feeds by breast (with some SNS help, about 10cc's each time).

Daniel ended up pulling his NG tube out that night, and the nurses asked me if I wanted to give it a try and just breastfeed only, with no further NG feeds.  I tried it, it worked, and after 24 hours they asked me if I wanted to room in in order to go home.  After another 24 hours of rooming in with him, they sent me home.

It is BY NO MEANS easy to feed him, as he gets very sleepy for about four to five of the eight feeds, and I have to struggle to wake him up every ten minutes in order to get him to take in 45 g, which is his needed amount.  We are on a very strict schedule:  feed, pump, sleep, repeat every 3 hours.  So far we did well for the six hours spent at home.  I have confidence now that it was not a mistake to walk out of the hospital with my baby boy.

His monitors came off last night, and I stayed awake for several hours making sure he is still breathing.  As I woke up every hour or so, I worried each time that I would find him dead from a spell of apnea.  Every time he was still breathing, I got a bit more confident.  Initially I tortured myself with statistics of SIDS in preemie boys that co-sleep with their mothers, but as the day went on, I decided to trust my instincts and hope for the best.  Just in case, we did get a bassinet, in which my precious baby is sleeping, but I have a feeling that, as I become more confident, he will end up in my bed just like Emma did.  (Emma ended up in my bed an hour after my C section, in fact I think I got her in the recovery area, and she never left since).

I am more cautious with Daniel for now because he is so small, and also because I don't want to rock the boat and change his habits right as he started feeding on his own 48 hours ago.  However, as we both gain confidence in each other's abilities, I cannot see him not ending up in the family bed, along with his sister and the cat.

Wednesday, April 16, 2014

update day 18

So, I have decided to take your guys warnings seriously about this bottle interference with the breast feeding.  I have told the nurses that enough is enough, no more bottles, because he really was refusing the breast outright.  In a preemie, 15-20 min of struggling to latch results in a total failure to feed, because by the time they finally latch, they are too exhausted to get a good feed in.

MrH came in armed to do battle as well, and when the nurses started with their speech about the whys and whereabouts of the bottle, he said "look, this is OUR baby, and we decide what is best for him in the long run" or something like that.  They backed out immediately.  I was a bit more subdued, but told them that I am willing to come in any time, day or night, with my boob, to get him something to suck on if he needs it, and that I really don't want any more bottles for the next week or so (I did not say never, though that is what I will ask for in one week, hehe).  Then, the nurse said finally that I can use the SNS.  Well, guess what, yesterday with the SNS, he got in two complete, full, oral feeds!!!

The moral of this story is that they must let me do what I want ;) as it usually works out better anyway.

Monday, April 14, 2014

NICU day 16, nipple confusion?

Daniel is doing quite well, latching on the breast and taking in anywhere from half to two thirds of a feed.  Then he gets tired and likes to relax with the boob in his mouth, which I love to watch.  Last night the nurses gave him two bottles, and I have noticed that today he did not latch that easily anymore, it took him about ten minutes each time to convince himself that the boob is a good idea.  I am pretty sure that the bottles have something to do with it, although the nurses are quite reassuring that preemie babies don't have much of a preference regarding which method of feeding is used.  I don't know if I buy this hypothesis, given what I am seeing with my own eyes.

My advantage is that I am bigger and smarter, and more experienced than my little man.  I have my methods to get him to latch, even though it takes some time.  One method involves walking around and bouncing up and down, for some reason I have noticed that both Emma and Daniel have the instinct to latch onto something when being gently bounced.  Perhaps they are trying to anchor themselves onto something stable?  It almost seems to be an inborn thing, and I have tried to test it out on other babies in the past, but the mothers seem reluctant to walk around or bounce on a giant fitness ball while breastfeeding.  Understandably...

My other method involves the increased flow that comes with the SNS, which I am going to be allowed to bring in tomorrow and try out on him.  The nurse that will be on tomorrow said that I could, so it is an individual thing depending on each nurse as to whether I will be allowed or not to use it in the NICU.

If these two methods fail in the end, I am going to come up with other methods, but incidentally I know that I can make peace with bottle feeding as well, if he does not want the breast anymore.  I hope it does not come down to that, but I very much doubt that, if it does, it will be the sort of thing to still upset me in five or ten years.

My expressed milk totals around 350 cc per day, and he is feeding about 340 cc's, so I have surpassed my own expectations at this point.  It seems that today I might do even better, as I am increasing almost daily by a couple of cc's over the past week.  I almost felt like I got an A in Math when the nurse said she was going to freeze some bottles of my own milk today (insert big grin ;).

Daniel is 35w1d today, and I am guessing he will stay in the NICU for 1.5 to 2 more weeks, but it is almost impossible to predict at this stage.  Apparently one day they just click, and they are unstoppable at oral feedings, after which they get discharged 2-3 days later.

I will update as soon as that happens, and hopefully sooner.

Sunday, April 6, 2014

Breast milk envy

I am making myself unhappy looking at other women in the NICU who pump a full 120 ml on the third day post partum, and certainly lots more on the eighth day post partum.  I am only making 30 ml per pumping session, and if I pump more often than every 3 hours, then I sometimes just get 10 ml.  Daniel is the only baby in that nursery that will soon need to be on formula, as we are going to run out of the donor milk that I was able to buy prior to his transfer from BC Children's hospital.  It is the only thing that hurts me a lot, again, not being able to feed my baby the way he deserves, the way I would like to.  It breaks my heart to see this little being latching on and actually working at sucking, and then not getting much out when I don't have milk.  Today he latched on even better than yesterday, but I had no milk, so he only transferred 2 g, and it was not for lack of sucking well, it was simply because you can't get milk out of a stone no matter how hard you try.

I have to realize time and time again that it is my thinking that is making me miserable, not the situation.  The same situation could be rephrased by realizing that hey, there is this wonderful product out there called formula, it is well researched and has been improved over the years, and is very good at keeping my baby alive and well fed and growing normally.  100 years ago I would have had to give him sugar water and boiled strained oats, along with goat's milk and who knows what else, if I could not afford or find a wet nurse.  And watching another woman breastfeed my baby that I cannot breastfeed myself?  That would have been torture for me.  As it is, I am feeding him about half of his feeds right now, and I have every reason to hope that this will improve with time and continued pumping.

Ha!  my psychologist would have been proud of me.  Cognitive reframing is the name of the game.

Saturday, April 5, 2014

Update, new NICU

Daniel was transferred to a level 2 NICU, which suits me just fine since he will be closer to my home here in Vancouver.  It takes me about 20 minutes to go visit him, and then another 20 min to climb up the four flights of stairs from the parking spot to the NICU.  My hemoglobin is certainly making itself felt, it is low, and I hardly can exert any effort.  On top of everything, my blood pressure is continuing to spike to scary numbers, and I am taking blood pressure meds, sometimes in double doses, to keep it in check.  Being exhausted in the evenings does not help, since my schedule includes going to the NICU from about 12 noon to 6 pm, during which time I get to sit in a chair, and do not get a chance to nap at all.  I am pumping every 2-3 hours, just to try and build up a supply, but it is very slow going compared to all the other women around me.  I am barely able to make up a feed sometimes (his feeds are 40 ml), most of the time I am pumping about 20-30 ml.

On the positive side, he latches very well for his first tries (and he is not even 34 weeks yet!), and was able to transfer 12 g last night, which was amazing.  Most of the time, they expect babies to transfer somewhere around 2 g, so this was an amazing feat for him.  Which makes me feel even worse that my flow is so slow and that I am just not making enough milk to feed him, as he could be exclusively breastfed easily from what I am assessing.  The NICU nurses don't want to let me  use the SNS (the supplementary nutritional system) that I have used with Emma, for fear that he might choke on too high a volume, but I doubt that will be an issue.  In any case, by the time he comes home, I can do whatever I want (insert evil grin, here comes SNS to the rescue!) (can you tell Emma is watching too much Diego?), so my hope is that he won't become too enamoured of the bottle while in the NICU.

Otherwise my bruises are healing, my incision does not hurt too much, and I am moving around reasonably well.  I have lost a total of 35 lb since delivery, most of which in the first 3 days.  I am continuing to lose, but only 2-3 lb a day, as opposed to peeing 350 ml every hour which I was doing in the first 2 days after delivery.  I am going to call it the "preeclampsia diet", extreme weight loss through magic methods.

I am extremely busy, between pumping so often, spending time with Emma, and the 6 hours a day in the NICU, which is why I am not updating daily anymore.  I will try to keep on top of the blog, as it is important, but overall if I don't post please don't worry.  Everything is fine, better than fine.

On this note, the public health nurse called to ask some post partum screening questions, and one of them was about post partum depression.  I feel like I have post partum happiness, heck, I made it out alive and so did Daniel, and all is good, how can I not be ecstatic about our situation?  I had such amazing care, from both internal medicine and the obstetricians, and Daniel was so well looked after by the paediatrics team!  I really felt surrounded by love and attention, and felt reasonably safe throughout the whole experience.  To put it in very visceral terms, the morning of my discharge from the hospital I woke up and looked at my very bruised arms, and thought oh, what if the bruising leaves permanent hemosiderin stains in the skin?  and then my next though was well, it will be a sweet reminder that somebody cared enough about me to start these IV's, and this arterial line.  How many women die alone of this disease, with nobody to look after them?  I was very blessed indeed, and so was my little man Daniel.

Friday, April 4, 2014

his first bath

He looks like he really enjoyed it!

Wednesday, April 2, 2014

Daniel video in NICU 33w3d

I managed to film this little video during one of his awake times.  His little tummy was gurgling really loudly when I did, I think it was bothering him a bit.  He is so cute!  I am completely in love!!!

NICU pictures