Of late

Happy 2012! Hopefully there will be a 'year in review' post up soon, 2011 was obviously an eventful one for us.

Looking back on the few posts I wrote since baby A. was born has been a trip - we have come a long way!

1. Sleep. Things got pretty bad there for a while. I can't even tell you when/how it all went down, I think because it was a relatively slow disintegration that bottomed out a few weeks ago. Enter the magical, wonderful Sleepeasy Solution. Definitely worth a read, especially if you are looking to night wean and are comfortable letting your babe cry a bit. We really just needed to work on the night wakings/feeds; baby A. has always been a pretty good napper and puts himself to sleep fairly easily too. We had also established a nighttime routine when he was a few months old. We decided to:

- run a fan for white noise during naps and nightime
- place 6-7 binkies in the crib for easy self-soothing
- wake him 1 hour before he usually wakes to eat (for us that meant 9 pm and 1 am). I was seriously skeptical about how this would work but he would literally nurse while half-asleep and then go straight back down in the crib. This was one of the major strategies in the book and the one that helped us the most.
- Nurse him for 10 minutes the first night, 8 the next, 6 the next, etc. until a feed session was eliminated
- employ a modified cry-it-out (go in after 5 minutes, then after 10, then after 15) in which we would enter the room and speak soothingly but not pull him out of the crib.

We eliminated night feedings after 5 days, and he's been sleeping from 7 pm to 7 am for a few weeks now. We never had to let him CIO either - when he wakes up, he fusses for 1-2 minutes, finds a binky, and settles back to sleep.

I don't need to tell you how fantastic a full night of rest feels. It's been great. Of course there will always be rough patches (his first tooth appeared about a week ago, we're waiting for more to erupt) but at least we have a plan to fall back on when necessary. I've also realized that probably our biggest mistake was being inconsistent - sometimes we would go in and give him a pat, sometimes I would let him sleep with me, sometimes we would try and let him cry. The poor little guy was probably so confused. I still don't understand how the simple components of our plan somehow add up to 12 hours of sleep, but I'll take it.

2. Breastfeeding - I am proud to say we are still going strong 10 months in. Baby has milk every ~4 hours, usually 4-5 times a day. On the days I go to school I nurse him in the morning and right before bed; in between he will have 3 - 8 oz. bottles of breastmilk+formula. I am pumping twice a day, and plan to reduce it down to once a day soon. I'd like to have him mostly weaned by a year old (in February) but wouldn't mind retaining the early morning and/or nighttime feeds. We'll see what he wants to do, there are times when he seems pretty disinterested in nursing (especially at bedtime) but I don't know if that's just a phase or what. I'm hoping to stay flexible and not stress about it too much.

3. Solid food - In between milk feeds he gets solids, mostly Earth's Best jars but lately we've graduated to rice rusks and veggie puffs. He loves yogurt and cottage cheese, and is definitely into tasting new things (for now at least!). A few nights ago I made a soba noodle soup with spinach and mushrooms and he loved the broth. He has also had a few bites of meatball and is definitely getting better at chewing. I'm looking forward to introducing him to all sorts of new tastes, it's entertaining to see his reactions.

4. Child care - I went back to school for 3 days/week when baby was 6 weeks (!). Still not sure how I managed, but for the first 5 months me, my husband and my mom watched him. In September I went back to four days/week and after much agonizing we hired a nanny to come to our home three days per week. She is wonderful and the baby loves her. It's worked out surprisingly well.

Starting this week I will be back at school five days/week, and the nanny will be with us on Mondays, Wednesdays and Fridays. On Tuesdays and Thursdays he will be attending a daycare that is really more like a school. We found one that we are really happy with, so I'm hoping this transition goes well. I'm excited for baby A. to meet some other babies and have some structure to his day, I really think he's going to love it. He's visited the infant room twice now, and each time he has happily crawled away from me to explore. I'm dreading the booger noses and fevers that are surely heading our way, but all I can do is continue breastfeeding and get through the cold and flu season.

Otherwise we are totally loving our little guy, he's the sweetest thing and is starting to interact with us more and more (waving hello, pointing to things and playing games). It's the biggest cliche but I can't believe how big he is getting and how time flies. I also feel pretty good about where we are with this parenting gig. It's not at all that I think we've mastered anything, just that I realize we have to roll with it all and enjoy each new stage.

Totally random but I love this

via stork bites man

Oh boy...

Of course the sleep gods read my last post about a 'good' night of sleep and decided to punish me. Here is a lovely example of a recent 'bad' night:

7:30 - bath/massage
8 -into crib, fussing, crying, binky-stuffing
8:17 -sleep (I checked since it felt like I had been soothing for ~25 hours)

10:30 - awake, eat and back to sleep right away
12:30 - awake, snack, back to sleep right away
2:30 - awake, eat, awake... until 3:30.
4:14 - awake again whyyyyyyy. Grunting, pants-pooping, general thrashing
5ish - asleep again until 6:45, where I traded him off to my mom for the morning shift. As she was changing his diaper he gave me a big gummy grin as if our forced all-nighter had not happened.

I hate to be so snarky about it since he obviously has a lot going on right now developmentally and just can't make it through long stretches of sleep. The sleep he does get does not appear to be particularly restful: he's constantly rolling around, shifting his head from side to side and crying out a lot.

But seriously. I need to be in the lab today and have a paper to finish, a dissertation to write and new students to train. Plus we're trying to figure out what to do about child care starting in September, which is giving me an ulcer.

In the meantime I may need one of these:

Found here

Sleep and Feed

Two topics very much on my mind lately!

A bit of background: when baby first arrived home, we had no idea what the eff we were doing in the sleep department and had no real plan re: where he would sleep. For the first few weeks, he either slept in his swing or in his car seat. We tried to put him in a moses basket but he refused to sleep in there. I was terrified of SIDS and suffocation and spent a lot of time checking that his nose was free of obstruction, reminding the world that he needed to be on his back at all times and making sure his blanket wasn't going to jump off the couch and somehow cover his little face.

At about six weeks of age I realized it was much easier to breastfeed while laying down in bed (we have a daybed in the nursery). So we started co-sleeping at that point, so that he would wake up, eat, and immediately fall asleep again. I would often drift off to sleep myself. Win.

I think it was around 12 weeks that he started to thrash and attempt to roll over in bed. He was also waking up many many times, snacking a little, and falling back to sleep. It became a not-so-restful-for-me situation and I started realizing I needed to phase out the co-sleeping if possible. It was also around this time that everyone and their cat was asking: is he sleeping Through The Night?? A.K.A. IHSTTN????? No. No he is not.

His head/neck control was much better at this point, so we started letting him sleep on his stomach. This led to longer stretches of night sleep.

After freaking out a bit when we realized that simply transitioning him to his crib wasn't going to happen overnight, I realized a couple of things:

1. It is completely normal for breast fed babies to wake up multiple times per night. It's even more normal for breastfed, co-sleeping babies to wake up a lot. And it's not like he would wake up and stay awake for any length of time, we both are half-asleep as he eats. I want to continue to breastfeed at night, so I think I'll have to let my 'sleep through the night' dream go for a while, probably at least until we introduce solids.

2. Our goal is for everyone in our house to get as much sleep as possible. Period. In any way that works.

3. We needed a bedtime ritual to show baby that it's time to wind down and go to bed.

4. The transition from co-sleeping to crib didn't have to be all-or-none, something in between is fine.

5. It was time for me to at least attempt to get him back to sleep without eating every time. I've been moderately successful in this department. I'm not ready to let him cry it out, but I do let him whine and cry for a little while, and try to re-introduce the binky, to make sure he is really hungry.

6. Ask Moxie is the best site ever. A couple of posts that pulled me back from the edge:

'time' to stop co-sleeping
quick and dirty on sleep
one year old not sleeping
sleep regressions

I also love amalah and her posts on alphamon

Reading through these posts and the associated comments have been SO comforting to me and have helped my husband and I come up with a plan that works for us.

Baby is 20 weeks old today. Here's where we're at: he sleeps in his swing during the day. He's always been a pretty good daytime napper, and takes two longer (1-3 hour) naps in the morning and a couple of catnaps in the afternoon. Our pattern is to eat (nowadays every 3-4 hours for about 15 minutes), play (with me or on his fantastic playmat that I can't recommend enough) Then sleep. He is generally never awake for longer than 2-3 hours, especially in the morning and early afternoon. As soon as I see him yawn or rub his eyes, into the swing he goes.

5:30 to 6 pm tends to be a cranky time. We make and eat dinner as best we can, and around 7:30, I take him upstairs for a bath and massage. I read him a short book and then feed him one last time laying down in bed. He's usually in the crib at 8 pm. I put him directly on his stomach, he'll just roll over if I try placing him on his back. Every night he fusses for a few minutes, and usually the fuss ramps up to full-fledged tears and real crying. My husband or I generally take him out of the crib at this point for some binkie and soothing. Once he's calm again, he goes back in the crib. He'll fuss a little more, and then finally lay his head down to sleep. He's usually out by 8:30 pm.

I've finally started sleeping for part of the night in my OWN bed again, which is in the adjoining room. On a good night, baby will wake up around 12, at which point I take him with me into the nursery bed again to eat. We'll both fall asleep until around 3, and he'll eat again. I usually change his diaper and put him back into the crib. Lately he wakes again at 6:45 or 7 am.

Of course, there are bad, BAD nights mixed in there. A few times this week he was up 4-5 times, but the last couple of nights he's back to waking two times.

OK, this is getting long! I'll have to save the 'feeding' topic for another time.

Adventures in breastfeeding - part II

Subtitle: pumping at school!

I really should have kept a journal during these last few weeks; I know there were other bumps in the road along the way (including googling 'I hate breastfeeding' one day) but amnesia has set in a little. I'll try my best to recap...

I believe I left off when baby was around 2 weeks old and I was trying to feed without the breast shields. The shields were great for transitioning us back from bottle to boob, but they get SO annoying to use, especially at night. They start to lose their suction power once they're sterilized a few times, so you end up fumbling to get it on as baby cries for food. I also think someone should invent a colored/ glow-in-the-dark breast shield - the clear ones kept getting lost all over our house! I was paranoid that someone would find one on our couch and be like, ewwww what is this???

It took a couple of days but I was eventually able to feed without the shields, around the time when my husband went back to work and I was on my own with baby all day. Much of that time is a blur but I know there were days when I just sat in our kitchen, holding the babe and sobbing... because I felt like I had NO IDEA what I was doing, feeling totally isolated and unsure I was doing it all 'right.' There were (and still are) times when the baby seems unsatisfied after feeding on both sides: crying, fussing and pulling at me in frustration. This was so stressful for me and it HURT at first, until I realized that it's his way of getting more milk and/or telling the boob factory to start producing more. Nowadays when this happens I just keep switching him back and forth until he is done, which seems to work.

I went back to school part time when the baby was 6 weeks old; a hard transition made easier by the fact that my mom is watching him at our house. My boss was really great about helping me set up a place to pump in a little storage closet near the lab; it's a tiny space but 1. the door locks behind me and 2. there's a big fan running constantly in the hallway so I don't have to worry about anyone wondering what that pumping noise behind the door is. At first I pumped every two hours, for a total of four sessions, but quickly realized I got the same amount if I pumped every three hours, three times total.

I don't get a lot out during each pumping session (nowadays about three ounces total) but I've read that's pretty common (Nice article here). What ends up happening is that I pump during the day, I fill four bottles after school for the next day, and supplement up to 3.5 ounces per bottle with formula. I breastfeed exclusively on my days off, and try to feed him right before leaving for school and right when I get home. A lot of the time I miss that 5:30 pm feed, so I have another pump set up at home and try to pump any time I miss a breastfeeding session. This has really helped me to generate a little breast milk cache to freeze.

Baby is now 11 weeks old and I'm happy to say things are running pretty smoothly (in the breast feeding department at least). I've fed him many times in the backseat of our car, and a few times out in public. He is sleeping with me at the moment, and I can now feed him laying on my side while half asleep. I try not to stress about the formula supplementation; I would love to breast feed exclusively but it's just impossible with me at school three days per week. Baby weighed 12 lbs 8 ounces at his last doctor's appointment (double his birth weight) and seems to be happy and well fed. My original goal was to make it to six months and I think it's totally feasible.

But of course with each challenge mastered there arises a new one, if not multiple new ones! Right now we're working on his sleeping 'situation.' He still eats every three hours or so, including at night. In fact, sometimes he eats more often than that at night, which I'm sure is because I'm right there beside him all night long. So at the moment I'm trying to let him go a little longer between feeds during the day by letting him fuss longer than I normally would, and I've started a little night time ritual - feed, bathe, massage, a book and then hopefully BED. Finally, I've introduced him to the wonderful world of his crib. Last week I put him in there during the day, just to hang out and see how awesome crib land really is. He wouldn't nap but it was a start. Last night after his book he slept in there for a few hours, and then I brought him into bed with me for the remainder of the night.

As I type he's asleep in the crib for his first nap of the day. I'm hoping to get him sleeping in there all night, with me sleeping in the room until he goes a little longer between feeds. Then maybe I can return to MY bed, and my snoozing husband. I'm learning that all of these things are just trial and error and I have to go with the flow and adjust when things aren't working. So we'll see...

Next up: adventures in cloth diapering. We have a consult today with Philly Diaper Service and I'm on board for a 12 week trial period.

Adventures in Breastfeeding - Part I

I'm really hoping the subtitle for Breastfeeding-Part II is "we exhibit total and complete mastery" and not "fail: we give up."

Actually I'm just being dramatic, today wasn't so bad at all. But the babe and I have put quite a lot of work into this breastfeeding venture in the last 10 days. I knew from reading a lot and from talking to my girlfriends that breastfeeding is 'hard' but I didn't really GET what that meant. And of course, every experience is different so I had no idea what was in store for me.

Phase I: Baby latched on immediately, probably 15 minutes after being born. This amazes me! At this point he knew much better than I did what to do. After a hospital lactation consultant helped me with my positioning, we were off - he fed really well for about 4 days.

Phase II: Then my milk came in. My boobs were hard as a rock and baby had no idea what to do. Suddenly he wouldn't latch and was obviously upset and very hungry. I tried taking a warm shower, applying a warm washcloth and continued to try and offer the breast. We were both getting more and more upset, since the hospital had told us to feed every 3 hours OR ELSE. Unfortunately I wasn't sure what OR ELSE entailed or what to do if I couldn't get him to eat. I don't know why I didn't just offer him some formula to take the edge off, but I didn't. Finally on day five we got the breast pump stuff cleaned and ready to go, and I figured out how to use it. He had gone for 6-7 hours without much food and was pretty cranky, as you can probably imagine.

Phase III: Meltdown time. Thankfully we had our first pediatrician appointment that morning. I was exhausted and worn out, and baby was still hungry. I was trying to hold it all together but started sobbing once we got into the exam room. Baby was screaming uncontrollably, was all chappy from us trying to console him with the pacifier, and was wearing an outfit that was probably 3 months too big - obviously we were all a mess. THANK GOD for our doctor: she ignored the chaos and was like, 'CHILL guys. Your first priority is to feed this baby. However you can. Give him formula if you need to, and keep pumping every two hours to maintain supply and ease engorgement'. Then she gave us three huge bottles of formula for free and told us to come in for a weight check in a week.

It was exactly what I needed to hear. I had been so focused on breast feeding, and avoiding giving a bottle (I had read to wait until 3 weeks of age to do that) that I had basically starved our baby in the process. Looking back I can see that I was obviously hormonal, but at the time I felt so ashamed and angry at myself.

There was one bright spot during our horror show of a ped visit: two moms in the waiting room. Both were there with their second kids; one was a toddler and the other baby was only 2 weeks old. I think they could tell I was about to fall apart and both made a point of saying 'hang in there! It totally gets better! We've been there!' Such a little thing... but it meant a lot.

Phase IV: So on day 5 I start pumping like crazy and supplementing with formula. At first it seems great because I feel so much more in control and can give formula if necessary. Plus my husband is now able to feed him too. Baby is finally getting food and it is obvious that he is much more content and happy.

Then I notice that baby is gulping from the bottle, which gives him a lot more gas. I also notice that he doesn't seem to know when to stop - he just keeps eating, and then eating more. I can only get him to latch on and breastfeed once on day 6 and another time on day 7... then not at all. So now we have another problem: how to get him back to breast feeding exclusively.

Phase V: After doing a little reading online I try for a day or two to get him back on the boob (making sure to remain as calm as possible, NEVER forcing the breast, bottle feeding near the breast so he gets used to positioning, etc). I didn't want to troubleshoot this issue for too long, and ended up setting up a consult with a lactation specialist at The Breastfeeding Resource Center (which is like 10 minutes from our house!). I met with Colette, who worked her magic and seriously had him breast feeding again after 10 or 15 minutes. She suggested a change in position and nipple shields (which feel more like a bottle nipple) and came up with a written plan for us to follow. I was also to pump as much as possible to try and increase supply.

So that was Tuesday, and I'm happy to report that we are doing much, much better. On Wednesday I was able to get him to breastfeed, and only had to supplement with formula/bottle a few times when it seemed like he was still hungry. He has been exclusively breast fed since Tuesday night; we are still using the nipple shields but every once in a while I can get him to latch without them.

Now he's feeding constantly, which can be hard since he's attached to me basically day and night, but we've made such good progress that it hardly matters. I'm hoping our winning streak continues... I'm just glad I stuck with it for this long, and asked for professional help when I needed it. No wonder so many people quit!

Whew. What a week.

AAO 2-21-11

Despite concerns that I might be pregnant forever, our baby boy arrived on February 21st at 4:08 PM. He was (is) a little guy, weighing in at 6lb3oz and 19 inches.

On Sunday the 20th (at 40w5d), we decided to visit the art museum, thinking that walking around a bit might help things along. I had lost my mucus plug the Friday before, but there were no other signs of labor at this point. I was huge, swollen and cranky. I was scheduled for an induction on Feb 25th, and was feeling so fearful of what an induction might bring and hoping hoping hoping for a vaginal delivery.

Around bedtime on Sunday night, I started dripping a little fluid. I went to bed, and felt two stronger drips while laying down. Contractions started around midnight, and I woke my husband up around 1 am. After talking with my ob, we decided to head to the hospital to see if my water had broke (there was no dramatic gush on our couch, in our bed, or in the car, as my husband feared).

I arrived in triage around 2 am, where the nurse determined that I was indeed leaking amniotic fluid. I was admitted and they wheeled me to the birthing suite, where we would remain until baby joined us. At this point I think I was 2-3 cm dilated, easily breathing through some mild contractions. They felt like menstrual cramps and were felt mostly in my lower back. The nurse gave me a little pitocin to move things along. I was scared that it would ramp things up uncontrollably, but it was such a slow drip that I didn't notice anything like that.

I started having more regular contractions and politely enquired re:epidural around 8 am. The doctor wanted a more defined contraction pattern and more dilation. I worked through contractions until 5 cm dilated, at which point things were starting to ramp up a bit. The ob broke the amniotic sac to release the rest of the fluid.

At this point they administered the epidural. I felt some odd pinching sensations and muscle twitchiness as the catheter was going in, but it truly wasn't that painful. Certainly nothing compared to the contractions I was having.

Once the epidural kicked in I felt fantastic - warm, calm and totally pain free. It was heaven. I made sure that friends and family knew it was game time:

Around 7 cm or so they decided baby was sunny side up - which explained why I was feeling a lot of pain in my back. I started to notice that I could feel some of the contractions on my right side, and wondered if the epidural was wearing off a little. This scared me... I started to get the chills.

A resident on duty came in to see me and had my lay in this "spider man" position - sort of on my stomach/side, right leg up and left leg down - in an effort to turn baby so that his head was facing toward my back. As you can see I'm starting to feel rather miserable:

At some point I was 10 cm dilated, but at zero position - meaning the baby wasn't far enough down the birth canal yet. They wanted me to wait a bit longer to see if he progressed.

Happily there are no photos of the next stage, where I got the shakes accompanied by painful, intense contractions. In the progression from 5cm to 10, the contractions had changed - they now felt like extreme pressure and pain in my rectal area. I started to whimper with each passing wave, and my incredibly calm and reassuring husband started pressing on my lower back to try and ease the pain. I'm truly not sure how long this phase lasted, maybe an hour?

Finally I couldn't take it any more and had my husband tell the nurse I had to start pushing. Pushing actually felt good (better than trying to breathe through a contraction, anyway). I pushed, and pushed, and pushed... I know there was a point about 30 minutes in where I was exhausted and feeling totally demoralized - is all this pushing doing anything??? I'm tired.

I kept going, my husband holding my right leg and a first year nursing student (his first day on the labor and delivery floor) on my left. At some point, they broke down the bed and my ob appears in hazmat gear - face shield, knee high booties, the works. I can start to feel what I think is the baby's head further down along the canal, and work to push against the pressure. I get a surge of energy everyone in the room cheers when the top of baby's head becomes visible.

It's all a blur after that, I pushed for an hour and 5 minutes total. Once the head was out, baby's body slid out immediately after. I tore pretty badly in the process, but thankfully was still a little numb down there so as to blunt the pain a bit. There was meconium in the amnoitic fluid, so my husband wasn't able to cut the cord. They whisked baby away immediately and started to make sure he was ok. Once I heard him cry I relaxed a bit and delivered the placenta. Then I tried not to crawl out of my skin when the ob started to stitch me up - OUCH.

Finally they brought him over to me - such a cute little guy. He was really calm in those first few moments. I'm feeling really good at this point, chatting with the doctors and nurses and trying to get a good look at the new addition.



Afterwards we were moved from labor and delivery to the post-natal ward, where we would remain for the next two days. Both sets of parents arrived to meet the baby, it was all so surreal.

I feel so lucky that everything went the way it did and that the baby is healthy and happy. My husband was seriously like a superhero - anticipating my needs and staying calm the entire time. I'm sure none of this was easy to watch!

We've been home now for about a week, enjoying this quiet time where it's just us. I have lots to say about what we've learned in that time, and what we're trying to figure out. Next time...