Sunday, November 6, 2011

How I Became a Breastfeeding Mother, Part 3

We fell into a pretty solid routine that involved lots of interrupted sleep so I could pump and feed Bettie every 3 hours or so.  Because she was so small, we were told to actually wake her up for feedings, so we did.

My hands were a mess from constantly washing bottles.  I'd pump while Adam gave Bettie a bottle.

I remember one night when we were both utterly exhausted.  It was around 5am.  I was hooked to the pump and Bettie needed a diaper.  Adam took her to the changing table, took her diaper off and she peed all over the place.  I (inappropriately, he would argue) started to laugh.  Adam got really upset and very petulantly said:  you did that on purpose!  That made me laugh even harder.  He finally saw the humor in telling a several weeks old baby that she was consciously holding on to pee so she could nail him as soon as the defenses were down.

Every time Bettie seemed interested, I'd put her to the breast.  Every time I was met by excruciating, toe curling pain.  I started to read message boards about EP, exclusively pumping and started feeling resigned to my fate.  I held her skin to skin quite a bit.  It calmed both of us down and she'd often fall asleep.

I started pumping more than Bettie was eating, so I began stockpiling milk in the freezer.  Our freezer isn't very big, and space became an issue.  We bought a very small deep freezer to store the stash.  I kept telling myself that the upside was that I wouldn't have to pump much once I returned to work.

On February 9th, 2009, two days after her due date, she started rooting around on my chest.  I put her to the breast.  It didn't hurt and I started to cry.  Adam ran over to me, looked a little dejected and asked:  It still hurts?  I said:  No...it's just the most beautiful thing I've ever experienced!

Thursday, October 20, 2011

How I Became a Breastfeeding Mother, Part 2

I felt so good when at the week mark Bettie was getting nothing but breastmilk.  I fell into a routine with my pumping, but my supply was still terrible.  I bought Fenugreek and Blessed Thistle and took them until I smelled like maple syrup.  My supply went up a little, but not significantly.  Luckily, my little darling wasn't consuming a great deal because she was small, so even with my supply issues, we were doing just fine, and I was able to stay ahead of the game.

I started feeling more comfortable about pumping and even left the bedroom for the living room.  It's amazing when something like pumping starts to feel so routine you don't even think about it anymore.  I remember one day, sitting in my glider pumping, when the UPS guy came to the door.  Our front door doesn't have much of a curtain, so he got an eye full and I didn't care.  That was a very big, very liberating moment for me.  The poor UPS guy was probably scarred for life!

Adam started referring to me as the "holy cow".  He meant it totally reverently (I keep telling myself).  :)

I was so excited when Bettie came home on day 15 of her life.  I just knew that I'd get her to latch and be done with the pump.  I was so looking forward to snuggling her and having the most amazing breastfeeding and bonding experience.

That's not what happened.  The first time she latched, it was so excruciatingly painful I was in tears.  I met my first lactation consultant at Bettie's first pediatrician's visit.  I was so excited because I just knew that if we had some help, we'd be successful.  The lactation consultant wasn't very friendly and at no time did she touch me or Bettie.  She stood on the sidelines and gave me instructions, but the experience was confusing and wasn't working.  Bettie's latch was still miserable.  She suggested that I keep pumping and told me that because Bettie hadn't been put to the breast early, and had been given bottles since birth, it was unlikely that she'd ever nurse.  That devastated me.  I couldn't believe that something that was so normal and innate to humans could be so permanently damaged that badly by bottles.  She was writing me off.  Instead of accepting that, I looked for help elsewhere.

I work for a company called SAS.  SAS is very family friendly, breastfeeding friendly and has free onsite healthcare staffed with doctors, nurse practitioners and lactation consultants.  One of the lactation consultants/family nurse practitioners listed on our internal website was a woman named Nancy Register.    Reaching out to her changed everything about my breastfeeding relationship with Bettie.  She responded to my emails enthusiastically and seemed very friendly and encouraging.  I made an appointment to see her.

I had no idea what to expect after my first lactation consultant experience.  I steeled myself for more bad news.  Nancy was so different.  First, she was so incredibly knowledgeable.  It was obvious that she was passionate about breastfeeding and helping moms and babies.  She answered all of my questions and made me feel so comfortable.  She actually touched Bettie and helped show me how to position her.  She showed me how to encourage Bettie to open her mouth wide to get a good latch.  She gave me so much good advice, and there in her office, Bettie latched and it was less excruciating, but still not great.

Just when I started to feel discouraged, Nancy explained that as a preemie, Bettie wasn't mature enough to have some of the same instincts that term babies have.  It was early January.  My due date was still a month away (February 7, 2009).  She explained that many preemies just "get it" around their due dates, and told me not to give up if this was something I felt like I wanted to do.  She encouraged me to keep trying.  It was also at that point that we decided that we wanted Nancy to be Bettie's pediatrician.

Tuesday, October 18, 2011

How I Became a Breastfeeding Mother, Part 1

When I first got pregnant, I just KNEW I wasn't going to breastfeed.  It seemed so antiquated and barbaric. It made me flash back to images from National Geographic.  I felt like breastfeeding was something men pushed on women to keep them tied down.  I never thought it could be empowering.

I thought that science had to have something better, and that that something was formula.  I knew that my mother breastfed my sister and me for 2 or 3 months, and our neighbor breastfed her children, but I never really put much thought into it.

Something changed when I saw my Bettie in the NICU.  That change intensified when I smelled the formula she was being fed.  It smelled rancid.  It was disgusting.  I didn't want her to have to ingest such foul smelling stuff.

I had a very supportive post-partum nurse named Katoya who first helped me pump (since the good folks in the NICU wouldn't let me try putting Bettie to the breast).  I remember being in awe when milk started to flow.  The oxytocin kicked in and really boosted the old mothering instincts.  That first session netted me less than half an ounce, but it got mixed with her formula.  I vowed to do whatever I had to do to get her weaned off formula and taking breastmilk exclusively.

Katoya explained that I should be pumping any time Bettie was eating.  Since she was eating every 3 hours, I should be pumping every 3 hours, so that's what I did.  When I was released from the hospital, I went home and got my Medela Symphony pump set up in the bedroom because I was very shy and embarrassed about the way pumping looked.  The first time I pumped, I had the suction turned up way too high.  I realized this when my nipples turned black and started to bleed.  I learned that high suction wasn't the answer to supply problems.  I found kellymom.com and started to learn more about breastfeeding and pumping.

I was pumping every 3 hours, 24 hours a day for about 30 minutes at a time.  Yes, I was getting out of bed.  My supply wasn't great--in 30 minutes I was lucky to get 2 ounces, so I felt like it was very important to not miss a session.  It was exhausting, but totally worth it.  After 7 days, Bettie was getting nothing but breastmilk.

Monday, October 17, 2011

From Baby Girl Osborne to the Notorious Bettie Paige

We had a lot of trouble with girl names.  When our child was officially deemed girl at 20 weeks after being told boy at 18, we jockeyed with a number of names.  Strike one against our child was the last name.  I love my husband.  I really do.  However, his last name is Maness.  You might think that means it's pronounced "man-ness".  Nope.  It's actually pronounced like "manus".  Yes.  My child's last name rhymes with anus.  He claims that no one ever called him Adam Maness the Anus in school, but I contend that boys just aren't as clever as girls (or maybe it's because he's become more flatulent as he's gotten older, so the association is just better now than when he was younger).

Hence baby girl Osborne.  I was too immature to accept his last name.  Actually, Mary Maness just doesn't sound right.  It sounds a little too 1950's June Cleaver to me.  One upside to the last name Maness is that it's one "D" short of Madness, which is very appropriate at times.  We had a last name.

Some of the first names that made our list (though we disagreed on some of these) included very funky, quirky names, like Phoenix (as in my child will rise from the ashes of my broken body as a beautiful phoenix) and Zora (the dawn...as in the dawn of a new chapter of our lives).  We also considered Aradia (the queen of the witches...however, once we discovered that Aradia was also the name of a pole dancing fitness gym, we immediately took a pass).  See?  Girl names are hard!  We considered Charlotte, but it was rising in popularity too quickly for my tastes.

I liked Hallow and Harlow, but was overruled on both.  Besides, when I really started thinking about it, could you be president with a name like Hallow Maness?  Don't answer that.  Also disregard the fact that people could twist that into "hollow anus".  I was pretty good at coming up with insults to accompany names.  If it could be readily twisted, it was out.

That brings us to the hospital.  When I went into labor, baby girl Osborne still didn't have a name.  Baby girl Osborne arrived on 12/21/2008--still no name.  We started working really hard on figuring out what to call this beautiful little girl.

My paternal grandmother's name was Betty.  She was often a curmudgeon, but was also often spirited and funny.  She was a big part of my life considering she lived with us.  I really like old fashioned names, and it turns out, Adam kinda liked the name Betty, too.  When I told my sister we were considering Betty, she got upset and said that she wanted to name her first born, Betty.  I told her to beat me to it...

We decided that if it was going to be Betty, we were going to modernize it a little and make it Bettie with an "ie".  Sure she'll be forever cursed by not being able to find a mug or a keychain with the proper spelling, but that's small potatoes for a lifetime of having a cool name.

There were several things that solidified Bettie for us...signs, if you will.  First, Bettie Page.  If you've never heard of Bettie Page, Google her.  She was a gorgeous 1950's pinup.  She was, unwittingly, at the forefront of the women's liberation movement.  She passed away on 12/12/2008.  A sign?  Maybe.

Second, on my birthday, 12/23/2008, Adam came blazing into the hospital saying the world needed another Bettie.  Apparently there'd been a silver alert on TV earlier for a missing Betty.  They did end up finding the missing Betty.  Adam just knew that was another sign.

On 12/24/2008 we were getting heat from the hospital administrators about getting our child's birth certificate filled out.  We had a first name, but no middle name.  It was almost like being back to square one.  Finally I asked Adam what he thought of the middle name Paige (get it?  Page?).  He thought it was cool.  It made Bettie's name quirky, but most people wouldn't get it.  If she got older and hated her "Edna" name, Bettie, she could go by the more modern Paige.  Baby girl Osborne finally had a name!  Bettie Paige Maness.

My father-in-law hated it.  When we told him that one reason we liked the name Bettie was that it hadn't appeared on the social security administration's top 10 list in 50 years (we wanted something somewhat unique, but not too far out there), he said:  I can see why!  To me, that just meant that the name was perfect!

The weirdest comment we've gotten about her name is this:  I've never seen an infant named Bettie before.  My reply?  Do you think Betty White started out as a Golden Girl?

Sunday, October 16, 2011

Trials of a NICU Mommy, Part 2

I was discharged on Christmas Eve 2008--3 days after the birth of my beautiful daughter and one day after my 33rd birthday.  No mother should ever have to leave the hospital after a birth without a baby.  It hurt so much to leave her.  People told us to enjoy the rest, but like I said before, it's very hard to rest when you're spending your time longing for your child.

We got home after 6pm and I was exhausted.  We got the house settled after 3 days away, and spent some time with our very understanding, but very lonely 3 dogs.  We headed back to the hospital for Bettie's 9pm feeding, spent a little more time with her, then got home again around 11.  I was about to collapse from exhaustion when the doorbell rang.  I was initially outraged because it was so late and we'd just gotten home.

It was my neighbor.  She had tears in her eyes and handed me a small present.  She said to open it after she left, but she thought we probably needed it.  She gave me a hug, said congratulations, then headed back to her house.  The gift?  It was a Baby's First Christmas ornament.  It was beautiful, and she was right.  We didn't have one because we didn't expect Bettie before Christmas.  It was such a touching and generous gesture I broke down into hysterics.  Sometimes those little gestures mean so much.

The next few days involved a flurry of visitors and trips to the hospital.  Bettie got to meet both of her grandfathers and an uncle.  We watched our sweet little girl grow stronger and put on a little weight.  Adam got to change his first diaper, then I got to change my first.  We were constantly running back and forth to the hospital to spend as much time as we could with our little Bettie.  We missed her bellybutton stump falling off.  One feeding it was there and the next it was gone.



She was slowly disconnected from gadgets and by day 7 in the NICU, she was moved to an open air bassinet.  At that point we had so much more freedom with her and could touch her as much as we wanted to.  That was pure, unadulterated heaven.  We were participating in most of her feedings, around the clock (I was up pumping anyway).  We had a few nurses who celebrated the mini-milestones and worked diligently with us to get her healthy enough for discharge.

We rang in 2009 in the NICU with a bottle of sparkling grape juice.  There were a few other NICU parents there.  Bettie was asleep at midnight, but I got my New Year's kiss anyway.  She was scheduled for a 1am feeding, so we got a picture of me feeding her in her fancy New Years Eve hat.  :)


Bettie was getting so close to meeting the criteria for discharge--eating well, gaining weight and maintaining her body temperature in an open air bassinet.  We got to meet with a developmental psychologist.  That was fun.  She told us about all of the developmental delays we could expect with Bettie's prematurity.  She made it sound like a done deal.  She lost credibility points with me, however, when she was talking about diet and started evangelizing about the evils of high fructose corn syrup.  I agreed with her on some points.  The loss of credibility came with her pronunciation of fructose.  She kept saying "fruck-tose".  I started ignoring her after that.  She had nothing encouraging to say beyond promising us a future with learning disabilities and delays.  

Next we got to meet with an actual doctor in the NICU.  Bettie had been in there for almost two weeks and this was the first doctor we'd gotten to see.  The doctor was also a ray of sunshine.  The highlight of the conversation revolved around Bettie's temperature.  She explained that if we allowed Bettie's temperature to drop, we would have to take her to the pediatric ER.  Because it was RSV season, she would likely contract RSV and could die.  She actually ended the conversation with the word fatal.  Thanks a lot, Dr. Doom.  Because of that conversation, when Bettie did come home, we kept the house positively tropical.  It was so hot that I was sweating all the time.  I learned that Bettie could sweat, too.  When I discovered her sweaty in the tropical heat of the house, multiple layers of clothes and blankets, I realized we were overreacting.  Sometimes a little dose of common sense tempered with the advice of a doctor can go a long way.  I could have done without the scare tactics though.

Saturday, October 15, 2011

Trials of a NICU Mommy, Part 1

Having a baby in the NICU is a daunting experience.  Your child looks so tiny and frail.  The monitors, wires and hoses are terrifying.  It can be very loud and very intimidating.  As with every other profession, there are good nurses and there are seemingly jaded, cold callous nurses.  My experience primarily involved the latter--especially during the day.  I know so much more now than I did then, and I kick myself for not being more prepared to be a NICU mommy.  Even though the signs all pointed towards pre-term labor, I just didn't want to believe that that was what was going to happen to me.





Part of my NICU experience, I think, was because it was so close to Christmas.  I've known a few other women who delivered at the same hospital I did and they had a completely different experience.  I am an optimist.  I like to give people the benefit of the doubt.  The moral of the story?  Don't have a baby close to a holiday--especially Christmas.

I was often discouraged and depressed while my baby was in the NICU.  The nurses weren't supportive of me holding her.  They said she needed to stay in the isolette in order to maintain her temperature.  I never had one nurse--not one--recommend kangaroo care or skin to skin bonding.  I know now that if I'd have held my baby skin to skin, my body heat would have helped her maintain her temperature and would have helped facilitate breastfeeding.  The bonding and closeness to me would have helped her get stronger.  My baby didn't require oxygen--the only reason to have her tethered to her isolette was to keep her temperature up.  I feel like I was robbed of the experience of early bonding with my daughter.

I wanted closeness.  I wanted to touch my baby.  Because she was "required" to stay in the isolette, I would often open the little portholes and lay my hands on her back.  I desperately needed the contact, and knew she did, too.  I got reprimanded constantly for doing that because by having the portholes open, the ambient temperature in the isolette would decrease.  I couldn't win.

I was pumping every 3 hours, 24 hours a day and my supply was pitiful.  I was hell bent on my beautiful child being weaned off of the terrible smelling formula and getting only my breastmilk.  People would tell us to go home and get some rest..enjoy our evenings.  How could we?  All we wanted was to have our baby home with us.

Adam and I spent a lot of time at the hospital, leaving only so I could pump.  I would tell the nurses that we were leaving so I could pump.  Not once did they tell me that I could pump in the NICU.  They never told me that pumping while looking at my child could help me yield more milk or get another letdown.

There were times that the nurses refused to let us give our child a bottle.  We got to watch them hold and feed our child.  We got lucky with some of the night nurses.  They were incredibly kind and because of them, we got to change our first diapers and were always allowed to feed her.

I was never encouraged to put my baby to the breast.  When I brought it up, one of the day nurses told me it wasn't a good idea because they had to measure every ounce of milk or formula my child was consuming.  If they couldn't measure the amount and keep track, I was told that she'd have to stay longer.  I felt like she was being held hostage.

The second day of my child's life, I had a breakdown after being reprimanded for having my hands on my child.  When I started to cry, the nurse asked what my problem was.  I told her I felt like my child didn't belong to me.  I still remember how that felt.

When Bettie was about 3 months old, I saw the documentary What Babies Want.  In that documentary, they talked about preemies from the perspective of the baby.  They said that because preemies spend so much time around machines, they bond with the machines.  It was a simple statement, but it broke my heart.  I broke down into hysterics over that simple, very short segment in a documentary because I felt like it was true.  I felt that with all the "regulations" my baby was probably forced to bond with machines instead of me.

Thursday, October 13, 2011

The Accidental Mommy, Part 4

The Saturday after my hospital stay we decided (at Thelma's insistence) to go see the movie the Punisher (worst movie in creation, by the way, followed by anything starring Sarah Michelle Gellar).  We invited our friend Chris to join us for the movie and a pre-movie dinner at a Mexican restaurant.

The funniest thing that happened at dinner happened during a pee break.  Thelma and I went to the bathroom, finished at about the same time and were washing our hands when I felt the urge to pee again.  It's worse when the baby is breech because the baby just dances on your bladder.  Pregnancy is a wonderful thing, but having to pee not 2 minutes after you've already peed gets a little old.  Thelma just stood there and laughed!

I was having Braxton Hicks all day, all through dinner and all through the movie.  After the movie we decided to go for some ice cream, then called it a night.

When we got home, I got hit with a BIG Braxton Hicks and had to bend over.  I was getting a little concerned, but the Braxton Hicks were nothing like the real contractions I was having earlier in the week, so I chalked it up to a little too much activity (even though the majority of the night had me sitting on my rear).  I decided to take a quick shower and get to bed.

I slept late on Sunday.  Around 10am, I felt like I was having contractions.  By 11am, I KNEW I was having contractions, and they were getting regular.  Adam was timing them.  When he saw how regular they were, he announced that he needed to shower before we went to the hospital.  Seriously.  I laughed and asked him what was going to be happening to HIM that required him to need a shower, but I let it go.

All I took with me was a laptop because I figured I'd be spending another night in the hospital after they stopped my labor again.

When we got to the hospital, we were taken to triage.  In triage, Nurse Ratchett appeared.  She snarkily said:  I see you're back.  I replied, duh...I'm pregnant and was planning to deliver here.

My nurse (not Nurse Ratchett) checked me and I was dilated to 3cm.  She put me on the fetal monitor, and because Bettie was breech, she had a really hard time getting her heartbeat to show up.

My contractions were getting intense, but were manageable.  Because they were increasing, the nurse checked me again.  I quickly went from 4cm to 7cm and Bettie's foot was through my cervix.  She decided it was time to call my doctor.  Dr. Holton came in and explained that he was going to perform an emergency c-section.  That's when things got real.  I signed all the papers and within 30 minutes I was taken to the OR.  Adam wasn't allowed to come in until after they administered the epidural, so I was alone, and it was a little scary.  The anesthesiologist came in and I tried to convince him that I was terrified of needles.  Then he saw my tattoo and realized I wasn't going to cry.  The process itself wasn't bad--just lonely and disorienting.  I was sitting down, bent over to round out my spine and was being held by a nurse I didn't know.  I don't know why they wouldn't let Adam at least do that part.  They let husbands do that for women getting epis with vaginal births.

The nurses asked me to take my bellybutton barbell out, but I couldn't get it loose.  The thing had been in for like 10 years and it was stuck.  I had to sign a waiver saying I wouldn't sue if they had to defib me and electrocuted me.  After I was fully numb, Dr. Holton actually wrangled it out.

Adam finally got to come in wearing head to toe scrubs.  They strapped my arms down (I really didn't like that) and put the blue curtain up.  There were like 15 people in the room which was very disconcerting.  No one explained why they were all there.  I later learned that some of them were NICU staff.  I'm still not sure why the rest of the army was there.

Within what felt like 15 or 20 minutes I saw my baby's grimacing little face being held over the curtain and heard the pronouncement that she was a girl.  It was 5:35pm on 12/21/2008 (though her birth certificate says 5:37pm).  She weighed 4 pounds 1 ounce and was 17.5" long.  She was born at 33 weeks and 2 days gestation.

White Christmas was playing on the radio.  There was a lot of rushing around behind the curtain.  Adam disappeared with the baby and I was left alone in the OR again.  At this point no one really acknowledged me.  I felt like a piece of meat on a slab while everyone in the room talked amongst themselves.  I found myself becoming very depressed.

A little while later Adam walked in and I got to see my baby.  She was all cleaned up, swaddled and wearing her little hat.  I didn't get to touch her because my arms were still strapped down.  Within seconds Adam and the baby disappeared again and I was alone...again.

During the rest of my stay in the OR I had the pleasure of hearing my doctor say:  "feel this" to a nurse.  I later learned that they both had their hands in my uterus (pleasant thought, huh?) and were checking out the uterine septum that caused my pre-term labor.  The whole post-delivery OR experience was so dehumanizing and utterly devastating to me.

When they were finished doing whatever it was that they were doing behind the curtain, I was taken to the recovery room.   I was left in there by myself for about 30 minutes.  Finally a nurse came in and asked where my husband was.  I told her he was with the baby.  The lower half of my body was still dead from the epidural.  She was cleaning me up a little and managed to drop my leg into the rails.  She apologized profusely and I just told her not to worry about it because at the time I had no feeling anyway.  She left and I was alone...again.

Finally Adam came in and showed me pictures he'd taken of our new baby girl.  I got to see pictures on a 2x2 digital camera screen.  He stayed with me as they took me to my postpartum room.

I thought I'd get to see the baby once I got to postpartum, but because it was close to Christmas and they'd had a few deliveries that evening, they were too understaffed to take me to the NICU.  It was like a bad dream.

My mom and sister arrived.  They both got to touch my baby before I did.  That still hurts me to my soul.  So many people got to see and touch her before I did.

Adam went home to feed the dogs and all I wanted was to go to sleep.  My legs were itching like mad because the epidural was wearing off.  The nurse came in and offered me something to help with the itching.  She injected me with something and I got sleepy.  I can't sleep when people are watching me, but Thelma and my mom refused to leave.  I begged them and they still wouldn't leave.  Adam told them to stay with me, and they were just following orders, but I was miserable and just wanted to go to sleep.

Adam finally got back a little after midnight and okayed Thelma and my mom leaving.  I finally tried to go to sleep, but that ship had sailed.  I didn't fall asleep until after 3am.

By 6am I was awake and was considering taking my own catheter out so I could walk to the NICU to see my baby.  The nurse finally came in and freed me.  I got up and discovered that the pain wasn't that big of a deal.  The worst part was the weird pulling sensation in my lower abdomen.

I took a very quick shower, removed my bandage like the nurse said to, got dressed and Adam walked me to the NICU.  They offered me a wheelchair, but I didn't feel like I needed it.

When I got to the NICU, I got to see baby girl Osborne in her little isolette.  She was so tiny.  I opened the little porthole on the side and put my hand in to touch her for the first time.  She barely stirred.  I touched her face (complete with feeding tube), her tummy and chest (with all the monitors) her little hands and her feet (complete with IVs).  I touched her tiny, tennis ball sized head covered with its downy dark brown hair.  It was so surreal.  I marveled at my little creation and I knew what it meant to love someone so much you'd readily give your life for theirs.