Hello Out There

Abbie, Mary, Julie, Amy, and Heather…if you haven’t already e-mailed me your addresses, please do so.  You lucky ladies were the winners of the What to Expect When You’re Expecting giveaway that ended yesterday.  Congratulations!

In other news, I have been absent lately.  We had a family reunion, appointments, and lots of other summer to-dos going on. 

Butterball had a developmental appointment because he was a preemie.  They did all these tests and then gave us where he was at.  It was nail-biting, I’ll admit.  No mother wants to hear that their child is behind.  And mine, as it turns out, didn’t have any red flags.  He’s right where he should be in cognition and language skills.  However, they said he’s 26% behind in motor skills, mainly because he’s not rolling over yet.  So they told us he needs to do a lot more tummy time…like 6 times a day.  We have to go back in six months.  It’s all mostly preventative, but I can’t help but feel like they’re looking for something that my sweet boy doesn’t have. 

Another big deal was leaving him with my parents this evening for a few hours while me and the hubby went to see Inception (good movie, by the way).  It was only the second time I’ve left him EVER (the only other time was our anniversary in May).  He seemed to do okay, but apparently refused the bottle.  Guess we better work on that before I go back to work at the end of August.  I also need to work on leaving him more often (with my husband, parents, etc) to get him used to not being with me 24/7.  He had a bit of a crying fit with my mom.  As much as it pains me to be separated from my baby, it’s going to hurt him a lot more if I throw him into a situation of being with somebody new for hours at a time without having ever practiced that separation.  So, we’ve got a bit of homework to do this summer to get ready.

I’ll leave you with my Butterball…sweetest little guy I know.

Mother’s Milk A Lifesaver for Preemies

Check out this CBS article “Mother’s Milk A Lifesaver For Preemies?”

I pumped for Butterball 8-10 times a day while he was in the NICU.  I went to the hospital 2 times a day and breastfed him for 3 feedings a day.  It was tedious, but worth every second I spent strapped to my pump like a dairy cow. 

Benefits of Breastmilk :

(from the Nutritional Support of the Very Low Birth Weight Infant) 

•  Breastmilk empties from the stomach faster  and reduces intestinal permeability faster.
• The use of breastmilk results in less residuals and faster realization of full enteral feedings.
• Many factors in human milk may stimulate gastrointestinal growth, motility and maturation
• Enzymes in breastmilk help immature infants absorb and utilize nutrients more efficiently and may also improve absorption of nutrients when breastmilk and artificial milks are combined.
• Reaching full feedings faster with the use of human milk means fewer days of  IV’s, less side effects from TPN, less infections and infiltrations from IV’s, and less costly and fewer hospital days
• Breastmilk-fed infants have a reduced incidence of necrotizing enterocolitis.
• Breastmilk use leads to reduced episodes of bacteremia and sepsis.
• Breastmilk use is associated with fewer urinary tract infections
• VLBW infants fed human milk tend to have higher IQ scores
• VLBW infants receiving breastmilk have improved visual development and less retinopathy of prematurity
• Human milk has anti-oxidant properties that assist the preterm infant in coping with increased oxidative stress

And here is a link to Dr. Sears’ chart on preemie problems and how mom milk helps. 

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You may also be interested in Breastfeeding a Preemie

The Birth of My Preemie: 29 weeks 4 days

I have always been a boringly reliable kind of a person.  My health has always been pretty perfect with no major issue (or minor for that matter).  I never had allergies, a weight problem, I got out of college in 3 years, never once got in trouble at school…you get the point.

I’m also a super planner.  When my husband and I started trying to conceive, I kept a detailed calendar and had been taking my folic acid for a few months.  My body, the reliable machine that it has always been, didn’t fail me and got pregnant a month after going off the pill.  I researched my brains out about pregnancy and babies—but it didn’t start with the positive pregnancy test.  I had spent my life preparing to be a mother, mostly in the capacity of tons of babysitting and lots of research.  I had attended two live births and was positive I didn’t want to go the hospital route—besides, I was terrified of needles.  I wasn’t terrified of a passing a watermelon through my vagina, but poke me with a needle?  No way.  Not me.  So my husband and I paid too much money out of pocket for a midwife and began preparing for a homebirth.

The first 10 weeks flew by flawlessly.  Around week 10 I got hit with the “morning sickness,” except it was a perpetual all-day-sickness that plagued me until around the time of my anatomy scan at 20 weeks, when it started to fade away slowly but surely.  I spent a good two months running back and forth to the toilet, and about the only good thing I can think of from that period of time was the fact that my toilet had never been kept cleaner since I spent so much time with my head stuck in it and had to keep it from nauseating me any further.  The anatomy scan showed that everything was perfect, and our little baby cooperated wonderfully with the technician who immediately saw the sex of the baby—it was a boy.  Our little boy.  I was on top of the world with thoughts of Little League baseball, dinosaurs, and having a little guy who would adore his mama. 

My last appointment with my midwives was at 28 weeks 4 days, just a few days after Christmas.  I did my gestational diabetes screening and passed; everything looked good.  I booked myself a slot for the breastfeeding class, birth details class, and ordered Hypnobabies.  Since I was on winter break (I’m a teacher), I even thought it was a good idea to get a head start on my birth plan, which I wouldn’t be discussing until I was 35 weeks pregnant, but me being the planner that I am, I was just itching to finish it. 

I remember really feeling the baby.  Not just little flutters, but body parts moving around inside of me:  kicking, rolling, and stretching.  I had so much excitement the first time I poked and prodded my stomach and felt a little kick back. 

He’s so smart, I giggled to my husband. 

My baby, growing bigger by the second.  I was anxiously tracking his progress online and in my baby books, always looking to see what size vegetable or fruit he could be compared to this week.  His arrival seemed leap years away. 

I remember being fatigued during my second week of vacation, which included New Years.  My stepson was visiting his mother, so my husband and I watched TrueBlood episodes in bed and lounged around in a way I was unaccustomed to doing.  You see, I’m just not the type to vegetate.  I can sit in front of the computer for hours, but not the television.  I wrote it off as third trimester fatigue.  And when I started to notice a little moisture on my panties, I wrote that off as third trimester discharge, which I had read so much about. That’s the problem with being too book smart and always trying to figure things out on your own.  Sometimes it’s better to lean on others–the experts. 

BeforeI knew it, winter break was drawing to a close.  I complained to my husband about having to get up for work the next morning after a nice two-week vacation filled with holiday festivities.  My back had been bugging me like crazy and I was beginning to feel as big as a whale, and the fatigue had not disappeared.  I remember telling my husband that the baby hadn’t moved much that day.  I had been doing kick counts for several weeks and it seemed a bit unusual. 

I’m probably being too paranoid, I thought to myself.  I was beginning to feel like my hypochondriac husband was turning me into one.  I quickly dismissed my fears. 

At around 10PM my poor husband was trying to go to sleep but I was a busy bee, frantically trying to finish paying monthly bills and put stamps on envelopes. 

“Why don’t you do that stuff later?” my husband asked sleepily.  “We have work tomorrow.”   

“I want to get it done,” I said, not really understanding my motivation to do it at that time of the day either.  But something inside of me kept pushing to get things done. 

Eventually I tried going to sleep, but the energy I had to do bills had taken a turn into the wrong direction.  Suddenly I felt sick…like “sick with the flu” sick.  I was vomiting, experiencing diarrhea, and having pain in my stomach.  Nasty stomach cramps.  Could it be the swine flu?  My husband, always the hypochondriac, kept asking if we should call my midwife. 

No, I assured him.  I’m sure it will pass.  Secretly I was cursing myself for picking up the flu somewhere.  But I had been so careful! 

After about a few rounds of going back and forth to the toilet, I eventually collapsed on the bathroom floor in a heap of pain.  Yes, the dirty bathroom floor.  That’s when you know I’m not feeling well.  I had enough wit to get my cell phone at one point.  I had a really sinking suspicion that the stomach cramps were coming with regularity…which was alarming.  I can’t even tell you the point in which I realized maybe they weren’t cramps…maybe they were contractions.  I had been wiping all night to make sure there wasn’t any blood, and there wasn’t any- until finally, after wiping a million times, there was slightly pink discharge on the wad of toilet paper. I began trying to rationalize it.  Maybe I wiped too much?  Wiped myself raw?! 

The thing with labor is that you know.  I know there are a lot of anxious new moms who want to know what labor feels like, but the best thing I can tell them is to listen to yourself.  You just know, even if you are only 29 weeks 4 days pregnant and labor comes from left field.  You know. 

I knew I had to muster together the strength to tell my husband in the next room.  I also knew he would surely panic.  And he did.  He frantically went through my birth folder that contained my midwives’ emergency numbers in there and began dialing.  Angela was on call.

She advised him to take me to the ER for a possible kidney infection.  I wasn’t able to stay on the phone with her myself because I was in so much pain.  But the word “hospital” had me panicked.  Hospital?  I was having a home birth to avoid the hospital?  How can I have a freaking kidney infection??!!  I wanted to believe it was a kidney infection, but my body was already considering it labor.  Pain can be a beautiful thing, because it managed to numb my emotions and push me down a path where my only focus was coming out in one piece.  Me, the worrier, the planner, the perfectionist, needed that numbing agent more than anything.

My husband woke up my 6 year old stepson.  I remember he met me in the hallway, me doubled over in pain, and him groggily inspecting the situation. 

“Is the baby coming tonight?”  he asked eagerly.

“God, I hope not!” I managed to say. But there was a twinkle in his eyes, and for a split second he made me happy with his eagerness to become a big brother.

My poor husband had to make a decision as to which hospital to take me to.  We are both not from this county, so we didn’t really know a lot of options.  We hadn’t even planned our emergency back-up hospital yet like we would’ve, because…well, it was just too darn early! 

Turns out, my dear husband made a brilliant decision.  He ended up taking me to the nearest Level 3 NICU, which was the best around.  We didn’t know we needed it at the time, but we were sure glad when we found out. 

I barely remember the drive to the hospital.  I vaguely remember my husband running through a red light.  I remember getting to the ER and immediately going to the bathroom to check for blood (a part of me still hoping this was all a bad joke…or maybe even the swine flu) before hobbling back to the check-in desk, where I then laid down on the chairs because I was in so much pain.  This prompted them to take us seriously, and almost instantly a wheelchair appeared and they were wheeling me back. 

They took me to labor and delivery, which scared the beejesus out of me.  Why was I here for a kidney infection?  But I was in too much pain to protest.  They still weren’t taking me seriously though, taking their time with the protocol they had to go through, particularly with the redudant questions they had to ask me.  I did a good job of ignoring them and letting my husband answer.  I mean, hello, I’m dying here…not really in the mood to answer the same questions over and over again!

I was taken to triage, where they instructed me to get in a robe.  Seriously people, I’m in pain here!  I had to pee in a cup.  My husband knocked on the door, asking if I was okay.  He had already called my mom, who was on her way and got there shortly after we got into the room.

Nurses continued to putter about, asking a zillion questions at least two times each.  Was this a pop quiz?  Who freaking cares!  Take care of my kidney infection! 

They took a swipe to test the fluids coming out of me.  The doctor started talking amniocentisis.  Um…excuse me??!!  This is me…the girl who is afraid of needles!  She did an ultrasound, where my mom and stepson ooohed and aahed over the little baby in my tummy.  Not enough amniotic fluid, the doctor concluded.  No amnio.  Phew.  I got hooked up to an iv (which was my biggest fear of them all).  They began talking about ways to stop labor.  I could hear them asking their zillion questions again, this time my mom chiming in to answer whatever she could.  I was refusing to talk to anyone at that point.

I got moved to a delivery room.  My stepson was sent off with my sister, and my mom went to the lobby to make a few phone calls.  Little did she know I’d be pushing out a baby.

I take pain in silence.  I don’t moan and cry.  I don’t talk.  I shut my eyes and bear the brunt of the pain like a trooper, reverting deep inside myself.  The contractions were getting nasty, and as the nurses and entourage waited for the doctor’s plans of stopping my labor, I worked to get through each contraction.  I couldn’t breathe with my mouth open, so I took in deep, slow breaths through my noise, trying desperately not to drown in pain. 

I still don’t think they took me seriously until I declared “I have to go to the bathroom.” 

I knew what this meant.  I had attended two births.  I had lived my whole life hearing my mom tell stories of birth feeling like needing to take a crap.  I knew it was here. 

The nurses told me not to push.  I could hear them paging the doctor and moving hurriedly around the room.  My poor, panic-stricken husband stood frozen with paralyzing fear at my side.  I kept waiting for him to reassure me that everything was going to be okay, but if you knew my husband, you would know that something like this would have him a million miles away in his own head.

I had high hopes of using Hypnobabies and concentrating so deeply the pain wouldn’t exist…but the course didn’t come in time.  And since I opted to not take any drugs, there was no stopping the pain.  I clamped my eyes shut and grabbed ahold of my husband’s hand and the bedrail, pushing myself to get through each contraction. 

Childbirth was almost like the backpacking trips I would take with my family to Yosemite…only with greater pain.  We would hike from Tuolumne Meadows to the Valley, going hours and hours with few breaks, heavy packs on our backs.  In my head I would wish to throw my pack down and dreamt of a helicopter magically appearing to take us down the mountain, where cold soda and juicy hamburgers awaited us instead of aches and pains and sweat and yucky camp food.  And then the logical part of my brain would interfere with the fantasy and gently remind myself that stopping would only mean not reaching our destination on time.  Stopping meant more mosquito bites, more bland food, more freezing cold mornings, and more days without a nice warm shower.  And so we’d push on, step-by-step, until we reached the valley and ate our well-deserved hamburgers. 

The time came when I was told to push.  I remember opening my eyes and realizing I was on stage:  bright lights pointed toward my spread legs, doctors and nurses crowding in the room, most of them watching and waiting.  And so I pushed…pushed like I was taking the biggest crap in my life. 

“Okay, I’m going to cut you now,” I remember the doctor saying. 

“What?” I screeched, opening my eyes and becoming suddenly alert.  “No cutting!”  I had only started pushing…why was there talk of cutting already?

The doctor explained something about wanting to get the baby out.  But little did she know that I had done my homework.  Lots and lots of homework.  And I had just written the rough draft of my birth plan, and there was going to be no episiotomy for me! 

“I don’t want it,” I persisted.  I was in a lot of pain, but I was still aware.  And I’m one stubborn girl.  Just ask my husband. 

“Okay,” she relented.  “I’ll let you push for a few more minutes.”

And push I did.  Give me a good challenge and I’ll make sure I take home first place.  Before I knew it, I felt the most amazing sense of relief…the final push when the baby pops out.  I had barely caught my breathe and reveled in the amazing feeling of reaching the bottom of the mountain when I opened my eyes and the baby had already been whisked away. 

It hit me.  I was so consumed with the pain and focusing on the birth that I hadn’t braced myself for a delivery room void of baby cries.  I hadn’t braced myself for not being able to see my husband cut the umbilical cord, or feel the warm, wet skin of my baby pressed against me.  I couldn’t even see them work on my baby.  I’ll never forget that feeling of emptiness and nervous anxiousness following the birth of my son. 

“Can you hold me?” I asked my husband, not knowing what else to do. 

They worked on the baby for probably half an hour.  A nurse came to my bedside, held him up for a split second for me to see, and then whisked him away.  I was left in the room with my mom and husband…no baby, just a lot of blood and after-birth. 

I remember not even crying.  No tears of joy and no tears of sadness…just emptiness.  Absolute hollowness. 

I had enough endorphines dancing around in me to keep my head up.  I made phone calls to announce the birth.  I announced it on Facebook.  And I waited patiently…waiting to see my baby, waiting for lactation nurses…waiting to make sense out of the trauma.

I’ve never shown anyone the pictures of me from that day.

The look on my face with that forced smile says it all:  worried, nervous, relieved, tired, stressed, sad.  Mostly sad.  When you picture having a baby, you picture people in the room and waiting room waiting to celebrate.  You picture the happy new mom holding her brand new baby, and the new dad beaming with pride.  I had none of that.  Just silence…and emptiness.

These pictures were taken by my mom and husband.  I wouldn’t get to see my baby for another 4 hours.  I kept wondering what he looked like.  The split second I got to see him in the delivery room was not enough.  Was he ok?  Would he know his mama wasn’t with him?  Would I be able to hold him?

Finally they wheeled me to the NICU to see my baby.  I remember putting the robe on and scrubbing my hands.  This wasn’t the picture of my first hours of motherhood I had spent my whole life dreaming about.  This was a foreign place I wasn’t fully prepared to be in. 

And then we met…me and my son.  He had been a part of me, but suddenly we felt like strangers. I didn’t feel like a mama.  I didn’t feel like anything.

This was our first touch.  No baby on my chest, but instead carefully touching his hand, scared that he would break at any moment.

And then they came…the tears.  The guilt.  The pain.  I watched the nurses take care of him and couldn’t help but feel jealous. 

Two days later I left the hospital with flowers and balloons in my hands, but no baby.  Just an empty womb and a broken heart.  It felt as if I were leaving a piece of my body behind.  That was when I took my first good cry.  I sobbed agonizing tears as my husband drove and appeared flustered by my sudden downpour of emotions. 

Our NICU stay would last 53 days.  53 days of back-and-forth…me twice a day and my husband once a day.

53 days before I would be able to have him with me again.  53 days until my heart would feel complete again.

Three months after his discharge, we’ve come a long way.  I didn’t feel like a mother when I gave birth, but today I feel like a seasoned pro.  I learned a lot about motherhood, life, and myself.  Most of all, I learned what it was like to love with every cell in my body.  Those 53 days seemed like they would never end, but I learned that it was a drop in the bucket next to the lifetime I plan on spending with my boy.

Here’s to all the great years we have ahead of us, Butterball.

****You may also be interested in my post on Breastfeeding a Preemie.

Breastfeeding a Preemie

I’ve given a lot of advice in the last four months based on my experiences breastfeeding a premature baby.  My preemie was born at 29 weeks 4 days.  When they whisk your baby away to get attached to machines and tubes in a life or death situation, breastfeeding isn’t going to happen the traditional way– at least not right away.

I want to reassure any mommy of a preemie that breastfeeding can happen, and it should happen.  Research supports the fact that breast milk is the best for a premature baby.  In fact, your body will produce milk extra packed with nutrients made especially for a preemie. 

For me, I found that breastfeeding was really the main thing I could do for my baby while he was in the care of the hospital.  It was the one thing that nobody else could do but me.  It helped me stay focused on the goal–a healthy baby–and kept me connected to him as his mother.  The NICU experience can be incredibly isolating, but through the milk I delivered on a daily basis for my baby, I felt like his mother instead of a woman who had just gone through a traumatic birth.  I wasn’t left feeling sorry for myself and my empty womb, but instead I had a mission.  I was making milk.  I was doing something so powerful for my baby. 

So I want to share with you a few lessons I learned through this entire experience.  It wasn’t always easy, but looking back it wasn’t exactly hard either.  It was definitely tedious, but for my baby I’d move the planets 🙂

1.  Rent a hospital grade pump

Like I said before, having a baby in the NICU and separated from you immediately after birth means you aren’t going to be doing this the traditional way.  You’re going to have to pump.  Do not use a cheapy pump from Wal Mart or try some other thrifty way.  You’re going to have to bite the bullet and rent a hospital grade pump (I used the Medela Symphony).  These are the best for milk production, especially for a mom of a preemie.  I paid about $70/month, but a lot of insurance companies will pay for them (I’m still waiting for my reimbursement).  Ask your lactation nurse or the doctor on staff to write a letter that you can give to your insurance company.  If you are on assistance, most of the times they will cover the pump rental too. 

2.  Pump, pump, pump

You are going to have to pump 8-10 times a day.  If your milk production runs low, you may have to insert hourly pumps to get it going.  You need to pump in the middle of the night too.  You’re going to have to pretend that the pump is your baby waking you up…you can’t ignore it!! 

3.  Do as much kangaroo care that you can, and then pump immediately afterward

Whenever first possible (nag your doctors and nurses if they don’t offer), start kangaroo care.  This is the skin-to-skin technique where you put your naked baby against your bare chest.  It has a ton of benefits, but one of the big ones is that it stimulates your milk production.  As soon as you put your baby done, start pumping.  In fact, push to be able to pump at your baby’s bedside.  The touching, smell of your baby, and sight of your baby will make your milk increase a ton.  It really works.  Once I thought I’d drive home after kangaroo care and pump right away…bad move.  I noticed a dramatic decrease in milk. 

4.  Fenugreek to increase supply

I drank Mother’s Milk several times a day.  Other people take fenugreek capsules or consume other products.  Fenugreek is considered to be a galactagogue. 

5.  Put baby on breast ASAP

As soon as you can, put your baby to your breast.  When they are born as young as my son, they can really only hold a latch and maybe lick, but this is practice for them.  You’ll do a lot of non-nutritive feedings (where they baby isn’t getting enough milk to sustain them) to eventually graduating to nutritive feedings.  I put my son to my breast a signficant amount of times before the NICU tried to give him a bottle.  My goal was to get him used to the breast before the bottle nipple…and it worked.  He always preferred the breast over the bottle. 

6.  Be patient with your breasts and baby

If you’re having a breast or milk related issue, or maybe the baby isn’t latching, do not despair.  Everything will get fixed over time.  I learned that lesson big time.  There is no sense in fretting over everything.  Everything will work out, just keep a bit of determination. 

7.  Log your milk output

At one point I realized I might not be producing the ideal amount of milk.  This is what helped me get on track:  keep a log of every pump session.  Log how much each breast produces.  At the end of the day, tally up how many ounces you produced. 

8.  Seek help from lactation specialists

Our NICU had 3 wonderful lactation specialists on staff.  They were amazing.  Definitely seek them out and pick their brains.  They are there to help YOU. 

If you have any questions or need some support feel free to contact me.  You can do it!!!

Here are some resources:

http://www.kellymom.com/bf/preemie/index.html

http://www.babycenter.com/0_breastfeeding-premature-babies_8480.bc

http://kidshealth.org/parent/growth/growing/preemies.html

http://www.naturalnews.com/019596_brst_milk_brstfeeding.html

http://www.mayoclinic.com/health/premature-baby/fl00108

****You may also be interested in my post The Birth of My Preemie:  29 weeks 4 days.

Preemie Advice- Updated

My son was born at 29 weeks 4 days after an otherwise perfect pregnancy.  I thought I had the flu.  My husband wanted me to go to the hospital, and bam!  Two hours later my son was here. 

I didn’t have time to stop and reflect on the seriousness of the situation because it happened so fast and the pain was tremendous (I opted to not have any drugs for pain).  But a few hours later, after my body issues were settled and I was put into a quiet postpartum room, it suddenly hit me.  I was one of the only women in that ward who didn’t have their baby next to my bed.  Physically I felt great (I had a natural delivery with no complications with my body), but mentally I quickly became a mess. 

I had big plans for my birthing experience.  In fact, I was waiting for the Hypnobabies course I had ordered merely days before to arrive so I could start studying how to have a peaceful, pain-free experience.  I had already spent good money on a midwife and was contemplating whether or not to purchase a birthing tub for my planned home birth.  I had plans to welcome my beautiful baby in my arms while he was still fresh out of the womb and start breastfeeding.

Such big plans.  In those two traumatic hours, I would quickly learn that life doesn’t necessarily care about plans.

My son spent 53 days in the NICU.  I began to grow attached to the hospital in a way a victim might get close to their kidnapper.  In those 53 days I had to learn to live with my heart outside of my body.  I had to learn to set aside expectations and adapt to a new life.  Most of all, I had to learn to be a mother for my son.

As with any struggle in life, I came out of it changed.  My priorities were different.  My mind was consumed and my heart enlarged with a kind of love you’d never know until you experienced it.  But more importantly, I learned a lot about life in those 53 days.

Lesson #1:  Roll with the Punches or the Punches Will Roll You 

I conceived my son with such set plans (he’d be due in March, and since I’m a teacher I’d get to be with him until the end of summer, etc).  Those plans were immediately dashed with his impromptu January arrival.  My husband and I had to scramble to figure out my time off and how I’d be able to stay off.  You see, maternity leave doesn’t wait for the baby to come home.  And since preemies don’t have physical maturity like full-term babies, you can’t exactly leave them at a daycare with other germy kids.  As a mother, you can’t exactly leave them at all, but with a mortgage and other bills to pay, life may dictate otherwise. 

I had planned to have my sweet baby at my breast immediately after birth, not a piece of cold, hard plastic pump.

I planned to be big and pregnant at my baby shower. 

I planned to finish the baby’s room.

I planned to show my baby off to family and friends, not be housebound and isolated for fear of the flu and RSV.

I planned to leave the hospital with my husband and baby and flowers and balloons, instead I left my baby behind. 

I didn’t plan on having to answer questions when people recognized me around town and asked where my baby was, or why I wasn’t pregnant anymore.

I didn’t plan on having to carry my son around attached to an apnea monitor, having it alarm at the most inopportune times (like the middle of the night). 

Plans are good, but they are not set in stone.  Learn to be flexible when premature delivery becomes your reality. 

Even better, plan to have back-up plans to your plans.  An “a”, “b”, and “c” plan never hurt anyone. 

Lesson #2:  Take Care of Yourself

Mommies of preemies (and daddies too) need to make sure they take good care of themselves and each other.  It’s so tempting to want to be at the hospital 24/7.  The reality is life outside the hospital keeps going, so you need to too.  Food needs to be made, homes cleaned, bills paid, sleep, etc.  Striking a balance is essential.  For me, I found making a schedule worked best.  I spent mornings at the hospital, and then I left by 1PM.  I was home before my husband was and was able to get a few things done. 

The guilt of “I should be there” never goes away.  Trust me, you’ll always feel guilty about something.  I felt guilty going to my own baby shower because I felt like I should have been at the hospital with my son.  If I had to do it over again, I would have taken more “me” time.  When you bring your baby home, you’re most likely going to be housebound.  You need to keep your preemie isolated from the masses because of the flu, colds, and other communicable diseases.  So, if I had to do it over again, I would have gotten that manicure and pedicure.  I would have gotten my teeth cleaned instead of postponing it so I could spend extra time with the baby.  I would have had that nice romantic dinner with my husband.

Don’t forget your husband.  He’s going through a lot too, and a lot of new moms put all their focus into their babies (rightfully so), but (wrongfully) forget the hubby.  Make time for each other.  Use the experience to build a stronger bond.  The alternative is to let the experience rip you apart from each other, and that ultimately won’t be good for your baby. 

Finally, don’t beat yourself up.  Many moms (me included) blame themselves when a premature delivery happens.  More often than not it isn’t your fault.  They thought mine was from placental abruption only to later find that it was a fluke infection of the amniotic fluid.  Once the birth happens you can’t focus on the “why” (until you decide to have another baby, that is).  Your focus should be on getting that little baby strong enough to go home.    

Lesson #3:  Optimism

Easier said than done, but staying optimistic is necessary for your sanity.  I’ve seen so many sick babies in the NICU. Some with heart defects, others with genetic diseases.  Some with brain damage.  Some with their intestines outside of their bodies.  And then I looked at my son, who was very tiny but healthy, and I had to be thankful.  Things can always be worse.  I kept repeating that to myself.

Limit your googling.  You’ll find information that will scare the heck out of you for no reason.  For example, my son was born with a brain bleed.  We freaked out.  We started asking the doctors for the “worst case scenario” (which they seem to always give you anyway) and googling our brains out for information.  We discovered that if the brain bleed doesn’t absorb and disappear on its own, he may need a shunt in his brain.  Imagine how you’d feel thinking of something being drilled into your baby’s head!  The point is that it healed properly and there was no cause for concern, but we got ourselves hysterical for no reason by doing too much research. 

Also, those preemie books the hospital gives you are bad too.  I recommend burying it somewhere in your house just in case, but don’t waste your time reading about all the disabilities your kid might develop or have.  This is a waste of emotions and energy.

Lesson #4:  Hospital Networking

If you’re going to be a NICU regular for a while, you might as well make friends.  Get to know the doctors, nurses, secretaries, even the janitors!  It will give you comfort during a time when you feel all alone and vulnerable.  Many hospitals even let you pick a “primary” nurse for your baby, giving you consistency and a familiar face you can depend on.  This is a great thing to have and usually not advertised. 

If there are lactation nurses, use them.  I bugged the three that worked in our NICU every day!  They were amazing, and they were more than just lactation nurses.  They were familiar faces I could talk to about anything.  I would talk to one every night from 9PM-10PM about everything.  When I left the hospital with my baby, I was still talking to them.  I even went back to see them.  These are the kind of relationships that will make this experience easier to handle for you.

Lesson #5:  Put Yourself before Family and Friends

I don’t know what it is, but it seems in times of crisis you will quickly discover who the keepers are and who should be put at a distance in your circle of family and friends.  Who you think will be the most supportive disappear into their own orbits, and people not on your radar will show up as sources of support. 

I had a grandma, aunt, and uncle decide to fight with me four weeks postpartum and in the thick of my NICU experience over their gripe with my mother.  I was floored at the lack of compassion they showed toward me and my situation.  I ended up losing all of them just to preserve my own sanity.  You can’t spend energy or time on other people’s negativity and drama while you’re going through the “preemie experience.” 

A lot of other people’s problems seem to stem from a lack of understanding of the difficulty one goes through with their baby in the NICU for a prolonged amount of time.  You can’t really understand the impact of the situation unless you’re in it.  So, I forgave people for not understanding, but at the same time I made a pact with myself not to let them bring me further down with their ignorance and lack of empathy. 

Lesson #6:  Accept Help

I’ve always been the independent type, so accepting help was difficult for me.  But the thing is, help won’t always be around, so you might as well grab it while you can.  One of the best things given to me was home-cooked meals.  Some of them were fresh, some were frozen for me.  It made it so nice to come home from the hospital and have something warm to eat.  It was also great to have pre-made meals when the baby came home and I was adjusting to having a new little one in the house (and the lack of sleep). 

Other nice things to have help with:  cleaning and grocery shopping. 

Lesson #7:  Find another Preemie Mom’s Shoulder to Lean On

This was one of the best things I did for myself.  I sought out other preemie moms to share and compare notes with, helping me navigate my way through my own experience.  They’re out there; you just need to connect with them.  I found the Internet to be a great way to find other moms in a similar situation.  You may also know somebody in real life but never really thought twice about their situation until you were in a similar one.

Lesson #8:  Pictures and Videos

Take loads of pictures.  Take video clips.  Share them with family and friends.  You can make a blog or a website, or even just post them on Facebook.  I found that by posting daily pictures of my son for the rest of the world to see, and seeing their well-wishes and comments about how beautiful he was and how strong they thought I was, it was enough of a pick-me-up to get me through the days.  It also makes your baby seem “real”, which is a difficult feeling to achieve when they are locked up in the NICU and not allowed any visitors (most only allow parents, grandparents, and siblings during non-flu and cold seasons). 

Lesson #9:  No Expectations  

Toward the end of your stay you’re going to start getting estimates from doctors and nurses about your baby’s discharge day.  While their intentions are good, this can lead to a lot of disappointment on your part.  You WILL cry the day they change discharge on you.  I remember watching a mom about half-way into our NICU stay.  Her baby was ready for discharge- or so they thought.  I was there when they told her the baby wouldn’t be discharged as expected, and she left the room in a flood of tears.  I remember thinking to myself “geez, it’s for the baby’s own good.  I will never allow myself to be over-emotional!”  Well, when it was my turn to have that happen, I cried the whole drive home.  Just take things as they go and don’t get too invested in one reality.  Your baby will be home before you know it.  It seems like forever as you’re going through it, but after it’s over you’ll wonder where the time went. 

Remember, you will get through this.  Be strong and keep your head clear.  Nobody will fault you for doing the best that you can.  Someday you’ll have many stories to share with your tough little baby

Life Update with a Preemie

As of yesterday E is now 6 lbs 13 oz (he was 6 lbs 2.5 oz last Thursday).  This may not sound very heavy, but consider the fact that he was born at 2 lbs 15 oz!  He seems so huge to me now. 

Everything is going well (he is now going on 2 weeks past his due date), especially since he was born at 29 weeks 4 days.  Our only real problem is his reflux. 

Tip for preemie moms:  make sure you stay on top of having your doctor adjust medicine doses as your baby grows (if needed).  E was starting to show signs that his reflux was worsening, so I too him into the doctor’s office yesterday and the doctor adjusted the doses.  The dose of each medicine he was previously taken was measured for him when he was one pound lighter.  Newborn medicine is given according to weight, so this is important.

Anyway, we still have the apnea monitor, but I haven’t noticed any “real” apnea spells.  Mostly it’s just annoying, like when it rang on and on last night for no apparent reason.  Always a blast when you finally have an opportunity to sleep when the baby is sleeping and a stupid machine keeps you awake.

I’m noticing more and more that E is increasingly alert.  He focuses on me and other objects, grabs a hold of things, and is awake for longer periods of time. 

So, I’d say things are going great around here!  I’m absolutely loving my little guy.

Preemie Information: Kangaroo Care

As I’ve mentioned before on this blog, my son E was born at 29 weeks 4 days.  It was random, unexpected, and traumatic.  One minute I was just starting to enjoy my baby’s kicks inside of me, and the next minute I was in full-blown labor before I was even prepared for it.  It took a while for the shock to wear off and for reality to hit, but when it hit, it HIT. 

When you are a mom to a preemie, you often feel tremendously helpless.  Your baby gets whisked off immediately, and in a lot of emergency situations like mine, you don’t even get to hold the baby.  I had to wait three whole agonizing days before I could have my little man in my arms. 

For other moms of preemies, one of the best pieces of advice I can give you is to immediately and actively become your own advocate for kangaroo care.  If you’re lucky to be in a NICU that routinely offers this, then you’re golden.  But I think a lot of us will find ourselves in NICUs that promote kangaroo care, but maybe get so busy and overworked that it may fall off their radar. 

Kangaroo care, also known as “skin-to-skin” is where you place your naked baby on your bare chest, usually tucked into your shirt.  Your body heat helps regulate your preemie’s temperature outside of the isolette.  In South America, where they didn’t have the technology to properly care for premature infants, they resorted to having the mothers hold their babies in this manner and saw positive effects on the babies. 

Think about it:  a premature baby belongs with his/her mother.  They’re supposed to be tucked inside of you swimming in warm fluids, protected deep in your womb.  Suddenly, for whatever circumstance, they are ejected into the cold, loud, harsh world, and some of these babies will never regain the warmth and protection they felt inside of their mommies.

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From http://my.clevelandclinic.org/healthy_living/Infant_Care/hic_Kangaroo_Care.aspx: 

The benefits of kangaroo care to the baby include:

• Stabilization of the baby’s heart rate
• Improved (more regular) breathing pattern
• Improved oxygen saturation levels (an indicator of how well oxygen is being delivered to all the infants organs and tissues)
• Gain in sleep time
• More rapid weight gain
• Decreased crying
• More successful breastfeeding episodes
• Earlier hospital discharge

The benefits of kangaroo care to the parents include:

• Improved bonding, feelings of closeness with their babies
• Increased breast milk supply
• Increased confidence in ability to care for their babies
• Increased confidence that their babies are well cared for
• Increased sense of control

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My story:  my son was born at 29 weeks 4 days.  As soon as I was able to start holding him (about three days later), we began doing kangaroo care.  I found that some nurses immediately offered it, while other nurses didn’t.  Usually a nurse didn’t offer it because she was too busy.  I only had one nurse who didn’t offer it because she seemed like a control freak. 

While I respect that the nurses are overworked, I was not about to lose a chance to hold my precious boy against my chest.  So, I spoke up, and that’s what I would encourage you to do too.  Ask them.  Demand politely.  Be adamant.  Learn how to take your baby in and out of the isolette.  If your NICU allows it, read a book while you cuddle with your baby.  I finished a couple books a week! 

I kangarooed my son every day of his stay in the NICU.  I often borrowed my husband’s button-down shirts to make it easier to slip my sweetie into my shirt.  We’d sit glued to each other for hours. 

Kangaroo care was not only good for my baby, but it helped me maintain my sanity.  It was something to look forward to and a contribution I could make to my helpless son.  When I had my son pressed against my chest, I felt like his mother.  Nothing will cure your postpartum NICU blues more quickly than kangaroo care.  TRY IT.

Our Breastfeeding Story

I have been dreaming and scheming about motherhood since I was a little girl.  I used to have a closet full of Cabbage Patch Dolls that I would swaddle, feed, rock, and they were all named after somebody in my family.  And since I was a little girl, I always knew that I would breastfeed my future babies- after all, that’s how my mom and grandma did it!  I grew up in a house where my parents were honest with us children about our bodies.  I knew a lot of people who were ashamed to nurse in front of their husbands, let alone strangers.  Boobs were taboo to so many people I have known in the course of my life, but not in my house.  We grew up knowing boobs were for food.  So, I had no qualms making future milk-production plans for my girls. 

When my turn finally came up and everything was in place for me to begin my own family, I sailed through a perfect pregnancy.  Not a single problem.  I was seeing a midwife and preparing for my perfect homebirth- it was years of playing with dolls and dreaming finally coming true.  I was in love with each and every little kick and movement I felt from my baby, who I learned was a little boy.  My little boy.  I was over the moon.

And then my picture perfect story took a turn in a different direction.  At 29 weeks 4 days, my husband, stepson, and I went to the ER in the middle of the night because I had what I thought was a “stomach virus.”  Could it be H1N1, my husband frantically wondered. 

H1N1 would’ve been good news.  I soon discovered my water had broken.  The doctor and nurses puttered around, contemplating how they would stop my labor.  I don’t think they took my seriously when I angrily ignored their five thousand questions.  When I announced my urge to “go to the bathroom,” it was then that they really checked between the legs and knew it was really happening. 

I naturally delivered my son after less than fifteen minutes of pushing.  It had only been two hours since I left my house.  Everything happened so fast there was no time to process.  I watched as they whisked my baby away, and I was left alone in the delivery room, finally getting a moment to wrap my mind around everything that had happened.

“I need to see the lactation nurse,” I said immediately, before the doctor had even finished her business with me.  I hadn’t planned to deliver in this way, but I had planned to breastfeed. 

“We’ll page her,” a friendly nurse offered. 

And so I waited.  And waited.  And requested a few more times until they promised to send the lactation nurse to my postpartum recovery room. 

“Don’t I have a window of time to start pumping?”  I nagged. 

They assured me the lactation nurse would be with me shortly. 

I’ve always been a bit of a planner, which is why my preterm delivery is so ironic, proving to me that not all things in life can be planned.  In the course of my planning, I had done my own research on breastfeeding.  Also in a bit of irony, I had completed a rough draft of my “birth plan” a week before, and I had made note that I wanted immediate skin-to-skin with my newborn and to start breastfeeding immediately.  There was no newborn to be seen in my delivery room, so I needed to know right away how this was going to work.

An hour or two later, Pam came to my postpartum room with a pump kit.  Next to my bed was a yellow Medela Symphony hospital-grade pump, and she was going to show me how to use it.

My mom and husband were in the room, and I wasn’t used to baring my breasts for public display.  I also never planned to pump- at least not until I had to go back to work.  I had always envisioned my sweet baby at my breast, not a piece of cold, hard plastic.  The optimism I had during the delivery was beginning to waver as the reality of my situation and the crushing of my dreams began to sink in.  This was not what I planned. 

Pam showed me how to use the pump.  I did it, but nothing came out.  She encouraged me that it would come in with due time, and to keep pumping every three hours for at least fifteen minutes.  She warned me that it was a bit more challenging to get milk with a preterm delivery. 

So I pumped.  Every three hours around the clock.  Each time, nothing.  Dry as a bone.  Later that night, my dad and mom came to visit me.  My dad awkwardly looked at the pumping supplies and my empty bottles and couldn’t refrain from cracking a joke. 

“Is there anything in there?” he laughed.  Very funny, Dad. 

I pumped 8 times before I saw even a drop of colostrum.  I set my cell phone alarms for every three hours and diligently did it all night.  Pump, clean.  Pump, clean.  They had told be to bring any amount I could get out to the NICU, even a drop.  It’s liquid gold, they told me. 

Finally the gold came, just a few drops at first, and then each time slightly more and more.  I remember being so ecstatic to see that yes, there was something in my breasts.  I took a picture of the tiny Snappi bottle holding a few meager drops of my liquid gold and texted it to my parents and husband.  Then I rushed over to the NICU (as fast as I could postpartum) and proudly delivered the colostrum for my baby boy. 

My next point of excitement came as I stood next to my baby’s isolette.  I was standing there watching him, my hand placed delicately around his fragile 2 lbs 15 oz body, when for the first time I felt my shirt become wet.  It was the first time I realized I needed nursing pads.  My body had responded to the touch and scent of the baby.  I was amazed.

When I was discharged from the hospital two days later, my husband came to pick me up and all my belongings.  I remember feeling like the only loser on the planet to leave the hospital with balloons but no baby.  I sobbed the whole car ride home feeling like my heart was being ripped out as I left my baby behind.

It was especially depressing to come home to a quiet house without my baby inside of me like he should have been.  I felt incomplete and empty.  I had to pump around the clock, every three hours, falling into a tedious but necessary routine.  Since my son was in the NICU, sterilization was essential, so I washed my hands, pumped, sealed the bottles, labeled the bottles, cleaned the pump parts, put the pump parts in the Medela microwave sterilization bag, wiped the parts clean, and repeated it all over again three hours later.  I washed my hands so frequently they were cracking and bleeding.  Every morning, I delivered the bag of milk to the NICU, proud to give something to my baby.  It was one of the only things I could give to my baby. 

I was lucky enough to be a fixture by my son’s side for the next 51 days, and in that time we fostered our breastfeeding relationship.  Every morning I did skin-to-skin (kangaroo care) with my son, placing his tiny, naked body against my bare chest.  I would borrow my husband’s button-down shirts to make it easy to slip the baby in there.  My son loved this time together, but I probably loved it even more!  We were able to start doing it about a week after his birth, and it was the first time that I begun to feel like a real mom.  It became everything I lived for in that trying time of my life.

Around week two postpartum, with the guidance of the awesome lactation nurses in the NICU, we started to put my son to my breast and let him “explore.”  He didn’t really do anything besides lick, but he latched immediately and held a good one each time.  A few days later we added a silicone nipple shield and he began his non-nutritive sucking.  He drank a little bit each session (once a day), but not enough to consider “nutritive,” so they continued feeding him through the nose.  I wanted so desperately for him to breastfeed and not have to use the tube in the nose, but my little guy had other plans.  He had virtually no issues for most of his NICU stay, but he slowly accepted the nipple.  Once again I was reminded that I was not in full control of my plans. 

It wasn’t until he was around34 to 35-weeks gestational age that my son began breastfeeding.  We got a doctor’s order for once a day as he tolerated it.  After a week, we increased it to three feedings a day by breast.  I spent all morning and early afternoon with the baby, breastfeeding, changing his diaper, taking his temperature, and doing skin-to-skin with him.   I’d go home and try to catch up on life, but always went back to the hospital for his 9PM feed.  Breastfeeding was our time.  It was something only I could provide.  My son had the breast first before a bottle (bottles with fortification are routine in the NICU for preemies), and he would maintain a preference for the breast. 

By the time my sweet boy came home after being in the NICU for 53 days, I was ready to breastfeed him exclusively.  He left the NICU with orders to have at least two bottles of expressed breast milk with 22-calorie Neosure, which I did for about two days.  I found that he was spitting up a lot due to his reflux every time he had his bottle, so we ditched the bottles and went full force into exclusive breastfeeding.  Since weight gain was a concern, I took him the pediatrician within the week to check on his weight.  It was perfect.  I was such a paranoid mommy that I went back a few times after that too.  Since he was gaining weight, I was given the green light to continue not giving him the Neosure.

When my son reached his due date, we began slowly getting rid of the nipple shield.  I took it away more and more each time until we no longer used it.  I had to work on his latch (he had a shallow one after using the shield), but other than that we have experienced a happy, healthy breastfeeding relationship despite the circumstances of my son’s birth.

And in the end, I lost the birth I had planned for, but preserved the breastfeeding relationship I had always wanted.