Thursday, August 21, 2014

What I Wish I'd Known About Breastfeeding as a New Mom


It's hard

Breastfeeding came about as naturally to Lily and me as it could. I latched her on immediately without help from anyone - whilst still in a daze from the anesthesia - and she nursed like a champ and had my milk in by day 2. I had attended a breastfeeding class so I sort of knew what I was doing, but I didn't know about feeding patterns of newborns or what cluster feeding would be like or how sore my nipples would be or what a vasospasm was or...the list goes on.  And it was "easy" for me!  God bless the mothers whose babies don't latch or whose babies are in the NICU or the moms who have to use nipple shields or who struggle with supply.  I can't even imagine.

I wish I would have known that it's hard and it takes determination and support.  You can be the strongest breastfeeding advocate in the world, but after 18 hours of cluster feeds that keep you confined to the couch that sample of formula you received in the mail looks pretty tempting.

It gets easier

After awhile the cluster feedings space out and the soreness goes away and you can get baby to latch without a shield or you work out your pumping schedule and one day, you realize that you're kind of a rockstar at this at you wonder what all of the fuss was about in the beginning because it's just feeding your baby.

You make enough milk 

This one is extra big because it needs to be seen.  Unless your baby is losing (or not gaining) weight or is not having adequate urine output or bowel movements, YOU DO NOT HAVE AN UNDERSUPPLY.  About one percent of the population has an undersupply.  ONE PERCENT.  The sad fact is that behaviors of breastfed babies are so misunderstood that pediatricians and uninformed family and the next door neighbor and the lady next to you in line at the grocery store and even the occasional lactation consultant give awful, awful, awful advice.  "Oh, your baby is crying for the breast every hour? You must have an undersupply! You should supplement!"  Excuse me while I go bang my head against the wall.  No! This is not true!!! Go find an IBCLC (International Board Certified Lactation Consultant) and get their advice.  Even if baby isn't gaining fast enough or having inadequate output, it may just be a latch/milk removal issue that can be resolved with a few changes and some time.

If you want to increase your supply, just leave your baby at the breast

The human body is amazing.  The fastest, most effective way to bring in your milk and to increase your supply is to nurse your baby.  The empty breast refills the fastest.  If your baby is suckling an empty breast, the brain gets the message and it's response is to tell your body to make more milk and make it in a hurry!  Pumping can help and galactagogues can help, but the absolute best way to up your supply is just to nurse.

Babies don't just nurse for hunger

They nurse for comfort, they nurse to up-regulate your supply, they nurse to fall asleep, and they nurse because there's a boob there so why not.

Cluster feeding sucks and is awesome at the same time

No one wants to be confined to the couch for an 18 hour day of nursing every hour for 30 minutes, but it is your baby's way of telling your body to make more milk because they're going through a growth spurt or a period of mental development.  It is not a sign that you do not make enough milk.  Your body responds by increasing your supply to meet the needs of a baby who is growing at a crazy pace.

If you have to supplement, donor breast milk is readily available - you need only ask

Every organization that deals with breastfeeding recommends feeding options in this order:
  1. Breast milk from the mother's breast
  2. Breast milk in a bottle pumped by the mother
  3. Breast milk in a bottle from a donor
  4. Formula
There are a few places you can go to request milk - human milk 4 human babies or eats on feets are great options.  Some people are weirded out by this, but I think it's weirder to give a human baby formula made from milk that is intended for baby cows.  Donating mothers are used to answering very personal questions about their medical histories, diet, etc. to make sure that their milk is acceptable for your baby.  That said, many women feel that if the milk is good enough for that woman's baby, it's good enough for their child too.  Donating milk (in the form of wet nursing) is how countless babies were fed in the centuries and millennia before formula was available.  It is awesome (and free) and one of the greatest gifts you can give or receive!

Side-lying nursing is God's gift to breastfeeding mothers

It's probably the only reason I get sleep.  And naps.  Being able to feed your baby without getting out of bed is the best.

Just looking in your baby's eyes while she's nursing is one of the best moments you'll ever have

Smart phones are great - but when your child looks up at you and her eyes are saying, "thanks mom!" and "this is just the best" and "I love you" and "isn't it so cool that your body is still sustaining my life after you grew me for 9 months?!" and your heart explodes, you would give up all your worldly possessions to have that moment last forever.

Thrush *really* sucks

The stabbing pains and the red nipples that look like Rudolph's nose and the gentian violet that makes it look like your child ate a purple Smurf... yeah, I can't recommend getting thrush.

Sunday, July 6, 2014

Healthy Competition (Pun Intended)

Since Matthew and I are very competitive people and we've struggled to get into a consistent rhythm of working out, we've decided to make a game out of losing weight.  We had a heart-to-heart this morning and determined that neither of us are happy with where we're at and we need to change.  We are both really great at coming up with ideas and not so great at putting them into practice - but we love competing with each other.  In order to get things started, went to the store tonight and got some white board markers and we're going to make our bathroom mirror the scoreboard.  That way we see it every day and it keeps us motivated.

The rules are as follows:

  • One goal per week.  We were going to do something exercise related, but it's pretty hard to adjust our goals so that they're fair considering Matthew has way more muscle tone than me.  To start, we're going to do lifestyle changes. This week's goal is to not suggest going out to eat (defined as: suggesting we eat something not prepared in our kitchen).
  • Track the score at least daily.  I'm sure we'll run upstairs to add to the tally every time the other person makes mention of eating out, though. :)
  • At the end of the week, the winner gets a prize (cash value of less than $10).  My prize this week will be one hour out of the house baby-free (oh the possibilities!).  Matt's will be an ebook he's been wanting.
  • If we tie at zero, we each get our prize.  If we tie above zero, neither of us do.
We will also track our weights daily before our workout to keep us on track.  I'm excited to start getting into a routine with this.

Tuesday, June 10, 2014

Getting Back on Track

Things are finally starting to feel normal around here again.  A new version of normal, but normal nonetheless.

My postpartum period for the first 3 months was a nightmare.  A really long, really drawn out, terrible awful bad nightmare.  I was diagnosed with postpartum depression and post-traumatic stress disorder after Lily's birth.  After two failed rounds of progesterone therapy to treat the depression, I ended up in the hospital with suicidal thoughts.  Thankfully, I have the most amazing husband in the world who dropped everything to make sure I was taken care of.  I was miraculously able to get an appointment to see a psychiatrist two days after my ER visit and got a prescription for anti-depressants.  Talk about a effective!  They aren't supposed to work right away, but for me they did.  Aside from the crazy (CRAZY!) dreams they give me, they are miracle workers.  They have made me a functioning human being again.  That and my decision to quit my job, work part-time in the evenings and stay home with Lily during the days.

Being able to stay home with Lily and care for the house is the best job I've ever had.  Turns out I love doing laundry and cleaning and cooking.  I feel so much pride in knowing that what I do matters.  I may not be impacting as many people as I was when I worked at Gallup, but the people I am impacting matter so much more to me.  I am so, so happy with 98% of my life.

Now that things are back to normal though, I have to face the reality of the situation: I gained a LOT of weight during the pregnancy and it wasn't just "baby weight".  I didn't work out and I didn't eat as well as I should have.  I craved sweet foods the entire pregnancy and I gave in every time.  Willpower was not my strong suit.  My first time going shopping postpartum was awful.  I ended up sobbing.  I had gone from being so proud of where I was and my clothing size to being bigger than I had ever been before.  People tell me it's because of the pregnancy and it's okay to gain baby weight, but I know that's not what the problem is.  You could barely tell I was pregnant until about 35 weeks when I popped.  I only got a handful of stretch marks and most of the weight I gained was not around my belly.  So I'm going back to where I was when I started this blog 3 years ago.  I'm going to go back through all of the struggles I went through and hopefully drop the weight I gained and more.  If I have another baby in the process, I plan to hold myself to a higher standard and do better for the baby in my eating and exercising habits the next time around.

This is what Matt and I are doing so far:
  • Exercising every day at 2 pm. 
    • We've blocked this off on our calendars and will either take a walk, do a body weight program, or do 30 Day Shred. 
  • Stopping our dining out habit
    • This is our worst habit and it is hard to break, but we are giving it our all. 
  • Creating a meal plan together
    • Matt used to create meals on his own, but it led to going out more because I didn't know what was for dinner and a lot of the time we would just decide that we didn't feel like cooking because he or I weren't crazy about that day's menu.
  • Eating fruit for sweet cravings
    • This will make a huge difference!  Summer offers so many great seasonal fruits and we are taking full advantage of this.  We have frozen grapes, tons of strawberries, and various other fruits in the house and it really does fulfill the craving!
The last couple days have been great, so hopefully they just continue to go up from here!  I can't wait to get healthier (and stay that way)!
 

Wednesday, April 23, 2014

An Explanation

It was brought to my attention recently that I have not been doing the best job of explaining why I am so upset about the c-section.  I knew that it was a traumatic event for me, but I didn't figure out exactly why I was so traumatized until the other day.  I knew all of the things that happened were incredibly upsetting, but I was finally able to pinpoint the real problem.

The issue is that as soon as it was determined I needed a c-section, Matthew was immediately pulled away and everyone else stopped talking to me.  Not a single nurse, my midwife, or either of the doctors said a word to me to explain what was happening, why there wasn't time for me to get a spinal or epidural and instead had to undergo general anesthesia, what the procedure would entail, when I would wake up, or why I couldn't talk to my husband or have him in the room.  Everything happened really fast and I was honestly a little in shock and it didn't occur to me to ask those questions.  I was clearly terrified though, and definitely upset.  I kept asking over and over again to talk to Matt and the only response I got was that he wasn't in the room.  I finally gave up and just asked them to tell him I loved him - and all I got was a, "yes, I will tell him".  It was more like I had been a petulant child begging my mom for something and her finally giving in than a compassionate response.

I felt dehumanized.  I was made to feel like I was a vessel carrying the child who needed to be cut out. I was made to feel like the only person who mattered in that room was my child - that there was no sense in caring for me.  I am not resentful toward Lily for any of this.  I am resentful toward and angry at the providers whose job it is to treat all of their patients in a compassionate manner.  Time may have been of the essence, but that is no excuse to neglect the patient on the table who would actually have emotions and memories of the experience.

Apparently I was so insignificant that it wasn't even necessary for one of the nurses to tell me that she was performing an incredibly painful procedure until I screamed out in agony and asked her what exactly she was doing.  After giving up hope of talking to my husband before an unplanned, unexpected, and major surgery, I was told, "you can't cry because I need a clear airway".  No apologies from the nurse for not telling me about the procedure and no empathy from the anesthesiologist.  It would not have taken more than five or ten seconds for the anesthesiologist to say that she knew it was a scary situation but it was important for her to have a clear airway in order to perform the operation as quickly as possible.  It would not have taken any more time than necessary for the nurse to tell me she was about to perform a procedure that was painful so that I could have a second or two to prepare for it.

I had sheets taped to me and was covered in antiseptic and had someone strap my hands down, and no one ever said a word to me about what they were doing or why they were doing it.  Not a single person took even a second of their time to care for me.  And that's why I'm mad, and that's why I'm upset and that's why I'm traumatized.  And that is why when you tell me I should be happy that I had the c-section, I get upset and hurt and angry.  It is because I am flooded with thoughts and feelings of the most degrading, heartbreaking, and scariest moments of my life and I'm expected to appreciate that all of it happened to me.

I am glad that I have Lily.  I could not love her more if I tried - she and her daddy are the two most important people in my life.  But I will never be grateful that the c-section happened the way that it did.  Maybe someday I will be able to separate the emotions of the c-section from the way that it was handled.  I am working toward that goal fervently, but for now I just need more time.

Monday, March 31, 2014

A letter to all Nebraska state senators

I'm going to print this off and mail it to each one of Nebraska's senators.  Feel free to edit as necessary and send it along to your senator (or all of them!) if you believe Nebraska needs to change its legislation.

Dear Senator,

I am writing today as a woman whose birth story, like many, involves medical intervention.  Unlike most women, however, I actually needed the interventions I had.  I planned and prepared for a totally natural birth at Nebraska’s only birth center.  Unfortunately, at 40 weeks and 6 days gestation, I had to be induced for legitimate medical reasons.  After 36 hours of induction and about 6 hours of real labor, I was rushed in for an emergency c-section because of a cord prolapse.   I hate that I had to have a c-section but I also knew that my midwife would not have recommended any of the procedures she did without strong evidence supporting the medical intervention.

The story of unnecessary medical intervention runs rampant in the United States, and with only one birth center in the entire state of Nebraska and without the option of midwife-attended homebirths, women across the state are being subjected to unnecessary or inappropriate interventions.  Many women don’t know their options and are inclined to simply listen to what their doctor says, trusting the person who has probably never really studied or seen more than a handful of natural births.  Some women may know what they want but they don't have the support of their caregivers and may be talked into interventions they don’t want or need.  Childbirth is such a fragile time and telling a woman who is in labor that she “needs” an intervention for the safety of her child is manipulative but it happens on a daily basis.  There are hundreds, thousands of these stories.  Ask any woman who’s given birth in the last few years and you’ll undoubtedly find at least one, but sadly probably many more than that.

Currently Nebraska state law does not allow for a Certified Nurse Midwife (CNM) to attend home births within the state.  This drives many women to either leave the state to give birth or to attempt an unattended homebirth where the risks run much higher.  The Journal of Midwifery and Women’s Health recently posted an article that studied 16,924 planned homebirths across the United States.  The numbers indicate that midwife-attended homebirths are as safe as, and may be safer than, hospital births for low risk mothers.  The homebirths also come with better breastfeeding outcomes than hospital births.  The abstract can be read and the full PDF downloaded here: http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12172/abstract.

I am writing because this issue is important to me.  Because my birth experience left me with PTSD, I do not want to see the inside of a labor and delivery unit ever again.  I’m told that my views may change with time, but even if they do, I should not be deprived of the right to birth my second child in an incredibly safe and comfortable environment with the oversight of a trained professional who I can trust enough to tell me if I do need to head to the hospital.

For now, I’m researching my options in Iowa because CNM attended homebirths are legal there and I will undoubtedly be able to find a midwife who will attend my Trial of Labor After Cesarean (TOLAC) that will hopefully result in a successful Vaginal Birth After Cesarean (VBAC).

My plea to you is this: please read the study I provided.  Please research the safety of TOLAC/VBAC and the dangers and outcomes of unnecessary intervention in hospital births.  I could throw statistics at you all day, but it’s something you need to research yourself.  Half of your constituents are women.  Please look out for them.  Please consider legislation to allow CNM attended home births in this great state.  I don’t want to have to have my second child in Iowa.  I love Nebraska and have loved it all my life.  I am so proud of this state.  I tell everyone I know from other places that this really is “The Good Life”.  But now that I’m looking toward my options for birth for my second child, I’m seriously doubting that claim.  Because now, I live in a state where I don’t have options.  I will (most likely) be a low risk pregnancy forced to give birth in a hospital and to labor attached to unnecessary machines, or I’ll be giving birth at home with no one to tell me if I am, or my child is, in danger.  There’s not really room to find the positive here.

You may not be “my” senator, but we are both citizens of this great state.  Please consider writing legislation that will enable all of the women in Nebraska to have a choice to birth how they desire.  Please consider legislation that will give me, a woman with PTSD, options that don’t give me flashbacks to the scariest, most terrifying moments of my life.

Thank you for your consideration and I look forward to hearing from you regarding this matter.

Sincerely,
Kelsey Leick

Thursday, March 27, 2014

Sometimes, having a happy, healthy baby isn't the only thing that matters.

I've written a lot about my desires for childbirth and the events that actually unfolded.  When I was in the hospital, I was in a daze and so happy to have Lily that I wasn't really hit by why happened.  I was okay with it.  I didn't really have to deal with it.  I thought I was fine.  And then reality checked in and everything that happened hit me with the force of a dozen semis at the same time.

I wasn't okay with what happened or how it did.  I was traumatized by the events of that morning.  All of my hopes and dreams that I'd been building up since I was 6 years old were ripped out of my hands. I didn't get a vaginal birth.  Hell, I wasn't even conscious for the birth.  All of that was taken from me in the harshest, most difficult, scariest situation imaginable.  I underwent major surgery that, while unlikely, carries a risk of death.  I didn't get to talk to Matthew between the decision that I would have a c-section and when they put me under.  Those two things together made the last thought I had before I was put out, "I am going to die and I'm not going to get to tell Matthew I love him."  Try walking away from that without being traumatized.

So when I tell people my story and they say, "Well at least you have a happy, healthy baby!  That's the important thing!" it's like a dagger through me.  It's like being told that my story doesn't matter, that what I went through doesn't matter.  That it shouldn't be a big deal to me because I'm alive and Lily is alive.  Yes, I have a beautiful, wonderful daughter who I couldn't possibly love more if I tried.  Yes, my physical recovery has been a breeze.  But I matter.  My story matters.  My mental and emotional recovery has hardly just begun.  The fact that I will never be the same, not only because I have a child now but because I walked away from her birth with PTSD, is important.  It matters.

I thank God every day for Lily, but I also ask him for answers every day.  Why me?  What did I do?  What could I have done differently?  I've all but gone through every single day of my pregnancy thinking about all the choices I made and the things that I could or should have done differently - that I will try my damnedest to do differently the next time around.  I'm not even sure I'm confident in my body's ability to do the thing it was literally built for - to carry and birth children.  Every day I ask myself why I was so confident - borderline cocky, really.  I feel like I'm being punished for so confidently going after what I wanted.  For defying the odds in this day and age of medicalized birth.  I hate what I had to go through.  I hate that I will have a physical reminder every time I look in the mirror and see that damned scar.

I hate that I have flashbacks of staring up into the lights thinking I'm going to die and that it keeps me up at night.  I hate that I have this beautiful, amazing child that I got to grow inside of me and sometimes just looking at her sends me into fits of tears because I couldn't give her the gift of a totally natural childbirth.  And I hate knowing that if she's ever diagnosed with asthma or any number of other conditions, I'm going to blame myself all over again because of the c-section.  I'll always wonder if it would be different if I'd had my natural birth.  I don't know if I'll ever be able to accept that it wasn't my fault.  I'm sure that it was.  I'm sure there's something I could have done differently.  Even if I successfully VBAC next time, I'm still going to hate that I couldn't have that the first time around.

I know that with childbirth and new babies, it's so common to hear/say that having a healthy baby is all that matters.  It's really not.  The mother matters and her experiences matter.  And if the birth is everything she never wanted, don't disregard her and her experiences.

Having a happy, healthy baby is wonderful, but it's definitely not the only important thing nor is it the only thing that matters.

(Disclaimer: I know that most people say this as a silver lining and it's not an intentional dig at me.  I'm just relaying how it feels to me in my current not-at-all rational mental state. This isn't intended to be a dig at anyone, I just needed to get it out.)

Sunday, March 16, 2014

Reminders for a Breastfeeding Mother (a.k.a. me)

Over the last week or so, my life has gotten significantly less chaotic and I finally feel like we've settled into a routine (minus the growth spurt that Lily went through).  I keep telling her to stop growing but she's already started the whole not listening to Mom thing.  My tiny little baby is now 8 pounds!  Eight! That just seems so big…

Obviously, we're not having any problems in the milk supply department, but figuring out breastfeeding in a culture that, on the grand scale, is anything but supportive has been a challenge.  For the first month or so, my instinct was to feed her when she cried because I didn't think about the other things that might be wrong.  While this helped my supply, it was definitely not the best thing for her or for me because as it turns out, breastfeeding can cause gas pain which can make a baby show hunger (to resolve the gas pain, which it does temporarily) which led to feeding which led to crying.  Definitely not a good situation for anyone.  We were in this endless cycle at the end of her growth spurt when I googled and found an excellent resource written by an IBCLC that explained so much of what I was going through.  (By the way, an IBCLC is an International Board Certified Lactation Consultant - do yourself a favor if you're a breastfeeding mom and FIND ONE.  You will not, not, not regret it!)

Since when I'm in the throes of things, I tend to revert back to cry --> feed --> cry --> feed --> never-ending unhappiness for all parties, I'm writing this post so I have something to look at  to remind myself that I need to stop feeding her on demand because hunger cues don't necessarily mean hunger if she's eating every hour.

The list:

  • Reflexes are just that - reflexes.  Just because I rub Lily's cheek and she turns her head, it doesn't necessarily mean she's hungry.  Only feed her if she continues to show other signs of hunger and everything else (gas, being sleepy, etc.) has been ruled out.
  • Until about 3 months, if she's sucking on her hand/fingers it doesn't necessarily mean she's hungry.  Once she gains control of her hands, it's a better indication but it could be self soothing.
  • Sometimes the developmental stage she's going through (Wonder Weeks app is great for this!) makes her want to suck for comfort and not for nourishment.
  • Lactose overload is a real thing. If she's super gassy, nursing will temporarily relieve her gas pains before making it worse.  If it's been less than two and a half hours since her last feed, try gas drops.  (Those things are miracle workers!)
  • She may be tired.  If her movements are jerky or she looks a little dazed, try swaddling with a pacifier to knock her out.

I'm just going to have to come back to this list (or just hang it on every surface of my house so I see it constantly) when I'm struggling.  They say breastfeeding gets easier at 6 weeks and that is today, so hopefully that rings true.  I'm glad that I have the support network I do and the wherewithal to ask for help when I need it.  I'm finally feeling like I can do this - I can be a working, exclusively breastfeeding mom (it helps that Lily will be at Gallup with me!) and we can hit our breastfeeding goals!