Breastfeeding, formula and hungry little Henry

My life since we got home from the hospital (the second time) has been a revolving door of feeding the baby, feeding the baby again, and everything else. I spend so much time feeding Henry that I actually wake up in the night thinking the body pillow I’m hugging (or the cat) is the baby.

For awhile we were supplementing every time he ate, then we finally got it down to supplementing every other time after we established that Henry was gaining weight again. It was still a hassle but felt like such a relief to have a little break. We did that for a week, then went in for a weight check to make sure he was still gaining enough. The doctor said that Henry was gaining, so we could try exclusively breast feeding for a week to see how that went, but we would have to come back in for another weight check after a week.

I was so happy when we got that news since we could finally get on a normal feeding schedule and not spend so much time on feeding the baby. We fed Henry every 2-3 hours, except at night when we let him sleep until he was hungry (he made it almost 7 hours one night!).

We had a great Christmas with family, and didn’t have to worry about taking a break to go pump, or worry about bringing bottles along with us. I could just feed Henry when he needed it, and it was so nice!

One month!

The day after Christmas we went in to have Henry weighed again, and were disappointed to learn that he had barely gained an ounce since the last check. The nurse didn’t seem too concerned, but we got a call later in the day from the doctor telling us we needed to give Henry formula so he could take in more calories. They told us that we could either breastfeed and then give him the formula after or we could gradually switch to exclusively feeding him formula.

This was not what we wanted to hear. At this point we felt like we had tried everything and had spent so many hours trying to get him to gain weight, and none of it was working, which was incredibly discouraging. Geoff and I discussed it, and decided to switch to formula completely but keep one breastfeeding session a day so that Henry can still get the benefits of breast milk, while also getting the calories from the formula. And that way we won’t burn ourselves out or have to change our routine again in a few days.

Luckily, Henry is not fussy when it comes to different bottles and formula, and was able to make the switch fairly easily. Unfortunately for me, my boobs probably thought I was feeding twins with all the nursing/pumping I was doing, so I was pretty uncomfortable the first couple days I didn’t nurse or pump every two hours. The discomfort didn’t last long though, and Henry already looks like he is filling out a little. As an added bonus, other people can feed him bottles, which means that I get breaks sometimes (yay!).

We have to bring him back again for another weight check at the end of this week, and he better have gained a good 7-8 oz by then or I don’t know what we will do! Wish us luck!

(For those who are curious, we started feeding Henry the premixed Similac Advance bottles, then switched to Gerber Good Start Gentle powdered formula in Playtex VentAire bottles. He spit up the Similac premixed bottles two different times, but hasn’t had any issues with the Gerber powdered formula.)

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Mini-Update

So it turns out that the doctor thought we had a bili-blanket for some reason, and that is why they were going to have us wait until tomorrow to do another blood draw. When I called to correct them they had us bring poor little Henry into the office this morning to test his bilirubin levels again. So much for a day without a doctor visit, I guess!

Anyway, we just got the results back, and his levels have dropped again! He was at 13.2 yesterday and now he is at 10.9. And that is without a bili-blanket and basically without sunlight (it has been foggy/rainy the past few days). What that means is that Henry doesn’t have to go to the doctor until his regular two week checkup next week! Hooray!

In other news, Geoff went back to the office from about 9-3:00 today, which meant I had little Henry all to myself. I was pretty nervous for Geoff to leave, since he has been such a huge help with everything, but I’d say everything went pretty smoothly considering. Not that I’m ready for him to head back to the office full-time yet, but at least I know I can do it when the time comes.

Thanks for all the love, support and well wishes over the past week. It is very much appreciated!

An Update on Henry

Looking a little jaundiced...

Thank you for all the love you’ve been sending since Henry was born – we appreciate it so much!! For those who have been asking how Henry is doing, I haven’t been ignoring you – I promise. I just didn’t know how to respond and I didn’t want anyone to worry. Here’s what’s been going on…

Henry had his first doctor appointment when he was four days old. We knew he was a bit jaundiced, but when we left the hospital we were told it was normal and was probably nothing to worry about. Unfortunately, that turned out not to be the case. The doctor told us that he had lost a little more weight than normal since birth, and that his bilirubin levels were pretty high, causing him to be jaundiced so we needed to use a special light to help get his levels down right away. We were told that normally we would be able to go pick up the light and use it at home, but as it was a holiday weekend there were none available except back at the hospital in the NICU. That meant that we were going to have to take Henry and go spend the night there, so we quickly packed a bag and headed over.

When we got checked into the NICU, Henry was immediately placed on top of a bili-blanket and under a bili-light on the warmer (the lights help break down the bilirubin that was causing his jaundice). He had to wear this little mask over his eyes to block out the bright light, and he absolutely hated it. Since he stayed on the blanket while breastfeeding he was supposed to keep the mask on, but he screamed so much that the nurses let us take it off for nursing. At this point his bilirubin level was even higher than it had been earlier that afternoon though, so we were starting to get really worried.

We also knew that Henry was having some slight issues with breastfeeding (he kept falling asleep and stopping) and my milk hadn’t come in yet, so he probably wasn’t getting all the nutrition he needed. We had been told that this was normal and that he would just have to catch up when my milk came in. What I didn’t know is that the body gets rid of bilirubin by peeing and pooping it out. Since Henry wasn’t eating that much, he wasn’t having many dirty diapers, and therefore he wasn’t able to flush the bilirubin out of his system. He also dropped from 7 lbs, 13 oz at birth to 6 lbs, 10 oz, which was pretty scary for us (losing 10% of his birth weight is considered normal, but this was closer to 16%).

So, in addition to the light, we worked with a lactation consultant to figure out how to get the little dude to eat better. Long story short, he gets frustrated very quickly if he doesn’t get milk right away and needs constant “reminders” to keep working for the milk, like stroking his jawline to remind him to suck. This was especially frustrating for me, since there was nothing I could do about it except keep practicing with him until he gets it. Even the lactation consultant said she was stumped and her recommendation was to just keep trying.

On a positive note, what was really nice about our hospital is that they have rooms for parents to stay in while their babies are in the NICU. We basically had a huge hotel room to stay in just down the hall from our little glow worm. I still had to feed Henry every 2 hours,but luckily Geoff was able to get a full 8 hours of sleep, which was great.

The next day around 1:00 they checked his levels again, and we saw a significant improvement! His bilirubin levels went from 20.8 to 14.7, and my milk had come in so he was picking up in the breastfeeding area (he gained an ounce in about 10 hours). The nurses told us that this was great progress, so they took away the light that was shining over Henry and left only the bili-blanket that he was laying on. They said that they wanted to make sure his levels didn’t go up when they took the light away, and if they went down we would be able to take Henry home either with a light of our own or maybe even without one completely.

The nurses had convinced us we would be going home, it was extra devastating when we found out that not only did Henry’s levels go up slightly from 14.7 to 14.9 (meaning we would need to stay another night), but we also found out he was dehydrated and we would need to start supplementing when he nursed. That meant that I either had to start pumping or we would have to use formula, neither of which were ideal because it meant we would have to use bottles. I was already feeling the pressure to get him to breastfeed better, but now I would have to compete with a bottle that allows the milk to come out a lot sooner and faster.

We decided to go the pumping route, but then our nurse clarified that in addition to pumping we would actually have to give him a bottle of formula right away. She explained that the milk I pumped right then wouldn’t be used until the next nursing session and they wanted to get something in him right away. So while Geoff fed Henry his first formula bottle, I sat down to figure out how the heck to use a breast pump.

For those who have not seen one, breast pumps are scary. I mean, they are there to literally suck milk out of you, and it is not fun one bit. I’ll leave it at that, but that night I basically had a breakdown from the stress and being so tired, and the thought of having to pump one more time made me burst into tears. We really didn’t have a choice since I needed to keep up my milk supply, so we started supplementing with pumped breast milk at every feeding.

By 6:00 a.m. the next morning Henry’s levels came back low enough (12.4) to take the blanket off and go home, though we were told we would need to continue to supplement at each feeding until he was able to pee and poop more of the bilirubin out of his system.

Looking a little better...Since then our at-home nursing routine is this:

  1. Nurse Henry (15-45 minutes). If he is eating well without falling asleep I can nurse him until he doesn’t want anymore. If he is having issues we have to stop after about 10-15 minutes of trying so he doesn’t burn more calories than he is taking in.
  2. Give Henry a bottle (5-10 minutes). This can be either breast milk I pumped at a previous session or a bottle of formula. We let him drink until he is full, which is usually when the milk is gone.
  3. Pump milk for the next nursing session (up to 30 minutes).
  4. Wait an hour (or less if he is hungry again) and do it all over again.

With all of that and prep/cleaning up time, I am spending about two hours on each nursing session. Then I get an hour off, and then I have to start up again. And that’s if Henry isn’t hungry again before that. That means I get to sleep for an hour at a time if I’m lucky. It is exhausting. At least he is having lots of dirty diapers so we know he’s not as dehydrated anymore and is flushing at least some of the bilirubin from his system.

Getting some sunshinePart of the deal for leaving the NICU was that Henry had to go to the doctor again the following day to make sure his levels were continuing to drop. The nurse called us fairly quickly after his appointment and we were not happy to find out that his bilirubin level was back up to 14.2. She said there still weren’t any bili-lights available, but that some were expected to come in later that day and she would try to track one down for us. In the meantime she told us to put Henry in the sun as much as possible, since the sun acts almost like the bili-light.

This wasn’t the news we wanted, but at least they didn’t tell us to go back to the NICU. Unfortunately, they were unable to find us a bili-light after all, so we had to unwrap poor little Henry from his blankets and hold him basically naked in the sun to get that light exposure.

We took him back to the doctor yesterday for another blood test, and this time his weight was up to 7 lbs, 1 oz, and his bilirubin levels had dropped by 1 point to 13.2. Still not ideal, but enough of a drop that the nurses told us to just keep doing what we are doing for today and come in for a (hopefully final) blood test tomorrow. That means little Henry gets a day off of going to the doctor for the second time in his life! Yay!

I’ll post updates as we receive more information, but we probably won’t know anything more until late Thursday. Please cross your fingers for him that his levels are normal by then!

Meeting Henry

It took me awhile to write this post since I didn’t want to leave anything out. It is pretty lengthy, so thanks for bearing with me!

It all started on the way home from the annual “Friendsgiving” party we have with our friends. I was 39 weeks, 5 days pregnant and ready to pop, and I started having contractions on the drive back to our house.

I was pretty sure this was the real deal, so I called the nurse hotline to confirm when they would want us to go to the hospital. We were told to wait until the contractions were less than six minutes apart for at least two straight hours, then to call back for further instructions.

Geoff started helping me time my contractions using a worksheet we had gotten at one of our classes, but what I really found useful was an iPhone app called “Full Term” that times your contractions for you and gives you averages on how far apart they are an how long they last. All I had to do was push start and stop.

My contractions were sort of all over the place, ranging from 5  to 20 minutes apart and lasting around 20-30 seconds each, so around 10 p.m. we decided to go to bed and try and get some sleep in preparation for what was coming. Geoff fell right to sleep, while I squirmed through my contractions for an hour before exhaustion overcame me. Even then I was only able to sleep for a little over an hour and I was waking up every four to six minutes from the contractions getting stronger and stronger.

When I couldn’t take laying in bed waiting anymore, I got up and decided to take a shower in case I wasn’t able to take one later on. After that I rounded up the last few hospital bag items we needed and got ready to head into the hospital. I called the nurse hotline again around 3:00 a.m. (after two hours of timing my contractions to be less than six minutes apart) and was told to come to the hospital as soon as we were able.

So I woke up Geoff who had been sleeping for about four hours, he took a shower and I dried my hair (it was only about 18 degrees outside), we fed the cat and headed into the hospital. I was so uncomfortable and tired that I barely remember the drive.

We got checked into the hospital, then just waited around for about an hour until the doctor came to make her rounds and to confirm that we were going to be staying for the delivery and not sent home to wait it out. In the meantime, Geoff decided to open the blinds in our room and we were surprised to see that there was a mini blizzard going on outside!

Henry's first snow

Once the doctor confirmed we were going to stay (I was at dilated to 4 cm by this point), we were walked through all the paperwork, including the epidural risks/consent. This was all supposed to be “before labor gets too bad.”

Contractions were pretty manageable at this pointI also got my IV all hooked up, which I had been dreading. I asked for some numbing cream so at least I wouldn’t feel most of it, and the nurse was happy to oblige. That’s when she told me that she normally worked the day shift and was just filling in for someone that night. She said since it was nearing the end of her shift she was starting to get really tired. Just what you want to hear from someone who is about to shove a giant needle into you! Luckily she grabbed another nurse to actually put in my IV since she realized she might not have been the best person for the job. So this new nurse comes in and tries to put the IV into one of the two spots where I had the numbing cream. Even with the cream it still hurt pretty bad, so I was NOT HAPPY when she told me she didn’t get it in because I had “tough skin.” She then decided she didn’t want to try the other numb spot on my hand and tried for a spot further up my wrist. This one hurt like a you-know-what. And guess what? IT STILL DIDN’T WORK. At this point I was clearly unhappy, so someone grabbed a THIRD nurse to try to put in the IV. This lady was my angel, since she used a numb spot and got it in on the first try.

At this point my water hadn’t broken on its own, so my doctor planned on breaking it for me when she came for rounds over the lunch hour. I was okay with this, since my contractions were strong but manageable. Geoff helped me breathe through each one. What really helped was having him watch them on the monitor and actually tell me when he could see that each one was going away. That way I knew the pain was about to go away. The weird part was that in between each contraction I felt completely fine. Tired, but not uncomfortable.

When the doctor arrived she came in and checked me. I was making progress and was dilated to 6 cm! She had me lay back in between contractions and broke my water, which didn’t feel like anything at all other than wet. They started putting my bed back in the upright position, and on the way up I felt instantly nauseous. I told the nurse I thought I was going to throw up, and she grabbed me a barf bag just in time. Luckily I hadn’t eaten since Friendsgiving, so there wasn’t anything in my stomach but water. The weird part was that I wasn’t having a contraction at the time, so I wasn’t in any pain. I mentioned it to the nurse and she said it is because I probably had a major cervical change right after they broke my water. Turns out the baby dropped from -2 to almost +2 instantly, which is what caused the vomiting. This whole water-breaking process only took about 30 seconds, and they told me that now that my water was broken I could start to push as soon as I was dilated to 10 cm.

The contractions were fairly strong at this point, but I was still able to get through them. I asked the nurse if they would get much worse, because if this was the strongest they would be and they were only going to get more frequent then I could probably stick it out and do a natural childbirth. About 10 seconds later I started having a horrible contraction that was way worse than anything I had felt yet. I only lasted through one more of those before I asked for an epidural.

The anesthesiologist came in pretty quickly (I later found out we were the only ones in the labor and delivery ward at that point) and asked me to sit up and dangle my legs off the edge of the bed, round my shoulders and push my lower back out toward him. He called this “the position.” In order to accomplish this, my bed had to be raised up off the floor so my feet wouldn’t touch the ground. I was pretty nervous about the giant needle, but it turns out that the feet dangling part was the hardest. I must have been using my feet to take some of the pressure out of the contractions, because as soon as my feet left the ground the pain was intensified again. This time the contraction was so strong that I started vomiting again and I wasn’t able to get into “the position.” They warned me earlier that the whole epidural process would take around 10-15 minutes, which for me was a blur of contractions and quite possibly the worst thing I’ve ever experienced. Apparently the anesthesiologist did mine really fast, so I guess it is good that it didn’t last longer than it did.

It took awhile for the epidural to kick in, but when it did my legs were completely numb. The weird part was that I could still wiggle my toes even though I couldn’t feel them. Since the baby was so low already I also had an incredible amount of pressure going on “down below,” which wasn’t painful but was so strong that it was really hard for me to breathe through the contractions.

I don’t remember how many contractions I had before they told me I could start pushing, but it can’t have been many. The nurse grabbed one of my legs and Geoff grabbed the other, I grabbed behind my thighs and, in the words of my doctor, I tried to “push the pressure away.” Geoff told me later that watching me push through those contractions was the worst part for him. I couldn’t catch my breath after each one, so I probably sounded terrible. I was pushing for around thirty minutes before little Henry was born.

Once Henry’s head was out, the doctor told me to look down, but I still couldn’t see anything. Geoff didn’t look at that point either. It wasn’t until Henry was about 3/4 of the way out that we both saw our son for the first time. They plonked him on my chest and started cleaning him up right away, though I was surprised at how clean he was. In my head he was going to be all gory and gross, but that wasn’t the case at all.

IMG_0184

Little man didn’t pink up right away so they took him from my chest pretty quickly and put him on the warmer. He got an APGAR score of 8 (both times) because he was still a little blue. Luckily that didn’t last long and Henry was able to come back and hang out with his mommy and daddy for the rest of the day. His grandmas and grandpas, uncles and aunts came to visit him right away, and it was clear by how full our room was that Henry is already a much-loved little boy. We couldn’t be happier to bring him home with us on his due date, Wednesday, November 27, 2013.

Week 39: BabyWatch 2013 Begins…

Seven days until D-Day and I’m still pregnant. I’ve reached the point where if I call someone the first thing out of their mouth is, “Is this baby coming?!” The good part about this is that people answer my calls no matter when/where they are, but are quickly disappointed when I am just calling to say hello or to have them send me a recipe or something.

At least I’m not alone. This week’s email from Pregnant Chicken says, “It’s right around this time that there’s a slooow shift from you being perceived as a glowing woman that is creating life, into a fat husk that’s hoarding that adorable baby they all want to see.” (By the way, if you’re pregnant, definitely subscribe to the weekly emails she sends out – they are awesome and hilarious.)

Remember when I had ankles?

Remember when I had ankles?

Not much is new this week. I’m still uncomfortable and not sleeping very well. My feet look like sausages half the time and my fingers are so swollen I can’t wear my wedding rings. Geoff put a pillow under our mattress so my feet are elevated while I sleep, and that has really been helping a lot.

We had our weekly doctor appointment on Monday, and we did another blood draw to check on my low platelet count. I’m at 135 now, so they have gone up slightly since last time, but the important thing is that they are staying steady in the 130s and not dropping near the 100 mark (which is when you have to see a hematologist to determine whether or not you can get an epidural). I think that was my last blood draw until baby comes, so yay for no more needles!

According to the doctor, I’m now 2 centimeters dilated and still 50% effaced, which is not really a change from last week’s appointment. I’m weirdly disappointed that I’m not further along, since I started dilating three weeks ago. I have two more Monday appointments scheduled, so cross your fingers that I’ll either have the baby before I have to go to both of them or that I’ll be further along at the next one so I don’t feel like I’m just waiting for something to happen.

People have started asking me if I’m nervous for labor, and the truthful answer is that I’m really not. Maybe it is because I know I’m in good hands, or because I’m very prepared as to what to expect, or because I can always get an epidural if I can’t handle the pain, or maybe I’m just excited to get this show on the road, but I’m not afraid. I keep expecting a wave of panic to set in, but it never comes. I mean, there’s no point in being afraid anyway, since I can’t really get out of it now!

We’ve had lots of guesses for the date of baby’s arrival. If you’d like to join in you can comment below or send me a message and I’ll add you to the calendar I’ve started.

This week according to What to Expect:

Your baby’s weight and height have probably increased only a little from last week (and your overstretched skin at 39 weeks pregnant is probably grateful for that). But his or her brain is still developing rapidly (a pace that continues during the first three years of life), with changes you’ll be able to recognize firsthand as your baby’s skill-packed bag of tricks expands almost daily. 

Heard that babies cry a lot?  There’s definitely truth to that rumor — as you’ll find out soon enough (and usually during the middle of the night).  But what you may not have heard is that tiny babies don’t produce tiny tears when they cry, since their tear ducts aren’t open for business yet.  While you’ll be consoling your crying baby right from the get-go, it won’t be until sometime after the first month that you’ll be wiping tears off those chubby cheeks.

Your baby’s skin has now finally changed from pink to white (no matter how dark-skinned he or she will be eventually; pigmentation will occur soon following birth). That’s because a thicker fat layer has been deposited over the blood vessels (making your baby’s cheeks —  both kinds — pinchably and kissably round).