An Aside: Breastfeeding

Breastfeeding is such a charged subject, that I'm a little leery of writing about my own experience with it. Women who formula-feed--even by necessity--are often looked down upon. And even if you breastfeed, you will be judged by method (Pump? Bottle? How many hours between feedings?), position (Cradle? Football hold? Biological nurturing?), and ESPECIALLY duration (6 months? Too short! 2 years? Too long!). If I'm being perfectly honest, I would tell you that I, too, have judged breastfeeding and non-breastfeeding mothers. We have all heard that breastfeeding is the ideal, and before having my own baby I thought, "Why would you not breastfeed your child? It's a crime!" but now I think, "Wow, that was seriously one of the most difficult things I've ever done in my life. I could see why some people might not be able to do it."

Staying in the NICU for 20 days (and pediatrics 2 days) was miserable, but I HIGHLY doubt that Q and I would be breastfeeding today if it hadn't been for our stay there. We had SO many things going against us, and the nurses in the NICU spent literally hours per day standing right by my side and helping me latch her and keep her awake. Then Steven would be called over to hold her flailing arms away from her face, so it was often a THREE PERSON JOB to get her fed.

So, I do feel incredibly proud of our perseverance (a couple of the nurses--not many, but a couple--had slightly implied that it was time for me to give up my quest to breastfeed and just bottle her), but I also want to be sensitive to those who weren't able to make that journey. Q's first month was beyond difficult, but what staying in the hospital for so long meant was that I had more professional help in the breastfeeding department than 99% of other women. And even then, there was probably half a dozen times that I seriously considered giving up.

My motivation--the factor that drove me on through the physical pain and Q's inability--was the knowledge that breastfeeding will reduce her risk of juvenile diabetes. I kept telling myself that 6 months to a year of pain and struggling was worth it if I could protect her from a lifetime of needles and an incurable disease. But realistically, it is true what they say--it gets MUCH easier after the first month.

So, for my own records, here are a list of the factors that contributed to difficulty breastfeeding:

• C-section: C-sections are notorious for making breastfeeding more difficult.
• Not seeing the baby: Breastfeeding is best established within 1-2 hours after birth, where the baby is set on the mom's chest and they are able to bond and have their first feeding. I did not see my baby for 12+ hours and did not breastfeed the first day or two.
• Baby's IV: Q had a glucose IV going to her head to help raise her blood sugar, which meant that she felt satiated and did not crave milk.
• Oxygen tube/breathing problems: Q had trouble with rapid breathing and decreased oxygen levels. A bottle was much easier for her; breastfeeding made her breathe hard, so she refused to suck.
• Jaundice: Jaundice makes babies sleepy. Sleepy babies don't feed well. We spent most of her feedings pinching her and rubbing cold cloths on her to wake her up.
• Size: Bigger babies are often slower to establish breastfeeding and are just plain lazy and have trouble sucking.

Of course, I went through the usual drama of sore and blistered nipples, not to mention engorgement. I began taking my pain meds not for my c-section incision, but just to get through the next feeding. We introduced the nipple shield to combat both my pain and Q's refusal to latch and suck, and I spent a good portion of the next few weeks trying to get back off it (I do, however, think it was necessary to get us over that hump). My supply also began running a little low, and she was supplemented with formula a couple of times. Every time you gave her a bottle of any kind (formula or breast milk), it made the next feeding more difficult. She was one of those babies who couldn't switch easily back and forth. We also used lactaid at various points (the little tube that you slip into her mouth while she's on the boob so that she tastes the milk coming in and is more motivated to suck). I pumped like madman.

SO many different methods were going on, it was overwhelming. Nipple shield, lactaid, bare breast, bottle, formula... We were BOTH confused,  but Q was quite jaundiced and not gaining weight, so I was just desperate to get her fed any way I could. Having so many different nurses, unfortunately, meant that I was pretty inundated with breastfeeding advice, much of it conflicting. One nurse told me to have her feed 15 minutes on each side, while another nurse told me to only do one breast per feeding so that she could get the back milk (the baby, not the nurse). Some nurses told me bottles would make breastfeeding harder for her, others said that was an old wives tale and that babies could switch back and forth effortlessly.  I'm STILL not sure what information is correct.

Finally, though, we are doing it. I won't disclose the details of how it works, but I have learned that there is no one set way to breastfeed. What works for you might not work for me. Q and I have our routine, and it is no longer an excruciating, tear-filled process (though there is still SOME pain associated, it can be combated with Tylenol and nipple cream). In the hospital, I got to the point where I thought I would snap if one more person offered me advice, and ultimately I realized that there truly is no single "right" way to breastfeed. I can tell you what worked for US, but hey, it might not be for you. I can see why breastfeeding is such a charged subject, but I hope that Q's and my difficult experience will teach me to be sensitive and to not judge others in their decisions (this has always been an area I struggle with in general).

To sum up, I am so proud of me and Q for getting to this point, and I don't think I could have without constant professional support during her first three weeks of life (we also went to the breastfeeding clinic after Q was discharged). I hope and I pray that this significantly lowers her chance of getting juvenile diabetes, and I will fight to breastfeed her for as long as I think it will help reduce that risk. I don't know what the future holds or whether some obstacle might arise that causes us to have to cease breastfeeding, but for now we are going strong. And I want to give my love to all you formula-feeding mamas out there--I know that you gave it your best and that it is just sometimes not possible to follow through (some babies react poorly to breast milk, for example; or the mother might be on a medication that passes into the milk).

Thanks again for reading about our roller-coaster of a journey through Q's first month. It's my great desire that this doesn't come off as preachy or boring! And, of course, I am so thankful for all of you who prayed for us during our difficult time. Having a daughter is the most wonderful, awe-inspiring, difficult things I have ever done, and I hardly remember who I was before her. I am honored every day that God chose me to be her mama, and holy crap I am getting really sentimental and had better end this post abruptly.

Part 2: Labor & Delivery

Today I was looking at photos online of Steven's cousin's baby girl, who was born on Christmas day, when I began crying. I was struck powerfully by how my experience was not normal--it didn't go like it supposed to. I was supposed to hold my baby in my arms right after I delivered her. I was supposed to breastfeed her right away. We were supposed to go home a few days later and enjoy each other. Steven's cousin's baby even LOOKED more normal--baby Q was born with big bruises all over her cheeks from where they tried to extract her with forceps and had a very misshapen head due to being wedged in my pelvis and then yanked back out the other way. Not to mention that she had an IV stuck into a little vein in her head and an oxygen tube wrapped around her face. In a way, it all felt normal to me because it is the only birthing experience I had, but seeing the photos of Q's new little second cousin really drove home to me what a normal birth process looked like. And how I had wanted one so badly.

Two consecutive days after I was given gel to induce labor, it began in earnest. I suspected that my water had broken--or was leaking anyway--and headed to the hospital to confirm it. Actually, my water broke on the hospital bed as I sat waiting for the results to see if my water had broken. I was admitted to the hospital and outfitted with various IVs (in the end, I had one in each hand--the first one they gave me was an insulin drip, and my blood sugar was checked every hour or two throughout the labor). The labor itself wasn't anything incredible, I think. Having a notoriously low pain tolerance, I had known from day 1 that I would be opting for the epidural, and I kindly requested the nurse to give it to me as soon as possible. I honestly don't even remember how long the labor was. The epidural really did take away all the pain; I could barely feel a thing.

The part I do remember is the three hours of pushing. I was so set on delivering the baby vaginally. The nurse had told me ahead of time that three hours is basically the limit--they find that after that amount of time, the mother is too exhausted and her pushing becomes ineffective. It was difficult to feel the contractions with the epidural, but I watched the monitor and pushed hard when the nurse told me to. I threw up about three times during the process, I think, but my mind was on other things and it wasn't too bad. It's not like I wasn't used to nausea. I wasn't able to move around or change positions because of the IVs and the epidural.

After three hours, the doctor was called in and announced that forceps and an episiotomy were in order. I wasn't happy about the episiotomy, but thankfully the doctor decided to try just the forceps first. I say thankfully because it turns out Q was not going to be delivered vaginally, and it would have sucked big time to be healing from a c-section AND an episiotomy. I pushed and he yanked, and I remember wondering how a fragile baby could keep from breaking under all that pressure and tugging. Then the doctor left the room and the nurse (she was wonderful, by the way--never left my side) gently broke the news to me that I would need a c-section. She told me it was okay to cry, and I did--I bawled. I had been so desperate to avoid a c-section; they are harder on the mom and harder on the baby.

By the time they wheeled me into the OR, my epidural was wearing off and I was in a lot of pain. I saw my mom and mother-in-law as I was wheeled down the hall, and they were crying. I was also a little panicky, and I was shaking uncontrollably. For those of you who are not aware, I have a lot of anxiety about being trapped or restrained (for example, I have not ridden in an elevator in about 10 years), so being strapped down to a metal table caused considerable anxiety for me. They topped up the epidural, but I could still feel the prick of the pin they used to test the sensation on my stomach, so they ultimately gave me a spinal tap. My back was killing me from lying on that table until the meds kicked in. The uncontrollable shaking was difficult to deal with because my brain didn't know whether it was from anxiety, medication, or low blood sugar.

I remember people telling me that the baby would be out within 5 minutes once the c-section began. That was not the case here. The doctors made my incision a little longer than normal so that they could reach their hands in to unwedge the baby from my pelvis, and I felt a great deal of tugging and pressure. I believe I had 18 stitches total, which isn't too bad, and healing actually went very well. But that baby was not out in 5 minutes. I was so out of it by this time that I remember wondering why everyone was so quiet and why the baby wasn't crying--and I remember not caring. I had some issues with bonding with the baby for at least the first half a day or more, which is one of the big downsides to a c-section and to not being able to hold your baby right away. Finally, we heard her screaming. I wanted Steven to stay with me, but he wasn't allowed to and needed to be with the baby, so he followed her to the NICU as I spent the next 20-30 minutes being stitched up. The hour following that was spent in the recovery room.

She was born at 2 p.m. on November 19, and that night was a difficult one for all of us. Q's blood sugars dipped low and she had to be put on an IV; they couldn't find a good vein in her arm, so it was attached to her head. They also found that her oxygen saturations weren't good, so she was put on oxygen, as well (she had meconium--her first poop--as I was being induced, and some of it possibly entered her lungs and contributed to the breathing complications she faced in the following weeks). In the meantime, I was experience greater than average blood loss (not from my incision) and was being checked around the clock. For hours they worked to stop it--putting various medications in my IVs, each of which had new and delightful side effects. I won't go into what those side effects were, but they added to my misery. I was honestly worried that I was going to die, though in reality I was never near that point. The doctor came in to check on me and discussed the possibility of doing a surgery to insert a balloon into my uterus. Apparently all the pushing and stress had made my uterus unable to contract properly and stop the bleeding as it should. Luckily, we never got to that point--that evening, the bleeding slowed down to normal levels.

Suffice it to say, I did not get to meet my daughter until the next day (I had seen her briefly in the OR while I was getting stitched up, but I was too out of it to make a connection at that point). A nurse wheeled me to the NICU and I got to hold her; I was very sore and tired, and she was hooked up to bunches of tubes and had a scrunched up head and bruises on her face. We were quite the sad pair, I think. I healed remarkably well from the c-section, and honestly, it was the least of my worries. I was waddling around the room on the 2nd day, and quite mobile by the time I was discharged (on the 5th or 6th day, I think).

A noteworthy aside is that I don't really think it could have gone any better. Someone was expressing their displeasure that the doctors hadn't just given me a c-section to begin with, but I really wanted a vaginal birth, and there wasn't an indication that she was going to be THAT big (her final ultrasounds showed her measuring in the 8 pound range). And anyway, 10 pound 5 ounce babies CAN be delivered vaginally--it's not always the weight that really matters (the head size and mother's pelvic size plays a big role). I think I had to try to deliver her normally, we had to try the forceps, and then we had to have a c-section. We might know different for next time, but this is the way it had to go. I at no point blamed the doctors or thought they made bad decisions. One thing I might have changed is having asked to have her induced so early (which was partially to blame for the meconium/lung problems), but on the other hand, she was already so big...

The whole story still makes me a little tearful, and I hope it doesn't come off as whiny or self-pitying. I do want to record it all for posterity, and to remind myself (and one day, Q) of where we came from and how beautiful and fragile life is. I am so incredibly blessed to have such a beautiful baby girl, and for us both to have made it through a traumatic experience relatively unscathed. She is God's second greatest gift to me (the first being His own Son). And maybe this experience has made holding that precious little girl in my arms just a little bit sweeter.

Part 1: Pregnancy Recap

Well, we have been out of the hospital for a couple of weeks now, and Q's bilirubin levels FINALLY seem to be decreasing on their own (slowly but surely). She wakes up looking a little yellow in the morning sometimes, but with a lot of sunshine and feedings, she is almost always back to normal-baby-color by the nighttime. Soon jaundice will be nothing but a distant memory!

Speaking of memories, now that I have all this free time to catch dozens of daily spit ups and the occasional explosive poop, I've had time to reflect a little bit on Q's birth story and thought I should write about it. My friend Candace visited for the first time the other day (one of the few visitors we've allowed so far), and she was expressing her surprise at how every aspect of the pregnancy, delivery, and newborn stage had gone awry. And it's true, I realized! I would say that everything went badly! But as any new parent can attest, they probably could've stuck a skewer through my right arm and forced me to listen to an endless loop of Justin Bieber hits, and it all would've been worth it.

To not-so-briefly recap the pregnancy, its main feature was unending, multiple-trimester nausea. In the first trimester, I lost close to 15 pounds (luckily, I had pounds to spare) and was ultimately put on a heavy duty anti-nausea medicine that they use for chemo patients. I was assured that it was the anti-nausea mothership, but it was also VERY expensive (on the full dose, close to $1,000 per month before insurance). Luckily, we had insurance, and I only needed the full dose for a month or so. The nausea meds greatly reduced my discomfort, though by no means did they eradicate the nausea completely. I also had a huge amount of swelling in my feet from about 19 weeks onward. I had "pitted edema," which meant that Steven spent many-a-night poking my foot with his finger so that he could see the indent. It also meant that by the end of my pregnancy, the ONLY thing that fit me was flip-flops, and there was snow on the ground. In the week following Q's delivery, my feet actually swelled up even more until my flip flops no longer fit.

Meanwhile, my diabetes kicked into high gear, and my insulin needs spiked incredibly (I was on up to 5x my original dose). The nausea complicated this, because if you take your insulin for the food you eat and then throw it up, you're in trouble. I had a few times where I was sitting in the living room trying to make myself throw up so that I could go ahead and treat a low blood sugar with some juice. Throughout the pregnancy, I had many, many ultrasounds, including an ECHO ultrasound in Calgary to check for heart defects. They didn't find anything that alarmed them, besides the baby's size, which consistently measured about 3 weeks ahead of her gestational age/in the 95th percentile. There were occasionally indications of increased amniotic fluid, which can be a side effect of the diabetes, but that seemed to wax and wane somewhat. All we knew for sure was that she was a big girl. Toward the end of the last trimester, I just felt absolutely ill all the time. I wasn't necessarily throwing up or even feeling "nauseous" persay. I just felt... ILL. That's the only way I can describe it. I was prescribed a medication for heartburn on top of the nausea meds.

Around 34 (?) weeks, I began getting unexplained low blood sugars in the middle of the night and stopped being able to feel them. This is a dangerous condition (for me--the worry being that eventually you might not feel the lows at all and never wake up) that landed me in the hospital for a number of days. My insulin was reduced and I was told to keep my blood sugars higher than normal (which terrified me, after the doctors having drilled into me so constantly for the past 8 months how vital it was to keep blood sugars in a very tight range). I was able to greatly reduce my lows, but between feeling ill, nausea, ridiculously high insulin needs, and an inability to feel low blood sugars, I asked my doctor if she would consider inducing me a week earlier than planned (most type 1 diabetics are induced before 40 weeks due to their placenta degrading faster and an increased risk of stillbirth). So in the middle of my 37th week, we began the induction process...

Welcome, Little Bean!

Well, I haven't updated this blog since I was 19 weeks pregnant, so clearly I haven't really been keeping up with things. Yes, I do wish that I had kept regular track of the pregnancy and recorded all my thoughts and sensations during that time, but on the other hand, I felt like a sack of crap sitting in the middle of the road that a dump truck filled with crap backed up to and dumped all that crap onto the crap. So I'm going to forgive myself for not making perky weekly updates and gushing over my latest pregnancy symptom ("gushing" may be an awkward choice of wording when describing pregnancy symptoms).

Anyway, she's here! Yaaay! Baby Q arrived on November 19, 2012 at 2:00p.m., weighing in at a whopping 10 lbs 5 oz (just imagine if we'd waited until her due date!). The labor & delivery story is predictably dramatic, and I will try to bring myself to describe it at some point so that I can horrify all my future children with vivid imagery as I try to make it sound like a near-death experience. And by "all my future children," I mean, "I miiiiight try for one more 5 years down the road, if I'm feeling particularly insane." Because having a baby is awfully great, but man, those preceding 9 months were hellish.

Q is two weeks old today, and it is also her due date. She is still chilling in the NICU with her much smaller neighbors as we try to get the jaundice and breathing issues under control, but she is looking extremely bright-eyed and alert and will undoubtedly get to come home with us in the near future. 

Somewhat related cool things today:

1. After 21 weeks, I put my wedding ring back on. And it fits! Slightly snug, but I have not been able to cram it onto my finger at all since the ridiculous swelling began at 19 weeks. I have missed it.

2. Pastor Dave came to visit and was allowed into the NICU to hold and pray for Quinn. He is the first non-parent/non-grandparent who has seen her, and I was excited to finally be able to show her off to someone!

3. I got a chocolate chunk cookie from Tim Horton's, and it was delicious.

Well, the husband, a.k.a. "bun abs" is here, so I'm going to wrap this up like a... pig in a blanket. I'm really hungry.