One Year Ago Today... Part Deux

One year ago today E came home from the NICU at last. I can't remember what we did that morning, but I remember they told us he should be ready to go by 2 or 3 pm... so I'm sure we just got ready and went to get him! It was so surreal, and as we were driving away I felt like I was stealing him ;). I really did. I have no words for how amazing it was, so I'll just show you the pictures instead.

Last time pulling up to the hospital...

Last time going up those weird things....

This is the lobby where I would eat and take my breaks from NICU...

LAST picture with leads on!!!

Changing into his going home outfit...

I'm back there changing him, the nurse is getting his discharge papers all ready..

E's going home outfit! We bought it the day I got my BFP!

So excited to have our family together.... Little did I know ;)

I insisted on sitting in the back seat. To make sure he didn't quit breathing. Naturally.

Finally at home!! We had the crib side-carred -look how teeny he was in it! Also note the thermometer and nasal aspirator IN THE CRIB. Because I was taking his temp every 3 hours, and you never know when you'll have an emergency and need the nasal aspirator now. ;) #paranoidNICUmom!

And today? A year later? His dad is no longer in the picture. But he and I are the most perfect family ever.

Today I took him to daycare while I went to school, and I didn't worry that he was going to die from germ exposure. I also took him with me to the store - again, I didn't think twice about it. I haven't taken his temp for weeks, and I don't periodically count his respirations anymore. I don't strip him down and watch for retractions, and I only sometimes worry that he'll stop breathing in his sleep. He's a big, strong, healthy boy.. and I'm a little less paranoid.

So blessed, I'm telling you.

Pumping Milestone - 6 months.

Yesterday E turned 6 months old, and I have been pumping since about an hour after his birth! I'm thrilled to have made it this long.

I get a lot of questions about pumping, so I decided in honor of 6 months I'd do a little Q&A of a few questions I'm asked frequently!

Why do you pump exclusively? E was born at 29 weeks and spent 6 weeks in NICU. Babies don't develop their suck/swallow/breathe coordination until around 32-34 weeks gestation, so for a few weeks E was fed only by a tube. I pumped at first so he could get colostrom through that tube! Later as he started learning how to 'nipple,' the NICU nurses were still concerned about how much he was able to take in at a feeding. It needed to be measurable, so he got breast milk through a bottle. When he got bigger, we were allowed to practice nursing twice a day.

So why do you still pump exclusively? When we started nursing practice, E was still only about 4 pounds. He had a very shallow latch and the lactation consultants at the hospital told me he was 'just small.' When I brought him home, he was around 5 pounds and things were not much better. I had an appointment to see a lactation consultant on his due date, but everything happened with M and I was unable to keep that appointment because I was 2,000 miles away :). Between the stress of moving, the affair, and everything else going on, for awhile it was easier to just pump and not worry about nursing practice. When I started again, E rejected the boob. I would try to get him latched and he would pull away and scream. I finally got a nipple shield, and that helped since he recognized the silicone texture, but he was too impatient to wait for let down and the practice session usually ended with both of us in tears, and with E still hungry enough to take a full bottle. I gave up practicing about a month ago.

Okay, so we know why you don't nurse, but why don't you just switch to formula? Wouldn't it be easier?  I don't switch to formula for a lot of reasons. It's expensive, it's inferior in composition (note that I didn't say it was poison! Just not as good!), and it's a pain to mix up. (I do know these things - E was on two bottles of Enfamil Enfacare per day until he reached his due date for the extra calories and iron.) Pumping itself is a pain too, but breast milk in a bottle is loads more convenient. It's stable at room temperature for 10 hours! I don't have to get up and mix bottles at night - I just put one on my nightstand before I go to bed, and it stays good all night. And then I have this weird psychological thing about pumping. I pumped every 2-3 hours the whole 46 hours that B was alive, only to have to try to dry up my milk after she died. After she died, I regretted hating pumping like you wouldn't believe.. I would pump 24/7 if I could have her back. So, after going through that it seems much more worth it to me to pump for E. If that makes sense. Plus, I love the extra calories it burns. I've lost a ton of weight without really even trying. It's fabulous.

I'm pregnant. Breastfeeding weirds me out, but I don't want to formula feed. Can I just pump? Theoretically, yes. Realistically? Unless you are 1000% committed, I'd bet you last two weeks before you throw in the towel. I was able to establish a great supply with a pump after E was born for a few reasons. First, I had access to a hospital grade pump (the Medela Symphony. I used the Medela Lactina with B. Both were great). This makes a huge difference. Secondly, E was in the NICU. He had an army of nurses to take care of his every need. I could kick back and pump while someone else dropped his feeds, changed his diaper, or re-inserted his pacifier for the first 6 weeks of his life. If you have a full term baby (which I certainly hope that you do), you will not have this luxury. Keep in mind that when you're taking care of the baby yourself, you not only have to pump but also feed. It takes up twice the time. You can't hold a baby and pump at the same time, so you have to hope your baby will sit in his swing or whatever for long enough. Sometimes, you have to listen to your baby fuss while you pump because you have to pump. It's not fun. It's also more dish washing - bottles and pump parts. Also, you have to plan outings very carefully to avoid going too long without pumping. I try to plan my life so I'm not away from home for more than 3 hours at a time. In summary, pumping is NOT the easy way out. It's very difficult, very time consuming, and definitely should be your second choice. Please, please put all your effort into nursing FIRST. Better for your sanity in the long run, I promise.

Are you sad that E won't nurse? Yes. Very. It breaks my heart.

What pump do you use? As I mentioned before, I established supply with a Medela Symphony for the first six weeks (you really should use hospital grade for the first twelve weeks, fyi). After that, I switched to my Lansinoh double electric pump for about 3 months. Then, a friend who had purchased a pump but decided to formula feed sent me her Medela Pump in Style Advanced, and that's what I use now. The Lansinoh is a great little pump for the price, and it served me well. The PIS is a fabulous pump though - a few more luxuries. But either of them would serve you well for EP'ing or going back to work. I bet the new Lansinoh is fab too, but I haven't tried it. I would also love to try the Medela Freestyle - seems like it would be perfect for EP'ers!

How do you keep your supply up? I struggle with it all the time, which is particularly discouraging for me since when E was in NICU I had a massive, massive oversupply. I try to pump at least 6-8 times a day, and I eat oatmeal for breakfast every morning. I drink about 90 oz of water/day. When I've been particularly stressed, supplements have helped me out. More Milk Plus and Reglan worked wonders for me (at separate times!), and Fenugreek on it's own didn't do a whole lot, but everyone is different. Also, I power pump on the weekends. Sometimes during the week, especially being in school, I get busy, E gets fussy, life happens and I miss a pump here and there. So by the end of the week my supply is a little diminished. I get it back up by pumping 10 minutes on, 10 minutes off for an hour, sometimes multiple times a day Friday/Saturday/Sunday. It always boosts my supply for the next week, and then I do it all over again. (It's best not to miss pumping sessions in the first place, but again, life happens.)

How long are you going to keep pumping? I hope for at least another six months! That is my goal. I would love to keep going after that, but we'll see how it goes when I get there. He'll be on solids and will need less breast milk, so I probably won't need to stress about my production as much.. it may get easier. Who knows.

My nightstand - lots of WATER, a container to warm bottles in, and of course, pumped milk! 

Fear

Today I got a message from M, saying he's contacted an attorney here. He says he wants to make the divorce process go as quickly and smoothly as possible. Sure sure, fine. I didn't see that coming, but whatever. He also said that his attorney said that we need to come up with a joint custody agreement so he can have a relationship with E.

At those words, my heart started beating a million miles a minute. I think that's the closest I've come to having an actual panic attack. Joint custody. Those words... they put massive, massive fear into my heart.

Theoretically, I want E to have a relationship with his father. Realistically, it's like I don't even know his father. We were together for 3 years, but with how differently he's acting now I may as well have been knocked up during a one night stand. Up until three days before I found out about the affair, M was telling me that everything was fine and he was happy. We had a sex life (albeit a kind of boring one, thanks to bed rest and child birth - but we had one!). We didn't fight other than occasional tiffs or disagreements that were usually resolved within the hour. I just cannot describe well enough how right and normal everything seemed. Then BAM - I found out about his affair, and suddenly he was this different person. He took up smoking, he was rude, he was horrible. And I promise it wasn't just the way I saw him - it wasn't a matter of perception. He really changed. Ever since I left I've been discovering more and more lies that he's told.. not just lies, but lies about lies. Layers of lies. A tangled web of lies. I simply do not know this man. This is not the man I thought I married. This is not the man I had a child with. And thinking of turning my precious, precious E over to him for any length of time terrifies me.

It's not like I can tell myself that he's E's father, and he loves him just as much as I love him. I want to tell myself that. I've tried telling myself that. All night tonight, I've been telling myself that he wants joint custody because he loves E, not because he's out to get me. However, I'm simply not sure that's true. M wasn't a devoted father from the beginning. While E was in NICU, on M's days off, he never wanted to stay more than 4 hours or so. I was at the NICU for 10-12 hours a day every day that M worked. I didn't think too much of it at the time - I thought maybe post traumatic stress from losing B made it hard for him to be there, to hear the same alarms we heard while watching her vital signs plummet, knowing she was going to die. He didn't ever want to change diapers - and in the NICU, changing diapers is a big deal. Changing dipes and taking temps are pretty much the only things you can do for your preemie at first, so it's a reasonable reaction to jump at the chance. Not M. He had to be badgered into it by myself and the nurses. And I believe it happened roughly twice. Seriously. He hated kangaroo care. He swaddle-held when E was big enough, but not too often. I always offered to let him hold when he would come, because I was there so much more, but he usually let me. At the time I thought he was being nice, because he knew how hard it was for me to be away from E. Once we got home, it was the same. He did two feedings on separate days after we got home - both so I could get some sleep, both on his days off. When he would get off work I'd ask him if he wanted to hold E, to spend some time with him while I got some things done, and he would say he was too tired from work and just wanted to relax.

Then, once I found out about the affair, he sent us away so easily. I asked him if we could just separate for awhile - if I could stay with his parents or another family member, 4 hours away, and he said no. He didn't ask to keep E overnight the night before we left (I was staying with a friend). He hardly showed any emotion saying goodbye to E before we left for the airport. I just didn't understand it. I still don't.

And what's more, he doesn't know E. He doesn't know that E is a little ticklish under his ribs, and sometimes you can get him to giggle that way. He doesn't know that E hates baths if you just give him one, but if you get in with him he loves them. He doesn't know that E doesn't eat much in the mornings, but eats constantly in the evening, and that it's normal for him. He doesn't know that you can't put E in pajamas that cover his hands or he'll be up all night because he can't find his thumb. He doesn't know that when E starts to get too tired, he starts fighting sleep, and you have to lay him on your chest and give him his pacifier, and even though he still fusses when you do that, he'll be fast asleep in five minutes. He just doesn't know him. 


I fought so hard for this baby. I agonized through the first trimester, praying I wouldn't miscarry like I did my first pregnancy. I spent the second trimester so nervous that he was just going to fall out, or I was going to go into labor. I got progesterone shots once a week. They hurt, and made me crazy emotional (on top of regular pregnancy hormones!). (Sorry to any readers doing fertility treatments - I know a once a week shot is NOTHING!) I had an ultrasound probe up my hoo-hoo every two weeks. I spent six weeks on hospital bed rest. I didn't cheat. All my nurses always commented on how compliant I was - I was only up to go to the bathroom, and even though I was allowed to shower every day, I only showered every other day. When I showered every day I felt much more pelvic pressure and it made me nervous. I had IV's, and I had to wear these dumb things on my legs to prevent blood clots. I had to have NST's twice a day. I had constant contractions. Some were dang uncomfortable. I ate hospital food for six weeks! I took Procardia, and it gave me the headache from hell and made my face turn bright red. It lowered my blood pressure so when I did get up to go to the bathroom, I had to do so very slowly as not to pass out. I was given terbutaline a couple of times, and that is really nasty stuff. I had more cervical checks than you can imagine. I had to discuss my every bodily function with strangers twice a day, often with my husband in the room. It was humiliating. I was on Labor & Delivery, trying to sleep on a delivery table, for THREE DAYS because I was too far gone for Antepartum but my labor had stalled out. I had painful contractions every 20 minutes during those 3 days, and every 3-5 minutes for hours at a time during those days. I was on mag. I was given terb about 2 hours before I delivered. And after delivery, once they took E to NICU, the first thing I did was ask for a pump. In NICU, I stayed with him 10-12 hours a day. I pumped every 3 hours, often at bedside in the NICU. I talked to him. I kangarooed. When I wasn't allowed to hold him, I just sat and daydreamed. About all the things we would do together when he got big, because if I didn't, my thoughts told me he was going to die like B did. I cried every time I left him - I relived the horror of walking out of the hospital empty handed after B died every single night. And when he finally came home, I did it on my own. M didn't take any time off of work. I did all his care every 3 hours (I was a NICU mom, so he got diaper changes, temps, and feeds every 3 until he would wake for feeds, etc.) and I pumped every 3 hours, and did nursing practice at all daytime feedings before his bottle. That left next to NO time for sleep, and I was so tired I couldn't see straight. And when I found out about the affair, I begged M to work it out. Because I wanted E to have an intact family. I swore to myself that if he ever cheated again, I'd leave, no questions asked. But when it came down to it, my son was more important than my dignity.

And M? He is playing house with another woman and her children. But because he donated his sperm to make this exquisitely perfect child, he still has rights.

I'm terrified.

Pumping Woes

I'm proud to say that E is fed breast milk exclusively. In the NICU, he was fed fortified breast milk, and then plain breast milk but 2 feedings a day of Enfamil Enfacare for the extra calories and iron. He never really needed the extra calories, he gained weight like a superstar, but he was really very anemic (barely escaped a blood transfusion in the NICU) so he needed the iron. He got off that when he hit 40 weeks, and has just had breast milk ever since.

I was a superstar pumper while he was in the NICU. About 4 weeks postpartum I was pumping 60 ounces a day. It was fab. I had a huuuuge freezer stash. I mean huge.

When I first brought him home, I totally thought nursing was going to work. I attempted nursing at all daytime feedings, but followed up with a bottle because he was still really small and I didn't want him losing weight. So I was still mostly pumping.

Then, the poop hit the fan and I found out about M's affair, and my milk supply went poof. Gone in an instant. I started taking More Milk Plus immediately and that got it back up, and I was even able to freeze a little. I'd say I was pumping about 35 oz/day. But that stuff is expensive and when it was gone I didn't buy more. I did okay for awhile but stopped having anything left over to freeze. Then M and I had a nasty fight and I needed to thaw some of the frozen stuff. So I bought some fenugreek and have been taking that 3 times a day religiously. It didn't help a whole lot.

Now I'm going on 5 months of pumping exclusively - I stopped trying to nurse after I found out about the affair - it was just too stressful at that point. I've tried since, but E rejects the breast. I think he doesn't recognize the texture as 'food,' and then since it takes a minute for let down he just gets frustrated and pulls off and screams. He'll latch with a nipple shield, but is very slow and will take almost a full feeding from a bottle after 30-45 min of nursing, so I don't think he's getting a whole lot. It's frustrating. So therefore, I'm still EP'ing.

Now that I'm going back to school, it would be sooo nice to have a freezer stash so I could just leave it at my sister's house for when she watches E. My big NICU stash got thrown away by M. I tried to have his parents bring some out when they brought my stuff out here, but they didn't ice it properly for the duration of the trip and it was all melted when it got here. *sigh* I wanted to donate it, but M didn't have time for nonsense like helping other people. Anyway, I'm considering asking my OB for some Reglan, but am concerned about the side effect of depression, since I'm on Zoloft and feeling fabulous on it. I don't want to feel un-fabulous quite yet. The fenugreek wasn't so helpful - I got a suggestion from the fabulous @earth_mommy on Twitter to try a combo of fenugreek and saw palmetto. Or I could just cough up and buy the More Milk Plus again, but it's just so painfully expensive... but it did work for me.

Today I've just been focusing on drinking lots of water and pumping faithfully every 3 hours. Hopefully that on its own will help, and then whatever I decide to do in addition will help get me a freezer stash!! This whole pumping thing is certainly not for the faint of heart... it's a ton of work!!

My Story - E

E. My rainbow baby. My pride, my joy, my baby boy.

Again, copying from www.babybumbleb.com

ELI

As a result of my history, we were much better prepared this time around. We took precautions against preterm labor with weekly progesterone shots, and biweekly cervical ultrasounds. I started having what I knew to be Braxton Hicks quite early in the pregnancy, which made me very nervous. I went in to be checked, in tears, more times than I can remember. I always thought I was in labor, or I was leaking fluid or something. All the times that I went in, I was wrong, and everything was fine.

Until I got to 23 weeks. I had just eaten dinner and was having more Braxton Hicks than usual. I decided to go lay down on my left side and drink a bunch of water before calling, because I knew that's what they'd tell me to do anyway. After an hour and a liter of water, I was still having them frequently, so I called my doctor. The doctor on call at L&D said she wasn't worried, but due to my history she wanted me to come get checked so I would be able to sleep that night.

My heart stopped when I was told I was dilated a centimeter and a half. I was admitted to the hospital and put on complete bed rest, continuous monitoring and a cocktail of drugs to prevent labor. The next day an ultrasound of my cervix showed funneling that hadn't been there 2 weeks prior. I only had half a centimeter of cervical length left.I was given steroid shots for the baby's lungs, and it was just a waiting game until my cervix would give out.

I held onto that half centimeter for 6 weeks in the hospital, only allowed in a wheelchair for my weekly appointments with my perinatologist. At 29 weeks I went into labor that was unstoppable with drugs. I delivered a screaming baby boy! He was whisked off to NICU right away, and spent 45 days there. He sailed through, needing little respiratory help. He was basically a feeder/grower the whole time.

Elias Adam
3 lbs, 6oz
08/02/2009

My Story - B

B. My beautiful angel.

I'm going to copy from a guest blog I did for my BFF Katie at www.babybumbleb.com.

BRIE

The day my daughter was born was the best day of my life, like a firstborns birthday is for all parents. It was also the most terrifying and devastating day of my life. Why? Because I was only 26 weeks pregnant.

We were literally in the middle of a cross-country move. Halfway between our old home and our new home. I had felt "off" all day, and started having what I thought were gas pains around noon. Eventually I noticed that the pains were consistent - every 5 minutes. We were traveling, so we stopped at the first emergency room we came across. I wasn't in a lot of pain, just a little uncomfortable, so I felt really, really silly going in to an emergency room. I was told I probably wasn't having contractions, because they didn't feel my WHOLE tummy getting hard. The baby was listened to with a doppler - she sounded beautiful. The doctor came in, repeated everything the nurses had done and told me I was having Braxton Hicks contractions due to the long car trip. "Drink more water, get up and walk around every 2-3 hours, and follow up with your OB when you get home" were the orders I was sent away with. I was not checked for cervical dilation. Because this was my first pregnancy, I had no idea that I should have been.

About eight hours later I was trying to sleep in a hotel room. The "Braxton Hicks" were getting worse. I thought "Wow, I must really be a baby if these are Braxton Hicks. I wonder what real labor is like?!" I thought maybe my appendix had burst or something weird like that, so I dragged my husband out of bed and we went to a different hospital. I was taken to triage where I was checked for dilation. I was 8 cm dilated and the baby was at +2 station.

There was no going back. I delivered her, and she let out the most beautiful cry. I was allowed to kiss her on the cheek before she was whisked away to the NICU. Forty-six hours later, we were told that she was suffering from pulmonary hemorrhage due to the immaturity of her lungs. They had done everything they could do, and it wasn't working. We chose to remove her life support and end her suffering. We held her for the first and last time, and she passed away peacefully in her parents arms.

Gabriella Nicole
1 lb, 15 oz
11/11/08-11/13/08