Wednesday, June 30, 2010

Confused about Nipple Confusion

The midwife came by on Monday to have a look at the Frog's feeding abilities.  She listened to my nipple confusion hypothesis, before shooting it down with a calm "I don't think it's that - it's pretty rare".  She then proceeded to grab the little blighter by the scruff of his neck, and pressed him firmly onto a nipple.  And the wretch didn't offer up a single squawk of complaint, but took it like a lamb (with less head-butting, fortunately).  So, I've worked out that it's the attitude that matters - and I need to be going for 'no-nonsense', rather than 'wittering, dithering mess'.

Meanwhile, I've been happily swapping labour stories with various other people from the ante-natal class.  I think I've finally worked out that the main benefit of ante-natal classes is that first-time parents can excitedly jabber on about their pregnancies, their deliveries and their new babies to one another, without having to inflict these stories on the general populace (thereby boring them into early rigor-mortis).

Sunday, June 27, 2010

Battling the Blues

Well, it's one week after the birth of the Frog (our new name for the Bean - mostly based on the way he curls his legs up like a wee tree frog when he sits against your front).

On the day following the birth, I felt surprisingly good.  I was ravenous right after labour, so before I even left the delivery suite, I was knocking back toast and milo with the best appetite I've had in ages.  The Frog and I slept pretty well that first day - I think we were both exhausted by the night's events.  Fortunately, the midwives came by regularly to check on us, as I certainly wasn't in any condition to be paying attention to any little grizzles coming from the cot next to my bed.  Hubs also took the opportunity to go home and sleep for a while, as it quickly became apparent that there really wasn't anything exciting going on in terms of Frog development in the first 24 hours of life.  He came back bearing Thai for dinner (and after I'd seen what was on offer for the hospital lunch, I was sincerely grateful!).

The Frog was beautifully behaved (read: he slept all the time) until Hubs left for the night.  At which point, he finally discovered these two little air sacs in his chest, and put them to excellent use.   It took me most of the night to work out how to manage the screaming (plug mouth with nipple.  repeat other side. continue until colostrum-induced coma occurs).  I was also pretty pleased that I didn't have to resort to pressing the panic button next to my bed - though at one point, a midwife doing the rounds noted that I had fallen asleep with the Frog clumsily cradled on my lap.  She basically then just tucked us both into bed a lot more comfortably, and we got on with the all-important business of catching z's.

The next day, after some basic checks on the Frog's and my anatomy, we pronounced ourselves ready to go home.  I was - at this point - a little frazzled, as I'd been up for the vast majority of the night, early morning and late morning on colostrum duty.  Additionally, the physical effects of labour were starting to make themselves obvious.  I felt like I'd been riding a horse bare-back for the past week, then run over repeatedly by a homicidal freak in an SUV.  A lot of that I'm assuming is due to the whole-body clench during each contraction.  My, what a good muscle work-out!   Anyway, we decided to take my sad and sorry body home, and we got to try out our car seat (going in and coming out involved a lot of screeching - not on my part for a change - but once on the road, the Frog seemed content to blink myopically at his hand).

There followed about 4 or 5 days of hormonally induced bliss (or about as much bliss as you can feel when you're on about 2-3 hours sleep per 24 hour stretch).  We goggled at the marvel that was the Frog.  Each fingernail and toenail was cooed over.  If he crossed his eyes in our general direction, we pronounced him amazingly precocious.  We footled with each of his tiny limbs, and patted his crazy hair into even crazier spikes.  And I wept.  Hoo-boy was there weeping.  This wasn't unhappy weeping, mind you.  Hubby sat there in a state of bemusement, as I became a saline fountain for the umpteenth time that day.  He'd pat me, and ask me what was wrong - at which point, I'd try to articulate between gulping sobs that I thought our little Frog was tiny and perfect.  Rational?  Undoubtedly not.

And then the feeding problems started.  I'd thought that the Frog and I had been doing fairly well - he had an awesome hungry latch, and I had extremely sore and bruised nipples.  Problem was that I didn't appear to be getting the milk in, so the poor Frog was feeding as often as he could for the meagre helpings of colostrum in my breasts.  At some point, my midwife decided that for the good of all he should be supplemented with a bit of formula - and so began the cycle of wash/sterilise/express/feed that I'd really hoped to avoid.

The expressing was something to be done after each feed to try to stimulate more milk production - and believe me, there's nothing more entertaining than watching your nipples being sucked rhythmically down into little plastic funnels.  If you're really lucky, you get to see little jets of milk squirting out with each pump action.  Amazing what is riveting to the sleep-deprived mind.  Anyway, while the Frog got everything I managed to express, it wasn't really close to the amount he needed to top-up a regular feed.   Annoying, but not end-of-the-world stuff.  But then the Frog started to have trouble latching on for his regular feeds.  He'd be desperate for food - hyperventilating, and shaking his little head - he'd even gape his mouth like before, but when I pulled him into position, he'd just hold the nipple and then drop it - no sucking or latching behaviour at all.  The more we tried this, the more frustrated he got, so a normal feed turned into 40 minutes of both of us crying desperately while he was unable to manage the couple of sucks that would draw the nipple into place, and give both of us 15 minutes of peace and comfort.

I had two days of this, and by the end of the second I was desperate and miserable.  Irritation levels were through the roof, and half-full rolls of loo paper graced every room, in the event I needed to sop up my copious out-pourings of grief and frustration.  And then hubby did some internet research to try to work out what was going on.  Turns out it's likely to be something called 'nipple confusion' - and it's very common in young babies who are given a bottle.  Essentially, they get confused about how to suck - the bottle just hands them the milk on a silver platter, while on the breast (well, on mine at least), they need to work for every droplet.  Once I had a name for the issue, I felt about a million times better (conservative estimate).  It's a known problem, and while it's tough to deal with, there are things you can do to try to avoid the worst of it - starting with feeding the bub before he gets really hungry - or giving him an interim feed with plenty of skin-to-skin contact, so that he associates you with positive feelings, not the frustration of being able to smell the food, but not being able to get to it.  I'm a bit annoyed the midwife didn't warn me about this effect. If it's so common, some kind of heads up would have been nice.  However, I know now that I can probably get some help with a lactation consultant at the hospital, so I no longer feel as frustrated and hopeless as I have the past couple of nights.

Wednesday, June 23, 2010

Labour of Lurve

Well, it's been a while since I last posted, but really - in those final weeks of pregnancy there wasn't much to report besides ever increasing girth, more waddling, and a loosening of pelvic ligaments (this last change was a bit of a disappointment - I'd been anticipating that finally I'd be able to sit like one of those swami-gurus, cross-legged for hours on end, but the actual effect of pelvic ligament loosening was simply to make walking or sitting or lying a little less comfortable than before).

Of course, as should be clear from the title of this post, we've moved on somewhat from pregnancy gripes.  And before I continue, I'll just make the point that I'm doing this in order to FULLY REMEMBER the experience end-to-end and make sure I NEVER feel like repeating it.  I mean it.

The Bean was due to come into the world on the 19th of June.  Sometime on the evening of the 18th, I started to feel a little crampy, and at some point felt a small gush.  As I've fortunately been blessed with continence throughout the pregnancy, and I don't normally use pants-wetting as an attention-getting strategy (at least, not since my mid-twenties), I thought "Hmmm, maybe waters breaking??".  Nothing much else happened though, so we went to bed.  I woke again at 2am - those cramps were really getting pretty irritating.  We decided to phone the midwife, who listened to what I had to say, then suggested a couple of panadol, getting some more sleep, and coming in for a check on the following day.  So, we did just that.  At 1pm, I was hooked up to a couple of monitors in the hospital, and those nice strong cramps I'd been feeling just dried up.  That's right, not a single one for a full half-hour of observation.  Always the way.  So, they muttered that sometimes Braxton Hicks contractions can be a little painful, and sent me home again.

During the afternoon and evening, the cramps just kept coming - but here's the tricky thing.  For it to be 'real' labour, you're looking to fulfil 3 conditions:

  • pains get longer, 
  • pains get stronger,
  • pains get closer together. 

Me being me, I drew up a spreadsheet (just on paper, though if I'd had my laptop ready, excel would have been trotted out for the job), with time, duration and intensity columns.  The upshot?  The length of my pains rarely exceeded 30 seconds (apparently 60 is around the expected duration).  It was very hard to estimate strength - even with my cunning 'mild', 'mild-med', 'medium', 'med-hard', and 'hard' sliding scale - because I have a feeling that 'hard' inches up in strength without you really noticing.  So at one point in the evening - somewhere between 9 and 10 - we sorta guessed that the 'hard' ones were the proper contractions, which were about 10-15 minutes apart .. but not really regular.  I was thinking that if this was what painful Braxton Hicks contractions were like, then real labour was going to effectively kill me, and I think hubby noticed my strained expression, so at 11pm, we called the midwife again (I'm sure she was really grateful for all my late-night calls).  She considered the evidence, and told me to get into a warm bath, and see if that helped.  So off we went.  I think I'd been sweltering in the heat for about half an hour, when it became obvious that the 'hard' contractions were now coming at 2 minute intervals, though still not lasting anything like a minute.  I sat about for another hour or so, considering how butch all the women who have preceded me in labour were, if I was considering begging for an epidural for something that was a pre-labour contraction, when there was a gush.  And I'm not talking a sissy 2-tablespoon trickle, I'm talking pints gushing under full pressure.  So THAT'S what they mean about waters breaking.

At this point, it was brown-trousers time (I won't go into gratuitous details about diarrhoea at this point, except to say that perhaps brown-trousers time could officially be said to start a little earlier...).  We called the midwife back (it was now around 1am), and said "that's it, we're coming in to the hospital".  She agreed to meet us there, so off we went, me sitting on a stack of towels which became soggier with each contraction.  As luck would have it, it was a rugby night that night, with the home-team winning big.  So the streets were full of drunken revellers. Hubby and I staggered from the car to the hospital, with me needing to stop and lean over for each new contraction which was - you guessed it - accompanied by more watery gushing.  This didn't escape the notice of the drunken crowd.  Some were very nice - offering to run ahead to the hospital and alert staff - some were just awed and impressed at the sogginess of my pants.  Anyway, to cut a long story slightly less long, we got inside, got to a delivery suite, met up with the midwife who, after having a little feel around, pronounced me at 7cm dilated (and here was I thinking that they did something a little more official, like using a slide-rule or callipers or some such).  She recommended that I might like some gas.  I nonchalantly acquiesced to her suggestion by grabbing the tube and sucking deeply on it throughout the rest of the labour.

My tips for getting through labour?  Hokey as it sounds: breathing.  This was one of the most intense experiences of my life to date, and while the nitrous may well have taken the edge off the pain, it sure didn't feel like it at the time.  What it DID do was give me a handy little tube to bite on, instead of grinding my teeth into little calcified splinters, and encourage me to breathe in a very regular way - which I used for each and every contraction:  4 beats in, 4 beats out.  When it started to get a little tougher, I used hubby as a resistance weights machine on one arm - so I was effectively doing a 4-count bicep curl (breathing in), and a 4-count tricep extension (breathing out).  Didn't stop the pain, but did give me something to focus on, which I think helps.  At some point during labour, you get to something called the 'transitional' stage.  This is when it stops hurting, and starts *really* hurting. You don't just get one nice peak in your contraction, but you get something with several peaks in it (ouch-ouch-OUCH-OUCH-ouch!), and you get the first 'pushy' type urges.  The best way I can think to explain the 'pushing' urge to someone who hasn't done labour, is:  think of when you're really nauseous - you start retching maybe a couple of times before you vomit.  That compulsion to retch, born of the nausea?  Well, it's the same as the compulsion to push, born of the contraction.  It starts off with a sort of mild involuntary push, but when you move fully to the pushing stage, then pushing is just what you GOT to do.  Unfortunately, while the contractions help you to get the necessary force into your pushes, they don't do all the work.  You have to get some oomph into it yourself.  And yes, it is exactly like shitting a watermelon.  Constipation no longer holds any terror for me.

The midwife was pretty awesome.  She knew exactly when to get me to change position in order to keep the labour moving on at the right pace.  Sometimes on the bed, on the loo, standing up - it was never comfortable trying to move around between contractions, but it was amazing the difference it did make.

Things I vividly remember?  The feeling of the head coming down the canal - actually feeling so stretched that it burned. Twice, it felt like I'd almost managed to pop out the little sucker, only to have him slide back in between contractions - almost right back into the cervix by the feel of it!  Getting the head out was by far the biggest "yes!" experience - from all the ante-natal prep, I figured that after that, all the other pushing was secondary, and indeed it was - the midwives can give a bit of help with the shoulders, and the placenta - though surprisingly large - was a doddle.

The moment he was fully out, the midwives stuck him on my belly - just pausing to dry his head a bit.  It was so bizarre to finally meet the little entity I'd been carrying about (and carrying on about) for the last 9 months.
Bizarre, and really .... kind of awesome.