Breast is Best. But is it?

Breastfeeding is such a hot topic right now which has really impacting my feeling about feeding Dylan.

There are so many things I would have done if I had not had a preemie.  I would have taken a picture of my belly before giving birth.  I would have packed a hospital bag.  I would have saved cord blood. I would have requested to hold Dylan immediately after he was born. And I would have breast fed (ideally).

My pre-baby thoughts on breastfeeding were that I really wanted to do it for about 6 months.  At that point I had no idea when babies started solids, etc.  As soon as I had Dylan and heard more about it, I decided that I wanted to give Dylan breast milk for at least a year, maybe even longer since I feel like maybe I could protect him from getting sick since he is so vulnerable.

My hospital is extremely pro-breastfeeding.  There are signs everywhere.  At 32 weeks gestational age, I put Dylan to my "dry" breast after pumping.  He did great!  Then at 34 weeks, we started regular breast feeding.  I can't remember the specifics, but I'm pretty sure we mixed bottle and breast right from the start.

Things got frustrating after this point.

1) The nurses would ask me how much I thought he took.  I could never answer the question.  For all I know it could have been suckling only.  I did ask a few times about weighing him before and after, but I never got a good response.  I have no idea why and I did not take it up with the charge nurse.  This is the one thing I probably would have done differently.

2) At some point reflux became an issue.  Dylan was fighting the breast and the bottle.  We were also nearing 40 weeks GA and I really wanted to get him home and taking full feeds was the only way to do it.  Eventually I quit putting him to breast because it usually consisted of 10 or more minutes of fighting and crying, then I had to give him a bottle, then pump. It was extremely frustrating.  I knew that he wasn't going to take a good volume from the bottle if he was already tired from fighting the breast and I was getting emotionally drained from having our time spent in such a negative way, so I quit trying to breastfeed...always planning to go back when he got feeding down.

I wish that the nurses had given me a little bit more direction here, but everything is a judgment call and they did the best they could.

Then we switched to formula as a last ditch effort to get him to eat before getting the g-tube.  And it worked.  

After much speculation and observation, I think it's the thickness that is really the issue.  We did try adding rice cereal to breast milk a couple of months ago, but his volume went down quite a bit.  Adding rice cereal is also tricky because breast milk breaks down the rice, so you have to mix it within 5 minutes of eating.  The Enfamil AR is already thickened.  We could absolutely go back to thickened breast milk which I think I will ask about this week, but that will only solve half of my problems.

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But I really want to breastfeed.  I have a new thing to be jealous about others moms for.  I know my "circle" for this issue is quite large - meaning I'm not nearly the only person in this boat, but still.  

This is really tough on me!  I agree that "breast is best."  But sometimes I actually feel like I'm being selfish trying to force it on Dylan.  Maybe it's not best for him.

Then I see posts online about defending breastfeeding.  I personally never thought it was under attack...it's really common in my area and my mom breastfed me for a year.  But the posts irk me.  They often say that the only reason someone doesn't breastfeed is because she didn't receive enough support in the hospital.  I don't want to feel like a mistake.  And I really don't think any were made.

I received lactation services the day of birth, had a pump in my post-partum room when I arrived that had a special "preemie" setting.  There was a pumping room before we switched to the new NICU.  I was able to get a great supply...something many preemie moms don't have.

I could have fought to EBF in the hospital, but what would that have looked like?  I wasn't going to live in that room for the 3 months he was old enough to BF.  So then I BF while I'm there, up to half of his feeds in a day.  We could have just gavaged all of the rest of his feedings.  

It could have worked.

But it could have taken a lot longer.  And because of the reflux, we probably would have had to introduce bottles anyway and it might have been much harder later in the game.  (He also needs to take his meds every day by bottle, so he would have always had to have at least one.)

I know this is rambly...I'm thinking through my thoughts as I go.

But the bottom line is that I feel like I have to defend not breastfeeding (or giving exclusive breast milk), even though I would prefer to be doing just those things.  And I feel like the people that do definitely feel like they are better than everyone else.  They do.  Even the nice ones.  And I probably would have felt the same way if I was them.

Don't you think I know how much easier it would be to just pull out my boob when Dylan was hungry?  Especially in the middle of the night.  

The bottom line is that I want what is best for Dylan.  And what is best for him, big picture, is calories.  I could probably teach him to breastfeed now.  But should I?  Struggle = calories spent.  (He's currently at 9lbs, 3oz which is about the 9th percentile.  Not bad, but he's gaining slowly and we don't have a ton of room left on the growth chart.

At the moment I'm adding 1/4 breastmilk to every bottle.  So out of the 26 or so ounces I'm producing at 3 pumps a day, he's eating about 6.  I can keep this up.  Even when I go back to work in May.  But it's very frustrating.  Especially because my husband doesn't get it.

So that's the story.  I hope it made a little sense while writing, because I don't have the energy to go back and revise!

The New Normal

We have a bit of a routine going around these parts which is nice.

Here's a snapshot:

During the night, Dylan eats between 2-3 and 5-6. My wonderful husband does the first feeding, I do the second. I really think Dylan would like to sleep through the night, but we are not allowed to let him yet (because he needs to gain weight), so we feed him at least every four hours at night.

The mornings are the hardest for me. Dylan is more often than not constipated in the morning and grunts and groans and is unhappy from anywhere between 4:30 and 7:30. I am NOT a morning person...not even a waking up person for that matter. So it's really tough for the first hour or so and then I'm good. I try to put Dylan back to sleep after his 7-8 feeding, but it depends...usually he'll sleep for a bit

Then it's coffee time! I've never been a daily coffee drinker. But now I look forward to my morning coffee so much! We got a Keurig and I love it. I think it should go on every new mom's registry!

Dylan's usually pretty awake in the morning so we talk and play and do tummy time. And I try to catch a smile in a picture. It's a fun game. He'll be smiling for like 5 minutes, I'll open the camera, he'll make a stink face. I've caught a few smiles, but most of the time they are blurry because I'm rushing to get it.

If we don't have anything scheduled for the day (doctor appt or walking with a friend), I take Dylan on a walk around the neighborhood mid-morning. But we have been having doctor appts twice a week so far and a walking date once.

The rest of the day is kind of fuzzy. It's a mix of me trying to eat lunch, Dylan eating, Dylan eating, Stella trying to lick Dylan, Stella wanting to play, Dylan sleeping on me, and Dylan sleeping in the swing, with a bit of tummy time mixed in.

Dylan is pretty strong. He can hold his head up pretty well and is almost propping himself on his elbows. He's rolled from front to back a few times. I know they say it's more of an accident at this age, but he does it slow enough that it doesn't really look like falling. I figure if we are ahead in any area, it will be muscular since he's been using his muscles a lot longer than term babies.

Dylan is supposed to be eating every 2 hours or so right now, again because he needs to keep gaining. He seems to like every 2 1/2 hours. Feeding has definitely been frustrating. He was eating really well for awhile, now he's barely eating 2 ounces a feeding. He never averaged much higher than that, but he had a few 3-4 ounce sessions sprinkled in. Now, not so much.

He averages about 18 ounces a day with a high of 20 and low of 14 (ugh). He is on a little higher calorie formula, but I'd still like to up his volume. (Breast milk is considered to be about 20 calories an ounce - so is formula. We do one scoop for 54mls instead of 60 to get to 22 calories. But I'm also adding 1/4 breast milk.)

He was 9lbs, 1oz on Weds which is 5 months actual, 8 weeks adjusted.

Overall things are great. Besides the feeding difficulty, Dylan is a pretty happy, easy baby. I have no idea if its the time in the NICU (probably) that taught him to self-soothe and be happy just hanging out awake by himself, but he's pretty chill most if the time. He does have his moments though...

I'm still pumping 3x a day and getting about 25 ounces. I'm going to keep it up for now because I still dream about Dylan going back to exclusive breast milk or in my wildest fantasies, breast feeding (wild, I know!) so I want to keep my options open for now.

Want some pictures?

Enjoy.

Baby Connect

Ok, that last post broke my blogging impasse and now I have to share something amazing.

Baby Connect

Let me go back for a second. When I started pumping, my sister recommended iBabylog. It's free, so I got it, but I didn't like it. I'm kind of a graphics snob and it was just ugly and not super easy to use. So I just logged all of my pumps in my notes. Yeah, not special at all.

Now that Dylan is home, I knew I needed an app to keep track of his feedings. I did a very small amount of research and narrowed it down to two apps: baby connect and some other one.

I bought it a few days ago for $4.99 and I'm seriously in love.

First, you can share the account with anyone who takes care of your LO. So Mr. GG bought it last night and instead of texting me in the MOTN how much D ate (he did this two nights ago and it really pissed me off...so tired), he logged it straight in the app. But grandparents, nannies, anybody can use it.

Second, and probably most importantly, as soon as I click the app open, it tells me how long it's been since Dylan last ate (or last pump or last diaper change). I can never remember exactly when it was so this is amazing.

Third - it keeps track of just about anything you could imagine. I'm currently using feeding, pumping, diapers, immunizations, stats (i.e. height, weight), and activities. But it's got sleep, mood, a diary, pictures, lots of stuff.

You can even have the height and eight plotted on the growth curve.

This almost annoyed me because it went by D's actual age instead of his adjusted age which makes him so far below the growth chart, he'd be in Mexico. But in preferences, there is an option to chart by due date instead. Score!

Fourth - You can graph any data entered in multiple ways. I can look at number of feeds, total volume, average volume, and interval between feeds. I love data so I stare at this all day long to see if he's improving.

Baby Connect is not paying me to say any if this. But I think they should! : )

There are many more features that I didn't even mention, but just get it. I highly doubt you'll be disappointed.

One Week Home

I'm not feeling any of the posts I've been writing, so let me just do a quick one to let you know how awesome it is having D home.

I'm tired.  He's mostly really happy most of the time.  We're going for walks and doing tummy time and reading books.

Like normal people!

It is so nice to be outside and active.  Thank goodness for our awesome SoCal weather (sorry snowstorm peeps).

He's eating and pooping adequate amounts.  I never thought I would get so excited for poop!

Dylan actually ate 120 mls tonight.  4 ounces!  Amazing.

I never thought I'd be napping from 8pm-10 pm.  Or that sleeping from 7:30-9:00 am, uninterrupted, could make make ridiculously excited.

On another note, pumping 4x a day around baby's feedings, hoping he's asleep at the right times and hoping the dog will leave me alone while your LO eats formula....sucks.  Hopefully we'll be back to breast milk soon - or I'll give in and quit pumping. One of the two will have to happen in the next week or so.

I really am LOVING life with my perfect little man.

More to come soon!

I cried.

Not long after I published my post yesterday, I asked if I could speak with the doctor. I knew Dylan had done well during the last 24 hours and I wanted to hear her thoughts.

So she walks in and says, "So Dylan's going home on Wednesday." Like I already knew this. I said "really?" She said "yep!"

And then she left.

And then I just started crying (damn...I'm doing it again).

I didn't think I cried happy tears but it looks like I do.

I just never thought this day would come.

I feel like we can finally start our lives as a family now.

When we're home, no one will be able to tell all of the things we've been through over the past 2 1/2 years. We will look like all the normal people. But we will be different. I'm not sure how that difference plays out in the real world, but it'll be there.

(Dylan just snorted and woke himself up...: ). He's napping on my chest while I blog on my phone.)

I feel myself physically unwinding. I definitely have some symptoms of post-traumatic stress. Seeing the little babies makes me weepy...even though I could handle seeing Dylan without crying. We watched a CPR video today that has actors play out scenarios with real babies. It was almost too painful to watch.

I rarely get sick, but after finals my 1st and 2nd years of college, I got a nasty flu. I can hold it together until the crisis passes and then my body finally deals with all of the stress. I wonder how it will manifest after this?

We are telling all visitors that they have to wait at least a week to come visit. I want to be in a cocoon and just be a family. And take newborn pics! (They're already scheduled for Friday.)

Sharing this experience with all of you and feeling your support and making connections with other preemie parents has really helped me to survive.

Excuse me while I go cry a bit more...

OMG

Now that it looks like Dylan is coming home this week...without the g-tube (yay!), I am starting to freak out.

I equate it to how the normal pregnant people feel as they approach their due date. I am going to have my baby at home!

What will it be like? How will Stella do with him? Will he sleep? Will he eat? Will I sleep? How will I do with no sleep? What will we do each day?

I really have no idea what it will be like.

Unlike most moms, I do already "know" my baby. I know his cues and his faces. I know what his schedule has been here on the NICU, but who knows what things will be like at home?

I'm so anxiously excited.

I want to nest and get things ready, but I'm spending most of my time with him, not at home.

It's so amazing and kind of hard to wrap my head around!

But I'm ready...

Maybe, Just Maybe

Let's get back to our regularly scheduled posting...

Dylan just took 95mls of Enfamil AR formula!

Now the irony is not lost upon me that I am pumping as I type this while he chugs away on formula, but if it's the answer, I'll take it!

His previous record was 70mls of breast milk set last night. He beat it by almost an ounce!  His 3 hour minimum is 67 and 4 hour minimum is 88.  I do think be could potentially do the same with breast milk, but the AR is thicker which prevents bradys so I am perfectly happy with trying it for now. I will probably try to go back to breast milk after we get home.

The key was letting him "sleep eat" over about an hour. Both times he took. 30-40 immediately, then pooped out and fell asleep. When I heard him smacking his lips, I laid him on his side and kept going.  It totally worked and didn't seem to use too much energy.

My nurse almost cried. (She's my favorite...she treats Dylan like he's her own son.) when I told some other nurses at the station they cheered out loud, one raising her hands in the air :).

Surgery is still set for Wednesday just in case but maybe, just maybe...