Posts Tagged ‘nursing’

Weaning update

Wednesday, August 14th, 2013

Waking up Monday morning (Aug 12), I was nervous about how Cate would react to skipping “Mommy Milk.” But I was hoping that if I kept us moving from potties to breakfast, that she might not notice.

Cate woke first, and after pottying, she and I went to the kitchen to start making breakfast. So far, so good!

Nane arrived a little before 8 am. Sam woke a moment or two later. Cate stayed in the kitchen with Nane while I went to gather Sam and take her to the potty.

Unfortunately, I hadn’t had a chance yet to alert Nane that I was changing the schedule. So a few minutes later, she sent Cate to find Mama, armed with my green hot pads, all ready for nursing.

I took them from Cate and thanked her, but I didn’t put them on. She asserted, “Mommy Milk.” I paused and replied, as studiedly as I could muster, “we’re going to wait and have milk later, before dinner.”

Cate, who was hungry, looked up sharply and said, “No! Mommy Milk, NOW!” I told her gently, “no, we’ll have milk later. Let’s go have breakfast together,” and Cate began to cry.

I soothed her best that I could. And then I think I distracted her with an offer of popsicles for breakfast, which she accepted readily.

Tuesday went smoother, and we managed to avoid any triggers related to nursing.

Wednesday after nap time, Sam played with a bath dolphin. At first, she tried to put it in the “pocket” of my neckline. But then, she turned the dolphin around to face my sternum, shoved it down toward my bra, and said, “hungry.”

As I asked Sam whether the dolphin was hungry, she replied, “si,” and started to make slurping sounds. Cate looked up, asserted, “Mommy milk,” and added, “Cate hungry, too.”

Again, I steered us toward the kitchen and a meal, and again they acquiesced.

Other that those two and perhaps a third incident, the girls have adapted well to nursing just once a day. It has felt freeing to be able to let a wakey girl go eat breakfast and let her sister sleep in, instead of waking her so two can nurse.

A couple of you expressed concern that I should keep offering to nurse as long as a girl was interested. I genuinely appreciate your care for their well-being.

When the girls were new little babies, we nursed them for sustenance and immune support. But now that they’re toddlers on a robust diet that includes cow milk, chicken, tofu, broccoli, mangoes, and all manner of other good food (and cheddar bunnies), the pediatrician calls what we’re doing “comfort nursing.”

I surmise that Cate’s interest in nursing has only a little to do with the milk, and a lot to do with cuddling, singing, and enjoying my (un)divided attention. So as we shift away from nursing, I’m making an effort to make sure that our day still includes hugs, silly songs, and one-on-one conversation.

We’re still nursing before dinner, although we’ve run late a couple of nights in the last week and I almost forgot (?!?) to nurse. But I enjoy it and they seem to, too. I’m not sure how long we’ll keep going, but it’s probably days or weeks, rather than months.

Also, I’m not the only one changing our nursing routine. Two days ago, Cate introduced a twist of her own, requesting that we nurse “out here” on the living room futon instead of in the bedroom. Did I mention that they have opinions?

In the meantime, I’m starting to exercise again. I’ve only managed a couple of weekend bike rides so far, but that’s more cardio training than I’ve done in a long time. We’ll see how things go.

Food Poisoning!

Sunday, February 24th, 2013

Friday evening, I made tortellini for the girls (thanks, Cindy, for the suggestion!), and Bill grilled up some spicy Italian sausage. Tossed with his homemade red sauce, the combination was delicious!

But afterward, I didn’t feel good, though Bill seemed fine. I tossed and turned all night. In the morning, confronted with a bit of water, my system gave up and evicted it’s contents. What a waste of a good dinner!

All day Saturday and all of today, so far, I’ve been down and out with food poisoning. I’m running a low-grade fever, can’t eat or drink without regretting it, and I’m wasted tired.

I’m 90% confident the culprit is a Stonyfield Farm peach fruit-on-the-bottom yogurt I ate Friday afternoon. It looked odd, but it was a different brand than I usually get and still “in date”, so I ate it anyway.

Big mistake. Next time, I will happily toss $1 worth of yogurt to stay on the safe side.

40 hours later, I’m still running a fever, but I managed to drink half a glass of Gatorade without ill effect. Progress!

In the meantime, I am immensely grateful to Auntie Em, who raced over here early yesterday morning to help Bill with girls so that I could stay in bed all day. And now she’s back today, too. So. Very. Grateful.

* * *

On a side note, dehydration and nursing don’t go well together. We’re still “comfort nursing” before breakfast and dinner, and then I pump before bedtime to get them another few ounces. I figure I’ll keep it up through the end of flu season.

I’m sick enough that sitting up and setting up to tandem nurse is exhausting. The girls are clearly eager to do it, and comforted by the Mom Time. But I swear they looked up at me this morning as if to say, “Really? That’s all?”

Judging by how little I was able to pump last night, making milk is not my body’s priority. I hope that it will get back in business once I’m able to drink more fluids. Otherwise, we may be about to wean rather abruptly.

* * *
It’s nearly noon and I’m finally not sleepy. My stomach is starting to rumble with what I hope are pangs of simple hunger. Time to get up and brave some broth and rice.

I want what she has!

Sunday, July 1st, 2012

Mealtimes for the babies are a multi-step process. After we nurse, there are 5-10 minutes while we make up bottles of formula for the difference. If there’s someone in house helping me, the babies and I usually hang out on the bed.

During this time, I usually note our nursing data in my iPhone app. If the girls spot my phone, they reach for it. At some point, in the interest of protecting my phone, I started distracting them by giving them my tube of lanolin to chew on in instead.

One Monday night in late May, Cate was quicker to express interest and I gave her the purple tube. But a few moments later, Sam noticed it, leaned over, pried the tube away from Cate, and commenced chewing on it.

Cate was obviously dismayed. She watched her sister sucking on her tube, and even leaned toward Sam a few times as if she was contemplating trying to take it back, but stayed put.

Noticing her disappointment, I offered up my iPhone as a consolation prize. Cate glanced at it briefly, but went back to gazing at Sam enjoying what she really wanted.

A minute or two later, Cate seemed to force herself to reach for the bendy ball and pick it up instead. She waved it about half-heartedly once or twice, then dropped it again, and went back to watching disconsolately as Sam continued to gnaw on the purple tube.

Finally, Sam looked up and noticed that my iPhone was untended. She immediately cast the purple tube aside, and took up the phone instead. Cate saw her opportunity: she collected the purple tube and began munching merrily. And for another few minutes, everyone was happy.

But at some point, Sam looked at Cate and realized what had happened: she now had her purple tube. This time, Sam dropped the phone and leaned over to Cate, reaching to take back the tube. Having watched with amusement as their interchange unfolded, I now intervened. I explained to Sam that Cate had waited patiently for her to finish with it and now she could do the same. Fair is fair.

* * *
When the next tube of lanolin arrived on Friday, I went ahead and opened it. Now there are two. We can practice sharing later.

What’s funny to me is that even having their own tube is not enough. Sometimes, when I offer them each a tube, their eyes are not on the one I’m offering them, but on the one I’m offering their sister. And even though the tubes are very similar (one is now empty), they are sometimes happiest when I immediately give them the opposite tube. Silly!


Cate and Sam mid-dinner with lanolin tubes

Speed blogging: gratuitous dig

Thursday, April 12th, 2012

Me, while tandem nursing: “Careful, babies. No hands in eyes. Because it’s 2:28 am and hands-in still sucks.”

Not eating… again

Sunday, March 25th, 2012

We first learned our girls suffer from gastroesophageal reflux (acid reflux) in December. Over a week or two, Catie became more selective about latching to nurse. After an initial spell, she would wiggle and dismount. Then she would open her mouth eagerly like she was hungry for more, but repeatedly let my nipple graze through her open mouth without latching. At the time, I couldn’t figure out why. Sometimes, she would nurse but not take her bottle.

Then by the end of December, Catie began resisting bottles altogether. After nursing, she would make hungry-looking fish mouths with protruding tongue, but when we presented a bottle, she would resist latching on to the nipple. We brainstormed possible causes and remedies: Does that nipple smell like dishwashing detergent? Do we have a bad batch of formula? Has she decided that she prefers breast milk?

Burping her and swapping out nipples only occasionally led to her taking the bottle. Catie’s total consumption decreased dramatically, and as a result, her rate of weight gain fell further behind her sister. As the problem worsened, we became increasingly concerned. Slowly, Sam developed some of the same issues, though to a lesser extent.

Finally, after a weekend in which Catie hardly ate, we called the pediatrician’s office. When we described the scenarios and issues, they concluded that our babies had gastroesophageal reflux, meaning milk/formula doesn’t stay down in their stomachs where it belongs. When milk and stomach acid return to their throats, it hurts, and they refuse to continue eating. Reflux is common among babies generally, and especially prevalent among preemies, though I’m not sure why.

Armed with a diagnosis, we started both girls on Prevacid twice a day and implemented procedural and mechanical improvements:

  • do Tummy Time and other lying-down activities before they eat,
  • change to a more-inclined tandem nursing position,
  • feed them smaller amounts at a time and burp them more often
  • keep them upright after eating and keep working on burping, and
  • offer them liquid antacid when they sound refluxy.

All of this makes feeding them even slower and more cumbersome. It often takes more than an hour of their limited awake time to finish. But they resumed eating and that’s important.

Now over the last two weeks, things are getting worse again. They had been eating almost 5 ounces of milk and/or formula 5 times a day, or about 25 ounces a day. But both girls have begun resisting/refusing their bottles again and we can’t figure out why. For example, Catie only took 19 ounces yesterday, and that’s typical this week. In fact, she’s taking so little formula that her bowel function resembles that of a breast-fed-only newborn for the first time in her life.

While Catie is clearly suffering more, Sam is suffering, too. Bill and I are struggling to figure out what, if anything, has changed in the last two weeks, and more importantly, what to do to solve the problem and keep them eating and sleeping. Hearing our babies whimper and cry and being unable to comfort them adequately is miserable.

Breast feeding update

Sunday, February 5th, 2012

After I wrote that I was struggling to decide whether to wean our babies or continue nursing, several of you took time to share your thoughts on the matter. To each of you who posted, emailed, texted, or called… thank you.

It turns out that weaning is a process, rather than a single momentous decision. That probably seems obvious to most of you, but in our current state of abject fatigue, little seems obvious here.

Anyway, like most processes, you can start, go for awhile, and reevaluate. So that’s what I’m doing. I’m now nursing for four out of five feedings, and they get only formula for the afternoon feeding.

Nursing a little less means my breasts are less tender less often. It also means I’m making a little less milk (~750 ml/day, down from ~880 ml/day), which means I can comfortably go a little longer between feedings. (I even managed to sleep for six hours straight on Friday night!)

In short, it’s better. Not perfect, but better enough to keep going for a while longer, and keep giving our girls the digestive and immune benefits of breast milk. On Saturday, they’ll be four months old, and I’m pleased that I’m able to carry on.

Our latest baby-feeding challenges

Monday, January 23rd, 2012

Week 1 (Oct 11)

The day Sam and Cate were born, post-delivery hemorhaging left me too weak to go to the NICU to see our babies, never mind nurse them. Further, they were really too little to nurse, but they needed to eat every three hours. So they took Neosure formula from a tiny bottle, just 1/3 of an ounce (~10 ml) at first, working up to an ounce at each feeding. The little 2-ounce bottles looked enormous next to their tiny faces. As preemies, they were so very sleepy that it was a challenge to get them to eat that much. We were only allowed 30 minutes to feed them each time, because the nurses explained that the energy required for all that sucking would quickly exceed the calories they took in.

Bill’s first “daddy nightmare” was about not being able to get Sam to eat, and he made a point to be in the NICU for the 9:00 am, noon, 3:00 pm, 6:00 pm, and 9:00 pm feedings every day to master the skill. I was only strong enough to go up to the NICU once a day, and I had less luck getting girls to eat. On several occasions, the NICU nurses took back the baby I was attempting to feed after 20 minutes to help make sure she got the nutrition she needed within the prescribed time window. The grandmothers, Baba Jean and Gram Nancy, came to the NICU on several occasions to help and learn, too.

Each baby was tethered back to her isolette, with monitors tracking their heart rates and respiration rhythm. Breathe-suck-swallow is a complicated set of motor skills, and we had to pay attention, and let them rest when they got overwhelmed. To burp the girls, the NICU nurses insisted that we sit them on our knee, holding their chin in one hand while thwacking their backs with the other, much harder than seemed appropriate for such tiny babies. Cuddling them close resulted in them falling asleep almost immediately.

Week 2 (Oct 18)

Once we were home, we continued to feed the girls when they woke every 3-4 hours. As their mouths got stronger and their stomachs grew, they quickly worked up to two ounces at each feeding. With single-minded purpose, the girls would now finish a bottle in 4-6 minutes, sometimes taking only one break in the middle to pant and catch their breath. They sucked so hard they often collapsed the bottle nipple, and at their two-week check-up, Dr. W found “sucking blisters” on their lips, exacerbated when we weren’t careful to make sure their lips were flanged out around the nipples. Dr. W encouraged us to stop using the prefilled formula and Medela breast milk bottles and begin using our Dr. Brown’s bottles with an internal vent stack to reduce pressure in their mouths.

As my anemia improved and my strength returned a little, I also nursed each of them during two feedings a day as I was able. But I only made enough milk for each of them to get half a feed from me. So even when they nursed, they also took some formula. I would nurse one baby on one boob, then hand her off to Bill to take a bottle while I nursed the second baby on the second boob. After we finished nursing, I would then give her a bottle.

Week 3 (Oct 25)

I continued to nurse each of the girls twice a day, and after renting a baby scale, we began tracking how much milk they were able to get from me. With more nursing and more pumping, my breasts produced more milk, and I hoped that I’d eventually make enough to nurse them exclusively. However, the plastic flanges for my breast pump were chafing the areola around my nipples, and it became increasingly uncomfortable to nurse or pump.

Week 4 (Nov 1)

The red, raw, chafed area on my left boob became visibly infected. Concerned that I had developed a yeast infection. Regarding their milky white tongues, I worried that our babies were getting “thrush”, and I switched to pumping exclusively for several days. We made plans to see doctors first thing the following Monday morning.

Week 5 (Nov 8)

The pediatrician checked out the girls and assured us that they were perfectly normal and healthy. Meanwhile, a lactation consultant recommended a (nearly useless) topical goo for my boob and discouraged me from taking any antifungal medication.

gas and simethicone?

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Week 10 (Dec 13)

Catie became more selective about latching to nurse. After an initial spell, she would wiggle and dismount. Then she would open her mouth eagerly like she was hungry for more, but repeatedly let my nipple graze through her open mouth without latching. At the time, I couldn’t figure out why. By the end of December, Catie began resisting bottles altogether. After nursing, she would make hungry-looking fish mouths with protruding tongue, but when we presented a bottle, she would resist latching on to the nipple. We brainstormed possible causes and remedies: Does that nipple smell like dishwashing detergent? Do we have a bad batch of formula? Has she decided that she prefers breast milk? Burping her and swapping out nipples only occasionally led to her taking the bottle. Catie’s total consumption decreased dramatically, and as a result, her rate of weight gain fell further behind her sister. As the problem worsened, we became increasingly concerned. Slowly, Sam developed some of the same issues, though to a lesser extent.

Week 12 (Dec 27)

After a week of increasingly sporadic eating, we called the pediatrician’s office and learned that their behavior was typical of babies suffering from acid reflux, when stomach contents seep into the esophagus and throat. She said reflux is common among preemies, and reassured us they will grow out of it eventually, six to nine months from now.

In the meantime, she encouraged us to keep girls upright at least 30 minutes after each feeding, and to feed them less milk/formula more often, in case trying to manage our daily routine with two babies wasn’t already challenging enough. Bouncy seats, to keep their heads elevated relative to their bellies, have become essential gear. She also “prescribed” propping the head of the crib mattresses on phone books.

In this age of internet search, we have already recycled all of ours. And we wonder: will these girls ever need to know what a “phone book” was?