Tuesday, June 30, 2009

Do they ever talk about anything else?

Yes, this is yet another post about sharing nursing of Ira. I swear we think about more than nursing around here, with all two brain cells that we possess between us in our current sleep deprived state, but since we haven't found anyone who has documented this particular process (two-mom family, one mom birthing, other mom re-lactates, both moms nurse one baby), we're trying to put our limited blogging energies towards this topic.

Here's the update: Ira will be 5 weeks old tomorrow, and Gail has been doing one feeding a day for a little over a week. Initially things did not go particularly smoothly because Ira was pretty miffed that her supply is not overflowing. We added a supplemental nurser (with a little of Gail's own expressed milk). That made for a few smooth feedings, and got her good stimulation to promote her supply. Two nights ago, we shifted to Gail taking the early morning nighttime feeding (between 4 and 5am) and found out that if she skips her 1am pumping, she actually has enough for a feeding on her own, is still only getting up one time, and I get a longer stretch of morning sleep. To make up for missing that feeding, I'm pumping directly after Ira's 1-2 am feeding, and directly after the 7-8 am feeding, which more than makes up for it. I'd probably be fine just pumping after the 1am, but I'm still kind of paranoid about losing supply.

What is challenging so far:
  1. Getting started nursing is challenging for many (I'd venture most) new mom & baby pairs. In this case, we're going through that difficulty twice, and the contrast between our bodies adds complication. Ira has to learn to deal with my fast let-down and medium-large supply, as well as Gail's slower let-down and less generous supply. That's a lot of extra complexity.
  2. Gail's feeding with the supplemental nurser are definitely much more cumbersome than bottle feedings would be, so for daytime feedings when Ira seems to need the SNS for now, there is absolutely no "convenience" payoff to Gail for nursing.
  3. There are a lot of logistics to work out in terms of how to time who feeds and pumps when. It's hard to think through everything, and for now, while Gail is trying to increase her supply, and I'm trying not to lose mine, there is a LOT of pumping going on in our house. Previously this was all falling to Gail and now I get to share the joy (actually, I think pumping is fun in a weird way, except for washing pump parts. Our hope is that ultimately we can cut back on this, once we see how much Ira needs from each of us.
  4. Related to point three, the complicated logistics can make it hard to feel like we've really hit a rhythm. Ira and I were just barely getting into the swing of things before we threw this in, which can make it hard to know when he's full, when he's hungry, and how long it will be until he's hungry again, but we probably would have been adding bottles in at this point anyway, which can cause the same problems.
  5. Related to points 3 & 4, changing up the rhythm and adding pumping feeds my worry about supply, especially with Ira doing a typical 4-6 week baby uptick in fussiness. It's pretty clear both from his weight gain and from what I get while pumping that there are no problems on this front, but that doesn't keep me from worrying some.
Indications there may be light at the end of the tunnel:
  1. The challenging emotions that I was having about Gail nursing were blessedly brief. Now that we're started, I only feel happy when they have a good feeding, and glad to help troubleshoot.
  2. Building in even just one feeding a day for Gail has automatically helped my interactions with Leigh. In the last week I've made breakfast with her (pleasantly) twice, just like old times, while Gail was busy feeding Ira.
  3. Once we figured out that Gail has enough milk to feed Ira without the SNS in the early morning, we both felt fabulous the next day. Gail felt great because she'd finally had a really satisfying feeding. I felt great because I got a slightly longer chunk of sleep. That was the first glimmer of a real payoff for all of this work (though the point would be very well made that the sleep payoff could have come just as easily with a bottle).
At this point it really isn't at all clear that this will give a payoff commensurate with the amount of effort we (and particularly Gail) have put in. On a daily basis, Gail is still pumping a ton, and enduring sometimes very fussy feedings (though at this point, so am I a fair portion of the time). If things don't smooth out once we're back at work, and she's getting long stretches (three solo days a week), and it's still this much work, we may let it go. But for now, we're still on the bandwagon and it looks like there is at least a little hope we may get some of the benefits for our family that we were hoping for (faster bonding for Gail and Ira, more uncomplicated one-on-one time for me and Leigh, better sharing of nighttime parenting...and most importantly, a damned impressive party trick. You have to admit it is pretty cool to both be out and about and both be able to nurse, which we did at a parent group last week).

One final note, it would be very hard to be in Gail's shoes if you had never nursed before. Even highly successful induction likely doesn't result in full supply, and several of these early feedings have been extremely frustrating. If it were also a first experience nursing, all while your partner has copious milk, and while trying to get up an running as a parent for the first time, I could imagine it not going well at all, and possibly doing more harm than good. Our experience has made me not regret at all that I did not induce lactation for Leigh. Given all of the other stuff I was working out about being a non-bio-mom, it would have been really hard, especially given my personality, and likely for not much payoff in terms of bonding, since we bonded so well anyway. I feel like our original lesson still stands: Nursing is great for bonding, but primarily because it guarantees time with your baby. Ultimately, time is what is important.

Sunday, June 21, 2009

Sharing Lactation, Part II

After Ira's birth, I was in rough shape. While Gail and I were admiring our brand new son, our doctor was assessing the damage. After several minutes, she said to me very gently that she was going to need to stitch me up in the operating room, under spinal anesthesia, "It will be about 20 minutes," she said "You enjoy your baby right now." It was actually a total of about 45 minutes before they rolled me out. I snuggled him close, we sang him a song, I was in awe that this whole baby had grown in my body and actually made it out, but he wasn't really interested in nursing.

When Gail picked Ira up before they took me out of the room, I said to her "Hold him. You nurse him if he wants to."

I know separations like that after birth can be really hard for lots of women. As I was laying there in the OR, I remember noticing that I really felt OK. I was so relieved that Ira was with his mom. I knew Gail was snuggling him, and it turned out that as she held him, he perked up, and started to nurse.

Since that first session, I've been nursing Ira. Even though Gail has milk since she has induced lactation, we wanted to make sure that my supply was well established before introducing a new variable, sort of like how you wait a few weeks to introduce a bottle. Now, at 3 1/2 weeks, that time has come, and today or tomorrow, Gail will nurse Ira, starting with one feeding a day.

Those first few days, when nursing was really hard (it went OK, but it was painful, and Ira was sluggish about learning to latch) and I was so exhausted, I sometimes wanted to just hand him over and say "You do it. You already know how." But we knew I needed to stick with it, and now Ira and I have worked things out. We've had some minor problems with over-supply but those are balancing out, too. He's growing wonderfully. I feel so proud that my body made this beautiful baby, and that now I am sustaining him.

On the eve of Gail's nursing debut, I find myself a bit reluctant to share.

There are lots of reasons that I will share anyway, not least of which is that I'm the one who nagged Gail until she agreed to induce lactation, and my reasons for wanting her to do so still stand. I also know that even though I find it satisfying to be Ira's sole source of nutrition, at some point, not too long from now, it will also be a burden. Even though I'm sticking with our plan, and am mostly happy to do so, my slight reluctance is interesting, and I want to know where it is coming from.

I'm reminded of a conversation I had with another mom back when Leigh was a baby. She was saying how her husband was taking to parenthood more slowly than she had hoped, that he didn't seem interested in the baby. I asked if he got any time with the baby, maybe even time alone, and she said that no, that it was too hard for her to leave the baby with anyone else (even the father), and that she cried if anyone else ever fed the baby. I confess that though I said supportive things, what I thought was that she needed to suck it up and hand over the kid, at least every now and then, if she had any real desire for her husband to parent their child. Three years later, it appears I'm experiencing some version of that same reluctance. Oh, I'm more than happy for Gail to trot off to the park alone with Ira after he's fed and show him off to the neighbors. I have zero qualms about her providing lots of his care once we're back at work. I don't think I'd be feeling this way if we were planning standard bottle feeding of my milk (like we did for Leigh). But nursing? It stings a bit. Now, I don't think I'll cry when she feeds him, but I'm not at all sure, so I guess I need to apologize to the universe now for some of the mean things I thought about that other mom.

There's also some piece of my reluctance that has to do with how much darn attention Gail gets for inducing lactation. When people find out that we're doing this, conversation always gets sucked into a giant lactation vortex, from which no other conversation topic can escape. Yes, it is super-interesting, but I sometimes think snarky things like "But wait! I grew the kid! And she only makes 10 ounces a day! I make like 3 million!"

Along similar lines, I find I'm having some non-bio-mom insecurity. She's getting all of these kudos for being the most deluxe NGP ever, and I find myself craving more credit for the work I did the last time. It's like I was some sort of first run model of a non-bio-mom, that still needed some bugs worked out, and all that work I did to connect with Leigh and parent her without the benefit of a nursing relationship, still comes up short. I already grappled with feeling like I came up short next to Gail when we just had Leigh, but now I'm wondering if I come up short as a non-bio-mom, too.

But at the same time I'm feeling these not-so-nice things, I'm also feeling thrilled that Gail is now voicing a real desire to nurse Ira. Back when I was pestering her to seriously consider it, her reasons for doing so were primarily logistical, and also probably to get me to shut up about it. She was reluctant to nurse again, partially because of the complications she had while nursing Leigh, and also because we both understand that nursing does not make a mother. But now that our son is here, she really wants to nurse him for him, not for some ideal of sharing care or doing nights "better" than we did last time. I love that. It makes me truly happy that she's excited about this.

I also have been thinking back to those moments right after Ira was born, when I got to know that he was close and secure with his other mom, and I didn't have to panic that we were separated or that he hadn't nursed during the 45 minutes I was with him before being rolled away to the OR. That was such a gift. Just like right after he was born, I won't always be able to be with Ira. I feel better knowing that when I'm not there, his other mom is providing for him.

(See also Sharing Lactation, Part I)

Sharing Lactation, Part I

Either Sunday or Monday, I am finally going to take the plunge and begin nursing Ira. At this point, I'm pumping about 10-13 ounces a day, or a little over 2 ounces each time I pump (5x daily). This isn't enough to be the sole milk supplier, but it is enough to feed half of a baby perfectly well. My supply is still increasing, but it is likely that I will need to supplement with pumped milk during days that I am home with Ira alone in the fall.

We're going to start the ball rolling by having me nurse once a day; Lyn will pump to keep up her supply. We are thankful that supply isn't much of an issue for her -- if anything she has a little too much -- but we still need to safeguard her milk. My first nursing sessions will be during the day, but if that goes well, we'll probably quickly transition to having me take over the second nighttime feeding (around 4 or 5am). In this feeding he nurses a little less actively and it should be relatively easy for Lyn to hold off on pumping until she wakes up (so that she'll actually see a sleep benefit from having me nurse).

I'm feeling a combination of excitement and anxiety. As I pumped myself dry earlier today, I told Lyn, "I feel like I'm cramming for an exam!" Really, it feels a bit like going out on a first date with someone who has been a friend for a while but who you are hoping will be a little more. What if he doesn't like my milk? What if he won't latch on?

Nervousness aside, I can't wait to get my hands on him (or, rather, my boobs). I wonder if Lyn felt this same way as we got close to doing Leigh's first bottle feeding, or if this feeling is different because it involves my body. I suspect it is a very similar feeling. Lyn and Ira get to spend so much time together, and Lyn gets to provide for his most important physical need in a way that I have not been able to. I'm ready to start providing for my baby, and I'm hoping that both Lyn and Ira are ready as well.

(Interested in hearing Lyn's feelings as we move forward: Sharing Lactation, Part II)

Monday, June 15, 2009

Sleeping like a Log with a Baby?

Cosleeping CatsMany parents report that the birth of their first child represents the end of sleep. There's the difficult newborn stage to get through which requires you to be up every few hours, but it's more than that. Parents report that a kind of hypervigilance sets in that keeps them from falling or staying deeply asleep.

I'm a little different. As a child, I struggled with insomnia. As a childless adult, I was easily awakened by noises at night (much more so than Lyn). As a parent, I sleep like a rock.

It seems strange to me that while so many other parents seem to become more sensitive to their childrens' needs, waking at the drop of a hat, I have learned to sleep like the dead. It happened while Leigh was a baby. For a while she was sleeping in the bed with us and she was a restless bed companion. I think she would have nursed all night if I had let her. So I would wake up, feed her, coax her back to sleep, and then roll over and ignore her hard. I learned to fall asleep quickly with a noisy, wriggling baby right beside me, wanting to nurse. I aslo learned to stay asleep through Leigh's noises until she was really, insistantly hungry.

Parenthood turned me into a much better sleeper, so you might ask what happened to Lyn. Back when we were first married, Lyn could sleep through anything. After Leigh was born, Lyn often had to sleep in the other room if she wanted to get any sleep at all. She woke up every time Leigh rustled or whined in her sleep and had a hard time returning to sleep after wake-ups.

With Ira's birth, I'm still a champion sleeper. I can sleep like a brick with him on my chest or snuggled in my arms. Because I had become such a good sleeper as a nursing mom, Lyn wondered if (hoped that) once she started to nurse Ira, she would become a champion sleeper, able to pass out after popping a boob in or to sleep soundly through Ira's rustling. No such luck. She finds that she is still hypervigilant. For a couple of nights last week, she slept in the other room and I brought Ira out to her, just so she could have a chance to get some really restful sleep. She reports that things are a bit better this week and she's able to get good rest with the baby in bed, provided that the baby isn't snuggled right up next to her.

So that's the sleep report from here. Ira is doing three-hour stretches and Lyn gets to sleep in most mornings, so we are all doing OK. But I am curious. Anyone else out there sleep better with a baby than before, or am I just a freak of nature?

Monday, June 8, 2009

As close as you'll get to a birth story

Instead of telling the birth story, I will do what I love most: give unsolicited advice. You already know we didn't want to be at the hospital for Ira's birth, but it turned out being at the hospital really did go OK. I still wouldn't have chosen it, but we managed not only to avoid the C-section I was so afraid of, but also to have a really good birth. In retrospect, there were several decisions that helped to make that happen, so I want to pass them on.

1) We prioritized sleep. Our process from first hospital admission to baby took over three full days (Sun night 5/24 through Wed night 5/27). I wasn't in labor that whole time, but it was a long haul. There were two decision points where we went against doctor recommendations and prioritized rest over continuing to push an induction that wasn't happening. The first was on Monday afternoon. I had cervadil placed on Sunday night, and had a really good response to it. It popped me into decent early labor and looked like I might not need pitocin. I labored into early afternoon, but then contractions fizzled and it was clear we'd need to soup things up. But at that point, it was getting late, and I really didn't want to start a pitocin drip in the evening, only to be up all night in "real" labor. At our doula's suggestion, we asked our doctor to release us so that we could go home, eat and sleep. She reluctantly agreed, scheduled us for continued induction (with a different doctor) the next morning, and then helped us carry our bags to the car (what doctor does that?!). The next morning we showed up fed, rested and ready to get the show on the road.

The second point that we prioritized sleep was early Wed morning. I'd labored all day Tuesday on pitocin, and eventually reached really high doses that got me close to active labor but not quite. I really wasn't making meaningful progress and the doctor suggested rupturing membranes. I was reluctant to do so and the doctor hesitantly offered a second option of shutting off pit, sleeping for a few hours, and seeing if it might work better in the morning, since sometimes that happens. I asked if I could eat while the pitocin was off and the answer was yes. That, and our doula's comment that Gail needed rest, too, sealed the deal. They shut it off. I stuffed my face with food before sleeping, and in the morning upon waking, and Gail and I grabbed a precious 4 hours of sleep. I never would have made it through "real" labor, once it finally actually started, without those periods of rest (and food)

2) We filtered information on progress through Gail. The strangest request on our "birth preferences" was for me not to be told information about progress at internal checks, especially information about how many "centimeters" I was. Instead, the doctor would check, and then talk to Gail in the hall where I couldn't hear, and she would share some information with me, but not all of it, and she could control the timing. This way, I was protected from that inevitable frustration of feeling like I'd been laboring forever not getting anywhere, and was better able to keep going. This ended up being absolutely critical, especially near the end of labor. At my second to last check, the one we now refer to as "the bad check," the doctor (we were now back to our favorite doctor, the one who was with us on Monday, and who I saw for prenatal appts) determined not only that I'd been "stalled" at about six centimeters for several hours of extremely strong and painful contractions, but that our boy was acynclitic. His head was tipped in the exact same way that Leigh's was during birth, and was pressing on my cervix in a lopsided way, making it hard for me to completely open. If I had gotten this information directly, it would have absolutely crushed me. Instead, Gail got the information. It did crush her (it was, in fact, the low point that she wrote about, where she wonders if she should have encouraged me to have an epidural right then and there). As the information filtered through the room, I felt energy seep away and frustration and fear seep in. But there was enough of a buffer that I was able to move on to the next step. Folks moved me straight away to the tub to change things up. Our midwife and doula dropped hints about the baby's position, and suggested things to try and that I ask our baby to move. I hung in there, but I figured out that Ira was positioned just like Leigh. I was able to do as they asked, but this was by far the hardest part of labor. I was feeling the urge to push far too early (which is what had prompted the "bad check" in the first place), and resisting that urge was the hardest thing I've ever done in my life. An hour later, it was clear that I was only marginally holding off on the pushing and we needed to do another check. I stated very clearly that if I had made no progress it was time for an epidural. I knew that was how Leigh had come. I knew it would be OK. But the next check turned out to be the one I actually wanted to hear. The doctor broke into a huge grin, "You are complete! You can push this baby out! He's at zero station!" The room practically broke out into a party. And wow, did I ever push. Our boy arrived less than a half hour later. If the info from "the bad check" had come to me directly, I wouldn't have been able to stick it out for that last little bit. It would have been fine. Believe me, I would have thoroughly enjoyed an epidural. But now that it is said and done, I'm so glad to have gotten the chance to push him out myself.

3) We had lots of (professional) support. We headed into this labor with an embarrassment of riches on the labor support front. Our midwife for our previously planned home birth was there in a doula role, and we went ahead and kept the doula we'd lined up for home already. We certainly felt a little silly heading in with two doulas, but figured it couldn't hurt. Turns out we needed both of their energy. With the process stretching on and on, they were able to trade off taking time with us, and were each able to get (some) rest and bring in new energy at different times. Our doula knew the hospital procedures well, and was essential in helping us navigate them and advocate for what we needed (see point 1 above re: sleep). They were both absolutely critical in keeping Gail going. After "the bad check" they were able to provide me with support that Gail simply could not have. Our midwife was an absolute lifeline for me through the most difficult parts of labor. Most importantly though, they both helped us understand what was going on and make the best decisions we could. That, more than anything, would have made everything OK, even if we had ended up needing surgery in order to keep Ira safe. No matter how things had turned out, we made good decisions the whole time, and we needed that supportive experienced presence to make those decisions. Now, do you really need two doulas? Probably not. One, and more reliance on the nursing staff would probably work fine (we really were boring for many of our nurses), but should you end up with two by a fluke of planning, go with it.

I guess that ended up covering a lot of the birth story anyway. It isn't the whole story. I left out good parts, like how my mom was there despite my insistence that I'd never want her at a birth, and it was wonderful to have her. I left out how it turns out that in the throes of labor, I'm still bossy, kind of funny, pessimistic, polite and worried about if everyone else has had enough to eat, which means that I'm still pretty much myself. I also left out some bad parts, like about the evil "Dragon Nurse." In any case, it was a wild ride. We're so happy to have Ira here safe.

Friday, June 5, 2009

Now I get it (being a non-bio mom is hard)

Earlier this week I was feeling like I had this whole two-kid thing locked up. Sure, I can take care of Lyn, keep the house clean, change poopy diapers, and deal with a toddler. No problem.

Yesterday I had to face up to the fact that it's actually hard. Sure, I can do everything needed to keep our household of four running, especially because I have the hands-on support of friends and family. But yesterday I realized that it's Lyn who does the lion's share of taking care of new baby Ira (yes! he has a name now!). I bring Ira to Lyn for a feeding and change his dirty diapers, but Lyn is the one who feeds him and who knows everything there is to know about his ears because she spends hours a day staring at them while nursing.

It turns out that being a non-biological mother is hard. I think it is especially hard for me right now because I remember being in Lyn's shoes, being the source of nourishment and having the close immediate bond that comes from nursing. I'm afraid I didn't realize at the time what a privileged position that was. I want Ira to need me and right now he doesn't. Yes, he will. Yes, I'm working to establish a bond that will be every bit as vital as Lyn's. But I want him to need me now.

Lyn and I were talking about these feelings this morning, and Lyn pointed out that Leigh needed much more active care-taking when she was a newborn. She demanded constant attention as a little baby (and, um, still does). Lyn had to learn to pacify Leigh very early; otherwise we would have gone crazy from all the crying and/or Leigh would have chewed my nipples right off. Ira (so far) just doesn't need as much, so there's less parenting for me to do.

I'll get over all of this. Ira will need more and more from me. Eventually I'll even get to nurse him. I'll grow more and more comfortable as an NGP. But before he was born I apparently believed that knowing all about the challenges of being a non-bio mom and already being comfortable with the role of mother meant that I would not have to feel any pain at all. Now I feel what I knew before in my head: that being a non-bio mom isn't easy. But it does come with a lot of benefits. I got to be with Lyn, supporting her in one of the most challenging things she'll ever do. I got to feel and hold Ira as he was being born. I even got to nurse him for a few minutes after Lyn was taken to the OR to get repair work done. And I get to fall in love with Lyn all over again because she's given such a precious gift.

Wednesday, June 3, 2009

Monday morning quarterback

It's really difficult to sit down and write about something as life-changing and intense as the birth of your son. I could write down a blow-by-blow of events from my point of view, but the more I talk about what happens the more ordinary the events seem and the further away the actual experience of them drifts. Instead I'll just try to get down a few rambling thoughts.

Over the last week or so I have come to appreciate Lyn's experiences three years ago. I appreciated her before, but labor, birth, and newborn time for a partner is very different that it is for a birthing mother (duh!). During labor, Lyn's only job was to focus on herself, but my
job, to a certain extent, was to manage the whole experience. I learned information from doctors that I didn't share with her because I judged it wouldn't be useful. I called family and decided what to share with them. I was instrumental in making decisions that potentially changed the course of labor, and it's really hard not to play the Monday-morning quarterback.

When I gave birth to Leigh a few years ago, I had a lot of clarity afterward. I knew that the birth went exactly how it needed to go, even though it was different than what we had planned. I had some regrets about not getting to birth Leigh at home, but mostly I felt the experience was wonderful and fundamentally right, both the parts at home and the parts at the hospital. Lyn had more doubts, and it took longer for her to come to terms with the birth.

I'm now in Lyn's position. I keep thinking about moments during the birth when I might have made a different decision and wondering if I was "right." In particular, I worry that I should have encouraged Lyn to have an epidural during the evening of the 27th. She was really struggling and I'm afraid that my decision about what to tell her and how to support her might have been based too much on my own experiences and not enough on what was happening with Lyn. For her part, Lyn says that everything happened just as it should have. She seems to see the birth as a series of events that went just right, including the bumps in the road. This is harder for me to do, just as it was harder for Lyn after my labor with Leigh.

Birth is a transformative experience for everyone involved. But I have learned over the course of two births that you don't get to pick the kind of transformation you have. Instead you have to be fully present and deal with each new twist in the road as it comes. It's great to plan ahead and imagine how you might deal with different alternatives, but things will most likely happen that you are completely unprepared for. That's the part that actually transforms you.

[By the way, all four of us are doing well. Lyn is recovering slowly but surely. I'm enjoying taking care of the family. Leigh loves nothing more than to kiss her baby brother and help with diaper changes. Our beautiful new baby boy is growing both in his body and in our hearts.]