On Poppy's First Birthday

In celebration of Poppy's first birthday, we went back to the NICU today to deliver gifts. We had done it before. I bought some preemie outfits and put them in a gift bag with this photo montage:


I dropped Rosemary off at daycare this morning and then Poppy and I took the long drive to St. Louis to meet Daddy up for lunch. After lunch, Daddy had to go back to work, but Poppy and I continued further into the city until we reached the hospital where both she and Rosemary were born.

The sense of deja vu that accompanies these visits always gives me the chills. Memories just washed over me: finding a spot in the parking garage ("I made it back to my car in the parking garage, sent Senpai a text asking him to take care of dinner, and then.... I dropped my chair back and took a nap."), using the elevator ("We laughed it off when the elevator took us to the basement, and then the sub-basement, but no one laughed when it stopped and the doors didn't open."), waiting in front of the NICU doors. Those memories seem like a lifetime ago... until I'm back there and it all comes rushing back. There were some changes, too. The bridge from the garage to the hospital that was under construction last year is completed. The roundabout to the back entrance is completed. With these projects done, the garage is metered again and no longer free (boo....). A new project that I hadn't seen started before is a beautiful waterscape descending from the front entrance to the back. I hope I get a chance to see that when it's done. 

Inside the building, the hallways were blocked off by new nurse stations and locked doors. I told the lady at the first station that I had gifts for the NICU, and she pushed the button to open the automatic doors. I walked a bit and avoided the next station by turning right to arrive at the NICU doors. I picked up the phone and told the receptionist that I had gifts to deliver. The doors swung open. 

This part lasted for only a moment. The receptionist was new, not someone who recognized us, so there were no happy greetings and no calling of free nurses to the front for a visit. I just told the guy, "It's this baby's birthday today. She was born here and stayed in the NICU, so we're celebrating her birthday by bringing preemie outfits for you." I handed him the bag and then walked out.

It was all rather anti-climactic. 

I decided to go to the cafeteria to see if they had any chocolate pudding for me to indulge in (it was my favorite lunch treat; I made quite a few facebook posts about it). I was happy to see plenty of dark pudding cups lined up in the cold case, but then I realized I couldn't afford one, haha. I had always eaten with a nursing mother voucher before! I was full from our lunch out with Senpai anyway, so it was probably for the best that I didn't further stuff myself with unnecessary treats.  

Not sure what to do next, I thought Poppy and I might go to the picnic tables outside where I used to eat. As we worked our way out of the cafeteria, I was thrilled to run into the lactation consultant who-- out of a group of three-- was the one who worked with us the most. It was a very serendipitous encounter.


The LC, Becki, was so thrilled to see us. She remembered Poppy's name and even recalled some details of her NICU stay, "She was one of those babies who did so well and then just conked out. Do you remember that? Around 36 weeks." Yes, I remember now. Becki loved hearing that Poppy breastfeeds so well, and further delighted in the fact that Poppy refuses to take bottles, "It's because you worked so hard at it. You did that." I did what I had to do. Everything that went wrong with Rosemary, I did the opposite for Poppy. I wish I had known better when it was Rosemary's turn, but there is nothing to be done about that now. It still makes me sad, though.

Becki took our picture to show to the other LC's and then we said our goodbyes. Poppy and I continued out to the courtyard.


We didn't stay outside for too long as the weather was cold and dreary. Making our way back through the cafeteria, we had another chance encounter with one of Poppy's NICU nurses, Kim.


After that, I let Poppy wander wherever she wanted to go.

The seats in front of the elevators...


and the stairs.


Poppy received many complements from passersby: She looks like Strawberry Shortcake! She's such a doll. Does she know how cute she is? They're all true.

We ended our visit with a walk through the gift shop. I bought Poppy a stuffed animal for a birthday gift, and I bought myself a bottled frappuccino. I didn't get my chocolate pudding, but no day at the hospital would have been complete without a vanilla frappuccino. I bought the place out back in the day! Overall, it was a lovely visit. I'm very glad we did this. 

Again.

Marching On

We participated in the March for Babies this past Saturday.



It was a rainy day.



We did not make any new friends like we hoped we would, but, like I said, it was a cold, rainy day. Nobody wants to stand around and chat in the rain. It was still an amazing experience to be surrounded by so many people who have been touched by prematurity. I'd look at the kids bundled up in wagons and strollers and wonder which of them spent nights in the NICU. Just one? Or, as in our case, all of them? And how many babies weren't there that day? How many are still in the hospitals?



During the opening announcements, when a singer belted out the National Anthem, I lost it. I  couldn't stop crying for the rest of the speeches. My tears blended with the fine mist of rain as I held Poppy's hands and helped her toddle around near the Chariot. The announcers standing on the dry stage were talking about the sheer number of walkers that day, in the past, in our local area, and everywhere. So many babies. Rosemary and Poppy are two success stories. But, as the yellow "In Memory" signs we saw at the end of the march pointed out, not all babies are so lucky. I am so very thankful.


My beautiful family.

Senpai mentioned places we could go eat lunch after the 3.1 mile walk. His most poignant idea was to go to the shopping center next to the hospital Rosemary and Poppy were delivered at, where many a lunch had been eaten before. It was a lovely idea, but I was cold, wet, and cranky. All I wanted to do was go home and curl up under blankets while nursing Poppy to sleep. My emotions were already fried; another punch to my heart would have sent me over the edge. So we went home. We stripped off rain-soaked clothes, I cuddled Poppy close under the covers, and we both drifted off to sleep together, counting our blessings.


We will do this again next year, hopefully in nicer weather.

Night Woes

Nighttime has gotten harder.

It used to be easy. Senpai used to take Rosemary upstairs and get her into bed while I nursed Poppy to sleep on the couch. Then I would carry Poppy up to her crib, kiss Rosemary goodnight, and Senpai and I would escape back downstairs. It was beautiful. We were guaranteed to be kid-free from 8 pm until Poppy woke up around 3 or 4 am. We even had our babysitter come one night, undetected by the kids, while we snuck out to see a movie. We should have done that more while we had the chance.

It started getting harder when Rosemary decided she was done having Daddy put her to sleep. Only Mommy would do. So then it was up to me to get both kids down because, though he tried, Senpai could not get Poppy to fall asleep. One after the other, I could get them both down by 9 pm. Of course, by then I'd be tired since I would have nursed Poppy to sleep by lying in bed with her for an hour. *yawn*

And now it has gotten even harder. Poppy is teething. It started with her wanting an 11 pm or midnight feed all of a sudden. And then it progressed. I would try to nurse her down, same as always, but she would pull off screaming, or wide awake, and certainly not the least bit tired. So we resorted to wearing her in the Boba carrier until she fell asleep. She spent the night before Christmas not dreaming of sugar-plums, but screaming. Oh yes, there were very many screams, and very little sleep. Christmas night had slightly fewer screams, but, oh, you should have seen the pains Senpai and I went through to keep Poppy out once she had fallen asleep in the Boba. Senpai carefully extracted her from the carrier (she was on my back) and laid her in bed, then I quickly tore my clothes off to hop in beside her, but not without accidentally ringing the bell we have hanging from our ceiling fan first. Senpai gave me wide eyes that said, "Are you kidding me?!!" Thankfully, the chime went unnoticed by the sleeping baby, and the bell now has a new home.

Each night since then has gotten slightly easier. For example, we didn't have to wear Poppy in the Boba to get her to fall asleep tonight. And there have been no screams. On the downside, Poppy has decided that she will not sleep without me. Oh, she'll nap during the day. That is, if I can get her upstairs still asleep without Rosemary shouting something random ("Tinkerbell! Where are you??") and waking her up first. But no, there is no nighttime sleep without Mommy anymore. So that is why I am typing this blog post on my phone. Pecking each letter out with one finger while I lie in bed next to a sleeping baby, with my sleeping husband beside her.

No more kid-free time, sigh.

Ah well, it won't last forever. At least, not while Les Mis in still in theaters. Right, Poppy? Please?

Donor Milk

I just donated 580 ounces of breastmilk to a family in need.




I had pumped my heart out for Poppy while she was in the NICU. Even after she came home, I continued to pump to fill up bottles for her since she wasn't nursing well. Our neighbor gave us a deep freezer (for free!) that he had gotten from his grandmother but wasn't using. I started to fill it up. When we realized in early July that Poppy had a dairy sensitivity and I needed to give up milk, cheese, and butter.... that large collection of pumped breastmilk was suddenly a waste of space: we couldn't give it to her. So it sat. Every month a bit of dairy would accidentally find its way into my mouth, and every month we were reaffirmed that no, she still can't handle dairy. The milk continued to sit. She's five months old now, the milk is getting closer and closer to expiring, and who knows when she'll be able to drink it, if ever. I reached out to the community.

I first contacted the National Milk Bank on the recommendation from a friend. It's really interesting what they do. Instead of taking your frozen bags of milk and redistributing them as is, they combine milk from multiple donors and process it into a human milk product. This concentrated milk product is then sent to NICU's to be used for premature and seriously ill infants. That sounded great to me, but unfortunately, they would not take my milk due to my insulin shots. Because the milk is intended for such fragile babies, they can't risk any medication finding its way into the babies' mouths.

So I kept looking. A woman from Poppy's online birth group recommended Human Milk 4 Human Babies, or HM4HB. The website redirects you to their local facebook pages, where you join and write on the wall if you have milk to share or are looking for milk. Here is what I wrote,

"I live in Belleville in the STL Metro East. I have 580 ounces of frozen breast milk pumped between 5/14 and 7/6 that I cannot feed to my baby because she has a dairy sensitivity, and that milk was all pumped while I was consuming dairy. I take insulin and Synthroid for type 1 diabetes and hypothyroidism. The National Milk Bank will not accept the milk due to the above medications. My baby was born premature on 5/10 at 33 weeks, so this milk from the first two months of her life is very fatty and nutritious."

I joined both the Illinois and Missouri pages, but only wrote my offer on the Illinois page. I didn't want anyone as far as Kansas City, say, to get their hopes up, but still, even on the Illinois page, I received quite a few messages from interested moms up in Chicago. The first decided it was too great a distance, which I completely agree, and the second was a doula for a couple from Sycamore. She gave my information to the mom, B, and I asked that B contact me before the end of two days or else I would move on to the next interested party. B did call me on the night of the second day and asked about my health issues. The doula had not given her all of the details from my post, only that I had a lot of milk to offer. She took down the name of my medications, not sounding sure of anything until she asked how much milk exactly was available. I told her 580 ounces to which she immediately replied, "I want it." Her voice was filled with conviction, "I want it." Then came the issue of how she would get it. She asked if I would meet her halfway, say in Springfield, and I said no. Here's where I became a meanie, but really, there were other people interested in the milk, and I get stressed out just driving the girls 20 minutes to STL! She sounded disappointed and then hung up. A little while later I got another call from her, and she said her husband worked it out with his job to drive the 5 hours down here today.

I had just put Rosemary up in her room for naptime and snuggled Poppy into the mamaRoo when B's husband, S, knocked on the door. He was a genuinely sweet man who was so in love with his daughter. He showed me a picture of her and just beamed with pride. He said he and his wife have been married for 17 years and this is their first child, now 3 months old. His wife is doing everything including taking medication to try to breastfeed the baby, but she isn't making enough milk. He brought some coolers inside and we loaded them up. The stash plus extra ice completely filled one large cooler and another medium sized one. I also gave him a list I had compiled of the dates, times, and amounts of each bag of milk, cause I'm organized like that.

When he was about to leave he pulled his wallet out and said he wanted to compensate me. I thanked him but turned him down. I didn't do it for money. I pumped all of that milk for my own baby, and when she couldn't have it, I'm glad to have found another (maybe even a better) use for it.

4 months, 2 1/2 years, and Peter Pan

Hello! Here I am. Did you miss me? I'm stopping by to let you know that on the nights where I really have something important to say, I'm too tired to sit down and type it out. Then on the nights where I have time to sit and write, I have nothing terribly interesting to say. Simply put, when you don't hear from me, just imagine all sorts of deep and profound parenting moments going on, and when you do hear from me, you can skim it because it can't be that great, lol!


Poppy is 4, almost 5, months old. She reaches for toys, smiles like she means it, and dances her little heart out on the changing table. The girl is a kicking machine! Though she still needs her reflux medicine and will tell you on the dot when she needs her next dose, spit-up has dramatically reduced. She still can't handle dairy. I cannot wait to one day (not anytime soon, mind you) wean her off breast milk and then have an ice cream party all to myself. Chocolate Milkshake? Sure! Mudslide? Even better! Let's whip up a pot of macaroni and cheese, too, just for good measure, hmm? Alright, I need to stop salivating on the keyboard! I must say that Senpai has been my savior here in the keep-Mommy-dairy-free effort. Without his trips to specialty stores in St. Louis to keep me stocked on dairy-free yogurt, cheese, butter, and (even more importantly) CUPCAKES and BROWNIES, I would've gone off the deep end a while ago. I'm not saying I would've given up on breastfeeding Poppy-- nuh-uh, I've got an iron will there-- it's just that I would most certainly be more miserable about it. Poppy and I thank you, Senpai.




Rosemary is growing like a weed. She is 2 1/2 now. It is safe to say that she is daytime potty trained. We're still working on reducing accidents at night. Though I say she is daytime potty trained, there was a rash of accidents recently because I up and moved her little potty from the living room into the bathroom with no warning. Apparently I was supposed to move it gradually-- about a foot a day-- until it ended up in the new location. Whoops, oh well. It was two days of messes, but she has since recovered nicely.



Rosemary's favorite game at the moment is to be chased. If no one is chasing her, she'll still run around in circles and say, "Peek-a-boo! I see you!" when she gets back to you. She has recently picked up my saying of, "Sleep well," when I put her down for bed. As I leave the room she could say anything from, "Nigh nigh," to "Sleep well," or even "See you later!" And sometimes all of the above. Though she picks up new words and sayings every day, she still strings together long sentences of gibberish just to hold your attention for minutes at a time before finally ending with a single real word. Granted, she has been throwing more real words into the middle of those gibberish sentences: "Pan! fgdskjds;odopid In the sky! dfkljdsofiufwei Fly! gfoepewop[eiof Smee! dkljfdoewiofl In the water! fgopifdoifnewkfn Tick tock!" She has so much to say about Peter Pan, it's adorable. :-)

Speaking of Peter Pan, that is our costume theme this year. Rosemary is the plucky boy herself, while Poppy is none other than the impetuous Tinkerbell. Senpai and I will be Captain Hook and Tiger Lily respectively. Here's a sneak preview of our little pixie:




Well, time to sign off.

Poppy looks adorable as ever, and I.... still look like a mom.

Precious Cargo

Precious Cargo

The house is quiet. I sit at my desk, completely aware of how lucky I am to have nothing else to do. That's not true, really. The house is a mess; there is always laundry to be done, dishes to be washed, sticky surfaces to be wiped, cloth diapers to be folded, etc, etc, etc... But I won't do any of it right now, because I don't want to disturb my precious cargo.



She doesn't nap well without me. Her little eye just peeked open, challenging me to put her down. I'm watching you. Really, I should be pacing, lulling this baby into a deep sleep, but I'm pausing for a moment to write. And since I don't want to type on my phone as I do my rounds of the dining room table, I will sit for a moment, get up, sit for a moment, get up. This is why I haven't written much since Poppy's been home. :-)


Floor Sleeper

I went upstairs to retrieve Poppy's reflux medicine from my bedside table, and this is what was waiting for me:



What inspires a kid to sleep on the floor when there is a perfectly good bed right next to her? I have to wonder, did she drop like a fly, or did she pause for a moment and think, "This looks like a particularly comfy stretch of carpet." It boggles the mind.

The reason for the weird framing of the photo is because I was trying to exclude her naked bum from the shot. ^_^ Speaking of which, potty training is going great. She is 100% diaper-free, and, while accidents still happen, their frequency has diminished.


Three Months



Poppy is three months old now. She eats every hour during the day, and then goes for five hour stretches at night. Reflux has got her bad. I walk around with a prefold tucked into my back pocket like a waiter with his napkin, so I always have it on hand to mop spit-up off my shoulders, Poppy, and the floor. She "snacks" every hour as this is easier on her stomach than taking full servings every three. But she nurses every time. And the nipple shield is a long forgotten memory. Yeah, we're doing well.

Quick Update

Just jumping in for a quick update here...

Rosemary's favorite teacher resigned from her daycare. She hates going to daycare now. She throws fits when we try to take her in the morning, and she's crying when we go to pick her up in the evening. I need to better learn how to handle both kids together because we can't keep sending Rosemary there.

Poppy nurses 100% of the time. Occasionally Senpai and I will heat up a bottle in a desperate attempt to try to settle Ms. Crankypants in the evenings, but she usually won't drink it. I saw a lactation consultant today, one of the ones who had worked with us while Poppy was in the NICU, and she was thrilled to see our progress. I told her how we were still using a nipple shield. I had experimented more with not using it in the past, but this week we had been using the nipple shield for every feeding. The consultant said it's time to wean Poppy off. It's past her due date and she's strong enough now to get a good latch. Yes, she'll be frustrated that it's gone, but now's the time for it to go, before she gets hooked on it. I'm thrilled.

I am so close to being able to feed my baby with no props whatsoever. No breastpump/cooler/hot water/bottle setup that I had with Rosemary. No nipple shield that I have to wonder where it is and fear if it will fall off, Poppy will knock it off, or it'll poke her in the eye. None of that. Just a good nursing bra, my baby, and me. Thrilled!!!

Breastfeeding Issues

Poppy does breastfeed, but we are having issues. She spends much time awake and uncomfortable (read: screaming) whenever I eat dairy, and even with removing dairy from my diet she spits up multiple times after most meals, arches her back after feedings, is very gassy, and she pops on and off the breast. You can see we're having fun over here, right? Here are some problems we are possibly encountering:

Dairy Sensitivity
The dairy problem was easy to diagnose. I'm still figuring out just how sensitive she is. Milk and cream are definite no-no's, but are cheese, yogurt, and butter okay? I don't know. I need to cut them out and gradually add them back. In the meantime, Senpai stocked the fridge with soy milk, ice cream, cheese, and yogurt for me. Except that babies can be sensitive to soy, too. (!) For now, I think we're okay with soy. Maybe after I address some of our other problems, if Poppy still seems uncomfortable, I'll continue trying to eliminate more things from my diet and see if it makes a difference.

Reflux
The frequent spitting up and back arching point to baby reflux. I will address this with our pediatrician and see if she thinks Poppy would benefit from medication. I can say that it definitely is not as bad a case as Rosemary had. Rosemary needed to be either reclined or lying on her stomach to comfortably fall asleep, whereas Poppy is perfectly content lying flat on her back. Rosemary didn't spit up like Poppy does, but they both are and were very gassy babies. Yay for preemie reflux! :-/

Fast/Overactive Letdown
This problem is on my end, obviously. Poppy's spit up, gassiness, and popping on and off the breast also point to fast/overactive letdown of my milk. I know this problem is exacerbated by pumping. I have reduced how much I pump to only about three times a day, based on how well Poppy breastfeeds, but it still seems like I have too much milk for her. I have to pump because she doesn't always breastfeed well, and those days require me to put milk in the fridge for bottles for her. It's a difficult balancing act of milk in the breasts vs. milk in the fridge vs. happy awake baby or sleepy disgruntled baby. I wish I didn't have to juggle these factors, but I do. I need to schedule an appointment with the lactation consultant and see what can be done. I guess I'd feel better if I had more of a concrete plan to follow, as opposed to being at the mercy of these separate but related elements.


So there's the plan for now: eliminate dairy (working on it), see the pediatrician (appt. scheduled for the 10th), see the lactation consultant (need to call tomorrow). I really hope we can iron out these issues so Poppy can be a happier baby and so we can have an easier time breastfeeding.  

Exactly Where I Want to Be

So.. you all know about my breastfeeding challenges with Rosemary, and how determined I am to breastfeed Poppy. Three weeks have gone by since we brought her home from the NICU, her due date passed by last Friday, and I keep asking myself, "Are we there?"

I haven't wanted to give myself an answer yet. Some days are great. Other days, not so great. But the trend is heading upward, and I am glad. Yes, I am so glad and happy at how she eats: most times with a nipple shield, occasionally without, and sometimes with a bottle when she's too tired or frustrated to nurse. But the bottle feedings are becoming less and less.

I struggled earlier this week with not being able to find the right time to pump. It always seemed like the moment I finished pumping my breasts dry would be the moment she would wake up hungry. I eventually had to stop and ask myself what I was doing: if I wanted her to get the milk from my nipples, why was I pumping it out? I had to let go of the notion of "pumping to maintain a supply." Let go of the fear and jump in headfirst; let Poppy create the demand for the supply. She hasn't let me (or my boobs) down. She's gaining weight and getting stronger every day. I change lots of wet diapers. What is there to still be afraid of?

Don't get me wrong, I still pump. I'm not making the same mistake I made with Rosemary when I stopped pumping completely. When I'm too engorged for Poppy to effectively nurse I will pump for 5 minutes prior to feeding. If I still feel pretty full after she's done, I'll pump 5 minutes after. If she downs a whole bottle instead of nursing, I'll pump a full 15-20 minute session. All of this equates to about three times a day.

I've stopped watching the clock; she tells me when she's hungry. Our clothes are soaked, we both smell of warm, spoiled milk and spit-up, and I know right where we are: exactly where I want to be. Even though there's a part of me that's too afraid to give voice to the answer of, "Are we there?" I feel it. It radiates from my heart.

Singing and Eating

Rosemary sings. For awhile she would sing, "Na, na, niiii! Na, na, niii!" It's supposed to be the name game from Pooh's Heffalump Movie, shown below.

The song starts at 0:39.

Now, she also sings, "Dow-ie dow... A dowie dow!" Which is her version of The Farmer in the Dell. I'll try to catch video of her doing it sometime. I sang that to her once because she asked me to sing a song about cheese. Having no other ideas, I remembered the cheese standing alone at the end.

********************

How did I end up in this position again?

Poppy came home on Monday of last week. I prepared a bottle for her after every nursing session. She would nurse strongly and still drink a half to a whole ounce from the bottle. On Wednesday I asked my lactation consultant how to wean myself off the breast pump. I spent a lot of time last week drenched in breast milk; it was super plentiful. I was making far too much milk for Poppy, and it was actually a problem. The engorged breasts were hard for her to latch onto, and the excess foremilk gave her digestive issues. I was given the advice to pump for only about 5 minutes - certainly not until I was empty. I followed those directions, and felt a lot more comfortable by Saturday. Sunday, Poppy didn't nurse well. On Monday I found myself struggling to rouse her enough to finish a bottle. She's getting better now, but we're doing more bottle-feeding. She either falls right to sleep at the breast, or she'll aimlessly (and endlessly) root without latching on. I'm back to pumping for full 15 minute sessions, usually because Poppy didn't drink out of the breasts at all.

I need to remember that she is still a preemie. Yes, she is a month old now. No, I can't just run out of the house for a day trip without bottles and expect her to eat well. I hate that I still have to pump these full feedings out, but I need to remember that it won't last forever.

I wish to remember worrying over numbers: Is she being fed every two and a half to three hours? How many ounces is she drinking? Can we get her to finish at least two ounces? Is she gaining weight, ounce by bitty ounce? Has she had six wet and three dirty diapers today? Numbers, numbers, numbers.  

Empty Arms

Poppy is 35 weeks old today. Look, isn't she beautiful?


I've lost the pep in my step. Tears spring up in my eyelids and I blink them away. When I'm smart, every meal includes coffee, not only to keep me awake, but also to inject some life back into this empty shell. Mostly, it just makes me feel jittery. But that could be the low blood sugar.

Walking by pamphlets displayed on the wall, "Heart Screening, Schedule Yours Today!" My heart is on a schedule. Hold and try to nurse Poppy at 9:00, noon, and 3:00. Turn off my heart while I pump, use the restroom, and eat something in the hours between. Go home. Light up at the sight of Rosemary lighting up for me. Figure out dinner, pump through the night, then start again the next day. This is getting old.


The variety in my day comes from choosing which restroom to use.

"It won't last forever," my Mom tells me over the phone. I know. That's the thought I pull my strength from. But it's 4:30 and Poppy is wide awake and actively rooting. This is a problem. It isn't one of her doctor decreed scheduled feeding times. As a mother who chooses to nurse on demand, it kills me. She was sleepy and did not eat at the previous three feedings that I struggled to give her (please just suck, baby, please), and here I see her, practically begging to have a nipple put in her wide mouth, and I'm not allowed to. I put my pinky finger in her mouth and gently stroke the tongue to help her learn how to coordinate her sucking while my heart shatters on the floor.

Senpai's boss gave him the day off today. I must admit I am jealous. I don't get days off from this. Looking forward to the day when I can bring my work home with me.

9-5 NICU Mom

Here she is!


I'm settling into my new gig of being Poppy's NICU Mom. Every morning I drive through rush hour traffic into the city, scramble to find a spot in the parking garage, rush to Poppy's bedside, then start the routine of feed, pump, and eat that cycles in three hour increments throughout the day. It's quite enjoyable, actually (minus the commute), but I should really bring my phone charger; my poor phone's battery can't handle being my sole source of entertainment all day!


I've got to say, I feel like an old hand at this. Senpai feels it, too. We've got a "been there, done that" nonchalant attitude about Poppy being in the NICU (we earned our stripes with Rosemary after all). I was not thrilled with the spinal tap, but otherwise, Poppy's development as a preemie is right on track. Since I've got experience to share, I figured I'd put together some pointers for new NICU parents.


GUIDE TO BEING A NICU PARENT

When it comes to premature babies, the goal of the NICU is as follows: intervene as medically required, and then slowly remove those interventions until baby can thrive on his own. The three things that all babies must be able to do before they will be sent home are:

1. Control their own temperature.
A baby should do well to be lightly dressed in a 70º room. Preemie babies initially need help holding their temperatures, especially in their hands and feet. They will be put on warming beds or into isolettes until they've got it down.

2. "Nipple" all feedings.
Nipple in this case is used as a verb. Whether the baby takes her food from a breast or a bottle, she must consume enough calories around the clock to meet the final goal.

3. GROW
Eating and controlling temperature use calories. The baby must have enough food in his tummy to do both those things, and still have plenty to spare to grow big and strong.


Here are some tips that will help you feel more involved in your baby's stay.

1. Know Your Nurse
So what do you do while in the NICU... just stare at your baby? Well, yes, depending on baby's level of prematurity. Even if baby is in an isolette, you may be able to at least change her diaper. Just ask the nurse. The worst she can say is no, but she might even say yes. And guess what? Every nurse is different. Just because yesterday's nurse said no, doesn't mean today's nurse will, too. Doctors make the orders, and it's up to the nurses to follow those directions, but not everything (such as being able to hold your baby) is set in stone.

2. Know What You Want and Tell Everyone
Let's say that it is very important to you that baby learns to breastfeed. If you're a regular reader on this blog, you know that to be true for me. What am I doing about it? I am telling everyone. Every nurse, doctor, and lactation consultant in this NICU knows about my struggles with breastfeeding Rosemary, and my desire to get it right this time with Poppy. I may sound like a broken record to myself, when I think of all the times I've had the same conversation with a different person (Poppy hasn't had the same nurse twice yet!), but I would much rather that than the alternative of nobody knowing and my wishes not being granted.

3. Talk to the Doctors
This point seems obvious, but I'll be honest with you, I did not do this so much with Rosemary. I would hear the doctor's orders from the nurses and then leave it at that. I assumed that the doctors' wills were set in stone, and nothing I could say would change that. That is not at all the case. In this NICU stay, I have already convinced the doctors to not add a mandatory bottle after a breastfeeding session, have increased the number of breastfeeding sessions, and turned down a spinal tap. They ended up talking my husband and I into the spinal tap anyway, but at first I said no. Do you see the pull you can have in your baby's growth and development? All of this is possible because I am there for the morning rounds (see below), I put a sticky note with my contact information on Poppy's bed, and I give every opportunity for these dialogues to happen. You should, too.

4. Attend Morning Rounds
This is when the doctor goes over the notes from each baby and determines their plan of action for the day, such as administering which medicines and removing what aid. If the parents are present, the doctor gives them the opportunity to ask questions and ADD THEIR INPUT. The second part of that sentence is very important. You may not be a medical professional, but you are absolutely just as much a member of your baby's care team as everyone on staff. You have a say in how your baby is handled, so say it.


There you go. I know being a NICU Parent is not a job anyone would willingly apply for, but you don't have to feel helpless or out of control. He's still your baby, and you're still Mom (or Dad). Much love and strength to you.

Nippling Day

Today was a much better day than yesterday. I got to hold Poppy three times! Each time, we tried to breastfeed. I had the help of two different lactation consultants for two out of the three feedings, and the consultants were impressed with Poppy's latch each time, though the little lady quickly passed out before any breastfeeding was done. She isn't used to being held, and took a little bit too much comfort in it. :-)

Thankfully, the nurse today was extremely patient with us. Oh, how well a day goes depends heavily on the nurse! The nurse explained that Poppy is still getting a lot of nutrition from the TPN (electrolytes: baby Gatorade) and lipids going into her IV, and that will prevent her from being and acting hungry. So now we get to play the slowly-cut-back-IV-fluids-and-monitor-growth game, hoping that she learns to eat well enough to replace the IV fluids. I just hope we can find the point where she is sufficiently hungry enough. I foresee challenges in this arena...

Valid Reasons to be Concerned

First, we saw her face!!! Though she has been more than eager to show off that she is a girl, Poppy has buried her face deep into my pelvis during every ultrasound. Which is a lot. I'm up to weekly ultrasounds now, people. Well, Tuesday was a good day; the ultrasound technician printed off picture after picture of my girl's chubby little face. <3

This is the best one. Though she is squished up against the placenta here, at least her fingers aren't protruding from her forehead like demon horns. >:-(


Speaking of chubby.... girl's measurements are off the chart! My huge belly confirms this: Poppy is a BIG baby. This leads us to some problems with delivery, of course. My doctor's plan is to keep monitoring her growth (hence the weekly ultrasounds), and do an amniocentesis at 36 weeks to check her lung function. If her lungs show to be well developed by then, we'll be induced. If she needs more time to ripen, then I will most likely have to get a c-section closer to her due date. I've got my fingers crossed for strong, healthy lungs for the little miss (and I hope you do, too!), because I am terrified of getting cut open and having my milk be delayed coming in and ruining our chances of breastfeeding. This is my last baby... I really hope we can do it this time. Get it right this time. I hope.

In order to maximize our chances of breastfeeding, I wrote out a birth plan. I showed it to my doctor on Tuesday and she signed off on it, agreeing that the requests I made were do-able (under ideal conditions, of course). I asked for all the new age mom type stuff: no epidural, no episiotomy, immediate skin to skin contact after baby is born, don't cut cord until it has stopped pulsing, delay tests and evaluations by an hour, no eye goo, and no baths. I've done my research and all of these points make sense to me. I'm looking forward to my ideal birth scenario. I won't be crushed if complications arise and it doesn't happen all sunshine and roses as I'd like, but I do still like to believe it could happen this way.

An early delivery would throw a wrench in plans by adding a NICU stay to the equation. I got scared and freaked out on my doctor at the end of the appointment Tuesday. The nurse had reminded me that headaches and blurry vision were signs of pre-eclampsia, and wouldn't you know it, as I sat there under the fluorescent lights I started to get all fuzzy-eyed and tense in the brain. Compounded to those sensations are the facts that there will be a FULL MOON at the end of this week correlating with Poppy turning 33 WEEKS gestation (same conditions Rosemary was born under). Yeah, I was freaking out. My doctor talked me down, reassuring me that my blood pressure was still fine and there was no protein in my urine; everything looked good. She also reminded me that I can call or visit the office at anytime. She said most moms get jumpy around this time, but, being high risk, I have valid reasons to be concerned.

Lying here on the couch, gulping down water, waiting for the Procardia to erase these contractions that like to pop up every so often, yeah, I'm concerned.

the NICU post

(Are you a new NICU parent? Read here for tips about what to do during your baby's NICU stay.)


I go more in detail into the birth in a previous post, but I'll start here with a quick recap: Rosemary was born at 33 weeks gestation. With the full moon, my body tried to push her out. The doctors were able to stop the contractions, but my liver fought back in the form of HELLP Syndrome, demanding that the baby get OUT. Start up the pitocin; my body couldn't handle being pregnant anymore. That's how my baby was born.

She had received the steroids for her lungs while she was still in utero, so she came out with a healthy cry. At least three of the many people in the operating room focused on her as soon as she came out. Is she breathing? How's her heartbeat? Any liquid in the lungs? Very fast-- within a couple of minutes-- she was cleaned up, wrapped up, and brought over to me (though still out of reach) to see that sweet, tiny face for all of one second. Just as fast as they brought her over they took her away, out of the room, down the hall, to NICU. Senpai asked if he could follow, and then my family was gone. Being left behind, without either my husband or newborn baby in the delivery room was an intensely lonely feeling that tasted bittersweet. My thoughts were along the lines of, "I carried this baby for seven months, I've been in pain for her, I just delivered her, and now... I can't see her." I clung to the image of her little red face, already fading in my memory, as I was taken back to my room and monitored by the nurses. She had been born at 9:29 pm. When I still hadn't seen her two hours later, I demanded to be taken to her. I touched my baby for the first time at 12:20 am.

First trip to the NICU.

Entering the NICU, it was so uniquely different from the rest of the hospital. People had to be buzzed in, signed in, watches and jewelry removed, and hands and arms scrubbed with disinfecting soap up to the elbow (I just remembered the smell of the soap). Children, the little germ harvesters that they are, were not allowed in. Parents and two family members (that you choose, but must specify on a form) were the only people allowed to see the baby, but only two at a time.

The NICU was divided into different sections with varying levels of care, labeled from A to G. Rosemary started out in an open bed in the last room, G. After the first night they then moved her to an incubator (they call them "isolettes" these days) against the wall to the right when you walked in the door. The first time I saw her in the NICU, she was on her stomach in her open bed, breathing with the help of a respirator tube. I wasn't worried. I knew she had received the steroids for her lungs, and I had heard her healthy cry after she had been delivered. I think I was also too tired to be worried. I was just so elated to finally see and touch the tiny 4 lb 13 oz little girl that had made my uterus her home for so long. I was taken back to my room after only about 20 minutes because I was starting to fall asleep in the wheelchair.



I was not one of those Moms who spends every minute in the NICU. I was still healing for one, very exhausted, trying to get my body's systems back to normal, and two, I believed that the doctors and nurses in the NICU were taking good care of my baby. She wasn't sick, she just wasn't meant to be out in the world yet. All she needed was to grow and learn how to eat, otherwise she was a healthy little camper. She would forget to breath sometimes, and for that she was put on a daily caffeine injection. I never saw her get stuck with anything. I would see the aftermath-- a new IV line in her head, little red spots on her hands-- but the nurses did the dirty work when the family wasn't around. I'm sure seeing her in pain would have broken my heart in two.



Senpai got to hold her first. I wasn't there to see it, but he came back to my room looking so excited. The first time I held her, maybe two days after she had been born, was so magical. She was itty bitty and warm, and red like a little lobster from the jaundice.



Under the bilirubin lights.

I think it was the fourth day when Senpai came back into my hospital room after visiting Rosemary in the NICU and said, "They want to start putting clothes on her." I looked over at the duffel bag we had packed with things from home, inside of which I knew was a teeny-tiny sweater I had crocheted while I was still pregnant. I had followed a pattern, but even with using a larger hook size the gauge came out incredibly small and the sweater looked like it could fit a doll. I had shaken my head at the microscopic sweater when it was completed, wondering how it would ever fit a full-term baby. There in my hospital room, I felt foolish all of a sudden for wanting to put it on her. Senpai had asked me before if he should bring it over to the NICU, but I hadn't wanted him to, I don't know why. It wasn't until the "order" as it were came down from the nurses that I knew she needed that sweater. We went right over, me clutching the smallest little sweater in the world, and miraculously, it fit her. That sweater I made was the first piece of clothing my baby ever wore. There was a matching hat, too, but it wouldn't fit over the IV line they had just put in her head.



The first way her Daddy and I got to care for her was to change her diaper. I don't know about Senpai, but I felt odd doing it at first, like it wasn't my place. I thought, "The nurses handle everything, feeding, diapering, changing bed linens, etc... Who am I to care for my baby? Wait, I'm her mother. I'm supposed to be doing this anyway. But she's in their charge; they make the important decisions, not I. Oh well, just change your baby's diaper, already!" That's how my head struggled with the facts. But the more we did it, of course, the more comfortable we became being Rosemary's parents.



My Mom and Dad drove up from Florida after Rosemary was unexpectedly born. Mom was able to stay Easter weekend, but she had to return back to work after that. Dad is retired, so he stayed with us the entire time I was in the hospital and even later. I was discharged after a week, but Rosemary was still in the NICU. It was strange.. I was discharged home without my baby. I am so grateful to both of my parents for being there for me when I was weak. Senpai, too, of course. But it would have been really hard if Dad hadn't stayed longer. He helped around the house, drove the 26 miles when I was too tired to do it myself, and kept me company while Senpai was at work. He was glad to help, but he was also happy when Rosemary finally came safely home, so he could return home, too. Thanks, Dad.

I pumped breastmilk to go into her tube, but her little body needed more nutrition than I could provide at first, and she was given formula as well. It was actually more like she was given formula plus the little bits of colostrum that I produced. I put my heart and soul into pumping, waking up every three hours even into the night, trying to rev up production. It wasn't until after I had been discharged home that my breasts finally produced enough milk so the NICU staff could feed her breast milk alone without formula. I was so thrilled to get to that point. I worked with a lactation consultant to try to breastfeed, too. One day I was trying to breastfeed Rosemary behind a screen when I could hear the doctor going over Rosemary's chart with the nurses. A male nurse relayed that Rosemary didn't tolerate formula well, and the doctor got the wrong idea, thinking that I was stopping giving her breast milk. The female doctor became all bullish all of a sudden, "Where's the mom? She's here?" and she poked her head over the screen, while I had my baby to my breast, and demanded to know why I wasn't breastfeeding. I just looked at her incredulously. It's humorous now. I'm glad they had Rosemary's best interests at heart.



Even though the breastmilk was there, getting her to ingest it for herself was a tall mountain to climb. She was born before her sucking reflex had developed. Every day the nurses, Senpai, and I would try to put a bottle in her mouth, just to have her mouth form an "o" from which she would poke her tiny little tongue out. It was the cutest thing in the world. I said, "That's adorable, Sweetie, but it's not going to help you eat." When she finally did learn to suck, it started as only one or two little sucks and then she would stop, mostly from exhaustion. The rest of the bottle had to go down her feeding tube. Gradually she started to drink more and more, still never finishing her bottle. She was just too short on strength and energy. When she had been there for 18 days, I finally broke down. When I got there I learned that the nurse that day had put an entire bottle down her tube, without even trying to get her to drink it. That was the standard procedure-- If a baby doesn't do well for one feeding, just tube feed the next-- but I was ready to punch her. They wouldn't send Rosemary home on a feeding tube, and she wouldn't be rid of the damn thing if they kept using it without even trying to get her to drink the milk for herself. I expressed my concerns to the nurse in the nicest way possible without actually punching her. She went and found the doctor-- a nice Asian fellow, not the bull woman from before-- and after hearing what happened he changed Rosemary's feeding schedule from every 3 hours to... whenever she was hungry.



This simple directive made an unbelievably profound difference. What a brilliant idea! Feed the baby when she's hungry! And, oh man, she ate SO WELL after that. It turned out that every 5 hours was her personal schedule. The NICU staff squirmed at that timeline, not really liking the idea of pushing feedings beyond 4 hours, but it was so good for her. She wasn't eating at 3 hours because she was still tired! She was supposed to be sleeping then according to her own schedule, but here were these nurses prodding her awake and forcing a bottle in her mouth, expecting her to chug it down. But when she was hungry, 5 hours later, she finished the whole bottle, every single one of them. She was discharged a day and a half later.

 

The Beginning of the End

It was bound to happen sometime, but it's still disappointing.

My milk is drying up.

I've been sick for over a week. I'm getting better, but I just can't stay hydrated enough. My supply has diminished, and I'm wondering if it's even worth it to continue sitting for pumping sessions. Of course it is. It's just so disappointing to come out with so very little milk at the end of 15 minutes... 20 minutes... no difference. I'm lucky if I get two ounces anymore.

I had wanted to give R breastmilk for a year. That was the idea. We're almost at 9 months. She's doing fine, she's great, really. She doesn't NEED it in the sense that formula disagrees with her. No, the formula sits with her just fine. I want to give her milk because of the immunity. Get her through the winter. That was my thinking. But I got sick. She didn't, which is huge in favor of continuing breastmilk, but I have to consider my health. My mental health is pining the loss of its ideals, my emotional health is going down with it, my physical health is getting better, but like I said, I'm just not hydrated enough to produce more milk, and I don't see that getting any better. I'm a sinking ship.

So do I continue? All signs point to no. Order a bulk batch of formula from Amazon and let that be it. Stop the depressing pumping sessions and use up what little milk is left in the freezer. But what about the two ounces that I am still getting? Will I really be okay with... giving up? Beat around the bush, but while my body still makes milk, that's what this boils down to: giving up. I had thought that I would pump and pump and pump until the bottles came out dry. I hadn't considered the mental or emotional effects of such steadfast ideals. My heart is already broken at two ounces, what will I feel with empty bottles? Am I already there? Is this the worst I can feel about it?

I can't just give up.

I'll continue to fight. My heart won't let me give up. Not yet. Not while I can still squeeze some drops of liquid from these dried up breasts.

What 7 mos. Looks Like

R is 7 months old! Not that it happened today, actually it was October 29th, but I was feeling nostalgic and decided to write about what she can do now.

I love that she is 7 months old because she is so much more fun to be around now! Crying has decreased dramatically, and smiles and laughter have flourished. She is so curious, looking and smiling at everything. She especially loves the pets. Her favorite toy is her ladybug book. She didn't pay her much attention before, but she likes Sophie now. She will grab a toy and whip it up and down with ferocity. She has started burrowing her face into whatever body part of yours is closest and gnawing with her gums. I can't wait to see her first tooth... She says words now, though she doesn't realize it. We've heard her say "hi," "okay," and "yeah." She rolls over! She can go from her front to her back, but she still needs help getting from her back to her front. She sits up with support; I'm looking forward to when she can do it all by herself. She sleeps through the night (usually.. unless she's teething). She eats pureed food, and sucks frozen strawberries or bananas out of a mesh feeder. Just as of today she has figured out how to drink water out of a sippy cup. What else, what else, what else? I don't know! I am just so in awe of and in love with my little R-baby.

On a separate but related note, R has been in our lives for the past 223 days. 223 days of laundering cloth diapers, pumping breast milk, and washing bottles. Exactly how much time have I spent attached to a breast pump? If I average a pumping time of 15 minutes 6 times a day, then I would have pumped 334 and a half HOURS total. I say "would have" because that average grossly under-represents the truth. In the beginning, I pumped for 45 minutes EVERY 3 hours-- including during the night-- desperately trying to keep the NICU stocked with milk for my baby. And though now I don't pump quite so often anymore, I do sometimes pump for as long as 40 minutes, depending on how long R naps for and how drawn into the interwebs I get. But still, 334.5 is a lot of hours, and there are many more to go until I reach my goal of feeding R breast milk for a year. I can (and will!) do it!!