Monday, April 30, 2012

Sleep!

Well, I may not be able to breastfeed full time, but my baby is sleeping through the night (or at least she did last night). We both took a really long nap yesterday afternoon (like 3 hours). I was ready to head for bed around 2am, which is usually when she wakes up and wants her last feeding, so it seems like a waste of time to go to bed earlier than that and just have to get up again. I nursed her, then she wanted a bottle, then she wanted another bottle, so I got out of bed and headed to the recliner to feed her.

After she ate (and ate and ate and ate), she started to get tired so I thought I'd just rock her until she fell asleep, then move to the bed. However, I ended up falling asleep with her on my chest (I don't even remember falling asleep) and we didn't wake up until 9:30 this morning! According to the baby-tracker app, it was 6.5 hours since she'd had her last bottle... which means that we probably slept for a good 6 hours! In a row! I feel fabulous this morning.

Tuesday, April 24, 2012

24 Hour Breastfeeding "Cure"

I was once again googling things to do with low milk supply and I came up with this: the 24 hour breastfeeding cure. The basic idea is that mom stays skin-to-skin in bed with baby for 24 hours and does nothing but breastfeed and relax. The skin-to-skin idea sounded good. We haven't done as much of that as we probably should because it's been sort of cold. I haven't wanted to be naked and I worried about this poor tiny baby with no body fat getting cold.

Oxytocin is the hormone associated with love and bonding. It's also important for breastfeeding (needed for milk ejection, although it doesn't seem to be associated with milk supply). Oxytocin levels can be boosted by massage or skin-to-skin contact with the baby. Naps apparently also increase oxytocin levels, which makes sense to me. I always feel like I have more milk after a good nap.

I'm taking domperidone, which should increase my levels of prolactin (hormone involved in production of milk duct tissue and in milk production), if those are low. Spending the day nursing the baby skin-to-skin should increase levels of oxytocin as well as cause bunches of nipple stimulation and stimulate milk production. It didn't seem like a bad idea.

I began the experiment by sleeping skin-to-skin with the baby on my chest for most of the night. Either the skin contact or the pressure of the baby did stimulate milk production because I leaked all over the sheets. That was a positive start.

I decided it was probably unrealistic to go from supplementing with 10-12oz of formula per day to entirely breastfeeding, so I gave the baby 2.5oz in the morning. Then, we started our skin-to-skin nursing project. She nursed pretty constantly for most of the afternoon. She didn't nap much, probably because she was vaguely hungry... but she didn't really get fussy very much either. I finally gave up and gave her more formula about 7pm. That was a block of about 10 hours that we exclusively breastfed. According to our baby app, I nursed for just over 5 hours yesterday (and I know there was nursing time that I didn't enter into the app just because I was tired of doing it). We only supplemented her with about 6oz of formula, down from 10-12 over the past week. She doesn't appear to have lost weight during the day yesterday, but it's hard to say because her weight fluctuated by a couple of ounces between the various times we weighed her. My conclusion from the experiment is that skin-to-skin and mega-nursing time during the day are very valuable for keeping my milk production up, but it wasn't a "cure" for anything.

The downside is that I didn't get anything done except nursing. Not that nursing isn't valuable, but I can't spend 24 hours (or even 12, which is about what I managed other than overnight time) skin-to-skin on a daily basis. There are things that I need to do.

My guess as to the  milk supply problem is that I don't have enough milk-producing breast tissue and I don't have a lot of room for milk storage. I'm basing this partly on the diagnosis of the lactation consultant and partly on the (voluminous) things I've googled on the subject. The lactation consultant said that women with breasts that "look like mine" often have trouble producing enough milk. I've googled it and there is a breast shape (often described as "tubular"; the technical term would be hypoplastic) for which this is true. Whether or not that applies to me is hard to say. Some of the descriptions fit, but some don't. It seems like a reasonable diagnosis based on the fact that I'm not producing enough milk. The breast tissue I have seems to be doing its best - I almost always have some milk and will reliably be able to pump a half-ounce if it's been an hour since I pumped or nursed. However, it's just not enough to fulfill the entire demand being placed upon it. If the baby nurses the whole day, I can get nearly enough milk into her because she's always getting the small amount that's being produced. However, I don't seem to be able to produce or store enough milk to entirely keep her supplied.

My new plan is to feed her on demand, then if she still seems hungry after she's nursed, give her 1oz of supplementation. If she's still hungry after that, she can nurse again, then we can do another 1oz from the bottle. That way, neither of us is getting too frustrated.

Thursday, April 19, 2012

Adventures in nursing, update

Still not producing enough milk. I started taking a drug called domperidone. It's typically used for something gastric, but one of the side effects is that it increases lactation in individuals where low milk supply is caused by low prolactin hormone levels. It's used to treat reflux in infants, so it's safe for the baby and all the evidence is that it's not secreted in milk except at very low levels.

I started taking it about a week and a half ago. I started at 20mg three times a day, then bumped up to 30mg a couple of days ago (at our last Dr appointment). The next bump will be to 30mg four times per day, which I will probably start doing sometime over the weekend.

I'm drinking Mother's Milk tea four or five times a day. People online complain about the taste, but I think it's actually fairly pleasant. It tastes vaguely licorice-y. I was taking fenugreek capsules (three, three times a day). I've now transitioned to More Milk Plus, which contains goats rue in addition to fenugreek. Goats rue is supposed to stimulate growth of additional breast tissue. I ran out of the tincture that I'd been taking from the birth center, which probably had some of the same things in it. The tincture tasted awful, so I'm not disappointed that it's gone.

I've been trying to nurse Sterling before every bottle so that she gets some from me, then just the extra she needs from the bottle. I haven't managed to accomplish that every time. I've also been trying to pump more, but that's also proved to be challenging. I've been nursing Sterling every 2 or 3 hours through the day, then trying to pump afterwards... but if I'm home by myself and she doesn't want to be put down, I can't really pump. I haven't quite figured out the logistics of holding her AND pumping at the same time. If Mike is here, it's much easier. I've been trying to either nurse or pump every hour when I'm home. I would say that I've accomplished that goal for maybe 3 or 4 hours a day for the past week or so.

Typically when I pump, I get maybe a half an ounce (if it's been a while since she nursed). I'm actually hopeful right not that something might be starting to work because when I just pumped, I got 1.7oz! That's like 3 times what I've ever gotten in one session before. It's at least enough to make me feel validated and like it's worth continuing with this whole project. It's really discouraging to spend this much time and not see any change in output. I'm spending roughly 4 hours a day trying to feed the baby using my boobs (nursing and pumping)... and still not managing it. I'm mildly hopeful that things might be turning around, but I don't want to get too excited about it in case they're really not and tonights pumping result is just some sort of fluke.

Tuesday, April 17, 2012

On March 23rd...

Sterling is asleep in her swing, I've done the dishes and am eating leftovers. It seemed like it would be fun to google things that happened on March 23.

1775 - Patrick Henry delivers his "Give me liberty, or give me death" speech.
1806 - Lewis and Clark start their journey home, after reaching the Pacific Ocean.
1857 - First elevator installed in NYC.
1933 - Hitler becomes dictator of Germany.
1963 - Gemini 2, the United State's first 2-man space craft, is launched.
1983 - Reagan unveils Star Wars program.

Births:
1905 - Joan Crawford
1912 - Wehner Von Braun

Deaths:
2011 - Elizabeth Taylor

Monday, April 16, 2012

Updates from Week 3

Things Sterling Loves:

-Being carried in the Moby wrap. She falls asleep almost immediately every time we put her in there. We've taken her on several walks and several shopping trips that way. Mike carries her around the house sometimes.



-Her swing (the one we got at the consignment sale). She'll actually sometimes fall asleep in it. If she's asleep already, she'll often stay asleep for a half hour or more.



-Eating. Today she wants to do it every hour or so. No, I'm not producing nearly enough milk for that to be effective. We're supplementing pretty heavily with formula. She'll get as much breast milk as I can give her, and the rest will come from a bottle. I've come to terms with that, although I am very disappointed.

-Riding in the car.

-Looking at lights. I think she inherited that trait from her father.


-Polliwog in a Bog, sung repeatedly.

Things Sterling Hates:


-Having her diaper changed. I think this is mainly due to the fact that her father, the main diaper-changer in the family, has freezingly cold hands a lot of the time.

-Being put down places other than her swing. She wants to be held (or swung) all the time.

-Not eating, unless she's asleep or looking at lights.



Wednesday, April 11, 2012

Consignment sale!

Today, I ill-advisedly went to the same consignment sale twice. The SuperKids Resale consignment sale happens twice a year (spring and fall). I went last year and bought a bunch of furry sleepers for next winter.  This year, I went looking for a few things and came home with mostly clothes. Today was the presale. I got to go at 2pm as a consigner (I consigned most of my maternity clothes). I had also registered for the new first-time parent presale, so Mike and I were able to go back this evening.

We wanted a few more newborn zip-up footie PJs. We like them better than the snap ones because they're easier to close. I'm not sure who thought it was a good idea to put 15 snaps up the front of a infant outfit - they wiggle and I mismatch the snaps without fail. I ended up looking for stuff in 3-6 months sizes for this summer. We should be totally set for clothes until fall (and probably we're set for then as well, depending on how fast she grows).

The Best Buy of the Day goes to the battery-powered swing that we got for $12. I was looking at them and was leaning towards this nice furry one with hanging animals on a mobile. It had all sorts of settings and looked really cozy... but it was $90. Since we aren't sure she'll even LIKE a swing, I was hesitant to spend that much money. Mike and I perused the other swings and found one for $12. It doesn't have nearly as many settings and it's not nearly as comfy-looking... but it's only $12, so if she hates it I won't feel bad. I wiped it down with clorox wipes and threw the cover in the washing machine. We'll try it out tomorrow.

We also got some other misc including a plug-in bottle warmer for the car, some 8oz glass bottles, and an electrical plug cover.

Total spent: $80

Tuesday, April 10, 2012

Kangaroos

We're doing kangaroo care tonight. That means that Tiny Squee is just wearing her diaper and is laying on my naked tummy/chest under a blanket. It's supposed to increase milk production. It certainly makes her sleep well. It also makes us both slightly sweaty and she sticks to me.

Monday, April 9, 2012

Diapers

So we've been diapering for slightly over two weeks now. Here's my reviews for diapering the tiniest of squees. She's still really too small to fit in a lot of things that we have.

We started with newborn gDiapers with disposable inserts because we didn't want to get meconium stuck on them (it's weird and black and tarry). We used them for the first couple of days, then it seemed like the elastic straps on the sides were rubbing on her legs. It seemed like they were too small, even though she's less than 7 pounds. Maybe we'll try the small gDiapers and see if they work better.

We like the kissaluvs size 0. They've very smooshy and fluffy. They seem very comfortable. We really like the kissaluvs contour diapers. You wrap them onto the baby and then secure them with a snappi. We also have some other contour diapers of some unknown brand. The snappi doesn't seem to attach to them very well, so I installed snaps (with my snap press!). They don't fit as well as the kissaluvs (poop blow-out!), but they're ok. All three of these require a cover, of which we have tons. Most of them are too big for her right now, but we have a few tiny ones that are working well. We also have Kushies all-in-one diapers that seem to be working pretty well. We've used them a couple of times... they are a little too big still (they apparently fit 10 pounds and up). We haven't gotten into the prefolds yet. They seem really bulky and too big for her still.

I'm guessing that in another 2 pounds or so, she'll fit in everything much better.

Weight gain!

Sterling weighs 6lbs 11.5oz as of our doctor's appointment this afternoon! Since the last appointment, we've been supplementing with 5-7 oz of formula / breast milk per day. Dr Liz says that she's still getting the majority of her nutrition from me, but that seems like a pretty sizable quantity to be getting not from me.   Basically, when she wakes up and gets hungry, I nurse her. If she's still hungry after nursing, which seems to be about 50% of the time, we give her a bottle. Typically she drinks 1-1.5oz per bottle feeding.

I tried to up the number of times I'm pumping per day, but it's tough to fit it in because I can't pump very well while I'm holding her. When I pump right after she's nursed, I get a trace amount of milk. If I wait for an hour, I get about 0.5oz (combined total). If it's been a while, like when she's only nursed on one side, I can get about 0.7oz.

I'm hoping that I'll be able to up the number of times that I can pump because we had a napping breakthrough today. Up until today, she was very reluctant to sleep unless someone was holding her. Today, she slept for an hour on her own in our hand-me-down baby papasan chair. It was lovely. I ate lunch, started a load of diaper laundry, and was able to pump. Unprecedented.



I'm currently drinking Mother's Milk tea, the herbal tincture from the Birthing Center, and taking fenugreek capsules every four hours. I don't know if it's helping, but it's not hurting.

Thursday, April 5, 2012

Doctor's Appointment

Sterling hasn't gained any weight since her last doctor's appointment on Monday. Here's the plan as it stands right now:
-Add more supplementation. She's getting enough milk from me to hold her weight steady and to pee and poop regularly, but she's apparently not getting enough to gain weight. We've been supplementing her a little bit before bed (otherwise she won't fall asleep), but we're going to start doing it more. We're now aiming for a total addition of 4-6 oz from a bottle.
-Continue with Mother's Milk Tea and tincture from birthing center. I'm also going to start drinking protein shakes (sounds lovely).
-Try to pump more regularly. This is good for nipple stimulation and we can feed the milk back to Sterling.

Here's how I'm going to try to work our schedule:
Typically, Sterling wants to nurse again 2-3 hours after she's filled herself up. At that point, I'm going to nurse her for about 5 minutes on each side (or as long as she's actively nursing; she tends to slow way down and fall asleep after not too long). Then, we'll give her a bottle and see if she's still hungry. Once she's full, she usually falls asleep. After about an hour, I'll give pumping a try. An hour or so later, baby can nurse again and we'll repeat the process. Dr Liz says that the fact that she sleeps in 4-5 hour stretches at night is fine and won't affect my production, but I think I'm going to try to get in at least one pumping session at night, too. At least for the next couple of days.

We go back in for our next weigh-in on Monday.

Wednesday, April 4, 2012

Adventures in nursing

I've spent the last 11 days working on Project Nursing.

Sterling weighed 7 lbs, 3 oz when she was born on Friday. When we went in for our first official weigh-in on Monday, she weighed 6 lbs, 2 oz. Babies lose weight after they're born, but they're not supposed to lose more than 10% of their weight. My milk hadn't come in.

Dr Liz recommended Mother's Milk tea and we got a tincture of something-or-other from the Birth center. She also recommended drinking a hoppy microbrewed beer. I also got out the breast pump to give that a try.

Since then, my life has revolved around feeding the baby. Because I'm not producing all that much milk, she doesn't get full when she eats most of the time. She alternates from one breast to the other, then wants to go back to the first side. Periodically, we have to give her a bottle. Luckily, formula showed up on our doorstep. I'm not sure how the formula people knew we were having a baby, but we've gotten two containers of formula so far.

According to our baby tracking app, last week, I spent almost 19 hours nursing. So far this week, I've spent 10 hours. The past couple of days, I've been nursing on average every 2 hours. On the plus side, she sleeps for 4 hours or so at a stretch at night and we take a couple of good naps during the day.

Dr Liz thinks that much of the problem will resolve itself as Sterling gets bigger. She'll be more adept at nursing and, as we nurse more, I'll produce more milk.

Tuesday, April 3, 2012