Newborn Weight & Breastfeeding

With the iPad it's easy to start blog entries and jot down my thoughts during the day or nights. It is harder to edit the entries and get them posted. I started this entry and thoughts earlier. It's not really an important entry for my readers - it's more important for future google-ers to find and maybe learn a bit from my experience.

I included some helpful links I was given at the end of the post. I also included some St. Louis resources for those in the area. 

Newborn Weight

Liam weighed 8 pounds and 3 ounces at birth. I consider this an elevated birth rate. I had been on IV fluids for 53 hours. I'm not sure how much fluid was pumped into my body, and even though it was a slow drip, it still affected my body (lots of swelling) and affected his birth weight. 

When we left the hospital I should have asked what his discharge weight was or what other weight they measured. He had a 24 hour birth rate of 7 pounds and 14 ounces. This is important to know. 

I was told to take him to the doctor on Monday (September 9).The main doctors I see (Dr. H or Dr. W.) were not available, and I asked for a pediatrician appointment and was scheduled with Dr. D. 

Jason went back to work and my mom went with me to the doctor appointment. (My mom is awesome, she came and stayed with us Sunday through Thursday.) Dr. D didn't know my birth story. Nor did she know Liam's birthrate or 24 hour weight. Nor does she have children. And it turns out she's only done a handful of infant exams. This is the only downfall to my doctor's office. I love that when I am sick I can get an appointment that day; but my newborn's first appointment should have been scheduled with a doctor who actually knew what they were doing. 

My doctor (Dr. H) is a lactation consultant and has a 5 month old! This is very important. At least maybe give me a doctor who has breastfed before! 

6-day old doctor appointment

So the doctor's appointment - Liam's weight had fallen to 7 pounds and 10 ounces. We had already talked to Lactation at Mercy on Friday afternoon because we were concerned about him not latching and how frustrating it was getting. Dr. P came in to examine him also. Liam wasn't dehydrated, and he was in great condition, but he had lost 9 ounces of weight. 

Dr. P told me to stop breast feeding and pump. He wanted me to measure how much milk Liam was getting. I wanted to know how much to feed him - and wasn't given a straight answer - "Feed when he's hungry." We were already supplementing with a friend's pumped breastmilk and increased that 10 fold when we got home. A first time mom, 6 days into having a newborn, does not want to pump exclusively. Later, I came to found out that Dr. P wasn't informed at all to tell a new mom to pump exclusively. I need a medical grade pump, not my little Medala personal pump. Dr. P also didn't tell me how to bottle feed my son correctly. He offered no advice - just a statement to "Pump and measure." 

We made a follow up appointment for Thursday (with Dr. H) for a weight check.

Depression Settles In - Thanks Dr. P

I spent the next two days very depressed. Pumping made me feel disconnected and demoralized. I sobbed the first night because I hated that I couldn't provide for my son. And in the end, it wasn't that I couldn't provide, it was that the doctor put this thought in my head that I wasn't able to provide. I had no desire to get out of bed at night to pump. I didn't want to be hooked up to a machine.

On Tuesday night and Wednesday I started to vocalize myself more about how unhappy I was. And my friend D said to stop pumping. Being depressed and pumping wasn't going to get me anywhere. I have a lot of resources in St. Louis (more on those later) but I figured I'd wait until I saw my real doctor on Thursday to see what other steps I should take. 

The most helpful was on Wednesday I went to Kangaroo Kids to purchase some nursing bras. This local place is very helpful and they fit you and give you a lot of options (even larger chested women have options.) The owner, who helped me with bras, is also a lactation consultant (LC). And I'm glad I talked to her. She agreed the doctor was wrong/stupid/dumb/on my shit list, and explained how to correctly bottle feed my son. She also told me that if I was going to pump I needed to be using a medical grade pump - and the doctor should have told me that. I've listed a few of her links down below. 

Doctor appointment Thursday

Jason went with me and I was very happy to see Dr. H. Liam's weight was 7 pounds and 15 ounces. I made a note to ask Dr. H about his elevated birthrate. She was able to pull up his hospital records and see all the important info. Why Dr. D couldn't do that four days before, I don't know. 

Dr. H spent an hour with us. She even had me breastfeed and helped me check his latch issue. She told me to stop pumping and just breastfeed as much as possible. I walked away feeling a lot more confident and reassured about breastfeeding. She said Liam was just perfect and his weight was fine. 

When I got home, I put the pump away. She did suggest that in the morning after feeding Liam, I could pump to help start establishing a supply, if I wanted. But no need to pump all day long or everytime, just once a day if I want.

Since the doctor appointment, things have been going much better. I haven't pumped since last Wednesday and Liam latches and eats well and often. I am not depressed about breastfeeding. Sometimes Liam still gets worked up and has trouble latching, but a little patience pays off and usually once he latches, it's a 20-30 minute latch.

Helpful Links & Resources

I have "flat nipples". (apologies if too much info.) At the hospital one of the nurses noticed this and gave me a Medela Contact Nipple. This little piece of plastic has been the most helpful tool with breastfeeding and establishing a latch. My doctor says she even used this with her child and it was a lifesaver. She recommends using it to get started during each BF session and then taking it away halfway through to teach him a true latch. Liam has done well with it and without it. It has helped a lot - I recommend it for anyone with latch issues, especially since it is not expensive. 

Caring for your baby and young child - This book is very helpful. It even covers prenatal care and birth (for the woman) before getting into newborn care. It was recommended at our Mercy Baby class. The book has a LOT of information and I would recommend it for all new parents.

KellyMom is a great resource for breastfeeding help. The LC at Kangaroo Kids gave me a few specific links to check out. My doctor also recommended checking out this website.
Establishing and maintaining milk supply when baby is not breastfeeding
How to bottle feed a breast fed baby
Is my baby getting enough?

For the St. Louis area folks - Kangaroo Kids is a great resource also. They offer breastfeeding support groups and lactation consultations. Kangaroo Kids is a resale shop - check them out for used children's clothing and toys. They also have an infant scale so you can weigh your baby. You can weigh, breastfeed, and weigh again to see how much your child took in. (This is useful unless your kiddo is like mine and poops during or right after breastfeeding.)

St. Louis La Leche League - this group is a breast feeding support group. The meetings are free to attend. A seminar is being held September 28, 2013 at the Zoo. It appears World Breastfeeding Week is coming up.

The other resource I have is the Mercy Hospital. They also have lactation consultants who answer questions via phone and will meet one-on-one for a small fee. There is also a free Breastfeeding with Confidence Group which meets every Wednesday from 1 to 2pm at Mercy Hospital. They also offer a newborn scale for weighing. 

My story of induction

I was scheduled for induction on the afternoon of Sunday, September 1, 2013 at Mercy. Baby Liam decided to finally arrive at 9:24 PM on Tuesday September 3, 2013. We remained in Labor and Delivery until 4:30 AM Wednesday September 4. (Yes, this is abnormal.) We were discharged from the hospital about 2PM on Thursday September 5. 

I logged as much as possible during my stay. It was just random blurbs of the timeline. It's taken a few days to get it in order for reading. Ok, honesty, it took me over a week to have time to get back to the computer to edit this entry. (Some of the tenses are past or present, I didn't care to change them all.) 

Note - I was being induced at 39 weeks because of the gestational diabetes diagnosis. Even though my GD was controlled by medication and diet, they (doctors?) still prefer to induce to prevent complications of high birth rate or placenta problems. 

Here it is - My Induction Story

Sunday September 1, 2013

The phone call came about 2:30 PM, my bed was ready. The car was already loaded and we were ready to go. We stopped at McDonald's to get some cheeseburgers and ran by the post office to mail my Baby Shower thank you notes, and got to the hospital around 3. I was checked into my room by 3:30.

They checked and I was only 1 CM dilated. (Same as the previous Friday.) They hooked up my IV and monitored the baby heart rate and my contractions for a while. It turns out I was having contractions and did not feel them. I was able to order dinner and eat. Luckily I wasn't being starved to death during my stay. While we waited, Jason and I watched Field of Dreams. I had never seen it! We had to keep pausing our movie when I was being checked.  

Around 9 PM the doctor gave me the 12-hour induction drug. It has to be placed near the cervix - which is very painful. (I edited out some of my commentary from the placement of the drug....it's better that way.) 

Even though I had an IV, I was still drinking lots of water. And around 11PM I was sprinting to the bathroom to pee for like the thousandth time since I got there. I tried to sleep. I am very uncomfortable from the contractions. It's hard to get all comfy in bed with an IV in one arm and two monitors strapped around my abdomen. I wish I had an early morning induction... I wish I would have slept more during the day (yesterday). And then during a 3 AM pee break my (wireless & waterproof) fetal monitor fell in the toilet. I felt bad for the nurse who had to fish it out.

Monday September 2, 2013

2PM. No baby yet. At 9 AM they checked and I was still only 1 CM dilated. So they did the 12-hour drug again. I was fortunately able to take a shower and go see my friend Alexsis and her new son, Cole, for 15 minutes. At the rate I am going they will be discharged before I give birth. I was able to eat lunch and napped on and off. I have to wait to be checked around 10 PM. At that point they will make a decision to do the 4-hour induction drug or the foley bulb. At this rate though, he's not coming until Tuesday.

Note - My parents, thinking I would be induced on Monday afternoon, told me they had planned to come Tuesday evening and Baby G better be here by then. I hated that added pressure for a less than 24-hour induction and birth experience. And that was why I didn't want waiting room warriors.. too much pressure and stress about giving birth on someone else's timeline. Especially when it turns out I was only 1 CM dilated. When my doctor changed my induction date to Sunday the 1st I lied and told very very few people. My friend Alexsis knew because she was already in the hospital with her new son. I told Dee in case I needed help with Monday (my dog), and Jason told his brother in case we needed his help. 

5:30 PM - Still only dilated 1 CM. Good news - I can eat dinner. Bad news - This kiddo is comfy. Super comfy. 

We spend the evening watching Harry Potter #6. We bought a handful of movies and are watching those and Cardinal baseball games. 

Around 8 PM I started to have regular contractions. I was starting to feel them more, but I still had to wait until almost 11PM to be checked again. 

11PM rolls around - and I am still only 1 CM dilated. I'm annoyed now. And in pain. I have nicknamed the cervical checks, vagina torture. And I still think that's a nice way to describe this process. The next step is using the foley bulb. You can feel free to google that - but again, it's not a walk in the park. This whole process sucks. 

General FYI-- I am still in "induction". Even with contractions, I am not considered in labor. 

Tuesday September 3, 2013

Midnight. Hopefully today is Baby G's birthday. He would share his birthday with Dave Ramsey! I am waiting an hour to be checked again. I am ready to be done. This is emotionally, mentally, and physically draining.

1 AM - The foley bulb has worked!!! I am 4.5 cm dilated. The most joyous part has finally arrived!! I can get an epidural!!! I take a quick shower since I won't be able to move after the EPI. Oh wonderful EPI, my new BFF. No pain, no pain, no pain... I can sleep through the contractions, I have a catheter and don't have to get up anymore. Everything is all tingling and there is no pain during cervical checks. (And no more crying).

I sleep. And sleep. Oh it's nice. My water breaks at 4:30 AM and they check my, I am 5 CM dilated. And am still not considered in active labor quite yet.

I always wonder how women calculate how long they were in labor when they say things like they labored for 24 hours or 40 hours with their child. When do they start counting? I would probably count from when I got the EPI, or maybe a little before that, but I won't count the 34 hours prior where they were trying to get my body ready. Of course, the big deadline is when your water breaks. The doctor's want the child out within 24 hours of your water breaking. 

9AM Tuesday September 3, 2013

I am now considered in active labor. I am 6-7 CM dilated. Whew whoo!! Progress has been made. We are currently watching Top Gun. 

When the nurse checked me around 3 PM she noticed my EPI was bleeding. I had complained that I was more uncomfortable during contractions, but I didn't know what was normal so I wasn't aware that something was wrong. Once my EPI was redone, I was much more comfortable. 

At 530 PM was finally 9.5 CM. During this time I discussed with doctor how I can push the baby out if I can't feel anything (which turns out wouldn't be a problem.) 

During the new few hours, my blood pressure and temperature kept rising. The doctors were concerned about this. I was too. I hated that my blood pressure was being taken every 15 minutes. It got annoying having it taken so much and being able to see my blood pressure continuing to rise. 

Around 7 PM I was finally 10 CM. My doctor wanted me to try some "test pushes." I think they tell FTM's (first time moms) that to trick them into actually starting to push. Baby G still hadn't descended all the way down (really, he was comfy and not ready to come out), so the test pushes should help move him down. 

I wasn't able to log during the next few hours - so this is all from memory a week later. 

Pushing was painful. My epidural had wore off. During the latest stages of pushing, my Epidural drug actually ran out. Maybe the epidural just lessons the pain of contractions but cannot actually eliminate the pain from pushing. I was in a lot of pain during each push. I no longer wanted to do it. And pushing wasn't making a ton of progress either. 

Eventually, after almost two hours of pushing, my blood pressure was raising with each push and Baby G's heart rate was dropping. I trust my doctor fully and the decision was made to use vacuum to aid with the birth. And Baby G was born at 9:24 PM. He weighed 8 pounds and 3 ounces and 21.5 inches long. 

While Mercy encourages immediate skin to skin contact, I wasn't able to do that because due to vacuum extraction and the falling heart rate they needed to examine him. 

Jason was able to hold him almost right away.... I had to wait almost two hours. Usually you spend only two hours after delivery in the Labor and Delivery room before being moved to postpartum. Due to complications, I remained in the room until 4:30AM - an extra 5 hours. 

Jason and Liam

So the complications..... I haven't spoken about the complications with many people, and I wasn't aware of these two possible complications so I want to share so other people will be aware. 

After birth, you have to deliver the placenta. (I was aware of this.) It usually happens within half an hour of giving birth. It didn't for me and I wasn't aware that it could or would be a problem. I was also still in a lot of pain. They wound up giving me a shot of the Epidural drug and morphine. (Which morphine sucks - it made my body feel like it was on fire.) My doctor had to check with the main OBGYN in the hospital to determine the protocol for the placenta complication. A few options were considered with the final option being a D&C (Dilation and Curettage) which means a surgeon would extract the placenta. Fortunately, additional pitocin and another drug aided with the placenta delivery. I'm not sure the timeline, but I know it wasn't long after my doctor inserted the second drug that my placenta delivered. 

It still wasn't over. 

My uterus wouldn't constrict after the placenta delivery. This is another complication that can be a problem. In order to help constrict my uterus, the nurses and doctors are constantly pushing on it. This also aids in "clearing" it out and making sure all the blood clots are out of it. All in all, another painful experience. It took awhile, but eventually it did constrict and was getting smaller. 

By the time we were being moved to postpartum around 4:30 AM, I was very much physically exhausted. And mentally drained. And so full of confusing emotions. I was in a lot of pain from being poked and prodded at for three days, and I was super swollen from the 3 days of IV fluids.

And thus ends the story of my induction and birth of my first (and most likely only) child. 

Some of the good - 

Almost every nurse we encountered was amazing. Very helpful, answered my questions, was helpful with anything I needed or asked about. The postpartum nurses are really great too - especially with helping new parents establish newborn care and breast feeding. We had some additional questions and the lactation nurses stopped by to talk to us. (And we called them after being home.) 

The rooms are great. The labor and delivery rooms are huge with large bathrooms which include jet tubs and the most amazing showers!  The postpartum rooms are smaller, but comfy, especially for the dad's sleeping. They talk of redoing the postpartum rooms - mostly the bathroom needs to be redone. It is such a let down after the L&D bathroom. 

The meals are great. You are given a huge menu and told to choose 1 item entree, and then 1 item from this list, 2 from this list, ect. It winds up with a lot of extra food sometimes, especially if your eyes are bigger than your stomach!