Tuesday, August 18, 2015

Breastfeeding Blues

I absolutely love nursing. For hundreds of reasons from nutrition to bonding. I hold no judgment for moms who choose or need to give their babies formula; it's a very personal choice. But for me, I am 100% dedicated to breastfeeding the Bug for as long as I possibly can. This has been a long journey already, and I am not a quitter!

As with many of the hardships of pregnancy, birth and raising a newborn, many of the details are forgotten once the immediacy passes. It has been the same with breastfeeding for me. I can intellectually recall the ups and downs of the initial process, but the emotional and physical intensity of it all is quickly getting lost in a fog of sleep-deprivation. With so many friends getting pregnant now, I want to document the experience while I still remember!

During my pregnancy, I read numerous books and even took a breastfeeding class from an American nurse who works part time between our school and the embassy. Interjection: This woman is incredibly -- she was also our doula. Anyway, I was determined to breastfeed. Then in middle of labor, during transition no less, my doctor exclaims, "You didn't tell me you have flat nipples! Nursing is will be hard for you." So I am breathing through contractions and she begins plucking at said nipples. Way to keep it positive, Doctor.

Flat nipples? It's not like I've seen that many others to really know the difference. Nor did I get the immediate post-birth skin-to-skin opportunity that I'd dreamed of to even try and nurse. Labor ended in Cesarian, Bug was whisked away to the NICU for oxygen and antibiotics, and I was left alone, paralyzed in the recovery area trying not to freak out. So much for the drug-free, oxytocin-induced euphoric bond I had hoped for.

I didn't actually get to see Bug until the next day. I was going crazy. Finally, the nurse took him out of the oxygen tent, handed him to me, provided a plastic chair to sit in, and instructed me to nurse. Nothing happened. Of course nothing happened. My baby was dazed and full of drugs, we had been separated, and hello people, have you heard of colostrum? As predicted, Bug did have a hard time latching because my nipples did not draw out are far as they needed to. But I kept pumping to stimulate milk flow, and we kept trying.

I do not know how many people grabbed my breasts over the next two days with conflicting advice on how to hold him or position myself. At one point, Brian went to the pharmacy to purchase nipple guards so Bug could have a quasi-nipple. Thankfully a gentle night nurse came in and told me not to bother with those, and that we were doing fine. She gave me a huge boost when I needed it.

Bug and I had a big breakthrough on our second night together (his third alive). Late that evening, we were snuggling skin-to-skin in the dark and Bug's nursing instinct finally kicked in. Just like I had imagined our first feeding after birth would would have been. I was reclined with him on my tummy, and he began to squirm. He rooted his head side to side and used his little legs to inch up my chest. The journey culminated with him face-planting on my nipple and suckling ferociously. All I did was help him keep balanced and make sure he could breath while face down. Maintaining the latch was tricky (and would continue to be for a few more days), but we did it!

Throughout our time in the hospital, the pediatrician kept coming in to check if I had milk yet. Um, you work in a maternity ward, don't you know that is not immediate? Apparently the doctors and nurses were not up to date on the necessity for and small quantity of colostrum that can sustain a baby in the first few days. He was not even two days old and they were pressuring me to give him formula or sugar water. Sugar water? What decade do we live in? I kept resisting until the next day when I agreed to give him formula with a syringe. Everything I read said absolutely do not give the baby a bottle or nipple confusion will ensue. I had enough issues with latching to not even go down that road. I knew in my heart that Bug was just fine, but they had sent my into a downward worry spiral. So the nurse brought in a syringe with 20 mL of formula and shamed me when I returned it after he had eaten 7 mL. I knew, and confirmed with my doula, that 7 mL was more than enough for feeding a three day old.

There were other issues at the hospital, but in the end Bug latched and we were both well enough to go home. My milk came in and he was eating around the clock. Latching was still tricky, so I was doing a few things to draw out my nipples, such as using an empty syringe or pumping for a few minutes before feeding. This on top of his constant un- and re-latching made my nipples so chapped and sore. I cringed before each feed and used deep breathing to make it through the pain. It felt like Bug was rubbing sandpaper across my chest rather than lovingly suckling. On the plus side, I never cracked or bled.

Let's just say he ate his weight in lanolin those first few weeks! Ultimately, I discovered that my nipples don't really love lanolin, so I switched to coconut oil. Fine by me, I am kindda crazy about putting coconut oil on/in everything; however, it was a little too thin for this particular use, so I also used olive oil, which felt amazing. The key to happy nipples is keeping them smothered in oil.

Nipple pain stopped around week six, and Bug and I eventually got so good at nursing that we could do it anywhere. Cafes, grocery stores, walking down the street, even running through the airport. He and I are an awesome team. Well, actually, Bug, BRIAN and I are an awesome team. My husband was (and still is) always there to encourage me, hand me my phone, or make sure I am hydrated. He also still often takes Bug to burp him after feeds so I can have a break. Eventually I was producing enough milk to began my pumping regimen, and the freezer quickly filled up.

Everything was going fantastically until we went to visit family and began experimenting with bottles. Brian had been successfully bottle-feeding him before bed each night using freshly pumped milk. However, while in the US, I needed to build up a stock so multiple people could experience feeding him...and I could actually have a beer or two :-) I accumulated several bottles of milk over a few days and tasted one to make sure it was still fresh. YUCK! Others agreed it tasted off, but I was confused because breast milk should last a lot longer than three days. I got on the internet and discovered that my milk might have a higher amount of an enzyme called lipase. This enzyme breaks down fats in the milk to help the baby digest it, and over time it may lead to a metallic taste. Unfortunately, refrigerating or freezing does not stop the process. Once we returned home, I defrosted and tasted milk of various dates from my three month stockpile, and they were all gross. The milk technically isn't spoiled and thus is safe to give to the baby if he'll drink it. Sadly, Bug's tastebuds are too discerning. He said, "No thank you."

The only way to stop the lipase from doing it's job so quickly is to scald the milk immediately after pumping (or as soon after as possible). Since there is no milk bank (which will still take the milk, I've read) here in Mozambique, I am going to have to throw it out. I tried mixing old milk with fresh milk, but Bug wasn't having it. So now I have to develop a new plan since I go back to work in four weeks. Bug will take milk that is one or two days old, so I will need to stay a few days ahead of schedule. Additionally, I  need to start over with my frozen stock by scalding before I freeze. The catch? Bug is growing like crazy and drink every drop that I currently produce. So time to chug fenugreek tea, eat oats with almonds every day, and sneak in pumping sessions where I can to convince my body to produce more milk. Is it ideal? Not at all. But I am committed to exclusive breastfeeding, so I accept this latest twist in the journey.

Tuesday, August 11, 2015

Mixed Feelings

Today is the first day of school...for Brian. I am still on maternity leave. I have gone to work, bringing Bug, a few times in the past week to help set up my classroom and meet with the substitute and my teaching assistant for planning. I even went yesterday for the new student orientation. But today I stay home.

A bit of adult interaction each day has been fantastic; I've needed it. But honestly, if I didn't have to work, I don't think I would go back. At least not until Bug and his future siblings were school-aged. Don't get me wrong, I do love my job. It is incredibly fulfilling. The students are little bundles of love and wonder, and I am always challenged to grow professionally. However, my priorities have completely shifted. Quiet snuggly mornings, silly playtime and intimate nursing are what I live for right now.

In reality, I will have to return to work in a very short five weeks. Both of us working affords our spacious apartment in the center of the city and all our amazing travels. Neither of which I am willing to give up. And I will probably need a life that entails more than wearing pjs all day, changing diapers every two hours and babbling in gibberish. So in preparation for that big event, we have hired a nanny. Yesterday was her first day. Before I had children, I thought I would be a laid back parent. Now, the thought of leaving Bug with someone who isn't family is terrifying. I know it is necessary, for many reasons, but I need a little more time. So we've brought the nanny on half time until I return to work. This allows all of us to get to know one another, and for me to model Bug's daily care and watch her with him.

Did my heart ache as I watched her rock my baby to sleep? Absolutely. Did Bug take to her gentle and caring ways immediately? Yup. I wouldn't have hired her if he didn't. So this is just going to be a process. He is in good hands, and I need to have a life outside my baby. Am I looking forward to leaving him on my first day of work? Heck no.

Monday, August 10, 2015

Fast Forward

Welcome table at our stateside reception
Yoo hoo. It's me again! Two years down the road, Brian and I had a fabulous wedding fiesta in December 2013 and a stateside celebration in July 2014. We've been nesting in Maputo since August 2013. Lots of African adventures under our belt -- to name a few: camping in Kruger, wild animal encounters, daily off-roading in our 4x4, rustic beach getaways, moving out of the burbs and into the city...and HAVING A BABY!

Ellies at Kruger Park.

Yes, Brian and I are officially parents. Our little guy, nicknamed Bug, was born in May 2015. After lots of wishy-washing we decided to deliver him here in Mozambique rather than crossing the border and dealing with passport and visa bureaucracies at embassies in South Africa. Many expats said we were "brave" (polite for "crazy"?), but really I felt safe and any negative aspects of the experience were not surprises. Oh, except for the cesarian after 16 hours of unmedicated natural labor. Or Bug's overnight NICU stay for oxygen and antibiotics. But those things could have happened anywhere, and it's all in the past now. I'm mending. Bug is healthy and happy. Brian is, as always, our calm eye in any storm.

Maputo cityscape
Life is not only good...it's amazing. I'm so happy that I'm actually afraid to admit it. So I've uncovered my Achilles heel -- not feeling worthy of such happiness. Thanks to Brian, I've already tackled the hurdle of not feeling worthy enough for genuine love and am working on uncovering my authentic self. As if having a baby wasn't enough of a growth experience (literally and spiritually!), now I'm signing up for a little more self-love bootcamp. Parenting and self-improvement...this could be an interesting combo!