On Hold

Breastfeeding is a wonderful and beautiful thing! It is a perfect way for mother and child to bond. Quite possibly the most natural thing a woman can do. OK, I'm getting a little carried away here. I'll have to say I agree with the first two, but that last one about being 'natural' is just a load of crap! I don't care how many people say breastfeeding is a natural skill that every baby and mother share, it's just simply not the case. It's a learned skill! In an earlier post I mentioned that I breastfed Lacey for 14 months and loved every second of it. Well, what I actually meant was that I loved every second AFTER the 400,000 or so it took her to get good at it. She didn't take a bottle until about 3 months and never really used a pacifier, so for her it was just a matter of figuring out how to latch on correctly, which is the key to successful nursing (and preventing EXTREME pain for mom). I know that a good latch is the key to preventing EXTREME pain from firsthand knowledge. There were nights I sat there crying in pain, determined to continue breastfeeding, adjusting her latch over and over, frustrating both her and me until we got it right. We trudged on through cracked and bleeding nipples, through a rough bout of thrush (yeast infection of the breast - ridiculously painful, like having broken glass in your nipples), and in spite of having a low milk supply. So to say that I loved every second of it is seriously discounting the serious 'work' we put into it at the beginning.

So the point of this vignette? Teaching a baby to breastfeed is complicated! Teaching a preemie to breastfeed is more complicated. Teaching a preemie who was unable to have any milk for the first month of his life, was fed through a feeding tube in his nose for the next month of his life, and has been drinking exclusively from a bottle for the last month to breastfeed is pushing the limits. Having thrush when your teaching a preemie . . . you get the point. The thrush, combined with Lawson's poor latch, makes it so painful that I can barely stand it! It does hurt to pump, but not as bad. Lawson does not have thrush in his mouth, but we're treating him with Nystatin just in case. Not sure what it is about my breasts, but this is the 4th time I've had thrush since he's been born! I've followed all the recommendations of the doctors and lactation consultants, but I feel like I've had thrush forever! I've boiled bottles and pump parts, used Newmans Nipple Cream and Nystatin, taken two weeks worth of Diflucan, washed bras in bleach and hot water, sat topless in the sun out on the deck. . . I've even painted the nipples with gentian violet (dark purple stain), supposedly THE cure for thrush, but nothing seems to work! Ugh!

So the day I've been waiting for, the day we were given the green light to breastfeed, has been put on hold until I can shake this recent bout of thrush.

The day we've been waiting for!

Today's visit to Duke was quite eventful! We were told to expect to be there a good part of the day, so we arranged for Lacey to have a play date with friends. It's a good thing, since our appointment was at 10am and we didn't finish until after 2pm. We met with the speech therapist, physical therapist, the neonatologist fellow, the attending physician, and a few other Lawson fans.

As we checked in, Lawson began working his smiley magic on the receptionist and continued throughout the day. We had been in the waiting area for quite a while, when one of our favorite fellows who was there when he was born, through it all, and there when he left, walked by. She smiled and waved but kept walking. Brian and I puzzled over why she wouldn't even stop to get a look at him. A few moments later, she reappeared, stopping to chat and oogle over Lawson. Every time we'd ever seen her, which was only in the NICU, she had been wearing scrubs. Since she was dressed in street clothes today, I asked, "So are you just hanging out at Duke today?" Her reply surprised and delighted me! "I actually wanted to see if I could get in on Lawson's appointment. If they can get you guys into a room soon, I'm going to stay."

The nurse came soon after to get his weight and height. They didn't have a room yet, so she asked us to leave the stroller and our stuff and just carry him to the scale. As I undressed him, I unwrapped an unexpected surprise! Lawson had blown out his diaper and had poop from his underarm all the way down his outfit to his toes!!!! I didn't notice at first, so it got all over the exam table! Since I had just carried him in there, I didn't have the diaper bag with me! I was mortified, yet cracking up at the same time! I left Lawson with the nurse and went back for the diaper bag. By the time we got him cleaned up and dressed in his third outfit for the day (he spit up on the 'special outfit' before we even left the house this morning), a room was ready for us.

One of the first people we met with today was Amanda, the speech therapist who nixed breastfeeding after the swallow study showed breastmilk that had not been thickened would aspirate into his lungs. So since we've had Lawson home, we've had to add Simply Thick to all of Lawson's bottles to protect his lungs. If you've read my earlier posts, you know how devistating it was to me that I would not be able to breastfeed. Well, we had our big test today. It just happened to be time for Lawson to feed while Amanda was there. She asked if I felt comfortable trying to breastfeed in front of her so she could see if Lawson seemed to be ready. Within a few seconds, Lawson was coughing. Oh no! Coughing is a sign of aspiration! My heart raced and spirits dropped! I know Amanda could see it on my face because she said, "Don't worry, he's just getting warmed up!" It didn't take long before got himself together and nursed like a champ! So the very best news we got today was that we don't have to use Simply Thick in his bottles any more and WE CAN BREASTFEED!!!!!

Other highlights of the day . . . Lawson now weighs 10lbs 9oz, still below the 5th percentile for his chronological age (actual age since his birth), but 25th percentile for his adjusted age (age since his due date). His is 22 inches long, 10th percentile for his adjusted age. He smiled at EVERYBODY who looked at him, charmed all the ladies, and managed to keep his good mood most of the day. He is on track for his chronological age in his social skills and on track for his adjusted age in physical development. We still have to be very careful to protect him from colds, illnesses, germs, etc due to his lungs still not being healed. He will continue the daily nebulizer and the current meds at higher doses based on his new weight. His feeding schedule will be to breastfeed whenever he is hungry and supplement with a bottle of breastmilk mixed with formula occasionally for the extra calories. I will continue to pump after feedings to keep up my milk supply. His next appointment is next Monday with our regular pediatrician. I can't imagine we'll have anything but good news to share from here on out, but there's no way anything can top the news we got today! :)

Snooze Button

It's 2:58 am and I'm wide awake! It's not that I can't sleep; I could, I was - very well actually. I'm instead doing the one thing I can actively do to help Lawson's recovery. One day, when he's well enough, he will need to eat to survive, so I'm pumping my breastmilk for the nurses to freeze until he is ready for it. (He is currently getting everything he needs through an IV.) All of the mothers of babies in the NICU are strongly encouraged to pump for the health of their babies. So in order to 'train' your body to produce the milk that is needed, you must pump every 3 hours, just as if he were actually feeding. As I sit here listening to the rhythmic sound of the breastpump, I'm thinking about something Brian said to 'lighten' the mood yesterday morning when my alarm was going off at 5:30 am. He said, "Hey, at least you can hit snooze! You can't snooze a real baby!" Oh that Brian has a way with words! :) I'd trade that baby in my arms for a snooze button any day! Soon enough . . .