Friday, May 20, 2011

Flu

Taking care of an infant is a thankless, messy, exhausting job under the best of conditions. I like to think that I normally handle it with a certain amount of finesse. I can deal with the sleep disturbances, the pacing back and forth, the bizarre way that all newborns can tell the difference between when you're standing and when you're sitting, the unpredictability of it all. I do it, and I smile. But you know when I'm ever-so-slightly less able to deal with the physical and emotional demands of taking care of an infant?

When I'm suffering from the worst stomach flu of my life.

I spent most of yesterday and today silently praying that I was sympathetic enough towards LL when he was sick with this flu last week, because holy cow this really sucks! I don't blame him at all for spending three days lying on the couch intermittently crying. I wish that I could do the same. Many people have written about how one of the worst things about motherhood is that you don't get any days off, not even sick days. Still, I think that most people can at least call on some family to step in with assistance when it gets really bad. The fact that we have no family in the area always hits me hardest at times like this, because just having somebody home with me who could help to hold Kermit on occasion, even if I still had to do the majority of the work of caring for him, would make a huge difference. It would help me to avoid those times yesterday (and yes, plural, multiple times yesterday, though slightly better today) when I sat in a rocking chair holding Kermit while both of us cried, as I gulped back my instinct to yell as loudly as I could about the misery of it all.

On the breast feeding front, Kermit is indeed breast feeding a bit. I'd say one-third of his feedings are entirely at the breast, one-third of his feedings he rejects the breast completely and eats just from a bottle, and the remaining third he nurses for some brief period of time before appearing frustrated, and then I top him off with a bottle. This sounds all nice and promising, except that it means that I never know how he's going to want any particular feeding. I attempt to nurse, then I need to go make a bottle, feed him the bottle, then put him down and hook myself up to the breast pump. The nurse-bottle-pump thing means that every single feeding takes an hour or longer, and I have to be at home for every single one of them. Thus, I can never leave the house. Which is not a long-term solution, obviously.

Even with pumping after every single feeding, I have run through my entire freezer of milk and have needed to start supplementing with formula. Even with three solid weeks of ridiculous over-the-top pumping, my milk supply has not budged at all, but Kermit's appetite (thanks to some reflux medication) has gone up. The stomach flu has thrown everything into even more chaos. Eating or drinking absolutely anything makes me ill, so I'd be dehydrated even if I weren't also trying to sustain another human being. Thus, my supply has taken another hit, and I haven't had the energy to pump for the past two days to try to keep it steady.

Perhaps I'll start up again after I'm recovered, but I suspect that my supply has dipped for good. And I'm trying to make peace with that. If I can figure out when Kermit is nursing and when he's not, I can just plan to nurse at those feedings and save myself the heartache of offering the breast at other times. My current plan, I think, will also include cutting out all that pumping. I know that this plan will cause my supply to continue to drop even further, so it probably means that Kermit will stop nursing entirely within the month, but I just don't have the energy to fight it anymore.

Assuming I'm over my flu, and assuming that S and Kermit don't get sick in the meantime, we're flying to visit my parents on Tuesday. I can bring a breast pump with me, but there's no way that I'll be able to pump eight times a day while on vacation. At this point, I kind of feel like I've been tilting at windmills for long enough. So, I'm nursing Kermit as best as I can right now, to try to force as many antibodies into him as he'll take, and once I'm over the flu, we're probably going to step it down a notch and let Kermit decide how much he wants to nurse.

But first, I have to get over this ridiculously awful flu.

Friday, May 13, 2011

Timeline

My month of May so far:

Sunday, 5/1 -- Like an idiot, I write a post about how Kermit's breast feeding is going better. I mention that I live in fear of him having a nursing strike like LL did, so I'm enjoying each day that he nurses well. Then I tempt fate even further by buying two new nursing bras.

Monday, 5/2 -- Kermit starts crying in the middle of every feeding. I am determined not to lose him over to bottle-feeding, so I refuse to give him any bottles. He's fussing a lot at feedings, but he also seems content by the end, so I trust that everything will right itself eventually.

Thursday, 5/5 -- Kermit stops nursing completely. He latches on, sucks once, then cries hysterically. By midday, it's obvious that he's hungry but he's not going to nurse, and I tearfully give him a bottle, then immediately call the lactation consultant.

Friday, 5/6 -- I meet with a lactation consultant. She thinks that I have a low supply, which is frustrating Kermit, hence the refusing to nurse. She tells me to rent a hospital-grade pump, then exclusively pump for the next two days and bottle-feed Kermit. Her prediction is that Kermit will eat 32 ounces a day (normal for this age is 30-36) and I will only pump 18-20. So basically, the nursing strike is entirely my fault. I'm heartbroken.

Saturday, 5/7 -- I spend much of the day hunched over a breast pump, crying. I'm in disbelief that my second child followed my first and rejected breast feeding at a far-too-young age. Today, Kermit turns just four months old. I feel like a total failure.

Sunday, 5/8 -- Having spent two days pumping 9 times a day and bottle feeding Kermit, it seems like all I'm doing is dealing with milk. The lactation consultant was only partially right: I did indeed only pump 18-19 ounces each day, which is horribly low. BUT, Kermit only ate 18 ounces each day, despite my offering him a seemingly limitless supply. The LC revises her diagnosis: rather than my low supply being the cause of the problem, it appears to be a symptom. Kermit decreased his demand for some reason, and my supply did what it was supposed to and adjusted to meet the lower demand. So now we have to figure out why Kermit doesn't want to eat.

Monday, 5/9 -- Kermit's well baby checkup with Dr. K. His growth is slow, and he has indeed dropped growth curves since two months, but he's still within normal bounds. We think he may have late-onset silent acid reflux. Or at least, we hope he does, because it's solvable. We start him on medication for reflux and cross our fingers. I also start downing fenugreek like it's going out of style. The hope is that the medication increases Kermit's appetite at the same time that the pumping + herbs increases my supply, so that by the end of the week, we can get Kermit back on the breast and eating a healthy amount. Which is good, because pumping 9 times a day while caring for two children is not long-term sustainable. In fact, it really sucks. At dinnertime, however, I discover a bigger impediment to finding the time to pump: LL has a sudden high fever, and will need to stay home from preschool until he's better.

Tuesday, 5/10 -- I'm home all day with a fussy Kermit and a feverish LL, trying to fit all those pumping sessions into a day already filled with caring for two mildly sick kids.

Wednesday, 5/11 -- The good news: LL seems better. The bad news: Kermit's appetite hasn't budged, and neither has my supply. At 3am, even my good news disappears: LL wakes up crying, then immediately vomits all over me. Guess he's not better after all.

Thursday, 5/12 -- All hell breaks loose. Both kids spend the entire morning crying. Kermit is burping and spitting up nonstop and wants to be held all the time. LL has horrible diarrhea and stomach cramps and wants to be held all the time. No matter which one I hold, the other one sobs. If one falls asleep, they soon wake up from their brother crying in pain. No way that I can adequately care for either one of them like this, much less keep up with the pumping. I call S and ask him to take a sick day and come home to help. When he gets home, LL is crying uncontrollably and in so much pain that he can't even hold his security blanket. He violently vomits all over his room, and I decide to take him to whatever pediatrician is free to see him. He's diagnosed with stomach flu. The pediatrician urges me to nurse Kermit as often as possible, to keep him from getting sick and to keep him hydrated. I mention the nursing strike, and the pediatrician predicts that Kermit will be sick within days, and will then need to be hospitalized for dehydration shortly thereafter. I return home with LL in total despair.

So, that's where we are right now. Three weeks ago, Kermit was sleeping well and eating well and growing well, or so I thought. Now he's a fussy mess and still refusing to breast feed for more than a minute or two at a time, getting all of his meager daily caloric intake from bottles while I desperately pump to try to produce even the small amount that he's eating. LL is violently sick with the flu and doesn't know what to do with himself other than clutch his stomach and cry. Having been vomited on yesterday more times than I can count, I can't imagine how I will possibly escape getting the flu myself, and I don't know how I will possibly keep it away from Kermit. After a week of effort, my milk supply has not increased at all, and getting sick will likely drop it even further. The lactation consultant predicts that Kermit will never breast feed again.

I'd like to say that I'm handling the nursing strike better than I did with LL. When he had his nursing strike, I sank into a month-long depression that I was only able to come out of once I gave up pumping and let my hormones even themselves out. I do feel a bit more even-keeled this time, but only barely, and it's probably just because LL's stomach flu is leaving me with very little time to dwell on how heartbroken I am about Kermit. For now, I need to figure out how long I'm willing to keep up with the pumping, holding onto the hope that Kermit may come back to me. In the mean time, I have two sick kids who need my attention, and I need to keep my head in the game.

Tuesday, May 10, 2011

200 Days Later

Here's the 200 day update to my 500 day goals. (Actually, I'm one day late, so this is my 201 day update. Things are spinning a bit out of control around here the past few days. The update on what the heck's going on is coming as soon as I have a little more time to breathe.) I have made progress on a few more of these in the last 100 days, but a lot of them are still untouched, so I find it a little scary that I'm practically halfway through. I knew that the first half would be slow, since Kermit was due just a little while into my 500 days, but it still feels unproductive to have so many of these still open. A lot of them are related to me finding a job, which is hopefully something that I will start to work on in the next 100 days.

1. Have two happy kids. (Done!)

2. Finish my PhD. (Holy cow, this one is done!!!)

3. Own a new (bigger) house. (Gotta get a job first.)

4. Work in a job that I enjoy. (Not yet. I plan to start looking for a job in another month or so.)

5. Bring both kids to visit my parents at least once. (We have a trip planned for later this month!)

6. Bring both kids to visit my in-laws at least once. (Done!)

7. Pay off all debt except the mortgage. (My last undergrad loan is out of deferral and in repayment. So I am making progress on this one.)

8. Lose all pregnancy and fertility treatment weight from both pregnancies. (That would be 22 pounds below pre-pregnancy weight with Kermit. Right now, this means that I still need to lose... 21 pounds. Before you clap too much for me that my pregnancy weight is gone, you should note that at my 100 day update, I only had 19 pounds to lose. So I've actually gained 2 pounds in the last 100 days. Good lord I get hungry when I'm breast feeding!)

9. Breast feed Kermit for one year. (Four months gone, eight months to go. Though this one is actually looking like I might not make it.)

10. Cook dinner at home 5 days each week. (I'm doing okay with this one, but only because I count reheating food I've stashed in the freezer as "cooking dinner." Not sure how I'm going to handle it when my supply of frozen food is depleted.)

11. Read 10 fiction books. (Ha! Total books read so far is still 0.)

12. Learn javascript. (Ha! Not yet.)

13. Learn perl. (Ha! Not yet.)

14. Have permanent assigned "homes" for most objects in the house. (Ha! Check back, um, after we've moved.)

15. Update work wardrobe. (I'll start working on this once I'm closer to the end of my maternity leave, and hopefully have lost a little more weight. Also, I only need a work wardrobe if I have a job, so this one is incredibly unnecessary right now.)

16. Shower every day. (Sadly, no progress on this one. Ugh.)

17. Wear makeup every work day. (Definitely not happening right now; I'm lucky if I manage to put on a shirt that doesn't have spit-up on the shoulder.)

Having a job should help me to make progress on more of these, so hopefully the next 100 days will see a bit more accomplished.

Sunday, May 1, 2011

Milk Update

I'm amazed by the differences with breast feeding this time around. With LL, I had horrible problems getting him to latch for the first 3 weeks or so -- a combination of my nipples being completely inverted and LL being rather lazy. During LL's early days, I saw no less than FOUR lactation consultants, all of whom said, "I'm sure that your nipples aren't truly inverted; it's very rare." And then they examined me and said, "Wow, yours really are! Um... not sure what to do next...." None of the first three LCs were any help at all, and then I struggled alone at home for a while, during which time LL barely gained any weight. S finally convinced me to go see another LC, and she was wonderful and helped us to pull through. By the time LL was one month old, we'd worked through the problems and breast feeding was great.

Kermit has been a completely different story. With LL, getting him to latch was unbelievably frustrating, and it required three hands, which meant that S had to actively participate in every single feeding for the first several weeks. But, I never had any pain. None. With Kermit, he latched on immediately, every single time. And I was so thrilled that I didn't have to fight so hard for a latch, and I could do it without S's help, that I didn't really pay attention to whether he had a good latch. By Day 5, it became clear that he was mangling me a bit when he ate, and by the end of the first week, I was in a lot of pain. This time around, though, I knew what to do -- we immediately called the LC who was actually helpful the last time, and once again, she was sympathetic, and she made it clear that she was considering both my interests and Kermit's interests, rather than ignoring me and just focusing on the baby.

Everyone told me that breast feeding my second child would be a lot easier than it was the first time around. And indeed, it has been a lot easier. Still, it hasn't been easy, and I hadn't really thought about that distinction before. There has still been a lot of frustration, and a lot of physical pain, which is something that I didn't see coming, since it hadn't happened at all with LL.

It turns out that Kermit did a lot of damage to my right breast in particular during those first two weeks or so. The LC told me that I needed to rest it for 2-3 days, pumping that side while feeding Kermit just on the left. She assured me that my milk supply was sufficient that he'd get plenty of food from just that one side, but by the second day of that plan, it was clear that she was wrong -- Kermit was ending each meal by screaming his little head off because he was still hungry, and once I clued into that, I started topping him off with a bottle of the milk that I'd pumped from the other side. In the mean time, he had so continuously and vigorously nursed exclusively on the left for those three days that he managed to damage that breast as well. So by the end of the third day, my right side had healed a bit (but not completely) and my left side was now sore as well. I went back to nursing on both sides, hoping to let my left side rest a bit, and the very next day Kermit got inexplicably frustrated at the beginning of one meal and bit down, hard, on my newly healed right breast, re-damaging it to the point of being even worse than it had been before the three days off.

We went back to the LC at that point, who offered a few more suggestions, and things have improved since then. My left breast got better quickly, but I continued to have a fair amount of pain on the right side during each feeding, and the damage to that breast was still visible, for a full two months.

With LL, all of the breast feeding frustration felt like it involved teaching him to do the right thing, which was very very stressful, but I always felt like we'd pull through it. This time around, all the frustration was within me -- will I be able to suffer through the intense pain I was feeling at each and every feeding, 9-10 times a day, for however long it would take for the pain to go away. It was a completely different kind of frustration. The worst part was how ridiculously sensitive my right breast was. When Kermit was seven weeks old, I still couldn't sleep on my stomach, because I couldn't put that kind of pressure on my right breast. Same thing with sleeping on my right side, which is normally how I like to sleep. Sleeping on my left side was okay, but only if I cradled my breast carefully with a pillow and avoided resting my arm on it.

It was like that for a full two months, and then all of a sudden, it just got better. No more pain. Yay!

Of course, it got better just in time for Kermit to enter his I'm-too-distracted-to-eat-well phase, where he eats for ten seconds and then needs to turn his head to make sure that he's not missing something interesting at the other end of the room. (He even does this in the dark -- what does he expect to see when he turns his head?) He latches and unlatches himself a gazillion times each feeding, and I have no way of knowing when he's truly done eating. And it's sad, because the part of breast feeding that I love the most are those long, peaceful nursing sessions where the baby snuggles against my body and drinks deeply and gives little content sighs. I feel like I was in the pain the entire time that Kermit was doing that, and now he won't settle down like that anymore, except occasionally at night, so I feel like I just sort of missed that phase. I only had a very brief period of time when LL was like that, too -- just a month or two, and then he entered this distracted phase as well, and then he went on strike and stopped nursing entirely.

Indeed, LL's nursing strike is hanging over me every time I nurse Kermit. I was so heartbroken when LL went on strike because it was so sudden. This time, each time Kermit nurses, I wonder if he's going to do the same thing. What if this is the very last time he nurses?!? He had a mini one-day strike a few weeks ago, and I completely panicked that he would never nurse again. So, I'm trying very hard to relish every breast feeding session we have that goes well. I'm also being a bit paranoid about anything that might have caused LL's strike. With LL, we dutifully gave him one bottle a day, as recommended for babies that need to learn to eat from a bottle. With Kermit, he's only had two bottles in the past six weeks, as I try to make sure that he believes that all milk must come from Mommy, at least for now. We'll see how it goes. In the mean time, I'm just relieved that nursing is pain-free for now, and that Kermit is growing and thriving.