Thursday, November 30, 2006

Hey, Just Act Natural

Just a quick run down of places and situations I've breastfed my baby in:

on a panel, giving a presentation
during a Toastmaster's meeting
during a board meeting
in the chair getting my eyes examined
in front of a room full of med students doing rounds
at the airport during a protest
at a women's investment group meeting
at the mall
hotel lobby
at the grocery store
in the waiting room of the pediatrician's office
in front of relatives at family gatherings
at restaurants
at a breastfeeding committee meeting

At no time and in no place have I recieved negative feedback- to my face. My philosophy is simply this; anytime, anyplace. I've lately wondered why I 'get away with it' Am I so discreet no-one knows I'm doing it? Am I so bold and brazen folks are shocked into silence? Am I so confident and natural about it, that no one questions me? Perhaps a little of all the above. At any rate, I'm tickled pink to be nursing all over town and doing my part to make breastfeeding an accepted and acceptable behavior in public venues.

Wednesday, November 29, 2006

Have Agenda, Will Travel

Well, I guess the hiatus is over. I have applied for 3 speaking engagements for next year. I didn't speak at all this year (except through this blog) because of the pregnancy. Now that opportunities are presenting themselves I can't wait to jump in start again next year. So far (if I'm accepted by all) I'll speak on breastfeeding in San Francisco in Feb, SIDs in KC in Feb, and breastfeeding in Florida in Oct. I'm glad I've devoted time to refining my speaking skills through Toastmasters this year, and private coaching last year. Now I can devote myself to content and not making a fool of myself in front of scores of my colleagues. Yesterday at our monthly Breastfeeding Committee meeting someone mentioned an LC position at the city hospital (they don't currently have an LC, their bf rates are in the toilet and they have a high population of Latina, AA, and immigrant and refugee populations- some might think I would be a descent match for this.) I asked myself yet again, why I didn't see myself in that role. I could become an LC within the year if I wanted to, but I don't want to. Its not my calling, neither is being a midwife, or a doula, or a cbe. This is problematic for me because I very much want to talk about breastfeeding and birth- even while my career choices take me further away from active practice. I have no intentions of doing L&D again, yet its that credential that lends me the most credibility. I get excited about writing and speaking, but not about doing the things I want to speak about. This seems inconsistent to me and somewhat uncomfortable. But I'm older and wiser now. I won't stretch myself to fit someone else's mold- I have to do the things that in my heart I know I must do. Someone better than me will have to take the LC job (I hope she's African-American and bilingual and works well making change within systems). My job is to create change with my writing and speaking abilities, or make a fool of myself trying.

Tuesday, November 28, 2006

What Would Mr. Rogers Do?

Boy, am I ticked. I found out a few days ago, that my midwife, Kirsten can no longer continue her homebirth practice! Why you ask? Because her collaborating physician's malpractice insurance will no longer cover him if he backs homebirth after the end of this year. Talk about a catch 22. Certified Nurse Midwives can't practice without a collaborative agreement with an OB and OBs can't collaborate without risking thier malpractice coverage. How's that for a kick in the head. Can you say "restraint of trade" boys and girls?

Thursday, November 23, 2006

Thanksgiving Meditation

I sit here profoundly grateful for my life and those who fill it:
my husband, whom I am blessed to share this life with
my baby Josiah who breaks my heart with his beauty and stregnth
all my other children who are so bright and healthy
my grandchildren who are well rooted and grow strong
my parents and grandmother who love me and keep me grounded
my sisters and thier families who fill my life to the very edges
my in-laws who gird us up and provide a strong support
my friends who keep me vigilent and accountable
my two cats and dog who give love and companionship so freely
all those in my life who freely share who they are and what they have
my creature comforts of hearth and home
my will to give, to take, to produce
my sense of mission
my saviour
my vision

Tuesday, November 21, 2006

Down in the Delta

Just back from the National Nurse-In. Josiah and I were the only ones there! What a disappointment : ( But I'm glad we went anyway. My sign read, "Delta's treatment of breastfeeding mothers is offensive" I passed out breastfeeding info, talked to a couple of folks and Josiah did his part by waking up to have a leisurely nosh at the breast (what a good little protester). He actually got more attention than I did. More people stopped to look at him than talk to me about my sign. Anyway, its done. Sorry Kansas City had such a low turn out and hope other cities fared better. But I feel great that we did our part.

National Nurse-In

Today is the National Nurse-In. Josiah and I will be at the Delta counter at our airport. I don't know if anyone else in town will be there, but we will be! I did sent out a few emails to the BF community but got no definite responses. I wish there had been more lead time, but it is what it is. For those who haven't heard, the Nurse-In was organized in response to a breastfeeding mom being removed from a Delta flight for failing to nurse "discreetly" (i.e. she refused to use the blanket the flight attendent brought her). I wouldn't use the damn blanket either. Seeing as Josiah and I will be flying several times next year (Mexico in January, San Francisco in February for starters) I certainly don't want to be harrassed while feeding my baby. I can't wait to get to the airport this morning. I've been working on my sign. Perhaps it'll say something provocative like "The boobs at Delta are offensive, not mine!" (okay, I won't make a sign like that, but part of me wants to) My sign will probably say "Delta unfair to nursing mothers" Anyway, kudos to all my Dear Readers who plan to attend the Nurse-In in your city.

Monday, November 20, 2006

My New Mantra

Created for me by Dear Reader, Celeste,

Flow milk flow
Grow Josiah grow!

A Steady Incline

So thankful that you both are well. I think there is still so very, very much we *don't* understand about nursing (and birth too)--nobody cared because it was "women's business" for years, and then formula came along and the medical establishment decided that was good enough, so why bother? Lots of women have so much trouble for no reason anyone understands! Is it the environment, or chemicals in our food, or something like that? Was it always this hard, or is it harder now?We *should* know a lot more than we do, so mamas like you might at least know how to work on it more effectively, and more babies would stay breast fed. It makes me angry that we don't. I had so much trouble with my supply, much like yours..but I assumed it was because of my c/sec. And I was so depressed that I had to put all my energy in that fight, not in nursing, so he became a formula baby at 2 months. And I felt like a failure, because everyone told me it was supposed to get easier. If I have another, I'll know I might have a fight on my hands, and plan accordingly. Thanks for blogging about it.

This comment from Dear Reader, Emjabee, really hits home the point that breastfeeding mothers are being failed. I'm all about stemming the tide of this societal failure. But first I had to confront my own predjudices. I fought giving Josiah formula in the hospital for two days. I didn't want to believe the problem was my milk supply. Then my 28 year old visited me and told me not to resist on account of my pride. He was right. I was prideful about being a successful breastfeeding mother, proud that I was the mother of nine and had homebirthed and breastfed 5 previous babies. I was also embarressed that this was happening to me- the town breastfeeding self-proclaimed guru (chairperson of the breastfeeding committee, yada, yada, yada) People came to me with their breastfeeding problems. Now I was having problems- major problems. It was a blow to my pride to give Josiah formula. I let the nurse give him the first formula bottle- still too proud to do it myself. As the days passed and it became indisputable that my milk supply was the problem, I remembered something I had heard Dr. Newman say at the conference last month. He spoke of formula feeding as a medical intervention. Surely, in this case, that's exactly what it was. I have no intention of abandoning breastfeeding. I'm taking 3 herbals and 1 medication (+ the beer) to boost my milk supply, and using formula in the meantime to increase his caloric intake. My baby needed the food, and if I couldn't supply him with adequate amounts of the best type of food, then the second best will do- for now. The more I saw him plump up as the days passed the more I became committed to supplying him with what he needed. I feel ashamed that I refused the formula at first on account of my pride instead of doing what was best for Josiah. I look at him now, his face fuller, his skin no longer sagging against his lanky limbs. I'm so thankful for the lactation consultants, and the nutritionist who worked with me to boost my supply while gently allowing me to introduce formula slowly and at my pace. I also thank you, Dear Readers- I feel your prayers and support. They are being answered because today, I pumped twice as much milk than I was getting when I was in the hospital.

Sunday, November 19, 2006

Shut Your Humble Pie Hole

We're home! Josiah's weight gain was sufficient this morning that Dr. W and the team let us go on home. We left the hospital and went straight to church. I felt the need to formally give thanks- and I wanted to see my friends after being isolated for a week. When I got home, I left Josiah in the baby-starved hands of his siblings, and crawled into my bed and slept peacefully. Its so good to be home with my baby-so good to see my kids. I feel full of gratitute. So what's the lesson here? I got to help myself to a great big helping of humble pie. I have to confess that in my heart, when a woman complained about her milk"going away" I dismissed her as lazy or uncommitted. After having my infant hospitalized for 5 days on account of a diminished milk supply, I think I'll have a little bit more compassion.

Saturday, November 18, 2006

A Slow Increase

The LC hooked me up with a lactaid device yesterday. So now I can breastfeed and supplement simultaneously. Its a pain in the butt but it keeps him on the breast while my milk supply rebuilds. This Medela hospital grade breast pump is sweet. I can pump both breasts in about 10 minutes. If only Josiah could work so efficiently! Dr. W and the team rounded this morning and said if his weight gain continues, he can go home on Monday. Yipee. You know, despite all the stress and work, this has been kind of a respite for me. Is that sad or what?

Dropping- Not So Much

Well, its done. I'm either breastfeeding or pumping and fortifying the milk, then following that with formula supplementation. After doing that for 24 hours now, I really do think he wasn't getting enough milk. All signs point to a reduced milk production. All his labs keep coming back normal (a few are still out). He's been gaining about 1/2 ounce per day. His face looks plumper to me. Even his little bottom no longer looks like sagging old man skin. I should be thrilled he doesn't have some dread metabolic disorder, but I feely badly that I was feeding him on starvation rations for two weeks. I'm still working on getting my milk back. My son will smuggle in some beer today. Hope to get my reglan perscription filled also. I've barely left this room in days. My kids came to visit last night and I took them down to the cafeteria for treats. I realized I hadn't even so much as stepped into the hall in two days. Making and feeding Josiah milk takes all my time. His Ped called yesterday and told me to take more naps to help my milk production. I'm following her orders. To say I'm exhausted and sleep deprived is an understatment. But its worth it to finally see progress.

Friday, November 17, 2006

A Drop in Spirit

The Gold Team just left. Josiah's urine output dropped. That means he's really not getting enough milk. More confirmation that I'm losing my milk supply. How is this happening and why? I'm working hard to get my milk to come back, but I pump less and less each time. What am I doing wrong?

A Voluminous Drop

Josiah's labs keep coming back normal. My milk supply keeps dropping. I started to supplement him last night. Each time I pump, I get less and less milk. I don't know now if my milk supply started dropping and made Josiah lose weight or if the stress has made my milk supply fall. Either way, despite the galactagogues, I'm losing my milk.

Thursday, November 16, 2006

The Waiting Game

I sit here in Josiah's room awaiting a visit from the "Gold Team" Dr. W and her legion of residents. I have started my regimen of galactagogues and medication for thrush. I've stepped up his feedings to every three hours around the clock and pump after each feeding to further stimulate my breasts to greater production. I'm doing my part but I'm not sure Dr. W will be impressed. He did gain weight in the last 24 hours but they attribute it to the IV fluids. Just to make things more interesting, I've had a tooth ache for 3 days and can barely talk. My dentist can squeeze me in this afternoon, so I'll leave Josiah with dad while I run over and get this tooth taken care of. I'm looking forward to seeing the Lactation Consultant this morning. I wish she would come at the same time as the team but I guess they don't coordinate that way. I'm hoping I'll hear something conclusive from all these tests they've been running. Some of them take a day or two to get back, so it may be Friday before all results are in. In the meantime, I just enjoy watching his sweet little face as he sleeps or nurses or earnestly searches my face and coos. Such a sweet little guy!

Wednesday, November 15, 2006

A Precipitous Drop

Dear Reader,
Please do not be unduly alarmed by the news I have to share. Josiah was admitted to the local children's hospital last night. This is what happened. Over the weekened, I began to think that I should take him to the Ped for a weight check. He just didn't seem to be gaining any weight. At his two week exam, he had gained a full pound, but I just didn't see him plumping up. He looked as scrawny as ever to me. After going around in my head all weekend about it, I called the Ped on Monday to bring him in for a weight check. I took him in on Tuesday afternoon. I couldn't believe my eyes when the nurse put him on the same scale as two weeks previous and it read 5lbs. 10 oz.! His birth weight had been 6lbs, 14oz. What the hell happened? He was a beautiful and robust nurser. He peed and pooped continuously. How could he have lost 2 lbs in 2 weeks and I not notice??? I couldn't even go home and pack, the Ped sent me to the children's hospital and gave me 20 minutes to get across town and admit him. I looked at my beautiful little boy. I so didn't want this for him. I felt like I had failed him. The Ped, a handsome young man who looked young enough to be one of my kids (my regular Ped was off yesterday), tried to comfort me by telling me I had done what I was supposed to do- I thought I saw a problem and brought him in. I knew he needed to go, but I confess I didn't want to take him to the hospital. I called my husband, and then headed in. My husband met me in admissions and we took him up to his room. All the rooms are private and quite lovely. (we're quite fortunate to live near such a first rate children's hospital- its a real show place) It held a crib for Josiah and a daybed for me, a bathroom, a small fridge, a closet a rocking chair, and lots of space for visitors. I settled Josiah in, and made a list for my husband of my things to bring me, especially my laptop. My husband went home to take care of the other kids, while I silently vowed not to leave Josiah's side. Whatever procedures he had to endure, I would be right there with him. The team of doctors (this is a teaching hospital, I've probably seen about 12 residents already) ordered lots of labs that have to be spread out over a couple of days, as he can only spare so much blood. He's a very difficult stick since he's so skinny and dehydrated besides. Its taken multiple sticks for each blood draw (poor baby). The last nurse finally just drew from a vein in his head and got sufficient blood. They also started an IV in his head as well. The upshot is the weight problem is either due to insuffient milk supply/calories, or inefficient metabolism. He nurses well, pees and poops, has no vomiting or diarrhea, and no fever. I would hate to think that my milk supply is the problem, but thats better than a metabolic disorder. Of course the docs wanted right away to supplement, I told them no. If milk supply/caloric intake is the problem, then I should work to correct that. The lactation consultant along with the nutritionist put together a plan, that the docs grudgingly will go along with- for a day or two. I am boosting my supply with more frequent feedings, post feeding pumping, domperidone pills, fenugreek tablets, and mother's milk tincture. This regimen should have me swimming in milk. If we don't start to see weight gain, then we will move to fortifying the expressed milk. We also discussed using human milk from a milk bank. I have liked working with a multidisciplinary group- and they all are agreeable to letting the lactation consultant lead the way- for now. The labs so far show nothing, except a little dehydration, but most are still out. They've taken blood, stool, and urine and seem to be leaving no stone unturned. My friends have been priceless. They gathered the domperdome, funugreek and tincture and got it to me at the hospital. The lactation consultant was very impressed that I could get my hands on these items, and so quickly. I simply told her, its all in the network! Those meds passed through many hands coming across town to get delivered to me. What wonderful friends and family. My mother-in-law is with the other kids so my husband could go on to work. Tonight, my job is to feed and pump, and rest when I can. I feel blessed that Josiah is recieving good care and that I can be here with him every step of the way.

Tuesday, November 14, 2006

Solving the SIDs Mystery

I read this excellent article in this week's issue of US News and World Report. Its been about 2 years since I've heard or read of any new info on SIDs (Sudden Infant Death Syndrome). I attended an excellent SIDs symposium here in my city in 2004 that included input from all the players, from docs, to social workers, to psychiatrists, to police detectives, and district attorneys and medical coroners, to community outreach workers. SIDs was examined from every angle, they even showed case studies of how SIDs investigations are carried out. I learned so much from that community symposium. I discuss what I learned, regularly in my pediatric CPR and first aid courses with students, (mostly nannies and childcare workers). I encourage you to read it, its not so very long, the jist of it is that new evidence points to SIDs being a disease caused by an abnormality in the brain. If this is so, a screening test could be developed to determine which babies are at risk, at birth. I remember my hermitess friend, Sr. Morningstar telling me once, (while she was taking a CPR class from me) that putting babies on their backs was *counter-intuitive.* While I agreed, I also couldn't discount the research that showed the dramatic drop in SIDs deaths since the practice has been implemented. I thought of Morningstar as I read the article. If effective screenings were created, then identified "at risk" babies could be put "back to sleep" while perhaps those not at risk could go back to sleeping on their bellies. I'm also excited by this research in that proving SIDs is a disease will not only give us tools for prevention, but will provide an answer to all those suffering parents who have lived through the experience of SIDs and ask themselves, "Why?" I'm sending my prayers to all those researchers, even as Josiah naps (on his back, of course) while I write.

Saturday, November 11, 2006

Have Baby, Will Travel

I have taken Josiah along me now to three meetings, my biracial family support group, my women's investment club, and the healthcare foundation board. He nursed at all of them. I also had him in tow as I attended two school functions and taught a couple of CPR classes, with him tucked into his sling. He causes quite a stir everywhere we go- all of it positive of course. I may face some friction, but I've decided to keep on carrying him to my meetings. He is such a sweet little thing, I can hardly bear to leave him. He should be with me, its his rightful place. I love the convenience of breastfeeding wherever I go. To see his angelic little face, his eyes shut tight, his little fists balled tightly, his nose twitching and jaws working back and forth as he concentrates on the work of getting milk. He's an incredible delight. I love to snuggle with him against me and breathe in his warm milky breath, to nuzzle his fuzzy little round head. I'm getting better at sharing him, taking him out of the sling so others can hold him. At first I didn't want to share at all, and would wickedly keep him all to myself. Now I can see the joy he brings to others- its a rare treat to snuggle a newborn.

Wednesday, November 08, 2006

A Birth Mother's Story

Last night I participated in a panel of birth mothers at a meeting for multi-racial families. Most of the audience were adoptive families with biracial or African American children. The panel included myself and two ohers, Peggy whose child is 35 and Sheena whose child is 15 months old. My adopted son will be 24 this month. Sheena was accompanied by her son's adoptive parents and together they spoke about open adoption. Both Peggy and I had closed adoptions so seeing how open adoptions works was very eye opening and educational for me. The audience seemed very grateful to hear the point of view of birth moms. I still think there is a stigma for birth moms even while everyone extolls their courage and selflessness. The three of us had an opportunity to tell our stories and take questions from the audience. Peggy had a particularly touching story of reuniting with her adult son a couple of years ago and how it felt to come full circle. My adoption search is still in the future. I don't know the impact to the audience, but I hope they found it helpful. I learned more than I was able to share. As I sat in front of the audience playing with my newborn, it struck me that at least some of the women in the audience were adoptive mothers because of infertility issues. It made me wonder if this is the crux of the divide between adoptive and birth mothers- perhaps the birth mother is a constant reminder of what the adoptive mother cannot accomplish and as such must be put out of sight, out of mind, marginalized and stigmitized. At any rate, I'm glad I sat on the panel and told my story.

Tuesday, November 07, 2006

The Nipple Nosher

Josiah is having his 3 week growth spurt. How do I know? By his dedicated attempt to nurse my nipples into bloody stubbs. Being a highly trained professional (ha), I recognize the signs of a growth spurt in progress and am not panicked by his seemingly insatiable appetite. I know this is when inexperienced, first time moms run for the phone in tears to their OB, pediatrician, LLL leader, fill in the blank whatever, about how breastfeeding is not working because the baby is hungry ALL the time. Does this in any way make the experience easier for me? No. After nursing him for over an hour last night (visiting each breast, twice) he continued to fuss, where before he would have settled down to sleep. Not wanting to compromise my tissue integrity (ie. develop sore nipples) and satisfied that he couldn't still be hungry (and that even if he was, my breasts were, for the time being, empty) I opted to hold him in my arms and let him cry. I didn't have the heart to abandon him to his cold lonely crib. He cried about 15 minutes, then slept till morning. This morning he again nursed over an hour while my nipples screamed for lanolin cream. I had forgotten how much fun growth spurts can be.

Bless the Lord

Bless the Lord, oh my soul and all that is within me, bless His holy name.
Bless the Lord, oh my soul and forget none of His benefits.
Psalm 103

Ok, maybe God knew what he was doing after all! At any rate He sure does good work. Even though my husband refers to the baby as "Golem" (you know that long skinny creature in Lord of the Rings) I think he's beautiful and perfect in every way. It's scary how much I love this baby. I'd do anything to protect him and keep him safe. I feel so blessed to be entrusted with him. I stopped by my kids old school yesterday, to show off the baby and visited nearly an hour with the school secretary, Lisa, whom I've always liked a great deal. She and her husband have four kids but have been trying to get pregnant again. After hearing her longing for another baby (and some infertile ladies I've talked to) its easy to see there is something worse than having a baby unexpectedly after eight years- not being able to conceive when you want to desperately. Oh how I shudder at some of the things I said and wrote before. Such ingratitude, such arrogance. I wouldn't change one step of this precious journey. I'm so glad Josiah is a part of our lives. I would have missed so much if he had never come to be. Thank you, Lord, thank you, a thousand times, thank you for knowing better our wants and needs than we know them ourselves.

Sunday, November 05, 2006

Big Blessing in a Small Package

I've just spent two days doing no work and holding my baby almost continuously. What a great two days. He's so long and scrawny. He doesn't really look like any of our other kids. He's quite unique. He loves to nurse and is quite good at it. I love the way he raises his eyebrows when he's sleeping, and the way he greedily sucks at his fingers when he's hungry. He has my husband's thin lips while the rest of the kids inherited my thick luscious ones. His thin fine baby hair is developing a 'crimp' so I'm wondering if he'll be the first of our kids to have kinky hair. All of my other babies were nice and plump, Josiah is long and skinny with piano player fingers and elongated feet. The crown of his head is nice and round but his face is long and lean and triangular. He oftentimes look like a wise old man while he sleeps. His eyes are huge and round and turning a lovely shade of brown from their current dark and murky hue. His skin is fair and his eyes often cross when he tries to focus on images close up. The girls fight to change his poopy diapers. I carry him everywhere in our sling. Most of the time people don't even know I'm carry around a baby. He's so small, he can't be seen in the sling, he slumps down into it. People always carry on likes its such a nice surprise to discover a small baby in a pouch. I love to show him off. I took him out of the sling at church today (for the first time) and let others hold him. It felt good to share him. My friend, Lee is dying from lung cancer that has metastisized to his brain and lymph nodes. It was especially satisfying to see Lee holding Josiah. He has two grandchildren due next year, that he may not live to see. I really wanted him to hold Josiah and smell his little fuzzy head. I wanted to give him that as a gift. I know its not the same as him holding his own unborn grandchildren, but its something I can give him. The airy sweet weight of him, no more than a small sack of potatoes, takes my breath away. His sweet little cry breaks my heart. What an incredible blessing this little guy is.

Friday, November 03, 2006

Farewell My Beloveds

I said goodbye to my beloved Brits yesterday. I will miss Larry and Lucy and baby Harper. I visited them to see my birth video and to say goodbye until they return in December. It was so good to see the video. Its funny, how my perception of the birth is that it was dark in the room, but the video showed a brightly lit room with sunlight streaming through. Watching the video I realized my eyes are closed most of the time (which accounts for the perception of darkness- ha!) Even though I lived it, I was really cool to see it on tape. My face looked at times in great pain and discomfort and at other times serene and beautiful. I loved seeing myself own my own birth experience and utilize coping skills that worked for me. I loved seeing my birth. The best part was after Josiah was born and I'm holding him and turn around and sit on the sofa. I didn't remember this, but on the video, I start laughing and laughing and laughing as I hold him and look at him. I don't remember doing that but celluloid doesn't lie. Its such a free and hearty laugh, so appropriate for the high that follows a joyous birth. Larry and Lucy will take all the video back to England and begin the editing process. They will send me some clips which I will *try* to post.

Wednesday, November 01, 2006

My whole world fits in a sling

I visited with the videographers a couple of days ago. They came over to do the final filming to follow-up the birth. I always worry that I won't sound convincing. Hopefully, the birth will speak for itself. Films and pictures have a way of conveying things we never meant to say, but it is what it is. Larry and Lucy (and American-born Harper) head back to the UK on Friday. I will miss them. I'm going to try to go over to their place today to view some footage of the birth. They didn't want to show me any before all the filming was done. I'm eager to see it since I only "viewed" the birth from inside my head. I want to see what it looked like from other's perspective. I feel so blessed as I sit here and type, with a little baby in my sling resting on my lap all squished up in a little warm breathy ball. He loves the sling (as all my babies did) and I love using it! He's so sweet and wonderful. I wish I could spend all day holding and staring at him. But I didn't go to the office yesterday, didn't even check phone messages, so I've got to get some work done today. I'll just take him along with, or if he falls asleep, leave him with his Dad while I rush there and back. Funny, I used to think, 'how will a baby fit into my life?', now my whole world revolves around him.