Tuesday, January 31, 2012

Us Three Girls

I'll never forget telling one of my mommy friends in Chicago that we were moving to New York.   When she realized I was going to be in New York when I had our second baby, she gasped and asked gravely, "What will you eat?"  Thinking I perhaps misheard her (she speaks with a sometimes heavy Mexican accent), I asked her to clarify.  "How will you get food?  After the birth, what will you eat?" she wondered.  I wondered, then, too.

We are truly blessed with generous family, though, who were willing to give up their time, vacation days, and resources to come and help us as we transitioned into a family of four.   For the first couple days after Etta's birth, Tyler took care of us three girls while our parents re-worked plane trips to try to get to us sooner than they had planned (no one had anticipated Etta's arrival being ten days before her due date- except me, maybe).  First, Tyler's mom stayed with us for a week, then my mom came for a week, and then my dad was here for a week.  We fully realize how fortunate we are to have had so much help from family, especially since they all had to fly in to be with us.  The lovingly home-cooked meals and help with housework really played a part in my recovery.  Most of all, having someone to play with Tye so I could nurse Etta or hold Etta so I could cuddle with Tye was priceless.  Dividing my attention between the two girls has been the hardest part of mothering two for me so far.  Those extra hands for the past three weeks were lifesavers.  

Yesterday was my first day with the girls without other adult help.  To say I was nervous about it wouldn't be an exaggeration- on Sunday, I was pretty scared of what might happen- or not happen.  I still spend a huge portion of each day sitting while I nurse Etta, and that can be hard for Tye, who has so much energy.  Until Etta can nurse in the sling while I can simultaneously entertain/chase Tye, I worry about how I'll manage.  

However, our first day was a notably excellent one.  We made coconut macaroons in the morning, did a load of laundry, napped, went to the playground in the afternoon, ran an errand on the way home, and made dinner, all without any major meltdowns from any of us (and we didn't resort to turning on the TV ever!).  That's a full day in my book.  While I know they won't all be this easy, starting out on a good note- or a good day- is always helpful.

Photographic evidence that we made it to the playground on day one of Us Three Girls:
(Don't worry, I could see Etta's face easily as she slept on my chest.)
The Big Sis!

Monday, January 30, 2012

Third week update

Wednesday's appointment with the Ear, Nose, and Throat specialist (which feels like forever ago) went incredibly smoothly.  My dad was in town helping out, so he and Tye came with to the appointment and I was incredibly grateful to have someone watching Tye while I waited nervously in the waiting room.  The doctor to whom we were referred was excellent- he was friendly and caring and also knew exactly what a breastfed newborn needs for an efficient latch.  He clamped Etta's frenulum, then quickly snipped it and- perhaps the smartest move of the day- had me hold a piece of gauze and apply pressure over the cut for 90 seconds.  Giving me a task at that moment forced me to into action rather than sitting, watching Etta and worrying about her.  As I held the wad of gauze in place, Etta stopped crying and was ready to nurse after the 90 seconds were up.  At home that evening, Etta seemed to be a little uncomfortable, which was hard to watch, but she slept well and was fine the next day.

The doctor who performed the fenectomy told me we'll likely see slow, continued improvement in Etta's latch over the next three weeks rather than an immediate improvement that day.  Sure enough, Etta's latch seems to be slowly improving as she learns how to use her new tongue.  Her latch is very noticeably stronger now, and she often needs less assistance to get a good, deep latch, but she still isn't completely clearing the breast on her own at a feeding.  It's only been a few days, and Etta seems to be taking in less air when she nurses and has less gas, though both are still happening (then again, that just happens with some babies...).  When Etta cries, I still look into her mouth at her new tongue in amazement.  

I get to see that tongue fairly often.  Etta's disposition is very different than Tye's when she was a newborn.  While Tye slept all day, every day, and had to be roused for feedings, Etta rarely stays asleep for long periods of time and wants to nurse constantly (partly, perhaps, because she never gets all the milk out of my breasts).  Whereas Tye, in her sleepy state, barely cried and never screamed unless it was really a serious event, Etta will be sitting or sleeping peacefully one second, then screaming the next.  I'm very grateful that Etta isn't as sleepy as Tye was in her first weeks, because I know that sleepiness contributed to my supply issues with her (she, too, never finished the breast, because she would fall asleep two minutes into the feeding and then sleep several hours...).  But I'm also grateful that Etta is my second child and I've had the experience of an easily consoled baby.  I feel confident in my parenting style and choices and know significantly more about breastfeeding this time around, so I'm not second-guessing my every action.  When Etta opens her mouth to scream and gives me a glimpse of her clipped tongue, I remind myself that she is making her needs known and that I'm doing everything possible to meet them.  

Wednesday, January 25, 2012

Monday, January 23, 2012

All Tied Up

During the hours after Etta's birth, she nursed quietly and slept peacefully.  Our midwife left just a few hours after her birth, leaving us to catch up on rest and bond as a family of four, knowing she would be back the next day to check on us.  That evening, as Etta let out one of her first real cries, I caught a glimpse of her little pink heart-shaped tongue.  Etta is tongue tied.
The heart shape; it sometimes looks even more pronounced.
I wasn't at all surprised to see the tip of Etta's tongue being pulled down by her tight frenulum.  My paternal grandfather, his three daughters including my mother, and one of my younger brothers were all tongue tied, and all but my brother had their tongues clipped.  When our midwife returned the next day, she confirmed that Etta is definitely tongue tied, but thought that between the strength of her latch and her ability to to reach her tongue beyond her gum line, that we would be okay nursing in the short term at least.  The midwife decided to return again on the third day to weigh Etta again, just to be sure she didn't lose more than 10% of her body weight.  By then, Etta was within the 10% weight loss allowed and my milk was already coming in, so we felt good about waiting until our one week appointment with the pediatrician.

Signs of tongue tie include Etta's heart-shaped tongue; difficulty latching, staying latched or a painful latch; slow weight gain; and recurrent clogged ducts and/or mastitis (especially if combined with slow weight gain).  When a newborn is tongue tied, her shorter tongue makes establishing an effective latch difficult or impossible, which in turn makes emptying the breast a challenge (making the mother prone to clogged ducts and mastitis).  With that in mind, I started several practices to make sure Etta would get as much milk as possible and gain as much as she could in her first week.  

First, I made sure Etta nursed at least every two hours- and often, Etta ensured she nursed at even shorter intervals.  Because she was drinking less at each feeding than she would have been with a great latch, those feedings needed to happen more often.  During nursing sessions, I used breast compressions to help Etta empty the breast (Dr. Jack Newman has a great video on breast compression technique, which you can use with any nursling, available on YouTube here).  To help establish a sufficient supply, I let Tye nurse often in place of pumping after nursing, which prevents a low supply that can accompany a poor latch.  

Using these techniques, Etta regained a good amount of the weight she lost after the birth by her one week appointment and weighed in at 6 pounds 8 ounces, close to the 6 pounds 13 ounces she weighed at birth.  By her two week appointment this past Thursday, Etta was up to 7 pounds even.  Although she wasn't worried about it, the pediatrician referred us to an Ear, Nose, and Throat specialist to look at the tongue tie because I expressed my concern at Etta's constant nursing, inability to clear the breast, and air intake during nursing causing extreme gassiness.  

Then, Thursday afternoon, I suddenly came down with mastitis.  I woke from a nap with a throbbing lump in my breast and within hours had a fever, chills, body aches, and a red, hot, swollen breast.  Thankfully, my mom is in town this week and was able to help entertain Tye and take care of me while I rested and tried a variety of natural remedies to take care of the infection.  By Saturday morning, with my regimen of raw garlic, increased vitamin C, topical applications of lavender essential oil, extra sleep, alternating heat and massage, and frequent nursing, my fever had broken.  I'm still keeping up everything I was doing because I still have a red, warm lump on my breast signaling at least a clogged duct, but now that the fever has lowered, I feel significantly better.  

At least, physically, I feel better.  Emotionally, I'm nervous about our appointment on Wednesday with the specialist.  I think Etta is a great candidate for a frenectomy, but I worry about the pain she'll experience and her- and my own- ability to cope with that.  Though my mom leaves town tomorrow, my dad will be here to help watch Tye during the appointment- something I'm extremely thankful for, since I don't think I could handle such an emotional appointment with Tye along, too (couldn't you just imagine the three of us all in tears, the doctor staring at us, speechless?).  

I'm hoping the frenectomy can be done quickly at the appointment Wednesday and that it provides a solution to Etta's weak latch, her constant nursing, and her gassiness, and that it prevents future bouts of mastitis.  Hopefully, the short-lived pain will be outweighed by the result of a happier baby, healthier mama, and easier nursing relationship.  Time, and likely a snip, will tell.  

Another great post on tongue tie, its symptoms and diagnosis, its affect on breastfeeding, and frenectomies was posted recently by Mommypotamus- a great read!  And Kellymom.com has great information available here.

Friday, January 13, 2012

Happy Birth Day, Etta!

On Wednesday, I washed three loads of laundry and baked two batches of cookies and cleaned our whole apartment top to bottom.  It wasn’t out of necessity- I was scrounging to find laundry dirty enough to wash and cleaning an already clean house.  I can only explain it as hormone-driven nesting, which felt like an intense, deep-down need to do those things.  It was the most intense of day of a week of nesting, during which time I accomplished everything on my to-do-before-baby list.  Physically, I was feeling quite uncomfortable- for almost a month, Baby Girl had been sitting so low I felt she might pop out if I squatted down; the Braxton-Hicks contractions were frequent and intense at times; and though the nesting hormones helped me accomplish an insane number of chores, they were keeping me from resting at all, and I was exhausted. 

Late that evening, while I was in the shower, I decided to have a little chat with Baby Girl.  With the hot water relaxing my sore back, I told her, You can come out any time now, Baby Girl.  We’re all ready to meet you.  I’m ready to meet you and kiss you; your Daddy might say he wants to work another couple days, but he has his whole life to work; and your sister is really excited for the milk you’re going to bring her.  We are all as ready as we’ll ever be, and we can’t wait to meet you.  You can come out whenever you’re ready.

I went to bed soon after, hoping for some rest.  I remember dreaming about contractions I was having, thinking These aren’t stronger than the ones I’ve been having, but each one is lasting longer.  I forgot how long actual labor contractions last. These are the real thing.  I’m definitely having this baby tonight.  So I should try to sleep through them for as long as I can….  Then soon after, These feel really close together.  Maybe I should be timing them.

Over the next two and a half hours, I had light but long contractions every 2-4 minutes as I took a warm bath, emptied the dishwasher, folded the last of the laundry, re-organized the refrigerator, and made chocolate chip almond flour scones.  Then suddenly, the contractions slowed and intensified.  The first intense contraction came, followed by another 10 minutes later, another 9 minutes after that, then 8, 7, 6, then several 5 minutes apart.  I called Linda, our midwife, at 3:02am and she headed over to us. 

Around 3:30, I woke Tyler and we started our home birth preparations- making the bed, moving furniture to make room for the birth tub, setting the mood with music and candles as we kept the lights low.  When Linda and her midwife assistant arrived, Tyler started blowing up the inflatable birth tub while Linda checked me.  Six to seven centimeters.  The midwife assistant got a kick out of my ability to rattle off all the food I had made for them while enjoying a cup of tea at 6-7 centimeters, and we had a good conversation about being foodies and good restaurants in NYC and Chicago. 
During that time, I made one special request of the birth team- that they remind me to open my eyes when Baby Girl enters the world.  When Tye was born, I was focusing all my energy on pushing and in my concentration, didn’t open my eyes to witness for myself Tye’s arrival into our world.  I remember the sounds of her birth, the feeling of her body slipping out of mine, and the flood of emotions with incredibly vivid clarity.  There’s just no visual to go with it.  Since Tye’s birth, I’ve wished so much that I could have just opened my eyes to fully experience her entrance.  With this birth, my heart was set on keeping my eyes open to witness the entire birth.  As I explained to the midwife and her assistant, I didn’t want to miss out on anything.

Over the next few hours, I continued to move around during my contractions.  We called the doula who would be hanging out with Tye during the birth, and she arrived just as Tye woke for the day.  Sometime between 6:30 and 7, I got in the tub.
The water helped ease me through the contractions and relax even more between them.  I could feel Baby Girl’s head just a couple inches inside, which was encouraging.  By sometime around 8 am, the contractions were so intense that I threw up after one of them.  I kept thinking I’d be ready to push when the next one arrived- but as much as my mind wanted to enter the pushing stage, my body wasn’t in the same place. 
Then, in the middle of a contraction, my water broke.  The popping sensation felt like a swift punch to my contracted uterus- definitely the most painful contraction of the whole day.  But with that one contraction, my body was suddenly ready, and I began to push. 
The pushing contractions were long and right on top of each other.  I felt like I had about 15 seconds between them, if that.  During the first two, I remember thinking, If I keep pushing as hard as I can, I’m going to tear.  But if I ease up, it will take longer for her to come out…  But I quickly gave up on holding back and just let my body push as hard as I could.  As Baby Girl was crowning and I was feeling that Ring of Fire, I had this sudden vision of chunky newborn baby legs.  As I imagined kissing the chubby creases of Baby Girl’s thighs, my heart felt like it was going to explode with love for this little baby who was about to enter our world.  I felt myself pushing with a new, almost primal power.

Suddenly, I heard Linda say, “Okay, on this next push, you’re going to have a baby!” I could hardly believe it was happening so quickly.  Without a break, the next contraction came on and Baby Girl’s head came out.  I opened my eyes just as I pushed the rest of Baby Girl’s body into the clear blue water. 

In both of my birth experiences, the moment when baby’s body slips out of mine is purely, truly miraculous.  It’s as if a switch is flipped and my whole body- my whole life- is changed.  I feel that surge of maternal hormones flood my body immediately.  It’s hard to explain.  I know not all mothers feel that wash of emotions at the same time, and there’s nothing else to compare it to.  When else do we knowingly experience our lives changing so significantly in the blink of an eye?  For me, that moment- feeling baby’s slippery limbs slide into their own existence- is magical. It’s precious, powerful, and unforgettable.   And this time, my eyes were wide open.

As Linda scooped up Baby Girl, she said something about the cord, but I was so eager to hold Baby Girl in my arms that I barely listened.  Linda pulled the cord from around Baby Girl’s neck where it was loosely wrapped once, and finally, she was mine to hold.   In a few seconds, she took her first breaths.  She was bluish and had a thin layer of vernix over her body (she was, after all, only 38 ½ weeks), but with a little time and back rubbing, she pinked up as we let the cord continue to pulse.  I told Baby Girl over and over again how much I love her as Tyler proudly declared from behind the video camera, “Yup, she looks just like me.” 
Soon, I moved to the bed, where we were covered with warm towels before Tyler cut the cord and I delivered the placenta.  Baby Girl latched on like a little nursing champ as Linda gave me five tiny stitches where I had just slightly torn skin.
Tye could see me from the hallway, but she wasn’t quite ready to come into the room just yet. When I was ready to stand up and make my way to the bathroom, Tyler carried Baby Girl into Tye’s room.  Upon seeing the baby, she whispered excitedly, “Shhh, baby sleeping!”  Once I was back in bed, Tye ran in and jumped in next to me.  I took Baby Girl back and began to nurse her, and Tye asked to nurse.  I never thought it would be me, but now I have a photo of me tandem nursing just minutes postpartum.  And nothing could make me prouder than cuddling both of my girls, watching Tye reach out to hold Baby Girl’s hand, and hearing her say in her sweet voice (nipple still partially in her mouth), “Hi, Baby Sister.” 
As soon as our tandem nursing session was over, Tye went back to playing with her new favorite grownup friends and everyone else set about cleaning up.  Tyler made me scrambled eggs and we toasted our daughter’s birth with Dogfish Head 90-Minute IPA, the same favorite microbrew we drank to celebrate Tye’s birth.  Amidst the hustle and bustle, Baby Girl and I laid in bed, skin to skin, nursing on and off as we took each other in.
We called family members and I cried tears of joy as we shared our news.  Every time Tyler tried to take a picture of me, the reality of the moment hit me and I started crying again.  The pictures may not be the most flattering, but they hold that much more emotion for me.
By around noon, everyone left.  We all, in various states of undress, climbed into bed together and took turns snuggling skin to skin and sleeping.
Eventually, Tyler and I decided on a name for Baby Girl- Etta Maeve.  That night, the four of us slept in our bed, in our home together- Tyler, Emily, Tye, and Etta.  Our family of four.

Saturday, January 7, 2012

Two Days Old

Introducing Etta Maeve!

Etta Maeve arrived January 5 at 9:04 am.  Less than 9 hours after the first contractions, she was born into a tub in our bedroom with our wonderful midwife in attendance.  She weighed 6 pounds 13 ounces and measured 20.25 inches long.  We're treasuring our precious time together as a new family of four and, quite frankly, all fighting over whose turn it is to hold Etta next.  What a beautiful little miracle we've been given.

Wednesday, January 4, 2012

Precious Mommy Moments

Christmas morning, Traye asked Tye to hug her baby sister.  The sweetness in this shot makes my heart melt.  Thank you, Traye.  

Tuesday, January 3, 2012

On your marks...

There's a thought that during the third trimester, our bodies' job is to make us so uncomfortable that by the time labor arrives, we will do whatever it takes- even pushing a large head through a very small space- to get the baby out.  

I'm there.  I'm very, very ready to have this baby.  Last week, I wasn't sure, and I even told Tyler that I wasn't sure I was ready emotionally.  I kept wondering if I was ready to be done being pregnant even if this is the last time I'm ever pregnant.  But this week?  Something shifted in my brain, and I am ready.  

Perhaps it's the never-ending contractions that are stronger than any practice contractions I remember with Tye (I keep telling myself they have to be doing something in there, as many as I'm having...).  Or maybe it's Baby Girl's head so low in my belly that every movement is uncomfortable, and many are downright impossible.  Or maybe it has to do with the crazy nesting urges I've been succumbing to all week that have encouraged me to launder every fabric item in our home, stuff our freezer full of reheatable meals, knit two hats, and re-organize every pocket of clutter, all between random cleaning binges.   I even have a half-made recipe of almond flour scones on the counter, ready to mix and bake so I'll have some delicious protein during and after the birth.  I'm ready.

But I'm afraid I'm the only one.  Tyler told me he has a week's worth of work he'd like to do before he takes paternity leave.  I'm not sure Tye is really ready or that she ever will be, but she's coming off of a nasty cold and any extra days towards healthy would benefit her transition to Big SIsterhood.  And most importantly, I need to wait until Baby GIrl is ready.  I keep reminding myself that she'll join us when she is ready, and until then, she's still growing and storing up fat for those first days out of the womb.  Thinking about her adding chub to her little legs and arms makes being patient simultaneously easier and harder.  I just want to kiss those tiny limbs already.  

Whenever I've run races, whether it's a local 5k or a huge marathon, I'm always one of the people rushing to the starting corrals at the very last minute or in some cases, even running to make it to the starting line before the chip timer is turned off.  But at each race, someone is the first runner to show up.  I'm sure she isn't alone- there are support personnel around preparing the stage and tents and others marking the course and directing traffic.  That first runner at the race is prepared; she's well-trained, her shoes are laced, her number is pinned to her shirt, and her bars and gels are tucked away neatly into pockets.  She's just waiting for someone to pull the trigger and start the race already.


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