Postpartum Calorie Counting....for Baby?

I thought when I gained 50 pounds during pregnancy (I blame the Christmas holiday and MIL's cooking) that my weight would be the primary focus of my postpartum obsessions.  Not that I really knew what that entailed. I have never counted calories.  There have been times when a little counting would have served me well, but...I'm not really that disciplined.  Or that good at math.  When I wanted to lose weight, I would exercise(-ish) and cut out junk food (-ish).  Anyway, it is not a practice that ever interested me. And then I became a parent.

Nicholas had trouble gaining weight from the beginning.  For the first several weeks of his life, we took him to the doctor once a week to get weighed.  There were weeks when things would get better, and then his progress would stall.  He also vomited, sometimes violently, and he would take hours to finish one bottle. We went through all of the formulas, slowly increasing price per ounce, before settling on the most expensive one, Nutramigen. We had an Upper GI that came back normal.  The weight was still an issue, so we were sent to a GI specialist in Houston (two hours from where we live).  

In preparation for the visit, I recorded everything Nicholas ate.  He was topping out at 21 ounces per day.  Any more and he would vomit.  The GI tested samples of his poop, which came back normal. He sent us to a Nutritionist who determined Nicholas was getting ~70% of the calories he needed.  In order to increase his calorie intake, we were told to concentrate his formula to 24 calories per ounce and add some rice to his nighttime bottle to help him keep it down (he was four months old by this point, so I was comfortable doing so).  A Gastric Emptying Scan was ordered and scheduled.

I continued to chart his eating, which continued to top out at 21 ounces per day.  In every other way, Nicholas was way ahead of the curve.  He wanted to stand and jump by two months. He rolled from back to tummy on a regular basis from the time he was three months. He was alert and engaged and interactive. He figured out how to army crawl before he was four months old.  The slow weight gain did not seem to negatively effect him.  

We took him down for a Gastric Emptying Scan (in Houston again). He was not allowed food for four hours beforehand.  He was strapped down, given a bottle (as much as he would eat at the time) and then had to lie there in the machine for  90 minutes without any more food.  We were able to hold his hand, but he hated not being able to move.  He cried for the entire 90 minutes.  The test came back normal.

We went back to the GI (another two hour drive!). Nicholas still had not gained much weight.  Every test was normal.  We were told to concentrate the formula to 27 calories per ounce. No solids until six months. They took urine and blood samples.  The idea that maybe he is just a small person was introduced (not “dwarf” small but just petite).  

A few weeks ago, it occurred to me (while I was trying to feed him and he was turning his head away) that maybe the taste of Nutramigen just is awful.  I pulled out an unopened sample of regular Similac I’d received and gave it to him in a bottle.  He sucked a four ounce bottle down in twenty minutes (as opposed to two hours).  He didn’t dribble any of it out of the side of his mouth.  The next day I gave him nothing but Similac, and he ate 24 ounces!   I was worried it would hurt his tummy, but so far it doesn’t seem to.  He has been eating so much better each day, and he seems to have gained significant weight. I’m not a medical expert, and I am not saying that our issues are solved, but I am wondering now if maybe my kid just is stubborn enough to be a picky eater. 

Formula Is For Parents Who Love Their Children Less...Right?

Before I gave birth, I was adamant that under no circumstances would my child be fed formula.  I had been reading everything the "Breast Is Best" campaign had been producing, and I knew that formula was bad news.  Formula is so passé anyway. Everyone who is anyone breast feeds these days.


Why else would they make such fashionable nursing covers?

I was angry at my mother for giving me formula when I was a baby.  I felt sorry for children whose mothers didn't love them enough to give them breast milk.  I ached for women whose breasts just didn't make milk.  And I was so far on my high horse that I knew I would be a far better mother than any of them because I would give my child what God had intended for me to give him.  I ignored the free samples of formula that I received in the mail.  I reminded my husband how lucky he was to have a wife who wouldn't make him pay for over-priced formula and even pointed out in the grocery store just how much money he would save every week.  Yeah, I was about as obnoxious as I could be.

When Nicholas was born, I proudly told the nurses I would be breast feeding.  He latched on the first time like a little pro.  I never had any pain, and he never had any trouble.  This was the beginning of a beautiful relationship.  Scott even let me pick out any nursing pillow I wanted in the gift shop.  Since he was premature, I was told his risk of developing jaundice would be high.  I needed to make sure he ate and kept gaining weight, so we set our alarms for every two hours and made sure he nursed for twenty to forty-five minutes.  We were released from the hospital on Wednesday- our boy weighed 6 lb 7 oz.

By Thursday night, something went wrong.  Nicholas would not eat. He was turning yellow. He slept all the time, and he would continue to sleep no matter what we did to try to get him to wake up to eat.  He went twelve hours without taking a sip.  As soon as Target opened the next morning, Scott went and bought a $300 breast pump, and I pumped as much milk as I could make.  We fed it to him with a medicine syringe.  We called the pediatrician and were told to bring him in.

Our boy had lost nearly a pound in 48 hours, and he was down to 5 lb 8 oz. The pediatrician confirmed through a blood test that he had jaundice.  We were to monitor him closely throughout the weekend and continue to feed him pumped milk, so I pumped every two hours.  We had daily blood tests.  The pedi called us a couple times a day. His jaundice numbers were climbing slowly.  Sunday night the pedi wanted to know how much he was eating, and I told him I only pumped half an ounce every 4 hours.  He told me that wasn't enough and to give him formula as a supplement, so I found the free samples and gave them to my son.  By the next morning, his numbers dropped significantly.  By the following day, his jaundice was gone.  By that Friday, he had regained his birth weight.  Things were looking up.

I continued to pump and alternate feeding formula.  I consulted lactation experts, took Fenugreek and Blessed Thistle, ate oatmeal at every meal and continued to wake every two hours to pump.  I tried to put Nicholas on the breast, but he would drink for about three minutes and start screaming.  By six weeks pp, I was producing all of three ounces of breast milk a day!

It was at this point that I finally admitted to myself that trying to be a good mother was turning me into a terrible one.  I was exhausted from pumping.  I was constantly having to put my son down to pump, leaving him in his bouncy seat for hours throughout the day.  Scott had to do the actual feedings while I pumped, so there was no chance for bonding.  No one was getting any sleep.  I felt like such a hypocrite the day I put the pump in the closet and started feeding him formula exclusively.  My need to "save face" turned me into the terrible mother.  Good mothers are the ones who put aside their personal feelings and do what is actually best for their children. 

I still get defensive when I read the instructions on my formula can, and it reminds me that breast milk is best. Or when I hear someone tell another person that they really hope she is breast feeding because she would be evil if she weren't.  I feel like wearing a banner that says "Breast is NOT ALWAYS best"!  

On that note, I would like to point out the (selfish) benefits of formula feeding:

Yep, My kid eats

1. Scott gets to do the night feedings too.  In fact, he has no excuse not to do them.

2. I can eat whatever I want and drink alcohol without a thought to the timing of feedings (Not that I drink more than a glass of wine at a time, but still....)

3. No need to keep on any baby weight.  My body is completely my own.

Birth Never Goes According to "Plan"

Let me preface this story with the fact that the idea of labor terrified me.  Before discovering I was expecting, I was never sure that I wanted to have children because the idea of tearing down there was the single worst thing I could imagine. The first time I walked into the OB's office, I was still shaking his hand when I told him I wanted an epidural at the first sign of labor.  That was the deal.  No way was I going to have a child au naturel. I then spent the next several months reading every piece of literature I could imagine on the subject of labor, so I would be more than prepared to recognize labor at the first sign.  I was determined I would be in the hospital hooked up to machines at the first sign of contractions.  I even skipped birthing classes because I knew I would never need to learn how to breathe through contractions.

Motherhood Lesson #1- Murphy's Law- Anything that can go wrong, will. Especially when it comes to a birthing plan.

Sunday, February 28, 6:30 a.m.(25 days before due date)

I awaken to a sudden gushing of fluid. I go to the bathroom and, sure enough, my panties and pajamas are soaked.  I remember the whole "change into dry panties and lie down for half an hour" thing from one of the books, so I change and go back to bed, watching the clock for thirty minutes.  

Sunday, 7:00 a.m.

I stand up and wait for the tell-tale gush of fluid and...nothing.  I chalk it up to a false alarm and continue about my morning.

Sunday, 11:00 a.m.

I'm sitting on the couch when I notice I am sitting in a wet spot.  I go to the bathroom and discover bloody mucous  (mucous plug?) on the TP.  I decide to call Labor and Delivery at the hospital, and they tell me to come on down to get checked out.

Sunday, 12:00 p.m.

We arrive at L&D (a 45 minute drive from our house), by which time my pants are soaking wet.  I get taken back to triage where they hook me up to monitors and take a swab of my fluid.  I'm having irregular, mild contractions, but the fluid comes back as not my "water", and I am not dilated at all. Since I am only 36 weeks pregnant, they give me two Ambien to calm my uterus and send me home with instructions to drink lots of water.

Sunday, 3:00-6:00 p.m.

I'm knocked out by the Ambien, but I keep waking up every 15 minutes with pain in my uterus.  I drink ~100 ounces of water during this stretch and continue lying down.  

Sunday, 11:00 p.m.

The pain has gotten worse.  I am so tired, but I can't stay asleep.  I keep crying out that it hurts so much.  DH calls his mother who tells him it couldn't hurt to go back to L&D to get checked out.  

Monday, March 1, 1:00 a.m (24 days before due date)

We have made the second 45 minute drive down to the hospital.  They hook me up to the machines again, and check for dilation.  I have not dilated at all ("Maybe half a pinky tip or so," says the nurse).  She says my contractions are not registering as "labor" stage and my uterus is not getting hard.  They are not consistent.  She suggests maybe I am dehydrated.  She gives me two more Ambien.  I ask why it hurts so much, and she tells me basically that I'm a wuss.   They give us a sheet of paper describing the symptoms of labor and say to come back if the following things happen (paraphrased, of course):

1. Water breaks

2. I bleed a lot.

3. Contractions are consistent and uterus gets hard during them.

Monday, 6:00 a.m.

I have been up for 24 hours.  I have had four Ambien.  The pain is so bad that I can't get comfortable. I can't lie down.  I have to walk, but then it hurts too much.  I'm exhausted.  I have been screaming every four minutes for a few hours.  My uterus is not hard.  There has been no gush of water.  There is no blood.  I only recall bits and pieces from this period, trauma must have blocked out the rest.

Monday, 11:00 a.m.

I have been screaming like a banshee for 6 hours now.  I keep feeling like I have to gonumber two, so I  keep sitting on the toilet.  Scott has the idea that maybe I just have really bad hemorrhoids, so he has set up a sitz bath on the toilet for me.  I will sit for a few seconds the stand and lean against the wall.  I have a flash of an episode of I Didn't Know I Was Pregnant where the woman gives birth on a toilet.  I have a premonition that I won't make it to the hospital before my baby is born.  Scott calls a PA friend of ours to ask her what to do.  She hears me screaming in the background, says that is not normal, and suggests we call the OB office.  OB office says to bring me in at 2 in the afternoon.  

Monday, 1:43 p.m.

We arrive at the OB office.  I waddle in, Scott gets in line and I lean over a nearby couch and try not to scream as I feel the my body stiffen in preparation for another contraction.  A nurse sees me and ushers me back to a room.  She tells me to undress and climb on the table, and the doctor will be in shortly.  I ask if they can just please give me something for the pain.  It takes a while to get on the table.  The OB walks in.  I ask for a pain shot.  Anything.  Just make it stop.  He puts on his gloves and slides his hands in to check for dilation.  A look of panic crosses his face, and he pulls his hand out quickly. 

He pulls out his phone and says, "Girl, you are at 9 centimeters.  Get to the hospital now. I'm calling to tell them you are on your way.  Do not stop for anything.  We have never had a baby born in our office, and we are not going to start now."

I ask for a pain killer again- a request that is ignored.  I get dressed. I'm in such a panic, I decide to leave my shoes as I believe they will take too long to put back on.  Luckily, Scott grabs them, I lead the way barefoot and we rush to the hospital.

Monday, 2:18 p.m.

DH drops me off at the entrance to go park. I walk toward L&D.  I get in sight of the check-in desk  and let out a scream.  Nurses rush over and get me to my room.  My progress is checked.  One nurse thinks if I just push then the baby will be born in moments.  I refuse to push until I get an epidural.  My mind is so gone that I have no comprehension of what is happening.  All I know is that I need an epidural.  I can't even remember why.  I am told it may be too late.  Two other nurses check me.  2 out of 3 agree. Baby is still far enough up that I can get my epidural.  But I need to practice breathing through my contractions before I can get it.  Apparently 13 hours of screaming and writhing is not good form in the art of labor.  

Monday, 3:18 p.m.

I finally get my epidural.  The world is suddenly in focus again.  For the first time I am able to actually comprehend that the baby will be born soon.  He is still early. No one knows if he will be a healthy weight.  There is concern and question over when my water broke.  I don't recall it ever happening, but it had broken.  The risk of infection is introduced.  

Monday, 4:30 p.m.

The doctor arrives for the birth.  I am given Pitocin because my contractions are not behaving how they should (groups of three and then nothing).  Doctor takes a look and determines that baby is head first but in an odd position. We never got our last ultrasound, so we had no idea.  That's why my contractions were not happening in my uterus or registering as very strong.  DH comes into the room; he is told to grab a leg and I am told to push.  I keep getting told I am a good pusher, which is good because I feel absolutely nothing and can't really tell if I am pushing or not.

Monday, 4:52 p.m.

Baby Nicholas is welcomed into the world.  He is gray and slimy and screaming and has a severe cone head.  I admit, for a second, I worry that my baby will be a freak.  His Daddy cuts his cord, and he is cleaned up and weighed and measured.  6 pounds 13 ounces. 19 inches long.   I never learned his Apgar score, but I assume it was fine.

He is healthy, and after being cleaned up and given a hat, absolutely the most gorgeous baby ever born.

  

Because he is technically premature, we stay an extra day in the hospital, but he passes all of his tests with flying colors, and he is sent home with a clean bill of health (and an enormous hospital bill, but that is American healthcare at the present moment).  

My friends who are now pregnant want to know the secret to knowing you are really in labor.  I have no answer for that.  All I can say is that labor is always different and cannot be planned, no matter how much you have read.  It's kind of cliche, but you really should expect to be surprised.  And don't worry about going to L&D too much.  I really wish I had gone back sooner, but we let our pride get the best of us and didn't want to look stupid.  I think delivering your baby on the side of the road may look a little more stupid.

Proud Daddy!!