Feeding the Machine

I've been debating about whether or not to chronicle this part of my experience for two reasons.  One, It's rather personal, and two I am NOT seeking advice on the matter.  But in an effort to share what NICU moms experience I have decided to overshare.  If this is too much information for you, feel free to stop reading now.

A few hours after Joshua was born, I was wheeled into a recovery room.  The nurse brought in a breast pump, gave me a two second tutorial, and told me to pump 8-10 times a day.  And so it began.  To date I have pumped over 400 times.

My milk came in after two days.  This was a miracle because I had three things working against me.

• Delivering at 29 weeks
• C-Section
• Magnesium Sulfate (a very uncomfortable, but important treatment)

I plodded along getting moderate amounts of milk for the first week or so.  I did everything recommended to me by the hospital to promote milk production.  This included:

• Pumping every two to three hours
• Pumping at the bedside
• Looking at pictures of Joshua while I pumped
• Drinking a lot of water
• Eating extra calories (happily)
• Taking fenugreek 
• Using hot packs
• Power pumping (pumping off and on every ten minutes for an hour)
• Double pumping (a strategy to preserve breast milk, but still get rest)

Can you see why I am not looking for advice?

I have been faithfully feeding the breast pump for nearly nine weeks.  I've had a few things working against me.

• You don't get the same hormonal connection feeding a machine as you do a baby.  Thus, I am not stimulated to make milk in the same way as a non-NICU mom.
• The NICU is a stressful experience.  The hormone released by stress inhibits breast milk production.
• I had a blood clot and about a million different prescriptions.  (I quadruple checked to make sure they were safe to take.)

And so I have watched my milk supply dwindle.  A month ago, I was distraught about it..  I've felt helpless throughout this whole experience.  Pumping was the one thing that I could do for my precious little boy.  It's been exhausting, time consuming and frustrating.  It's also been unproductive.  The doctors and nurses all praised me for my efforts and expressed their surprise that I even had milk. 

A few days ago, I decided it was time to be done.  After discussing it with the occupational therapist, I've cut the number of times a day that I pump in half.  I will decrease from there.  I feel so relieved.

I want to be clear that I don't consider this giving up.  I want to focus my mothering energy in more useful ways.  This is a choice that has not been easy to make. 

Hopefully, none of my readers out there are feeling the need to be judgmental.  I've discovered that women can be downright cruel to each other about the breast/bottle/formula feeding debate.  Does it need to be a debate?  One women online said that women who formula feed are selfish and ignorant.  Shouldn't we all agree that mothers are capable of making the right choices for their children?

I'm fairly certain that what I get back in emotional stability is going to be more helpful to my little man than two ounces of breast milk a day.    

Happy 2 Month Birthday

Joshua turned 2 months old today.  His special treat was to meet his Uncle Richard.

He also had plenty of quality time with his daddy and I.

The one major draw back to being two months old is the vaccinations.  But I am sure he will bear them with fortitude.  Little Joshua has been through a lot ofter all.   

Our Voices

Jerry and I have been asked many times if Joshua can identify our voices.  We've been told that they can distinguish our voices from the doctors' and nurses' voices.  I'm going to break one of my major rules and not cite any scientific evidence of it, but instead provide anecdotes.

Usually when I arrive at the NICU, Joshua is fast asleep.  But when I open the incubator and start talking to him, he'll pop his eyes open and start looking around.  He does not respond this way to the nurses.

When I'm done holding him, he gets mad when we put him back.  While the nurse was positioning him, Joshua grunted and squealed.  I stood him, rubbed his back and said something on the lines of "You're okay, the nurse is just making sure you are comfy and cozy."  Joshua stopped fussing immediately.

Lest you think he doesn't understand, I have this dialogue as evidence.

Joshua: hiccup, hiccup, hiccup
Jerry:  I wish I could come up with a way to scare you.
Joshua: hiccup, hiccup, hiccup
Jerry:  (very softly) Boo.
Joshua: hiccup, hiccup, hiccup
Jerry:  (very softly) Boo.
Joshua: hiccup, hiccup, hiccup
Jerry:  I know!  Temperature probe! (He holds up the thermometer)
Joshua:  Silence, Silence, Silence

Joshua really, really, really hates the thermometer.  It goes in his armpit, but somehow it is the worst thing of all time.  

Emotions

When Joshua was about a week old, Jerry and I made our usual visit.  Because we were still not able to hold him frequently, I sat next to his incubator, reached inside and held his head.  Tears poured from my eyes uncontrollably.  You could blame the tears on postpartum hormones or the stress of having the little one in the NICU.

It wasn't either of those two things.  What I felt was a strange new emotion that I have decided to term sorrowful joy.  At that moment, I felt so much joy and love at the little thing that had grown in my belly.  I even missed feeling him kick around inside of me.  But I also felt a sadness of watching someone you love so much have to go through something so hard.

Since the first moment of his birth, Joshua has been poked, prodded, and pricked more than this little innocent thing deserves.  I've seen him get shots, IVs, Picc lines.  His eyes have been dilated.  His lungs and intestines X-rayed.  I could go on, but I think the list is extensive enough.  My heart hurts so much sometimes.

I could probably term this emotion parenthood.  Perhaps this new feeling is just a preparation as I imagine most parents encounter something similar.  It's funny how love seems to be a mash up of so many other feelings.

 

Bonding

I close my eyes I think of you, 

I take a step I think of you,
I catch my breath I think of you, 

I cannot rest I think of you

--- Brandi Carlile "Looking Out"

The other night, I crawled into bed closed my eyes and saw my little boy's tiny double chin and round face.  The flashes reminded me of what I see when I play Tetris for too long.  This made me think even more about bonding with Joshua than I already have.

A few days after I went on bed rest, I asked Jerry to give me a priesthood blessing.*  I was hoping to hear that this business with preeclampsia would go away and that I would have a healthy pregnancy for the duration.  I did not.  Instead, the blessing encouraged me to find ways to bond with Joshua.  What I did not realize, it that we would be bonding in the NICU.

Because Joshua was whisked away from me in the delivery room, I missed out on those precious first few moments of motherhood.  The moment when you immediately get to hold your child after he is born.  I know many mothers have had to endure this and it is painful for everyone. 

I embarked on a plan to bond with my son.  When I am outside of the NICU, I try to occupy my times in projects for him.  As mentioned in the earlier post, I wrote him a book.  I'm also crocheting him a blanket.  Jerry has set our TV up to play a constant slideshow of his pictures.  I've found it's very easy to constantly think about Joshua when I am away.

In the NICU, we are encouraged to talk to Joshua as much as possible.  When we hold him we typically do skin to skin also called kangaroo care which has been shown to benefit both parent and child.  But honestly, I feel most bonded to him in the quiet moments of holding him.  I treasure the moments when he's lying with me, nothing is beeping, and the nurses are occupied elsewhere.  Often his breathing improves dramatically when I hold him.  I take that as a sign that he feels bonded to me as well.

How does Jerry fair with bonding?  Most excellently!  Jerry is full of goofy conversation, reads fun stories, and would make Joshua smile tons if Joshua could smile yet.  He's a natural.  

*For those not familiar with the LDS faith, a priesthood blessing is when a priesthood holder (in this case Jerry) lays his hands on your head and gives spiritual insight and counsel as he feels inspired to do.  A blessing can grant healing or be an opportunity to gain peace, insight, and direction from the Lord.    

Gratitude - Part I

For the past couple of months, many people have reached out to us with overwhelming kindness.  I would be remiss if I did not acknowledge the kindness and love that has been shown to us.  In the interest of brevity, I am going to split my gratitude posts into a few installments.

First I would like to thank the many medical professionals who have made life-saving decisions for both Joshua and I.  Between the two of us, we have been cared for by obstetricians, perinatologists, neonatologists, nurse practitioners, radiologists, and occupational therapists.  Their commitment and passion for their work has really blessed our family.

Really, I have to give a huge shout out to the nurses.  It was a nurse who first heeded the warning signs that I might have preeclampsia.  Nurses monitor Joshua 24 hours a day.  Nurses cried with me and were patient with me every time I reacted to news I was not happy to hear.  They remain composed in the NICU and are helpful and friendly.  We've gotten to know many of them quite well and they are just great people.  

Then there's the BYU MBA program.  For those of you who don't know Jerry has been working on his MBA at BYU for the past couple years.  He'll finish in a week or so.  We are so privileged to be a part of this community.  The students in the MBA program have been amazing to us.  The morning of Joshua's birth many of the students were gathered together joking around and having fun.  When they heard the news our family and another family that was experiencing a life-threatening trial, they immediately stopped what they were doing to pray for us.  Prayers for our family continued throughout the week.

The MBA Spouses Association and MBA students organized a donation drive for us.  One of my good friends who helped me a ton especially while I was in the hospital took charge of the organization.  Jerry came home one evening with a small garbage bag of donations.  I was delighted.  What I didn't know is that was just the beginning.  My friend showed up with a car full of diapers, wipes, clothes, and blankets for us.  Other students have brought us meals, diapers, chocolates and good company.  Nothing I can do will properly demonstrate my gratitude. 

NICU Dreams

Anxiety is common among parents of babies in the NICU.  I'm not going to describe the exact feelings I had initially, because I don't want to relive them.  Suffice it to say that I did not feel myself.  As my body has healed, my anxiety has made its way to my subconscious.  I've had some crazy dreams.

I've repeatedly had dreams of nurses telling me what to do.  They are in my house and waking me up to pump.  The problem is that I actually do wake up convinced that it is time to pump.  Then, I immediately wake up Jerry and tell him frantically that I forgot to wake up on time.  Then I realize I had only been asleep for an hour or so apologize to my husband and make my way back to bed.  I told a nurse about these dreams and she said, "Those sound more like nightmares."

One night, I dreamed that Joshua had come home, but I couldn't find him in the house.  This led to a partially awake/ partially asleep search through the whole house.  He was in the pile of blankets next to Jerry who was sleeping.  I was exasperated at how careless Jerry was being!  Again, I came to my senses and crawled back in bed.  Luckily I didn't wake my husband up this time.

Then there was the dream when I was a nurse.  To me this was the most terrifying of all.  I am not cut out for any medical profession.

I also remember little wisps of dreams.  Doctors, nurse practitioners, and  nurses always seem to play a key role in them even if it has nothing to do with the hospital.  This is probably because they play a key role in my life right now.

The nurses warned me that this would happen and I just kind of laughed it off.  I'm just grateful that that my stress is buried a little deeper than it was in the beginning.

Joshua's NICU Library

When Joshua was born, we were encouraged to read to him. It's a great way for babies to learn the sounds of their parents voices. I had planned on reading to Joshua during my third trimester, but I missed that opportunity. It's been great fun getting to share my passion with him so soon. Here's what little Joshua has heard to far.

Jerry visited Joshua in the middle of the night on his first night.  My sister had brought us Brown Bear, Brown Bear, What Do You See, a classic for all young children.  This was the first book that Joshua heard.  Jerry has read it many times since and made a few changes along the way.  It's now "Grizzly Bear, Grizzly Bear."  Blue horses and purple cats don't exist, and black sheep are weird.
 

Other picture/board books include:

• The House in the Night (This is probably my all time favorite picture book.)
• Max's ABC's
• Jorge el Curioso (I brought this thinking it was in English, but it wasn't.  Jerry read it to Joshua anyway.)
• Snuggle Puppy (Thanks, Mom!)
• Pajama Time
• How Do Dinosaurs Learn Their Colors?

As you can see he listens very intently.   We also decided that he was advanced enough for chapter books.

• Midnight on the Moon
• The Phantom Tollbooth (This was lovingly sent to me by an old friend.

 Last but not least, I wrote Joshua a little book.  This was going to be a bed rest project for me, but I made it postpartum instead.  It's almost as big as he is.

Thoughts on the NICU

The NICU has been our home away from home for about five weeks now.  I've been wanting to write about it for some time now, but haven't had time/energy/emotional strength to do so.  But the raw anxiety of the first week of Joshua's life is starting to wear off and I feel ready to write.

The occupational therapist told me I needed to keep a blog when I said, "Be careful, sometimes he forgets to breathe when he sucks on his pacifier."  Apparently, she thought I was joking.

A Few Bullet Points on the NICU

• You see a lot of careworn faces in the NICU.  Women who have just given birth being wheeled by their husbands into to visit their child.  Some have children at home or in the waiting room.  Others, like us, are being thrown into parenthood head first.  Sometimes, I see these people and think, "I'm sure glad we don't look like that."  The truth is we do.  Thanks to a blood clot, I spent a lot more time than most moms in that wheelchair.  And Jerry and I live in a constant state of exhaustion.

• Joshua sleeps, bathes, eats, and pretty much engages in life in a bed called a giraffe.  Thanks to my sister we decorated it with a giraffe.  The bed keeps him warm and recreates the womb experience as much as possible.  This is hard to do because he is expected to act like an infant and not a fetus.  It's a little bittersweet to know that he his thriving more in that bed than he would have been in my belly.

• We've pretty much made ourselves at home in the NICU.  When we arrive the staff runs off to fill our drink orders.  (Yeah, they are pretty awesome to us.)  I know what all of the machines do and I could (but don't) adjust many of the settings myself.

All I"m saying is the nurses shouldn't be too surprised if they ever catch me digging around in the storage closet. 

• The NICU is a surprisingly calm place. The lights are dim. The staff remains remarkably composed and now that I know what all the sounds mean, I don't get too concerned. After a stressful morning full of tears, I found my center at the NICU while holding Joshua. It's tiring, but it's the best part of the day. Seeing little Joshua's face makes every moment worth it.

• We've been in this already for what I"m sure has been scientifically called the "long haul."  We've already seen a lot of babies come and go.  I congratulate everyone I see who is carrying a carseat in or out of the NICU knowing that eventually that might be us.  

Check back for more NICU insights in the future.