March 2008

We’re sitting in the pediatrician’s waiting room, each admiring the others’ babies as they rest at our feet, each snuggled into their own baby bucket carrier. Hers is dressed in pink and is fleshy and plump and noticeably larger than Lucas.

“He’s beautiful,” she tells me, admiring Lucas. I beam, and return the compliment.

“It goes by so fast, doesn’t it?” I respond, thinking her baby is at least a few weeks older than Lucas. “When was she born?” I ask, expecting her to say some time around the end of December or early January.

“February 12,” she answers. “And how old is your little guy?”

“He was born February 8,” I say, trying not to sound defensive, even though I suddenly don’t feel like chatting with this woman.

“Oh, he’s so tiny! Was he a preemie?” she asks, unaware.

“No,” I answer rather abruptly. I consider elaborating, but can’t find the words to do so. I want to tell her that he was over 10 lbs, but is having trouble gaining weight, that he’s healthy and hearty in all other ways, but just doesn’t seem to be able to accrue the weight he is supposed to be gaining. I want to justify, to explain, to rationalize, but my words are stuck like lumps of undiluted formula in my throat; I’ve just for the first time realized that maybe Lucas’s weight gain issues are more serious than I have let myself believe. The difference in size between the two children is unmistakable, and I wonder how we’ve gone from “oh my god, what a big boy” to “oh, he’s so tiny!” How has this happened?

I haven’t blogged much about Lucas’s ongoing weight-gain struggles because like the infernal optimist that I am, I kept expecting things would be fine any day now. “Well,” I’d tell myself, “this has just been a really chaotic week and maybe I haven’t been nursing often enough. I’m sure it will be better next week.” Or, “I was sick and off my own food and drink, so of course my milk was thin.” Or, “He was spitting up an awful lot because I forgot to give him his medication one day, so of course he didn’t gain enough.” But as I controlled for one variable after another, week after week there has been one constant: Lucas simply isn’t gaining enough weight. He will be seven weeks old on Friday, and he has only gained a little more than 8 oz over his birth weight. He should have gained three or four pounds by now. It’s not as dire as it would have been if he wasn’t born a hefty 10 lbs, but I can no longer ignore the fact that the trend is clear week after week… my milk is simply not good enough this time around.

Time to face the reality: I need to supplement, and I need to supplement more. The 4 oz a day bottle isn’t cutting it. I have to crank it up to 6 oz twice a day, and I suspect that at those levels, it may have an effect on my milk supply. I want to nurse Lucas as long as I nursed Simon (to 16 months) or beyond, but I can no longer rely on my milk to provide the calories he needs to grow. I don’t know why the milk that four years ago was more than enough to sustain Simon is no longer good enough, but apparently my milk has a shelf life and beyond 38 years it begins to thin out. Or something like that. I’ll keep offering it to him as long as he keeps taking it, but I need to top him up nutritionally for now. I’m offering the bottles in addition to regular nursing as opposed to substituting, so hopefully that will help.

I don’t really know why my milk is thin. I don’t think it’s a supply issue… he’s satisfied at the end of a feed, and making plenty (and I mean PLENTY!) of wet diapers. He’s otherwise healthy and happy and generally content — except during the arsenic hours of 3 to 9 pm, which are still challenging but improving. (Best colic solution ever = running faucets. What we saved with the high-efficiency washer we’ve lost down the drain as running the tap in the kitchen is sometimes the only thing I can do to settle him!)

The reflux is still an occasional issue even with medication, but for the most part (80% of the time) it’s just normal baby spit-up amounts. I can feel the letdown and my breasts still leak even with regular feedings, so there is milk there — it’s just not fatty enough, I guess.

I’d like to rationalize and say I’ve done everything I possibly can to make exclusively nursing work, but that’s not quite true. I’ve done a lot, endured the bleeding and the nighttime alarm-setting and what seems like all-day feeding sessions and even a blocked milk duct, and we’ve worked through all of it. I could pump, I could try some sort of herbal supplement, I could pay for a few more hours with the lactation consultant. But I have two other boys and a busy house, and I’ve more or less dedicated the last month to trying to make this work and it still isn’t working out well enough. Next month we’ll be giving up our nanny, too, and there just isn’t enough of me for everyone as it is. There is always more I could do to nurse exclusively, but I think I may have reached the limits of what I’m willing to do. Now I have to make my peace with it.

I wrote the first half of this post this morning, and have since been to see my darling midwives as well. Despite his paltry weight gain, Lucas has grown an impressive 7 cm (2 1/2 inches) in length, and his head circumference has increased by 3 cm since birth, so he’s obviously growing well. He is meeting all of his developmental milestones, including and especially the social ones — he flirted shamelessly with the midwives and anyone else with whom he made eye contact.

I’m still disappointed and frustrated with the lack of weight gain, but deeply reassured that he is otherwise well. And speaking of social, he is currently sitting patiently in his bouncy chair where he has awoken from a brief nap, waiting for me to stop with the tap-tap-tapping and get back to gazing lovingly into his eyes, something I seem to spend a large preponderance of my time (happily) doing these days.

Sorry, bloggy peeps. Much as I love all of you, you really can’t compete with him for my attention these days…

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