Category: Mothering without a licence

Sigh. Went for another weigh-in today, and Lucas only gained 70 grams, where the ped wanted to see him gain twice that. He’ll be five weeks old on Friday and is only two ounces above his birthweight at 10 lbs 3 oz..

I don’t think the problem is with my milk supply, but perhaps with the quality of my milk. I can hear him gulping when the milk lets down, and he has plenty of wet and soiled diapers, as I’ve mentioned. More likely, it seems like I’m making skim milk when Lucas needs something more like homogenized. So, starting tonight, I’ll be supplementing my milk with one bottle of formula per day. Hopefully, this will be enough extra calories to help him gain a bit more.

I left the substitute ped’s office (mine’s on March Break, but this is the plan we formulated – pardon the pun – before he left, in the contingency that Lucas did not gain at least 20 grams per day) feeling inadequate, even as I tried to convince myself that it’s no fault of mine. Heck, I even supplemented with Tristan from the time he was four months old right through until he weaned himself at 10 months, and that worked fine. But damn, I felt lousy standing in the formula aisle at Loblaws this afternoon. Rationally, I know this is what Lucas needs, so of course this is the best thing to do. I’m not giving up breastfeeding entirely, so he’ll get the best of both worlds… nutrition from the formula, antibodies and iron and other goodies from my breastmilk. But I still feel like I’m letting him down… or, more specifically, that my vexatious breasts have once again let me down.

The greatest irony is that the nursing has just become easy again — it doesn’t hurt to latch, and he can feed to his heart’s content without hurting my nipples. He has been, too — last couple of days, he’s been feeding every two hours in the afternoon and every three or so overnight, so maybe that’s another sign that he’s just not getting satisfaction from the quantity he’s getting from me.

One other alternative I might explore is some sort of supplement you can add to expressed breast milk. I am not overly fond of pumping – especially in those kind of quantities and over the long term – but maybe it’s worth looking into. My midwife just mentioned it now, so I’ll ask the ped about it next week.

Crying baby alert… more later.

Okay, I think we’re back on track (touch wood) with the feeding thing. As of Sunday, Lucas was back up to 10 lbs even, which means he gained four ounces in four days. Not stellar, but certainly an improvement over the nothing of the previous week, and it brings him within spitting up distance of his birthweight of 10 lbs 1 oz. I suspect at my appointment this morning, we’ll see him hurdle over that milestone, too.

To what do we attribute our newfound success? All the latching techniques in the world don’t make up for a good prescription for zantac when baby is suffering from gastroesophageal reflux disease (GERD). Lucas had been spitting up a lot since birth, but in the week he didn’t gain any weight and the few days when I ramped up the feeding efforts, I could see that he was spitting up way too much — both in the quantity and the frequency categories. There were times he would spit up five, six, even eight times after a feed, and sometimes enough to soak through two layers of blankets and a sleeper. Not your average newborn spit-up, and there is nothing more heartbreaking than keeping baby latched on for an extra 10 or 15 minutes in the middle of the night to cram in a few precious ounces and then see it come spewing back out again two minutes after you pull him off the breast. That, and he’d been incredibly fussy in the evenings, crying inconsolably and arching his back, obviously in pain or at least uncomfortable. When I told the ped this on Friday, he prescribed a zantac equivalent. Both Tristan and Simon were also diagnosed with reflux around four or five months, although they were both old enough to take it with food, as opposed to the drops Lucas is getting.

It has made all the difference. I don’t have to change his sleeper four times a day because he has soaked through the bib AND sleeper with his spit-up…. some feeds, he doesn’t spit at all, much to my delight. The evening fussiness has been toned down, if not eliminated entirely. (Anybody care to offer insight into colic? I’m beginning to wonder, and I’ve never dealt with it before.) And the best indicator of success is of course those four ounces he gained over the weekend.

Once again, I have to declare my love for our ped, who read the letter from the midwives with their concerns about the weight gain and listened to everything I’d been doing through the week and everything I’d talked to the midwives and lactation consultant about, then reassured me that he thought Lucas was doing fine, and opined that in a year we’ll have forgotten all about this. And it seems he was right (again with the touch wood.) Reflux does seem to have been the main problem, although the improvements to the latch and extra feedings have certainly helped.

So far, so good. And the great irony is that now that I don’t have to set the alarm to wake him up every three hours (not fun, not for him and not for me!) the baby who would formerly sleep up to five hours at a stretch now wakes every three hours — sometimes every two hours! — on his own and asks to be fed. Sigh.

Remember how Day 3 was supposed to be the bad day? The day when postpartum emotions and the physical toll of childbirth and caring for a newborn come crashing down on your head leaving you a weeping, exhausted mess? Day 3’s got nothing on Day 18.

We’d hit a bit of a rough patch the last couple of days that culminated yesterday. I’d been sick (wickedly painful constipation and a head cold, followed by hemmerhoids, followed by the trots, accompanied by a chest cold, with a migraine chaser over the course of a week), the boys had been sick (Tristan has spiked not one but two fevers since Lucas was born, and Simon has had a juicy chest cough for a week), and the nanny has been either sick or absent for all or a part of the last five days. Lucas went through a couple of painfully gassy phases, one in particular on Monday night that left the poor child crying for three hours solid. By dinnertime yesterday, I was bawling my eyes out as I stuffed a frozen meat pie and french fries into the oven for dinner. And you know what finally did me in? The idea that I was not taking good care of Tristan and Simon. I’d been snappish all afternoon, and just couldn’t take any more. I bawled simply because I was overwhelmed and felt terribly guilty for not being a good mother to anyone. It was messy, to say the least.

The good news is, the bawling was the nadir, and after a good cry I did feel better. Darling Lucas slept a couple of good stretches last night, and I was ready to face the world again today. The headache was gone, the croak in my throat only a minor irritation, and I thought we were back in the game. I had planned to stop by the midwives’ office for a quick weigh-in to check our progress from last week, and then head out to make up the birthday lunch I was supposed to have with my Mom on Monday but that I had to cancel when the nanny called in sick.

The bad news is, Lucas didn’t gain any weight last week. At all. He’s still the same 9 lbs 12 oz he was last Wednesday. Babies are supposed to regain their birthweight by the time they’re three weeks old, and he’s still four ounces short with his three-week birthday in two days.

So, instead of a 10-minute weigh-in, I once again missed lunch with my Mom because we had an hour and a half visit with the midwife, where we ironed out a plan. I’ve got a call in to see a Lactation Consultant, which is fine but expensive. I have to feed him every three hours round the clock, on both sides, instead of just one one-side-per-feed pattern I’ve been following. This also means, unfortunately, that I have to set my alarm to wake us both every three hours through the night, and I don’t know which of the two of us will be more irritated by this plan. I have to keep stimulating him during a feed, because I suspect he’s getting satisfied from the foremilk and slacking off into sipping and snoozing during the fatty hindmilk phase of the feed.

Because he gained nothing, the midwives have to consult with a pediatrician to make sure there is nothing medically preventing him from gaining, so it’s a good thing I’ve already touched base with mine. We have an appointment scheduled for Friday, where hopefully we’ll see at least a couple of ounces of gain, otherwise we’ll have to start a major feeding intervention by renting an electric pump and supplementing that way. If that doesn’t work, we may have to consider formula supplementing, too. And he’ll have to be reweighed on Sunday and every two days until he regains his birthweight at least.

Sigh.

Lucas is otherwise perfectly healthy, and I’m gobsmacked that he didn’t gain so much as an ounce, because I’m an experienced mother and I can see we’re doing all the right things. Lots of wet and soiled diapers, I can hear him swallowing, I can feel him draining the breast. Aside from the fact that he’s a horrendous spitter-upper (as were his brothers) and a couple of incidents of obvious gas pain, everything seems perfect.

Frankly, it’s deja vu all over again, because I went through a lot of this with Tristan. I dunno, maybe I just make crappy milk — or maybe it takes a while for me to ramp up production. With Tristan, I could blame the poor latch and lack of experience. This time, I just don’t know. It’s kind of ironic that Lucas so physically resembles Tristan as a baby, since he’s now showing the same weight-gain issues. Starving Simon, who demanded to be fed every two hours for the first — well, he STILL demands to be fed every two hours, but now it’s pogos and guacamole instead of breastmilk, never had any weight gain issues as a newborn.

So my job for the next couple of days at least is to exclusively concentrate on feeding this baby and try not to hate my breasts all over again. I swear to god, they’ve truly been my nemesis since I was twelve years old, and continue to vex me all these years later. At least they don’t really hurt anymore, because I can see we’re going to be doing a whole hell of a lot of latching over the next couple of days.

Funny that in the comments on my penultimate post, both Snackmommy and KarynB said they want to see some pix of Lucas’ baby fat rolls, because I was already planning to post a few pix to show y’all exactly what a 10 lbs 1 oz baby (now a svelte 9 lbs 12 1/4 oz, as of his appointment last week) looks like. You’d think he’d be like Simon was (at 10 lbs), chubby and corpulent with rings and rolls of baby fat all over him. You’d be wrong. Take a look at these chicken legs!

Here’s another one, cuz he was too squiggley to get a good picture:

I don’t know where he’s keeping all the weight, but I suspect his bones may well be the source of the elusive “dark matter” that counterbalances the universe. His legs are so long that he’s already too long for the 3-mos size sleepers, and his ginormous flipper feet keep getting stuck in the legs of the sleepers. His feet are so big that even the 12-mos size socks keep sliding off. Here he is wearing a pair of newborn socks — note the heel right about where the arch in his foot is!

Truth be told, his weight must come from his sheer length. I brought him in for his first visit to our pediatrician last week, and had to laugh at his nurse’s reaction when she measured Lucas’ length. Keep in mind, our pediatrician (I’ve blogged before about how much I like him) is one of the more popular and busy peds here, and the day I was there he was seeing three newborns — I can only imagine how many new babies cruise through that office in the average week. Dozens in a month, I’m sure. All that to say, it made it even funnier when Judy the nurse went to measure Lucas’ length and did a classic double-take then laughed out loud. “He can’t possibly be 24 and a quarter inches long,” she laughed as she remeasured him. “He’s the longest one we’ve ever had!”

Barrhaven’s biggest baby — that’s my Lucas! (Okay, so Barrhaven’s busiest ped’s biggest baby — but that just doesn’t flow quite so well.)

He’s a tad on the slow side regaining his birth weight, but not enough to be concerned about yet. The ped confirmed that he’s “borderline” tongue-tied, and we may consider getting his frenulum clipped. I’ve read everything from “this is cruel and unnecessary” (Sick Kids says it won’t do it under any circumstances before age one) to “this is vital to a good latch, decent feeding and essential weight gain.” The nursing is much better than it was – my nipples are no longer cracked or bleeding – but still painful. We’ll give it to his next visit to the ped on Friday to decide, I think. Each day is better, though, so I’m leaning toward leaving it be — like circumcision, it comes down to the fact that I just can’t bear to cause him any discomfort that’s not absolutely necessary, and the latch seems to improve day by day. As long as his weight gain is okay – and right now, it’s just on the low side of acceptable at this point – I am tempted to just let it be.

A 10+ lbs baby with no fat rolls — how about that?