February 27, 2011
February 26, 2011
Every baby in the NICU gets a special quilt sewn by a local volunteer.
When I arrived for a visit a few days ago, Merritt's new blanket was draped over his isolette.
SPACE! Constellations, planets, hot air balloons, kites, astronauts, they're all here!!
February 25, 2011
So far, Merritt's journey in the NICU has been pretty uneventful (thankfully!). He has been stable since he arrived, and spends the time that I'm not with him seemingly content, nestled asleep in his isolette. I can't believe that a week has passed by already.
For three days he was under the bili lights and could only come out for 30 minutes every four hours.
Now that his jaundice has been addressed I can hold him for an hour or so every 4 hours. Usually we try nursing for the first 30 minutes and then do kangaroo care for the rest of the time.
Merritt is slowly being weaned from each of the interventions currently in place (TPN via IV, nasogastric tube feedings, room air nasal cannula, and incubator). The biggest milestone so far will hopefully come tomorrow night when his intravenous nutrition will be discontinued and we'll begin the process of weaning him from the nasogastric tube to the breast.
The stress and strain of the circumstance is beginning to take its toll on all of us. My days begin at the hospital at 7:30 am and I alternate between spending 2-3 hours at the NICU and 1-2 hours at home, with pumping in between. I don't typically make it home at night before 10pm.
The last couple of days I tried to cut down on the back and forth by staying at the hospital all day, but then I missed out on seeing Roscoe. I'm tired, and it has been difficult to find balance in time spent with each of the boys. I feel a greater pull to be with Merritt, but I still feel terrible when Roscoe looks at me with his big eyes and says "miss you" while rhetorically asking "Ug?" (hug). Andy has only been to the NICU a few times this week, and the distance is making Merritt's existence seem abstract.
Andy and I have been brainstorming alternative arrangements to mix things up a bit, maybe we'll switch roles for a day and see how we each feel. All I know is that I really miss my first little guy, and I think it's important that we get to spend some quality time together.
I'm finding comfort in focusing on the few things that I have control over: pumping, nursing, making sure that I'm available for Merritt as much as possible. It's been hard for me to give up control over Roscoe's daily routine but Andy has filled in for me as seamlessly as I knew he would. It's been an unusual opportunity for Poppa/Roscoe bonding, but I know that home-life demands have left Andy feeling equally worn out.
For now, we're literally taking each day one at a time (parent pow-wows commence nightly before bed, in order to plan for the following day). Breakdowns ensue when we try to think too far ahead, and lately my breakdowns are coming more frequently, and without notice. I suppose a good cry is in order every now and then.
Generally, we're expecting at least another week in the NICU, maybe longer. I have a lot of anxiety about what lies ahead for us as Merritt becomes more independent. I'm not sure how easily some of my mothering principles will integrate with the process and procedures of the NICU. Feeding on demand, and responding to his cries are two of my top concerns. I hate to say it, but often the other babies are left to cry for 15 or 20 minutes and then eventually fall asleep without ever being tended to. I guess I'll have to set up camp at his isolette to ensure that my little lion gets all the attention he deserves.
Any other attachment minded parents out there with NICU experience to share with us?
Happy one week birthday Merritt!
February 22, 2011
February 20, 2011
Not surprisingly, Merritt's birth story is not as straightforward to write as I had hoped. In the meantime, I thought I'd provide an update on our nursing progress.
First let me say that we're lucky to have an entire staff of breastfeeding supportive nurses working with us. I knew I was in the right place when the nursing guru and aptly named "breast whisperer" was assigned to care for Merritt.
Andy and I were able to visit with Merritt for the first time about 2.5 hours after he was born. Because he was stable I was allowed to hold him skin to skin for about 45 minutes. I started pumping when we left the nursery and have been following an every 2 hour pumping schedule.
My hope was to provide him with exclusive breast milk, so I was disappointed when they wanted to begin feeding him yesterday morning and my milk hadn't yet come in. The plan we established was to pump whatever amount of colostrum/milk that I could, and then they would make up the difference with formula until I was able to provide enough for his full feeds.
My first two sessions resulted in a combined 1/5 of a cc of colostrum, and at the time he needed 5ml every 3 hours. Slowly but surely I've been able to pump more and more, and I am so proud to tell you that I'm now making enough milk to exclusively feed him, no supplementation needed. I feel like one awesome Momma! By tomorrow my milk should be flowing, and I hope to begin banking surplus.
To coincide with his feedings, I also get to nurse him. The Neonatalogist encouraged me to offer the breast for the first time yesterday morning and Merritt surprised us all and latched on with ease. I forgot how intense those uterine contractions are postpartum (way worse this time than last!). They radiate all through my back and down my legs, and yesterday actually required me to deep breathe through them. Needless to say, Ibuprofin has become an integral part of the routine.
It was difficult to meet Merritt for the first time in the context of the NICU. He didn't really feel like our baby, and it seemed as if we had been catapulted into the unknown. All the barriers presented by the environment seemed to challenge our ability to act on our parental instinct. It can be discouraging to have to ask permission to care for your baby: to feed him, to change his diaper, to be an active part of his daily routine. Negotiating for our priorities hasn't been as difficult as I thought it might be, but we have had to make some comprises as well and concede to those things which do not fall at the top of our must-haves list.
Nursing, as I might have guessed, allows us each to assume our respective roles as Momma and Baby, pure and simple, in the face of all this chaos. The hours we spend together, and even the time I spend pumping, are the highlight of my day.
February 18, 2011
My day was made when I opened my inbox Saturday morning to find the message, "Andy + Jacqueline: Happy Valentine's Day to one of my favorite couples!".
A graphic designer friend of mine, who has over the years shared her talent with us on several occasions, indulged us with a replica print of an inspiration piece she spied online. I wish I had artistic talent and Adobe Illustrator know-how!
I think I love silhouettes almost as much as Jessa does (remember that fun plate we made for Roscoe's grandma?). It brought a smile to my face to hear of her early memory sitting patiently underneath the bright hotness of the living room lamp with her little brother by her side, as her mother carefully traced their shadows.
The gift was such a sweet gesture, and now I'm dying to send her some photos to make a silhouette to celebrate my two boys and the start of their brotherhood. Or of our dog. Or of my pregnant belly. (Wouldn't it be cool to have a 9 month series?)
Jessa, can you hear me?!
My water broke yesterday around 12:30pm. I wrapped up a conference call, put Roscoe down for his nap and then settled in for a snack and some email catchup. A few small gushes and a double check in the bathroom didn't convince me, but as I walked back to my computer more water trickled out and I was back to the toilet where I sat for 30 minutes with water intermittently dripping and gushing as I called my midwife, Andy, my mom, and my doula, in that order.
36 weeks is the cutoff for home birth. I'm 33 weeks today. After much debate, and because we thought the baby might come quickly, we went to our nearest hospital, instead of my primary choice located in the heart of DC. I wasn't experiencing much in the way of contractions so we took our time at the house--I showered, we packed my bag, and gathered all the necessities including extra pillows. We left around 2:45; Roscoe was sawing logs in his bed, and my mom was elbow deep folding a huge pile of laundry.
When we first arrived I tried my best to resist any internal exams because they significantly increase risk of infection once the amniotic sac has ruptured. When the doctor couldn't visually see my cervix with the speculum she convinced me to do an internal, my first FAIL.
My cervix was soft, thick, and 1 centimeter dilated. We were told the baby might come tonight, or in a week.
The sonographer paid us a visit and Little Sears was well engaged in my pelvis, head down, and butted up snuggly to my cervix. I thought we might get a glimpse of his sweet little face but it was buried. He's measuring right on track (estimated weight: 3 pounds 13 oz. plus or minus 11oz.) and he hasn't shown any signs of distress so far.
We spent over an hour with the neonatal intensive care nurse practitioner to get a better understanding of the NICU's policies and procedures. At this stage in the pregnancy we're guaranteed a minimum two week stay, and of course the realities that go along with that break my heart, but we're trying to stay positive and advocate for the things that are important to us.
I can't imagine leaving him in the NICU alone. ever. We've been told that we can stay with him 24 hours a day, practice kangaroo care whenever possible, and I've expressed my very strong preference that he receive only breast milk. I was a horrible pumper last time so the learning curve will be interesting. Once he is born we will initiate the process to request donor milk in case he needs to be supplemented.
I was transferred to the ante/postpartum ward and ordered for strict bed rest with trips to the bathroom as needed. I've been able to change back into my own clothes and I have a "room service" menu to order from at all hours so, for the moment, I'm pretty content. Overall we've been pleasantly surprised, staff have been really wonderful and we're bummed that they'll be switching shifts in four hours. Of course, I couldn't escape confinement to the bed and continuous monitoring, didn't get to eat for almost 12 hours, or use the bathroom for the first 6, but comfort measures are hard to come by here. Even pillows are a hot commodity and I'm glad we brought three. 'Tis the nature of the hospital I suppose.
I finally fell asleep around 1:30am but woke around 2:00am with contractions that are now 5-8 minutes apart--they're not painful, but I would definitely categorize them as contractions vs. the cramping I've been experiencing off and on over the last two weeks. I'm torn between wanting to keep the baby in as long as possible (I received the first of a series of steroid injections around 6 this evening), and wanting to avoid infection and the higher risk for a c-section. When my body goes into labor they will not try to stop it. My doula is on call, and my hope is that I will still have a natural, vaginal birth. The current estimate is that he'll be born within the next three or four days.
For now everyone is exercising the wait and see approach, which is just fine with me. I'm still processing everything and I'm grateful for this little lull in activity which not only bides us time to emotionally and mentally prepare in the context of the current situation, but to gather our thoughts around our priorities and to adequately communicate them to everyone on staff.
Keep Little Sears in your thoughts, outcomes are typically great for babies at 33 weeks.
February 17, 2011
When Roscoe was born he received from his cousin Mack, London, a mini blabla dog. It's become one of our favorite stuffed toys, and I've since gifted several to my friends with new babies. Blabla dolls are so soft and lovable, and they have appendages the perfect size for babies to grasp. Roscoe sucked the ears of his so often that they are permanently Pippy Longstockinged.
One of Little Sears's middle names will be Leonidas, which translates to little lion or lion man. This is a nod to both my Greek heritage, and to the Leo zodiac which describes this moody Momma to a T.
Of course, if Roscoe has such a special friend, Little Sears should get one too. It seems that Charles already fits right in.
February 16, 2011
In the wee hours of the morning last Friday I got a call from my doula inviting me to the birth of one of her clients who at the time was in the pushing stage of labor and headed for the hospital. The baby was born 4 hours later and my original plan to drive to Maryland for my 32 week prenatal visit was abandoned in favor of a reschedule.
Susan arrived yesterday afternoon with perfect timing--my work day was practically over, and I had just put Roscoe down for his afternoon snooze.
Little Sears is still positioned head down, with his body along my right side. His heart rate was in the 130's. My fundal height is back on track at 33 weeks. I've now gained close to 30 pounds.
We spent most of the visit discussing the birth I attended last week. While in many ways it affirmed my belief that I am best birthing at home, the abrupt nature of the experience had left me feeling apprehensive about unexpected emergencies. In short, the laboring mother received an epidural, the baby's heart rate dipped (as is a common side effect), and eventually plummeted to 70 beats per minute. Within 90 seconds the room was emptied--mother, father, and nursing staff evacuated to the operating room for a c-section.
Intermittent fetal monitoring (as practiced by my midwife) has been shown to be as effective as continuous fetal monitoring--with far fewer reactive interventions. There's also the consideration that an epidural inherently alters the course of natural labor because it restricts the mother's mobility (and her ability to facilitate the baby's descent, or react to situations like a drop in heart rate, with a change in position). Interestingly, my midwife said that in her experience the vast majority of hospital transfers are for first time mothers who get tired and want/need an epidural. A hospital transfer for a safety related emergency is very rare.
At each visit we reiterate the plan that I will alert Susan at my first inclination of labor. Of course there's no way to know how quickly my labor will progress, but it seems that 2-3 hours is the current estimate. I have no interest in free-birthing, however, our conversation today made me feel more confident in the event that the baby is born before she arrives--even though I still don't want to think of the possibility. The good news is that naturally fast labors tend to be efficient and inherently complication-free.
So what's next? I'll be making one last trip to Maryland in 2 weeks (at 35 weeks), our doula/birth assistant will visit us at 37 weeks, and Susan will make another home visit at 38.5 weeks. Whee! Despite the downtrodden mood of Monday's post regarding the amount of time left in this pregnancy, if Little Sears is born around the time that Roscoe was born, I have only 5 weeks to go! While I don't want to give myself false hope, it may be just the thing I need to get through the next few weeks.
February 15, 2011
Valentine's Day 2011 was marked with lots o' crafts, lots o' toddlers, and lots o' love.
Saturday night Andy and I dined at our favorite restaurant in DC. We don't go often, but it is the place we gravitate to when we've got something special to celebrate. The Tuscan Italian menu is amazing, and the prosciutto casalingo coi panserotti (prosciutto and Florentine bread fritters) alone, are well worth the trip--not to mention the tagliatelle fresche con funghi e piselli. We almost died and went to heaven during our three hour meal. And we hit a new parent milestone by staying out past midnight, something we haven't done since Roscoe was born. I even managed to squeeze my finger into my wedding bands for the occasion.
Sunday morning we exchanged cards and gifts with Roscoe, then prepared all the fixin's for ice cream sundaes--the main event for that afternoon's annual Bradley Babies Valentine's Day party. We made hot fudge, vanilla whipped cream, chocolate whipped cream, and strawberry sauce. If you've never made chocolate whipped cream, you must. Here's the recipe:
1 cup heavy cream
3 tablespoons cocoa powder
3 tablespoons sugar (use granulated if you want to eat it right away, use powdered if you plan to store it for a while)
1/2 tablespoon vanilla extract
Mix at medium speed until the cream begins to thicken, then whip it on medium/high speed until the cream reaches the desired consistency. (makes 2 cups)
After all that, it was still only 8:00 in the morning and we were feeling creative so Roscoe painted frames for his Grandma and Tippy.
After nap we were off to celebrate St. Valentine with our favorite toddler valentines. One of the moms brought a craft--more picture frames(!!)--and I was thrilled to finally be the recipient of one of Roscoe's works of art.
After the kids exchanged their valentines, we attempted to catch a group shot and they were downright uncooperative! The outtakes are hilarious, but this is the best shot I captured.
February 14, 2011
Note: McFatty Monday's is no longer! Instead I will post Momma's Monday Check-in. Join me as I eat and exercise my way through the next 7.5 weeks.
Due Date: April 8, 2011
Total weight gain: 30
Pregnancy Symptoms: My fingers are swollen, and my hip joints are really loosening up. Even side-lying is uncomfortable now--too much pressure on my hips!!
Sleep: Andy brought Roscoe back in the bed, I think he gets better sleep with this arrangement. It's not been so bad the last few days, and I do love being close to Roscoe at night. We've been staying up until 11:30 and 12:00, which is dumb, but Roscoe's also been taking 3 and 4 hour naps in the afternoon, and I've been able to join him for at least part of that time. It's given me both a chance to catch up on rest, and to have quiet time during the day.
I can't live without: I broke down and bought more maternity clothes. I started out this pregnancy with every intention to remain stylish and sexy for 40 full weeks, with the help of Bump It Up by Amy Tara Koch. All I can think about now is comfort. That. is. all. I've never weighed this much and I have NOTHING to wear. I've even run out of pajamas. So I threw out all the rules and bought a bunch of comfy stuff. Items that will last the next few weeks and become staples postpartum. Stretchy tanks; sweat pants and stretch pants with full panels. Oh my gosh, I feel so much better!
I am looking forward to: My prenatal appointment was rescheduled from last Friday to tomorrow.
Best moment this week: I had the opportunity to attend a hospital birth on Friday morning! Also, our Valentine's Day weekend was awesome! We had an amazing, and much needed, date night and devoted most of the weekend to quality togetherness. I'm refueled for the busy week ahead.
Aha Moment: Roscoe's birthday party is almost fully planned (we're trying to save ourselves from the stress of party planning in the weeks following Little Sears's birth). A good friend of ours pointed out that this time next year we'll have a one year old and three year old. Crazy how the time will pass whether we like it or not.
Milestones: I feel like my face has finally been taken over by the pregnancy. So big and round, I'm counting down the days to birth-day and the start of weight watchers.
Movement: This baby has developed a mean cervix punch.
Exercise: Lifting weights was a success this week. Of course, there's always room for improvement, but doing something a few times a week feels so much better than not doing it. Most nights I'd so prefer to veg out and catch up on things in the evenings, but I'm glad that I'm making the time for exercise.
Diet: I'm hungry all of the time! And being tired doesn't help. Ugh...while I'm really counting on a baby next month, the reality exists that I could be pregnant for another 10 weeks (unlikely, but still!). I'm getting a little nervous about the potential for insane weight gain in these last weeks.
Goals for the upcoming week: Lift weights twice, take advantage of the forecasted fifty and sixty degree weather (SPRING is coming!!!) and walk with Roscoe at least twice in the afternoons--it may be the perfect opportunity to finally download a book on tape.
February 8, 2011
Note: McFatty Monday's is no longer! Instead I will post Momma's Monday Check-in. Join me as I eat and exercise my way through the next 8.5 weeks.
Due Date: April 8, 2011
Total weight gain: 29
Sleep: Decent. Roscoe's back in his own bed and after a few nights of 4 and 5 wakes, his sleep has improved a lot. It's nice to be back in my own bed, alone, with Andy (and my many support pillows).
I can't live without: Knowing that the end is near (sort of)! I've been feeling trapped in my own body lately, and it helps to know that this pregnancy won't last forever.
I miss: (and I think Roscoe misses) more lap room.
I am looking forward to: A 32 week prenatal appointment on Friday, and Andy has the day off so he gets to join us. Andy and I have a hot date on Sunday night, and the Bradley
Babies Toddlers' annual Valentine's Day party is on Sunday.
Best moment this week: I learned to de-bone a chicken!! Such a simple and useful thing to know how to do. We also finished the nursery, although something is missing and I have yet to figure out what. When it's truly complete I'll devote a whole post to the baby's new room.
Aha Moment: I finally noticed my linea nigra. Maybe I've just been too busy to look for it, and it seems a lot lighter than last time. It's also really crooked.
Milestones: Only five more weeks of work, and so much to do!
Movement: I've actually been enjoying his movement more recently. I think it's because he feels so big and I can easily make out his baby parts. His feet have been front and center.
Exercise: I lifted weights last week and made that the focus of my workouts. Even though I felt big, I felt strong too and that inspired me to keep at it.
Diet: I only gained 1.5 pounds last week...not 2!
Goals for the upcoming week: Workout twice, enjoy Roscoe while Andy is on his overnight Vegas trip (for business), and have a fun-filled family weekend.
February 3, 2011
Have you ever wondered what would be needed for a home birth?
Here is the official supply list, given to us by our midwife at our 28 week appointment. It is requested that all supplies be gathered in one place by 36 weeks.
Supplies for labor and birth
Basically, Momma needs to be hydrated and nourished during labor--we have stocked coconut water for hydration and runners "GU" for quick energy. Our cupboards were absolutely bare when I went into labor with Roscoe, and my parents saved the day by dropping off a full load of groceries shortly after labor began. I didn't have a desire to eat any food, but I did suck down two gels during the pushing phase, and had maybe a few sips of grape juice at some point or another. For women with longer labors I imagine that a few easy to eat snacks would be lifesavers.
Since we've done this before we have quite a lot of leftover items, so our job of gathering everything on the list was made pretty easy. We will use two of our laundry baskets and line them with trash bags for whatever trash and linens accumulate during the process. I had a really easy recovery after Roscoe's birth, but I do remember a need in the first 36 hours for frozen peas and Ziploc baggies wrapped in paper towels (homemade perineal ice packs!!). Friends of mine swear by the commercial ice pads provided in-hospital, and when I found them on the birth supply website I decided they would be worth the investment at $2.50 a piece. I'm not sure that anyone will be at my beck and call to reload the pea packs every couple hours so I think the convenience will be great.
We're using the same set of receiving blankets that were used at Roscoe's birth, and Susan will bring an electric heating pad to warm them. Baby hats, newborn diapers, and a digital thermometer are all baby basics and easy to come by. Vaseline makes the first meconium poops so easy to clean up--we put a few dabs on Roscoe for the first three diaper changes and saved ourselves the effort of wrestling with the tarry stuff.
A good selection, and large quantity of pads in different absorbencies were essential and it was nice to have bought them ahead of time so that Andy didn't have to later run to the store and guess at what I might need/prefer.
The supplies designated for the actual birth are a little harder to come by, but my midwife has a relationship with a homebirth supplier and last time we ordered a customized kit for a little over 40 dollars with shipping--it included everything that our midwife requested. Because we had at least a small quantity leftover of most of the necessary items, this time I only had to order a few more packs of chux pads, 7 or 8 gauze pads, and several sets of sterile gloves.
Before we experienced it, one of our biggest superficial concerns was the "mess" involved with birth and how our white carpets would fare. Fear not! Those blue chux pads are perfect for the job, and in the final weeks of pregnancy I highly recommend stashing a few in your bag, desk drawer, and glove box in case your water breaks and you need something to sit on. My water broke as my first sign of labor. I happened to be asleep on the couch, but what if I had been mid-commute!? Those pads would have come in handy!
Ammonia and hydrogen peroxide serve as all purpose cleaners. I can't speak to their effectiveness because we didn't need to use them (hope the expiration date hasn't passed because they're in the box again). When the birth team left our house late Tuesday night, everything was in order and a load of laundry was humming in the wash. You would have never guessed that baby Roscoe was birthed on the floor in the corner of our bedroom.
Preparing the labor and birth space
I plan to labor throughout the house as I feel comfortable, and give birth in our bedroom or bathroom (who knows where, really!). In early March we'll make our bed with clean sheets, put a plastic painter's drop cloth on top, and then stretch a fitted sheet over the whole thing and make the bed as usual. I know one thing, we'll be sure not to wait until week 38 and 2 days (like last time!). I remember stripping our bed and tossing the sheets in the machine while I waited for my contractions to ramp up, but neither of us can recall how the bed actually got made! Either way, I spent only the intense transitional phase of labor under the sheets, nestled between pillows, so we didn't really make use of the whole preparation.
I love admiring our little stockpile of birth-day supplies. We're one step closer in preparing to meet Little Sears and I can't believe that we get to do this again! And soon!
If you're planning a homebirth do you have a similar list?
February 1, 2011
Note: McFatty Monday's is no longer! Instead I will post Momma's Monday Check-in. Join me as I eat and exercise my way through the next 10 weeks.
Due Date: April 8, 2011
Total weight gain: 26
Sleep: I'm just waiting for the pregnancy insomnia to resume in these last weeks, but for now falling asleep and staying asleep isn't the problem. Roscoe, our little steam roller, is the problem, and establishing a different routine before the baby comes might be a good idea--for me but also for Roscoe because I'm not sure how he'll fare with little brother's frequent night wakes/nurses and Momma getting in and out bed at all hours.
I can't live without: Dates with my girlfriends. I went to high tea on Sunday and it was energizing.
I miss: It's only been less than a week, but I already miss wearing my wedding rings!
I am looking forward to: SPRING. Warmer weather, sunny skies, a new babe in arms. I can't wait. Also, I get to attend a birth in February as part of my certification requirements for Bradley!
Best moment this week: I organized ALL of my photo files in Aperture, which is a huge accomplishment because I have tens of thousands of digital files dating all the way back to 2002. I decided to catalog the files by year and month and now I finally have a system that makes sense and that works for the way that I take photos.
Aha Moment: I'm really enjoying work days that end at 1:00pm. Roscoe's been napping later in the day which means that I'm still able to catch a short snooze after work. I'm loving the long days and all the Roscoe and Momma time that we're getting to spend together.
Milestones: Let's see...30 weeks down! My engagement ring has been benched thanks to moderate swelling. Heart burn has ramped up.
Movement: There's a BABY in there, and I can feel all of him all of the time.
Exercise: I lifted weights this week and made that the focus of my workouts. It actually felt really good, and made me want to do it again last night. I think this is progress!
Diet: I've really been enjoying food lately. I've been trying out a lot of new recipes and have been having FUN every day in the kitchen. The downside: I can't seem to escape gaining at least two pounds every week. gah. MUST slow down! I think the baby gains about a half pound every week from here on out, so that other pound and half? It's hard to imagine that I'm overeating by THAT much every week, but I suppose it's possible.
Goals for the upcoming week: Go to the gym twice (just trying to be realistic!).