Sunday, May 25, 2008

Nursing Drama

So far, it seems that Megan really is a bit of a sleeper. I'm not willing to totally buy it until I'm completely off codine but she is currently about a million times easier to care for than I remember Charlie being.

She tends to nurse fairly quickly and efficiently during the day for 15 minutes or so and then goes to sleep for another 3 hours. In the late evening she will cluster feed for a good hour or hour and a half but then sleeps for 4-5 hours, nurses in a highly focused manner for 10-15 minutes and then goes back down for another 3-4 hours. This might be slightly less than accurate (re:codine) but is what my muzzy brain remembers. Last night and today have been a bit different but I think we may have hit the 7 day growth spurt. This nursing pattern is a bit on the unusual side for a newborn (and is vastly different from Charlie's clockwork 45 minute session starting every hour and a half around the clock) and caused a bit of drama at the hospital where they really don't like them to go much more than 2-3 hours at the outside. Megan has strong feelings about when she would like to sleep and when she would like to eat and does not appreciate attempts to mold her to your will. But, since she was making plenty of wet and poopies and appeared quite healthy and happy the nurses didn't really push it on the whole. I also got a lot of ground from having nursed Charlie for 14 months- including through my 1st trimester. The nurses seemed to feel that this was plenty sufficient to ensure my nursing competence. The pediatricians were a different story.

We had to use the on-call practice because our family physician doesn't do hospital rounds for newborns. We also did this with Charlie and liked the doctors reasonably well and since it's only for a few days it didn't seem like a big deal. This time was different. Starting with the 1st visit, less than 12 hours after Megan was born, I started getting told to consider supplementing because Megan was such a big baby. The first pediatrician made the argument that I wouldn't ever be able to get any rest because it would be such a struggle to feed her. Instead, we should make liberal use of the night nursery and allow for supplements from the start. There were so many things wrong with this argument, I was stunned. How did she ever expect my supply to catch up if I was supplementing from the start? In addition, there were simply no indicators that there even was a problem and, while 9 2, is on the larger size, considering that one woman can nurse multiples or tandem nurse siblings, the assumption that one newborn is beyond the capacity of a woman who never even fully lost her milk from her previous nursing stint, was just dumb. I was of the impression that most new parents understood that sleep deprivation is part and parcel of new parenthood.

Things continued to go downhill as she dropped weight every day. The hospital flagged 8 6 as being the point of concern (although it isn't actually the 10% mark) and she hit 8 5 on Tuesday morning. Since this was also the day of discharge, the pediatrician (a different one) decided that he needed to be as dour as possible, telling tales of readmission and droopy, dehydrated babies needing IVs. The dreaded supplements were brought up again (for the 3rd time). The thing is that while 8 5 was a fairly steep drop, it didn't appear that the pediatrician actually looked at any other health indicators. Megan routinely nursed to the point of falling off the nipple, falling asleep contentedly or having a brief and happy awake period. She showed no signs of the fussy or listless behavior that come with an infant who isn't getting enough milk. I showed signs that my milk was coming in that morning. Her poop was rapidly shifting from merconium. There were plenty of wet diapers. She showed no signs of jaundice and her blood sugar (checked several times of the first 36 hours as a matter of course for babies over 9 pounds) was wonderfully stable. The daily visits from the lactation consultants were brief and positive. As far as I can tell, the only thing the pedi looked at was weight. He didn't even bother to ask me about how nursing was going, my milk coming in, etc. He said he would send in the lactation consultant to talk to me about supplementing, helpfully adding that she didn't need to go directly to the bottle, instead we could look at finger feeding and cups. This still didn't really fix the issue of the best way to increase supply being to nurse more and, as she was apparently starving before my eyes, she should be more than happy to nurse, right? Of course, every time I had tried to increase her nursing frequency, I was met by hours of frustration and tears on both our parts but I figured we could work around that somehow.

After he left I just started sobbing (no mean feat for a woman who just had abdominal surgery). As far as I could tell my baby was happy and healthy with just my milk and supplementing was the last thing I wanted. I was already quite disappointed about not being able to deliver vaginally (more to come later but I'm not ready to "talk" about it yet). The idea that my body would fail again was quite upsetting. Particularly as I just didn't see it. Luckily, the lactation consultant was able to observe a nursing session right after she came in and agreed with me that Megan seemed completely fine and that my milk was already starting to come in. I was encourage to simply continue on the current course, go to our doctor for a weight check the next day and was told to write plenty on the evaluation form I was given that would go to the nursing supervisor. We took Megan to our doctor on Wednesday and she was actually down a few more ounces but our regular doctor wasn't at all concerned. Megan continued to look healthy and happy and her weight was far from being at a concerning level. She said we could bring Megan back early this week for another weight check if we wanted but she felt the 2 week appointment would be plenty soon enough for her.

I don't know why she wound up dropping so much weight. I have a few theories. She got rid of almost all of her merconium on the first day which had to account for a least a couple of ounces. I had a good hunk of water weight gain in the last week or so of my pregnancy and she may have gained with that as well. On a less logical note, I wonder if there was a reason that she did wind up so very unexpectedly big so that I would need a c-section. God does work in mysterious ways and all indicators flatly contradicted my growing a 9 pound baby. I am so beyond thankful that I somehow managed to have a relatively easy recovery that allowed me the option to go home on Tuesday. I shudder to think what would have happened if Megan had stayed in the care of those pediatricians another day, knowing she went down a few more ounces. I am also so thankful that I had a strong confidence in my ability to breastfeed as well as plenty of factual knowledge to back up my instincts. I really worry about the poor, first time mother who would be in a similar situation. The advice I was given would set her up for failure and oodles of unnecessary stress. I'm somewhat hopeful that the lactation consultants are now aware of an unfortunate tendency by this practice and will act to alleviate it's effects.

1 comment:

kat said...

Congratulations! I'm glad you stuck to your guns and didn't cave into the guilt trips. I hope you heal up quickly and are feeling better. Does Charlie like being a big brother?