Tuesday, June 30, 2009

Grace's nursing

This is for my own records, it's a week since we saw the occupational therapist, so it seems a good time to record where she is at.

Her lip curling has improved, I used to have to correct both her lips every single time she latched, now it's only occasional, I need to keep more of an eye on whether it's her lower or upper lip that needs to be adjusted.

Despite this, her latch is still shallow and often painful :-(. Nipples are still chisel shaped after feeding.

She still chomps her chin up and down rather than forwards and backwards, using a finger to support her lower jaw seems to make this worse not better, as if she's trying to push your finger away. Cheek support does appear to help.

She shows definite preference to nursing on my right breast, particularly in side lieing position. She often shows resistance to nursing on my left breast in cradle or cross cradle hold and thrashes around a lot. This is a shame as my left breast had always been the better producer, so she'd probably find it easier to get a full feed if she'd spend more time there. I'm confident that her left breast issues are not related to oversupply or overactive let down as if she is resisting it she'll resist right from being help in that position.

My supply is finally taking a hit from the reduced pumping schedule, it's still ok as I can still pump enough in the daytime to meet her overnight and supplement needs, but I'll need to be careful it doesn't decrease further.

Monday, June 29, 2009

Busy Monday

My day began with Andrew rushing into the bedroom at five to ten, thrusting breakfast at me and asking me what time we needed to leave for my 10.30 appointment, oops, didn't occur to any of us that an alarm might be required to be on time for something at 10.30am!

We were late, but fortunately the psychiatrist was running late too. I told her how I'd been feeling this last week and she thinks it's too soon to change things, so I'm to keep on with the same meds. My vit D levels are very low, so I'm to take a huge dose twice a week, along with the smaller dose I've been taking daily for a while, she thinks that should have an effect pretty quickly.

I spent some of the rest of the day ironing for buggy barn night at quilt group. I should have stuck to my instincts and not taken my sewing machine, I was pretty sure I'd need all the time to cut and that is indeed what happened. On the way home, I realised how much I'd enjoyed the night, which I find encouraging, I've mostly managed to keep attending quilt group, but have just been going through the motions, rather than enjoying things.

Monday is also shopping arrival day, the recipe I plan to prepare tomorrow is a nice easy one, sticky ginger chicken, basically I make a marinade from lemon juice, sugar, ginger and soy sauce then skin a whole load of chicken drumsticks and throw it all in the freezer.

Amongst all that I managed to squeeze in watching some of Wimbledon, following the Andy Murray match into a tense 5th set. If he makes it to the final, that's one thing I'll definitely be setting an alarm for!

Friday, June 26, 2009

This stinks

I feel terrible and don't know what to do with myself. I hate feeling like this and really want to be able to just snap out of it, but I can't. I'm really worried that I'm on this amount of medication and still feel terrible. I've had awful thoughts going through my head this morning and I don't really feel safe and don't know what to do to make that change.

Monday, June 22, 2009

Buggy Barn quilt


My quilt group decided to learn a new technique, where you create crazy blocks by careful rearranging of stacks of cut pieces. The one I've chosen to work on is Going in Circles. The fabric requirements were 23 fat quarters of red and 23 fat quarters of light brown, which is a lot of fat quarters! So I've been waiting for a sale at JoAnns to get them, I was pleasantly surprised to find that I could get 23 for each of my requirements, I was expecting to get less than that, then have to buy more from a quilt store.
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knitting finished


Other than a tiny bit of crochet around the armholes, the circular cardigan I've been working on is finished, here it is being blocked on a pile of cloth nappies. Unfortunately when sewing it up, I discovered one tiny mistake, about half way around, there is a cable crossed the wrong way, thankfully because of where it is, when the collar is folded over it gets hidden - but I still know it's there :-(.
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The new plan

It's all change on the medication front, I'm now going to be taking Lexapro, the psychiatrist seems to think this is ok for breastfeeding, but I've seen information that suggests it makes babies sleepy, which would not be good, Grace is already a fairly sleepy baby.

I'm also increasing my dose of seroquel, it's mostly to help me sleep, but it should also boost my mood, this is not a good drug to be taking long term, but it's a good one for sleeping at this stage as it is barely detectable in breastmilk.

This means DH is doing night feeds, initially I was pumping in the middle of the night, but as I was producing more than twice what Grace needs I stopped doing that and am producing more like one and a half times what she needs, I'm recording what I produce each session and keeping track of totals for each day, at the moment it's pretty constant, but if it starts to drop off I'll have to consider what to do, though hopefully she'll be breastfeeding directly unless we want her to do otherwise.

Sunday, June 21, 2009

feeling very down

My mood has really dropped this week. I've definitely felt worse that I'm feeling today, but that's not much consolation, particularly considering the doses of various meds that I'm taking. I'm on 200mg of Zoloft (sertraline), which as far as I know is the maximum dose. Zoloft was what worked for me before, but I didn't get to this dose and wasn't on 150mg for very long either. Zoloft is also the preferred antidepressant for breastfeeding.

I have an appointment with my psychiatrist tomorrow, I wonder what on earth she will suggest.

Fisherman's Pie

I've finally settled on making a fish pie with potatoes on top, I had been thinking of doing something with ground beef, but I was really struggling to find anything that would work. I'm obviously looking for things that freeze well, which adds an extra dimension of complexity. Maybe I should try and work on a three week cycle, chicken/turkey, fish, beef etc.

Saturday, June 20, 2009

Scrapbooking Grace

I started scrapbooking when Sausage Boy was a baby and have produced a scrapbook for both him and Banana Girl as babies, along with ones for 2004, 2005, 2006 and started working backwards, including some pages with copies of very old photos.

When we moved here, I did manage to carry on, attending several Friday night crops at a local store, but when that store closed down, nearly two years ago, I didn't manage to keep scrapbooking in my schedule.

We look at the other scrapbooks fairly frequently, so I knew I definitely wanted to do one for Grace, so when I saw albums were 40% off this week and JoAnns, it seemed like a good time to get started. As Banana Girl's album is pink, I wanted to choose something different for Grace and I found one that combines purple with a pattern, it's girly, but not very babyish. I also found a stack of papers on sale and selected some card to go with them. Now I have the task of sorting through my other stuff to fine embellishments to go with them and to actually remember what tools I have to create lettering!

Fortunately photo printing is pretty easy, I upload them and get them printed in an hour at a local drugstore. She's less than a month old and I just ordered 36 pictures, so this could be quite a bulky scrapbook!

Thursday, June 18, 2009

these cookies are just too good

DH, along with the help of Sausage Boy and Banana Girl, made up another batch of lactation cookies. I have now lost count of how many I have eaten, they are just soooooo yummy. I'm just so hungry right now that I can't believe that the extra calories I'm consuming are being used up by breastfeeding, but I also don't want to restrict consumption in case it does impact milk supply.

I put on a lot of weight after Banana Girl was born, part of that was making poor choices about what I ate when I ate extra, I ate a lot of chocolate, but also it was that I was physically in such a bad state that I was very inactive. I'm not sure that I'm much more active now though, it's been tiredness and a bit of dizziness that has been restricting that, I walked home from the mall on Friday and was completely done in by the time I got home.

The past couple of days I've felt worse in my lower abdomen, a different type of pain, rather than the incision feeling sore, I feel much more bruised, as if I'd been kicked. I've no reason to suspect this is anything but normal, but it's not something I expected, though I suppose I should have done as it seems all surgeries don't have a smooth road to recovery, there are peaks and dips as your body goes through different phases of the healing process and as you adjust your activities to match where you are at. I've not been lifting anything heavier than Grace, but recently I've been less careful about how I lift her, now pain levels are forcing me to be more cautious again.

I checked where dancing classes are at on the rotation through the various dances and it turns out that waltz is the standard dance for July, the first Monday in July is 6 weeks and a day post surgery, I wonder if that is overambitious or not...

pumped in the car

I did a pumping session in the car today, it was after Grace had fed at the breast whilst we were out and then refused to take a supplement from me, but I still got 9oz, which is loads!

I took her in to see the lactation consultant this afternoon and we did the weighing before and after a feed thing to get a measure of how much she consumed and we came up with 54ml, which is spot on what she needs, providing she does that 10 times a day.

She thinks Grace is ready to get the vast majority of her milk directly, but am I ready to give that? The feed we measured required me to be actively involved, watching her latch, doing breast compressions, waking her up and relatching her if she started to get lazy etc. not just letting her do her thing. I'm also concerned that maybe she only did so well at that feed because of all the work I'm doing to increase supply with pumping. There are still some signs that she is less than perfect at stimulating me correctly, so I'm anxious that if I stop pumping after her next weight check (as is suggested), that we'll be back to square one again.

Wednesday, June 17, 2009

more on depression

Thanks to medication my mood isn't down in the pits, if you were to bump into me and chat with me, you'd not notice anything out of the ordinary, you may even think I'm doing really well. But that isn't the whole story and whilst superficially I might seem relatively well, the bigger picture is more complicated. Of course some of that is simply recovering from pregnancy, delivery and having a newborn in the house and some of it is due to other medical conditions.

I feel a million miles away from running a household and caring for 3 children and being a helpmeet to my husband, even just running a household seems like a huge task. Even cooking a meal is surprisingly challenging, when a few months ago I was completely on top of that, with a different meal everyday, cooking double portions some days to freeze and basically having us all eat pretty well. One of the reasons for cooking in bulk, is that if I'm going to go to the effort of figuring out a recipe, then I might as well do it many times over, but that's a change from the days when following a recipe was a non issue.

Having been through depression before, thankfully I know that things will change, but one thing that won't change for a while is taking medication. When I was on Zoloft before, I didn't notice whilst I was on it, but when I came off it, it seemed like my capacity to love, to enjoy etc really expanded. I'm more alert to that this time, though obviously it's hard to know whether some of it is an effect of depression rather than medication.

In summary, I think I'm doing ok, good even, but things are a long way from normal and communicating that to others isn't always easy, and if people perceive me as normal, I'm liable to overdo things and crash.

Tuesday, June 16, 2009

pump solutions

I have a few nursing camis of various designs, with the aid of a couple of safety pins, I seem to have managed to get hooked up pretty securely. Thankfully it's the design that I have two of and if I sew in hooks and eyes to do the job the safety pins are currently doing, then I'll gain a lot of freedom.

This top claims to allow hands free pumping, but I had a look at it in the women's clinic today and I don't see how it can be adjusted to be secure enough and it's quite expensive to buy and find it doesn't work. It still could be a good top for us though as it may help Grace to have some skin to skin time with me.

We have mobility!

I just bought the cable needed to connect the breastpump to the cigarette lighter, which should give us a lot more flexibility. I'm going to have to put some thought in to the logistics of decency, right now I'm taking off anything on my top half to put on a pumping bra. I also bought some wipes for cleaning the parts and bags that have an attachment so you can pump straight into them.

Monday, June 15, 2009

weight gain!

We went to LLL tonight and as it meets at the women's clinic, Andrew decided he'd weigh Grace whilst we were there, but that he wouldn't tell me if the weight wasn't good! Thankfully it was spot on she was 7lb6oz, which is 6oz up from 6 days ago and is her first weigh in above her birth weight!

We met another baby born the same day, who weighed an ounce more at birth and now weighs over a pound more than Grace.

Although we don't have a firm plan of needing to do x, y and z to get Grace nursing at the breast, I think we've got some more ideas now, I also feel more positive about the whole thing and encouraged to keep working on things, even if it takes a long time.

Sunday, June 14, 2009

Wearing Grace


I pulled out my baby sling for the first time last night, Grace seemed to love it and was instantly calm and dozed off. I felt fine wearing it too and went for a short walk around our complex. I wore my other babies a lot at this stage, I found it so much easier than dealing with strollers and car seats and now, post c-section, I definitely do not want to attempt to carry the car seat anymore than just lifting it on and off the stroller or base. I haven't needed to yet, as I haven't been out with Grace by myself, but I plan to tomorrow evening as it's our local La Leche League meeting.
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baby shower gift


I actually knitted this jumper with our baby in mind, I'm not quite sure what I was thinking when I bought the wool back in January, I should have chosen something neutral rather than specifically for a boy. I hope it doesn't seem stingy to gift something in this way! It seemed to be well received.

It turned out to be a difficult event for me, it was a shower for a baby that is being adopted, so naturally the conversation turned to things about the birth parents and some of the feelings surrounding that, particularly how she felt the agency handled things really well and makes sure that the birth mother is making the decision for herself and isn't being pressured into anything - a distinct possibility when the birth mother is only 15. Inside me, it raised lots of thoughts about how I felt about Grace, more than one person had suggested adoption to us and I'd found that very hard, unplanned though the pregnancy was, deep down I firmly believe that God planned for Grace to join our family, but living that out is still a process, I don't feel as bonded with her as with my other children at this stage and with all the difficulties we are having with feeding, I think it's even harder, but it is happening and I couldn't imagine giving her up.
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over ambitious?

Keeping on with my cook one recipe in bulk each week plan, I settled on Chicken Biryani. In theory it should be pretty straight forward, even though the ingredient list is quite long, basically you partially cook the rice, with some spices, then cook onions and chicken with more spices, then stick it all in a casserole dish to bake in the oven, along with a few other ingredients, at which point I'll freeze it, rather than cook it.

I've ended up having to buy quite a few spices to do this, hopefully they are ones I'll use again. I don't own a pestle and mortar, so I had to buy both whole cloves and ground ones. Also, buying online meant I had to buy a fixed quantity of fresh ginger root, thankfully, I know that it's something that freezes well and I have another recipe up my sleeves that requires it!

Tomorrow we will have Banana Girl's slightly belated 4th birthday party, I'm really grateful to friends for helping make this happen, our role in organising it has been very minimal, we bought and filled a pinata.

Saturday, June 13, 2009

little cutie


Ok, so you can't see much of her, but when I got home to find her sleeping like this, I couldn't resist taking a picture.
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still here, still pumping

I'm still pumping around the clock, it's hard to tell if Grace is making any progress in learning how to transfer milk, I think we're going to have to do the weighing before and after a feed thing to see if she is managing to.

She likes to have at least two long sleeps in 24 hours, so we're not really sure if she's even taking enough in. Her random pattern makes it hard for me to do the ideal of feed her first, then pump. I'm pumping right now, as it's 3 hours since I last did so, but she seems to be deeply asleep, which means if she wakes up not long after I finish, there will be less available for her.

I seem to get slightly more milk each day, which means our fridge and freezer are getting full of milk!

I've made a concious decision that I just have to relax and enjoy the freedom that her not being an efficient nurser has given me. I'm part of a quilt group at our old church and they meet once a month on a Saturday for the full day, that was today, so I was able to go for a couple of hours and work on some hand sewing. It was also my first time driving, which went fine. Tomorrow I'm going to a baby shower for someone from church, the first time I've ever been to one!

Tuesday, June 9, 2009

busy day

Today has been very busy, but we survived! I'm tired now, but way better than it would have felt a few days ago, I took a painkiller in the morning then didn't feel the need until the last hour or so of the day.

I now have 4 trays of moussaka in the freezer and one in the fridge, the only thing remaining to be done to them is sprinkle grated cheese on top, which is a job for Andrew! Our regular shopping delivery being on a Monday and the cleaners coming on Wednesday makes Tuesday a good day for bulk cooking. Now I have to think of something for next week, maybe chicken enchiladas, probably chicken anyway.

Sausage Boy finishes school on Friday, which will make mornings slightly more relaxed, we will still have regular commitments as we signed them both up for a gymnastics class on Wednesdays and his dancing doesn't take a summer break.

An idea we came up with was to plan at least one exciting trip per week, where we do something touristy, this could be a bit challenging with pumping, I'll have to look and see if I can get an adapter to use the pump in the car, or use another pump, I have a hand pump and my less fancy double electric can be used with batteries, so I do have options. So far trip ideas include Seattle Zoo, which apparently has a new penguin exhibit. Possibly the aquarium, which has had a new section opened since we last went. Banana Girl has never actually been up the Space Needle, though ideally we should have done that before she turns 4, as that's when they start charging, though that doesn't apply if we do the restaurant.

We'll also hopefully do some of the Western Washington Quilt Shop Hop, this is an annual event in late June, where quilt shops in the area join together and have some special fabric designed and then each shop provides you with instructions and some bits to make a block. It's rather fun to take the chance to visit quilt shops and I enjoy making the blocks too, I haven't actually finished a quilt from either 2007 or 2008, but I have made progress, in fact I might take the opportunity of this year's event to try and find some fabric to tie together the quilt I've designed from my 2007 blocks.

Sunday, June 7, 2009

holding Grace


It's hard to get a good picture of two kids at once, let alone three, perhaps it's the not looking at the camera that made this one turn out ok!
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projectile vomiting

Grace has distinguished herself today, she's managed to projectile vomit 3 times. We spoke to her doctor who says we need to watch it over the next 48 hours, but that probably it's a case of her getting too much air in when she feeds and that causing the explosion, I'm not convinced. She held a feed down in the afternoon and currently seems to be feeding ok, the advice is to feed her little and often, which is a bit tricky, she already eats pretty small feeds and probably needs to go more often even on those volumes. I guess we'll just have to see how it goes...

Thursday, June 4, 2009

I'm not paranoid!

Grace really wasn't getting enough at the breast, after a marathon feed lasting from about 4pm to 10.30pm last night and then this morning me being able to pump 5.5oz after she'd spent 2.5hrs at the breast, I finally knew we had a problem, rather than just being worried that we might have a problem.

We met with a lactation consultant this afternoon, she listened to our story and watched Grace feed, we also weighed Grace before and after a feed to see how much she was getting at it turned out to be a tiny 6ml. Her theory is that the tongue tie isn't likely to be the issue and that it's just her not quite having figured out how to suck quite right, probably as a consequence of being born at 37 weeks. Her suggested plan is that I limit Grace's time at the breast to 10mins each side, rather than let her carry on indefinitely, then supplement her and pump, so that we're working on rebuilding my milk supply, getting her fed and trying to teach her to suck properly at the breast.

We also managed to get in to see Grace's doctor and went ahead with getting the tongue tie snipped, as it seems to be a fairly benign intervention and without doing it, we'd probably always be wondering if it would help.

We were advised to supplement either by bottle, or finger feeding, we're currently going with the finger feeding to try and avoid nipple confusion issues. Looks like I'll be spending a lot of time hooked to a breast pump over the next few days, but that could potentially be easier than her draining behaviour last night.

Wednesday, June 3, 2009

Breastfeeding challenges

I'm probably being totally paranoid, but as my breasts have changed very rapidly from extremly engorged to feeling deflated, I've been worried that for some reason Grace just isn't stimulating me quite right and that she's not getting enough milk. The reality checks of her diaper counts and weight gain all being ok aren't quite reassurring me.

One issue is that she has some kind of tongue tie, it's not a full blown one, my nipples would be feeling an awful lot worse if it was, but it's enough to make me wonder if we should get it snipped.

My paranoia led to a dash to Whole Foods last night to get ingredients for lactation cookies and various herbal teas to try and up supply. This could all be overkill, but it feels good to actually do something. DH galantly made up a batch of the cookie dough, substituting rice flour, potato flour and xanthan gum for regular flour and they really are great cookies, so regardless of any lactation related properties they are a good cookie recipe. For several years now I've included oats as part of my basic cookie recipe, I think the extra yumminess of these must come from the flax seed meal as my previous experiences with flax seed products have always tasted good. Given we now have a huge jar of brewer's yeast, I won't be experimenting with leaving that out to see if that's a less essential ingredient taste wise.

Photo session




My parents are complaining they can't really see much of Grace on photos they've seen so far, so whilst she was having a rare awake and happy moment I took a few - so here they are!
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Monday, June 1, 2009

a better day

No tears today! Which sets me on the road of believing that my tearfulness over the past few days probably was just a case of the baby blues!

We took Grace in to the Women's Center for a postpartum visit, which made me crave the British system of midwife and health visitor visits at home. Her weight was 2 and a bit ounces up from Friday, which is perfect, but they still want us to come in and weigh her again on Wednesday - then in the almost the same breath are reminding you that you've just had major surgery and should be taking it easy!

I feel much more hopeful looking to the future now, even just thinking about little things. One thing I managed to do before things went really crazy was to stock the freezer well with meals and I think I've figured out a plan to at least partially maintain that, which is that if each week I pick a single recipe, but make multiple servings of it, then I'll end up putting in at least half as many as I take out each week, or even equal as I add in some meals each week that don't come from the freezer, not everything freezes well and it can get quite boring always eating things that have been frozen.

My plan for the first meal is Moussaka, a friend brought round a meal last week that was sort of lasagna, but with sliced courgette (zucchini) rather than layers of pasta and it made me think of moussaka, which I've only made once before, when we got aubergine (eggplant) in a veg box, but it's relatively simple to make and should freeze well, so I'm going for it!