Thursday, March 20, 2014

Newborn sleep 2.0

I will admit: we are a sleep-obsessed family. Take the old adage, "If mama ain't happy, ain't nobody happy," change it to, "If baby ain't sleeping, ain't nobody happy," and you get an insight into our little world.

The past 10 weeks have been a roller coaster of emotions and expectations, nearly all of which boil down to concerns over sleep -- not getting enough, when will our lives return to normal....ohmygoddidwemakeahorriblemistake. The conclusion is that no, in fact, we did not make a mistake; we have another wonderful sleeper on our hands, but it just took us some time to adjust. In many ways learning to be patient with newborn sleep was a lot harder for Matt and me this second time around because Natalie set the bar so high with her excellent sleep habits from early on, and we were unrealistically eager to get that show on the road with Adam.

We had forgotten some things along the way and we tried some new tricks this time, too. Ultimately, we had a really successful time with Adam's newborn sleep stage even though in the thick of it all we wouldn't have admitted so easily that things weren't that bad.

Here's what we forgot:
Newborns can typically only stay awake for 1-2 hour stretches for the first few months
Adam would cry, and we'd think, "Well, you have a clean diaper and a full stomach, but maybe you still need to keep eating?" Wrong. He really needed to sleep. Rereading my favorite baby sleep book, Healthy Sleep Habits, Happy Child corrected that mistake fast and we started putting Adam down for naps and bedtime much more quickly. We discovered that Adam has a 1 hour, 15 minute awake cycle. By about 1 hour of being awake he needs to start his soothing to sleep routine.

Try to put babies down drowsy but awake
In those earliest weeks it really doesn't matter what you do; a baby will sleep whenever and however it feels like sleeping. But, out of parenting necessity, we wanted to get Adam aboard the Better Sleep Habits Train as early as possible, so we started trying to put him down drowsy but awake starting when he was about 5 weeks old. This meant that, though he would often fall asleep while nursing or even having a bottle, we'd wait until the feeding was over to swaddle him so that he'd be awake but ready to fall asleep by the time he got into his crib.

Here's what we did differently this time:
Adam slept in his own room when he was less than 2 weeks old
I already mentioned this, but this point bears repeating. If I was doing it all over again, I would have insisted on Natalie sleeping in her own room much earlier. Even though she was in the nursery for bedtime by the time she was 6 weeks old, I think we all could have been a lot happier if we'd ripped the Band-Aid off sooner. This time around we did, and we were much happier.

Adam got an early bedtime at 6 weeks
Natalie didn't earn an early bedtime until she was 3 months old. This time around, we knew we wanted to do that differently. I already also mentioned, though, how in our haste we tried to force an early bedtime on Adam when he was only a few weeks old. That was a major failure. We tried again, though, when Adam turned 6 weeks old, and despite a few rough nights at the beginning of that effort, Adam has maintained a bedtime that falls between 6:30 and 7 p.m. and it has led to some seriously good sleep habits (sleep begets sleep!). We must start his bedtime routine early to account for the possibility that it could take him some time to wind down, but by his second week of an early bedtime he stopped waking up before midnight. This meant he was consistently getting at least a 5-hour stretch of sleep every night beginning at 7 weeks old. His first incredibly long stretch of sleep (longer than 6 hours) came when he was 8 weeks old and slept for 9.5 hours straight. Now that Adam's 10 weeks old he seems to be in a holding pattern of waking up around 3 a.m. (meaning he's asleep for 8-8.5 hours) feeding for about 15 minutes, and then waking up "for the day" from anywhere between 6:30 and 7:30 a.m. One blessed night a few days ago the child actually slept from 6:30 a.m. to 6:30 p.m. The skies parted and the angels sang.

Adam takes most of his naps in his crib
This is another point I mentioned that once again bears repeating. We treated newborn Natalie as our portable little baby, not really concerned with whether or not she napped in her crib. Because Natalie has her own nap schedule though (typically between 1 and 3:30 each day) we are more homebound and therefore have gotten Adam to take nearly all his naps while at home in his crib. He's a champion at sleeping in the Ergo carrier, which is great because Natalie still has activities and trips that get in the way of him always sleeping at home when he needs to, but I'm glad that he has some solid napping experience in his crib already.

The pause
We sort of did "the pause" with Natalie, but we are really following this technique with Adam, partly out of necessity and partly because we now know better. Basically, as the book Bringing Up Bebe reveals, European parents are more likely to use this technique of waiting approximately 5 minutes after a baby makes his initial sound before entering the baby's room. We do this with Adam, both at naptime and at night, and on many occasions have discovered that he puts himself back to sleep in that 5-minute window. It may be challenging to hear a baby cry and not respond, but we have to remember that our baby is better for learning how to put himself back to sleep and not having his sleep interrupted before he's really ready to wake up.

Adam sometimes cries a little to put himself to sleep
I think when I only had Natalie, I believed that if a baby cried some while going to sleep, that was "crying it out." No, "crying it out" is truly when parents just leave their babies in their rooms to let them cry for as long as it takes to fall asleep. As Dr. Weissbluth points out in his book, Healthy Sleep Habits, Happy Baby, "extinction" or "gradual extinction" are two methods most parents actually use that people often confuse with "crying it out." In both these methods, babies are only allowed to cry after all their needs have been met, and these are techniques that Dr. Weissbluth recommends only using once a baby has reached 4 months old. In true "crying it out" there's no real regard for whether or not a baby's needs have been satisfied. With Natalie I really thought I couldn't let her cry while falling asleep before turning 4 months old. But upon rereading Healthy Sleep Habits, I was reminded that it's quite normal for tiny babies to still need to cry (fuss) a little before going to sleep. So, we've discovered that sometimes Adam needs up to 5 minutes of crying to get to sleep. Once he hits that 5-minute mark, though, we know he's reached the point where he won't fall asleep without our help. Often he only needs something as simple as one of us holding him for a couple minutes, and then he's truly out.

But we have been impatient
Considering how great Adam is today in terms of sleep, you'd think our lives have been perfect of the past 10 weeks. As I said earlier, though, we were sort of brats about his sleep habits before they really turned the corner around the 7-week mark. I definitely crashed at week 5. I felt like I had 5 weeks' worth of adrenaline, and then I hit a wall at week 5 and felt like I couldn't function. I definitely cried a number of times, once several times in one day, and I even went so far as to tell Matt when he got home from work one day, "If you were wondering what's the number of children a couple should have, the correct answer is no more than one." I was sleep deprived, I wasn't being nice, and I wasn't thinking straight. A set of ladies and their toddlers bounded up to me at the mall during this sleep-deprived period when I was able to run a few errands with only Adam in tow. The ladies, assuming I was a first-time mother, looked at me wistfully and said, "Once you get over that 6-week hump, the hardest time is over." I knew this was true, too, but I could not imagine a life in which I would ever sleep again. It's so easy to take whatever you're experiencing that week with a newborn and think this will be the rest of your life, but it's so important to remember how quickly babies change.

Now I just hope the changes we have ahead of us are for the better, not for the worse.

Saturday, March 1, 2014

Helping new parents

The other week a good friend alerted me to a great post: 100 Ways to Encourage a New Mom. This list really speaks to me, especially now that we're exiting the earliest of newborn weeks (and crossing our fingers that "the worst is behind us" as so many people have tried to remind me).

The author of the list invites everyone to share her post and add their own thoughts. I have to say that after now having had two newborns two years apart, we've experienced a tremendous outpouring of love and support from so many friends and family. I've learned from their example in discovering what is most (and sometimes least) helpful for parents of a new baby. So, below is the compiled wisdom of my friends and family. Though this list is mostly geared toward helping a new mom, because, let's face it, much of the physical toll falls on her, this is also applicable to all those great fathers like my own husband who are in the trenches too. Some of the items on my list likely overlap with the list in the link above. Please forgive me for any repeats; I'm the mom of a newborn.

The guiding philosophy behind dealing with parents of a newborn is: Don't enter your interactions with any selfish motives. You want to see a cute little baby, one likely tinier than you've ever seen, but they just want to get through the day (and the night...oh, the night). Make everything in your visits and offers of help about the parents, not about yourself, and you'll be the most helpful.

Here are some more specific ways we've been helped:


  • When giving a gift after the baby is born, tell them no thank you note or email is necessary. My good friend who sent me the link above reminded me of this one. I try to say this to my friends, too.
  • Provide gift receipts for baby clothes
  • Buy 9 or 12 month baby clothes
  • Bring diapers and baby wipes
  • Don't regift them items you know they won't like/need, and don't give them your leftovers of items you know are not the best quality, like cheap diapers that don't actually hold leaks
  • Give her a robe she can wear for late-night nursing sessions
  • Give her a nursing tank she can just wear (and sweat through) at night (seriously, my night sweats need to end already)
  • Give her beauty items she can use on days when she doesn't shower or just wants to feel a little better. A friend brought me these Say Yes to Blueberries Age Refresh Towelettes and they're awesome.
  • Share your Amazon Prime membership with them (it can be shared between two mailing addresses)
  • Bring toys or other activities to entertain the toddler that: don't make really loud noise, don't require batteries, don't require parental supervision

Gifts don't have to be new!

  • Bring any of your leftover, unused baby essentials, such as newborn or size 1 diapers, breastmilk storage bags, nursing pads, extra breastpump parts, formula
  • Offer to loan her big-ticket baby items she may not own, such as a swing, bouncer, carrier, infant gym, Snap n Go or Pack n Play

The most appreciated gifts often come in the form of food. Really, you can't go wrong here, but here are a few additional ways we've been shown kindness:

  • Bring food in disposable containers or containers you don't except returned
  • Bring food that can be easily frozen. Don't have time to cook? A friend brought us frozen meals from Dinner Done. See if there's a similar service where you live.
  • Bring breakfast and lunch food they can eat with one hand -- muffins, bagels, fruit that doesn't require cutting or peeling (or that's already cut/peeled)
  • Bring food the week that she and/or her mate returns to work
  • Bring gift cards for places that offer takeout and/or delivery
  • Bring coffee

Helping around the house

  • Offer to do the chore they hate the most
  • Hire a cleaning service to come by when they've been home from the hospital for two weeks and the house has gotten sufficiently dirty
  • Take care of their animals -- take the dogs for a walk or the cat to get its nails trimmed (or, dear god, someone figure out how to make my dogs' breath not smell horrible...)

Emotional support

  • Tell her you've also cried in the shower
  • Tell her it gets better
  • When asked, couch any advice in, "What worked for us was..."
  • Help connect her with other moms who have babies roughly the same age as hers
  • If you're going to send her links about parenting or babies, make sure there is not a hint of judgment in what you're sending (i.e. the benefits of breastfeeding to a mom who's formula feeding or the dangers of co-sleeping to a mom who's co-sleeping)
  • Send her links to articles and websites that have nothing to do with motherhood or babies
  • Watch the baby, even if only for an hour, so she and her mate can leave the house together and do something without the baby
  • Give her the benefit of the doubt -- she is likely unable to maintain coherent conversations, she might have a meltdown in front of you. (True story: my dog stole my hard-earned sandwich off my plate while one of my best friends was visiting, and I started crying rather irrationally in front of her. She understood.) Don't take it seriously or personally. Just say, "I've been there."

Thursday, February 6, 2014

Leaving the house with two kids

Today I completed my first by myself out-of-house adventure with my toddler and my baby. I wanted to write it all down for myself so I can remember the steps of this quasi-routine for the future. I did not really plan ahead for today's outing, except to set my alarm, and somehow the cards fell into place.

Here's photographic evidence of our excursion:

Here, now, for your amusement, an account of my nearly two hours of preparation for a 45-minute toddler music class:

7:33 a.m. Human alarm clock (aka baby) goes off seven minutes before my iPhone is scheduled to wake me up. Oops, false alarm. Baby just let out a cry and put himself back to sleep. Still, I rush downstairs, turn on the coffee maker, get out a bottle for Natalie, fill up the diaper bag while waiting for coffee to brew. Put cereal in a snack trap for toddler, fill up a sippy cup with water and ice for toddler, grab more newborn diapers for baby, pull my wallet and keys from purse, fill up my water bottle, and add all those items to the diaper bag. Finish just in time to pour myself a cup of coffee.

7:43 a.m. Baby and toddler are still miraculously asleep, so I turn on shower and hop in. I manage to even do my hair when...

8:05 a.m. Baby is legitimately screaming now, and I'm at least partly dressed, so I go grab him.

8:10 a.m. Bring baby downstairs to nurse while I drink coffee and watch Today Show.

8:30 a.m. Baby is done and sufficiently burped and has even drifted back to sleep. Put baby in bouncer seat that is upstairs in our master bedroom. Take bottle to toddler who of course wants to read books in her crib. She reads while I put on a shirt and brush my teeth. I also lay out all needed diapers and clothes (even remember socks!) for baby in nursery and toddler in big girl room. I run downstairs, Ergo, Ergo infant insert, baby's hat, and diaper bag in tow to throw in the car during this rare moment when neither child needs me.

8:40 a.m. Time to dress toddler. She wants to take her bunny (aka her "lovie") out of her crib. Then she wants to put him back in the crib with his friends. Then she wants to analyze all the colors of all her new socks.

8:50 a.m. Baby's still sleeping, so I take toddler downstairs to put her hair in ponytails while she watches videos on her YouTube channel. I make it through "Five Little Monkeys" with her and then set up the videos on autoplay. I run downstairs to grab toddler's coat, scarf and shoes, then put them on her while she watches the "Old McDonald" video. As I rush upstairs to change the baby, I hear toddler say, "Please may I watch more videos please?" (this is a new, shocking development -- the complete sentence, polite request) and, with perfect timing, the next video in the queue comes up. Wish granted!

8:55 a.m. Baby has an especially dirty diaper and isn't pleased to be aroused from sleep. He's especially not pleased when I put his onesie over his head and cram his tiny, refusing-to-bend arms through the long sleeves. He wears a pair of socks for the first time. Those Trumpettes are amazing. They only sort of fit, but the elastic is so quality that they still don't fall off his miniature feet. I grab baby's burp cloth, and oh, yes, baby, and head downstairs.

9:07 a.m. I tell toddler it's time to leave for music class. "NO!" she whines. I say, "OK, well, then Baby Adam and I are going to music class and you can stay here." "Natalie go to music class too, please!" she whines. "Great, then follow me," I say. I open the baby gate while holding baby, toddler grabs my hand (she's finally getting the hang of going down stairs but still needs assistance at least some times). Toddler makes it down about three steps before letting go of my hand, so I go ahead and put baby in car seat. With perfect timing, by the time baby is in car seat, toddler is all the way downstairs. I get toddler into her car seat. I run back inside to get my shoes. As I'm getting into the car, I realize I'd like a scarf but decide it's too much trouble. I reach into diaper bag to hand toddler snack trap full of cereal and sippy cup right as toddler says, "Blue and red cup!" Eureka! Another wish granted. Then toddler asks for Rufus, the teddy bear who spends 90 percent of his life in our car. Rufus, though, came inside two days ago and has been residing in the living room ever since. I'm not going back inside. So, I say, "Rufus didn't make it. Sorry." Yes, I tell my toddler the teddy bear is a casualty of this morning. Ha.

9:12 a.m. I turn on the car and we're on the road, seven minutes after the arbitrary, imaginary time I gave us for leaving.

9:22 a.m. We pull into the rec center parking lot.

9:28 a.m. We have made it past the rec center front desk just in time to walk down the stairs to the music class.

Two minutes to spare! Seriously, where is my medal.

Tuesday, February 4, 2014

Two kids, one adult

For the past four weeks, when friends and family would ask how we were doing adjusting to life with two kids, Matt and I would respond that things were going shockingly well. Nothing has changed in that regard, except to say that life got a lot more real yesterday when Matt returned to work full time. Adam's first four weeks of life will forever be referred to as our "honeymoon" period because it really was quite easy having two adults at home managing two kids. Now that Matt's back at work and my work is picking up again, I can't say we're going to have the same easy experience.

So, I am trying to adjust to the new normal. With Natalie, the new normal came at times as a bit of a shock. I had to feed her just the same amount any newborn needs to be fed, but as a first-time mom it felt like I was just always feeding my child. Now I see breastfeeding Adam as a quiet break from the sometimes-chaos of the day. But with two kids the constant question in my mind is, "What do I do when they're both freaking out at the same time?" To this, I have no good answer, other than to say that kids are just going to cry at times, and they'll have to be patient (I know, not really something either of them understands) because one adult cannot handle two kids' every needs at every single minute of the day. I just try not to cry with them.

A particularly good moment

Of course, as I said at the beginning, the transition to two adults and two kids and now one adult and two kids has been majorly easier than I thought it would be. Here are some key points from our new life thus far:

The morning shower necessity
Somewhere between 7:30 and 8:45 a.m. Adam and I are "up for the day." The point is, newborns don't have schedules, right? And newborns sleep the majority of the day anyway, so to say that Adam will or won't be awake at any given time is a crap shoot because he's only awake for about two hours at a time max.

Although I feel about 95 percent recovered from my c-section, I am still experiencing the notorious postpartum night sweats and they absolutely suck. I am so tired of waking up (or really, being woken up) in the middle of the night in a pool of my own sweat. Add to this the fact that it's the dead of winter, so the sweats make me super cold, and I'm just unhappy in bed. The point of this is that for me right now skipping a morning shower is just not an option. As tempting as it is to get in 10 more minutes of sleep, I've been trying to orchestrate a shower for myself every morning so I can not feel disgusting.

There are mornings like yesterday when Adam wakes up at 8:25 am., does a quick feeding, and then sleeps in his crib for another hour, giving me a perfect window for taking a shower before tending to Natalie.

Then there are mornings like today when Adam wakes up at 8 a.m. just as I have started running the shower water and I have to quickly throw on a robe, change him, feed him, soothe him, and manage to get him to sit in his bouncer seat in our bathroom for 10 minutes while I get myself together.

Either way, it's not bad, and I'm not complaining. There's just no sure-fire way for me to get in a shower unless I'm ready at a second's notice when there's a moment of peace.

The obliging toddler
Of all the things in my current bag of tricks, here's the best one: my two-year old happily hangs out in her crib until 9 a.m. I know. This is insane and absolutely not normal, but I am hoping to ride this wave as long as possible. Because Natalie is so obliging, on mornings like this one I was able to feed Adam a second time while Natalie played with her (now eight) stuffed animals who have taken up residence in her crib in her new room. I handed her five books from her bookcase, and while I was in the nursery adjacent to her room I enjoyed eavesdropping on her reading Peter Rabbit and Llama Llama to herself. There's something about hearing her say "Floppsy, Mopsy and Cottontail" that makes me smile.

After Natalie's officially done with her books in her crib for the morning, I get her dressed and then bring her downstairs for a morning bottle (yes, she is still drinking milk three times a day out of a bottle -- it continues to be her final vestige of babyhood). We sit and watch a few videos from her YouTube channel while I put her hair in ponytails (still haven't gotten her a first haircut...probably should). Adam may or may not be with us during this time.

She is still a horribly picky eater, so breakfast may or may not happen, with cereal or berries or a bagel. If I suggest cream cheese on her bagel, she says "no cream cheese." If I assume that she does not want cream cheese on her bagel, based on her track record for the past two weeks, she'll of course insist that I get out that cream cheese and slather it all over her bagel. Such is life with a toddler.

Natalie oversees Baby Adam's activity gym time

In addition to showing a positive interest in what Adam's doing for at least a portion of each day, Natalie has been totally into using her art supplies, which is amazing. I just strap that child into her amazing high chair and let her go to town. I have a whole bin of art supplies stationed above our fridge since Nat's art happens exclusively in the kitchen. That bin and its contents will have to be the subject of its own blog post. What I can say now is that art supplies can keep this child happy for up to an hour at a time, and it is glorious.

Breastfeeding 2.0
Although I could probably also write a whole post about breastfeeding Adam, I'll give you a quick update.

I briefly alluded in Adam's birth story to the fact that I have such better supply this time around. This is definitely thanks to him being with me since birth. This is also likely attributed to the fact that apparently in subsequent pregnancies many women have increased breast tissue. Whatever got me to this point, I am grateful. At Adam's two-week appointment he was already a full pound over his birth weight, which means we are not concerned about growth charts the way we were forced to be when Natalie wasn't up to her birth weight after three weeks of life.

Part of my routine each day is to meet my goal of pumping twice. Some days this happens, some days this doesn't. If both kids oblige me with a mid-day nap, then pumping is something I'm able to do fairly easily after putting Adam down (he's almost always asleep after Natalie gets down for her nap and rarely before she goes down). I had to relearn the fact that I should pump after feeding Adam, not before, and not an hour or two between feedings. This is one of those facts I forgot in the span of the last two years. I also pump at night while Matt is giving Adam a bottle. We've been successfully meeting our goal of having Matt give Adam one bottle a day, right now at night, so he gets accustomed to being fed by someone besides me. Of course, this means that I had to disregard the admonition of the lactation consultant at the hospital, who cautioned me against pumping or bottle feeding before Adam hit the one-month mark. He's still a couple days shy of one month, and I've been pumping practically since the day I returned home from the hospital, and he's been getting a bottle a day since he was about a week old. Breastfeeding has not suffered as a result -- no nipple confusion here. My philosophy with pumping and bottles is definitely to start as early as possible. That means that I now have in our freezer after about four weeks of pumping as much as I ever had in the freezer throughout Natalie's entire life. This will come in handy in the next couple weeks as I resume my work schedule.

As a quick sidenote, the pump itself has turned into a symbol of the latest healthcare legislation. When Natalie was born I rented a hospital-grade pump -- the Ameda Elite -- from where I delivered and kept extending the rental until Natalie was over 10 months old. I planned to do the same thing this time around, but then I discovered that the hospital I delivered at with Natalie no longer carries that pump for rental, and the prices for Ameda pump rentals from there have increased dramatically. Remembering too that under the Affordable Care Act legislation women are able to get coverage for breast pumps, I looked into what my insurance offers. After getting conflicting information from six sources -- the HR person at my husband's work, the head nurse at my practice, two customer service reps through our insurance (whose statements contradicted what our statement of benefits says), our insurance's lactation consultant, and finally my own doctor -- I realized that because our insurance plan was "grandfathered in" and because the employer mandate does not kick in until 2015 (though the individual coverage mandate kicked in this year) I was going to get zilch in the way of breast pump coverage.

Wanting to have a breast pump at our house the moment I got home from the hospital, I researched online breast pump rental options. The best deal I could find came from the AmedaDirect website, which allows users to rent an Ameda Elite pump for 6 months at $240. This offer also includes free shipping (normally $15) and a free accessory kit (normally $50). This is the best deal, as monthly rentals run $50 and do not cover shipping or the accessory kit. So, we're paying for my pump rental out-of-pocket with no hope of reimbursement, but in the grand scheme this is fairly cheap. I know I could buy a single-user pump for the same cost (or even less) but I just love this breast pump. Yes, loving a breast pump is an oxymoron I suppose, but hey, it's super-duper efficient so it takes me just minutes to pump a lot of milk. Renting from the AmedaDirect site has been really easy -- I did not, as the site suggests, have to send in the rental agreement via snail mail but instead scanned and emailed the completed form, and then the pump shipped out the same day I sent the email, arriving at our house within three days of placing the order.

The dual nap
Natalie has been taking one nap per day since right around the time she turned one year old. She goes down for this nap sometime between 12:30 and 1 on a typical day. I've been trying to get Adam to oblige me with a solid mid-day nap at the same time. Yesterday he did not, so I held him for the two and a half hours Natalie was sleeping. Not bad, but not productive. Today, though, he's contentedly snoozing in his room while Natalie tries to fall asleep. Whether Natalie really falls asleep or not during her nap is a little up in the air lately. She used to religiously sleep for about two and a half hours for her nap, falling asleep within moments of me leaving her room, but now she seems to be entertaining herself and taking an hour or more to fall asleep. She's clearly tired when I leave her, but she's no doubt experiencing a little sleep interference thanks to her brother's arrival (they do share a wall, after all). Whether she sleeps or not, though, Natalie is quiet and content in her crib, and she needs this quiet time in order to make it happily to bed time.

When the dual nap occurs, I can eat lunch using both my hands. If there's no dual nap then I need to figure out what I can easily eat in stages, often while standing. Thankfully, the dual nap occurs more often than not.

Because Natalie stays in her crib until at least 3 p.m., and because Matt is usually able to be home from work between 3 and 3:30, the afternoon is pretty manageable. It will not be as easy in a couple weeks when I resume my afternoon and evening work schedule, as Matt will have to rush home, walk the dogs and be ready for a dual-baby hand off within a matter of minutes before I have to get to work, but he will figure out a way to make it work just as I'm learning to care for two kids during the first half of the day.

Nighttime "routine"
Although we're raising Adam in almost an identical way to how we raised Natalie as a newborn, here's something that's different: Natalie stayed in her bassinet next to our bed for about six weeks, whereas Adam spent a little more than two weeks next to our bed before we decided it was time to make the switch. I am way less concerned about whether or not he's breathing (I watched Natalie in the middle of the night like a hawk) because I know that worrying isn't going to change anything. That helped making his transition to his bassinet in his nursery less difficult for me. Adam? He did not notice the change at all. I'm glad we did this as early as we did. I'm sleeping better, Matt's sleeping better, and Adam wasn't affected positively or negatively -- he's just a typical newborn.

One aspect of newborn life that Matt and I kind of forgot is that newborns don't have much of a routine when it comes to sleep and "bedtime" (what is bedtime to a newborn? Isn't their life one perpetual bedtime?). So, we tried a couple weeks ago to get Adam to go to sleep for the night starting around 8 p.m. so we could enjoy some evening adult time. After a few nights of doing what Matt correctly dubbed "chasing our own tails" as it would take a couple hours to get Adam to go to sleep, we finally realized we needed to accept the fact that for at least the next few months we don't get an evening break. We have to trade off who's eating dinner when and live with the fact that one, if not both, of us will be eating cold food.

With Matt back at work, though, we have been trying to change Adam for bed and give Adam a bottle sometime between 9:30 and 10. Ideally, Adam would fall asleep after having a 3-ounce bottle, and then he'd stay asleep for at least a few hours. But, nights like last night remind me that Adam is most content breastfeeding. So, he took the bottle, but then he fussed, and fussed, and fussed. Traditional soothing methods did not calm him down, so I resorted to doing what I do not like to do and breastfed him for comfort rather than nutrition. He barely fed -- because of course he was totally full -- but he did fall asleep within a matter of minutes.

So last night Adam slept for 3.5 hours, then woke up at 2 a.m., breastfed for 15 minutes, and immediately fell back asleep in his bassinet for another two hours. He woke up at 4:30 a.m., breastfed again for another 15 minutes, but wouldn't fall back asleep in his bassinet. Not wanting to experience what we did a couple weeks ago when it would take him at least two hours at a time to fall asleep each time he'd wake up in the middle of the night, I resorted to putting him to sleep in his swing. He slept contentedly in there for another 3.5 hours. This is, for the record, one of his best nights of sleep. Although I don't like to put him anywhere but his bassinet at night, I need to remember -- as my current rereading of my favorite baby book, Healthy Sleep Habits, Happy Child, reminds me -- that there's really no such thing as establishing bad habits for a baby under four months old. A line I reread last night said to "do whatever is necessary to get your baby to sleep." Duly noted!

Sometimes I wonder if Adam is going to be a good sleeper or not. It's way too early to tell. But I am meticulously tracking his eating and sleeping habits on my iBaby Log app just as I did with Natalie. I can still see all of Natalie's data from two years ago. It's reassuring to see that Adam and Natalie are so far practically identical in their newborn sleep habits. In fact, Adam wins bonus points for the fact that he's willing to take at least one nap a day in his bassinet in the nursery, whereas Natalie basically never did that for the first six weeks of her life, and rarely even took naps in her crib before she was four months old.

Seeing the world through rose-colored glasses?
I'm writing this blog post on a good day after a really good night, so I know it sounds like my life is easy and everything is perfect. And my life is pretty easy and I am pretty lucky as well. But I've also just spared you from another post I drafted on a really crappy day. It sounded really complain-y, so I'm happy to have something real but less annoying to share.

Also, I have yet to venture out of the house with the two kids by myself. That experiment will take place later this week when we (attempt to) attend Natalie's music class. We have done plenty of family-of-four outings, and Matt is getting the hang of the Baby Bjorn carrier we borrowed from our friends (I'm still rocking the Ergo, but Matt's not comfortable getting that on by himself, hence the Bjorn loan). So, for now, while I contentedly hang out at home with two kids, I feel like I have things somewhat under control and will wait to tackle the next challenge of the outside the house adventure in a couple days.

Wednesday, January 15, 2014

Adam's birth story and my recovery (part 1)

Adam's birth story really begins at the start of my pregnancy. When I found out I was pregnant, my first feeling was, "It's a boy," and my next thought was, "Am I going to have another c-section?" Natalie's birth story was actually, in retrospect, fairly traumatic, and I was very emotionally upset by it for a long time. A lot of my emotion was tied up in the fact that I knew that a first c-section has a high probability of turning into a repeat c-section for a second birth.

For a long time I was leaning toward attempting a VBAC (vaginal birth after c-section). I tried to find reputable information about the pros and cons of attempting a VBAC versus choosing a repeat c-section, but I found a depressing lack of information in both print and electronic form. The best information came from my midwife friend who sent me a 48-page document from National Institutes of Health titled, "NIH Consensus Development Conference Statement on Vaginal Birth After Cesarean: New Insights" published in March 2010. The abstract of the paper really spoke to me when it said:
The data reviewed in this report show that both trial of labor and elective repeat cesarean delivery for a pregnant woman with one prior transverse uterine incision have important risks and benefits and that these risks and benefits differ for the woman and her fetus. This poses a profound ethical dilemma for the woman, as well as her caregivers, because benefit for the woman may come at the price
of increased risk for the fetus and vice versa. 

This is exactly how I have felt when trying to make this decision. I can see the benefits and drawbacks of each choice, and I didn't want to make either choice lightly.

Finally, after being honest with myself about my emotional state after trying and failing to have a vaginal delivery with Natalie, and the unpleasant aspects of (what still amounted to, in the grand scheme of things, a relatively easy) recovery, I opted for a repeat, scheduled c-section. It took me the majority of my pregnancy to reach this decision, but once I did, I found great peace with my choice. The conclusion of my entire delivery story this time around is that this experience was almost therapeutic -- it really helped me come to terms with my previous labor and delivery.

This peace was only amplified on delivery day. Yes, I cried as I left home, saying goodbye to my mom who was there to take care of Natalie during our two-night hospital stay. I cried as I realized this was the last time I'd see Natalie as an only child. But I also cried because I was a little scared. Sure, I'd had a c-section two years prior, but last time I didn't have time to really think about what was happening to me because it all occurred so fast. This time I had plenty of time to psyche myself out. Despite my fragile emotions on the way to the hospital, once we were there and I was getting prepped for surgery, I went back to a peaceful feeling, knowing that in a matter of moments we'd have our son out in the world.

With a scheduled c-section, my doctor gave me two important instructions:

1) Do not eat anything after midnight (which was 12 hours before my scheduled c-section the next day).

2) Take a shower the night before the surgery and the morning of the surgery using Hibiclens, this weird, super strong pink liquid that can be purchased at pharmacies (or apparently online). According to my doctor, using Hibiclens this way has been clinically proven to significantly reduce the risk of catching a hospital-borne infection. She also advised me to wear clean PJs the night before surgery and to sleep on clean sheets and use clean towels and washcloths. 

So, I did the following:

1) I ate an Italian sub at midnight, and I drank three big bottles of water, knowing that I might not eat again for a really long time. The fact that I went without food or drink for so long during Natalie's labor and delivery is just one of the many reasons that experience was particularly trying, and I didn't want to repeat that.

2) I went into a final cleaning frenzy the two days before my scheduled c-section, cleaning all sheets and towels. Fortunately, in a particularly not-organized move, I also waited until the last possible second to pack my hospital bag, so I was also washing everything I'd need for the hospital in the final two days before my surgery. We slept on insanely clean sheets the night before going to the hospital.

Here's the timeline from there:

Monday, January 6, 2014 -- Adam's birthday
10 a.m.
We arrived at the hospital. We realized we didn't know exactly where to check in (somehow that tiny detail had been overlooked by us and my doctors) so we had a 15-minute walking tour of the hospital, during which Matt joked, "You should walk up to someone and ask, 'Where can I go to get this baby taken out of me?'" 

10:15 a.m. 
We sauntered up late to the nurse's station in labor and delivery where we were greeted with, "Oh, we thought maybe you'd changed your mind." Good news: the hospital was running a little behind, so our being 15 minutes late didn't change anything. I filled out two super simple forms and got taken with Matt to a pre-op room.

Final pregnancy picture...ever

Here's something I didn't know how to answer before the day before my surgery, so I thought I'd share it here: If you're having a planned c-section, take as little as possible with you into the hospital before your surgery. For us, that meant me bringing a purse containing a consolidated version of my wallet with my ID, my insurance card, a little cash and a credit card, just in case, as well as my phone. Matt brought our DSLR camera and our car keys and his phone. Otherwise, we had nothing on us. My nurse, Mindi, took my clothes and put them in one of those patient's belongings hospital-issue plastic bags and stored them in a locker in the PACU (post-anesthesia care unit) where I'd be recovering for a couple hours after the surgery.

10:20 a.m.-12:20 p.m.
We spent these two hours in the pre-op room, where I changed into a gown, was hooked up to a fetal heart monitor, had my blood drawn, had an IV inserted in my arm and was given my first round of fluids, and had the surgeon, anesthesiologist, nurse, and a medical student ask me a series of (relatively redundant) questions. Everyone was super nice, and the only time I was unhappy was when the nurse put in my IV. I do not do well with that last step, so when I started to feel faint after she'd put in the IV, I asked for an ice pack on my head and all was well again.

12:20 p.m.-12:30 p.m.
The operating room was ready and my blood work was back (this is apparently the step that can hold up the surgery) so the nurse draped a sheet over my back and had me walk in my hospital-issued non-skid socks to the OR. Walking to the OR was a surreal experience. It's also the time during which I was separated from Matt. He was taken to a "weird tiny room with nothing but a chair," he says, while I was in the OR getting my spinal block. Here's another scheduled c-section fun fact I learned in this process: Most doctors and anethesiologists prefer a spinal block to an epidural, the reason being a spinal block takes effect much more quickly than an epidural, and the effects of the spinal block wear off more quickly than an epidural. Having experienced both an epidural with Natalie's birth and a spinal block with Adam's, I can say that my spinal block definitely took effect fast. In fact, as a nurse was holding me up while my spinal block was inserted, I started laughing because I couldn't feel my feet basically the second the anesthesiologist put it in. All this time, I kept noticing how peaceful the OR felt this time. Last time, during Natalie's birth, it felt like there were about 20 people in the OR. Whether that's true or not, I don't know, but I was so traumatized and out of my mind that I felt like my body was being taken over by hordes of people in scrubs. This time, though, there were a couple nurses, my surgeon, my anesthesiologist, and two ladies (a nurse and a pediatrician?) there to take care of Adam when he emerged. Everyone was happy and calm, and that really set me up for such a better experience than last time. To make sure that my spinal block had taken full effect, the anesthesiologist took an alcohol swab and asked me to tell her if I felt hot or cold or nothing as she swiped the swab across different parts of my body. She's swipe my forehead, where the swab felt cold, and then my chest or my legs or my stomach, where I either felt a slight warmth or nothing at all. This felt like a test, and I couldn't tell if I was failing or not. Good news: You should feel cold on your forehead, but you shouldn't feel cold anywhere else. I passed! Whew.

12:30 p.m.-12:53 p.m.
Matt arrived in the OR. The blue sheet went up, separating my head from the rest of my body in what is perhaps one of the most bizarre aspects of a c-section. The anesthesiologist kept telling me that as soon as I felt nauseous I needed to tell her and she'd "give me something" in my IV to make me feel better. I asked Matt to tell her about five times during these 25 minutes that I was beginning to feel nauseous, a common reaction to the spinal block.

I reminded the anesthesiologist that during Natalie's birth I felt pain, not just pressure, when they took her out of me. She reminded me that the spinal block doesn't block out pressure, but she would give me fair warning when I should start feeling pressure. She was super great about walking me through everything I should be feeling and when. I think thanks to her narration, and the fact that Adam was nearly 2 pounds lighter than Natalie and therefore not as tightly lodged underneath my rib cage, this time I truly did feel pressure and not pain, and for that I am so thankful.

12:54 p.m.
Matt and I heard a cry, and we both broke out in tears before they even brought Adam around to the other side of the blue sheet. I didn't know if I'd have as emotional of a reaction this time as I did last time, given the fact that this was such an insanely orchestrated procedure, but in some ways I was perhaps even more emotional the first time I heard Adam cry. I think I not only felt happy to know we had a healthy baby, but also to know that we are so lucky that this is the second time in our lives that we get to experience this. It's like lightning has struck twice in the best possible way, and I don't want to take it for granted. 

12:55-1:40 p.m.
During this time, Adam was getting cleaned off and measured and having his two rounds of Apgar tests (8 and 9, respectively -- good job on your first assessments!). I was being sown up and given my first round of Pictocin to help my uterus shrink back down. My world's-most-amazing anesthesiologist was chatting us up and taking some pretty awesome operating room photos. This time I delivered at a different hospital (not by choice, but by insurance policy necessity) and I am so glad I was in a different hospital because during this 45-minute post-delivery period in the OR this hospital keeps the entire family together, unlike my previous hospital for Natalie's birth where they almost immediately whisk the father and baby away, leaving the mother awkwardly alone and pretty scared (or maybe that's just me). We got to just admire our son and talk to the medical staff and it was glorious and so happy.

Adam's first photo
 Our first photo of the three of us
The photographic evidence from Adam's birth says what words really cannot express. Last time, I did not want any pictures of me, and we didn't even bring our nice camera into the OR. If we'd gotten photos that involved me in the OR (besides the top of my head, not my face), I definitely would not be sharing them here. This time, though, I love the fact that we have these early pictures.

Now, on to recovery...
I'll begin my recovery story, which is an ongoing story, seeing as Adam is now only 9 days old, with the PACU.

1:40-3:45 p.m.
We spent these two hours in the PACU, where my nurse for my c-section continued to be nearby monitoring the baby and me. At 2:30, the nurse brought me ice and a little water to see how I could handle it (basically, without throwing up). I took down the first cup slowly but with no problems, so she brought me another round soon after, this time with more water and less ice, and I drank it faster.  Somewhere in this time I breastfed Adam for the first time, and he did really well.

4 p.m.
By now I'd been transported to my official post-partum hospital room. I scored a super-spacious accommodation thanks to the c-section. Although it wasn't the world's most comfortable sofa, Matt was happy to see a full-size sofa in addition to a rocking chair and several other chairs in the room. My new nurse, Chrissy, said I could order from the liquid-diet menu, so she brought me an Italian ice, some lemon Jello, and apple juice, all of which I took down super fast.

6 p.m.
At this point I was allowed to order off the regular-diet menu, so I put in my request for a turkey sandwich and some sides. I was thrilled to have only gone about 14 hours without liquids and 18 hours without solid food, compared to my experience with Natalie's birth when I didn't have liquids for over 24 hours and didn't have solid food for something like 48 hours.

Tuesday, January 7, 2014
2 a.m.
My night nurse told me that I'd be getting my catheter removed and getting out of bed to walk to the bathroom for the first time. I was really afraid of this moment, because last time with Natalie's birth it took three different women supporting me to get out of bed, and I experienced a decent amount of pain as I tried to sit down. This time, though, I only needed the nurse to hold my hand when I was getting out of bed. Once both of my feet were on the floor it was smooth sailing.

I won't bore you/gross you out (though it's probably too late for either of those) with every last detail, but let's just say that before I could get my IV taken out I had to prove that I could go to the bathroom unassisted. I passed those tests -- hooray! I most wanted my IV removed so I could take a shower. 

7 a.m.
An OB/GYN came by to check me out and took off my bandages over my incision. This is also when the doctors started really pressing down on my stomach to check the size and texture of my uterus. It is not the most pleasant experience, but I was on pain meds by then and didn't feel too much discomfort.

10 a.m.
My IV was out and I was showering, ready to turn back into a quasi-normal person. It's seriously so liberating to get that IV out and get out of the hospital gown and into my own clothes, PJs though they may be.

2 p.m.
I attended a breastfeeding class, something I never had the chance to do at the other hospital where I delivered Natalie. At first I thought going to a breastfeeding class as a second-time mom wasn't going to be particularly helpful, but as I soon realized I missed out on much of the first week of breastfeeding Natalie due to her week in the NICU. When the lactation consultant would say, "Well, you already know what it's like to nurse a one-day old baby," I would say, "Actually, I don't," so she refreshed me with some pointers on positioning and realistic expectations for a baby this age. It was a mostly positive experience.

Wednesday, January 8, 2014
1:30 p.m.
Our discharge papers were complete and we were ready to leave the hospital with our son who had just turned two days old. We took a few parting shots in the nice afternoon sun that was filtering through the hospital window (just after the Polar Vortex had come to a close). As we walked out the sliding glass doors toward our car, our son in his carseat carrier, we kept waiting for someone to stop us and tell us we had to come back. It was such a different experience to leave the hospital with our baby than to leave without him.

Here are a few other recovery-related details:

Swelling -- Before I left for the hospital on Monday, I took iPhone photos of my hands and feet to track what I expected would be out-of-control swelling like I had last time. This time, though, I hardly experienced any swelling. I even arrived prepared this time with flip flops and my husband's socks, and I didn't expect to wear my tennis shoes home. But I didn't need his socks, and I wore my tennis shoes home. Most importantly, I was so much more comfortable this time and not the Pillsbury Dough Boy like I was with Natalie's birth.

Walking and stairs -- Last time I had residual pain down the lefthand side of my body for about three weeks following Natalie's birth. It turns out that my pain was more a result of the 3.5 hours of pushing I did for Natalie rather than related to the epidural or the c-section, as I originally thought. I have experienced zero pain while walking, and I had no discomfort this time with the stairs in our house. In fact, just now I practically ran up the stairs.

Pain management -- By late Monday night or early Tuesday morning in the hospital, I was taking two pain meds: Percocet every 4 hours and Motrin every 6 hours. At first the nurses had me on two Percocets at a time, but after a few rounds of that I was practically feeling drunk, which I didn't think was particularly safe for me or the baby, so I went down to one Percocet every 4 hours and stuck with the Motrin regimen. By Thursday night I was taking no more Percocet (I just don't like the side effects and I didn't think I needed it anymore). I took one Motrin two days ago, which was exactly one week after Adam was born, and I haven't taken anything since then. With Natalie's birth I stayed on pain meds quite a few days longer, likely because I was more beaten up, having experienced essentially both types of deliveries, and I was having to go back and forth between home and the NICU, which wasn't conducive to recuperating.

Breastfeeding -- This warrants its own post, and hopefully one day I'll write it, but for now I'll just say that having my baby by my side for virtually his whole life has made breastfeeding a heck of a lot easier. Last time I was mostly pumping for the first eight days, and I think my supply suffered as a result. Fortunately, I didn't have too much breastfeeding difficulty with Natalie, but (knock on wood) this time is infinitely easier.

We have thoroughly enjoyed our week at home from the hospital as a family of four! (even if big sister Natalie doesn't look thrilled here, she's been shockingly sweet and well-adjusted so far...)