Tuesday, February 28, 2012

Packing a maternity-ward hospital bag: a retrospective

I have to say that back in December when I packed my hospital bag and subsequently wrote about it in this post, I did a pretty spot-on job. I used almost everything I brought with me. Here are the only things I did not use:

Labor and delivery room bag
  • Cheap flip flops -- As I walked around the labor and delivery floor for hours, I was walking in my tennis shoes (which still fit me at the time). Before I gave birth I guess I thought things were going to be messy from the get-go. That was silly. Things are only messy at the very end of delivery and then in recovery, but recovery is not nearly as messy as I thought it would be, either. So, I would pack flip flops just in the recovery room bag.
  • Sugar-free hard candies -- Although the nurse in the childbirth class recommended having these on hand I never touched them, probably because I ate about six Popsicles while in the labor and delivery room. Popsicles were way more exciting than candy at the time, though interestingly enough my nurse tried to track down sugar Popsicles for me (her idea, not mine) and could only gather up the orange, purple, and red sugar-free variety. Still they were amazing.
  • Quarters for vending machines for Matt -- Never used them. Guess who used Coinstar yesterday at the grocery store to convert a bunch of coins into an Amazon gift card?

Overnight room bag
  • Underwear -- Maybe it's because I had a c-section but I never wore my own underwear in the hospital. I wore those hospital-issued mesh disposable granny panties and, dare I say, I loved them. More on that below. I tried wearing what I thought were my huge, cheap underwear I picked up at Target and those were never even close to cutting it.
  • Nursing supplies: soothies gel pads -- Never used these, but I chalk this up to the fact that nursing was and continues to be shockingly easy and pain-free for me. I am glad I brought these, though, as a safety measure to have on hand. Better to be prepared I think.
  • Travel pack of baby wipes -- Never used these, but it's hard to say what my experience would have been like had Natalie actually been in the room with us and not in the NICU. My guess is, though, these could have stayed home.
  • Newborn onesie -- Natalie did not wear this home because it would have rubbed against her umbilical cord stump, as I figured before, so we could have gotten away with just the long-sleeve T-shirt and footed fleece sleeper she went home in.

Boppy pillow -- We left this in the car and never used it because I only fed Natalie in the hospital room one time before she was taken to the NICU. Also, the NICU provided me with a My Brest Friend (horrible name!) pillow but I found it horribly uncomfortable because it hit me right at my c-section incision.

Although I thought we were super prepared, we had actually underpacked, something I don't believe has ever happened to me. Of course, we thought we'd be there two nights max and we wound up being there four nights, so had we experienced a normal hospital stay we would have been fine. Here's what we needed:
  • More clothes for Matt -- He only really brought one additional outfit. Fortunately he was able to run home in the middle of our stay.
  • Bigger socks and shoes for me -- I really needed to wear Matt's socks after delivery, which is what I did when we got home from the hospital. I was painfully swollen to a degree I could have never anticipated, and that swelling did not go away until about six days after delivery. I could not even fit in my loose-fitting tennis shoes with the laces untied. So, I wore flip flops in the middle of winter, even when leaving the hospital, but thankfully it was not terribly cold (and I was still hot from the postpartum hormonal roller coaster).
  • More nursing tanks/bras for me -- I brought one nursing bra and one nursing tank, the only ones I owned, to the hospital. Unfortunately I was sweating so much and got a weird cut on my chest (and subsequently bled on my nursing bra) that these felt gross fast. In retrospect I would have bought and brought along at least one more nursing tank to the hospital, probably the cheap, unfashionable variety, and saved the good stuff for home.
I think it's also worth noting what the hospital will give you while you're there. I wore the hospital gown every night while I slept because I was sweating so much that my own clothes would have just been damp. So, during the day it was nice to wear my PJs as my clothes and change into the hospital gown for sleeping purposes.

As I mentioned above, I embraced the hospital-issued mesh disposable granny panties. Curious to see what they look like?

They're basically as big as a pair of boy shorts from Victoria's Secret, but step into them and you quickly discover the meaning of one-size-fits-all. These suckers are huge, and fortunately so. They will go over your still-six-month-looking-pregnant-but-not-pregnant belly and they will not at all cause your c-section incision to hurt, unlike all other underwear I tried on in the first week postpartum. I know some women hate these, but I was the weird one who asked for extras to take home.

As any woman who has given birth knows, going to the bathroom postpartum is a bit of a process, and the hospital has lots of supplies on hand that you'll be able to bring home with you too to make life a little easier. The first is the enormous hospital-issued maxi pad that may as well be called a diaper. For comparison purposes, here is one next to a regular pad, the kind you might wear for up to a month postpartum (remember, tampons are not allowed during this stage!).

Sexy, right? This is where my friends who haven't given birth quietly exit my blog post, scared out of their minds. Please return soon!

Then there are all the hospital-issued items you can place on top of the giant adult diaper. These include the giant ice packs that are activated when you twist them. (For what it's worth, even in my recovering state I was impressed by this technology.) Then on top of the ice pack you are encouraged to make what's been called a "salami sandwich" of witch hazel pads (aka Tucks). Spray the witch hazel pads with Dermoplast pain relief spray and add a dollop of hydrocortisone ointment and you're set.

Of course before you actually get up from the toilet you need to spray yourself down with warm water in one of these peri bottles, yours for the keeping!

If you're wondering why it takes a woman who has just given birth about 15 minutes to go to the bathroom, this is why.

The hospital will also supply you with what you need for a sitz bath, but that's something I never needed to take advantage of.

And yes, I still have extras of all these supplies on hand, so should a woman have a drive-by delivery on my front porch I can provide her with decent postpartum hygienic care.

Today's takeaway messages: be nice to the women you know who've just given birth, and when you go to the hospital leave your underwear at home.

Thursday, February 23, 2012

6 weeks

So six weeks ago today I heard my baby scream for the first time as she was being pulled from my body.

Today that primal scream is back.

We have entered week 6, which according to quite a few moms I know and a book or two I've read is a difficult week.

Somehow we went from this...

...to this:

Like clockwork, today Natalie is being fussy and insisting on only being quiet when being held.

I tried the baby bouncer, which calmed her down for about two of the five minutes I was in the shower.

So we moved on to the Ergo carrier. I've used it on a couple shopping trips, including our solo expedition to the grocery store yesterday (we walked there and back and made a lot of elderly people very happy!). But now I've joined the league of moms who wear it around the house to soothe their baby to sleep and free up their hands for a bit.

All it took was about 25 minutes worth of Jack Johnson's Sing-Along Songs, an Ergo carrier, and plenty of mom dancing to get this baby to calm down.

It's just amazing to me that as soon as she hit six weeks she had her worst day. Maybe if Natalie stays this predictable we can cross our fingers that she'll magically be sleeping through the night as soon as we hit four months...right?

Tuesday, February 21, 2012

DJ Roomba's flaw

You may recall that right before we brought Natalie into our home we brought a Craigslisted Roomba robot vacuum cleaner -- or as we like to call him, DJ Roomba -- into our home. So far DJ Roomba is doing a great job keeping our main level of our home remarkably clean with one exception. All too often I wake up in the mornings, go into the kitchen, and notice this:

DJ Roomba is great on carpet. DJ Roomba is not so hot on wood floors. He is swirling all the dog hair around and distributing it into piles on the wood floors, but he is not actually doing his job of scooping up the piles of dog hair. I guess this is his one flaw. Of course, I can easily grab the Dust Buster and get up those piles of dog hair quickly, but still, I think his advanced technological prowess should include him completing this final step.

I will say, though, that is remarkable that once his little vacuum cartridge is full of dust, dog hair, and debris every night while we sleep DJ Roomba does what I call his "ET Phone Home" moment when he returns to his little port where he lives for 23 hours of the day. Smooth move, robot!

It's official, we are living in the future, and it is weird and fascinating.

And our future dogs will be the kind that do not shed.

Tuesday, February 14, 2012

New parenting 101: Redefining the word "schedule"

Everyone warns you before you have a baby to "get your sleep now because you won't once the baby arrives!" I assume the implication is that you can somehow stockpile your sleep. Well, obviously you can't. The good news for me, though, is that because I was (in retrospect) getting such horrible sleep throughout much of my pregnancy and it was at its worst in the final two months, I am actually getting better sleep now than I have in almost a year.

What people had warned me about that is true, however, is that I'm having to seriously redefine my waking hours and the concept of a schedule and productivity.

I used to be able to make a list of five relatively substantial tasks that I could tackle in a couple hours on a Saturday morning. Now I feel like that same list takes me at least a week to complete. I figured this would be true as we prepared for Natalie's arrival, but I don't think the degree to which it would be true struck me until last week when Matt went back to work.

Don't get me wrong, I'm not complaining about this fact; instead, I'm actually kind of embracing this new lifestyle and the less-intense level of expectations that comes along with it. Like I was telling my friend the other week, I have a to-do list, but the good news is that on any given day I don't actually have to do anything besides sustain the life of a tiny human (no big deal!). It's rather freeing.

Still, in an effort to keep myself goal-oriented I am keeping two running lists. One list contains everything I'd like to get accomplished eventually, which I'll define as in the next several months. The other list is my daily to-do list.

I've written before about my non-negotiable daily tasks. These still hold true with some slight adjustments. Here's generally what I always have on my to-do list:

1) Wake up and immediately make bed before Natalie starts fussing. Bonus points if I can put away last night's dishes before she wakes up, too.

2) Eat breakfast while doing the first nursing of the day.

3) Shower and change clothes.

4) Eat lunch.

5) Pump 1-2 times per day.

6) Make sure I'm giving Natalie lots of stimulation: reading, activity gym time, tummy time, toy time, etc.

This may seem absurd, but making the bed, showering, changing clothes and making sure I've fed myself well during daylight hours are critical to my daily routine and my sense of sanity. I could stay in my PJs all day, but that would make me feel pathetic (I know because I've done it a couple times already).

Additionally, so many of my hours are taken up by nursing that it's easy to overlook that as one of my most essential duties right now as well.

I also keep having to constantly remind myself that interacting with Natalie while she's awake is an important part of my job right now. Because she doesn't give much feedback yet, it's sometimes easy to forget that age-appropriate stimulation is still important to her development. The amount of hours she's awake during daylight hours is starting to increase, and she's hinting at the very beginnings of some social smiling, so hopefully soon she'll seem more like a little person than a little blob.

Each day I add a couple more items to that day's to-do list, and I am not satisfied unless I complete them. These change daily and I write them down to motivate myself to get them done. I am giving myself credit for accomplishing mundane tasks that before I did not even think of as accomplishments.

For example, yesterday I wrote three thank you notes and I mailed a gift at the post office. Those were the only two to-dos I required myself to accomplish yesterday on top of my regular to-do list.

Today my to-do list includes washing the new bed sheets I picked up over the weekend, emptying the dishwasher, giving Natalie a bath, and finishing reading a set of short stories. (Note about the sheets: I picked up a set of cotton percale bed sheets two years ago once I discovered that these are supposedly the longest-lasting kind of sheets. They really are holding up well, and I decided we needed another set because I am disgusted by how much I am continuing to sweat at night and how frequently I am washing sheets as a result. Postpartum night sweats are no joke. I am ready for that to end -- will it end, or am I doomed to be a sweat monster for the rest of my life? Moms, you tell me.)

As I hope you can tell, by giving myself significant credit for emptying the dishwasher I have clearly downgraded my definition of daily productivity.

And that is fine.

Thursday, February 9, 2012

Making sense of maternity leave

Learning the ins and outs of your company's maternity leave policies can be maddening. For starters, no one you talk to seems to have the right answers, and definitely no one has all the answers. Then, you read about all the benefits the French get when they have babies and you might just drive yourself mad when you find out that as an American you basically get Diddly-Squat.

So, in an effort to help others learn from my experience, I can at least tell you everything I learned. Like everyone else I surely do not have all the answers, but maybe this can get you started.

For me I was so worried about people at my job thinking I was about to have a baby or being all up in my business that I did not talk about baby making or maternity leave with people at work. I spent several years listening intently whenever a colleague would talk about her maternity leave experience, but whenever I asked a follow-up question someone either outright asked me if I was trying to have a baby or asked a friend of mine the same question later on. So I soon gave up on that route and went straight to calling HR to find out all I could.

I called HR a good two years before we even started trying to conceive. I was trying to figure out the "optimal time" as a teacher to give birth. (The answer, if you're curious, would be exactly 12 weeks before the school year ends, since that's how long the Family Medical Leave Act gives for time off work.) While on the phone with several different people from HR I also tried to get their help in making sense of what seemed (and in retrospect still seems) like a complicated maternity leave policy.

Here's my school system's maternity leave policy in a nutshell:

If a woman gives birth during the school year, depending on how she gives birth she gets either 2 weeks or 4 weeks of paid time off (aka Short Term Disability). If she gives birth during the summer she gets no paid time off, but she can take 12 weeks of time off in the fall under the Family Medical Leave Act and receive paid time off provided she uses her own leave.

My school system also publishes this (difficult-to-find) document on its HR website titled "Your Pregnancy and Taking a Leave of Absence" (scroll down to the Disability and Leaves section of this link). It answers many, but not all, of my maternity leave questions. 

Here's the long form of that information:
But first, a reminder why any of this matters to begin with...spending time with this sleeping beauty.

...who is increasingly alert during the day!

Part 1: Starting from the day a woman gives birth she goes into a 4-week "elimination period." This horribly titled time period is a 20-work-day window in which she must use her own sick leave (if she has any) and get paid for her 20 days off, or if she does not have sick leave she goes on leave-without-pay status.

Part 2: After the 20-day elimination period the woman goes on Short Term Disability (that comes with the horrible acronym STD...I know because I was just asked to write this on a form). The short-term disability period is 2 weeks if she had a vaginal delivery or 4 weeks for a c-section. Because I had a c-section I won the short-term disability lottery -- holler! This 2 or 4-week period is the time during which the woman receives 100% of her salary whether or not she has leave acrued (and she doesn't use her own leave during this time).

Part 3: By the time a woman has completed what I've called Part 2 of her maternity leave, she has either been out of work for 6 weeks (vaginal delivery) or 8 weeks (c-section). Now she is entitled to either 6 more weeks of leave under FMLA (vaginal delivery) or 4 more weeks of leave (c-section). She can take her leave with or without pay depending on whether or not she has sick leave left over.

Part 4: When the 12-week FMLA period is over a woman may continue to take time off work by filing for a Leave of Absence. In our school system we are allowed to take up to two years off at a time and still retain our job. (Note that this does not mean a woman gets her exact same job held for two years. Instead, she is guaranteed a similar position in the county when she returns, though that position could be at another work location [i.e. school].)

So, when I lay it out for you this way, hopefully this does not seem overly complicated. With me so far? Good.

But then it's time to to understand the difference between Short Term Disability and Family Medical Leave Act.

The FMLA time covers 12 weeks' worth of working days. As teachers we get a generous amount of time off work, such as winter break, spring break, and the majority of federal holidays (though we don't get Veteran's Day, and I'm still not sure why...). So as teachers FMLA gives us exactly 60 work days off. This means that if I had, for example, given birth on Dec. 23 when winter break began my FMLA would not have begun until Jan. 3 when the students reported back to school.

But here's the kicker: Short Term Disability counts calendar days, not working days. Think of Short Term Disability like a stopwatch that starts ticking the moment your baby enters the world. So, had I given birth on Dec. 23 and had a vaginal delivery I would have used up the majority of my Short Term Disability days by virtue of giving birth vaginally over a break. If I had given birth in the middle of the summer, such as some time in July, I would not have gotten any Short Term Disability days. Thankfully Natalie decided to hold off until after the holidays were over.

So, ironically then, as teachers it's to our financial advantage to avoid giving birth during breaks from school because by doing so we lose our 2 or 4 paid weeks of maternity leave (aka Short Term Disability). Avoid giving birth in the summer if you want paid time off! Lesson learned.

Then it's time to fill out the paper work. Here's what I learned:

1) Because I needed to use my own sick days for my 20-day elimination period, before I left work I filled out 4 weeks' worth of blank time sheets for my secretary. I left them with her so that she can fill in the dates and submit them for me while I'm gone.

2) Our school system uses Liberty Mutual (1-800-524-0740) as the neutral third-party to handle disability claims. I had been instructed to call Liberty Mutual to begin my claim process at least 30 days before my due date. So I called 35 days before my due date. When I called the woman I spoke to said I was calling too soon. I said I was calling at least 30 days before my due date. She only agreed to work with me because my last day of work was the day winter break began, so when I spoke to her I was less than 30 days from my last day of work. I guess if I had been planning to work up until my due date I would have had to have called back later. Seems odd all around -- if you want women to call exactly 30 days before their due date then you need to state that directly. Liberty Mutual sent me a Medical Release form for my doctor's office that authorized Liberty Mutual to access my medical information from my doctor as needed to handle my disability claim. (Again, interestingly enough, when I contacted Liberty Mutual to initiate my claim the woman I spoke to asked me if I had submitted my Medical Release form. I said I did not yet have a Medical Release form because I thought that's what she would be sending me today. It felt like a game of Who's on First?)

3) I needed to call Liberty Mutual when Natalie was born informing them of the birthday and method of delivery. They beat me to it, though, and called me multiple times during the 10-day waiting period between Natalie's due date and her birthday. I did call them from the hospital, though, the day after her birth and let them know I had a c-section.

4) After Liberty Mutual filed my Short Term Disability claim with my school system I received a letter in the mail from Liberty Mutual telling me they had initiated my claim.

5) Last week, three weeks after Natalie's birth, I received a call from my school system's Disabilities Office. They wanted to know when I intend to return to work, and the answer is not for the remainder of this school year. They needed me to fill out two forms:

Form 1: an FMLA form A. This form requires my principal's signature. I knew I needed to get this form filled out, I just wasn't sure when. It requires including Natalie's birthday as the Beginning Date of Absence. I should have filled it out prior to leaving work in December and just left the dates blank (and trusted that my principal would trust me to fill it out appropriately). The top of this form says I need to fill out the Certification of Health Care Provider form along with this form, but that is just a trick! I don't need that form after all. Complicated, right?

Form 2: Request for Leave of Absence form. Because my FMLA time off ends April 13 and I plan to take the remainder of the school year off, my leave of absence officially begins April 16. Even though the top of this form indicates that I need to submit this form by March 31 to take time off for the upcoming school year, I can disregard that instruction as well and simply return this form to HR for this school year asap.

Believe it or not, although this may sound complicated, handling my maternity leave questions has actually been much easier than handling my state teaching license questions from back in my first year of teaching.

I hope when you take maternity leave that you have a good benefits system in place wherever you work, and I hope if you work for the same school system as I do you'll be able to use this knowledge to your advantage!

Sunday, February 5, 2012

Newborn products: The MVPs

I am sure as Natalie grows I will have reflections on products that helped get us through each stage. While we already have items on hand for late in her first year and into the toddler years, for now I can only comment on the items we've used the most during her first few weeks of life. These are the items that, if I was doing it over again, I would make sure I had on hand before she was born. (Quite a few of these items I picked up since her birth, even though I previously thought we couldn't possibly need to bring any more baby items into our home for a long time.)

Graco Pack 'N Play with bassinet attachment in Kensly
Keeping Natalie in her Pack 'N Play next to my side of our bed has worked out perfectly so far. She wakes up 2-3 times per night for a diaper change and feeding, and having her at arms reach has made the process much easier. Last night I was able to soothe her back to sleep while just holding her hand. (This required me putting my pillow right next to the edge of her bassinet, but it still worked.)

While our Pack 'N Play doesn't have all the bells and whistles of the other Pack 'N Play products,  frankly I can't imagine needing anything more than this device provides. I know the Pack 'N Play is criticized as being cumbersome for travel, but, having not yet carted it around an airport, I don't find it particularly heavy either.
Graco quilted Pack 'N Play sheets -- get 2!
I don't know if it truly matters or not, but Graco encourages consumers to use the sheets it manufactures for the Pack 'N Play sets. I am fairly certain this is mostly a marketing scheme, but I gave in and got two of these sheets. At first I had only one on hand, which was silly because it just meant more laundry.

Halo Sleep Sack Swaddles -- micro-fleece, newborn size, get 2!
This wearable blanket has been great for keeping Natalie warm and safe at night. The micro-fleece is wonderful for a winter baby, and the newborn size fits infants from 6-12 pounds, which is most likely when you'll want to swaddle your baby. We are swaddling Natalie with her arms out (rather than arms in as you'll see in the photo below) because, believe it or not, Natalie has already proven that she can roll onto her stomach so we don't want to take any chances with her having her arms encased in the swaddle and her face down on the mattress. One of our Halo swaddles came with Velcro closures, the other did not, even though I thought I was ordering the exact same product. The verdict? I prefer the Velcro kind -- easier to keep in place.

Infant gowns -- have 4-6 on hand
I mentioned these before, but these make changing diapers in the middle of the night so much easier. Just lift up the gown to see if it's time for a diaper change rather than deal with snaps or zippers at 3 a.m. Sizing doesn't matter much here. We have some gowns that are size 3 months, some that say 0-3 months, and one that says "one size fits all," and all of them fit Natalie.
Bath time
Safety 1st Comfy Bath Cushion
I know a lot of people like to bathe their newborns in the kitchen sink, but I've been hesitant to try that out thanks to our granite countertops and wood floors in the kitchen. If the little lady bumped her head (or, let's get real, WE bumped her head) it wouldn't be too pleasant. Instead we've opted for bathing her in the hallway bathroom's bath tub. We put this cushion inside her baby bathtub...

Fisher-Price Precious Planet Whale of a Tub
...the frog sponge helps keep Natalie in place since she can't completely control her neck or sit up in the tub.
Circo Bath Time Kneeling Pad (from Target)
...and this pad is keeping my knees from giving way while I crouch over the bath tub.

Hooded towels and baby washcloths -- at least 3 hooded towels and 6 washcloths.
We had just 2 hooded towels on hand before Natalie's arrival, and since she was born we've received quite a few as gifts. This was great because we could use more and Natalie gets the luxury of a totally clean towel every time she's bathed (which is not a luxury I indulge myself in). Two good types of baby wash cloths are these terry velour ones by Swaddle Designs and the ever-popular Aden + Anais line with its so-soft muslin fabric.

Hats! -- well, I should say hat as you really only need one...
We have not bought Natalie a single hat, yet she owns at least a dozen. The cutest one that gets all the compliments is this adorable knit bunny ears hat from Baby Gap. It's size 0-6 months.

Zippered footed onesies -- get 4-8. We needed newborn size (despite having an 8-lb. baby)
These are by far the easiest items to dress your newborn in. We have about 4-5 footed onesies in newborn size with snaps and about 4-5 footed onesies in newborn size with zippers. We dress Natalie in both snaps and zippers equally, but I hear less noise emanating from the nursery (both from Natalie and from Matt) when Matt's doing a diaper change when Natalie's in a zippered onesie. Newborn outfits with pants are cute, and we like dressing Natalie in these as well, but they're much more impractical than the zippered footed onesie.

On the go
Graco SnugRidger Infant Car Seat Stroller Frame (aka Snap 'N Go)
Thanks to unusually high winter temperatures we've been taking Natalie on lots of walks. This stroller frame has held up perfectly. I know friends and relatives who live in more urban areas with rough pavement find jogging strollers are the way to go, but for us living in our suburban, ridiculously-clean-and-manicured paradise this really basic stroller frame does the job well.
Car seat
Now, as far as car seats are concerned, I feel like I can't speak with much authority here, seeing as if I did it over again I probably would not choose our Graco SnugRide 35 Infant Car Seat because it is so big. We've had a chance to compare it to other people's infant car seats, and ours is definitely the big one. I can't tell you with authority which is the better car seat to choose, size-wise, so maybe some readers can reply with comments on what infant car seat they'd recommend. (Please do!)
Stroller blanket
Instead of getting any attachments for the infant car seat, such as the popular JJ Cole bunting, we've been bundling Natalie with a stroller blanket around two-thirds of her body when we take her for a car ride or a stroller walk. My sister-in-law bought us this beautiful Petunia Pickle Bottom stroller blanket and we take it everywhere.

Medela Easy Expression Bustier
This is the hands-free breast pump bra. Without it you're subjecting yourself to 10-20 minutes of holding your arms up while you milk yourself. With it you buy yourself 10-20 minutes to send emails, make phone calls, or write your blog (just kidding on that last one). You will be shocked to know how many of your female friends look like the woman below when they are communicating with you electronically. Ahhh, modern women.

UPDATE: Realize I left these two important items off initially: nursing camis and nursing bras
A Pea in the Pod nursing tank
Awesome and universally flattering.  I have a nursing cami from Target, and based on its inability to enhance my shape (or I would argue most women's shapes) I was happy to spend twice as much money for these way better camis from A Pea in the Pod.

A Pea in the Pod seamless clip-down nursing bra
So comfortable it's kind of like a sports bra, but way more flattering.

Lansinoh Breast Milk Storage Bags 
If you are trying to stockpile your breastmilk in the freezer like I am so you can, you know, get a hair cut, go to the doctor's office, or have a few hours to spend with your girlfriends, these bags are a must-have.

Lansinoh Disposable Nursing Pads
These are particularly useful to wear at night, I've found, even though they're primarily intended to keep you from experiencing the wet T-shirt contest look while out in public.

Lansinoh HPA Lanolin
I had this nipple cresm on hand in case I needed it, and I used it several times in the very beginning. I can't say that for me this product is a true MVP because I've been so lucky with breastfeeding, but I know it's a godsend to lots of breastfeeding moms.

Boppy pillow with slipcover -- I recommend two Boppys (if you live in a multi-story house) and a couple extra slipcovers.
I did not use the Boppy at first, mostly because I was feeding Natalie in the NICU and I was still dealing with a healing c-section incision. Now that Natalie is slightly heavier and my c-section incision is fully (or at least almost fully) healed, I'm finding the Boppy is helping to keep me from arching my back too much. Now I want a second Boppy so I don't have to carry it and the baby up and down the stairs several times a day.
Aden + Anais Burpy Bibs -- buy at least 6.
These burp cloths are like Burp Cloths 2.0 because they double as bibs when your babe is a little older, they come in adorable designs, and the classic Aden + Anais muslin cloth is so soft. We always have four burp cloths in rotation at once -- one next to the Pack 'N Play, one in the nursery, one in the living room, and one in my purse (I haven't yet started using my diaper bag because we've only taken Natalie out for short trips to the doctor and a couple restaurants [where she slept like a champ!]).
Bottle feeding
Dr. Brown's BPA Free Natural Flow Bottles -- buy 3 of the 4-ounce bottles for getting started.
Natalie needs to be burped often, so we opted for these bottles that (at least claim to) reduce colic, spit up, burping and gas. Others have critiqued these bottles as being too difficult to clean because they involve multiple parts, but I have not seen this as a problem. We pop them in the dishwasher using the....

Oxo Tot Dishwasher Basket
...to corral all the bottle parts and accessories.
Boon Grass Countertop Drying Rack
Some of the bottles and accessories come out of the dishwasher needing some extra time to air out, so this little drying rack is both cute and functional.

Philips Avent Soothie Pacifier -- 0-3 months, pack of 2 
I mentioned this in yesterday's NICU post, but even though these were items we did not have on hand at first they have been helpful in calming Natalie when all else fails.
Multiple changing pad covers
Although one of my trying-not-to-go-insane tasks I completed while waiting for Natalie to arrive was the creation of a diaper caddy, we've found we prefer to change Natalie in her nursery on her changing pad. Seeing as the first night home from the hospital she soiled one changing pad cover, we were happy to have another one on hand. Additionally, we've learned to take plain burp cloths (not the Aden + Anais kind) and place them underneath Natalie when changing her for added protection.

Covered trash can for the nursery
I did not want a Diaper Genie in the nursery because I hate how they look and the fact that they only serve one function. Instead I picked up a small metal trash can at Home Goods for diaper and wipe disposal (we'll have a different system in place when we transition to cloth diapers). It has a detachable pail that makes trash day easy to handle, and the seal on the trash can is strong enough that it's kept offensive odors out of the nursery.

UPDATE: I also realize I initially left off this important item: infant swing!
Fisher Price Nature's Touch Cradle Swing
The exact swing we own, because it's a hand-me-down, doesn't appear to be sold anymore, but all the Fisher Price infant swings are roughly the same. I know the Fisher Price My Little Lamb swing is quite popular right now and essentially identical to the swing we own. This swing is perfect for putting Natalie in for a day-time nap. Half of her day-time naps seem to take place in my arms (or Matt's arms), and the other half happen in this swing in our living room.

What I left off...
I have not included diapers or wipes because, while those are clearly needed, you can wait and use up your hospital-issued supply before you go out to buy more. With diapers in particular you may want to wait until you know how big your baby is before you get extras because an over-8-lb. baby will need to be in size 1 diapers (Pampers Swaddlers, at least) whereas an under-8-lb. baby will need to be in size newborn diapers.

I also did not include a bulb syringe nasal aspirator because hopefully you'll be given one at the hospital, but if not this is definitely something to have on hand.
That's my list! I am interested to hear from the parents out there about what you recommend having on hand for those early weeks of life.

Saturday, February 4, 2012

NICU culture: Blessings in disguise

I was talking to my friend Mimi the other day during a beautiful June-uary mid-afternoon walk and she asked me a poignant question: Did I feel resentful about Natalie's labor and delivery story? The answer to that question is no. As I told Mimi, although it didn't happen the way I would have chosen, I knew going into this process that I would have little control over the way everything occurred. I did, however, respond that I feel some resentment regarding Natalie's NICU stay, particularly the 40 hours I was sequestered and not allowed to visit her.

But, as easy as it is to wallow in self pity, basically ever since it finally registered that Natalie was, in fact, going to spend the majority of her first week of life away from us, I tried to look at the good in the NICU experience. Although I am not a religious or even spiritual person, I do believe in the concept of things happening for a reason. I tried to think positively while she was in the NICU. With the clarity that comes with hindsight I've come to terms with all the blessings in disguise that the NICU gave our little family.

Blessing 1: If you can make it here, you can make it anywhere.

In a way, the NICU is a lot like the vision of New York that Sinatra sang about. Neither Matt nor I had any experience with infant care before Natalie entered the world. We had not changed a diaper. So, we learned to change Natalie's diapers through the holes of the incubator she was housed in, with all the IV lines and sensor cords attached to her. We learned to give her a sponge bath with a nurse's assistance. We finally understood how to use the bulb aspirator. We gave her bottles and burped her. Basically, we got eased into parenthood under the supervision of what are no doubt some of the world's greatest medical professionals.
Pictured above, our absolutely favorite nurse. She deserves a medal, but the best we can probably do is bring her bagels and a nice note.

Blessing 2: Breastfeeding support

My nurses up in Family Centered Care, where I was recovering while Natalie was housed in the NICU, knew I wanted to breastfeed. So, just hours after Natalie was whisked away in the early hours of Friday morning they brought me a hospital-grade breast pump (the Ameda Elite) and had me get to work. They knew that I needed to pump if I was going to be successful once Natalie and I were reunited. One bonus is that they gave me all the attachments I'd need (which cost roughly $40) for free since Natalie was in the NICU.

The Ameda Elite hospital pump costs $950 to purchase at the hospital, but I could rent it for $19 a week or $72 a month from my hospital. I'm glad I didn't buy a heavy-duty pump before Natalie was born because I'll continue to rent this one for a while.

Here's the bottom line: breast pumps are no fun but totally necessary. One particularly patient nurse sat with me while I attempted to fill these tiny syringes with colostrum (the yellow stuff women produce before the actual breast milk comes in). To my (and her) shock, she helped me fill three syringes on my first attempt. They are a pain and a half to work with, but sending these syringes of colostrum down to Natalie in the NICU made me feel like I was doing something productive when I couldn't see her.

Of course, the first lactation consultation I met with came into my hospital room as I was in my final minute of pumping, round 2. In an attempt to help she grabbed the breast pump, eh, suction cups (?) off my boobs and spilled everything I'd spent 20 minutes pumping. I started to cry. That was a breast feeding low point.

After I requested that the horrible lactation consultant never visit me again, I met with three different lactation consultants, including one who specifically works with mothers of NICU patients. The NICU consultant was perhaps the most helpful, but all three women were good despite the fact that they literally all gave me very different advice. Finally, as I was sitting in the middle of the NICU bare-chested (lost my shame a long time ago in this process, if you'll recall) with Natalie draped across me, her splinted arm with its IV line across my stomach and various plastic bits from all her tubes poking into me as I tried to keep her off my c-section incision, the NICU lactation consultant asked me if she was latching on and if I was comfortable. I could reply yes to both. She said that's good because the technique I was using she would never recommend to anyone but if it worked for me I should keep going. Yes, in the circumstances, this was working and it was the best I could do.

As with all other aspects of infant care, I knew that if I could learn to breast feed Natalie in this environment we would get home and everything would be fine. That prophecy indeed came true.

Blessing 3: Versatile baby!

Like most mothers-to-be out there I read a bunch of baby books and talked to lots of friends who'd given birth over the years and soaked up all the information I could. I had heard enough about seemingly classic conundrums such as nipple confusion that I was determined to follow a regimented schedule: Natalie would not use a pacifier; she would get a bottle between 2-3 weeks of life after my breast milk supply was established and a breast feeding routine was well under way.

All these plans went out the window the moment Natalie was admitted to the NICU.

To soothe babies in the NICU, who, like Natalie, can't be held for long because they need to be in their incubators and/or underneath the bilirubin lights (or in her case underneath an oxygen hood for her pneumonia treatment), the nurses use pacifiers (the Philips Avent Soothies kind).

Because Natalie was separated from me, we obviously could not breast feed on a normal schedule, so she immediately needed not only an IV line but also supplemental formula (the NICU uses Enfamil Ready to Use newborn formula).

She was released from her incubator every three hours for a temperature check, diaper change, and feeding. Matt and I tried to get to as many of these feedings as we could, but inevitably we couldn't go to every single one, so Natalie was often handled by the awesome nurses.

The point of all this is that even though we were not caring for Natalie ourselves the way we would have chosen had she been with us at home, at least partially as a result of her NICU care Natalie is incredibly versatile. She takes a pacifier but isn't reliant on it. She takes a bottle of my breast milk about once a day from Matt. I love the freedom this gives me to run an errand or meet a friend for a few hours. But neither the pacifier nor the bottle created "nipple confusion" (a concept all our nurses essentially described as a crock). She doesn't need to be held by me to be soothed -- she will gladly fall asleep on anyone. And because she learned to sleep in a loud environment with beeping machines, crying babies and sirens blaring often, she can sleep anywhere. She is not the kind of baby who is woken up by barking dogs, ringing phones, door bells, the TV, loud voices....basically anything. You do not need to adjust your volume around Natalie. I have to attribute at least some of these qualities to her NICU experience.

Blessing 4: Free stuff

This may sound ridiculous, seeing as the NICU is a very serious place, but while receiving what the nurses aptly described as "the most expensive babysitting in the world" we also got a lot of free stuff. All my breast pumping supplies were free, which was great, and we received double portions of all the baby care items the hospital hands out for free to take home, such as diapers, wipes, and formula starter packs, but the most noteworthy free items would be the classes NICU parents can take.

The NICU has social workers who visit all the parents and inform parents of available classes and other services. Although our stay was so short we only participated in one class, I really like the fact that there are even classes such as scrapbooking that help parents bond with each other and take their minds off the heartache they are dealing with (while documenting their child's early weeks, or sadly, months of life).

We expressed interest in taking Infant CPR, and the two days later we were in the class. This was a class we were going to shell out $150 for through our hospital's parent education classes. (To put this in perspective, you may recall that we paid $100 for Natalie's labor and delivery, my extended hospital stay, and Natalie's week in the NICU -- thank you, health insurance.)

Everything we learned in our Infant CPR class will be subject of a future blog post, but for now I'll give you this little preview with the infant blow-up dummy we brought home from the class (which Matt has determined will somehow get worked into Natalie's first Halloween costume, perhaps as her evil twin).

In the Infant CPR class, we interacted with other NICU parents. We were by far the ones with the shortest stay. One mother who was there gave birth to twin boys January 1. One twin was transported to our hospital (because it's known for having a NICU so advanced it's like it's on steroids) and the other remained about 30 minutes away in the NICU of the hospital where they were born. This single mother (who also didn't speak English) expected for her babies to be released from the NICU in April. Sitting beside her we felt like absolute frauds, getting out of jail free, as the case may be. One of our nurses told us that the shortest NICU stay she's seen is five days and the longest is 250. We are indeed lucky.

As I learn to increasingly accept the things I cannot control, looking at all the hidden benefits of our NICU experience has been a great exercise.