The extra nice kind of visitors

In the first weeks of having my baby girl Charlie Bear, I had lots of visitors including family and friends.  They would come bearing gifts and flowers, but most importantly food!  It was great to see so many loved ones within such a short time, and we ate like kings.

However having visitors takes its toll.  You are already sleep deprived and yet you feel obliged to entertain, feed and water the visitors so they feel welcome and will come again.  Then they leave, and you are left with another pile of dishes to wash (no dishwasher in this household, sadly) and a hole in the pantry that needs to be refilled.  And you are tired, oh so tired.

I think I had only one visitor who offered to do some housework. I said she could hang out my sheets on the line, and afterwards she folded a small basket of laundry, unprompted.  You can't really say "Hell yes! Can you please dust, vacuum, mop the floor, and clean the bathroom and toilet while you are at it?  Thanks so much!" while you are sitting on your ass eating a biscuit.  

This same visitor then asked if I would like a glass of water while I was breastfeeding.  She even made me a cup of tea.  What a doll!  These are the extra nice kind of visitors.  It's very refreshing.

I wouldn't expect everyone to offer to do my housework.  It is tedious enough doing your own, so why would you ever offer to do someone else's!  And when visiting someone with a new baby, it doesn't really come up when you are having a nice time catching up, having cuddles and enjoying the new bub. It just doesn't - I totally get it!

But for future reference, when visiting a friend or family member with a new baby, do something useful while you are there.  Even if you make her a cup of tea, or bring some sweets (better yet dinner) it all helps.  If there is a pile of dishes in the sink - wash them (or unpack and stack the dishwasher). If there is a load of laundry that needs drying, hang it out.  Just these few small gestures will help a new mum feel a little more supported and in control, when so much of their life at the point is chaotic.

Tethered

Previously I have talked about the breastfeeding difficulties I had in the first few weeks of being Charlie Bear's mummy.  I ended up using a nipple shield with every single feed for about three months - and only just now have a been able to feed her without it.

Nowadays, the feeds are very different and much more enjoyable. She still doesn't attach all that well and tends to pull on my nipples - but it doesn't hurt me nearly as much as it used to.  She seems to have drawn my nipples out more and they seem harder and more resistant to damage than they were in those first few weeks.

I'm enjoying having her breastfeed with full contact about 50% of the time.  The other 50% of the time I use the shields because she is either messing about and not attaching or I'm feeling a bit tender,  interestingly this happens more with the left side than the right.  I have better posture on the left side but she attaches worse. Conversely I get a sore shoulder on the right hand side as I seem to hunch when she is on that side, but she attaches much better on the right.

While the feeds are going much better nowadays, there is still a downside to this exclusive breastfeeding business.  I'm currently unable to express any milk in excess of about 10-20 mls - not that it matters - Charlie Bear refuses to drink out of a bottle anyway.  In that vein this means I am tethered to her.  During the day, I can only go out by myself for an hour and a half maximum, and only immediately after a feed.  Hubby has tried several times to bottle feed her expressed milk and it has just ended in tears for more than just baby.  It recently occurred to me maybe I could try a supply line - then she could suck on a finger (anyones!!). I must give this a go one day soon.  I would like just to have the option to leave her with someone when she is going to need a feed - or else it will be six months without having a break from her, and as much as I love her, I'd like to have some flexibility.

In researching supply lines on the interwebs I stumbled across this blog - I wish I had found it earlier as it has that "real person experience" which is invaluable to order to avoid developing feelings of inadequacy when what works for you contradicts expert opinion.  http://commumsense.com/2011/01/22/top-ten-tips-for-surviving-breastfeeding-supply-issues/

I'm planning on going out tomorrow night to a party sans hubby and baby (after she's gone to bed, obviously, when the boobies aren't needed for another 5 or so hours).  It should be interesting.  I wonder if I will be able to have a conversation about anything else than babies? And - will I dare to have a drink!???

Breastfeeding is a pain in more ways than one

My baby had a difficult birth requiring vacuum extraction so she had a bit of a squished head. I believe this lead to her being a slightly jaundiced, which makes newborn babies very sleepy. To flush out the jaundice they have to be woken to be fed every three hours, otherwise the condition can worsen leading to other complications.  In hospital I coped with this with lots of support from the midwives, but once we came home I found this extremely stressful.

My baby was not a good feeder, as she had very poor attachment at the breast.  A tongue-tie was corrected surgically while we were still in hospital, so I was sent home in the belief that the surgical correction would magically alleviate the problems I was having with feeds.  It didn't.

During the first night after we came home from hospital I got more and more anxious about waking my baby for feeds.  Firstly, I was finding it very difficult to adjusting to having a newborn baby to look after when there are no midwives or nurses on hand at the push of a button.  Secondly, I was not getting much sleep at night as we had her in our bedroom with us in a bassinet (as is advised by SIDS and Kids).  She was not a quiet sleeper, and made lots and lots of snorting and snuffling noises that seemed to scrape on my already strung out nerves.

Thirdly, and most importantly, the time and effort that it was taking to feed my baby was physically and emotionally painful and exhausting.  She could not attach properly and was 'nipple-feeding' which was really painful, and three hourly feeds doesn't mean three hours between feeds, it means three hours from the beginning of the last feed.  So, if you start a feed at 12am you need to start the next one at 3am.  Experts will tell you a breastfeed should take 20 minutes on each side.  It was taking me and hour and a half to feed my baby, as she was so sleepy she would feed sporadically before falling asleep. I would have to tickle her feet, pat her on the back, tickle under the chin, sponge her head with a wet flannel and so on, to wake her up and keep feeding.

All this meant I was getting no sleep - it was a constant cycle of hour and a half feeds then an hour and half of lying awake listening to her snuffling and snorting, getting more and more anxious about the next feed and how painful it would be.

The child health nurses that visited us at home in the first days at home didn't help in trying to get my baby to attach properly or referring me to a lactation consultant, but instead suggested expressing milk and bottle feeding, or giving her baby formula.  I didn't feel very comfortable giving her formula as I had made the decision very early on in my pregnancy to exclusively breastfeed for as long as possible.  They discharged me after two visits with the advice to go to the hospital if I ever felt overwhelmed.

On the second day at home my anxiety was sky-high, so much so I was shaking and trying to swallow down my panic.  It wasn't rational at all, what is so hard about waking a baby to feed her?  But feeding was getting harder and harder.  My nipples were getting more and more sore - red, cracked and bleeding even with regular application of nipple balm.  I was dreading feeding my baby, and not enjoying her at all.  I was really starting to get to the point of wanting to give her back - but to whom!?

By the second evening at home, I called it.  We went to a GP clinic who immediately referred me to the Emergency Department at Joondalup Health Campus.  I asked if I could use some hospital equipment to express milk so I could feed my baby while we were waiting.  This is probably the best thing I could have done because it meant a nurse had to come in and show me how to use it.  Her name was Lily and she ended up being the person who turned things around for me.

She came in smelling to high heaven of cigarette smoke, obviously just off from smoke-o.  It always surprises me when health professionals smoke - but then again, I don't exercise nearly as much as I should do, everyone has a vice.  Blonde and probably pushing 60, she was motherly and kind but also very matter of fact, down to earth and had a practical perspective, which most other health professionals I had dealt with to this point had definitely lacked.

Her advice was to scrap the regimented feeding schedule and forget watching the clock.  Finish the feed, settle her back to sleep, get yourself a cup of tea and relax, then check what the time is.  Don't worry about starting the next feed at three hours on the dot, but don't go longer than five hours.  She also said not to feel guilty about giving her formula if that was the only way to get her to feed.  Her son had formula and he turned out ok.  I asked if she was a midwife or lactation consultant - she said no, but she was a Mum.  I went home much calmer and the rising panic subsided.

When my baby was 10 days old we took her to have her newborn photography session at Kristy Mannix Photography.  She was so good, she stayed asleep pretty much the whole time and only wet herself once.  After the session was over we were chatting with the photographer Kristy and her assistant Carly about how things were going.  When I explained about the problems I was having with feeds, one of the girls (I can't remember who now!) said that her friend had a similar experience with her baby and had invested in some nipple shields and they had really helped.  Nipple shields, I asked, what is a nipple shield?

Nipple shields are amazing.  They are soft silicone teats that go over your nipples, with a wide flange that goes over the areola.  Wow! I had never heard of those before!  We immediately drove to the chemist and bought a set, sterilised them and used them at the next feed.  It was instant relief and my baby had the best feed in ages.  She was still sleepy and taking a long time with feeds, but now she was breastfeeding and not nipple-feeding!  Things were looking up.

That weekend we went to a family lunch.  I was still stressed out as although the nipple shields were helping my baby feed more efficiently, I had a blocked duct that was quite painful and uncomfortable.  Family members that asked how things were going got probably more information than they intended, but it had an amazing effect.

Suddenly, all the mums, cousins and aunties were telling me their breastfeeding woes with their own children.  How they had used nipple shields for 9 months.  How they had stroke the baby with a wet flannel to keep them awake during feeds.  How they had flat and inverted nipples.  How the baby had a tongue-tie (my husband).  How they had to feed the baby formula (also my husband, and he turned out ok!).  I was floored.  How come no-one ever said anything about how hard breastfeeding is?!  Then it hit me - unless it is currently happening to you or has happened to you, how on earth can you ever describe the pain and emotional anguish that goes with breastfeeding difficulties, especially when you are determined to exclusively breastfeed.

This is just one example of the most valuable lessons I have learned over and over again in my (so far short) journey as a mother.  On one hand, Health Professionals will tell you what a baby "should" do as defined by the textbooks, and give you standardised advice according to their health care policies.  I have found that a lot of information (in baby care books, and on websites) talk about how nipple shields can reduce your supply - this never happened to me.  On the other hand, Real Mums will tell you what babies actually do and also provide helpful, useful and practical advice.  I have since had several conversations with Real Mums who freely admitted that using a nipple shield was the only way they could feed their baby.

The problem is that sifting through all the conflicting information and finding what works for you.  This is extremely difficult when you are sleep deprived and so deeply concerned about your little one - so when you do find something that works, go with it!

Childbirth is horrendous, but I'd do it again

I found my first childbirth experience absolutely horrendous.  Now I have had some space and time to process it all, I am sure if I had made more of an effort and prepared myself a little more from an emotional perspective, the experience or the outcome would not have changed, but the way I felt about it afterward would have been different.

I was diagnosed with gestational diabetes (GDM) and so my labour was induced when I was 39 weeks and 5 days pregnant, I was told this is because the placenta does not function as well after the 40 weeks mark in GDM, and being a public patient, I had to go with the flow.

Basically the induction process involved prostin gel, a syntocin drip and rupturing of the membranes.  This was all fine, or it was relative to what happened at the pointy end of things.

In a normal vaginal birth, the baby's head has to come down and then turn slightly to get around the pelvic bones.  If this progresses normally, there is a point at which the mother has an incredible urge to push and nothing in the world can stop her, or so I've been told.  I never had this urge. At all.  And hence after a full hour of being fully dilated and trying to push in vain, the worried looks and whispering between doctor and midwife began.

From the way they were shoving their fingers inside to feel the position of the head, and consulting together in hushed tones, I was able to figure out that my baby's head had not turned around the U-bend and was facing the wrong way. They tried to encourage me to push by the yet more shoving of fingers inside - "Push against my fingers!" and strategic placement of a large mirror on wheels (Are my lady parts really that big!?: No, they are just swollen).

After about an hour and half of this, the crack team of medicos was called in.  This is when you know things are not going well, when a senior registrar, a paediatrician and the head of the obstetrics department all arrive at the same time, and start putting on scrub aprons and bringing out scalpels and vacuum extractors and the like.  I was informed that intervention was necessary - primarily a vacuum extraction (colloquially known as a kiwi).

From my excellent vantage point with the table angled just so, feet in stirrups (I thought these were just for the movies!), I could watch the doctor pulling and tugging away while I tried to push.  He managed to work up quite a sweat, and I swear if he could have put a foot up to get some leverage he would have.

On the third attempt at extraction the pump popped off my baby's head and took some of her scalp with it. Thankfully she was delivered on the fourth attempt. I asked the doctor afterwards how many attempts are made before they consider the other options?: Five. I then asked what happens if I had not delivered after attempt five?: Forceps and then a caesarean.

Now the problem with vacuum extractions is that you more often than not need an episiotomy, which is the fancy medical term for cutting from your vaginal wall outwards with scissors.  The doctor gave me a local anaesthetic, but it didn't do jack all for me.  I've heard other people say they never felt theirs being done.  I felt mine, for sure.  There are people in China who heard me scream.

There is some contention as to whether natural tears are better than surgical intervention, but in my case it didn't really matter as I tore upwards anyway.  Upwards you ask? Yes upwards, as in up right through the inner and upper lady parts, where the fun is to be had in the bedroom.  This is great in terms of bowel continence, but rubbish for sitting on your backside and going to the toilet for about six weeks, and of course, bedroom antics.

There is more.

The third stage of labour is when the placenta is delivered, this is now "managed" in hospitals.  This means they inject your thigh with syntocin to make sure the uterus contracts enough to push the placenta off, so it can be pulled out via the cord.  As the doctor was pulling on the cord, it snapped off leaving the placenta behind.  Oh the joy! I got to have more hands on the inside, pulling bits of placenta out of me.  This is less than painless and I needed the gas the entire time this procedure was being done, about 10 minutes.

Nope, not done yet, there is still more.

Now for the stitching up and recovery phase. Once the placenta had been confirmed as wholly removed, they could repair the damage downstairs.   Once again, local anaesthetic that didn't do jack, and once again I was sucking on the gas for about half an hour.  Afterwards I asked the doctor How many stitches?: Just one, it's a running stitch. But how many times did you stitch?: Quite a few.  How many is quite a few, 10, 20... 30!?: Yes about 30.  Holy Moses.  There goes my sex life.

The normal procedure for a natural labour and birth is for the baby to remain on mums chest for a cuddle and attempt at feeding within about an hour of birth, before showering and going back to the ward.  My memory of this part is very hazy, I barely remember what happened after the stitching was finished, but by that time an hour had already passed.  I know that we did attempt a feed and it didn't go well, probably because my baby had a sore head and was feeling a bit squashed and confused. So a midwife came bearing syringes and we extracted colostrum manually and she fed it to my baby.  I got to have a shower and something to eat, and then we were ready go to back to the ward.

The thing I remember most about this part was that the only wheelchair they could find was for obese patients, basically a double width wheelchair.  For some strange reason, even though I was completely emotionally shattered by what had happened, on the way back I was cracking jokes with the midwifes about how fat I had gotten during my pregnancy and how I needed an oversize wheelchair.

When I finally got to the ward, the birth suite midwife did a changeover with the ward midwife.  This seemed to take forever, and they were a bit chatty.  I started to get frustrated.  I hadn't fed my baby yet. Why weren't they bothered that I hadn't fed my baby yet? I haven't fed my baby yet, can I feed her now?: In a moment, no rush. 

My birth experience had not been what I expected, what with my baby's head getting stuck and needing the vacuum extraction, having both an episiotomy and tearing, having my placenta manually extracted, not being able feed my baby in the delivery suite, and now the midwives were brushing me off.  I started to get a bit anxious, and repeated myself a few times. I think they finally got the message that I wanted to attempt a feed again.  So, they brought her to me (remember, sore backside, hurts to move!) and we tried to have a feed.  Immediately I started crying and crying.  Even though in that moment I had absolutely no desire to go through what had just happened ever again, I was so happy that my little baby girl had arrived safely and was alive and well.  She might have had a sore on her head and been a bit squished, but she was otherwise healthy and doing all the things a little newborn baby should do.

At the time I felt absolutely shattered both physically and emotionally, and I was appalled at what had happened to me and my baby.  For weeks afterwards, visitors would ask me How was the birth? and I would say: Childbirth is horrendous.  Now I think I was just underprepared, and I had a relatively uncomplicated birth on the balance of things.

During my pregnancy I just had not ever contemplated what birthing might be like, instead pushing all thoughts of childbirth out of my head, and adopting a "she'll be right" attitude.  I now see that I was sticking my head in the sand, when I should have been at least acknowledging that I might not have a "normal" birth.

Importantly, what if it had been worse? What if something really bad had happened, like my baby's heart rate dropping, or my blood pressure going through the roof, or a prolapsed cord, or haemorrhage, or... the list goes on.  And it happens! It happens every day, to women all over the world, they have much worse complications and lose their babies in the process, sometimes even their own lives.

I wasn't ever told by anyone how to prepare, but if they did I wouldn't have listened anyway.  You can't ever force someone to do something they don't want to do.  I didn't want to think about childbirth, and apart from the obligatory "pain relief" discussion with the doctors at the hospital, I just assumed that things would go the way they would and there was nothing I could do about it.  This might be true, but it is also quite a disempowering way of looking at things.  Now I can look objectively and say I had a difficult birth but a good outcome, now I have a lovely little bub whom I adore, and yes, I'd do it all over again.