Wednesday, May 13, 2009

Some Weighty Issues

So this isn't a picture of Lucy but in her first couple weeks of life, she was frequently weighed on a scale similar to the one above. The hospital wanted us to stay in for at least two days but we petitioned to leave a day early so we could return to the comfort of our home and not have a million different aids, nurses, residents, and doctors coming in and out of the room. By the time we left the hospital, Lucy's weight had decreased from 7 lbs 6 oz to 7 lbs 1 oz which they told us was normal for a newborn to have some initial weight loss. The hospital staff wanted us to stay the full time so that they could check for weight and jaundice but since we already had a pediatrician appointment scheduled for Lucy at 4 days old, they discharged us.

When we went to the pediatrician, we were astounded to find out that Lucy weighed only 6 lbs 8 oz! Over the course of just a day and a half, we had somehow managed to let Lucy lose another 9 oz (in addition to the 5 oz she lost in the hospital) which put her total weight loss close to 13% (they don't like to see more than a 10% weight loss) and her blood sugar was at 48 (which they actually like to see closer to 60). Brandon and I were devastated and felt like we had already failed the parenting test. And to make matters worse, we were told that we needed to supplement her breastfeeding with formula which interfered with our plans to exclusively breastfeed and introduced a bottle much earlier than we had wanted. A weight check was scheduled the next day at 5 days old.

That day was horrible as we were vigilant about feeding Lucy every two hours so she could put on some weight but she was so tired (probably from her lack of energy) that it took so much time just to wake her up. We bundled her up (because we were stupid enough in those first days not to keep her warm enough which we realized probably contributed to her weight loss as she was using her energy trying to keep herself warm) but then had to strip her down to wake her up at each feeding.

Next day weight check: 6 lbs 7 oz - she had lost another ounce and the pediatrician was hoping to have her gain at least 1/2 oz - 1 oz. Devastation again. Her blood sugar had gone up to 54 but it broke my heart to see her all withered and gray. The pediatrician ordered that I only breastfeed every other feeding because Lucy was expending too much energy on trying to breastfeed and that a bottle would be easier for her. A third weight check was scheduled for the next day at 6 days old. If she didn't gain by the next day, the pediatrician told us that we would have to go to Primary Children's Hospital to make sure that there was not a more serious metabolic issue going on.

By this time, we had rented one of these:A hospital grade dual electric breast pump. I then knew what a cow felt like but in some ways, it was a small comfort to at least be able to give her breastmilk instead of formula (and relief for my engorged breasts as well). The day was then again full of stress as we fed every 2 hours (breastfed babies are supposed to be fed 8-12 times a day or every 2-3 hours while formula fed babies only need to be fed every 3-4 hours but we were on doctor's orders for every 2 hours). This doesn't always leave much time in between as a feeding session can take 30 minutes to an hour and then you have to feed again in an hour, leaving you with hour increments to eat and sleep yourself.

The next day at weight check (so much more stressful than any college exam), our little champ weighed in at 6 lbs 12 oz - she had gained 5 oz in just one day! It seemed nothing short of a miracle. We were of course, enthralled but still not feeling completely out of the woods. I attributed the huge weight gain to the superiority of my breastmilk over the formula but it could have also been the answer to some very fervent prayers. But somewhat confusing, Lucy's blood sugar had again dropped down to 47 but the pediatrician wasn't as concerned with that anymore because of her weight gain. However, another weight check was scheduled for 8 days old.

We were finally able to calm down a bit and the pediatrician gave the ok to increase breastfeeding but every third feeding, we could only use the bottle and still had to supplement with the bottle after the first and second breastfeeding and we were still going every 2-3 hours. But by this time, new frustration had set in - Lucy wouldn't latch for breastfeeding and even though I was given the ok to breastfeed, we were increasingly using the bottle because it was so much easier for her and the only way we were getting her to feed. Cue more tears and more stress.

So it was time to bring in the big guns - instead of church on Sunday, we called on Lois Foard RN, IBCLC for an in-home visit - a certified lactation consultant and the best $50 I ever spent. Lucy had been latching incorrectly since the beginning (despite having three lactation consultations from the hospital lactation consultants but we were just so overwhelmed that first day and my milk hadn't come in yet either). Lois just showed me some better positioning and techniques and we were on a roll. Breastfeeding still came with some difficulties along the way but we were starting to see the light at the end of the tunnel. And then we were essentially told to ignore our pediatrician's orders and given new ones - get rid of the bottle and use instead one of these:A supplemental nursing system (SNS) which was pretty cool. Ours didn't look exactly like the one above but same idea - you put the breastmilk in the little container and the tiny tube gets taped to your nipple and the baby gets supplemented while she is breastfed and you can keep track of exactly how much (because one of the downfalls of breastfeeding is that you have no idea how much breastmilk that your baby is getting unlike formula where it is easy to measure in the bottle). So we were still following doctor's orders but just a little differently (to the pediatrician's credit, she had actually recommended a lactation consultation the very first day and had even mentioned the SNS but I foolishly disregarded the advice initially). By the 8 day weight check, Lucy packed on another 3 1/2 oz for a total of 6 lbs 15 1/2 oz so we knew we were on the right track and just needed to keep it up. We could already see a difference in her coloring (which thank goodness had not been affected by jaundice at all) and a little pudge coming in. According to all we read, when she went in for her regularly scheduled 2 week check, she should be back at her birth weight (7 lbs 6 oz) but she was actually 7 lbs 11 oz. Hurray - no more weight checks until her 2 month appointment!

All this seems like it happened so long ago now that Lucy is already 4 weeks old and getting bigger everyday. Breastfeeding is now relatively easy and even though it was somewhat of an initial investment (pump rental, smaller hand pump purchase, lactation consultation, SNS) and stress, I believe that over the long run, will have saved us a lot of money in formula and associated paraphernalia and is great for mom and baby. At this point, I just want to throw all the bottle stuff into a box and forget about it. And I actually, in some ways, want to forget about the whole incident written above but in some ways, it's good to remember how difficult it was initially and to see how far we've come and that it was overcome. It still brings me to tears to recount all of it (although that could just be the hormones) but also brings me some incredible joy that I can successfully breastfeed my baby and don't have to go through the hassle of preparing bottles of formula and sanitizing bottle nipples or pumping my breasts and feeling like a cow. That's not to say that I won't ever pump or we won't ever use a bottle in the future or that there is anything wrong with formula but I am just glad that I can breastfeed my baby (cause I understand that not everyone can for various reasons) and that we don't have to worry about these weighty issues anymore.


2 comments:

MamaM said...

I felt so sad for you during those days! But it was a good learning experience (for you and me) and all worked out in the end. I'm so glad Lucy is healthy! Also, you're actually a pretty good writer, Annie. Keep it up!

Grasshopper said...

trial by fire, little sister! but now you'll be a more conscientous mother and have more empathy for other moms. it is a tough task, this mothering business. but you're wonderful. i'm glad you're chronicling it - and so eloquently, too - for all of us to follow.