Daily Peep: Instant Access

She might not be walking (just) yet, but she's certainly nursing like a toddler.

Shhh - Baby Sleeping!

We've been seeing / making some changes in Peeper's sleep habits lately, but I've been scared to write about them, for fear of jinxing it.

It's been almost a month now, so I'm going to take my chances.

We've never really had big "problems" with Peeper's sleep, other than the nights that she's napped too late and then stayed up way later than we wanted.

That was mostly my fault, for allowing the nap (knowing damn well that I'd be sorry a few hours later) so I can't really complain too much.

Once she's down for the night, though, she will wake a few times to nurse (which just requires rolling over and flopping a boob in her general direction) and that's it until morning - which is usually about ten hours later.

(When I told BabyBro that, he (the father of then-six-week-old twins) said, in awe, "Ten hours?! In a row?!")

Only very, very rarely have we actually had to get up with her in the night - and that's only been when she's sick and feeling crappy and having trouble breathing while laying down (and while nursing).

Yes, we do realize how lucky we are.

The one catch to her nighttime sleep, though, has been when it happens. Because of Shrike's second-shift schedule, we've always waited up for her and then slept from like 2 am (or later, at times) to noon.

Which is fine and dandy, except that everything in the world that you can go and do with a baby - from MOMS Club activities, to story time at the library, to The Little Gym toddler time - happens at 10 am.

Evidently, normal babies sleep all afternoon, and then their big brothers and sisters come home from school, and then there's dinner and bedtime and for some reason nobody wants to play with me and Peeper at 9 pm! Or even 3 pm.

So, for quiet a while, we've been trying to figure out how to get her on an earlier schedule, so that we can go and do in the mornings, but without a lot of luck.

Then, we fell back.

I think we are the only parents of young children in the entire world who were actually happy about what the time change did to their kid!

On Halloween, Peeper just happened to get an early and short first nap, then she fell asleep while trick-or-treating, and had an early and short second nap, which set her up to go to bed about an hour early.

And the time changed that night - which added up to a two-hour shift in her bed time and wake up time.

Somehow, I managed to maintain that shift over the next week or so. We bathed around 11 pm, and were at least ready for bed when Shrike got home. Some night, she was even asleep in my lap, and actually stayed that way through the dogs greeting Shrike, and the transfer to bed.

When we went to Texas, we didn't have Shrike's schedule to work against, so we continued to keep it up, even going to bed and getting up "earlier" some nights, because of the timezone difference.

Then, we made another big shift while we were in Texas.

As I've mentioned before, Peeper has always taken her naps in my lap, usually nursing the whole time.

A few months ago, we switched to getting her to sleep for the night in bed, rather than nursing in front of the computer then moving to bed, but the naps hadn't changed.

Also, it was very difficult to leave her alone in the bed while sleeping, either at night or during the day, because she'd wake up so easily. She would get a much longer nap in my lap, so it was hard to get motivated to do anything different.

Mostly, I really like her sleeping in my lap, but sometimes I do suppose it would be handy to be able to "do things" while she's alseep, somewhere other than in front of the computer.

When we were in Texas, though, she was often in dire need of a nap, but not settling down while other people were around, so I'd take her in the bedroom and nurse her to sleep in the bed.

Sometimes, I fell asleep with her, but other times, I snuck out and left her alone with a baby monitor, and - wonder of wonders - she slept!

Maybe not as long as she would have if I could just pop a boob in her mouth when she stirred, but long enough to get the job done.

Then at night, I also snuck out of bed for a while - to get a snack, or start some laundry, or blog and check email / facebook / twitter, or just to have a bit of time to "myself."

I guess that was the thing that made it different there - although my family was around all the time, I was still 100% "on duty" with Peeper 24/7. At home, I hand her off to Shrike and can relax, knowing that she's perfectly happy, but when we're travelling, I can't leave the room to go potty without worrying that she's going to be upset about it, so those few minutes of "freedom" while she slept on her own were very welcome.

The other thing that I think really helped was the music. I started playing music while we were napping to drown out the noisy neighbors, but I've kept it up and made it part of our nap/bedtime routine.

Since we've been home, I've stuck with this new routine, and have tried to do one nap a day in bed (usually the second one; for example she's in my lap right now, having her first nap), and then we've bathed and gotten in bed by around eleven most nights.

I leave the music playing for her, and turn on the monitor and go about my business.

Yes, I would hear her cry without the monitor, but it makes me more comfortable with going to the other end of the house - where the kitchen and laundry room are. Also, I'll hear her more quickly, and can get in there and settle her before she gets good and awake.

Most nights, she's not stirred or woken enough to cry until well after Shrike's gotten home. I think the music helps a lot by drowning out the other sounds in the house - like me doing dishes (on occassion) and, especially, the dogs greeting Shrike when she gets in.

So far, we're thrilled with this arrangement.

Peeper doesn't seem to mind too much (As long as we get to her pretty quickly when she does wake up - I do still feel awful about her waking up in there alone, even if it's only for a few seconds, really.), I get some free time (maybe I'll even work my way up to cooking while she naps, or something crazy like that) and Shrike and I actually have a few minutes alone together, which is pretty novel, and rather nice.

On a semi-related note, now that we're getting up earlier, I'm trying to get out to more MOMS Club activities - sometimes even all by myself.

As hard as it is (and I do still hate walking out the door and leaving Peeper behind) I do enjoy myself while I'm there and the baby-free time is rather refreshing.

Also, I know that it's very good for Mommy and Peeper to have some time alone together, without Mama checking up on them, or poised to swoop in to the rescue.

Yesterday, I went to book club for about three hours. Things went pretty well at home, and I didn't even cry!

Shrike tells me that Peeper did have one "episode" during which she was crying and was signing "milk" at her (Knife in my heart! But also, so proud of her!) but then she settled down, and when I got home, they were both asleep in the bed!

It seems that they were reading books in Peeper's room, when Shrike noticed Peep's head bobbing up and down. She put her in the bed, and she was out.

This morning, I went to a MOMS-only coffeed (At Starbucks! In Target!) and they stayed home again. This trip was much shorter, because I had to get home from Shrike to go into work early (early deadline tonight, because of all the Black Friday inserts going in tomorrow's paper).

This time, when I picked Peeper up to say goodbye, she just waved at me like, "Yeah, whatever, Mama. Check ya later," and Shrike said she was just fine the whole time I was gone.

If this goes well another time or two, we might even have - gasp! - someone else watch her, so we can have - gasp! - a datenight or something.

Daily Peep: Greek Gunk

I suppose Peeper ought to learn to use utensils eventually, so in an effort to work on the spoon concept, I bought some Greek style yoghurt, which is about the consistency of sour cream.

My British baby feeding friends are all about it, because it sticks to the spoon well.

And to the baby. And the table. And the pajamas. And the dog.

And way more of the live-action version of this than you really care to see:

Daily Peep: Target!

Daily Peep: Home Again, Again.

Peeper and Mommy playing with cars.




And kickin' it old school.

Carnival of Breastfeeding: Your Breastfeeding Experience in the Hospital The Nipple Intervention

Welcome Carnival of Breastfeeding readers!

This month's theme is "Your Breastfeeding Experience in the Hospital."

Please visit the other carnival participants, listed below.

(More entries will be added through the end of the day on November 23, 2009, as they are posted - check back!)

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The following is a letter that will probably never actually be sent.

My therapist, Dr T, actually suggested writing it several months ago, after we'd spent a good bit of time discussing how traumatized (her words) I was by the "nipple intervention" - as I refer to the "conversation" that I describe in the letter.

I wrote my breastfeeding story several months ago, and that went a long way toward helping me to "let go" some of my anger, but the idea of an actual letter to the people responsible has been in the back of my mind since then.

When I saw this month's topic, I knew that this was the push I needed to actually write it.

If, through some miracle of the Powerball and assisted reproductive technology, I were to find myself preparing to deliver another baby in that hospital, I would definitely not only send the letter, but also schedule a meeting with the medical director to discuss it in person.

I can't imagine going through a pregnancy and labor with the possibility of a repeat of this experience hanging over my head.

Even a year later, I am still very angry about not only the bad advice we were given, but that what should have been a simple conversation was handled so unprofessionally, and turned into an unnecessarily traumatic experience.

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To the Medical Director of MyCounty Pediatrics:
(cc to Hospital Lactation Consultants, Risk Management Department)

I am writing to share some concerns that I have about how my daughter's care was handled, and how I was treated, during our hospitalization after her birth.

To refresh your memory, Peeper was born on October 27, 2008, at 36 weeks gestation, in a non-medicated vaginal delivery, with vacuum assistance. Her birthweight was recorded as 5 lb, 4 oz.

I was very eager to get her started breastfeeding, and when she was less than enthusiastic about it that evening, I asked to see a lactation consultant as soon as possible.

LC#2 visited us the next morning, and one of the first things she told me when she walked into the room was that, "Most of our preemies need to be supplemented. I recommend a breast pump and a nipple shield and she may need some formula."

As Peeper had recently nursed, she did not observe us nursing at all, nor did she check Peeper's latch or suck with her finger.

A while later, both a breastpump and a nipple shield were delivered to my room, with little or no explanation of how to use them.

When Peeper was about twenty-four hours old, her weight was 4 lb 4 oz, and when you examined her you told me that you suspected the birthweight to have been off, since "this doesn't look like a baby who's lost a full pound," but that we'd have to assume she had lost a full pound, and go from there.

According to several different sources, I now understand that it's not uncommon for babies whose mothers have received IV fluids during labor (as I had) to be over hydrated at birth and to safely lose well over 10% of their birthweight, but it did not seem that possibility was taken into account at the time.

Assuming she had lost 20% of her birth weight, you said that we would have to start supplementing her, with breast milk if possible, or formula if "necessary."

I was very concerned that introducing any artificial nipples would jeopardize her ability to breastfeed by creating nipple confusion, so we began by finger feeding her using a supplemental nursing system, and also used the SNS at the breast, when she was willing to latch.

I was also very strongly against her receiving any formula, but you required that she take in a certain amount of milk, supplementing with formula if I could not pump that amount.

I don't remember the exact amounts, but after two pumping sessions, I think I got about five or six milliliters, and you wanted Peeper to have fifteen, so we mixed it with about ten milliliters of formula.

However, by the next feeding, I was able to pump enough to match the amount that she was required to take, so I feel that had we been given just a bit more time, we could have avoided her receiving any formula at all, as was my goal, which I'd very clearly stated, both to you and your staff and to the lactation consultants.

Peeper was born on a Monday afternoon, and on Wednesday afternoon, I was discharged and she was transferred to the Pediatric ward, where my partner Shrike and I roomed in with her.

The routine at that point was that, every three hours, I would put her to the breast and attempt to get her to latch, usually using the SNS, and then Shrike would finger feed her expressed breast milk while I pumped for the next feeding.

On Wednesday, it was determined that Peeper was jaundiced and she began phototherapy. That evening, she was hypoglycemic, and received glucose (also finger fed with the SNS) which brought her blood sugar back to an acceptable level.

On Thursday, I made several requests for the lactation consultant, but it was evening before she made it to the Pediatrics ward to see us, and she'd just arrived when Dr. L. came in to talk to us.

Of our entire hospital stay, it is this conversation that bothers me the most. I feel that it was not handled professionally, nor were we fully informed of the options available.

Peeper had been having trouble keeping her temperature up, while laying under the bililights in just a diaper, so the heat in the room had been turned up, and I was sitting on a chair in the corner of the room, directly under the ceiling heat lamp, making it even hotter.

Peeper was in her bassinet, and Shrike was somewhere on the other side of the room. In the tiny room with us were the lactation consultant, the pediatrician, Shrike's mother and sister, and one or two nurses.

Dr. L. started by saying that "I know that breastfeeding is important to you, and it is the best thing for Peeper, so we definitely want her to do it, but . . . ."

She told me that both breastfeeding and finger feeding were too much work for Peeper, and she still wasn't keeping her blood sugar up like she should, and we had to get milk into her more quickly, so we were going to have to give her bottles.

I expressed a concern about using artificial nipples, and the lactation consultant said that we could use Nuk nipples which "are much less likely to cause nipple confusion."

When I asked if there were any other options, Dr. L did not suggest either cup or syringe feeding, either of which, I have since learned, would have been appropriate solutions, and would have avoided the risk of nipple confusion.

Shrike was neither being consulted by Dr L, nor was I even able to discuss it with her, as she was on the opposite side of room the whole time.

Because of the large number of people in the room, including my inlaws who were being very unsupportive of my desire to exclusively breastfeed Peeper, and the fact that no alternative feeding methods were even being acknowledged, I felt that I had no option but to agree with what Dr. L was "suggesting," although it went against my desires, against all recommendations for avoiding nipple confusion and against my better judgement.

I feel that I was not so much consulted, as I was intimidated into agreeing with Dr. L's opinion that bottlefeeding was the way to go.

A more appropriate way to have handled the situation would have been for Dr L to have spoken with me and Shrike alone, not with our entire family and several of the hospital's staff in the room, and for her to have given us a complete list of the options for alternative feeding methods.
I would have happily agreed to cup or syringe feeding, which would have just fed Peeper just as efficiently, without introducing artificial nipples and jeopardizing her ability to breastfeed.

Over the next day, Peeper's blood sugar stabilized, and her weight continued to go up, and we were discharged on Saturday.

The bottles had been successful in getting the milk into her more quickly and easily, but as I'd feared, she had become nipple confused, and was almost completely refusing the breast by that point.

For nearly six weeks, I pumped and bottlefed Peeper almost exclusively, with her only latching and nursing occassionally, although I was offering the breast several times a day.

During this time, I suffered incredible nipple pain, not only when I was pumping, but constantly.
I attribute this primarily to a lack of training in how to properly use the breast pump. I was not fitted for properly-sized pump flanges, and was not told how to adjust the pump suction.

Too-small flanges and too-high suction during the first week seriously damaged my nipples, and they were unable to heal until I stopped pumping completely.

Thanks primarily to the advice and support of my La Leche League leader, I stuck with it and eventually, Peeper was able to latch using a nipple shield, and stop requiring bottles when she was six weeks old.

Once she was finally able to breastfeed on her own, she has never looked back, and has been bottle-free since then, other than immediately following her open-heart surgery.

She was exclusively breastfed until just past six months and now, at almost thirteen months, still nurses quite frequently. It is my hope that she will continue to breastfeed for at least the full two years recommended by the World Health Organization.

However, had I not had the support of La Leche League and had I not gone into the situation absolutely determined to breastfeed, I very well might have given up before she ever learned to latch.

I dare say most mothers would have.

During Peeper's first six weeks, I did a great deal of research on nipple confusion, and found very little advice on how to correct it, but a great deal of advice on how to avoid it, all saying essentially the same thing:

However, using an artificial nipple (i.e., any nipple that's not attached to mom) to feed a young breastfeeding infant is likely to lead to nipple confusion. The sucking technique which baby learns from the rubber nipple does not work at the breast, and baby quickly becomes frustrated. This is why bottles are not the best choice for giving supplement to infants less than four weeks of age. Alternatives include cup-feeding, spoon-feeding, an eyedropper or feeding syringe, or a nursing supplementer. (Dr. William Sears)

If at all possible,delay introducing the bottle until the baby has well established nursing and latch on skills. If baby must receive supplements early on, use a Supplemental Nursing System, feeding cup, medicine dropper or spoon to feed baby. (Dr. Jack Newman)

Breast and bottle feeding require different oral-motor skills, and rubber nipples provide a type of "super stimulus" that babies may imprint upon instead of the softer breast. As a result, some babies develop suck confusion and apply inappropriate suckling techniques to the breast when they switch between breast and bottle. (The Breastfeeding Answer Book)

Last on the list, but most often thought of first in discussions of supplementation, is bottle-feeding. The timing and frequency of these feedings are most often implicated in later problems with breastfeeding (Neifert, Lawrence & Seacat 1995). Therefore, bottle-feedings should be avoided or delayed until after the baby is well acquainted with breastfeeding and accomplishes it with ease. (La Leche League website)

If this simple, well-known advice had been followed by Peeper's pediatricians, I might have been spared a great deal of pain, both physical and emotional, and we might have been able to spend our first six weeks as a family concentrating on bonding with our baby, rather than on trying to correct a problem which never should have been allowed to develop in the first place.

Over the past year, we have been generally pleased with the care that Peeper has received at your practice, and I hope to continue this relationship, but I just could not let these things go unsaid any longer.

I hope that you will discuss my concerns with Dr. L and the other pediatricians on your staff, and that in the future, you will offer families more breastfeeding-friendly options when babies are not successfully nursing.

I also hope that you will be more sensitive to the needs and emotions of new parents, and will hold these sort of discussions in private, so that the parents can make decisions for themselves, without undue pressure and influence from family members or medical staff.


Thank you,
Whozat

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Other Carnival of Breastfeeding Posts
(Keep checking back - more will be added through the end of the day on November 23, 2009)

• Breastfeeding Support: A Tale of Two Hospitals - Hobo Mama
• My Hospital Experience in Norway - Momma's Angel
• Newborns, nursing, and hospital(ity) - The Milk Mama
• Breastfeeding Experiences in the Hospital - Breastfeeding 1-2-3
• Had a good or bad experience in the hospital? Tell them! - Motherwear Breastfeeding Blog
• Breastfeeding in the Hospital - The Beautiful Letdown
• Top Tips for Breastfeeding Success - Breastfeeding Mums

Any Day Now

People have been telling us for months that Peeper is "about to walk," but I think she really is now.

You saw the video from Wednesday, of her voluntarily (with coaxing) letting go and taking a few steps, and she's been doing that more and more.

Since we've been at the conference, I think she's had a lot of incentive to try to go places on her own, because there are lots of other babies to go check out.

Last night, she stood up for at least a minute or two, just like it was the most natural thing in the world.

A little while later, I was sitting in the floor, and she was sitting on my leg, and before I realized what was going on, she'd stood up (just like an adult would pop right up out of a chair) and walked about two or three steps over to another baby.

I was like, "Whoa! You're not supposed to do that!"

Today, she's been standing unassisted a lot more, and taking some more steps.

There's a twelve-year-old boy here who's taken quite a shine to her, and has made it his goal for the weekend to teach her to walk. This afternoon, she was very happy to walk back and forth (about four steps?) between us, which just made his day.

Then, this evening, she took off from my lap and walked several steps, almost to a little kitchen toy (the exact same one our library has, actually).

She made it almost there -about 2 steps away, and I think she realized what she'd done and sort of panicked.

She stopped and crouched a bit and kind of swayed back and forth and then plopped down on her booty.

It was quite impressive.

I think our days are numbered.

Daily Peep: Making Friends

This little girl is exactly a month younger than Peeper, but they are exactly the same gestational age.

The actually played fairly well "together," although they did take toys away from each other, and pat each other's heads and faces a bit roughly at times. No tears, though, so I consider that a success!



On a semi-related note, I think that Peeper is signing "gentle."

Or maybe she thinks she's signing "baby" or "cat" or "breakable item?"

I use that word all the time, when she's petting animals (or cousins) or well, doing anything that she should do gently.

I have, in the past, signed it, either myself or "onto" her.

(It's a finger stroking the other arm gently. I usually stroke her arm, so she can feel what "gentle" should feel like.)

I don't know that I've actually signed it very much recently, but a couple of days ago, she was petting the cats, and I was telling her to be gentle, and she started rubbing the back of one arm/hand with the other.

(Not gently at all.)

There are a lot of baby signers here at the conference, and when I've recounted that story, several different people have told me that their kids would use signs that they'd not seen in quite a while, too.

It is definitely a sign of some sort (whether or not she actually means "gentle") because she's done it repeatedly, and in exactly the same way.

She has used it "in reference to" other babies (lots and lots and lots of other babies here to see and sign about!), so I'm not exactly she what she means by that.

However, she also signed it when this little girl patted her on the head, or was checking out her hair or something. (And it was just a pat, she was not hitting her.)

Maybe she was just saying "Hey, there's a baby!" but I like to think she was saying, "Hey, easy there, kid, that's my head!"

She also signed it one time while I was in the middle of getting her in the wrap. Coincidence, or was she telling me that I was handling her too roughly?

(The last little part of the process does pretty much require snapping her legs off at the knee, then sticking them back on.)

This signing this is really taking off. I can't wait to see what she learns next!

Daily Peep: Room Service

Peeper and I are at the Eastern BlueState La Leche League Conference. Tonight was just meet-and-greet stuff, and the actual sessions start tomorrow.

So far, it reminds me, in a way, of the first time Shrike and I went to a pride festival.

With, you know, less gay people and more boobs.

But, in the sense of suddenly being one of many, instead of one of very few.

I've already seen more nursing babies this evening than I have in, oh, let's say at least since Peeper was born and I joined the club.

Here's Peeper having a pre-bedtime snack of Cheerios in our hotel room.

And here she is after her bedtime snack of goody.

What's on the iPod? Well, when I took the photo, she was actually listening to "The Girl With The Flaxen Hair" by Claude Debussy.

Fitting, no?

Congratulations, Dr. T!

Whoops - I meant to say something about this when I first got the news, but the email arrived literally while I was on the plane to Texas, so I got distracted.

Dr. T had her baby on November 6, and everything went well. She reports that he's doing very well and is "nursing like a champ."

(Because you know she knew that would be my first question!)