Miss you already

Today Matthew headed back to work. We miss him already!

Before Matthew headed out we bundled Grayson up and took him on his first stroller outing – a walk around the block. It was a bright (but cold) day and we even convinced our dog to join us. To say Mugsy is a reluctant walker is an understatement, so that was pretty impressive.

Grayson and I have since had a nice afternoon and evening. We even managed to sneak in a nap between feedings and confirmed our place on the waiting list at our first choice daycare. He is napping now and I am going to try to do the same.

Let’s hope this transition day becomes habit. I could deal well with many more like this one.

Diapers!

Diapers and diaper accessories – a review, so far.

Diaper Disposal – We have figured out that there is no wayyyyyy our diaper genie disposal bags hold the number of diapers claimed. Either that or we have no idea how to use this thing properly. We blew through that first set of bags in no time. However, this did result in Matthew making the find that at Walmart carries the arm and hammer brand of refill bags, which are cheaper and smell better than the original diaper genie brand. Overall, I have no complaints about the disposal unit itself – certainly it seems to contain any bad smells.

Wipes – We bought 2 giant cases of Huggies Natural Care wipes on sale at Walmart (we were prepared to price match elsewhere, if need be). I have to say these wipes win my vote so far. Our little guy seems far less irritated by them and I find they are thicker and do a better job cleaning than the ones we used before. I can’t even remember what kind of box wipes we had before (thank you lack of sleep), but they didn’t impress me. At the hospital we used some spray and these plush paper towel like cloths – that worked pretty well, too. One of the nurses said she swears by warm water and a cloth, which I can see being effective in some poopy situations. However, if you are willing to pay for the convenience – wipes are much easier.

Diapers – we skipped right over the NewBorn (NB) size diapers and went straight into Size 1. So far we have tried 3 brands – Huggies, PC and Pampers. Why all 3? We were gifted a variety by lovely people whose babies had outgrown the size ones. My rating so far – all are pretty good.

PC are cheaper and are very effective. The one drawback when compared to Pampers or Huggies is that there is no colour indicator for a wet diaper. Overall, I liked these, but I definitely appreciated the colour indicator diapers during the first days at home because they offered us certainty about the number of pees our baby was doing (a question asked at every follow up appointment we have had. Also, in NICU they actually weigh the diaper to see how much urine is expelled in relation to feeding amount and IV fluids).

Huggies work well to contain messes and have a colour indicator for urine. They are often on sale at a major grocery and so if you price match, you can probably get them on sale regularly. They are also available at Costco so that makes buying them convenient, if you shop there often.

Pampers work well and have a colour indicator, as well. The one drawback we have found is that the mesh-like lining sticks slightly to our baby. It doesn’t seem to upset him much, but it is definitely happening regularly.

Change Mat – we vote buying more than one of these to throw down on top of your change pad. The change mat is now better known as the “oopsies mat” in our house. It’s a good thing these are machine washable because once the diaper is off there are sometimes messy accidents.

(none of these statements are endorsements, just our observations so far)

Followed Through

Grayson is 2 weeks old and has made it through his follow up appointments.

He is perfectly healthy and will not require any further specialized follow up. We are very happy about this 🙂

Today’s final follow up visit was from a Registered Nurse from the Region of Peel. It provided another perspective about Grayson’s health and mine, as new baby and mom. So far, so good.

Each follow up we have had has been thorough, but different. Aside from the evaluation of Grayson’s health, these appointments have provided us with access to professional opinions and knowledge of the resources Grayson and I can access when we are ready. There sure are a lot of resources!

There do not appear to be clear cut guidelines about when Grayson can venture out into the world. Generally, the idea is keep him away from germs (e.g., sneezing, coughing, fevers, unwashed hands), crowds and extreme temperature. We are thinking we a walk around the block might be doable on a day that isn’t too cold, with his proper clothing on. We intend to wait on the crowds, outings, visits to other spaces than our home until we feel comfortable and  Grayson is a bit older.

The great news is there is a lot to look forward to in our neighbourhood, which is exciting. For now though, we look forward to any nap time we can sneak in and making sure Gryson gets some tummy time each day….trickier than one might think, since he sure loves to sleep and eat!

Time Blur

Time is a blur at this point for me.

There is the obvious blurring – where occasionally I wonder what day it is and what time it is. But that only really matters if there is an appointment we need to get to.

The bigger blurring is the challenge to keep up with what happened when, hour-by-hour in just a day. We have resolved to record feedings and diaperings – something we had begun while in NICU. For me, my mind can’t keep track of things right now, so if it isn’t on the paper it may as well not have happened. This extends to self care too; it is currently 11:20am and I know I was up feeding Grayson 3 times through the night because I wrote it down. I know i took some Advil and Tylenol, fed and walked the dog because I also wrote that down. I don’t know what or if I ate. Sometimes I can infer based on the dish or granola bar wrapper left behind. I guess I need more lists.

It’s the itty bitty minutes of sleep that have taken a toll on my mind and my body. This is hard. With the reintroduction of pumping at almost every feed those minutes have become even more precious. The honest truth is, I know I often wonder if I didn’t eat, should I bother or just try to sleep? Crazy what takes weight. I know it doesn’t stay like this forever – it wouldn’t be humanly possible to keep this up. In the meantime, some I have some tough calls to make.

Battle to Breastfeed

Today has been a tough day on the breastfeeding front.

Since our first appointment last week at the Breastfeeding Clinic (BFC), Grayson has steadily been breastfeeding (with a shield) during daytime feedings and it has been going well. Yesterday at BFC he even latched without a shield.

Today….he has other ideas.
Each time I have brought him to feed he has engaged for about 10-15 minutes in total – with burbs, snuggles and changes as efforts to try to re-engage him. Nope.

The outcome of the screaming, punching, kicking and general “nooooooo!” bring dished out by this little human is his bottle to finish eating. And he will happily take that. He eats it up and seems to be quite content. To date he has had no real problem switching between breast and bottle, but today has me worried.

Today’s battles to feed have been trying. I hope this stuggle resolves. Upset baby is hard. Upset baby and discouraged mom is double hard. But in trying to keep perspective, he is fed and he is healthy….either way. Keeping that at the forefront is key to keeping our spirits up.

Postpartum IDKs

Things I now know and can offer to moms-to-be…

  1. Extreme Thirst – Since delivery I have been the thirstiest version of myself. And this is perfectly normal. If you are breastfeeding and/or pumping you are losing a lot of fluid. My doctor recommended that every feeding I drink at least an entire glass of water. I can tell you, I can do that and then some (as long as it is within arms reach).
  2. Swollen Feet, Legs, Hands and Face – I never had much swelling while pregnant, but postpartum I was (am) swollen! My feet looked like I had tensor bandages on under on socks and I had to leave the hospital in my slippers because I couldn’t get my boots on. Glad we brought those hard soled slippers.
  3. Sweat – Much like changing our baby’s onsies, I find myself changing almost as often because I am sweating nonstop, especially when I am sleeping. My Doctor said that is perfectly normal but all the more reason to drink as much water as you can.
  4. Overpack – I regret following the advice of sites and pins that suggested bringing only the essentials in our hospital bag. I recommend bringing more than you think you will need. Sure, it is a hassle to cart around for your partner (or whomever) but ultimately I believe it beats having to have that person leave to go restock if you find your stay is longer than planned.
  5. Bring Lanolin Ointment – I never thought I would be pumping on the birthday of my son, but sure enough I was. I didn’t pack lanolin but was lucky to be given some freebies from the hospital to tie me over until the onsite pharmacy opened. My personal preference is Lansinoh (no endorsement). I tried this and Medela, I found the Medela too slick; it made it hard to properly use the pump and shield.
  6. Milk Mishaps – I should have asked a nurse or lactation consultant for help with pumping sooner (or latching, but they were on top of that). It sure would have been better than hoping it’s all good and hurting my tissue, which may have interfered with milk production/collection. If you pump be careful trying to get that last drop out before you seal the container…my tapping resulted in a spill of more than a drop -,-
  7. Pump Settings – I didn’t know that a breast pump has settings. It does. I was assured by one RN I just needed to turn the power on and go…. The LC later informed me this may be why I was having a hard and painful time as the settings were too high!
  8. Comfortable Shoes – My partner offers the advice of making sure support people/ labour coaches wear comfortable shoes. Although the discomfort is nothing compared to giving birth, the person (if like Matthew) will be standing basically the entire labour.
  9. Slow Cooker – A genius invention that has mostly sat in our cupboard until now. We found a few easy recipes and are doing the fill and forget method of cooking that this appliance allows. Highly recommended.

New parents out there, what did you not know that you can now share with soon to be parents?

Feeding the Tongue Tied

Feeding a new baby is a hot topic in parenting. Everyone has an opinion and every new parent has expectations, which may or may not pan out.

I am not offering an opinion on breast, bottle and/or formula, only offering my honest experience with all 3 so far.

Because Grayson was admitted to NICU upon birth we did not get to start trying to breastfeed as quickly as most moms get to. I felt awful because I thought that I needed to get him to latch within the first hour. But, rest assured, every medical professional assured us that delaying his latching was okay! Grayson had an IV set up so that extended the window of time before he needed to be fed. The hospital honoured our desire to breastfeed and so we waited.

Once he was settled into NICU (and after I was transferred to recovery) I tried to breastfeed. Grayson was not having any of it. He screamed, yelled, bit, scratched, kicked and punched and yet we tried…and tried…and tried. We had the support of the nursing staff (RN) and then of the hospital’s Lactation Consultant (LC). This went on for hours. It certainly was not helping that he was being poked and prodded at with needles for IVs and blood sugar – that made for a hard time keeping him settled. It was really hard on me too. I had waves of feeling terrible. But fortunately the support of others to remind me that this wasn’t a reflection of me as a mom or of Grayson and my bond helped me to rebound emotionally.

We continued to put off introducing formula. That being our decision, the hospital staff set me up with the tools to start pumping. My first time pumping produced about 50 mL of colostrum (apparently that is a lot). As the literal end of day approached, we made the decision to provide Grayson with the breast milk from a bottle. A success, which we would then try to repeat.

Pumping and trying to latch meant that our schedule went like this: Every 3 hours Grayson and I (plus an RN or LC and/or Matthew) would engage in a 20 min plus wrestling match trying to get him to breastfeed. Minimal luck. Then we would provide the bottled breast milk, which would require about 30+ minutes, inclusive of burping. Then settle Grayson to bed and then return to Postpartum (a short walk if you hadn’t just delivered a baby ;), where I would pump 15 minutes on each side. Add in cleaning and sanitizing, having some food and water, and the walk back to NICU and I was looking at less than 40 minutes to rest between feedings. That was really hard. I felt stressed, self-imposed pressure and I was in pain.

The next few times I pumped I collected less and less colostrum. That only elevated my feelings of frustration and inadequacy. Again, though, support people were key. I rebounded each time and persevered.

Ultimately, I had to make the choice to top up Grayson’s feeds with formula. Still upon doing that, the feeding routine didn’t change; it was only altered to include bottle feeding breast milk and/or formula. Thus the incredibly short gaps between feedings didn’t change either.

Sometime in the early morning on Saturday it was mentioned that Grayson may be tongue tied. This is when the tongue is not easily lifted up and/or extended outward due to the frenulum (skin under the tongue) attaching too close to the tongue’s tip. This impacts latch, which impacts ability to feed. We were told it can be corrected but it is no longer done at the hospital and so, nevertheless, we continued with our painstaking feeding routine.

Attempt to latch. Bottled breast milk. Bottled formula. Burp. Settle. Pump. Repeat.

Skipping ahead to our first day home I was so sore that I could I barely stand it. My milk was coming in, but I was having a hard time pumping. But we kept going – believing the advice that the best way to resolve engorgement is to breastfeed, hand express and/or pump.

Upon discharge, the hospital had arranged an appointment for us with a Breastfeeding Clinic that also corrects tongue ties. We attended the Clinic on Wednesday morning. The Doctor we saw was very concerned as I was in a tremendous amount of pain and my breast tissue was very red. We marked the redness and scheduled a tongue tie snip and follow up for the next day, which would result in prescribed antibiotics if the redness persisted/worsened.

While we were at the Clinic the Doctor showed me how to rub out some of the swelling. It was PAINFUL! However, she assured me that it would subside when/if we got the milk ducts unblocked. While we did this, we got Grayson to latch using the help of a nipple shield. HOORAY!

After we left the Clinic, Grayson latched onto the shield each feeding. Then I would pump and rub out the swelling. I continued this for most of the afternoon and night and by the time we saw the Doctor the following day my breast engorgement and pain was almost 100% remedied! YES!!!!!!

Grayson had his tongue tie snipped on Thursday. That was hard to watch. He took it like a champ. Cried briefly and then was able to latch to the shield with his new and improved tongue.

Since the tongue tie was snipped things have been down and are now on the way back up. Initially it seemed the pain under his tongue had created a new barrier to consistently latching. This created a need to intensify the latch, bottle, pump routine. I was feeling the impact. It was wearing on me.

Fortunately, our Family Doctor came for a visit on Friday and we talked through the routine and how I have been feeling and (not) sleeping. We resolved to augment the routine. So now we do as follows: Latch to the shield and feed for as long as possible then top up (if need be) with pumped milk or formula.

As of this afternoon I have pretty well stopped pumping, as this will only intensify the supply and demand, and as a result create repetitive engorgement.

I will be heading back to the Clinic Tuesday. I presume to begin to transition away from using the shield. Another adjustment.

Feeding is hard. Breastfeeding may be the best, but for all the moms out there who struggle to get their baby to latch, I believe we can relate to one another. This sometimes feels impossible and like a standard that is unattainable. It is frustrating and then there are small gains, which are wonderful but sometimes few and far between. I am trying to stick this out, but I can’t say whether that will last. Controversial, I know.

I am grateful to the people who continue to remind me that everyone has different viewpoints about feeding, but ultimately a fed baby, who is gaining weight is a healthy baby.

Grayson (as of Friday) is 8lbs5oz. I will chalk that up as a giant success.

 

 

What We Learned in NICU

We were admitted to the NICU

It is pretty incredible that I can say that most terrifying experience was at the same time so rewarding. The memories and meaningfulness of the time we spent at BCH is invaluable.

We learned so much.

Probably the biggest thing that our experience reinforced is that it was so critical to have no plan and honor that. As we say, que sera sera.

The other thing our time in NICU made quite evident is that when people say everyone has different ways to parent, they are right! We saw differences in every RN, and all were awesome in their own ways. That has brought some confidence to us now that we are home.

The last thing that stands out is that we have some perspective on what is an emergency. We got to observe the responsiveness of highly trained staff, and I know that for myself that was priceless.

Now that we are home I still feel calm, as opposed to anxious. Certainly emotional at times, but those emotions are focused on the positives and if they go awry, Matthew is here helping me stay true to my intentions. This adventure has already shone its light on the key role of mindset. 

I remember that Matthew and I laughed when, during the pregnancy, we found out my blood type is B+…. really it is fitting. 

Human Elements

The Human Elements

Outside of Grayson getting the all clear, I believe the most relevant part of this journey so far is to make mention of the glue that held things together – the people.

Beginning first with those with whom I have a history:

First and foremost, my partner, Matthew. Without him I would have derailed long before things got really scary.

And also our closest family and friends. Thank you for the love, support and space we needed to process and persevere.

Then there are those individuals we encountered through their professional expertise and our circumstances: the incredible staff at Brampton Civic Hospital and those they referred us to.

We want to acknowledge their collective support, which was essential to us throughout Grayson’s life so far! Their person centred approaches have made all the difference in the world.

It is pretty incredible that I can say this most terrifying experience was at the same time so rewarding. The memories and meaningfulness of the time we spent at BCH is invaluable.

Without exception, from admission through discharge and now being at home – the professional support and personal approaches of our Health Care providers has been amazing. Thank you to all of you.

Key to our Care – 

Additionally, there are a few people who have especially stood out and so I offer a few words to each of you.

Dr. Hall –  (who delivered our baby) thank you. Your read on me and my needs from the moment we met made me feel comfortable and safe. I am someone who has struggled with balancing my desire to have physical and emotional privacy while doing what I know I need to. You understood that without me saying so and for that I could not be more grateful. It was such a privilege to have you deliver our baby and a blessing that he was born before you had your shift change. Thank you, too, for your calmness and reassurance when Grayson showed distress and for your follow up care. Your kindness, honesty and support is a real gift to our family.

Lauren – (the RN who provided tremendous care) thank you for being there with me from epidural to almost the birth of our baby boy. I appreciated your kindness and commitment to the best care throughout our labour and (almost) delivery.

Jackie –  (the Lactation Consultant) you made our time at BCH more comfortable with your sincerity and support. I looked forward to your visits and appreciated how responsive you were to our baby and I. Also, a HUGE thank you for even arranging for Matthew to attend the breastfeeding class with me and the other new moms in postpartum.

NICU staff –  what a team. Thank you all for the commitment you have made to providing care to beautiful babies and to families. Each one of you brought a level of care that we believe went way beyond job expectations to support us.

 

Our Birth Story

Let the Induction Begin
We went to Brampton Civic to Labour & Delivery for 8 am and began the process of labour induction on Thursday Jan. 12. In our case I was already experiencing contractions, so this meant applying gel internally to create a more favorable cervix. After the gel was administered, we were monitored for about an hour. Then we got to go home, with instructions to return in 6 hours from the gel application (or in some other specific circumstances). We were told by the RN that this process can be repeated up to 3 times. We came back for 2:30 pm for a repeat. By the time we saw the Doctor it was looking like a return for 10pm.
Other Ideas: Early Labour
10 pm….nope. Grayson had other ideas. Matthew called BCH at 7:30pm to clarify about contraction timing and based on what was happening (intense, frequent contractions) – we were told to return to the hospital.
When we arrived all the beds were full so we had to wait. Ha! Waiting while having contractions that seem to have hardly a break in between is easier said than done. Matthew was the most amazing support during that time – He helped me to breathe, remain calm, keep fed and hydrated when possible and promised no more making me laugh.
At 9:10pm we decided to storm the nursing station! We were then given a room.
When our exam happened we met the Doctor, Dr. Hall, from our Family Health Team, who would be doing the deliveries up until 8:00 am. I was so out of control by the time I met her (i.e., having a full blown panic attack), I almost lost it.
Thank Goodness for Matthew advocating for me as I needed some physical and mental space to calm down. Dr. Hall, too, had such a good read on me. I could only hope that she would be the Doctor from our Family Health Team to deliver our baby. Once we got through the exam,  we were ready to be admitted. Go time.
Labour and Delivery
Neither Matthew or I thought the birthing room would be the way it was. We are not sure what we thought it would be like… In any case it was private, spacious, bright and had big windows along one wall. Beautiful.
Once there we met the RN who would be on and providing care for us through until 7:3o am. Her name was Lauren and she was a tremendous support through the whole process. Matthew had to leave the room for them to put in my epidural because it is a sterile process. Luckily Lauren was there with me and held my hand the whole time.
Once my epidural was in I was much more calm. Grayson’s head was already low, so we waited and rested some and then, at about 1 am, Dr. Hall broke my water. After that things picked up and eventually it was time to start pushing. Even with the epidural I could feel the contractions coming and so I was in a good situation. Dr Hall and Lauren were happy that I could push and sense how to do the “right kind of pushing.”
Lauren and Matthew coached me through much of the pushing. Dr. Hall checked in often. When it came time to actually deliver Grayson it was the shift change for nurses. The woman that took over was named Maryanne, and she, too, was great.
Just before 8 am Dr. Hall came in to deliver Grayson and we planned for a controlled delivery. That was a success. I felt so relieved that Grayson would be born before the doctor shift change.
It was during the final stages of delivery that the biggest scare of my life started.
My scariest Moment 
As I did the final pushes, all of a sudden Grayson’s heart rate went up really high, so they called in the team to stand by. When Grayson was successfully delivered (at  8:01 am) I never heard a sound from him. Immediately the team took him to the table to the right of us. I was terrified. I panicked. Thank goodness, again, for Matthew and Dr. Hall. I do not know how they (especially Matthew) were able to put aside their own fear to support me when I needed them most.
Terrified and Trying to Stay Calm 
Upon delivery, Grayson had meconium in his nose and face and he had a high heart rate (called tachycardia). There was some concern about him having inhaled meconium. Once the urgent emergency was resolved at the table in our birthing room, Grayson and Matthew went with the team, led then by Dr. Dwight, to the Neonatal Intensive Care Unit (NICU). It ended up that they returned quite quickly and I was then able to hold Grayson for the first time. YAY!!!!!!
Back to NICU
Shortly after Grayson and I met face-to-face he ran a temperature. That meant he had to go back to NICU. Matthew went along. I had to stay in recovery. They explained to me that Grayson would need some blood tests and a lumbar puncture. There was not much to say expect “okay”.  As it ended up Grayson is a fighter. He would not give in easily to the idea of being poked and prodded. It took 4 staff to hold him still to get his blood. They never did the lumbar, because he would not allow them to do it.
Waiting for Results
Then it was a waiting game. The blood tests were to take 48 hours, so we knew then that Grayson would be staying until Sunday, earliest.
I was transferred to Postpartum. Once settled there we headed over to visit Grayson in NICU. They gave us an update – GOOD NEWS – upon admission he was put on an IV and antibiotics and his breathing and heart rate were all stable. THE BEST NEWS…This remained the same from then on.
Matthew and I visited Grayson often and we fed him in his room every 3 hours. I was so relieved that NICU provides so much to try to make things as normal and as comfortable as possible.
Waiting for Results
 
I was released from Postpartum on Saturday at about noon. I was worried about what would happen since I was released but Grayson was not. But the hospital staff had arranged for us to move from Postpartum to a Consideration for Parent Room, which is off the NICU. We stayed there for Saturday night. The Courtesy Room set up means that Grayson sleeps in his area of his NICU pod and we sleep in a separate room nearby while we wait to see what happens next.This allowed us to visit Grayson as often as we could and continue to do every feeding with him. What a relief.
On Sunday afternoon we got the GREAT NEWS that Grayson’s blood work was all negative. I have never felt the emotions I felt in that moment before in my life. Relief is an understatement. And since healthy babies get to go home, that meant we began the transition to home life.
We stayed that night in a Care By Parents Room. In this room we stayed as a family and got to practice parenting a bit before leaving to go home!
Home and Follow Up
We came home on Monday evening and things have been great. Grayson is pretty calm, so far. We have now had to venture out twice – yesterday and today to see a specialist to help us to get this tongue tied little guy to latch! Again, an amazing Doctor. Grayson had a little procedure done to his mouth to free his tongue. He got through it like a champ. 

This Friday Dr. Hall is coming to visit us at home. (Home visit?!?! Yep! Grayson was born just in time to access this new (and incredible) service provided by our Family Health Team.)

We will also be busy with some appointments next week – follow up with Dr. Dwight, the Neonatologist from the team, follow up at the Breastfeeding Clinic and we will also have a visit provided by an RN from Peel Public Health.

Aside from attending necessary appointments, we do not intend to take Grayson out during these early days. Our Family Doctor had discussed with us during pregnancy the risks associated with a newborn getting a fever in the first month, and at this point that risk has already been a lived reality, so we are taking every precaution and taking this all very seriously.
Grayson is an incredible little human already. He has held his own and seems to take everything in stride.
We are so grateful and so lucky. What a beginning.