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This Postpartum Body

18 Wednesday Apr 2018

Posted by frannyritchie in babies, Parenthood, pregnancy

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Tags

breastfeeding, fitness, health, high risk pregnancy, motherhood, Parenthood, partpartum, preemies

I often joke about my uterus deserving a participation trophy: it tried, bless it, but it really wasn’t totally up to the task. My first child, though term, was so small that he was barely on the growth chart (he was, and is, developmentally fine – he was just small for gestational age). My second pregnancy lasted eleven weeks and one day. My third time, I made it to 31 weeksbefore delivering two babies, by dramatic emergency c section, whose combined weight was less than my first child.

I have stretch marks, but because all my children were so small, I don’t have the dramatic diastasis recti or saggy skin on my stomach that is the aftermath of a healthier twin pregnancy. I’ve mostly lost the weight I gained and am at the same weight now as when I first got pregnant. I don’t really have much to complain about, really.

Of course that’s not stopping me. I have recently stopped breastfeeding so the last hope I had of blaming the babies is over and I am coming to final, depressing terms with my body. This is what I’ve got. It works. I can run and jump and swim and dance, and I so grateful for that. But when I do any of those things, I shake and jiggle and flop, and that’s a little harder to appreciate.

I went to get fitted for a bra recently, because my shape has changed in my post-breastfeeding life. The woman assigned to do my fitting told me, with a sour face, that my breast tissue was wide, wrapping around my rib cage more than most women’s. And I wanted to snap ‘yes, I know, they’re pancakes. Now get me a damn bra that fits anyway!’

She brought me a few options, including a hilariously awful old-lady bra in hot pink (so bad I sent a pic to my sister with the caption ‘fml.’) In the end, though, I bought a sports/yoga bra and ran out of the shop; a different woman at the checkout said ‘oh these are brilliant – though of course you can’t wear them during the day’

And I wanted to weep with frustration. Even worse, I have worn it exclusively since – I don’t have a *better* option.

I had thought in the past that I might like to get plastic surgery. Thirty-four is too young to be done feeling happy with your body, and all the cardio in the world isn’t going to change the fact that I breastfed three kids. When I think about it now, I tell myself that as a mother of daughters I need to set an example, but really I’m just too cheap and pain-averse to do it, not to mention too lazy. And my husband thinks I’m being ridiculous, which is…good, I guess? He says ‘You don’t have teenager breasts. You’re not a teenager!’

In the last few days, my son has taken to saying ‘silly old mummy!’ – a phrase he learned from Winnie the Pooh. When I told him I didn’t feel old, he said that I was objectively old and I should get used to it (I paraphrase). Maybe my discomfort with my body is an outgrowth of the fact that I may not be objectively old but I am objectively middle-aged and that, well, sucks. I don’t want to be a teenager, but I don’t love watching my body deteriorate either.

I spent a lot of time wishing that I could have carried my girls longer: every extra day, we clawed back the chance of infant mortality or cognitive impairment. Extra baby weight or diastasis recti was a small price to pay for a diminishing chance of major developmental delays. My medical team was thrilled that we got to 31 weeks, but I still wish I could have done better, even a year later, when everything seems to have turned out fine. It doesn’t keep me up at night anymore, but if I could trade my physical presentation for my daughter’s health, obviously there’d be no choice. Since that is a given, I feel guilty that I have spent so much time in the last few months being frustrated with something I can’t change and wouldn’t want to anyway. If given the opportunity, I’d want exactly the kids I have and I’d want to breastfeed them again, and if pancake breasts are the price, well. That’s that, isn’t it?

BUT SERIOUSLY I wish I could have it both ways. Surely that’s not too much to ask.

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15 Thursday Jun 2017

Posted by frannyritchie in babies, Delivery, Early Days

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Addenbrookes Hospital, breastfeeding, breastmilk, breastpumping, breastpumps, breasts, Delivery, Early Days, labour, Lady Mary Ward, NICU, preemies, premature, premature babies, pumping

[Usual disclaimer about how I am not a medical professional, breast feeding peer supporter or anyone with any official knowledge about breastfeeding]


Its kind of lunacy to think that I can contribute anything much to the world of online breastfeeding resources when a. its extremely well-trod territory and b. my qualification is, I’ve done some breastfeeding. Both times I had a stressful start: with my first, mostly because of incompetence; the second time, there was that whole NICU thing.  But both times I gave birth, my baby had a nasal gastric tube. Theo had low blood sugar and, though he was full term, was tiny; he had a feeding tube put in directly after birth and spent an afternoon in Special Care. He was also born with an infection and was floppy and lethargic for the first 36 hours of his life, even by newborn standards.

Both times I was desperate to breastfeed. The first time I just couldn’t get the damn baby to latch. I ended up exclusively pumping after failing, every three hours, to get a latch, then dumping milk and formula down the NG tube into his stomach. The midwives didn’t believe me, but the whole depressing ritual – fail to latch, feed, pump, sterilise – took about two hours and forty minutes, leaving you with twenty minutes before it was time to start again. I have confirmed with other women: no matter how long the health professionals say it should take, it takes 2 hours, 40 minutes. For the first several days, no one bothered to tell me that you can pump on both sides simultaneously. Our hospital doled out single-breast packs (one bottle, one set of vacuum parts) and everyone on the ward shared a communal pool of hospital grade pumps.

On the third night, I called my husband, who was asleep at home, to act completely insane and accuse him of failing to support me in my attempts to breastfeed. I have no memory of what behaviour  of his set  me off, but I do remember that trying to get Theo on the boob had left me shrieking in frustration. I mean,  in the normal course of things, I’m not much of a shrieker.

Anyway. The thing that I originally wanted to impart is this: I have had three occasions where I have had kids on NG tubes and have had to introduce breastfeeding slowly, instead of doing the normal thing where you have a kid, put the baby on the  boob (or the bottle), call it a day and go home. Even if you do have a lot of success with breastfeeding (in which case, pin a rose on your nose) it can still be painful, time consuming, frustrating….my sister said she was glad she knows, from my experience, that feeding is not an easy and magical experience. And it seems obvious to me now, but three years ago I thought that I would have a baby and they would eat. I thought it was something I could prep for with classes and research. I was wrong.

That said, if you are in a situation similar to mine (especially if you have preemies) there are some things I recommend. First, it is important to be proactive, even if your child will not immediately be taking milk (ie if they are on liquid nutrition to start). You can start hand expressing immediately after birth, and – new in the last couple years – medela, the most common supplier of hospital-grade pumps, has created a ‘preemie initiate’ setting that stimulates the breast before hand expressing.

If you want to breastfeed, the best hing you can do is get after it. Milk yourself every three hours – the way a baby would if they were eating. Only expect a tiny amount at first – colostrum, the milk that comes right after birth, is meticulously collected in il syringes. But if it hurts or you aren’t getting any, ask for help: nurses, midwives and care assistants have experience milking new mums, and they’re probably better at it than you are. If your hospital is stressed for resources, ask for a lesson and have your partner help you collect it. It’s not dignified but…well…you get over it quickly. On my fourth day postpartum, I so get out one of the women who had helped me eke out my first drops and proudly showed her my freshly collected 35 mils. I actually got a little choked up – it was a mix of gratitude, pride, relief and Hormones.

Basically the biggest lesson – which I suspect is a theme – is advocate for yourself. Failing that, prep your partner and have them do it for you. There is no way to physically prepare for breastfeeding, so the best thing you can do if it doesn’t come naturally is ask for help – loudly and repeatedly if needed – and be patient with yourself.

And if, after all that, it doesn’t work out or you decide you actually kind of hate it, buy some formula and move on.

Tips on Surviving the NICU

09 Friday Jun 2017

Posted by frannyritchie in Uncategorized

≈ 6 Comments

Tags

babies, breastfeeding, high risk pregnancy, hospital, NICU, parents, preemies, pregnancy, premature, premature babies, self-care

Daphne getting moved into special care!


So first of all, my post on do’s and don’ts for supporting families in the NICU has resulted in a few really sweet but totally unnecessary apologies. People took amazing care of us, and when missteps were made, it was always with the best of intentions. It was not at all my intention to make anyone feel guilty because my overriding sentiment is that people were amazingly kind and generous with us during the ten weeks we spent in the NICU. Which is particularly worth mentioning because that sort of emotional support is hard to sustain for months on end.

Which brings me here. I asked my husband for tips on the NICU and he said ‘Don’t.’

Spot on advice, I have to say.

I was lucky (as these things go) in that I knew I was facing a long time with babies in the hospital. When they were born, they were pretty fetal. I found it relatively easy to leave because it was so obvious that they couldn’t come home. It was later, when they looked and acted like regular babies and we had been in the home stretch for weeks that I began to really ache to have them home.

I prepped for the NICU by reading Alexa Stevenson, who wrote the book ‘Half Baked‘ and also gave a useful interview at Alphamom.com (I actually read the book twice – once while pregnant and once while in the NICU). I also listened to a really lovely interview with Rob Huebel on Longest Shortest Time, a parenting podcast that has hit some really high highs in the course of its five year (?) run.

Forty percent of NICU parents have some sort of PTSD (my coping strategy is…well, this). Here are the things that helped me (worth noting: I’m an urban planner, not a medical professional, so all the medical stuff in here I either picked up in NICU or googled. I’m pretty sure its accurate, but…).

  1. SLEEP. This one is pretty obvious, but it bears repeating, because if you have just given birth you have Hormones, and you might be expressing, and you might still be staying in the hospital or a place that isn’t home, and you are going through something that is just ridiculously stressful – but sleep (and self-care in general) is pretty critical.
  2. Express breastmilk (this one is for the birthing parent, obviously). Fed is best – I’m not hating on formula per se – but babies that receive milk in the NICU are less likely to develop infections. Infections are the worst. They can set your baby back weeks, and in the worst case scenario they can be fatal. Furthermore, breast milk is medicine. Some parents won’t even be able to hold their babies, but this is something you can do that is concrete and incredibly useful to your child. Its also good for women: it reduces the incidence of post partum depression; it burns calories and helps shrink your uterus; breastfeeding (if/when you get there) releases oxytocin and helps with bonding. There’s another weird thing about pumping, though, that I didn’t expect: most of the socialising I did with other parents, I did in the expressing room. I didn’t make any lifelong friends, but I did make some Facebook friends, and I was grateful for the interaction with people who knew what I was going through. Our hospital had a small room with three little cubicles separated by sheets, and while I often listened to podcasts or watched shows on my phone, I would occasionally chat with other women through the curtains. I suspect American hospitals don’t have pumping rooms (because babies have rooms rather than bays), so this may not be relevant to you.  But my point is, there is value in NICU solidarity, and there will always be ‘long termers’ both ahead and behind you. Its not a community anyone wants to be part of, but knowing other parents on the ward is certainly useful.
  3. Don’t be afraid to advocate for your baby, or to ask questions of the staff. My girls were on high-flow oxygen forever. FOREVER. They kept taking Fiona off high-flow, only for her oxygenation to dip into marginal territory. Her monitors would alarm on and off for an hour and then they would hook her back up. Finally, one day, as they prepared to turn her machine back on, I said ‘could we try low flow?’ (low flow is what you think of when you hear someone is on oxygen – tiny little nasal prongs that hook over the ears). Low flow is better because its easier on their lungs, it makes them much easier to handle (better for parent cuddles) and, on our NICU, it meant they could be moved into Special Care, which was quieter and calmer and less stressful for everyone. Anyway. Fiona killed it on low-flow. And then, a couple weeks later, almost the exact same thing happened with Daphne, except this time I spoke up earlier. The staff know what they’re doing, but you know your child best.
  4. If you live far away, or are unable to spend time at the hospital, ask if there are ‘cuddle clubs.’ Babies benefit from being held – they gain weight more quickly; their blood oxygenation goes up; and their breathing rate can slow too. A cuddle club is a program where volunteers hang out with a baby for a couple hours – the same way a parent would. The nurses will hold babies when they can, but it never hurts to ask for more.
  5. You can always call the NICU. I tried to call when I was pumping, or before I went to bed at night. The reports got less detailed as the girls got bigger and healthier – after Fiona moved into Special Care, I called and the nurse was like ‘…yeah, she’s fine. She’s settled and sleeping.’ and that’s when I realised we had entered a new phase of the NICU journey. But it meant that I never went to sleep worrying that I was missing something, and it also meant that I knew who the nurses were, and they recognised me as well. Once they started breastfeeding, I called to let the nurses know I was coming, and that was really helpful for the staff. Its also THE WORST when you show up to breastfeed your kid, only to realise you’re a little late and they’ve just been given a feed by the staff. The staff hate it too.
  6. Please please please take care of yourself (see: SLEEP). Eat real food, seek help if you need it (most hospitals offer grief counseling and/or have counselors on the NICU, which you may as well use, since its there and you’re clearly going through some stuff)(even if you don’t, make allies in the NICU. I was so grateful for a lot of the staff, but particularly the breastfeeding consultant and speech and language therapist, both of whom had more flexible schedules than the rest of the staff and were more available to answer questions and help  me chart a path through the NICU).
  7. Get some fresh air. NICUs are hermetically sealed so if its gorgeous outside, take a walk. In fact, unless its a torrential downpour or subzero degrees (Fahrenheit), I would suggest spending some time outside.
  8. Accept help when it is offered, and remember life is long, and you can reciprocate later. People want to help, so let them.

It turns out I had to really curb my instinct to write a LOT about boobs, so I think I’ll write more about that next time…? Lucky you.

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