Sunday, January 26, 2014

My hospital delivery "must have" and "not needed" list

Laura, a blogger friend recently posted her list of what she has packed in her hospital bag and it was interesting for me to recount what I had planned vs what I actually had with me, and then compare to what I wish I'd had after the fact. I added to what would have been the longest comment in the world and posted it here instead.

I ended up in the hospital without anything because I was on a business trip, and to be perfectly honest, I was fine without it (even though I'm pretty particular about things). My husband brought my half packed hospital bag, carseat and breast pump when he flew out and my co-worker brought my suitcase from traveling to the hospital later that day. All I had during delivery was what was in my purse.

This is what I used and loved having:

1. A robe
I ordered one from a pea in the pod (they no longer sell it, but I linked to the closest thing)
It was thin and covered my hospital gown while I was there after delivery. I still use it at night and in the morning over a tank top. Otherwise regarding clothes, I left in the same clothes I arrived in which were a maternity t shirt, maternity tanktop and maternity yoga pants. They were truly the most comfortable thing I could ever have planned to wear and I ended up in them 10 days later (after washing of course) for the 16+ hour drive home from the hospital. I also wore the sticky bottomed non-slip socks from the hospital to walk around in while there (and my flipflops). You feel a little like you've been hit by a truck, so something comfy (and still stretchy :)) is a must. I had my suitcase from traveling, so I had tons of cloths and underwear (all maternity and all business professional). I wore almost none of it while I was in the hospital. However, I continued to wear maternity clothing for the next 2 weeks or so.

2. My maternity tank tops from Gap
They were and continue to be my favorite "nursing cami" even though they weren't designed for that. While pregnant I had a black one and a white one. Since then, I've switched to a smaller size and have 2 black and 2 white. They are long, strechy and supportive and fit just right in all the right places and continue to be great at 4 months old. I often wear them instead of a regular bra and use them under regular shirts and nursing tops and wear them at night instead of nursing jammies. They just pull down and haven't lost their stretch, also they are lots cheaper than any nursing bra. The built in shelf probably won't work well during the initial engorgement though. I have about 6-7 nursing bras that all suck and no longer fit. I dropped the weight so fast that they all are now huge, I won't be replacing them with duplicates in smaller sizes. I have since bought one more bra and it is the best so far (Bella Materna Women's Maternity Anytime Padded Nursing Bralet though I've pulled out the padding in favor of disposable nursing pads). It's highly adjustably with 4-5 clasps and could have a lot of ust before and after delivery and long into breastfeeding. I am a huge fan of the pull down, pull up, pull aside bras, camis and shirts and not a fan of the clip down ones.

3. Nursing pads, lanolin and a nipple shield
I probably didn't need these until my milk came in, however, it was nice to have them at the hospital. Also, if I'm ever lucky enough to find myself in this position again, I would definitely have a nipple shield with me. However, if you can do without the nipple shield, DO NOT USE IT. We are 4 months in and can't seem to wean off of it. It's nice if you absolutely need it, but if you can push through without it, it is totally worth it.

3. A baby outfit
Pick one you like and don't worry too much about size. However, the one we brought was way WAY to big on our preemie and my mom washed and brought a preemie onesie and pair of pants, the hospital had a hat and socks. This mattered a lot less to me at the time than I thought it would. I thought he had to be brought home in the perfect outfit, but even now it doesn't matter to me. The onsie and pants are cute and tiny and packed away now. Also, don't forget the baby mittens if it is cold out!

4. A carseat and blanket
Did you know they aren't supposed to wear anything fluffy under the carseat straps?

I also had all the stuff that was regularly in my purse during travel including my phone charger.

I needed and wanted nothing during labor except my phone to text my husband. I had no massage tools for my co-worker to use except her fists to give counter pressure on my lower back. I had no music or headphones. I had nothing to read or do. I kept notes on my phone. I was not hungry until hours after delivery. Good thing because I had no food or snacks.  After delivery, I used the soap, shampoo, conditioner, toothbrush and toothpaste from the hospital, as well as the mesh undies and giant pads they had...and I lived. I had been at a fancy hotel and used their nice stuff while traveling but had not gotten those things into my hospital bag. I did have my makeup bag and put some on for pictures and comfort over the next few days in the NICU. And because I didn't have many of these things they now sound excessive to me.

It would have been nice to have a boppy to both sit on and breastfeed with. A headband to push my hair out of my face would have been nice too (I had one in my hospital bag, but since my bag arrived after delivery...). My feet were never really swollen during pregnancy but ballooned up after delivery and compression socks would have been great for the first week or so. I still have no use for a nursing cover. I prefer looser tops to wear over my camis rather than most of the nursing tops I have. After the first few weeks, I'm lucky that I fit back into my pre-pregnancy pants including jeans.

The good thing is that once the baby arrives, you kind of forget about your own comfort :) and don't really miss anything that you don't have with you. And my minimalist experience shows that even if you forget something at home, its not the end of the world, the baby will come anyway! Then, hopefully, friends, family and amazon prime can deliver the few things you discover that you need while you are in your early-on-sleepless-night-don't-want-to-leave-the-house fog.

What do you consider a must have, didn't need, or wish you'd thought of?

Monday, January 20, 2014

16 and 17 weeks old

Ethan was 16 weeks on Friday, January 10th and turned 17 weeks old on Friday, January 17th. Today, January 20th he turned 4 months old to the day.

He has outgrown all of the onsies I bought before he was born. They were a size 3 months from R U.s but are now like second skin on him. I picked up some 3-6 months from's and they fit much better with a little extra room.

I had to add another towel to the basket to bring him up a bit closer so that he wasn't so squished. He likes to press his feet to the bottom of the basket which mashes his head against the top. I'm not sure if it makes him look bigger or smaller.

I think we caught a little half smile!

We also had our 4 month vaccinations today...what a bear! He took it like a little trooper and was fast asleep in his moby wrap in no time. We also got another EKG done today on the fly. We need it for his cardiology appointment next week but just got the order in the mail on Friday.

He is now 11.9 lbs (I thought he was over 12 based on our home scale) and 23 inches. Both of these measurements put him below the 2nd percentile based on age. His head, however, measures 40 cm, which puts him in the 10th percentile. We have our very own bobble head!....Just kidding! He actually seems very proportionate, if small for his age.

They give you this questionaire to fill out prior to the appointment to see if he is meeting all of his milestones. They do not correct for prematurity so I had to put "no", or "only sometimes" for nearly every question on there, I think I only put "yes" for 2 things. 1: Can hold his head 3 inches off the ground during tummy time and doesn't let it fall to the ground but rather lays it back down. 2: When held in a sitting position, keeps his head from wobbling around most of the time.

The doctor said "he's not going to be the biggest kid in his class", however, the other day when we were shopping, a woman, whom I don't know, came up to me and pulled the moby wrap aside to look at his face and said "what a husky little fellow". This kid could not be considered husky in any sense of the word. Maybe she thought he was big for a newborn! But he is definitely small for a 4 month old. Either way, he's just chugging right along.

Saturday, January 11, 2014

3 month update: Breastfeeding

I always knew that I would breastfeed. The nutritional and immunological benefits of breastfeeding can't be beat by something that modern science can create. But I definitely had some concerns about the realities of breastfeeding.

Before E was born, I was simply hoping that I would make enough milk for him. I was hoping that he would latch properly and get all of his nutrition at the breast. However, plans had to change when he came so early. Plans had to change immediately. We did not have the chance to do skin to skin due to his prematurity. He did not latch within the first hour as I had hoped. Finally, he was given a bottle of formula before I even made it to the NICU to see him.
first bottle

I was brought a pump in my recovery room and given some basic instructions to pump for 15 minutes every 2-3 hours. With a baby in the NICU, pumping every 2 hours was impossible, I never would have been able to see him. I pumped for 15 minutes every 3 hours around the clock the entire time he was in the NICU. Nate brought my pump to Las Vegas when he flew out, so I used that in the hotel room at night, and I used the pumps at one of two pumping stations they had in his pod in the NICU. I struggled initially with cracked and bleeding nipples, but had purchased some lanolin which Nate brought to me too. I was told that a little blood in the milk was ok, but I would pump about half an ounce and dump it if there was blood in it because it would stop after letdown. My nipples stopped bleeding and I stopped using the lanolin long before we headed back home, maybe after the first 5 days. However, it was uncomfortable to wear breastpads that stuck to the bleeding and cracking and then have to peel them off to pump. They mixed my milk with formula for 3 days until I had enough for a full feeding.
bottle feeding expressed milk in the NICU
Later in the NICU

I have since read that during the first 6 weeks after birth, your milk is essentially controlled hormonally, but after that is controlled by supply and demand. My hormones must have been telling my breasts that I had 5 children to feed because when my supply came in on day 4, I was constantly engorged for the next 3 weeks or so. I pumped colostrum only for the first 3 days, then produced yellow milk for about 5 days, then pumped appropriate fore and hind milk from then on. However, I pumped it in unheard of quantities. I could pump 6-8 oz every 3 hours when E was eating less than 2 oz ever 3 hours. So I brought my milk to the NICU and they stored it in their freezer and refridgerator. It was always their preference to use fresh milk, so they would take a bottle from me and freeze the remaining 2-3. They provided little plastic bottles that hold 2 oz of milk each. When we left the NICU on day 10, we bought a cooler and some ice to travel with the milk, but I could not believe how much they had in their freezer that we had to bring home! Unfortunately, my milk thawed on the ride and because it has to be used within 24 hours after thawing, I could only save about a dozen bottles that were still frozen, and ended up dumping out about 30 more bottles (that's 60 oz of wasted milk that I spent hours pumping!!!).
half of the milk I had to dump

Milk down the drain

When we got home, we continued bottle feeding the milk I was pumping for the next 4 days. Then I decided to try to breastfeed. Ethan had not latch up to that point. I had tried 2 times to breastfeed in the NICU, but we were encouraged to bottle feed him to get him out of there faster. He had only had an artificial nipple up until then. I really felt that my nipples were flat so I purchased a Medela contact nipple shield to try. Voila! he latched to that nipple shield like a pro. The only issue I had was my oversupply and overactive letdown. I had a fever and very sore breasts and back that whole day. I had to stop breastfeeding and pump to be anything close to comfortable. I called the local lactation consultant but got no response, so I contacted the local La Leche League and the leader said she'd come over the very next day. She confirmed my suspicions of flat nipples and recommended the nipple shield. She also confirmed my oversupply and overactive letdown. She recommended pumping after feeding and leaning back when breastfeeding.

[I had a very cute picture of his first latch here, but the husband vetoed it being on the blog]

After that we exclusively breastfed, no more pumped milk in bottles. I'd feed him for 15-20 minutes and then pump for another 15. Then I'd change his diapers, put him down for a nap and start over every 2 hours. I went from pumping 10 oz after feeding him, to not needing to pump at all, but it took nearly 3 months. Somewhere around 2 months, he went from a two hour schedule to a 3 hour schedule and right around 3 months he started sleeping for longer periods at night and now skips 2 feedings. He went from eating 12 times a day to eating 6-7 times a day.

At 15 weeks, I went back to work and back to pumping. I started pumping the weekend before to make sure that I wouldn't suffer a drop in supply. Currently my schedule is to breastfeed at 1 AM, sometimes 4 AM, and 7 AM, then Nate bottle feeds at 10 AM, 1 PM, and 4 PM, while I double pump at home at 7:00 AM after he eats then at work at 10:30 AM and 2 PM, then I breastfeed at 6 PM and 8 PM. We still use the nipple shield at every feeding.
dad's feeding him again when I'm at work
Breastfeeding on the couch this week

Here are some of the things that I have learned are absolute musts/must haves from my own personal experience that I never heard or read about before. I am not being compensated for promotion of any of the things below, they are simply the things that I have found to work and or love:

1. I keep a supply of white washcloths (about 20) that I bought at sam's club next to where I nurse. When I pull down my bra, I tuck an new dry one into my bra before each feeding. It catches anything that leaks (which is sometimes a lot) and then I use it as a burp/spitup rag. My oversupply leads to a lot of leaking during feeding and sometimes 2-3 oz of spitup. Sometimes, when Ethan turns his head he will pull off the nipple shield and I spray him in the face, the washcloth gets use then. The washcloth also protects my clothing (most of the time). They can be bleached clean and are cheaper than anything else. I have to wash all of them every 2-3 days. I toss them in our tub when they are dirty so that they can airdry. The milk and spit up will turn moldy if put into a hamper or really anywhere else.

2. I nurse in the same chair next to a nightstand in our room. I had set up a station in his room too, but only use it to read a story after I change him and put him in his PJs. Our room is just much more convenient. My pump sits there, the TV remote and my phone are all right next to me because I never know how long I will be there. I also keep a coaster for a drink and nail clippers for E's little daggers that need to be cut every 4-5 days or so. It would be nice to have a glider, or even just a footrest, but I have done without these things thusfar. The washcloths are int he drawer of the nightstand. I can not nurse in anything but the cradle hold, cross cradle, football and sidelying do not allow me to tip back and slow my letdown. So this chair works just fine. Also, I had to use a boppy initially, but now can do without as my arms are a little stronger. I usually do have it though. A boppy with a watterproof cover is also a must. I have two and I keep one for nursing and one for propping him during tummy/mat time.

3. Nursing pads are a must, but most of them suck. I had bought a dozen cotton reusable pads to use for nursing. They all sit in a drawer. Initially I leaked all the time and would let down at random times, like in walmart when I saw another mom with her baby, or when I rolled over in bed. I would leak right through those cotton pads because they did not have any backing protecting my bra and shirt. I immediately switched to disposable pads, which mostly also suck. I've tried most of the brands at walmart and walgreens and finally settled on Johnson and Johnson pads. They are the right shape, size, contour and absorbancy for me. Unlike Medela, lansinoh, nuk, avent and most of the others, they are not folded and glued to shape a cupped breast, but rather already cup shaped. All of them have a sticky pad on the back that is totally worthless, I don't even pull off the paper anymore before I put them in. I have stopped leaking during the day when I double pump, however, I still let down on both sides when I nurse E and must have a pad in place to catch the excess. I have seen the things that catch and let you use the extra milk, but that continues to encourage letdown on the opposite side. Buy a small supply of a variety of different brands to find what you like if you need to use nursing pads.

4. Pumping also sucks, but my life has been made so much easier since I bought a new invention called a Freemie. It attaches to my Medela pump, but instead of the traditional horn and bottle design, a cup fits around the horns and valves and catches the milk. This allows the whole thing to be inserted into a traditional bra and be used hands free. I also think they are easier to clean and fit better into my pump bag. It wasn't absolutely necessary when I was pumping at home, but back at work, I can sit at my desk and pump without removing or lifting my shirt. Also I can continue to work!

5. Co-sleeping has saved my sanity. I like having my baby close to me. I want to be attentive to his cries and able to comfort him. I also don't want to trapse across the house to check on him or get him. Initially we co-slept in the form of room sharing. We had his bassinette/co-sleeper in our room but not against our bed. I now have the co-sleeper tied to our mattress up on leg extensions. It would be nice to be able to just pull him into our bed to nurse at night, but I have to get up and go through the routine of the nipple shield and the washcloth.

 I wanted to document where we were 3 months in, but I also hope that some of our experiences help someone else. I hope to keep this up at 3, 6, 9 and 12 months.

Saturday, January 4, 2014

15 weeks old

Yesterday 1/3/14 the E-man turned 15 weeks old. (Yay for posting in a timely manner)

We had a rather exciting week as we celebrated the new year and my return to work.

We went to a friend's house for new years eve, it was sort of a last minute plan, but we had fun playing cards and then watching the ball drop on TV. This was immediately followed by going home and crashing into bed as I no longer function so well this late due to the hours that E keeps.

I have put in two full days at work and I didn't lose it like I thought I might when I left the house. It really helped that E stays home with Nate when I go to work. This means that I can request as many updates and pictures as I want throughout the day. I came home over lunch on Friday but wasn't able to feed him as I had hoped. They changed so much at work while I was gone that I'm struggling a bit to keep up, and also, I didn't have an assistant on Friday. So in addition to seeing patients, I had to man the phones and the front desk (it was a little insane actually). I hope this isn't the case every Friday, but I was afraid to ask.

This was the face that I came home to on Thursday.

My return to work meant a return to pumping. I intend to do a whole post on breastfeeding thus far, so to keep it short and sweet here...I am a milk making machine! I hope it continues to go well for us as I would like to breastfeed E as long as it is mutually desirable for us both.

Somehow, return to regular life has me motivated to post. I hope that motivation stays long enough to actually do so.