Thursday, February 12, 2015

The Crying Game

There is nothing more heart wrenching than to hear your baby cry. Often, I start crying with my baby - a physical reaction I cannot control. I blame it on the hormones. My hubby does not have the same reaction. When speaking with my mama friends, they understand the crying (and leakage!) and their husbands also can remain stoic as they collapse.

I am quite relieved that my hubby does not have the same reaction as me as it is better for our son to have a parent that does not also collapse with him. Since our son has hydronephrosis, we have had to put him through numerous scans and procedures since he was born. The two most exhausting were the VUR scan and the most recent - and the far worse of the two - the lasix renal scan. My son had to have a catheter inserted for both and for the latter scan, we not only had to deny him food for nearly seven hours but had to give him an IV. He was crying for food for the last couple of hours and I couldn't stand the pained and confused expression he gave me when he tried to take the breast and I denied him. The nurse noted he could smell the milk and that it was better for hubby to hold him. We tried to divert him with the aid of Larry the Llama but knew we were on a losing streak, with L becoming more agitated as the hours dragged on. Not being able to feed my hungry son was one of the worst pains I have ever felt. For me, that lasted but half a day but unfortunately for too many mothers in the world, this is a more permanent predicament. This should never be the case.

How do you explain to your child why they are in pain when they are too small to comprehend what is happening and before they can understand what you speak? For several days before L's procedure, I explained to him what was to happen to him, how he would feel and why, hoping that on some subconscious level, he would understand. When he was crying from hunger and crying from the pain of green strangers holding him down and stabbing him repeatedly with a needle - for it is difficult to insert an IV in a three month old - he looked at us imploringly to help him. What must he have felt? What must he have thought? The people that were always so loving to him, that fed, washed and clothed him, suddenly holding him down as green strangers tortured him. I was asked to leave the room as I crumbled and apparently appeared so pallid the doctors thought I would faint. The last thing I wanted was the doctors paying any attention to me, away from my son, so I left and immediately crumbled in a heap, drenched in tears, outside the room.

Both scans were done at Cornell and I have to commend them for their care, management and efficiency (now were are in the hands of UCSF, which I hear is fantastic but have not experienced yet). My son had a team of specialists looking after him both times. Despite having two pediatric anesthesiologists on the team, it took them numerous attempts to insert an IV in. They tried his right hand and after several attempts, moved onto his right foot, again to no avail- at which point I was asked to leave the room - then according to hubby they moved through his other appendages and finally inserted it in his left foot. My husband was holding him and speaking soothingly to him as they kept poking him with the needles and when it was his left foot's turn, he jokingly said, "Luca, you better relax so the doctors get it, or your head would be next."In fact, that is where they would have went. The veins in a baby's head are bigger and easier to get than their extremities. Scalp IVs are not usually the first place to go as parents tend to freak out, although nurses find they are both easier and give the child more mobility (as children move, they have to have the IV foot or hand taped to a board to render it immobile).

My son also cries when he wakes up as if he is having nightmares. I wonder what dire dreams he could be having. Did he dream the milk dried up? It's as if babies are remembering their previous life and are shocked to discover they are waking up to a nightmare - which surely it must appear to them - in which they cannot move, they cannot speak, cannot hear and see properly and generally have to relearn and renegotiate all their communication and understanding anew. Sometimes, in my more morose moments, I wonder whether he is remembering his previous deaths.

Recently my son has started crying for attention. Before, he would cry for physical reasons that he could not fix himself only -  if he were wet, hungry, cold, hot etc we would come to the rescue and rectify the situation. Now, my son understands the power of his cry and uses it to bring us to his side for no reason at all, except to just be. This can be quite frustrating if I'm attempting to get anything done (they said the swing would work!) but as soon as I pick him up and he stops crying and looks at me with such wonder and love, I melt and am all his.

Thursday, February 5, 2015

The Moo Diaries

Breastfeeding is one of the most- if not the most- challenging things, both physically and psychologically, I have ever done in my life. It has overwhelmed my life since my son was born. Granted, we had a particularly bad run at it. My son had tongue tie so he was mostly chewing on my nipples, causing them to scar, bleed and bruise, rather than suckling milk out. This lowered my milk production as well as causing plugged and inflamed milk ducts and in turn mastitis, a yeast infection and vasospasms. The lactation consultants that saw me both said that I had pretty much everything they treat women for. Lucky me. It's three months since my son was born and I am still breast feeding him and while I fear to write this in case I jinx our progress, we have established a routine, which albeit it includes supplement- thank God you can find organic milk based formula (thank you to all the cows feeding my son!!)- is a routine I can keep without going insane. When the milk runs dry, so be it.

Before we had L clipped, breast feeding was a nightmare, but I pushed through it, believing the incredible pain was due to a low pain threshold. After all, all my friends told me the first week was a nightmare. Maybe for me, this was just extended to two, three, four, five, six weeks - then I called it, and called a lactation consultant. When she  inspected my bleeding and bruised nipples and his obvious tongue tie, she dignified me with the description of being the most stoic mother she had ever met, noting that she did not believe any other mother would have continued to feed. Had she arrived narry five minutes before, she would have seen a perfect example of stoicism by the expression of what it was not. My daily breakdown: I was on the bed, crying, in the foetal position, wanting to crawl into a hole and not feel, exhausted and overwhelmed by the sheer scalding pain of my nipples. In the first few weeks, when my stitches were still healing and it was mired misery down there, I was overloaded by pain, my body collapsing and not being able to register where the screams should be directed. Conscious that anything I took passed into my milk, I kept off the meds and suffered through it. My pain was so overwhelming that I all I could do was feed. When he finished - which at times took two hours as he was unable to latch properly, unbeknownst to us- I would fend him off to whomever was closest as it was too painful to have him lie on my chest. We missed out on pressure cuddle time - which not only is a magical experience but important for milk production as it releases oxytocin, mammals' neurohypophysial hormone.

No pain was greater, however, than my husband poking my nipples with a needle and squeezing out milk (mastitis was nothing compared to this! Possibly because my fevers were so high I was too delirious to register the pain), trying to unplug my milk ducts (before his clip, my son was not pulling my milk out and I had numerous plugged ducts). It was at that time I realized that either our walls were super soundproof, or none of the neighbours cared (which reminds me of the NYC saying, "the best thing about New York, is that no one gives a fuck. The worst thing about New York, is that no one gives a fuck") and I was ready meat  to be chopped up by any psychopath that roamed our West Village condo complex (surprisingly, in the three and a half years there, the only skirmish we witnessed was outside our window on  Christopher Street, where the drags queens had a punch out).

It was a downward spiral - pain increases stress and decreased the "love" hormone, the decrease in milk supply in turn caused me further stress and anxiety, which caused cortisol to rise and oxytocin to fall, further decreasing my milk supply. The repeated infections - the mastitis infections and yeast infections - further dropped my supply so that I was pumping anywhere between 1/3 of an oz to 1 oz from both breasts. My husband asked me to quit. I growled at him. Increasing my milk production became a crusade.

I became obsessed with the fact that I couldn't feed my son without supplement and became quite depressed, anxious and embarrassed, feeling guilty and inadequate. I imagined we would be stuck somewhere in the wilderness, where I could not obtain any formula, and my son would starve as he looked desperately at my dry mammary glands (yes, that's how crazy I got). All my insecurities and regrets in my life, all my perceived failings, were zoned in to producing milk - if I produced for my son, none of it mattered. If I failed - it was the final expression of everything that I had failed to achieve, solidifying my inadequacy. I felt I was a bad mother and undeserving of my son. Unfortunately, stress and depression increases cortisol levels, which depletes milk production and so I descended deeper into the downward spiral.

For nearly two months, I would feed my son, bottle feed my son and pump. I would also get up a few times in the middle of the night to pump, so that I was sleeping in two and a half bursts, failing to enjoy the fact that my son was a super awesome sleeper that slept 7 hours straight after two months. During the day, I gorged on galactagogues - oatmeal, Guinness et al and rigidly took my supplements fenugreek and blessed thistle - and watched the trickle of my milk as I pumped. My lactation consultant advised that I watch a sitcom while I pumped. So I re-watched nearly all of Frasier and as we live in a loft, so did my husband to his increasing chagrin.

My mother in law came to help out and she - who bottle fed- was gently trying to persuade me that it wasn't worth it. I took this opinion as a challenge and plundered through the last of my wits, until I collapsed and decided I was no longer going to pump and I would sleep when my son slept. Slowly, I decreased my rigid routine, felt better and - when I said to hell with it - my milk went up! I was pumping 3 oz from both breasts (which I understand is laughingly meagre compared to most lactating women but for me was a deluge! And I stood proud).

I made peace with my milk, or lack thereof. In fact, since I have accepted that I have done everything possible - both physically and emotionally- to provide milk, I now even enjoy the convenience that providing formula can offer. He sleeps more during the night because we provide him a bigger feeding when he goes to bed, giving me and hubby some needed time as well as some much needed sleep. I still breastfeed every time he feeds and provide him all my antibodies and all that good stuff and I have accepted that the organic formula we give him (which in a way is an oxymoron for by its very definition, "formula" is formulated and there are additives in there which are not natural, even if good for the baby, such as DHA, Vitamin D etc) provides him whatever my milk lacks (for mother's milk is only as good as the mother after all). So in a way he gets the best of both worlds. For me, it's still double the work - I have to breast feed and bottle feed each time - but knowing I supply my son my milk and bonding with him (he stops during feedings and gives me a bashful smile as if saying "thank you mum! I appreciate this!") is all worth it. I've made peace with the way we feed and with the fact that my milk may dry up - until it does, we feed and feed and feed. I'm much happier and a better mother for it as I am not discarding my son for the pump.

One of the reasons I was so against formula (apart from anxiety that a corporation was feeding my son and wondering how tightly controlled this psychopathic creature was) was that I believed it was the "easy way out" - certainly now, breast and bottle feeding - we did not choose the easiest option (nor the least expensive by any means). Being ignorant of how difficult it was to breastfeed, I had incorrectly assumed that mothers that fed formula to their little ones were choosing the convenience of it and denying the good stuff to their babies (in my defense, I had read that one of the main reasons women choose not to breastfeed was fear that it would affect their breasts - such a cosmetic and selfish reason, I found unpalatable). These mothers, in my mind, were therefore not as good, as they preferred their own convenience and appearance to their babies' health. It's always good (and sometimes necessary) when the universe slaps you a lesson that unveils your ignorance and increases your empathy. My forage into the stygian side of breastfeeding has taught me the lesson that women do not make this choice easily and most of the time, it is made for them.

Wednesday, February 4, 2015

A Circus Act (Luca's Playground)

I am stealing this post in as L is entertained by his safari mobile. I reckon I have about 20 mins before he becomes fidgety - either bored, wet or needing to burp. In order to get anything done, I have to bounce L from contraption to contraption throughout the day when he is not feeding or sleeping so that he is diverted while I (try to) work. Sometimes, the plan falls through - such as the mobile that I had placed between two couch cushions in our temporary accommodation (we've moved the fam from NY to SF!) that stayed in place by the pressure of me sitting on one cushion, nearly falling on top of him when I moved without thinking, during my conversation with the clerk of the court in a Southern District case I'm litigating at the moment and resulting in some ambient acoustics for the young clerk (who may now think twice about early motherhood). Another diversion, which I can only use when reviewing (or buying more L diversions on Amazon), is to put on the Beatles or the Beach Boys, which L loves and have one of his plush friends, Benjamin the Bunny or Larry the Llama or Marius the Giraffe rock on to their beats, which employs one hand only and leaves the other to click through as needed. The baby bouncer provides some relief, but only works if Sir L can look at me while I am doing something interesting - which to him involves movement and definitely not typing. It worked great while we were moving as he he loved seeing me put things into boxes. A swing is on the way which purportedly will give me more time.

In this way, as L goes from ride to ride in his playground throughout the day and mum goes about her deeds in bursts, a precious hour and change is achieved. I cut a deal with my hubby to be on duty for 90 mins in the morning or evening most days to get more work in. However, if I'm realistically going to continue my practice, now that the grandmothers are gone, we're going to have to find a breathing biped diversion. I'm very nervous about this, particularly as L has vesicoureteral reflux ie if he gets a UTI, he gets a kidney infection. We watch him like hawks and bathe him every time he poops. I worry that any sitter we employ would not be as diligent. That is my main and my professed concern as I know it sounds reasonable. I have other concerns, that I understand to be a little from left field, but that still gnaw at me. What if a sitter appears fantastic but is really a kidnapper? Or a sadist? Or has horrible grammar that influences the currently vulnerable linguistic wiring of my son? I trust the older he gets, the less panicked I will be, but I am prone to being a worry wart and may have to stalk any potential babysitter online to see if they are suitable for Sir L.

A lesser concern is the economics of the situation. Employing a babysitter while I bill is a no brainer. But what of employing a babysitter when I am not billing but doing what is necessary for my practice? This brings me back to my earlier point in a previous blog as to how important childcare is for women's career choices. Many women do not go back to work because by doing so, their whole salaries may go towards childcare and in such case, why have a stranger look after your heart and soul? The fact that there is no subsidized or government provided childcare is absurd.

L is starting to fidget and my time is nearly up. Next, we will go onto tasks that can be done by the both of us. I've become quite adept at doing things one handed, holding L with the other arm and that's saying something because before he was born, even doing things with two could be a hassle - I am terribly accident prone. Necessity is not only the mother of invention, but adaption too.

After that, it'll be back to mama on the go-go, the full time circus act that has only one but devoted customer and who pays in gems of priceless smiles and gurgles. There's the slippery dip, where I hoist him up and slide him down my legs as I lie on my back and lift my legs up, the "aero ride" where I hold him flat as I stand and spin and many a puppet show and song and dance routine. I have my standard gigs and then I switch it up, but its's always go-go-go. It can be tiring but you can't beat that smile as a reward. It's worth the world to me.