Post-op and Nursing

Last Thursday, Ivy had a quick visit with the surgeon who repaired her fistula. And it was quick: the nurse practitioner spoke with us for a couple of minutes and had us update her on how Ivy's been doing, and then the surgeon came in and looked at her incision and her IV site (they looked fine) and sent us on our way. He said that it'll take 3-6 months for both to completely heal, which is a long time but I think she'll be bandage- (and Billy Idol glove-) free much sooner than that. They also set up an appointment for us to do another swallow test and do an ultrasound to look for renal birth defects (they doubt there are any but they're just being safe) in six weeks.

We also swung by the children's hospital (which is a separate wing from where the appointment was) so that we could pick up some milk that had been left in the deep freezer (there was a ton!) and take a couple of photos at the entrance sign. It was weird being back there, like we never left and also like it was a year ago.

Breastfeeding is going better! Leaning back a bit and using pillows has made a big difference. Ivy is still taking a supplemental bottle shortly after every meal with me, which will hopefully stop eventually as she learns to eat more efficiently. She wiggles a lot and ends up popping herself off several times but she's getting better at latching back on without much help. She usually ends up just kinda lying there and nibbling after awhile, and I always think she's going to nurse herself to sleep, but she always wakes up the second I move her. I rubbed her head after her feeding at 2am last night and put her to sleep, though - it was cute.

Breastfeeding Woes

By far, the hardest part of this early-parenting thing has been trying to transition off of the bottle. I had grand plans of never letting Ivy have a pacifier, and not bottle feeding until I had to go back to work and she had to go to daycare. Of course, because of her situation, that totally did not happen. So starting in the NICU, I tried breastfeeding here and there, but never tried very hard because our top priority was gaining weight. Then we got home, and still had that priority, and then I started down a spiral of thoughts like "now there's only x weeks left of my maternity leave, so is there even a point to breastfeeding?" and "she's got nipple confusion" and "I'm tired so I'm going to go take a nap while Cory feeds her." I also had an assumption that no matter how tricky people said breastfeeding was to master at first, that I was a natural and would have no real problems. (It's a pet peeve I have for myself: I was a smart kid, and learning/school came easily to me, so I created this bravado around anything I hadn't tried yet. And then gave up in a huff and tears as soon as it didn't come easily.)

But this bottle-feed-then-pump-then-clean-bottle-and-pump-parts schedule takes an hour (which is a lot when she needs to be fed every three hours at night and I'm trying to sleep) and I would really like to be able to travel without a bottle as well as give her milk as soon as she wants it rather than having to reheat refrigerated milk. And of course there's the bonding thing, and all of the other great benefits that breastfeeding has. I'm proud that she's been able to reap the benefits of having been fed only expressed breast milk (even when she was brand new and I was having my D&C for the retained placenta; she had donated milk) but I'd really like to achieve the breastfeeding goal despite all of her setbacks.

To that end, I visited a lactation consultant at the OB's office today. I explained that Ivy has latching issues, that she would sorta latch and then spit the nipple out or come off of it several times before she got a good latch; and then she would spent maybe ten minutes (if we were lucky) on one side, reject the second side, and fall asleep - and be ready for a bottle very soon after. We timed the appointment really well, as she was just starting to get fussy out of hunger, and of course she latched on quickly and easily and made me worried that the LC wouldn't have any advice for me.

The LC went over a lot of things that I knew already, but it was really nice to hear it again and to sometimes have explanations about why/how things work. The most helpful thing she did, though, was to immediately adjust my posture. I'd been putting Ivy on my lap and hunching over her, trying to push my nipple into her mouth when she opened up. The LC had me lean back and put lots of pillows under my arms and under Ivy, bringing her way up further on my torso than I'd ever tried, and it seemed to work really well. She even latched on to the right side, which seems to be more difficult for her, after having already spent time on the left.

Then we weighed her, and she's gained 7 ounces since last Thursday. She's now 8 pounds 4 ounces - out of the 7 pounder club forever!

I left feeling pretty energized about the whole thing, and was happy when she only took 40ml of a supplemental bottle (her full feeding is around 90ml) when I got home - only to lose steam just a few hours later when I was dead tired and asked Cory to bottle feed her so I could take a nap. Gah. I can tell my downward spiral of thoughts need more uplifting than just one successful breastfeeding - that'll be the thing I have to work on the most.

One Month Already

My little sweet pea, I have no idea how it's been a month already. It honestly seems like last week that I reached for a brand-new you, still attached to me, and said hello to you for the first time. I wish your first two weeks went a little bit differently - I wish I could remember more of our first moments, unfettered by the hemorrhage. I wish that you didn't have to know already what it's like to have strangers messing with you, to have tubes in your nose and down your throat, to hurt despite morphine. But, aside from lots of check-ups, that part of your life is done and mama won't leave you alone any more.

Our lives are much happier now that we're home. We're slowly settling into - not a routine, exactly, but a strategy. You're throwing us curve balls every once in awhile, like yesterday when (apart from a few catnaps) you stayed awake almost all day and into the night. Nursing still isn't coming naturally to us, but we have an appointment with a lactation consultant on Monday and you're at least learning to latch a little more quickly than before. (We'll get there!) You're an easy baby overall, and while there's no reason why we'd deserve that, we are very happy that now we can just enjoy you. After all the trouble you've been, from the time you were only ingredients inside of us, it's nice to have a little break.

Linus and Dexter aren't quite adjusted to you yet, but we know that will come. We, on the other hand, count our blessings every day, even through the sleepy or frustrated times. You can't know how much we adore you. Your daddy and I have settled into our orbit around your light, and there we'll stay forever.

HOME!

Just a quick note to say that we are HOME! It was touch and go yesterday; in the morning they told us they wanted to see 48 hours of weight gain and then in the afternoon they said they wanted to see three days of weight gain. So we thought we might not be able to get out of the hospital until Monday. Cory gave both the doctor and one of the surgeons a piece of his mind yesterday afternoon, and this morning the doctor talked to the head surgeon and they decided it was OK to let us go.

And now, here we are. It has been super hot this past week, and the house has succumbed to it - it was about the same temperature inside as it was outside when we got home. We stripped Ivy down to her onesie and she has slept like the dead pretty much all day - we've had to wake her up every two hours to feed because if we wait longer we have to feed her a higher quantity of milk and we can't keep her awake to finish it. Either the drive tuckered her out, or this heat has. I've found myself almost missing the nurses and monitors (almost), just because they helped me feel more confident. I think our biggest project now is re-establishing a schedule that we can all stick to. That and establishing breastfeeding: we've been so focused on cramming milk down her gullet that I haven't had a chance to just let her feed naturally. Another best-laid plan that didn't quite work out the way I thought it would. Oh well.

Eat and sleep.

We are marking Day 13 in a much different way than we have marked days last time I posted. A few days ago, Ivy came off of all of her tubes and wires (except for the monitors which are just stuck to her chest). And she is quite a different baby now. When everything came out, we saw a little different energy, and a lot of sleeping. I think she's finally getting that deep healing sleep that she needs to really recover from the trauma of the last couple of weeks.

Today Cory is spending a few hours re-learning infant CPR, and I spent some time with the lactation consultant. Our lives now revolve around the biggest thing that needs to happen in order for us to go home: gaining weight. Ivy has a prescribed amount of milk she needs to take, and it's a chore almost every time. This is because she tends to go to sleep partway through her feeding, and we are discovering it's likely because she is still learning how to swallow and wants to protect her airway so she has figured out how to stop the threat. Or at least take a break from it, since we are working with her very closely so that she takes the amount of milk she is supposed to. We really want to get out of here. Unfortunately, the nurse relayed to me earlier that the doctor told her we aren't getting out of here tomorrow, which is what my personal goal was, but it should be by the end of the weekend. Of course, we are on Hospital Time, which could mean we go home on Monday or we could go home this afternoon, depending on what the doctor says. (Monday is more likely than this afternoon.)

Now that Ivy has got no strings, I've been feeling much better. That's only part of it though: Cory has been absolutely amazing. He has done so many of the feedings, saving me from the frustration of the volume of milk she has to take and doesn't want to. He has encouraged me to take a ton of naps, and focus on pumping, which was a huge help yesterday and has made me feel much better today. I took a postpartum depression screening test yesterday (based on how I felt in the last week) and scored an 11, and the threshold is 10, but they told me it was just because of being in the NICU and I shouldn't be worried about it. And indeed, as each tube has come out and we come that much closer to leaving, more weight is being lifted off my shoulders. I sometimes look at her little info board on the wall and see how she will be two weeks old tomorrow, and it makes me so sad that she hasn't even been home yet and our leave time is being eaten up by living in a hospital - but I can't dwell on that. Eyes on the prize, and all that.