For TB

My good friend Tammie has just given birth to a beautiful baby boy! If you haven't already, please head over to Soul Gardening to congratulate her. This post is in her honor.

The Best Ass-Vice I Got Before Having Kids:

1. "Don't hold babies too much, or you'll spoil them." Holding my babies is the best part of my day! I'd like to think it's the best part of theirs, too. Babies need to be held.

2. "If you keep using bottles, your babies will stop taking the breast." Said to me during Week 2. Two months and counting--they're still taking the breast. Apparently a handful of babies, if given bottles while learning to nurse, will refuse the breast. The rest of us get to pump milk, get some sleep, or just give our nipples a break.

3. "Enjoy the end of the pregnancy, because it's easier to take care of babies when they're inside than when they're outside." I was miserable at the end of my pregnancy. I was elated after delivery. Taking care of newborns isn't easy, but it's far from the horror that many people make it out to be. I think it's much, much better than being extremely pregnant.

The Best Advice I Got Before Having Kids:

1. "Swaddle your babies before putting them to sleep." It not only helps keep them on their backs, but it also keeps them from scratching themselves, and it helps them sleep longer, because they don't startle themselves and wake themselves up.

2. "Get a steam sterilizer." Makes life much, much easier than pots of boiling water.

3. "C-sections aren't as bad as they're made out to be." SO true. I'm sorry I wasted so much time worrying about one. Childbirth of any kind is hard; C-sections are no exception, but they're hardly a horror. And there are benefits to them: no episiotomies, no hemorrhoids, etc.

Much thanks to Cool Mom Picks, Her Bad Mother, and Mothergoosemouse for organizing this virtual shower, and congratulations also to the ladies at Mom-101 and A Mommy Story on their babies!

The Mommy Track

For the first two weeks of my sons' lives, I never wanted to go out to dinner, work, or go shopping again.

"Would you like to take a nap?" My mom asked me. "I could watch the babies."

"No, thanks. I just want to sit in a chair and bury my face in my sons' heads."

"Would you like to go out for an hour or so to the store?" My dad inquired. "I could watch the babies."

"No, thanks. I just want to sit in a chair and bury my face in my sons' heads."

"Would the two of you like to go and get a bite to eat?" Our friends asked Ty and me. "We could come over and watch the babies."

"No, thanks. We just want to sit on the couch and bury our faces in our sons' heads."

Then, sometime in the midst of the diapers and the feedings and the tiny fingers and the chubby cheeks and the wonderfulness of having newborns at home, something happened.

I turned thirty.

"What would you like to do for your thirtieth birthday?" My family asked me.

"I want to sit in a chair and bury my face in my sons' heads. Oh, and eat cake, and takeout sushi," I replied. (After all, it HAD been nine months...)

When the last piece of yellowtail was gone, I opened my presents. Among my husband's generous offerings was a gift certificate to my favorite local clothing store. I remembered how I used to sneak away, in between grocery shopping and picking up dry cleaning, and spend a pleasant hour or so sorting through the racks there.

And I had turned thirty.

And babies--well, they cry a lot. And they poop.

And I got my bank statement. And, well, they aren't cheap.

So, a few weeks later, I started to think about doing some work.

Around the same time, someone I know called with some work for me. It was the kind of project I'd really like to do, but have long been afraid of doing. In fact, I've turned down similar work before. Not because I couldn't do it, but because I was scared to do it.

But, well--now things are different. I need some money. And I'm thirty. I am the mother of two children. I've had a C-section. I've injected myself daily for months. I've been solely responsible for the health of two unborn babies, who, towards the end of the pregnancy, depended on me focusing on their movements at all times and marking any changes, to make sure they stayed alive. Now I'm responsible for the health of two born babies. Babies who've doubled their weight in eight weeks. Babies who already smile, reach for their bottles, and sense when their parents enter the room.

It's time to stop being scared, isn't it?

As it turns out, thirty is pretty good.

Shakespeare and Sugar

5:46 am. I'm exhausted. My computer, however, is wide awake, having loudly and obnoxiously chimed to announce the installation of a new version of SpamKiller. It also has offered me some variation on "java," but not the kind I really need right now.

We're baptizing the boys today. I've been hovering over them all night to make sure they're still breathing, because didn't Shakespeare say something about irony being a cruel bitch? Or is that just what happens when a pretentious former English major gets too little sleep?

Now Sage is crying. Stupid loud computer! It's going to be another one-handed post. Oh well. At least he's temporarily entertained by the sight of me in my reading glasses.

I have a bit of public-appearance anxiety about today. Ty and I were late to the Baptism meeting and all the other people had to move their chairs to expand their circle, and then I was really too tired to participate in any meaningful way.

I logged on to post this after feeding the babies and having put them back down to sleep. I had ambitious ideas; I was going to write about religion and my faith and how I never write about it and how it ties into other areas of my life and why it's important to me and how I reconcile it with things about myself that are seemingly inconsistent and Earth Day and spring and flowers and Baptismal waters and renewal, but now both babies are crying and Sage is puking all over my wishfully MILFy red nursing nightgown, so I'm going to have to settle for pretending that this post is a meaningful commentary on balancing one's own wants and needs and creativity with meeting the needs of one's children.

It looks like I'm up for good this morning. But screw the cereal I was going to eat for breakfast; I'm having the stale Entenmann's chocolate chip cookies.

The invisible invisible woman

Dear Blogger,

Why don't you remember me on your login page even though I click "Remember Me" every single effing time I post????

I have been blogging with you for a year and a half. I stayed with you through thick and thin and smenita and Beta. Yet, I am less memorable to you than to a lady I bought a single pair of shoes from two years ago, who still smiles at me when I walk past her shop.

Oh, but it's okay...I have nothing better to do than type unnecessary words every single time I sit at my computer, while TWO hungry babies scream and poop.

Thanks a BUNCH.

Sincerely,
Arabella

Il Latte League: Arabella on Breastfeeding

PLEASE NOTE: I am not a lactation consultant or medical professional of any kind. I am simply, to paraphrase Grover Monster, "a mother who is trying." Here is a bit of what I've learned in the past six weeks, while nursing my twins.

1. One thing that nobody tells you about breastfeeding is the tremendous time commitment involved. After giving birth, I was taught in the hospital that, to help milk come in and to keep it up, one initially needs to nurse or pump (or do a combination of the two) 8-12 times per 24 hour period (therefore, every two to three hours), for 15-20 minutes on each breast at each time. For example, if your baby nurses on each side for five minutes, then pump for 10-15 minutes on each side right afterwards. Yes, this means that...

...you will have to excuse yourself in the midst of a family gathering to go and pump. When your 80-year-old uncle asks why you're leaving the room, you will have to announce that you are going to "pump." He won't understand, and will ask you to clarify. You will need to explain that you are pumping milk--as in, from your breasts. Probably loudly, because it is always the relative who is hardest of hearing that asks such things. This explanation will not be nearly as embarrassing as it sounds, because 1) 531 different strangers will have seen you in several unsavory variations on naked during your delivery and subsequent recovery, 2) every man you have ever known will suddenly ask you about your breasts, and 3) at least one well-meaning relative, while attempting to cook you dinner or bake you something sweet, will spy your freshly-cleaned breast pump parts on the drainboard and mistake them for a funnel, and you will already have had to launch into an embarrassing explanation about what they really were for.

...you will not be able to be away from your baby and/or your pump for any length of time. This is okay; it is just one of many, many reasons why you need to clear your schedule and not plan on doing anything after you give birth.

...you will have to get up in the middle of the night even if you have someone helping you feed your baby/babies at night. It is still worth it to have help at night, though, if you are lucky enough to have someone offer. Pumping for 15 minutes twice during the night is way, way better than being up ALL night, and changing diapers, to boot.

...you may have to type a blog entry about breastfeeding with one hand while you clutch a baby at your breast with the other, not that I would know anything about that. Particularly not as I write this.

2. In spite of the time commitment, breastfeeding is still very, very much worthwhile. Aside from being so good for your baby, it really does help your uterus shrink back to its regular size, and it really does help you lose weight. Before very long, you will be able to go a little bit longer between pumping sessions, if you are pumping, and you will probably be able to empty your breasts in less than 15 minutes. Plus, you'll have huge knockers. Of course, if you can't, won't, or don't breastfeed, don't feel badly about it, and don't let anybody else make you feel badly about it, either! It's not easy.

3. Don't worry too much if you get off-schedule. Just pump or nurse as soon as you can, and then get right back on schedule. I went five hours on the day I was discharged from the hospital, and came home terrified and panicked about engorgement. I assembled my breast pump in a hurry and pumped as soon as I could; everything was fine.

4. Don't panic if you can't put your baby to your breast within 60 minutes of delivery, as is suggested by every lactation consultant (LC) in the universe.

5. Similarly, don't panic if you learn that the NICU or nursery staff has fed your baby formula, or has used bottles or pacifiers, also contrary to the advice suggested by every LC in the universe. In my very humble, completely biased, and totally inexperienced opinion, the threat of nipple confusion is greatly exaggerated. (Yes, bottles are easy, but breasts are warm and soft.) BUT...that said, make your wishes known, early and often, regarding whether you want the staff to avoid formula, bottles, and pacifiers. Remember, YOU are the parent. BUT...be flexible and realistic enough to listen to the advice of qualified professionals, if there is a real reason why your baby needs to be fed formula in order to thrive.

6. Breastfed babies eat more often than formula-fed babies (for example, it could be every two hours versus every three). If you make the decision both to breastfeed AND use formula, you may want to breastfeed during the day (for maximum fun and bonding) and use the formula at night (for maximum sleep).

7. When you first try putting your baby to the breast, hold your baby's head with the hand opposite the breast you're working with. Hold your breast with the other hand, behind the areola. Using your index and ring fingers (on the bottom) and thumb (on top), gently press your breast until it gets a bit more horizontal, like a sandwich. Hold the mayo and all other disgusting condiments. Touch your breast to your baby's nose, wait until he or she opens his or her mouth wide, and then guide the baby's head to the breast, not vice-versa. Put as much of the nipple AND areola into the baby's mouth as you can.

8. If at all possible, arrange to meet one-on-one with a lactation consultant. Do this as soon as you can.

9. Ask your friends for help and advice about breastfeeding. Or e-mail strangers on the Internet; whatever you prefer.

10. I have heard that, if you have the option, it is better to put your baby directly to the breast than to feed the baby pumped breast milk, the reason being that there is evidence that your body senses germs in the baby's mouth and manufactures antibodies to them. I do not know whether this is true, but if it is, it sure is cool. Pumped milk is quite rich in antibodies, too, though, so don't worry if you can't put your baby directly to your breast.

11. If possible, let the baby come off the breast himself/herself. If not, use your clean pinky finger to break the suction at the baby's mouth before pulling away.

12. If you have a C-section, talk to your doctor about taking your pain medication before a breastfeeding session to give it time to kick in. The reason for doing this is that breastfeeding makes your uterus contract, which can hurt a bit after a C-section. Make sure your doctor knows you are breastfeeding and prescribes a pain medication that is safe for breastfeeding. If it is like pulling teeth to try to get your pain medication out of the nursing staff, talk to your doctor and have him or her make it clear to the staff that you are to get your pain medication on time and without a hassle. If they make you "describe the pain" before they give you your medication, instead of saying "burning" or "numbness" or "stinging" or "4 on a scale of 1 to 10," one particularly descriptive way of doing so might be to say, "It's the kind of pain you feel when someone cuts your stomach open and then the same area is made to contract, so give me my ____ doctor-prescribed-and-authorized pills (insert expletive of choice)."

13. Breastfeeding may initially make you wince a little, but the pain shouldn't be overwhelming, by any stretch of the imagination. Pain is often caused by a poor latch. If you feel pain while breastfeeding, have a lactation consultant check the position of the baby's latch. For what it's worth, I found the so-called "pain" at the breast to be no big deal, and I'm a huge baby about stuff like that.

14. For further reading, I recommend So That's What They're For! by Janet Tamaro. Like most experts, she advocates exclusive breastfeeding, which made me feel a bit guilty, because I'm supplementing, but she does cut slack to mothers of twins and other special situations. Plus, the book is really funny.

15. Enjoy this special time with your baby!

Did You Know?

You never stop feeling silly when you say the word "binky."

Even better, though, is when your father, recalling the brand-name "Nuk," calls your baby's pacifier a "nookie."

"Hey, baby. Want nookie?"

Afterglow

After about five to ten minutes of this dubious nursing, the nice nurse gently suggested that I attend one of the breastfeeding classes being offered at the hospital. I picked up a schedule on the way back to my room.

During one of the endless visits from nurses to give me pills or injections, one of them wheeled a hospital-grade breast pump into my room. I cringed. To me, it seemed mysterious and potentially barbaric and painful.

"I'll just leave this here," she said. "When you're ready, let me know, and I'll set it up for you."

I wheeled it into the corner and tried not to look at it or think about it. Clearly, I was having trouble with this breastfeeding thing. With the odds stacked so significantly against me, I thought, was it any wonder? Formula and bottles and pacifiers and time lags. Oh my! I imagined every lactation consultant and breastfeeding advocate in the universe collectively letting out a huge sigh. Aaarrrgggghhh! You've made your babies lazy and they won't take your breast! Nipple confusion! Your milk will dry up! Your children will suffer! You'll have trouble bonding! It's harder with a C-section because it will hurt! It's harder if you have an epidural--your babies won't be interested! They should have been put to the breast within 60 minutes of delivery!

Some time later, I visited the NICU again to try to nurse. There had been a shift change. I told the nurse on duty that I was there to breastfeed.

"You've got five minutes," she told me. She was determined that the babies' diapers would be changed on the dot of the hour, and NOT ONE SECOND LATER.

I held Sage's brother to me, hereinafter Thyme. He fussed and cried and wouldn't take the breast, and my precious time (get it? Thyme?) rapidly came to a close. I would have cried, but Ty made some joke about the Nursing Gestapo, so I laughed instead. I resolved to try the breastfeeding class the next day.

When I showed up, there were three other women there. I was the only one in grungy pajamas and without my baby (babies). The other babies were in the nursery, not the NICU, so they were allowed to be with their mothers, who were clutching them to their breasts, and looked competent.

"You can bring your baby with you, if you'd like," the nurse in charge told me, as I introduced myself.

"My babies are in the NICU."

"Did you have twins? Congratulations!" She smiled. I felt a little bit better.

Then, instead of the blackboard-oriented lecture I was expecting, she asked if we were comfortable, and, one by one, she went around to each of us as we unbuttoned our blouses and she assessed our situations. I fairly quickly went from worrying that there was some Joe Francis-wannabe operating a hidden camera in the room to watching and learning.

The first woman had high-end pajamas and a baby with a gorgeous head of hair. I was intimidated by her, until she unbuttoned her blouse and the nurse diagnosed engorgement.

"He prefers one breast over the other," she explained, and winced as the nurse manually helped relieve her.

The next woman was young, bosomy, blond, and Scandinavian. Her baby had red hair and was completely adorable. When she unbuttoned her blouse, she revealed a well-fitting nursing bra complete with nursing pads. Again, I was intimidated, figuring she had it all together. As it turns out, she had a problem with positioning the baby at the breast.

The next woman had the oldest baby among all of us, and had been working on nursing the longest. She was getting the hang of it, but still had problems getting the baby to latch on.

Next, it was my turn.

"One of my babies latched on okay, but I don't think I have anything. Not even colostrum," I said softly.

I unbuttoned my blouse, and she told me that my babies would be able to latch on well. "Very good," she told me.

I brightened. It's amazing what ONE bit of positive feedback can do, even after a deluge of negativity.

"Here. Here's your colostrum," she said, showing me, for the first time, a drop of what looked like yellow ointment. "When did you deliver?"

"Almost 48 hours ago."

"You should start pumping."

"Really?"

"Yes, absolutely." She began to assemble a pumping contraption, hooked it up to a hospital-grade pump like the one in my room, and showed me how to hold the funnel-like cones to my breasts. The pump, on the lowest pressure, felt strange, but didn't really hurt.

The nurse instructed me to pump every 2-3 hours for 15-20 minutes at a time, and to try putting the babies to my breast whenever I could.

I followed her advice. I asked the other nurse to help me with the pump in my room. For several pumping sessions, I had nothing. When I tried putting the babies to my breast, I met with mixed success. Sage took to it a little bit easier than Thyme. I just kept trying. Thyme would learn to latch on over his first week of life, and, eventually, it would come just as naturally to him as it had to Sage. Persistence was the key.

By late the next day, I was producing minute quantities of a thick and, well, milky substance.

By the following morning, I was producing small quantities of what I had anticipated milk would look like.

I had done it. Contrary to basically all advice I had ever heard regarding how to establish successful breastfeeding. In spite of a C-section, a 19-hour lapse between delivery and first contact with the breast, and use of bottles, formula, and pacifiers, I had become a nursing mother. Of twins. And I still am. And I still use bottles and pacifiers and--gasp--formula, when I need to. And you know what? My babies are thriving. And they love nursing. And so do I. And I'm happy, and actually enjoying the initial postpartum period, after a very difficult pregnancy that could have made for significant postpartum depression. What on earth is wrong with what I'm doing? The answer is, NOTHING.

The moral of the story is, Don't let anybody, however well-intentioned, discourage you, or make you feel like it's all over just because something happens that prevents you from following every single bit of nursing advice. Do what you have to do for yourself and your babies, and keep at it.

To be continued.