Nursing Your Kids

A friend asked via email, “How is Sam doing? Is he adjusting any better?”

The answer:

Not really. He’s a mess. He’s taken to grinding and clicking his teeth, clenching his jaw into an underbite when he plans on hitting or biting, he’s biting his fingernails and toenails, and today he’s sick so everything is magnified. It’s distressing to say the least. I put him to bed every night and get up with him and cuddle every morning in addition to the times while the baby is napping or Bob’s around that I can spend alone with him during the day. So it’s not like he’s not getting alone time with me. He’s also spending plenty of alone time with Bob. He’s fine if we have play dates or things to do, but when we’re home alone he’s a terror.

I’m on the verge of tears just thinking about it and he’s had me in tears just about every day. He’s such a sweet boy, gentle and easy going that most people who know him don’t even believe me. I get these glimpses of him a few times a day, these moments where I recognize him again, which make me feel even worse about his behavior. I feel awful that he’s so distraught by the new addition but I don’t know what I can do to make him feel secure again. I keep bending over backwards to accommodate him, often at poor Ben’s expense.

Sam doesn’t hate Ben. He demands to hold him and brings him toys and says, ‘it’s okay Ben’ when he cries, but then out of nowhere he’ll just hit him or try to squish him or kick him. He also demands to nurse when Ben nurses, and I don’t know what to do except let him. He doesn’t even want to nurse. He just latches on, looks confused and gets off.

I’ll skip day 9 because it was relatively uneventful compared to Ben’s 10th day out of the womb. To keep Sam occupied and violence free I scheduled a play date for this morning and a visit from Grandmom (my mother-in-law) this afternoon. All was well until around five o’clock. We were sitting outside and I started to feel a little bit cold. I was a little sore under the armpits. ( For those of you who may not have breastfed yet, the milk glands start under the armpit and milk can collect there making them lumpy and sore.)

When my MIL left I went inside. I still felt cold so I put on a sweatshirt and looked at the thermometer. It was 70 degrees in the house. Not a good sign. I took my temperature and sure enough I had a low fever. I didn’t put the two things together- sore armpits and a fever- until Bob reminded me that I could have an infection. Sure enough, my left breast was fire engine red and hot to the touch and I started feeling flu-ish.

It was after office hours but my doctor was on call so I had her call in a prescription for antibiotics for me. I was still hoping that I could avoid them since Ben had a little yeast rash in the diaper area and antibiotics can cause yeast problems like thrush, a condition I managed to avoid with Sam, but I wanted to have them if I didn’t get better without.

I put on a heating pad and let Ben nurse on the sore breast for a long time. I block nursed for the night, just one side at a time to make sure everything was well-drained and put heat on the sore side before each nursing session. I took advil to help with the discomfort and swelling and went to bed early waking to nurse regularly, hoping for the best.

Unfortunately I still had a temperature Saturday morning and my breast was still hot and red to the touch. So I started the antibiotics. Bob took Sam out for the day so I was able to rest with Ben most of the day. By Sunday I was feeling better. Yesterday, Monday, I was still sore, but all of the other symptoms had completely subsided.

Mastitis sucks but I’m glad I caught it early.

FOR IMMEDIATE RELEASE
May 23, 2008

Media Inquiries:
Rita Chappelle, 301-827-6242
Consumer Inquiries:
888-INFO-FDA

FDA Warns Consumers Against Using Mommy’s Bliss Nipple Cream
Product can be harmful to nursing infants

The U.S. Food and Drug Administration is warning consumers not to use or purchase Mommy’s Bliss Nipple Cream, marketed by MOM Enterprises, Inc., because the product contains potentially harmful ingredients that may cause respiratory distress or vomiting and diarrhea in infants. The product is promoted to nursing mothers to help soothe and heal dry or cracked nipples. Product labeling specifically states that there is no need for mothers to remove the cream prior to nursing. However, the ingredients contained in the product may be harmful to nursing infants.

Potentially harmful ingredients in Mommy’s Bliss Nipple Cream are chlorphenesin and phenoxyethanol. Chlorphenesin relaxes skeletal muscle and can depress the central nervous system and cause respiratory depression (slow or shallow breathing) in infants. Phenoxyethanol is a preservative that is primarily used in cosmetics and medications. It also can depress the central nervous system and may cause vomiting and diarrhea, which can lead to dehydration in infants.

Mothers and caregivers should watch for a decrease in an infant’s appetite. More serious signs would be difficulty in awakening the child, limpness of extremities or a decrease in an infant’s strength of grip and a change in skin color. Please seek immediate medical attention if your child is showing these signs and symptoms.

“The FDA is particularly concerned that nursing infants are being unwittingly exposed by their mothers to this product with dangerous side effects,” said Janet Woodcock, M.D., director, FDA’s Center for Drug Evaluation and Research. “Additionally, these two ingredients may interact with one another to further compound and increase the risk of respiratory depression in nursing infants.”

Though the FDA has not received any reports of injury to infants, the agency is alerting the public because of the potential harm this product can have on a child.

Chlorphenesin can also harm the mother by causing dermatitis, a skin condition that can worsen the drying and cracking of nipple skin.

MOM Enterprises, Inc. is based in San Rafael, Calif. The company has stated that it has discontinued marketing the nipple cream with the potentially harmful ingredients. The FDA is advising consumers to discontinue use of Mommy’s Bliss Nipple Cream and to consult a health care professional if they experience problems or believe that their infant may have experienced problems due to this product. Nursing mothers with cracked, painful nipples, which is often a side effect of nursing, should speak with their health care professional or a certified lactation consultant if the problem is severe or for other treatment options.

Consumers are strongly encouraged to report adverse events related to this product or any FDA approved product to MedWatch, the agency’s voluntary reporting program, by e-mail at www.fda.gov/medwatch/report.htm, or by phone at 800-332-1088, or by fax to 800-332-0178. Consumers may also mail reports of adverse events to MedWatch, Food and Drug Administration, 5600 Fishers Lane, Rockville, MD, 20852-9787.

Day 7

The jealousy is getting worse. Now Sam’s is getting violent towards Ben, hitting him and trying to pull him out of my lap. Today I was in tears after Sam hit me, hit Ben, then tried to push Ben out of the bouncy chair. Ben didn’t notice, but it kills me to see my sweet Sam act so terribly. I know that adjustment issues are common and that it won’t last forever, but I’m afraid of being on my own for a full day with them.

The engorgement is getting better. Ben’s nursing more and sleeping less. It still hurts like hell when he latches on, but it goes away after a minute or two. He’s a fast nurser, gulping down breastmilk quickly then looking around for a while trying to decide if he’s still hungry. It’s amazing how different he is from Sam. Sam used to nurse forever. Most days he’d nurse for about an hour out of every two hours. I know he’s only a week old, but so far Ben couldn’t be more different. He’s done in 10 minutes easily, gasping for breath after drinking so hard.

Day 8

Ben’s first doctor’s appointment was this morning. Bob took the day off from work to go with us. When the nurse weighed him we were astonished to see that he’s lost weight after being discharged from the hospital. His discharge weight was 7 lbs 8 oz. His weight a week later was 7 lbs even. But he’d grown a full inch. He nursed for a while after being weighed and measured before the doctor came in.

The pediatrician was concerned about the weight loss and asked a number of questions. She wanted to know if he was nursing 8-10 times in a 24 hour period and if he was gulping while he ate. She asked if my milk had come in. Hoping she’d weigh him again I mentioned that he’d nursed after he was weighed. The doctor’s scale isn’t as sensitive as a lactation consultant’s, but she thought she’d weigh him again just to see. Sure enough, his weight the second time was 7 lbs 11 oz. She weighed him again just to make sure and it was the same. I don’t know what happened the first time. Bob and I were both watching the nurse as he weighed Ben and he didn’t do anything wrong. I was so relieved that he’s gaining weight.

Day 4

With the milk in, Ben started nursing a little bit more, taking huge gulps followed by a more leisurely pace. The only way I could get him to nurse on both sides was to change his diaper in between feedings. He still wouldn’t nurse much on the second side, but he’d nurse a little before falling asleep again.

He woke up to nurse three times in the night, which is a good sign. He’s sleeping in our room in a bassinet next to the bed. After the first wakeup I tend to fall asleep while he nurses so he generally doesn’t make it back into his own bed. The good news is that we’re both sleeping pretty well. I don’t know how long it will last since this early newborn sleepy stage is fleeting, but I’m enjoying getting my rest while I can.

Day 5

Nothing remarkable today. Ben continues to nurse and sleep with stretches of wide-eyed wakefulness in between. I am still engorged and it hurts.

Day 6

The inevitable has happened. Sam’s jealousy has kicked in full force and he wants to be on my lap when Ben is and he wants to do what Ben does. If Ben’s in the bouncy chair Sam wants to be in the bouncy chair. If Ben’s in the wrap attached to my chest, Sam wants to be in the wrap attached to me. Twice today Sam asked to nurse because Ben was nursing. Both times I let him and thankfully once he got close he shied away. The second time he tried to latch on and may have suckled for a second, but he seemed confused and stopped pretty quickly. I am still engorged and it still hurts.

Day 2

Late Wednesday night the baby was named. Thursday, Benjamin’s second full day on the outside, was busy. He was circumcised in the morning and returned to me a few hours later still sleepy from the Tylenol. When he woke up he was hungry and he latched on and nursed like a pro before falling asleep again. The pediatrician on call gave us discharge papers and even though I was worried that he wasn’t eating enough he’d only lost an ounce in the hospital. Since Sam had lost 11 ounces, more than half a pound in those first few days, I was ecstatic that Ben had done so well. Soon after we went home and spent our first afternoon together as a family.

My milk still hadn’t come in and even though I was putting him on the breast regularly Ben wasn’t eating much. His latch, though correct, was starting to become really painful. My nipples were still in tact, with no bruises, blisters or sores, but I’d forgotten how much breastfeeding hurts those first few days.

Day 3

By Friday evening my milk had officially come in. My breasts had reached epic, porn star proportions and Bob kept asking to look at them again. Ben STILL wasn’t eating enough and the engorgement was painful. My right breast, which has always been slightly bigger than the left, was clearly overachieving in the milk department and started to become hot and red. I panicked, thinking I was getting mastitis already, but after Ben nursed on that side for a good five minutes the redness faded and all was well.

Still nameless, my baby wasn’t any more interested in nursing the day after his birth than he was immediately after. He spent most of the day asleep, waking sporadically to look around. Despite his disinterest, I put him to the breast every two hours he was with me hoping he’d eventually get hungry. Since he was so sleepy still I timed feedings with diaper changes, since stripping off his diaper was the only thing that seemed to wake him up. After a diaper change he’d nurse for a few minutes, rarely averaging more than 5 minutes a side.

The lactation consultant came in to visit with me and ask how things were going. I remembered her and her good advice from when Sam was born and I was struggling. I told her that the baby’s latch was okay from what I could tell but he just wasn’t interested in eating. I also expressed my concern that him not eating could delay my milk coming in since it took five days to come in when Sam was born. She told me not to worry, that he’d eat when he was ready and told me where in the hospital breastfeeding manual I could access support numbers for lactation consultants in the area. She also told me that my insurance covers one or two visits with a Certified Lactation Consultant.

Eventually the baby got hungry and nursed for a 40-minute stretch before sleeping for a few more hours. I was afraid he’d be up all night, hungry, but he slept pretty well and only nursed twice between 12 and 6am.

After delivery my very messy baby was given to me. His eyes wide open, I held him close against my chest. My instincts were to see if he wanted to nurse, but I didn’t want to stop looking at his face. I also knew that I needed a few stitches and that they’d want to clean and wrap him up. After a few minutes they took him to the other side of the room. My doctor attended to me while they weighed and cleaned the baby. Bob took pictures.

It felt like forever before they gave him back, but it was only about five minutes. I started to unsnap my gown but Bob stopped me to take a few pictures first. Then it was show time. He latched on right away and knew just what to do. His little jaw started working and I felt a familiar pull. But just as quickly as he started he stopped. I tried to encourage him to nurse more over the next 45 minutes but he didn’t seem all that interested.

He was alert and looking around the room. He looked at me and he looked at Bob. We admired him back. Our baby boy looked nothing like Sam did at birth. He was a full pound heavier with darker skin, darker eyes and a head of thick, black hair. While Sam was happy to latch on and nurse for close to an hour after his birth, Sam’s little brother was happy just to look. He didn’t cry and he didn’t fuss, he just took everything in.

We stayed in the delivery room with him for more than an hour before they took him to the nursery for assessments and took me to my room in the maternity ward. Bob got us food and I had a midnight snack of chicken fingers and French fries while my baby had his first bath. Bob went home for the night. Not too long after a nurse brought me my son and it was time to nurse him again.

Again he latched well but didn’t really want to breastfeed. He was too tired. I stripped off his swaddle, removed his shirt and tickled his feet to wake him up to nurse. He was not happy about being so rudely awakened, but he did latch again and nurse for about five minutes. The nurse took him back to the nursery to warm him up and I was able to sleep for an hour before they brought him back.

When he returned for the night he finally latched on and nursed for about forty-five minutes before falling asleep, completely exhausted. He slept in my arms the rest of the night, completely oblivious to the nurses coming in and out, checking my blood pressure and temperature and patting my uterus. He was one tired baby boy.

At my 9.45 weekly checkup yesterday my doctor told me that since she was on call I’d better go into labor that night. I said I’d be happy to, if there was anything she could do to move it along. She said she’d have to check out my cervix and see if anything was happening, and if there was she could give me a little push to get going. I was 3 cm dilated and 75% effaced, a huge change from the week before so she stripped my membranes and told me I could either go straight to L&D to see if I was contracting or I could go home and wait. My dad was babysitting and I’m pessimistic by nature so I went home.

Sam and I took a walk up to the playground. I started feeling some contractions on our walk, but nothing painful and nothing regular. I was uncomfortable though, and Bob had locked his keys in his car so we left the playground early so I could drive to his work to get them out. On our walk home the contractions grew stronger. Once we got home I plugged my cell phone in to charge and decided to lay down on my left side for a bit to see if they subsided. They did not and lying on my left side was uncomfortable. It occurred to me that 2 hours after she stripped my membranes I was really, truly in labor.

I called Bob and asked if he’d be able to break into his car to get his keys. I called my mother-in-law to see if she was able to come and take care of Sam. The contractions grew stronger and closer together and I was no longer able to sit or stand comfortably. After about an hour and a half and a number of phone calls (including one to my OB where I was told to head to the hospital right away) my friend arrived to drop Sam off with my mother-in-law and Bob arrived a few minutes later to take me to labor and delivery.

We got to the hospital around 2.30 and my contractions were 1.5-2 minutes apart. I was dilated 6 cm and wanted an epidural. They had to get me hooked up to an IV first, but there were two anesthesiologists on the floor and the epidural was working by 4. My contractions slowed to 2-2.5 minutes apart, but they were steady and regular. My nurse told me she just wanted to leave me alone and let the baby come when it was ready. As long as I was comfortable and things were moving I should just wait. She sat me up so gravity could help the process. So we waited. And waited. And waited. The epidural made my right leg completely numb and it made me shaky, but aside from that I was fine. We watched several episodes of The Family Guy.

I was 9 cm and fully effaced then I was 10 cm and at a 0 station. We waited some more. The nurse changed my position so I was on my left side. The baby, who had been hanging out on my right side for most of the pregnancy started to move. I could feel a lot of pressure down low. About 45 minutes after they’d found me to be complete they checked again and the baby was at a +1 or +2 station. The nurse took a look and showed Bob the baby’s head, ready to come out. The resident came in, took a look, and went out to get my doctor. My doctor came in and I started to push. Five minutes later my son, my second son, was born.

Since moving him to his brand new room just under two weeks ago Sam has slept through the night all but two of those nights. For those of you counting (me) that’s 11 out of 13 nights. Starting the night before we moved him he slept through the night as well (12 out of 14) and in addition, putting the little guy to bed has been easy. Aside from one night when I went up one more time after he called from the gate and one night when my parents babysat and put him to bed and he came downstairs (they didn’t think the gate was important!!!) he’s gone to bed after a few stories without complaint each night.

I haven’t lost my memory completely. I know that Sam’s sleep habits have always gone in phases, both good and bad. I doubt that this wonderful stage that so perfectly coincides with the end of my pregnancy will last. With Sam, all good sleep is bound to come to an end sooner or later, and since the baby will be a huge disruption to our household and our lives I imagine this good sleep stage will come to an end as soon as this baby drops.

He’s also pretty much stopped napping. Car naps have been sporadic at best (one on Saturday and one yesterday) and napping in his room just won’t happen. He obviously still needs the naps, but I don’t know what to do to help him take them. He’s willing to lie down and rest for a while reading stories when the car naps fail, but the sleep won’t come. I am exhausted when Bob gets home.

But he’s sleeping through the night. Some nights I’ve slept through the entire night for eight whole hours. Other nights I’ve gotten up to use the bathroom and I’ve been able to go right back to sleep without having to spend 15 minutes to an hour soothing an angry toddler later.

The best thing about Sammy’s new room is that when he wakes up in the morning he doesn’t start screaming for me immediately. He plays. He actually wakes up and plays. I hear his little voice talking to his trains and the trains running around the tracks. Some days I hear him reading his books to himself. I can go back to sleep and doze for half an hour some mornings hearing him enjoying his books and toys. It’s lovely waking up to a child in a good mood.

My friend called the other day to tell me about the front page news of the study that shows breastfeeding may boost IQ and I pretty much ignored him, saying, “duh,” like the 10-year-old I am. (I mean really, doesn’t everyone already know that breastfeeding is the best thing you can do for your baby, the IQ points, which have been hotly contested in the past, are just gravy.) After my mature reaction he explained that he was just telling me so I could write about it on my blog and I felt like a jerk for blowing him off. So I feel like I should at least mention the recent MSNBC front-page article with the headline, Breast-feeding may boost children’s IQ and the tagline, Study provides new evidence that nursing makes kids smarter.

The study follows up other studies that have pretty much shown the same thing. The question was whether the IQ differences were based on nature or nurture, since breastfeeding mothers in the US and Canada tend to be more well-off financially than mothers who formula feed. This time, researchers followed babies born to mothers in Belarus, randomly assigning babies to a group where breastfeeding was encouraged.

Previous studies had indicated brain development and intelligence benefits for breast-fed children.

The design of the study — randomly assigning babies to two groups regardless of the mothers’ characteristics — was intended to eliminate the confusion.

A BBC article about the study explains,

They found that those who breastfed exclusively for the first three months - with many also continuing to 12 months - scored an average of 5.9 points higher on IQ tests in childhood.

Lead researcher Professor Michael Kramer said: “Long-term, exclusive breastfeeding appears to improve children’s cognitive development.”

I think Micky at Mocha Milk said it best when in response to the latest “news”:

And by the way, breastfed babies don’t have increased intelligence. They have NORMAL intelligence. Formula fed babies, unfortunately are at increased risk of lowered intelligence. Think of it as an investment in your child’s ability to get college scholarships!

Two weeks until due date and I’m ready.

Okay, ready is relative. I don’t know that I’ll ever be ready for taking care of both a newborn and a toddler (preschooler according to the website that sends me weekly child development updates) at the same time, but that’s just one of those things I’ll have to do, not really prepare for. When I say ready, I mean the house is pretty much ready to go.

I’ve got a freezer full of meals that should last us until Bob finishes school for the summer and a few more things to cook and freeze in the next day or two. I’ve got a chicken stock portioned for two different kinds of soups- chicken noodle and a vegetable- and a beef roast that will become beef stew. I know, not the most seasonally appropriate foods, but they freeze well and use ingredients I have so I don’t have to make any special shopping trips to accommodate.

The nursery is not set up, but the gender-neutral newborn clothes and diapers are washed and folded and the other seasonally appropriate boy’s clothes are out and ready to be washed if it’s a boy. Baby gear is ready to go. I still need to dig out the Boppy pillow (which I found utterly useless for nursing, but fantastic for sitting on after delivery) and wash the cover, but that’s the only thing that really needs to be washed.

The house is in a perpetual state of fairly clean. Well cleanish. I’ve been straightening and vacuuming and organizing daily so the house is ready for grandparents, aunts and uncles to come in and take care of Sam. Lists have been written, outlining how to wash the cloth diapers and basic Sammy-care like “don’t forget to change his diapers,” and “he needs to wear sunscreen in the sun.”

Now I’m just waiting. Impatiently waiting. This baby could come any minute or it could come in four weeks. This part is the hardest. I’ll pack my bag when the contractions hit. I’m afraid if I pack too soon the baby will never come.