Friday, June 22, 2012

Learning Curve

Parenting has been quite the paradox.  We've had to figure out what PB&J need at any given time, what I need as I have been recovering, and making sure Momma B and I communicate at all times.  It's been emotional and a lot of trial and error.  I have been both very hard on myself and yet understanding.   I have been ridden with guilt, overcome with joy, and have cried over spilled milk (literally).  I feel a bit lost most of the time, but I'm starting to get the hang of things.  

Feeding these boys has probably been the biggest source of stress for me.  After all the time in the NICU, our boys were very used to bottles being the sole source of nutrition.  I've tried breastfeeding over and over; though they latch well with a nipple shield, neither PB nor J are able to sufficiently eat - J just lets milk dribble out the side of his mouth and PB does well, but spits up afterward every time (no matter what I eat).  I was okay with exclusively pumping, especially with J's eating issues.  It felt better always knowing how much he was consuming.  I was consistently pumping every 2-3 hours and I was very good at it while they were in the NICU.  I was still able to maintain it, for the most part, after PB came home.  However, once J came home all hell broke loose and pumping became the biggest challenge ... and the biggest source of unhappiness and stress.  I wasn't making nearly enough of what the boys required, PB was already up to 3 - 5 oz per feeding and J needed 2 - 2.5 oz.  I was overly exhausted pumping after almost every feeding and neither were on the same schedule at all - that first week they both went through periods of cluster feeding.  I also was doing it wrong.  Had I had time to research it beforehand, I would have found out I was pumping far too long at each session and I could've dropped a couple of pumping sessions and still made just as much.  And I'll be honest, we had to do a cost analysis as renting a hospital-grade pump and the necessity of formula (both for the higher calorie content they require post-discharge and sheer volume needed to feed them both) together was far more expensive than formula alone.  

Everything in me knew I couldn't keep it up.  I struggled with it, cried over it, and felt such a heavy dose of guilt for not being "mom" enough.  I felt good for having given them as much breast milk as I could during their first month, but I felt terrible for wanting to quit.  The stress, the lack of sleep, and the sheer unhappiness I felt trying to keep up the pumping schedule was too much - I was going into a dark place that wouldn't have been good for me and certainly wouldn't have been good for PB&J.  I already felt so inadequate for not being able to produce enough milk for both of them.  I was extremely hard on myself, not allowing myself to realize even without breast milk the boys would still be healthy and happy ... and I would be able to actually enjoy the time I had with them.  It took Momma B and my friends' reassurance and support for me to relent and open myself up to what I felt was best for me and for our boys.  And though I have felt a lot of relief since we decided to wean off the pumping and switch over exclusively to formula, I still feel an underlying guilt that can bring tears in an instant.  I try not to let outside influences get to me, there is so much pressure from people I know and society alone about breastfeeding and/or feeding them breast milk.  It was a personal decision and one that I am, overall, happy with - I am doing much better emotionally and our boys are healthy and gaining weight appropriately.  I couldn't ask for anything else.

Diapering has been another unexpected challenge.  While pregnant, we had planned on using the gDiaper system.  We were realistic enough to know in the beginning the disposable inserts would be the easiest for us as the newborn period is wrought with never-ending pee and poop.  Though we reviewed the videos and read all about the system, it is a bit more difficult to execute than it looks and it is not fun at all to mess with in the middle of the night.  Reality came home with us in the form of PB.  This kid goes beyond what I thought the typical newborn could come up with, at times going through three diaper changes in one sitting.  Fresh air hits his skin *BAM* he pees.  Put a little ointment on his bottom *POW* he pees.  He gets a wrinkle in his forehead *WATCH OUT!* poop is about to explode!  I've never done so much laundry in my life.  We haven't given up on the gDiapers as the execution can totally be operator error and will take practice, but the 3-diapers per change? ... we're hoping as they get older the books will be right and these things will ease up a bit.  So disposables it is, for now.  And who knows?  It may continue to be if ultimately things don't work out with the cloth inserts in future.  And that's okay.

What I'm learning is flexibility - with myself, our boys, and our expectations.  Some things may seem wonderful, in theory, but in practice may not work out.  And I'm learning to be okay with that.  I'm learning to take it easy on myself.  There is nothing I've judged myself so harshly than I have my ideals v. my reality with regard to parenting.  Thankfully, I have Momma B to soften things and reassure me.  She takes everything in stride and doesn't seem to struggle with expectations.  I think she has been far more open and flexible than I, thankfully.  She keeps me from falling apart at times, which in my postpartum hormonal haze is a very good thing!

But don't get me wrong.  I love being a mother and wouldn't trade it for anything.  These boys of ours can make me smile when nothing else can, they fascinate and amuse me, and my heart fills up every time I see them or even just think about them.  I can live up to the challenge because I love them.  No matter what, every decision is made to make their lives comfortable and happy.  That is my reality and I'm definitely okay with that.

Moral support at the pediatricians office.  =)

Sunday, June 10, 2012

Family of Four

Our boys are three weeks old ... and they're both at home!  It was a happy three week birthday for all of us.  We finally feel like a family of four.

J took to the feeding-on-demand schedule very well.  It was a bit of a transition, but it worked and he found his hunger and his vigor for eating!  The change in him was so obvious to us both and we were excited our plan worked.  He gained weight and was eating regularly, so on his 21st day he finally got to bid the NICU farewell.  

J says - see ya suckas!
Having PB&J at home has definitely had it's challenges as both boys, especially J, have been cluster feeding every hour to hour and a half during the wee hours of the night.  Sleep is at a premium around here, but we'd rather have this than worrying about splitting our time between home and hospital.  We have gotten out of the house a few times - to lunch with friends, for a walk to the park, a trip to Buy Buy Baby - and they have done really well, but mostly I've been impressed with us and our ability to keep their accouterments to a minimum while still being prepared for anything (working around their schedules thus far not being quite as challenging as I had anticipated).  Yet finding time to eat, let alone supplying the actual meals, has been far more difficult than we could have planned for ... so we welcome all visitors that come bearing food!

Shop 'til you drop!
However, I would say having both boys at home has definitely had it's rewards more than anything.  They have remained easy-going babies, crying only when hungry, but easily consoled.  Their periods of alertness are stretching out and they definitely recognize their mommas' voices.  They're both gaining weight and have an impressive appetite (even our "little" J gained four ounces in the last two days, easing this momma's worries).  We're starting to see small half-smiles and their personalities are certainly starting to show.  

J in action
PB's milk-drunk look
I'm sure it'll still take some time for life to settle into our new normal, but I look forward to that day.  I am not trying to rush through and miss any experience, yet life does feel a little disjointed currently.  Momma B and I also have a lot of plans and experiences we wish for our boys, but we need more sleep and energy to make them happen.  So though today is a good day, that day will be even better!
Brotherly Love

Monday, June 4, 2012

A Light at the End of the Tunnel

There are so many things that have happened in the last week and a half, but the biggest focus for us has been the NICU.  It's had it's ups, but to be honest it's had more downs.  This has to be one of the most difficult things we've had to deal with - as these are our children, who cannot speak for themselves ... but I am jumping ahead of myself.

PB plunged ahead and started taking full bottles completely by himself, so the NG tube was taken out and after two days of feeding independently he was discharged home on Tuesday. It was a bittersweet moment.  On the one hand, we celebrated because our big boy was finally acting more like a term baby and was able to come home.  On the other hand J, our little guy, had to stay at the hospital and now we were split - in heart, time and space.  

Having a baby at home and one in the NICU is far more difficult and heart-wrenching than having both in the NICU.  Though we were allowed to bring PB into the hospital with us to visit his brother, it was not worth it - there was no place to change him, we were crammed into a small space that was barely big enough for us both to be there let alone with another baby, and time with J was still compromised as we tried to care for PB (sometimes Momma B was left on her own with them both because I had to go pump).  We then decided we needed to take shifts, but it felt like it was splitting our family even more and not all of our concerns would be met because only one momma was there to represent us both.  Additionally, we were getting far less sleep caring for PB at home, so it was even more difficult for us to get a lot of time in with J.  

Then there were our issues with the NICU's plan of care for our little guy.  He was finally eating - he didn't need any assistance with a chin hold and he was down to every third feeding through the NG.  However, we noticed a big discrepancy between nurses and the amount he would eat.  Somehow one nurse that took care of him five nights in a row was able to get him to eat near to all of a bottle at each feeding, even skipping NG feedings if he acted actively hungry.  Yet other nurses that were very negative in their communications with us would only get him to get maybe a third of his bottles and would decide he needed to have more rest thus going back to every other feeding thru the NG. When these concerns were brought up, we were often shut down by other nurses with the statement that it's always at the nurses' discretion.  It was all very suspicious to us.  

Then Momma B noticed one night that J was rooting and fussing, but it was an hour before the scheduled feeding (in the NICU babies are on a very strict every 3 hour feeding schedule) and the nurse refused to let her feed him and instead stuck a pacifier in his mouth.  Thus by the time his scheduled feed came up, he didn't consume much because he'd wasted so much energy sucking on a non-nutritive pacifier.  

Questions, frustrations, concerns were often not taken seriously or we were given grand generalizations about babies and eating and developmental milestones.  We both had our moments where we just broke down - leaving little J got harder and harder every day.  And four days after PB was discharged it seemed like J had not made any progress.  In addition, we rarely got to see the doctor and requests for him to call us were never fulfilled.  Yesterday I couldn't take it any more and let all my concerns out to his day shift nurse and finally I got a willing listener and someone that was also willing to help me find different solutions to address with the doctor to get our little guy home sooner.  She also wrote a note to the chart at my request so there was no longer any question on whether the doctor was told to call me.  It felt good to be able to talk about it with someone receptive enough to help.  

And the doctor did call!  In fact, today was a breath of fresh air.  The doctor on call this weekend is not our baby's primary neonatologist, but is an older gentleman that seems a little more lenient with some of the protocols and more willing to try different ways to get these babies home.  He stated exactly what we suspected, that it seemed like J's problem wasn't eating but rather a synchronization problem with his schedule and the NICU's.  He was willing to work with us and allow him to get his NG tube removed and just be fed on demand.  He did warn me that meant we'd have to be in the NICU for most of the day.  He also warned me it may not happen right away, it may take up to five days, but we definitely needed to give it the full chance to work.  J may lose a little weight at first or hopefully just break even, but if he "gets it" then he'll start to gain weight again and take in his full amount of needed calories.  

In short, we can finally see a light at the end of this dark tunnel we had been navigating so blindly.  He's been in the NICU for 17 very long days.  We're ready for our family to be whole.

I'm also happy to tell you tonight we actually feel like we are as this is the first night we get to spend all together.  The nurse reserved the family sleep room at the NICU for us so we can care for and feed J ourselves on his schedule.  PB is chillin' in his porta-crib and we're lounging on a pull-out couch, but we're all together in one room with minimal interruptions.  It almost feels like normal.  Of course, it'll be so much better at home, but this gives us a glimpse into what that will be like.  

All I know is our hearts are full tonight. 
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