Mastitis, Take 3

If you find any discussion of breastfeeding uncomfortable, please skip this post. It'll just be embarrassing for both of us. However, if you're a young momma who could benefit from my mistakes, well, then they'd feel a little less like mistakes.

Most girls I know who breastfeed have had mastitis with at least one child. It's incredibly common. It's also particularly inconvenient. It usually occurs in the first couple months of breastfeeding, when you're busy adjusting to a few other things. It's painful in a very sensitive area and is accompanied by the flu. Not the actual flu, but it feels like the flu. Its treatment is squeezing and otherwise torturing the sensitive area while taking drugs. And if you get the wrong type, it can lead to hospitalization. Attractive, right? Now let's get to the good stuff: my mistakes.

I've had mastitis with each baby, but this time was memorable for several reasons:

1) FULL: It was preceded by a day of less-than-stellar choices. I've missed church terribly since Isaac was born so Sunday I decided to take him for service (and keep him in the Ergo). All was well until after church. There was a big picnic on the lawn with tents and foodtrucks. It was magnetic (food trucks!), so I went "just long enough to give Isaac a bottle and get myself some fun food." Two hours later, we got home hot and tired and close to his next feeding, so I skipped pumping. Then, I was so full, that he just ate on one side per feeding that evening. I spent the night full. (Which is not to say I caused my illness, but I created a nice cozy habitat for it.)

(I figure his chagrin is much cuter than mine.)

2) A AND B: Monday morning, I woke up in pain. A) Clog or B) infection? I felt around for a lump just under the skin, but found nothing. By 11am I had fever/chills/aches. Mystery solved: must be B (mastitis), so I called the doctor for antibiotics. I made sure Isaac nursed on the affected side, but I stopped looking for A. As time went on, Isaac didn't seem to be getting much from that side - nor did I when I pumped. It wasn't until Tuesday night -- 36 hours after the mastitis began -- that I found the clogged duct, hiding deeper in the tissue, easily overlooked or confused with...like...a rib. By then, it was much more stubborn and had me worried.

3) PANIC: It's really never helpful to assume the worst, so uncharacteristically I homed in on the worst case scenarios immediately. Either this deep duct had blocked the milk flow long enough that I wouldn't be able to get it back, or it was a tumor. And I chose to deal with this late Tuesday night, from about 11pm-12:30am. Very rational hours.

4) TURN UP THE HEAT: My usual sissy remedies for a superficial duct weren't cutting it, so sweet friends came to the rescue with advice: A long and very hot shower while massaging the spot, then pumping/nursing frequently while massaging the spot. Then massage it a little more because it feels so good (not). Now repeat. It's like boot camp for your breast. And it did help, though in my befuddled state I still found it hard to tell if I was detecting the clogged duct or a rib. To this day (Thursday), the lump isn't entirely gone, but the milk is flowing and with time (and killer drugs) it's settling down. Miraculously, I haven't dried up, and I seem to not have cancer. I even went on a mini-date with Josh. Which led to...

5) INSOMNIA: When you are starting to feel better, don't eat anything with beans in it, and don't order coffee out unless you're POSITIVE it's decaf. Otherwise, you may be unloading the dishwasher and blogging about your own foolishness at 4:15am.

Tummy Time

We've learned a lot from our previous boys, and one of those lessons is the importance of tummy time. So Isaac gets his daily dose, and his push-ups are really coming along! Now if only he could figure out where that lovely fist goes when he's on his back...

Baby Carriers

There have always been moments when I don't have enough hands, but now that I have more boys than hands, it's truer than ever. Which is why I've been on the hunt for a good hands-free baby carrier. It's like buying a new stroller and (gasp) costs as much. So, I'm going to share my findings in hopes I save someone else from hours of research and fittings.

Here were my priorities in order of their importance to me:

1. Ergonomic - If it makes my back hurt, I won't use it.
2. Self-donning - If I can't put it on alone, then I can't use it when I need it most.
3. Local - I really wanted to try something on before buying (to ensure #1 and #2).
4. Cool - It's August. I'm hot. He's hot. We don't need to contain all our heat.
5. Washable - I give birth to spitters.
6. Scalable - If I'm gonna pay big bucks, I want it to last beyond his 3-month birthday.
7. Front or Back-Facing - Allows the baby to face me when sleeping but out when awake.
8. Cheap

I scoured Amazon for reviews and CraigsList for used carriers. I considered:

-- Beco Baby Carrier Gemini, but it wasn't self-donning, local, or washable.
-- BabyBjorn Air, but it wasn't ergonomic or scalable.
-- Slings (like this Moby), but I can never get the baby positioned right, plus I don't find them ergonomic or scalable.
-- Ergo Original, but it wasn't as cool or washable as the...

Ergo Performance, which is what I ultimately bought. It fit #1-6 so I gave up #7-8. I've wasted $20 on cheap knock-offs before, so I went for the most popular carrier. And judging from CraigsList, I should be able to sell it someday and recoup some of the cost (much like the Bob joggers).

In the meantime, Josh finished his 18-month odyssey of looking for another kind of baby carrier: a new car. In fact, you should ask him about it. He has always loved car talk, but now that he has a new "baby" to carry his new baby, he could use a few more listening ears to absorb all his enthusiasm. Tonight, he even asked what errands he could run, just so he could drive it. And that grin. My big boy. So cute.

The Wheels on the Bus...

Time marches on, and so does the school bus! Yesterday was Aaron's first day at his new preschool, and today was his first day riding the bus. He has taken to both like a fish to water. He's my hero. And as the youngest kid at school, I think he's their hero, too. :)

Newborn Care

Newborn care is shockingly complex. Considering they just drink milk, poop, and sleep, newborn care seems like it should be easy. Most mothers of teens remember it that way and get fondly nostalgic around infants. Now that I have a 4-year-old going on 14, I get that. Parenting someone who can cop an attitude and fixate on all kinds of nastiness seems far more challenging than sleep training an adorable blob. But it doesn't feel that way when you're the one actually caring for the newborn.

Many of my friends are currently struggling with this fact. I have absolutely struggled with this fact (cases in point: "Tired" and "The Art of Napping"). Which is why I spent the last year resolving not to make the same mistakes this time around. I've written about this before (Top 10 of #2), but I realized it's time for an update with #3. So here's my attempt to boil a complicated and polarizing subject down to a few bullets focused on the things I'm doing differently this time...

First, I have to say that I'm not confident all of this would have worked with my last newborn.
Second, it may not work with yours.
Third, it may not continue to work with my current newborn either - I'll let you know in about 3 months.

EAT
I've been incredibly blessed that all of my boys have been full-term, healthy newborns of average weight who breastfed exclusively. With that in mind, eating per se has not been my boys' issue -- eating as it affects sleep has been! Hence the following...

-- Avg 3-hr Daytime Feedings: (7am, 10am, 1pm, 4pm, 7pm*) I try not to feed Isaac closer than 2.75hrs, knowing feedings too close together are more likely to upset his stomach. If he's rooting sooner, I know it's likely for comfort (not hunger), so I swaddle him, rock him, "ergo" him, or put him in the swing. If he's asleep at the 3hr mark, I'll wait and wake him at 3.5-4hrs to eat. Some moms feed every 4 hours round the clock, but I've found Isaac naturally fits the 3hr daytime schedule.

-- Min 4-hr Nighttime Feedings: (10:30pm, 2:30am*) They did this in the hospital, so I'm confident he can do this now. There's an army of moms out there who can testify that a healthy full-term baby is capable of sleeping through the night, so 4hrs is my minimum between night feedings. Plus I know all too well the evil spiral that is created when I feed him too much at night (he eats less during the day, needing more at night, etc).

-- Bottle-feeding: Isaac just turned 3weeks, so I plan to start 1 bottle/day this week (probably during the dream feed) in hopes that someone else (i.e. Josh) can help feed him from time to time, allowing them to bond and me to nap, work, and ultimately travel at least a wee bit. I've never done this successfully, but I've never been this committed to it either.

SLEEP!
With my first, I could make up sleep during his naps. With my second, that wasn't possible, so I got sick a lot and lived in a fog for 5 months. With my 3rd, I don't even have the option to live in a sickly fog. So my priority has been to train our newborn to sleep through the night as soon as possible.  Here are the tips I'm implementing this time around:

-- Bedtime (7:30ish) - All three of our boys go to bed at the same time and get up about the same time (11-12 hours later). Sometimes Isaac makes this earlier (last night he slept 6pm-6:30am with feedings at 9:30pm and 1:30am).

-- "Dream Feed" (10:30ish) - Before I go to bed, I wake him (diaper change) just enough to eat, but the room stays dark and silent. This ensures he only needs one mid-night feeding.

-- "Mid-night Feed" (2:30ish) - If he sleeps longer, I do not wake him, but I also don't go in before 4 hours. Once Isaac reaches 11lbs, I'll try to drop this feeding and see how he reacts after a few nights.

-- Nighttime Crying: If I'm asleep and he's fussing between feedings (i.e. 11pm-6:30am), I know he's fed/clean/burped so I turn off the monitor and set my alarm for the 4hr mark when I will turn the monitor on again.

-- Naptime Crying: If I'm awake and Isaac is supposed to be sleeping, I turn off the monitor and set an alarm for 5min (see "Le Pause" below). If he's still crying at the end of the 5min, I go in and burp him. If he cries after that (rarely), I set an alarm for 10min. He's almost never crying at the end of 10min.

-- Swaddling: This isn't new for us, but I have to give a shout-out to our ever-lovable miracle blanket, the best swaddling blanket I've found. It may be hard to imagine babies LIKE a straightjacket, but we've used it for all 3 of ours and they have clearly felt safer and slept better on their backs when swaddled.

ROUTINE

-- Eat-Awake-Sleep: I generally try to follow the eat-awake-sleep routine, but I also keep in mind that at this stage, he may need 20 hours sleep/day, so he still sleeps the whole time between some feedings (preferably during afternoon rest time!). If it's not hard to keep him awake for 30-90 minutes after a feeding, then I do. Once he shows signs of being tired, I swaddle him and lay him down for a nap till his next feeding. (based on Hogg's E-A-S-Y)

-- Le Pause: I don't love everything in Bringing Up Bebe but I've found this concept extremely helpful (I think it's in Hogg's book too). When baby starts to cry, WAIT before reacting. Not wait 5 seconds. Wait 3-10 minutes, depending on the situation. It teaches delayed gratification, self-soothing, and can help you figure out if something's really up. I'm applying this at naps, at night, and even when I'm making dinner. (Note: My new video monitor has made this much easier, as I can see if something's obviously wrong.)

-- Start as You Mean to Go On: I've wrestled with this concept, since I've seen that some things only work at certain stages. Others come with time and development. But there's a lot I can start teaching my son now. If I carry him all the time when he's 8lbs, will he expect it when he's 18lbs? If he snacks round the clock at 3 weeks, will he expect it at 13wks? Generally, the answer is yes, and bad habits just get harder to break. So, I'm even more committed to this concept than I was when I first endorsed it here.

-- LOVE: Since all of this sounds a bit draconian, I just have to emphasize how much I love on Isaac, hold him, cuddle him, talk to him, smell him, and enjoy him. The schedule and routines above are not about smothering any of that! Rather, I know from experience that keeping my sanity is key to loving my boys well, and sleep is key to keeping my sanity, and scheduling is key to getting sleep, so here goes...

Whether it works? TO BE CONTINUED... ;)

*All feedings times are approximate, not absolute!

That Face

Two Weeks

Our first two weeks with Isaac have been heavy on sleep for him, help from my mom, and transition for the rest of us - a very good combination. 

His arrival fell between our summer and fall activities, meaning Noah and Aaron are not only adjusting to a new brother and busier mommy but have also lost their usual routines associated with school/church/pool/etc. I'm glad we've been able to hunker down at home, but I'm sorry the boys haven't had the consistency of a classroom to return to.

They've handled it remarkably well, loving on their new brother by talking to him, giving him toys, fetching supplies, and gently stroking his uber-soft hair. Aaron loves to remind me, "Baby Isaac - MY baby!" The other day, Noah told me he and Isaac were "playing father and son." And then yesterday...

Me: You get to go to a playdate today!
N: Yea! But while I'm gone, can you do everything for baby Isaac that I would do? Like rock him and play with him and help him go to sleep?

Still, it has rattled them both a bit, so I am really grateful Mom was here to help take care of them while I recovered from labor (a process that takes longer than I remembered!). It was also a way for both of us to enjoy that she is officially done with her cancer treatment!! Praise God. Praise God.

Meanwhile, Isaac has pretty much slept through all of it, also making the first and most extreme part of this transition easier. Between my experiences with my previous two newborns, a newborn care CD from some very wise grandmothers, and my current read (Bringing Up Bebe by Druckerman), I've been eager to see if we can help him sleep well early on. It's been going great, but then again, he probably would've been sleeping anyway. The real test comes now that we're entering the third week, as he starts to spend more hours awake and form opinions about his own schedule...