Showing posts with label sleep. Show all posts
Showing posts with label sleep. Show all posts

Sunday, September 13, 2009

Breastfeeding

The time has come to wean Sarah off breastfeeding. This is actually rather abrupt due to the requirement of myself needing to start medication to kill tuberculosis (it's currently dormant so I'm not contageous). Jonathan reminded me of some of the breasfeeding ups and downs we've had during these last 13 months or so. I realized I hadn't documented any of my breastfeeding woes and successes.

I did mention that after Sarah was born she seemed to latch on fine but that due to jaundice there were expectations that Sarah would feed often and quickly and she just didn't seem to want to be on that schedule. During our stay in the hospital the three days after she was born my focus was feeding Sarah. She was in the NICU so I was unable to practice changing her diapers, putting her to sleep, soothing her when/if she was upset, etc.

When we brought Sarah home, that first night was long (it's embarassingly comical now). I was basically irrational and super paranoid of harming her. Everytime I tried to put her down while she was sleeping, she would wake up. I ended up sitting in our recliner holding her the whole night. I wouldn't let myself go to sleep because of all the warnings that you could smother/kill your child if you sleep with them. I realized that in the NICU I never got to practice swaddling her and putting her to sleep because the nurses did that. Sarah always seemed more than willing to sleep in her little warming bed in the NICU. I decided that because I was having no luck putting her down to sleep I would just stay awake until the morning while holding my sleeping baby and then I would have my in-laws watch her while I slept. During this time the easiest thing was the breastfeeding. My milk seemed to have come in and I realized this was the only thing I practiced while in the hospital with her.

When she was a few weeks old, the metabolic doctors basically said my breastmilk contains the fat that could (in layman's terms) poison her cells and cause her to stop functoning and die if she has the disorder that she was flagged as possbly having by the NBS. I was told to stop breastfeeding and feed her the elixir. The elixir included some long-chain fats because the human brain requires it for development. Instead of using formula in the elixir I pumped, or expressed, my milk so as to keep my milk supply flowing because I was determined to breastfeed and I wanted to be able to still breastfeed if Sarah's NBS was a false-positive. I stored up lots of breastmilk in those days. Our freezer was stuffed with breastmilk (an overstatement, but it felt that way when the occasional solid bag of breastmilk would fall out on us when we opened the freezer door).

It was during this time that I had some emotional breakdowns because at that point breastfeeding was my most confident area of parenting. That was the thing I had down, and I felt like I was being robbed of it. I remember in particular watching the "First 5" video on basic infant care that was given to us when we left the hospital. Phylicia Rashad (the mom from the Cosby show) was on the video talking about the benefits of breastfeeding and how breastmilk was the best thing for your baby - I broke down because of the thought that my breastmilk could kill Sarah and it wasn't the best thing for her.

There was another time when Sarah was upset and I knew that breastfeeding her would calm her down, but I knew that I wasn't supposed to. It was during the time when I was supposed to alternate between breastfeeding and bottle feeding her elixir.  I can't remember exactly what the issue was but I was extremely upset and it ended with Jonathan just talking me into breastfeeding Sarah and it calmed both of us, Sarah and me, down.  I think it had to do with me once again fearing that by breastfeeding her, it could kill her, but feeling that breastfeeding was exactly what I was supposed to be doing. 

Due to the requirement that Sarah needed to eat every three hours and, later in her first year of life, every five hours, there were some stressful experiences when she just wasn't wanting to eat and so I would fight with her to eat.  The "fighting" looked like me basically trying to get my boob in her mouth and coaxing her to suck all the while she is flailing her limbs and turning her head away from the food source.  Those times usually ended with me giving up and figuring that she had enough energy to survive a little bit longer and I would just be aware that at the first sign of hunger she needed to be fed.  There were other times when she would bite me and so the breastfeeding session would end prematurely in order to teach her that biting her food source was unacceptable.

Through many of these situations I learned the importance of handing over my anxiety to God and asking for peace unless I needed to be worried.  My trust in God increased greatly during this time.  I learned that I had little control.

Our last breastfeeding sessions took place after Jonathan and I confidently felt that Sarah didn't have CPT II so I was feeding on demand (as opposed to scheduled feedings).  The last two days included about 4-6 relaxing and beautiful times of breastfeeding.  Our routine included Sarah twirling my hair in her fingers while we looked at each other, and often she would fall asleep.  I've heard some people talk about breastfeeding as though they LOVED it and found it extremely spiritual, I am not one of those people but I enjoyed that it was something special that Sarah and I shared together and it connected us.     

What's Different Now?



The process of taking Sarah off treatment has been easy in some ways and in other ways it required adjusting our schedule.

Allowing her to sleep through the night has influenced the time she wakes up and her nap schedule. When I would feed her during the night, she would usually sleep-drink her 2am bottle and 7am bottle and then sleep until 9 or 9:30am. Now she is waking anytime between 6:30 and 8:30am. She is also taking two longer naps during the day.

Stopping the carnitine was easy. Sarah quite enjoyed the carnitine as she got older. She was a pro at taking it with her bottles. I regret not documenting it on video. I did try to take some pictures of her one day when she was sucking on her carnitine syringe.

I've noticed her urine smells differently now. I always thought her urine smelled weird, not fishy like some people complain of when they are taking carnitine supplements but it was distinct. Now it smells less distinct.

She seems to be adjusting fine to the whole milk mixed with her Lipistart. At first she was drinking less of her bottles but now she is drinking as much as usual.

Monday, August 31, 2009

Seed of Doubt

The last two days Sarah has fallen asleep during lunch. I know this happens sometimes, I remember a pic of me asleep in my spaghetti. I didn't think much about it except that maybe I need to start feeding her earlier so she is ready to nap when she has been getting tired lately. Then my wise husband pointed out that we should be aware of the possible connection between her being really sleepy at this time and CPT II. A friend of ours was eating with us and said he was wondering if there was a connection between the two also.

Is this lethargy or normal sleepy?

Ah man . . . this started the whole process of trying to be aware but not worry about it. The whole time she slept uninterrupted (we cleaned her up, put clothes on her, transported her to a birthday party where she continued to sleep) I could feel myself dreading the possible need to rush her to the hospital. She woke up happy, normal, and well rested. She proceeded to enjoy the rest of the birthday party (it turns out Sarah and the birthday girl both woke at about the same time so no festivities were missed).

We'll see tomorrow if she falls asleep during lunchtime.

Thursday, May 7, 2009

Sleep Training

February 2009

With Sarah's feeding requirements of feeding her every 4-5 hours, this means we do not sleep through the night. I was struggling with getting her to go to sleep in her crib. We tried the Ferber method of letting her cry-it-out but it wasn't really working. I decided I must be doing something wrong with how I was trying to sleep train Sarah. I went to the library but they only had a VHS tape called "Your Baby Can Sleep" by Dr. Stuart Tomares M.D. and I decided that could work because I didn't really have time to read a book anyway.

Through this video I realized the things I was doing that were hindering the sleep training. These were:
  1. We didn't have a consistent bedtime routine
  2. I was laying down to breastfeed her in the middle of the night and often fell asleep with her OR I would have just bottle-fed her and then she would cry and I was so tired that I just brought her into bed with me because she would stop crying.

In order to have a consistent and set night time routine, I would need to feed right before to maximize the length of sleep she was able to get. In order to ensure this, I decided to set up a time schedule for feeding so she would actually eat before bed.

Sarah’s Schedule

2:00AM breastfeeding
7:00AM Lipistart feeding
Lisa gets dressed and ready for the day, quiet time (often, I sleep some more)
9:00AM wake Sarah up if she is still sleeping, feed breakfast
Sarah playtime Lisa does dishes/housework
11:00AM breastfeeding
12:00PM lunch
3:00PM Lipistart feeding
5:00PM dinner
7:00PM breastfeeding
9:00PM Lipistart feeding
put on pajamas and fresh diaper
brush teeth
read book
lullaby
prayer
9:30PM bedtime

This schedule is nice because the middle of the night feeding is always breastfeeding so I don't need to warm a bottle. This means more sleep for me. I just need to ensure that I am involved with something to keep myself awake so that I don't fall asleep with Sarah.

Also, the 7PM feeding helps with adjusting for when the schedule gets a little off during the day. Meaning: 4 hours is the longest we are to let Sarah go between daytime feedings but she may get hungry after only three hours between one set of meals and then the daily schedule is adjusted accordingly the 7PM feeding would move forward but the 9PM is constant for bedtime.

NAPS
With this routine the nap times are whenever she seems tired during the day and/or falls asleep. Some days she has 4 short naps and some days she has 2 longer naps. This sleep guy advises not to worry about the naps because if they are sleeping well at night their naps will work themselves out on their own. We just shouldn't let naps go longer than 2-3 hours.
This has worked with Sarah.

April 2009
It seemed like Sarah wasn't wanting to breastfeed as much as she wanted to eat solid food and drink the bottle. I looked into it and found that having scheduled feedings is not as good as feeding on demand and can increase the likelihood of premature weaning. At about 8-10 months baby's often (from what I found on the Internet on different sites) tend to seem like they are weaning themselves off the breast. The sites encouraged to just keep plugging away and offering the breast.

With this information, I realized the importance of keeping the schedule flexible. I feed on-demand to a certain degree. The 7PM feeding helps with this. Also, I adjust the schedule so that she often eats solid foods a short time after she has breastfed or drank a bottle.

Also, I've realized that she has shown no signs of CPT II and there is a big possibility that she may not have CPT II. With this knowledge, I just don't stress out about feeding her. I've been treating her feedings as though she were an average child. If we are out of the house and she goes past four hours but I know she has had solid foods in between and she is acting perfectly fine, I just stay calm and get to a place where I can prepare for whatever feeding is next.

This all has made life much easier to handle. Praise God.

Thursday, March 26, 2009

Can we function? - My breakdown

August, 2008

Jon was working as a teacher. His first day of school was the day Sarah was born (he took the day off work :~) ). I know how stressful and tiring teaching can be. I did not want Jon to be too sleep deprived considering he needed to do well at his job and I wanted him to be able to drive safely to work each day. Jon, being the great husband that he is, would still come home and help clean the house and spend time bonding with Sarah and learning how to care for her.

Treating Sarah, due to the possibility of CPT II, required us to feed her every 3 hours. This is an average time between feedings for a newborn. It is usual for new parents to be sleep deprived. We knew this. The general advice is to sleep when your baby is sleeping.

Sarah seemed to wake whenever I tried to set her down. Sarah also seemed to know when I was about to eat. I would finally get her to sleep and not in my arms. I would prepare my food and as soon as I was about to eat, she would wake up. It happened often (seemed like every time I tried to eat). Even though I was desperately tired and knew I needed to eat (I didn't usually feel hungry), I saw the humor in the situation.

It also seemed that as soon as I was able to sleep, Sarah would wake up. I did not find this humorous.

I was determined to breastfeed Sarah. There was still the chance that the Newborn Screening was a false/positive and so I didn't want my breast milk to dry up. This required me to pump my breast milk in order to mix it into the elixir. I had only purchased a hand breast pump considering I was going to stay home with Sarah I figured we would only need to have extra breast milk for weekly date nights.

I realized I wasn't finding time to eat or time to sleep or both. I wrote out all that was required of me and the amount of time it usually took to accomplish each task to see if somehow I could work out a system or schedule to get everything done.

Daily Requirements
  • prepare elixir
  • get dressed - brush teeth, brush hair (at least)
  • tummy time for Sarah
  • *sleep some*
  • *eat more calories than normal to promote breast milk production*

Every 3 Hours

  • Heat bottle
  • Wake-up Sarah
  • Change her diaper
  • Feed Sarah
  • Interact with Sarah while she is awake
  • Try to get Sarah to fall back asleep and lay her down without her waking-up
  • Pump my breast milk
  • Store breast milk and clean the bottles
  • *Eat and drink something*
  • *Sleep until next feeding round (unless at this point Sarah was awake, then I needed to take care of Sarah)*
I can't remember the timing of everything but when I was finished with the list, I realized that I could not function. There wasn't enough time to get everything done. I called Jon at work. I was crying and trying to explain the process I had gone through to come to my conclusion. Jon got the next day off work so we could see if there was a way that we could function under the circumstances.

We ended up buying enough Medela bottles so I could pump with them and use them to feed Sarah the elixir without needing to clean them during each three hour allotment of time. Jon took on the role of nightly bottle cleaning duty. He also ensured that Sarah did tummy time to help her get stronger, especially if I hadn't been able to during the day. We purchased microwave meals so I could easily and quickly prepare food for myself during the day. We also purchased a thermos to hold hot water so that I was able to feed Sarah a bottle away from home. The gift of no longer being so confined was very freeing. I searched out a way to get an electric breast pump for free until we found out whether Sarah had CPT II.

We admitted to close friends and family that we were struggling. I learned to ask for more help. I learned to be more dependent and not to fear being an inconvenience. Brian and Kerry were a great help in making sure that I remembered to eat and was able to find the time while Jon was gone at work. My sister gave me the best birthday gift of caring for Sarah overnight while I caught up on sleep (and got totally engorged but it was well worth the rest :~) ). There were quite a few times that I would go to my mom's house to sleep while they cared for Sarah.

It was a rough time but, by the grace of God, we survived.