Welcome to Titland

Clara is the star of the show these days, and my breasts are the all-important supporting players. They are still tired and sore, and Clara wants nothing more than to gum them all day every day. Often she's not even eating; she just wants to suck on them for comfort. Although she is healthy, she is not gaining weight quickly enough to suit the midwives, and so they've got me back on four doses a day of fenugreek and blessed thistle. On Monday she was 7 pounds, 11 ounces; they were hoping for 7lbs 15oz. (7lbs 11oz is still much better than 6lbs 4oz, which was her lowest weight [and still an ounce and a half heavier than I was at birth].) Breastfed babies often take longer to gain weight, but are far less likely to become obese later in their lives.

She is a great baby, minimally fussy. When she does fuss, she wants to be fed or changed or picked up and held, or she wants a finger in her mouth. (We tried a pacifier. "PIH!" said Clara as she spat it out. Oh well.) She has been to two Movies for Mommies so far: last week's The Prestige and this week's Little Miss Sunshine. It has been many, many years since I saw two movies in movie theatres in such quick succession. Clara was wonderful: fed or slept straight through, both times. Bless her. Today I was practically giddy at having gotten out of the house with her all on my own. I'm mobile again! Hooray! Calloo callay!

Martha likes to sit on my lap pressed up against Clara as I feed her. Charlotte has finally, four weeks later, started to sleep on our bed again. She still doesn't like the baby, but she's seeming a little less freaked by the idea.

Mr. K has Clara in the sling right now, and she is sucking his finger for dear life. So I need to get some dinner together for him. Two nights ago I made a massive pad Thai (I make fabulous pad Thai, if I do say so myself), and last night we collaborated on a baked pasta dish with cheeses and tomato sauce and ricotta and the rest of the tofu left over from my mother's tofu cheese pie from the weekend. (My mother is a good cook. I wish she'd felt more like cooking while she was here. My dad, bless him, did the dishes several times and cleaned the bathrooms. Hooray for Dad.)

This time is hard, but also very rewarding. My love for Clara is sneaking up on me. I think that if it had hit all at once, my heart might have exploded. Sweet, sweet baby.

Life with baby

Something I didn't know before Clara was born: the active ingredients in Preparation H are yeast and shark liver oil. Who thought of this? "Ow, my anus hurts! I know, I'll squeeze the oil out of this here shark's liver and put it where the sun don't shine!"

I wonder about such things.

Clara is a great baby. She gets fussy sometimes, as babies do, but she doesn't cry much at all. One or the other of us is holding her just about all the time, except at night, when she sleeps in her co-sleeper. Mr. K has been reading about all the great benefits of having the baby sleep in the parents' bed, but when she does, I don't sleep. If I don't sleep, I don't make milk, and baby doesn't get enough to eat. (Plus I get incredibly cranky during the day.) So into the co-sleeper she goes.

We went to the Canadian Car Seat Installation Centre yesterday and let them do their thing. Clara is still very small and looks pretty ridiculous in the seat, but it's nice to know that she's protected when we're riding around. I sit in the back with her and Mr. K chauffeurs us as we go out to buy things such as nursing clothes for me, baby clothes for her, and small pieces of furniture from IKEA, such as a little table and chairs for the nursery (the chairs to be assembled later, when she is old enough to sit in them) and a pair of lamps for the living room. I'm finding it pretty necessary to get out of the house every day. Yesterday we discovered the baby care room at IKEA: wow. Nice armchairs, changing tables, free diapers (which we didn't need, but still), a nursing pillow, stuffed animals lurking here and there, dim lighting, and a lock on the door. We took Clara in there to change and feed her both before and after we went shopping; this meant that we could spend more time out of the house without worrying that she wasn't eating enough. (I'm still working on mastering the art of breastfeeding in public.) Why can't more places have rooms like that?

Clara wanted to eat ALL DAY yesterday. Every time I took her off the breast she wanted back on. While I was getting ready for bed, Mr. K gave her an ounce of expressed breast milk through the feeding tube off his finger, and she finished the whole ounce in four minutes. (She's been known to take as long as 25 to polish off the same amount.) There must be a growth spurt coming.

My parents arrive tomorrow, and Mr. K goes back to work on Tuesday. Life goes on whether you want it to or not.

Update: I see I'm getting a few hits from an amusingly satirical blog. The more I learn about breastfeeding, the better an idea it seems: savings of thousands of dollars, no supporting incredibly irresponsible and soulless corporations, non-stinky diapers, reduced chance of ovarian and breast cancer and osteoporosis for me, a better immune system for Clara, less stuff to haul around, no worries about formula recalls, and lots of quality time bonding with my baby. Yeah, it's being tough to get it started, but I know it's worth it.

Progress

1. Clara is feeding much better and is back up to her birth weight as of yesterday. Hooray. We went to the breastfeeding clinic again a couple of days ago to try to get her latch fixed, because my nipples were on fire. There was another couple there describing their experience having a baby at Mount Sinai Hospital. The doctors refused to give the baby to the mother for the first hour (critical bonding time) because they said her (the mother's) blood pressure was too low. Then the night nurse, when the baby wouldn't feed, laid a huge guilt trip on them about how the baby was STARVING and was going to get JAUNDICE and needed formula RIGHT THEN. What a great idea: actively discourage a new mother from trying to breastfeed. Grr. Hearing this made me nearly incandescent with anger. (Everything is very, very close to the surface right now.) If I hadn't thought before that we'd made the right decision to have midwives... This poor couple. We talked to them and tried to reassure them that yes, it's hard in the first week(s), but if they really want to do it they'll be able to feed their baby the way they want to. It was weird feeling like the grizzled veterans already.
   
2. The family politics, never enjoyable even at the best of times, are taking their toll and, I suspect, are only going to get worse. Hint to everyone: now is not the time for deep discussions with me and it is not the time to grouse to anyone about my requests for only positive energy in the house. Sigh.
3. I need more sleep.
4. I don't want Mr. K to go back to work next week, even if my parents are going to be here. He's my rock.
5. For a while this afternoon, both Clara and Martha were asleep on my lap, baby's back smooshed up against the cat's. Hooray redux. (Now if only Charlotte would start sleeping at the foot of the bed again instead of spending all her time downstairs.)
6. Right now my life doesn't seem to have changed all that much from the way it was in the last month of my pregnancy: I'm home most of the time, I screw around on the Internet too much, I watch some TV, and it's hard to move around. The biggest difference is that I'm a lot more sleep-deprived, and there's someone small around who likes to munch on my tits all the time. She's not very interactive yet and even though I love her, I don't feel as engaged with her as part of me thinks I should be by now. But evidently this is normal too: falling completely in love with the baby takes time. Hard to believe she's two weeks old already.
7. I think part of me is still grieving the loss of the first baby two years ago. When I lost the pregnancy, we wrapped the pee test stick up with an amethyst (would've been a February baby) and a cotton cloth I'd knitted, inside a piece of paper that Mr. K had made. Something from his hands and something from mine. We buried the little package on A. Island, where his parents have a bit of property. (Our beloved James is buried there too.) Last night it occurred to me to put Clara's footprints on another piece of Mr. K's handmade paper; I mentioned the idea to him this morning. He said that he'd thrown the paper out during the Great Cleaning before the baby came. I went to pieces and cried for much of the day. Tonight, thank heaven, he found five pieces of it. Oddly enough, I don't feel that much better yet. Tomorrow we're going to hunt down some water-soluble ink.
   
8. Clara is stirring. Titmunching time again, I guess.
   

Martha seems to have come to terms with the recent addition

Charlotte... not so much. She spent the first three days downstairs. She's reclaimed her place at the foot of the bed, but the second that Clara starts fussing, Charlotte is gone like a shot. Pics here.

Clara had a big day: her grandparents, Aunt Sheila, and great-aunt Mary came to visit. Grandma made lunch (her famous mac and cheese). The visit was nice and it was good to see everyone, but it seemed more exhausting for me and Mr. K than it did for Clara: it's still hard having extra people around, even if they're helping.

Clara has had lots of visitors so far, and more are on the way. Aunt Dori and her sweetie Melody blew through town on Monday night, leaving Dori's and my parents to be the last close family to meet her. They're arriving on the 21st and staying until the 31st. I'm a bit worried about this. It will of course be great to see them, but as I said, even the mere presence of extra people in the house right now is draining, and we're going to have to be crystal clear that there is to be no negative energy brought in. Certain topics (like family politics) stay outside, for example. If it gets to be too much, I think we'll gently suggest that my parents visit Mr. K's for a day or three.

In other news, Clara is feeding much, much better. She's not getting all her nutrition on the breast, but she's figured out how to nurse and will do it much of the time. (If only my nipples weren't so damn sore.) She had her first bath last night, going into the tub with me, and got through it by breastfeeding for dear life. Sweet little girl.

Feeding Clara; how to visit new parents; where we've found help so far

On feeding Clara. She had her first away mission yesterday, to the breastfeeding clinic at the Toronto East General Hospital. A very, very nice public health nurse watched Clara at the nipple, and then made some suggestions and adjusted how I was holding her. Clara then fed like a champ for more than 20 minutes. As we were leaving the clinic I was teary-eyed with relief: she can do it, she can do it, we're over the next hurdle.

After we got home, Clara decided once again: screw you, nipple; I want the finger with the tube. So back she went to the clinic today.

Today's nurse watched what I was doing and said yes, you're doing everything exactly right; it's just going to take time for her to figure it out. This evening, Clara will go to the nipple without screaming, she'll get a great latch, and then she'll just hang out without sucking. This is a step forward, so we're happy about it. Each small step brings us closer to an easily fed baby. So many parents have told us that the first few weeks of breastfeeding their kids were sheer hell, but that they got through the rough patch, and the patience required to get things started is more than worthwhile.

How to visit new parents. Mr. K's sister Sheila is the queen of visiting new parents. She's in the first days of her student teaching, so she has plenty to keep her busy in her own life. But on Monday she brought us a full homecooked Thanksgiving dinner, spent some time visiting with the baby, and then washed all of our dishes. Washing the dishes seems like a trivial thing, but for new parents who are overwhelmed by everything, it's a wonderful gift. Every time she comes by she brings food and support and a sensitive ear, helping so much to keep a positive energy in the house even when she herself is exhausted. She puts her own stuff aside and just pitches in to help. Yay Sheila.

Moxie describes the first days at home with baby beautifully:

[You] soon realize that you'll be attempting to nurse, changing diapers, attempting to nurse, changing diapers, attempting to nurse, changing diapers on a nonstop loop, spelled only by going to the bathroom to change your pad and looking at your partner saying "We have a baby!" with a mixture of wonder and fear.

When you're doing nothing but lactating and changing diapers, your partner has to pick up the slack by doing everything else involved in not only running a household, but changing your entire way of life. Plus fielding phone calls and dealing with a crying baby and crying mom (the hormones!). It's really hard.

You'll need help.

It's easy to think about how romantic the first few weeks after the baby's birth will be, when your cozy little family will be working things out. And it's true that it might be like that. Some people have a pretty smooth postpartum period. But it's also a possibility that you'll be either a little or a lot overwhelmed, the three of you, with odd sleeping schedules and engorgement and sore nipples and poop all over and dirty laundry and crying (all three of you) and friends demanding pictures and thank-you notes and it's-8-o'clock-what-are-we-having-for-dinner? and you're all just so tired. And it would be really helpful to have someone there who could fix you some food or take out the trash or even just smooth your hair and tell you you're doing a good job.

You need someone who will actually help you, not make you cook or make tea or have certain things on hand while s/he holds your baby and gets all the sighs and coos you should be getting. The only people who are allowed to come for more than an hour are people who understand they're there to help you, not just fawn over the baby.

Amen, sister.

Places where we have found help so far. So many people have been unbelievably kind to us. Andrea Page of FitMom kept me in shape through the pregnancy, gave freely of her endless knowledge and encouragement, and even lent us her handheld electric breast pump. Cristi and Ian got me through the pregnancy by giving me a huge stash of maternity clothes. My dear friend AM, who just had a baby herself four weeks ago, has sent us a shiny new double pump that her insurance covered but that she doesn't need; she's been checking in almost every day to see how everyone is doing. Cynthia, Melida, and Tia, the midwives: I can't say enough about them, especially Cynthia. Stephanie, our doula, coached us through an intense labour and helped make sure that the birth was exactly what we'd wanted. She's even going to give us boxes of baby clothes as she cleans out her basement. Moxie and her commenters have been lifesavers. The nurses at the TEGH breastfeeding clinic have given us reassurance and calmness. Mr. K's colleagues sent a huge, gorgeous bouquet that has been brightening the bedroom for a week now. Vik, those two blankets you guys gave us are in heavy, heavy rotation; Clara sleeps swaddled in one or the other every night. Everyone who chats with me on AIM (Krapsnart) or Yahoo (Knitchyk) is helping keep me sane as I try to adjust to this fundamental shift in my identity. (This will become even more important when Mr. K goes back to work and the midwives aren't dropping in every few days. I have a history of clinical depression and am doing my damnedest to ward off the PPD.) And so many our friends and family have offered congratulations and support: this is a wondrous time, but it's also very hard and we are vulnerable. We really, really appreciate your kindness.

Evidently breastfeeding has a learning curve.

Holy fez, have we been having a rough few days. My milk did indeed come in, but not enough of it, because Clara hasn't been nursing enough to get it going well yet. A typical feeding: I pump my breasts for 15 minutes and get less than an ounce of milk. We tape a tube to my nipple and put a bright-eyed little Clara to the breast. She finds the tube and gets a bad latch on my breast as she drinks greedily from the easy supply. We pull her away to try to get a good latch. She gets angry and starts to scream, then refuses to go back on the nipple. We end up finger-feeding her what's left for the tube. She finishes it in less than a minute, then screams and screams because she's still hungry.

Alternatively, we try to wake her up for a middle-of-the-night feeding (which she needs; she's lost more than a pound since she was born) and nothing will rouse her. Not tickling her feet, not swabbing her with a cold wet cloth, not speaking to her loudly, not changing her diaper, nothing. Except maybe another finger feeding, which means another missed opportunity to get her established on the breast.

Or: I let her suck my finger for a while, then try to move her mouth to my breast. She starts to scream. She seems to want to suck anything (finger, wet washcloth, her own hand) except what makes the food.

This morning she was busily refusing my nipple while Mr. K was downstairs getting me some breakfast, and the dam finally broke and I started to sob. When he came back up to report that the breastfeeding clinic at the Toronto East General Hospital was closed today (Canadian Thanksgiving), he started to sob too.

You know what? Sometimes the occasional sob really helps.

So we called Cynthia. She has been so great through this: she came over at quarter to ten on Saturday night to see what she could do to help, and she came again today with some herbs (fenugreek and blessed thistle) to get my milk supply going. She stayed for the better part of three hours and saw a whole attempted feeding, from the pumping, to the WAKEY WAKEY bit, to the tightly pursed little lips at the nipple, to the screaming, and eventually to the finger and tube put in frustration into Clara's tiny mouth just to get something into her.

Cynthia, in consultation with Melida, finally recommended that we do this:

1. Boost my milk supply with pumping and herbs.
2. Put Clara to the breast as much as possible, supplementing what she can get out of there with whatever breast milk I can produce plus whatever formula (sigh) is needed to bring the supplement to two ounces.
3. Go to the TEGH clinic tomorrow.

So that's the current plan.

Just sitting and talking to Cynthia for more than an hour, about babies, career choices, life histories, travel, etc., made me feel so much better. When she finally left, able to report that even with Clara's grumpiness she'd still gained two ounces since Saturday, I felt calm again. Mr. K and I have been trying so hard to stay calm and positive to keep a good vibe going in the house, but there's only so much we can do by sheer force of will. I know this will all work out and that I'll be able to breastfeed this baby, but oy, I can sure see how tempting it would be to throw up one's hands and just quit trying. And there are all those formula companies lurking and waiting to prey on exhausted parents who just want to make sure their babies are getting enough to eat, waiting to profit from people's misery. I feel very lucky to have so much support available to get us through this fiercely difficult stretch.

I find myself thinking a lot about whether these first few days reflect Clara's character: will she always be so impatient? What can we do to teach her patience, now and later?

I look at this tiny person on my chest and think: I cannot believe how much I love you.

There really is a baby here

Clara, Mr. K, and I have spent the past few days learning about each other. She likes instant gratification. My milk is not in yet. Yesterday was rough. She screamed for the entire day and well into the night because even though she could get a good latch on my breasts, the good stuff didn't arrive quickly enough to suit her. By 2am she was dehydrated and we were beside ourselves. Mr. K took her into the nursery to rock her for a while so I could try to sleep, but when the shrieks of desperation started again, they hit me like jolts of electricity.

I checked Dr. Jack Newman's Guide to Breastfeeding, which mentions that the second best choice for a newborn after pure colostrum is colostrum mixed with a bit of sugar water. So I hauled my sore self downstairs and made up a little shot glass for her.

Mr. K held her as I cup-fed her. We both got teary-eyed hearing her swallow. She calmed down immediately, and even fed from the breast for a while afterwards. Words cannot convey the relief we felt.

The midwives visited this morning, and Melida, the primary one, confirmed our decision, saying, "You have to go with whatever works." She and Cynthia, the student midwife who was mostly in charge during the labour and birth, gave us a piece of long, 1/16" surgical tubing. One end goes in the sugar water, and the other end goes right next to my nipple. This way, Clara gets her instant gratification, and once she's sucking, away goes the tube. This is a fabulous way to jump-start a feeding: she gets fussy, she gets a few drops of sweetness, she's on the nipple and happy. She's been drinking colostrum on and off all day, and the more she works, the sooner the milk comes. Melida says it will probably arrive by tonight. Yay!

Adam asks (hi Adam!) who does suturing at a home birth. If the home birth is attended by midwives, as this one was, they do. In Ontario, registered midwives go to school for five years and do at least a year of supervised clinical practice, as Cynthia is doing now. They bring a great deal of equipment to a birth: oxygen, a neonatal resuscitation unit, IV supplies, and so forth: at least 80% of what would be available in a hospital. They have to be recertified annually to do certain procedures, and often what they do is based more on evidence and research than what many OBs do. Plus, they don't limit themselves to what would be available in a hospital pharmacy: they use a lot of traditional herbal remedies such as black cohosh and blue cohosh (which brought on my labour like gangbusters after the water broke) and the aforementioned shepherd's purse, which is very effective at stopping bleeding. I suspect midwives have been using such remedies for hundreds of years.

Mr. K and I have both been so impressed by them and by the quality of care that Clara and I have received. They are far less interested in numbers than they are in holistic assessment, and this laid-back approach suits us all just fine. For example, they never asked once about my weight, because they don't consider it as relevant as the size of the uterus. They put Clara onto my chest as soon as she was born, and gave us well over an hour together before they even mentioned weighing or measuring her. Today they didn't weigh her or check her bilirubin levels (she's a bit jaundiced, as is common in breastfed newborns); Melida told us just to put her in sunlight, which has worked wonders already. Melida's quiet wisdom seemed a bit brusque at first, but as we've gotten to know her it's come to seem exactly the right approach. Cynthia's enthusiasm and love for her new work make her a wonderful complement to Melida. Cynthia's eyes were so bright as she talked about how exciting it was for her to watch the development of this baby in utero and then finally meet her on the outside.

They've shown great respect for the emotional and spiritual aspects of pregnancy and birth, as well as great medical knowledge and competence. I feel that they've cared for us as whole people, and that has been such a gift.

And now Clara Elizabeth sleeps on my chest, and all is right with the world.

P. S. It has taken all day to write this. The milk truck has arrived. My breasts are now bigger than Clara's head. Yow.

Meet Clara

Born at home with wonderful midwives and a doula yesterday at 6:41am. Seven pounds, six ounces; 20.5 inches long. My water broke with a huge gush at 2:30 Monday morning, and by midnight I'd started seven hours of intense, intense unmedicated active labour, most of it standing up and hanging on for dear life to Mr. K. Eventually they got me to sit down on a birthing stool, and she crowned fairly quickly after that. At the end of it her whole little body came out with one giant push.

She is alert and mostly very calm. She and I are learning how to keep her fed. I am sore -- I tore in a bunch of rather odd places and needed stitches, and oh my god the hemorrhoids -- and had a bad time yesterday a couple of hours after the birth when I got up to use the washroom. I ended up leaving a trail of bloody footprints from the bed to the toilet, and nearly passed out while I was sitting there. A big bottle of Gatorade, a shot of Oxytocin, and some shepherd's purse helped a lot; within hours I was feeling worlds better.

The home birth was exactly the right option for us. Surrounded by familiar things, able to move around as we wanted, into our own bed shortly after her arrival. I haven't been out of bed much since; she's been getting plenty of skin-to-skin contact. So far she's met Mr. K's parents and sister, who are somewhat pleased to have her around. Mr. K has handled all the diaper duty so far, which is more than fine with me.

She is here and I feel like a lioness.