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.