Monday, March 30, 2009

Six months

So, Andrew's six months old. I love this stage of babyhood, because he's old enough to have personality, but he's still easy to keep up with. That will be short-lived, because he is rolling/squirming himself all over the place, and I think we are no more than a month or so away from actual crawling. He still tends to fall over when sitting up, but he's figuring it out day by day. He's a very happy baby as long as he is being played with, held, talked to, and otherwise interacted with, full of smiles and giggles. Until this weekend, he'd been doing very well about sleeping through the night, and even the 45-minute naps are slowly stretching out to an hour, sometimes an hour and a half. In most respects, things are going well.

The not-so-good respects is our old bugbear milk supply. At his six-month checkup last week, he weighed 15 lb 14 oz. That's 25th percentile, not terrible of itself, but it's only a six-ounce gain in five weeks. The doctor pronounced herself unconcerned, because babies do often slow down at this point, but now he's started acting hungry again. He's nursing every two hours again, biting and acting mad at me after feedings, and waking up at night again. He feels lighter to me than he did a couple weeks ago, and my mom also noticed a difference. When the wet diaper count started to drop off, I was pretty sure we had a problem again.

I had weaned myself mostly off the Reglan, mainly because I was tired of taking pills, so the first thing I did was to go back on it three times a day. I've taken Reglan for months now, and took it for months during my pregnancy with no problem, but apparently I've crossed some side-effect threshold. After just two days of increased dosage, I've been jumping out of my skin, restless and anxious and weepy and sad and obsessive, in a way that is very much not like me. My LC's nurse thinks this is probably due to the Reglan, and told me to get off it posthaste. Low milk supply is better than emotional instability, to be sure, but I'm not happy about losing the Reglan just when I need it more.

I had started Andrew on solids on his birthday, beginning with mashed banana and pureed pears and applesauce. He's been showing signs of readiness for a while -- watching our food like a hawk, stealing off our plates, gumming anything you hold up for him to taste -- so I was surprised when he wasn't enthusiastic at all about the fruits I offered. After some experimentation, though, I think perhaps he just doesn't like fruit much, because he likes oatmeal just fine, and any bits of our food that are soft enough for him to eat. Rice with vindaloo sauce was a huge hit, and I thought the kid was going to take my hand off over mashed-up new potatoes -- I couldn't get them in his mouth fast enough.

So solid supplementation will take some of the pressure off the milk-supply thing, I hope. I'm giving him a bottle at bedtime again, too, which he attacks with enough vigor to reassure me that he needs it. I don't intend to wean him yet if I can help it, and would really like to keep nursing to the one-year mark, but it looks like I just can't keep up with breastfeeding alone.

Low milk supply is a real thing and does happen, even to women who do everything "right". I've never doubted that, but I just didn't think it would happen to me. I had hoped the first episode was a temporary hurdle, but it looks like something I'll have to fight for the rest of my time as a nursing mother. It's not just the Reglan talking when I say I'm sad today.

Thursday, March 19, 2009

To everyone who ever asked me

"Why don't you just adopt?"

I come down on the pro-life side of the abortion continuum, if mildly so. Obviously, I am less than hardcore, as I was prepared to proceed to IVF, and got up-close-and-personal with the possiblity of high-order multiples and of serious genetic defects. I would not, I think, have chosen termination under either circumstance, and I am sure that I would have gone down the embryo-adoption path had it come to that; but I've at least thought it through enough to know that I am somewhat mushier on the subject than, say, the Catholic Church. However, I have much greater reservations about ending pregnancies which are merely unwanted due to age or circumstance, which don't fall into those exceptional categories or involve rape, incest, or maternal health.

That doesn't mean I can wave my hands and talk about how adoption is always such a wonderful alternative. It can be, under some circumstances, and under others, it can be hideously damaging. We most likely would not have considered adoption, although you never know until you get there, and this article illuminates one of my major reservations. I have deep misgivings about taking another woman's baby just because I happen to be wealthier and have a broken reproductive system. It's one thing if we're talking about babies who are already in a foreign orphanage or the foster-care system, and another thing entirely when the baby's mother isn't out of the picture before the subject of adoption arises.

There are no easy answers, and I think it's important for pro-lifers to understand that adoption is not a panacea. It's possible to believe that an unborn baby's right to life is important, while acknowledging the real consequences of that belief. Rights are about more than just the least-unpleasant alternative, but that doesn't mean you get to pretend the collateral damage doesn't exist.

Sunday, March 01, 2009

I am contractually obligated

If you have a parenting blog, it's mandatory to do a sleep post at some point. (I'm sure it's in that terms-of-service legalese SOMEWHERE.)

We started out with Andrew in the co-sleeper, swaddled and pacifiered, and initially it was lovely to roll over, feed, and put him back to bed. As newborns do, he napped wherever he happened to be, in the swing or in the crib or especially in the bed for naptime with Mama. We've fought the 45-minute nap monster his whole life, but he seemed happy enough, and went to bed at 8 PM or thereabouts without complaint. In November, he started sleeping until 7 AM, and I thought we had the sleep thing more or less licked.

In retrospect, the return of the night wakings should have been a clue that my milk production was on the wane. Once I got clued in to the great milk supply debacle, I started making sure he got a supplemental bottle at bedtime, and resigned myself to night feedings for a while. There was no question he was getting hungry in the middle of the night, and straightening out his weight gain was the top priority. Eventually he dropped the 2 AM feed, but was still waking up at 5 AM and then getting up for the day somewhere in the 7-8 AM range.

The milk supply seems to be pretty well fixed now. I gradually weaned him down to one 4-oz bottle a day, and when he gained a whole pound in a week on that single bottle, the doctor gave me the okay to discontinue it. (He even had RSV and needed a nebulizer during that week, and still he gained a pound!) I'm still on the Reglan, mainly because I'm scared to mess with non-brokenness. He's obviously gaining weight, and during the day seems very content. He's spacing his feeds out to be more like every three hours, instead of wanting to eat every hour and a half or two hours, which is a really nice break.

Now that he's knocking on the door of six months old, I'm getting really ready to get him out of our bedroom. He is a light sleeper, easily disturbed by the TV on the other side of the wall, or the barking dogs, or toddler wails. I miss not being able to read before falling asleep, and fold and put the laundry away in the evening, and have conversations with my husband in bed at night. To that end, I spent last week painting his room and setting up his nursery (total case of third-child syndrome, that).

More importantly to Andrew, I took his pacifier away and stopped nursing him down. He got to where I couldn't put him down unless he was so deeply asleep that he didn't care if it fell out of his mouth, and couldn't get back to sleep without it if he started to wake up. I'm still rocking him to sleep, and he fusses for a minute or so about wanting something to suck on, but then he goes down and stays that way until he wakes up for a feed. I'll be dropping the swaddle tonight, since he is outgrowing the blanket and also keeps winding up on his tummy, despite the sleep-positioner foam blocks I bought to prevent that. No plans to drop the rocking -- that was a major production with the girls and involved some crying-it-out, which I'm just not big on at his age. (I don't consider the pacifier removal fussing to be CIO, given that he's crying while being held, rocked, and sung to.) He's still waking up to eat in the middle of the night at least once, but at this point I'd rather go upstairs and either nurse him there or bring him back downstairs.

I'm pondering night-weaning, but I'm not ready for it yet, especially given that I am probably about to disturb the milk-supply equilibrium with endometriosis treatment stuff. After almost three weeks of good days, I've had some pain trouble again for the last several days; and I can't explain without going into TMI territory, but the endo has clearly been growing. I'm going to see the RE for another scan this week, and depending on what the ultrasound shows, it's probably time to start treating it, before it gets too invasive. I am half leaning toward asking for another lap excision, but I expect he will want to at least try BCP first. We'll see.

The sleep thing could certainly be worse, and it makes me realize just how fantastic the girls were at this age. They slept from 8 PM to 8 AM with three 1.5 hour daytime naps, which is as close to textbook sleep habits as you can get. I could wish Andrew napped better and didn't still wake up in the night, but I know the status quo really isn't too bad.