Posts tagged ‘midwife’

July 1, 2011

formula for success (bye bye nipple shield)

As of today, I am (mostly) pleased to say I am no longer part of the breastfeeding fraternity.  Or rather, sisterhood.

Of course, I would rather breastfeed, happily for at least 6 months.  But just like Lottie’s birth, things dont always go to plan.

It all goes back to the first few days after the little one was born.  For her first few days in the nursery, Lottie was tube fed, as are many premmie babies. 

Then just as I was feeling about ready to commence feeding after she was born, on the second or third day, I ended up with an obstructed bowel (apparently this happens frequently after abdominal trauma, and was compounded by the fact a doctor told me to drink two litres of water in two hours, before anyone had confirmed my bowels were working properly after he surgery).

Anyway, the bowel obstruction was painful.  And having just been through labour pains, I can say it was ten times worse than labour and therefore spent the next couple of days dosed up on morphine and in no state to feed.

During this time, they began to give Lottie bottles (without my knowledge) which meant that a few days later when I was able to try breastfeeding again, she wouldnt latch on to my bare nipple.

Several midwives tried (and by tried I mean jammed her head against my bosom, giving me different order as to what I should be doing, depending on who was on duty) to no avail.

On the fourth or fifth try, one of the midwives gave me a nipple shield to use.

For the uninitiated, these are thin, flexible, silicon shields worn over the nipple to be used in situations like mine and also for women with sore, cracked or inverted nipples.

Finally, success!  Lottie latched on, thinking my nipple to be more like the bottles she had already gotten used to.

My happiness was short lived though, with all subsequent midwives who came to view my breastfeeding attempts telling me I should never have been offered one because it would be more difficult to wean bubba off them later on.

At the time I didnt see a a problem – she was feeding from my breast, relatively happily.  Isn’t what they all wanted in the grand scheme of things?

By the time we left hospital I was still struggling with the feeding but figured it would all get better once we both got the hang of things.

Fast forward a few weeks later and I was still struggling.  Lottie was grumpy, when she was awake (which thankfully wasn’t that often).  Darling boy kept telling me to feed her more, or offer formula, but I kept telling him ‘Baby Love says hunger is not the problem for unsettled babies’, then I’d get grumpy at him for insinuating somehow me, or my boobs, were at fault.

Turns out nipple shields are a boon for women who need to use them temporarily (for exmaple, a bout of cracked nipples) but using them in the long term can reduce your supply.

The fact that I had a traumatic birth and blood transfusion didnt help either as this can reduce your supply as well. That I didn’t get to feed Lottie for a few days after birth made matters worse.

So I ended up with a pathetic supply.

What to do?  I visited a lactation consultant at the hospital twice and was given a simple, yet physically hard routine to follow to increase my supply which involved 10 feeds of 40 minuts each a day, with 20 minutes of expressing after each feed.

This meant that each feed, expressing session, subsequen sterilising of equipment and settling of bub took around 2 hours, then in hour or less it was time to start again!

I was struggling, exhausted and frustrated, and bub was still grumpy. 

I tried fenugreek seed, I tried cashews (not that I minded that).  Nothing worked.

And to top it all off?  The expressing sessions alone kept me pretty house bound, but I was also loathe to feed in public with the nipple shield which meant I really had to get a boob out and attach a screaming baby to it.

Oh, how I envied the women in mothers group whose calm, happy babies latched on easily for a beatiful and discreet nursing session.

After all the feeding, expressing and so-called milk enhancing foods/herbs, at my last visit to the pediatrician he told me he wasnt happy with Lottie’s weight gain – while ‘adequate’ it was at the low end of the scale, so he suggested I top her up with a bottle of formula for one or two feeds a day.

Bub sculled the first bottle I offered her with gusto, and for the first time looked happy and content while awake after a feed. 

The doc also suggested I visit Possum Cottage, a local day stay centre for mothers experiencing breastfeeding and settling (among other) issues.

Off I went, wondering what I could learn that hadnt been covered by the lactation consultant.

First thing I was told was NOT to offer the bottle of formula instead of a feed, as it would further reduce my supply.

Instead I was to offer additional formula after every breast feed.

I was never keen on this idea as, like the expressing milk, it dragged out feeds to an hour and a half (an hour of feeding, then a bottle. then sterilising) but I thought I’d give it a go – if it worked, it worked.

For the first two feeds, it worked, Then Lottie stopped taking the boob completely.  By this I mean 40 minutes of screaming and thrashing about at the breast, only to be sated with a nice bottle of formula.

Understandably this made both of us upset and frustrated every time feeding rolled around.

So I did what most midwives would have you believe is a devilish act and gave her a full bottle of formula.  Next feed?  Same again.

And now a coulple days later I havent looked back (although I am giving her expressed milk when I can rustle up a bottle).

Darling bub is happy, content and alert.  I am happy, content and alert.

It might not be the ideal resolution to the problem, but for us it is working.

As an added bonus?  Today I had all the coffee and chocolate I could handle, with no worries about it contaminating my milk.

I thought I’d feel so guilty about this decision but I’ve given it a good shot for 8 weeks, sought help from the experts and done everything recommended in my well-worn baby books.

All I want is what’s best for my darling, and if formula makes her happy and well fed, formula for her it is!

(and here I need to plug a brilliant book called Staying Mum by Mara Lee which chronicles her somehwat similar story – even if your new baby experience is nothing like mine or hers, it is a good read for any new or expectant mum).

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March 29, 2011

cheap labour

As birth day fast approaches (8 weeks to go!) it’s about time to give some more thought to the labour process and more specifically, where it will take place.

For me, it’s the simple option – the local public hospital.

I chose this option because I had a good relationship with my GP and this, coupled with the fact that I didn’t forsee any problems due to my health, size or age, meant I didn’t think I’d need the specialist services of an obstetrician.

Cost came into it as well to a degree but it wasn’t a deciding factor – some time ago I did actually take out additional private health insurance to cover pregnancy and birth but in the end decided not to use it.

In hindsight I’m so glad I haven’t already forked out thousands (on top of my private health cover) for a completely straightforward pregnancy.

Perhaps if my local hospital (Royal Hospital for Women @ Randwick) didn’t have such a great reputation I may have felt differently.

If I could change one thing? I had wanted to go to the birth centre  (more relaxed environment, dedicated midwife care, less intervention) instead of the delivery ward but don’t like waiting lists, and for the birth centre there was a lengthy one.

I would’ve made it in there by now I think but wanted to be settled and know where I was going and also to receive continuity of care throughout my pregnancy rather than changing halfway through (that being said, I’ve never seen the same midwife twice and it hasn’t bothered me one bit).

A friend recently gave birth at the birth centre and couldn’t be more positive about it so there is a part of me that regrets not signing up!

Plus she was home the same day she gave birth which really appeals to me – I’m crossing my fingers that I can get out of the hospital and home with baby as soon as possible.

My concerns are nothing major though – at this stage I just want it OUT and healthy.

Writing this has made me realise how much I don’t know about how the whole labour day(s) thing will work, but I’ve got baby classes at the hospital coming up that should answer some questions (here’s hoping).

I’d love to hear comments from anyone with an opinion on RHW at Randwick, or the labour experience in general (in terms of type of delivery) – did you go public or private? Birth centre or delivery ward? How long were you in hospital after birth? Let me know, ladies!

For more information on birthing options, Huggies has a good run down on the topic.

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January 20, 2011

c-section tension

Dawn Brown of Knees Up Mother Brown had a great post this week that really got me thinking.

She’s been advised that she may need to have a c-section if her baby’s position doesn’t change, and (understandably) has a few concerns:

“1) I hate the idea of a spinal/ edipural and not being able to feel my legs/lower body. This is probably my worst fear and it’s the one that gives me nightmares. I know if I have to have a c-section then it’s inevitable but I just hate the thought of it

2) I really don’t like the idea of not being able to sit up, cuddle and breastfeed the new baby as soon as it’s been born. Within minutes of Zara being born we were sat having cuddles and it was lovely, I don’t want the new baby to be wheeled away and I have to lie there being sewn up again etc before I see it again.

3) I really don’t like the idea of having to rely on midwives, nurses etc having to come and help me to lift the baby etc I’m really independent and I want to be capable of going and picking up the baby if it’s crying

4) I worry about how long it will take to heal afterwards, especially when I will also have a 15 month old toddler as well to look after, if I can’t lift anything or can’t drive then I’m going to be pretty much useless and it will drive me insane.”

I’m 100% behind Dawn here.

While of course all anyone cares about is a happy and healthy baby, the delivery method is such an emotional one for many mums to be.

Even before looking into it much, I knew I didn’t want an elective c-section as I kind of thought it was cheating.  In my eyes, it was like skipping the trek and getting dropped to Everest’s summit by helicopter.

Bear in mind I have no medical reasons whatsoever to even consider a caesarean and I don’t feel that other women are ‘cheating’ if they have one, for whatever reason.  For me though, it wouldn’t have felt right.

This is not to say that I didn’t always harbour hopes that I would be told a c-section was necessary and I’d get to bypass a long and painful natural birth on doctors orders – in my mind it’s different if you have to have one! I guess like attempting to climb Everest and only stopping because you broke your legs, not because you got tired or couldn’t be bothered with the trek.

However the more I discover about the (serious) operation the more I am running scared from a caesar.

For the reasons Dawn lists, and others:

My mum’s experience:

My mum had five kids – four ‘normal and one caesarean (that would be me).  Many, many, MANY times over the years she told my sisters and I how much worse a c-section was.

Much of this could be attributed to the fact that 1) it was 30 years ago and they are probably done differently these days and 2) it was an emergency Caesar so the scar (massive, muscle severing) was a lot bigger than you would find in an elective c-section.

She stressed to us how hard it was not being able to cough or sneeze properly for weeks, no being able to pick anything up easily (including baby) and even once she had been given the all clear it took ages for her to relax around anything that made her use that part of her body.

She also stressed how much longer the recovery was for a c-section compared with vaginal birth.  This however could have something to do with me being a late ‘surprise’ baby and her being a lot older than when she gave birth to my siblings.

The epidural:

Not so much being numb from the waist down that bothers me, more the needle into my spine, ugh – have long held a fear (probably unfounded) that if they slip Ill be paralysed for life.

Catheter:

Enough said.

The ‘repair’:

Stitches or staples, I don’t want either on my belly, thanks.  At least if I need to get them from a natural birth they’ll be out of sight, out of mind (or so I tell myself).

Regardless of these fears, I have plenty regarding a ‘normal’ birth as well!  Best not to think about it all really and just stay focused on the end prize – whatever happens it will be worth it.

January 16, 2011

public versus private – why pay more?

So, I was at a hens party for a very close friend last night. 

Despite not being able to drink (well, I may have had a glass of wine) I had a great time and luckily there were a few other pregnant women and new mums to chat to.  I did feel sorry for some of the other girls who kept getting sucked into to our gasbagging about baby names, doctors, health etc! 

One issue that kept popping up was private vs public health care.

I was surprised at the number of women who had opted for private when a) the public medical system in Australia is so good and b) the cost of going private is so high (I’ve heard around $4,000 out of pocket AFTER claims, even with full cover), especially considering many of these women are scraping money together to pay a mortgage etc.

I’ve always been a big fan of public health and only signed up to private to reduce my tax bill. 

Luckily I am in a position to be able to afford private if I wanted to, but I’ve always found better uses for my hard earned moolah.

Besides, if anything serious happens you have to go to a public hospital anyway, so what’s the go?  Am I missing something? 

Am tempted to think it’s purely snobbery but perhaps there are other more convincing reasons people have for going private.

I know my local private hospital puts new mums up at a nice hotel after the birth so their partners can stay over, they can enjoy decent room service and have water views…but I don’t plan to be in hospital long after the birth anyway.

And for a couple of days of crappy hospital food (was planning on getting takeaway anyway) I could use that extra $7k for an extended holiday with baby, which could be madness in itself.

Another new mum suggested that rather than attend the birth classes provided by the hospital I give her midwife a call.  This midwife runs a five week course (two hours per week) for $2000. 

My first thought was, if this midwife isn’t putting this through the books (and even if she is) she’s got a real cash cow on her hands.

The second was, what’s the difference? 

Apparently, in hospital they show you “bad 80s DVDs with lots of grunting and hairy bits”.  The midwife also shows similar DVDs but “more recent”.  Oh, she also serves supper.

Is that worth the extra $2,000?  Or would I be better off putting this money into a savings account for whatever my child needs on a rainy day?

Melissa Maimann has an excellent post on this topic but I’m still undecided.