Friday, 26 August 2011

A little blip along the way

I have just got back from hospital an there is so much to say - I am going to rant first and then go back to tell you about my really positive experience of the hospital an Cesarean later. First I need to let off steam! I am sitting hear with cracked nipples and engorged breasts because I was not listened to until I registered on their system and then I was bullied into taking extreme action.

Beanie was born and was perfect! Despite being a Cesarean within 35 minutes of birth he had latched on perfectly and the transition from bump to bond was seamless. The downside to the Cesarean was that I know that he was not ready to be born and the vital body signals had not been fired. I remember the pattern with the Pickle - she latched on perfectly after birth but she would suck constantly and leave the breast furious, with angry tears. One night when she refused to settle a nursery nurse checked her out an saw the tell tale sign of urates (tiny salmon coloured crystals) and suggested that she was dehydrated as my milk had not come in and I should top up the breast feeding with a little formula. I tried expressing a little milk and sure enough there was nothing there - so the next 24 hours I breastfed and topped up with formula until my milk came in. It was hideous seeing her in thay way and despite wanting to avoid formula it seemed a reasonable price to pay to restore her good health. The Pickle then went from strength to strength and breastfed happily from there on in an I never saw her in such distress again.

Needless to say I remembered this  vividly as dehydrating my daughter was distressing to say the least. I could tell that I was going down the same path with Beanie. My breasts seem to know no half measures, they are barren then they miraculously gush! I flagged this up to the midwife and we gave him 5ml of formula then she dismissed further top ups as unwise - writing it up in my notes as a bad idea of mine. At the same time Beanie started to do rather spectacular mucus pukes, not little delicate possets but full on vomits. The midwife actually congratulated me saying that as a c-section baby it was great to see him bring up all the mucus that he could not expel while in the course of a natural delivery. I was changing him and his sheets continuously. Then to a final blow to the little Bean the sun came up over the building adjacent and started to bake our room.

I did not really think much about the overall impact of these factors as I had expressed my concerns and the professionals had allayed my fears. Anyway, at this stage my milk came in so I knew that Beanie would soon be as right as rain. All the focus seemed to be on me an my blood pressure the was slowly coming back down. Finally, on day four I was well enough to be released! hooray! One last formality was to weigh the Bean and I could be back home - simple? That was where the nightmare began!

He had lost 12% of his birth weight and that set off all the alarm bells! I was a bad Mum - Beanie had to be assessed at the specialist unit with blood tests and all sorts of prodding and poking.  He was both mildly jaundiced and dehydrated - erm, what had I been saying? That was just the start of the journey and the nursery nurses were delighted to be in control - as I was obviously failling.

The remedial routine was specific and it made Gina Ford look mild:
- breastfeed for no longer than 15 minutes (it was never explained why any longer would be detrimental)
- top up with 40ml expressed milk - as bottle fed milk feeds the mouth further back than breast milk so is better for babies. (later this particular fact was contradicted by everybody as being just daft)
- change him and play with him for the rest of the hour - but not over the hour that started with the 15mins of breastfeeding.
- put him down in the cot for exactly three hours for sleep. Any form of contact: cuddles etc will disrupt the benefits of the pure rest required. (This seemed at odds with all the posters they had advocating skin to skin contact and 'kangaroo' care.)

Just to prove that she was human and in touch she talked about her sister, having given birth six weeks previously. When I started to cry (it was on the notorious 3rd day after birth, when hormones would unsettle a cart horse) she explained how her sister was often in tears 'not that she has post natal depression or anything.' Is she so sure? I got the impression that she was saying that because her sister was not the kind of person to get post natal depression. Either way I was concerned that a professional dismissed so casually a condition that effects around 10% of mothers who have recently given birth and is still often subject to stigma.

Anyway I expressed 30ml in no time then prepared to start the regime. I breastfed (I forgot to set the stop watch) bottle fed the expressed milk, played and changed ready for the enforced sleep. Needless to say Beanie was not impressed and started to howl - so eventually to calm him down I fed him a little more and had a little more play. As a three day old baby I did not want to ruin the bond that I had forged with him on the basis of a concept that seemed a little extreme based on just his weight loss. A new Nursery Nurse had taken over and she came in to insult consult me, and say that she would be spying on looking after me, after an hour of rest in his crib he had woken, was ready for a feed and starting to let rip. The nurse was adamant that in order to help Beanie I must follow the routine, but that I could not breastfeed until I had the next lot of expressed milk on stand by.

Hold on, I had been running myself ragged getting into their routine - in little over an hour I had expressed my first batch and breastfed but not started to stock up supplies of milk for future use. The atmosphere was somewhere between glacial and police state. It was clear they felt I had failed and they were doing their best to save my baby. To make it clear she pressed her views home saying "You should have planned properly in advance" letting me know that it was my failure that was the issue. This condemnation was being played out to the strains of Beanie's hungry cries.The Hubster had taken Pickle for a walk and so it was left to my Mum to hold Beanie while I was trying to reason with the nurse and for her to offer fierce moral support.

Then the Doctor came in - and so did the rationale. With the words "there seems to have been a misunderstanding" my life started to take shape again. Gone were the proscriptive rules - and clarity was restored. Beanie needed feeding at least every 4 hours - the 4 hour gap just allows Mums some time to recover and sleep through the night and not get ground down and ill. Each feed period should be topped up by expressed milk just so we could guarantee that Beanie was getting the quantity. Apart from that there were no hard and fast rules.

Come shift change who should appear but the lovely Margaret who had been so amazing with the Pickle. I told her our story and she decided to help again. To give me the maximum sleep she woke me up at feed time during the night with bringing the last lot of expressed milk, then later when ready picked up the next lot milk for the fridge before letting me sleep again. She then suggested that she could weigh the Bean secretly before her shift ended - and if the weight gain was significant she would get me discharged that day. I felt that I was feeding up a veal calf - relentlessly forcing milk into the mouth of a newborn. I wanted Beanie well and at home where I could listen to his needs and respond to him rather than waiting for him to hit or miss standardised targets. Don't get me wrong, I respect the Doctors and think that everybody at the hospital were genuinely doing their best for both me and Beanie and that most of them were well informed and professional - just there is (as the saying goes) no place like home!

By the next morning Beanie had put on 200g and was less then 10% under his birth weight - and ready to leave the hospital for the first time. Home sweet home!

The most important thing is that Beanie is well and was never in danger. As a Mum the wellfare of my children is paramount and any personal discomfort is irrelevant compared with the importance of their health.  I am cross that my concerns were ignored until they suddenly they registered on a measurement that they accepted and then I was made to feel at fault. i was given contradictory advice, and had I not queried it I am concerned as to the impact it would have had. I was left with excruciatingly painful cracked nipples from the expressing and the temporary enforced catch up milk production left me with painful cannon ball boobs that looked more pneumatic Babewatch than human as they stretched to accommodate the extra milk. But three days on I can feed without screeching in pain, Beanie is eating his fill and his nappies indicate all is well. I predict a happy future!

1 comment:

  1. First of all, congratulations!
    Secondly, I am furious on your behalf. We had a similar thing happen, we were told the baby would get brain damage if we didn't top up (with formula). Anyway, this could turn into a big old rant, so I'll stop! I'm glad all's well that ends well xxx


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