The Hospital
I didn’t have much expectations of motherhood, but so far it’s been surprisingly harder than I’d expected. The first two days in the hospital were a little tough because everything was new, I was learning how to cope with breastfeeding and interpreting a baby’s screams (at all hours), but the nurses tended to me and helped me with everything from latching to caring for my nether regions, and I didn’t have to find my own food or leave the room. Medical supplies and freebies were ample. Mr. W was always by my side, helping care for Allie. It wasn’t easy, but it was like new parenting with training wheels.

On Our Own
After we came home, I still didn’t quite have the hang of how to get her to latch right, and I already had painful cracking and blisters on both sides. The nurses and lactation consultants at the hospital said that based on the amount of diapers Allie was going through, I was doing just fine, I had “plenty of milk (colostrum, thick pre-runny-milk nutrition for a baby with a tiny stomach),” that sore nipples are normal, and it would be no problem for Allie to breastfeed despite those cracks and sores, so I kept at it, hoping things would improve on their own. They got worse. Allie cried through the night, I was in a lot of pain every time I nursed her, and it took forever to finish a feeding because she would constantly fall sleep and only suckle periodically. The second day we were home, we logged a total of 11 hours and 4 minutes spent breastfeeding, done over 12 feedings. (Mr. W has a great iPad app he keeps these records on.) She still cried for food often, was seemingly endlessly rooting even after she had just come off the breast minutes prior. I was grateful for our system that Mr. W automatically started — when she cried, Mr. W would pick her up from our cosleeper in our bedroom, check her diaper, change it if necessary as I prepared the Boppy or Brest Friend and myself for nursing, then hand her to me to nurse. After Allie finishes with one side, he’d take and burp her, then return her to me for the other side. After that, he’d take and burp her, swaddle her, and (try to) put her back to bed. We figured out that when she screamed bloody murder, it was because she needed changing, had gas, or was hungry. The problem is that she is ALWAYS hungry and rooting (mouth opening and closing in the air, head turning when she feels contact with a person to look for a breast, stuffing her fists in her mouth), and screaming. This is especially hard between 11pm and 2am when we are exhausted from being up all day and are not allowed to sleep, even after we’d just fed her. I had been fairly well-adjusted and optimistic, but Mr. W was troubled by Allie’s unproductive feeding, I picked it up, and suddenly got the baby blues over the weekend. I actually wondered whether I’d made a mistake and was incapable of being a good mother; I couldn’t even feed my child right.

Scary News, New Instructions
Our 2nd day home, thankfully, was also Allie’s first out-of-hospital pediatrician appointment. We were sent to an out-of-town doctor because that was the only place open on weekends (it was Sunday). Our major concern is that altho she was wetting and poopying on as many diapers as she should in the hospital — more than, even — as soon as she came home, she stopped. Day 3 of life means 3 wet, 3 poopy diapers. She had 1 each. Day 4 of life means 4 wet, 4 poopy diapers. She had 1 wet, no poopy. Day 5 was the appointment. She had 3 wet diapers that day but still no poopy since she left the hospital. That female doctor was a God-sent. Mr. W was at first lamenting the long drive to Garden Grove to see her when the pediatrician we’d selected is conveniently in our own town, but we left Garden Grove knowing we’d been given a blessing.
Allie weighed in that day at a shocking 7 lbs 5 oz. She’d lost 9.5% of her birthweight (normal is 7% weight loss, 10% means a serious problem), and was very dehydrated. She wasn’t pooping because her body had entered survival mode and was withholding every calorie, refusing to waste anything by expelling it. The constant screaming for food was because, the pediatrician explained, Allie was starving and wasting away, and her survival instinct was to fight it by demanding food constantly.
Given the dire situation, the doctor immediately brought a 2-oz disposable bottle of prepared baby formula, and had Mr. W feed it to her. She recommended no more than an ounce as supplement, but said this time to let Allie have as much as she wanted to get her back on track. Allie sucked up 2/3 of the bottle in less than 2 minutes. I was then put on the “10-10-10” feeding plan. Clearly my 11 hours per day feedings were unproductive; she was largely using me as a pacifier, wearing down my body but getting insufficient nutrition, so instead of marathon feedings, I was instructed to feed every 3 hours by putting her 10 minutes on one side, burp, 10 minutes on the other side, burp, then supplement with 10mL of baby formula. The doctor actually told me to spend the next 2 days giving Allie 1 oz of baby formula supplementation because her weight was so low, and hopefully that would catch her up for the first week of her life. I was to pump my breastmilk after each feeding to tell my body I need more supply, and I was to always breastfeed first so she doesn’t get too used to the ease of the bottle and start rejecting my breasts. What I pumped out would be used to supplement (by bottle) in lieu of the formula until my pumped supply is good enough that I could wean her off formula. What? I get to bottle feed in addition to breastfeed, breastfeed so many fewer hours, AND I got permission to use formula? This was going to fix my baby? For the first time, I cried. I didn’t know why I was crying, maybe relief, maybe because I was just tired and stressed for so long without a rest, but my crying made the pediatrician cry a little, too. That’s the mark of a great doctor, cuz by this time in my career, there’s likely no one who could walk into court and give me a sob story so great that it’d make ME give a crap about their case. We were sent home with a 6-pack of premixed 2-oz baby formula bottles, instructions, and best of all, hope for improvement.
The rest of that day (till midnight), Allie pooped 3 times and had 4 more wet diapers. I’d never celebrated poo before. There’s a first time for everything.

Improvement?
After that the graphs on Mr. W’s iPad app showing my feeding schedule looked much more normal. The feedings were at regular intervals, the durations much shorter. I’d spend an average of 3 hours per day nursing (in addition to Mr. W’s supplementing) instead of 11 hours. My husband has been amazing. I thought I’d be doing the nighttime stuff on my own since he’s more an early riser and needs his sleep, but instead, I was never, never alone. As frustrated as he was to not be able to sleep due to a screaming baby wanting to nurse every couple of hours, then refusing to go down to sleep for inexplicable reasons, he kept at it. Daily, around 10pm, 1am, 4am, 7am, 11am, 2pm, 4pm, 7pm, he’d stop what he was doing (including sleeping), change the screaming baby’s diaper, bring her to me to nurse, burp her in between sides, prepare 15-20 mL (30 mLs is 1 ounce) of previously pumped breastmilk, bottle-feed her as I pump, then sit with her comforting her until I was done pumping, help me with the pump (taking it apart, storing the milk), swaddle and put Allie to bed. And then we’d lay there in the dark freaking out with every gurgle and squeak, terrified it’d turn into screams of bloody murder as she refused to be put to sleep despite the fact that she was so comatose during the ends of feedings that I’d have to keep tickling and annoying her to keep her awake so that she could get enough milk in her system (apparently normal in newborns). We decided to switch the order we did things to see if we could take advantage of her food comas. Instead of changing and swaddling her after the feedings, which would seem to wake her up, we did all those things before she switched to the second breast so that once she dropped off, we could put her to bed immediately. Sometimes that helped, but only sometimes.
I cried a couple of times at our usual most difficult stretch of 11:30pm to 2am, when she would just stay awake and scream and cry despite the feeding she’d just had. Mr. W comforted me, told me to stop apologizing to him, that we were in this together. I just felt like I brought such a difficulty and nuisance into his lifestyle with this baby whom I can’t handle on my own. The number of diapers he’d changed vs. the number I’d changed was at a ratio of something like 20 to 1. Maybe 25 to 1. And he was so tired and aggravated, especially during that stretch. Despite that, he kept getting up, every time, telling me to take care of myself, to rest a few minutes and ready the breastfeeding pillows. And then he’d bring me water with a bendy straw as I nursed, and Allie would gulp as I gulped.
Allie was wetting regularly now, 8 or more diapers a day, but still no poopy since the ones after the formula bottle feed of Sunday’s pediatrician appointment.

Lactation Clinic to the Rescue
Allie’s 7th day of life, I had an appointment at the lactation clinic at the hospital I birthed Allie. Mr. W came with me and was allowed to stay in there as long as no other women came in for their consultation, since we breastfeed in there. The lactation nurse weighed Allie naked and there was already a huge improvement. Allie had gained 8 ounces in the past 2 days since the pediatrician appointment, a bigger improvement than the nurse, already familiar with Allie’s medical chart, had hoped for. She was now 7 lbs 13 oz. The nurse then instructed me to breastfeed from one side. She cringed when she saw my nipples and said I was a trooper, most people would’ve given up before they looked like this. She noted I wasn’t complaining. Complain? Because I couldn’t seem to do the basic thing needed for my child’s survival? That just made me more diligent, to force my body to do what I need it to. Who has time to complain? The nurse took Allie and weighed her during that feed, announced
Allie had taken in half an ounce. She returned Allie to me, taught me to fix my latch on the same breast and to nurse properly. Apparently I’m not aggressive enough with the baby, causing her to latch too shallowly (painful). I ended up putting an ounce of milk from each breast into Allie, and Allie was fat, dumb and happy after that. She slept the entire way home. The nurse said by the looks of things, my transition milk (more volume, less thick) had come in just that day, and I can stop using the formula to supplement now. She said to pump only when necessary or just once in awhile to give my nipples a break while Allie’s bottle-fed with pumped milk, and said I can now supplement with my own milk exclusively.
I asked her about the screaming bloody murder and refusing to sleep thing, despite falling asleep all the time during nursing, and the nurse said Allie’s a survivor who fights hard to let us know that she’s not done with her feeding yet, she didn’t get her 2 oz of food, and to not give up on feeding her. That’s all the screaming. As far as the rooting right after she eats, that’s just her looking for a little topper to soothe her into sleep; if I give it to her it should be minutes before she drifts off into the food coma again. And the nurse revealed another reason for her cries: in addition to needing diaper changes, food, and to be burped or relieved of gas discomforts, sometimes the cries are just for a little cuddle after she eats. So if I don’t see a dirty diaper, she’s not rooting or she just ate, and I couldn’t figure out what’s wrong, just holding and rocking her calms her pretty quickly if she just wants a cuddle. Swaddling also helps. Mr. W is now an expert swaddler.
The problem left is that altho I now know I can produce 2 oz of formula total, the amount the lactation nurse said a baby this age needs to drink at each feeding, I don’t know how much I’m putting in her because I don’t have a baby scale at home. So how do I know I’m supplementing enough? How long do I keep her at each breast?

The Turn
I had been pumping 8-15 mL of milk after my feedings since I started pumping 4 days ago, but I decided last night to skip the 10:30pm session of breastfeeding and pump exclusively as Mr. W bottle-fed Allie 2 oz of formula (which we thought would knock her out like it did at the pediatrician appointment). That would get us sleep through the usual difficult period until her next feeding at 1:30a or 2a, it would give my breasts a break as they were finally starting to heal, and I would find out how much milk I’m producing and better estimate how much she’s taking in from me directly. If I produced 1 oz on each side (as proven I could at the lactation clinic), and I could still pump out 15 mL (1/2 oz) after she’s done feeding, I’d know she’d only gotten 1.5 oz from me directly, and that the correct supplementation is half an ounce. Plus we’d now have a little stockpile of breastmilk to supp with in our fridge.
Several things were surprising last night. One, Allie drained about 1.5 oz of formula (Mr. W accidentally spilled some from the 2-oz bottle) in record time, he added half an ounce more of breastmilk to supplement for 2 oz total, and she still rooted and screamed and cried afterwards, refusing to go to sleep. Maybe she she got more from nursing than just the physical milk. They sat with me as I pumped, and the rhythmic machine sounds soothed her and she eventually dozed off. Two, I pumped out 55 mL from one side and 45 mL from the other for a total of 100 mL; that’s close to 4 ounces. That’s an incredible amount of milk for someone’s first baby, nursing for just a week. (Happy 1 Week birthday, little baby! Here’s 4 oz of breastmilk as your gift.)
Also surprising, it was still a miserable time slot in the first part of the night, and so miserable that I even nursed her after pumping. She dozed as usual, but we’d put her down, she’d start breathing funny, I’d internally panic and wake up every time I heard anything from her, and sure enough, she was up and screaming bloody murder in seconds, rooting again. How could she be rooting? She just drank an enormous amount of formula, way thicker and longer-lasting than breastmilk. Mr. W would sigh, get up, rub his sore back, unswaddle her, check her diaper, change and/or reswaddle her, try to rock her, as she wailed her head off. I found myself guilt-ridden again, apologetic, and told him I don’t mind doing feedings 2 hours apart instead of 3 hours because maybe this is her body’s way of getting her over the starvation hump. I offered to take her and rock her, but he told me to try to sleep and give my breasts a break as he took care of it. I finally convinced him 2 hour increment feedings are as normal as 3 hour increment feedings if a baby is to be fed between 8-12 times a day, and that I didn’t mind doing it. He relented, because at least during the feedings, he gets 15-20 minutes per side to snooze. He still took over the burping in between sides and the logging of the information into his iPad. I thank him for being here, I apologize for being so dependent on him for help; he says he feels bad he can’t feed her in addition to all that he already does to give me more of a break.
I finally realized while studying Allie in the wee hours that last night, she seemed to make throaty sleep apnea sounds and wake up crying so often because she was using a Boppy Noggin Nest head support thing that we’d just gotten yesterday. When we followed the recommended guideline of sleeping on her back on a firm mattress, no head support, she would turn and watch us as she got drowsy, then turn away from us toward the dark wall as she slept. With the Noggin Nest, she couldn’t turn her head and it seemed to affect her breathing. As she screamed, I picked her up and cradled her to me, rocked her to sleep easily enough, and looked curiously at the tags on the Boppy Noggin Nest. It said to never use for playard, crib, bed; only use when the baby is in a recline position, such as in a swing or a rocker. I removed the Noggin Nest and the rest of the night, she slept more soundly. Mr. W called me a genius.
This morning, Allie made her first poop since Sunday, and it was a double-sized load or more. Hopefully this means her body was just cluster-feeding to push her over the starvation mode she had been in, and now she could sleep longer knowing she was going to get adequate milk.

Grandma & Grandpa’s Support
My parents or at least my mom has been coming by most of this week with freshly cooked food prepared in accordance with a Chinese model of proper postnatal nutrition. Things were made in the proper order with proper organic ingredients to do things like replenish my blood, cleanse my body, shrink my uterus, get my milk supply to come in, in that order. Daily during the Thanksgiving break and weekend, she’d cook in the morning and bring different dishes for me and Mr. W in tupperware containers to make sure we didn’t have to cook, then she and my dad would spend a little time with their granddaughter while Mr. W and I ate. Now she refers to herself as “grandma” when talking to Allie (usually misleadingly asleep) and she seems happy with that title. Mom revealed that my dad had said that he misses Allie when he’s not with her. While they were here the first time, my dad came excitedly into the dining room where Mr. W and I were eating, to report that Allie turns her head in her sleep. Then my mom followed later to report that she smiled in her sleep and that it was so cute. They are gonna be one of those people who have boring grandparent stories to tell their friends, but they’ll tell them very enthusiastically.
Sure my mom nags me about having a window open or Mr. W taking Allie into the backyard for a few moments because drafts are deadly to babies and to postnatal women, and she got on me for not wearing slippers in our house and walking on cool travertine tile floors (which I ignored), but at least she’s easily distracted now by even a small gas expression on a baby. We’re very grateful for their help, eating fresh homemade food prepared daily.

Crossing Fingers
Oh, and Allie’s umbilical cord fell off this afternoon, revealing a round little white belly button. We were told to expect that in 2 weeks, not 1. I’m gonna cross my fingers that this is a good sign of her progressing development, and that tonight will go better without the crying bloody murder thing between 11pm and 2am.