cindy's world

Today was a dash through the rain so Allie could meet her personal pediatrician for the first time. He was impressed with how well her belly button’s healed, how much weight she’d gained (she’s at 9lbs 7oz now, well past her 8lb 2oz birth weight), how well her sleeping/feeding patterns have been established. Allie goes 4-4.5 hours between feedings between 12am and 9am, and only yesterday started shortening her daytime feedings to every 2-3 hours. The doctor said this is setting her up to have longer nighttime naps and more active day, which is exactly the ideal. He said some babies are flip-flopped and are more active at night, and the parents have to switch the baby’s clock. I said Allie’s pretty much doing this herself, and he said there are likely subtle things we do to help her along, such as
* keeping nighttime feedings boring and unstimulating: yes, we keep the lights low, we don’t play with her, it’s pretty much change diaper, feed, burp, swaddle, put her back down to sleep. He said some parents sing to their kids and entertain them at night feedings, and the baby will get used to and wake up just for that, even if it’s not that hungry.
* not co-sleeping with her: she’s right next to us, either in the separate cosleeper unit on her playard by me, or in her rocker cradle next to Mr. W, and we only pick her up if she starts crying. If she coos or makes other noises, we wait to see if she’ll go back to sleep first, and most of the time, she does. The doctor said co-sleeping tends to make the babies wake up more often, and keep the parent more interactive, either as a pacifier or as entertainment.
* not letting her stay latched when she’s not actively feeding: I’ve been following the lactation nurse’s advice and breaking the latch as soon as she goes into half-asleep light sucking mode. According to the doctor, this teaches her that I’m not a pacifier available for comfort at all hours of the night. If she still wants to suckle, she’s given a pacifier in her co-sleeper or cradle, or she’s rocked to sleep in my/Mr. W’s arms with a pacifier and then placed in bed.
* keeping it lit, noisy, busy in the day: the TV’s on, a light’s on, the tree’s on, her lullaby music’s on. She sleeps through it all, and as she’s increasingly interactive, Mr. W has been laying her on a play gym to look at all the colorful noise-making animals. We’ve taken her on occasional short walks in the stroller just around the block or up to the next shopping center, and the doctor said babies love that, the change in the looks and feel of the environment, and they knock out quickly from the new experience. (My mom would kill me if she knew.)
* letting her feed on demand every 2-3 hours in the day: according to the doctor, if we were to stretch out the time in between her feedings in the day, she’d still make sure she gets the correct number of calories she needs so she’ll just be up more often at night to demand it. Making sure she’s able to eat when she’s hungry in the day, even if it were every 2 hours like it was yesterday, keeps her on her 4-hour sleeping track through the night. He said we could coax her to eat semi-regularly but not to stretch it out unnecessarily at this age. Later on toward a year old when we are establishing specific feeding times, she could be kept on a schedule, such as eating at 2pm daily. He looked at our feeding chart on the iPad app and said that it’s great that these patterns (sleeping long at night, eating more often in the day, feedings dropping down to 10-12 mins each) are emerging early, and the way things are going, we’re quickly approaching the eating every 5 hours at night mark. YAY!

I had some concerns, and the doctor alleviated them all.
Q: Her growth has been rapid, should I be concerned how much milk she’s taking in and maybe control that a little?
A: No, babies (especially breastfed babies because bottles dispense much faster than babies’ sensory mechanisms can register fullness) don’t typically overeat their first year of life. They’ll know when to stop, and they’ll pull off or stop drinking. Her growth is great — she gained weight but her height and head circumference also grew proportionately to her weight so she’s fine. [I think she only gained 1/2 inch in height, though, and I don’t remember what her head circumference is; the nurse forgot to bring us the printout with the information.]
Q: She’s REALLY gassy; how much is TOO gassy?
A: [laughs] There’s a really wide range of normal gassiness in newborns. Allie’s stomach feels soft and not hard and distended, so that’s a good sign. She’ll learn to swallow less air with her feedings as she learns to be a more efficient feeder around the 6-week point. Although, because she’s early in reaching her developmental goals, maybe she’ll get there in one month. Plus right now, she’s not used to how her gas feels so she’ll fuss. As babies get older, we think they’re less gassy but it’s often because they’re used to the feel of it and so they don’t fuss and you don’t know about the gas. Remember, all these sensations of digestion are still new to her.
Q: She still has inexplicable crying after feedings especially at night, but we’ve changed her, burped her, swaddled her, given her a pacifier, what else could be wrong?
A: To babies this young, because they’re not used to the feelings of digestion, being full feels like how it feels to us when we’ve overeaten — sort of uncomfortable and “ugh.” But it’s normal because her stomach’s supposed to be filled, she’s just not used to the sensation. As she gets older, she’ll be used to it and stop fussing. Meanwhile, you can distract her from focusing on her stomach if she’s fussing too much. Sing to her, show her toys, something to get her mind off her fullness. [This explains why she fusses more at night; nothing to distract her from overfocusing on her stomach.]
Q: She’s also started spitting up more in the last few days, especially if she has to be on her back after a feeding so we can swaddle or change her; is that all right?
A: Perfectly normal; her stomach’s not strong enough yet to hold in all the food. As she grows and the stomach strengthens, it won’t happen as much. And it’s NOT a sign of overeating. [He read my mind.]

So basically, she’s doing great and she’ll just outgrow a lot of this stuff. He checked her and said she’s doing well, taught us how to bicycle-leg her while she’s on her back and then bring up her knees so she learns to feel and use her bowel muscles instead of her ab muscles when working on pooping. He said babies often get all red-faced and strain with their hands tucked in trying to work out a fart or poopie, and he demonstrated EXACTLY what she looks like sometimes as she does this straining; it was hilarious. It’ll get better once she realizes how to use the right muscles. She laid there good-naturedly waving her arms around and bringing her legs in and out watching us and the doctor talk, and the doctor said this is a healthy awake state; if she’s lethargic during awake times we should bring her in because it means she’s sick. I said she’s in that active mode for an hour or more at a time now in the day between feedings and he said, “Really? Already?” I had him approve of the all-natural Gripe Water to alleviate gas symptoms (basically sugar water with ginger and fennel seed extract) and the multi-vitamin drops, he said the Gripe Water only works sometimes but it’s totally safe and harmless, and to dispense 1oz of the vitamins once a day but not before a feeding because babies don’t tend to like the taste and they may refuse to feed afterwards, and we were on our way.

Two Weeks Down
A friend/coworker Katie reminded me on Wednesday that Allie was 2 weeks old and I happened to have her sleeping on my lap, so I snapped this shot to commemorate.

Things are progressing fast. The feedings have indeed become 10 minutes long (I let her nurse approximately 5 minutes on each breast so one doesn’t get too painfully engorged from being ignored through a feeding) and she is now sleeping 3.5-4.5 hours most stretches before waking in hunger. She’s also up longer in the day; she’ll sit around in her swing and observe things and smile on occasion, or hang out in our arms and watch us carefully. We still have inexplicable crying spells after she’s nursed sometimes and this frustrates her dad, who’ll sigh, “I don’t know…” after he’s tried burping, diaper-changing, and swaddling to her screams. I’ve found that I can usually take her over at times like this and if I could calm her by holding her tightly, she’d doze, but she wants to doze being cuddled, sometimes with a pacifier in place. It’s still the most difficult between 11p-2a, but tonight, Mr. W took her upstairs without me to bed and for the first time in the past 15 nights, I did not hear screaming and crying coming from upstairs that I have to run up for. Note that this is currently her most difficult time slot of 11p-2a. So I get to blog, yay!

Generation Gaps
My mom’s been on me about posting photos of Allie, but not in the way you’d expect. The other day it was, “Stop putting up photos of her naked — she’s a girl!” And then yesterday, she emailed me that she was able to right-click and save photos of Allie on the social networking site, which means that others can do it, too, so I must stop posting photos of her immediately. Ironically, she ended her email the way she ends all her emails these days, by asking for current photos of Allie. I have my social circle and privacy settings on the networking site limited so people who have access to those photos are very controlled. (Good thing she doesn’t know about this blog.) But to avoid further aggravation for my mother, I did what any caring Asian child would do — I removed my mother and anyone who has access to my mother from being able to see all future photos I post. Hey, the demand for Allie’s photos are high and people enjoy seeing my first baby, especially since so few people have seen her in person so far. I’m being a paranoid mom and following the pediatrician’s advice, limiting visits to people who are vaccinated against pertussis and flu (I made my parents get shots) until Allie’s immune system is up and she gets her own vaccinations at 2 months. I don’t care if this makes me anti-social; sick babies land in NICU.

Cousin Jennifer’s Visit and The Great Poopie Incident of 2011
Luckily for us, one such person who’s vaccinated is my cousin Jennifer, who just had her own first baby about 3 months ago. She’s exactly on the same page as I am about infant health. She had offered before Allie was born to give us her leftover newborn-size diapers, as her little girl Alexandra had outgrown that size already. I’d accepted, and now that we’re two weeks into diapering, we’re down to our last few diapers at each of our changing stations. I was considering going to the store, but called her instead yesterday. She happened to be out having lunch with a friend, so she said she’d come over with the diapers. I had last seen her baby Alexandra when she was the same age as Allie is now, but when I saw her yesterday, she had grown! Huge eyes blinked their long cartoon-like lashes at me. They DO grow fast! Jennifer cooed at Allie, “Oh my gosh, she’s so tiny!” What? My nearly 9-pounder? We put the cousins side-by-side and Jennifer thought they’re nearly the same length. I give Mr. W credit for the length; if it were only my genetics, my babies would be nubs.

Aside from rescuing me by bringing a TON of diapers, both newborn and size 1s, my cousin Jennifer also saved me from a potential panic attack. It started with this photo she took for me:

I posted the above photo on the social networking site with the caption: “This was taken moments before The Great Poopie Incident of 2011. Mass panic & scrambling ensued from 4-5p. This photo should be named ‘Joy of Naivete.’ Doing laundry now. =P ” My blog sponsor Mike, father of a 2-year-old and a 4-month-old, must’ve spoken from experience when he commented, “ah, how naive you are to think that THAT was the Great Poopie Incident of 2011. Wait until the Greater Poopie Incident of an hour from now…every hour of every day for the rest of your life.”
Let me explain why I think this IS “the” Great Poopie Incident of 2011.
I was still looking at the photo Jennifer had just taken when Allie let out some long wet-sounding toots. I figured she may be pooping, which she does only slightly more frequently than she used to at 0-2 poopies a day, so I kinda ignored it. Suddenly, Jennifer said, “Oh! Oh! She’s pooping out of her diaper!” Neither Mr. W nor I had ever heard the phrase “pooping out of a diaper” until that day, when Jennifer explained earlier that you know it’s time to go a size up on diapers when the baby “poops out of her current diaper.” And now Allie was demonstrating the term. I watched a wet stain appear in the middle of Allie’s waistline (good thing her umbilical cord came off last week!) and quickly spread until it came out her side and dripped onto my shirt and seeped through that to my jeans. This happened in probably 3 seconds. I grabbed Allie, stood, and went downstairs to Mr. W, calling for him to come help. I’ve never seen the inside of a diaper so saturated with stuff. I was still wiping when suddenly, she went again, oozing yellow mustard-like poop until it overflowed. Of course this was when Mr. W’s daughter came home and she wanted to stand over us and exclaim over how gross it was while gabbing nonstop about her day. Mr. W was trying to keep Allie’s waving hands and feet from dipping into her mess and yelling that I was wiping too slowly, and I was soon running around like a madwoman trying to get another diaper, more wipes, dispose of the dirty diaper and wipes before more stuff oozed out, and finally deciding it was hopeless, I ran around and grabbed her baby tub to give her a second bath this week. I filled it with my hand in the water which must’ve gotten used to the temperature, because when Mr. W dipped his finger in, he exclaimed it was too hot. I cooled it as quickly as I could and as Mr. W placed Allie in the tub, I ran around like a crazy woman again up and down the stairs getting her hooded towels and washcloths, and then she pooped mustard again in the bathtub! My baby was liquifying into poop. Jennifer was upstairs feeding her peaceful little girl, and when I ran back up I would ask her advice on what to do. She said to rinse out the poopy clothes immediately, use a little soap to keep from staining, and then I could wash them with Allie’s regular clothes. I did that while hubby dried and clothed Allie, still in hurried panic mode. She soon left, giving me a sideways hug to avoid the poop stains still on my clothes.
I then did Allie’s laundry and my own, and when I was done, I texted Jennifer, thanking her for the diapers, the visit, and the advice. (She assured me the poop[ies] was normal, wasn’t diarrhea, and was likely a freak incident and not a sign that Allie was growing out of her newborn diapers already.) I realized when things were calmer that if she hadn’t been here when that happened, I may have thought that my baby’s stomach exploded or something. The stuff came out at her waistline, didn’t stop for awhile, and seeped through her diaper, her undershirt, overshirt, my shirt, and my jeans! Given that it’s almost mid-December, I don’t think there’s going to be another 4-pooper incident to beat this as The Great Poopie Incident of 2011.

Baby Steps
I noticed that Allie’s been filling out. Her cheeks are rounder, her jawline is curved with a little baby fat under the chin instead of looking chiseled, her tummy is rounded and her torso teardrop-shaped above the diaper instead of the previous elongated lean shape. This morning during nursing, I held her little fingers and thought, “Her nails are larger. Her hands are larger.”

Progress at the Lactation Clinic
Sure enough, at her second lactation clinic consultation today, the same nurse weighed her and said, “Oh my — she’s gained A POUND in the last week!” The average weight gain for a newborn is approximately 5 oz per week. She caught up and flew ahead. The nurse made sure to say she’s not fat, just doing really well and has noticeably grown healthy and “robust.” There was another baby there who was smaller than Allie, Mr. W noted how “tiny” she was. I found out that other baby is ELEVEN weeks old, but the mom is having major problems with breastfeeding so her baby’s growth is a little undernourished.
When asked how Allie’s been doing since we were last there a week ago, I responded that Allie’s developed a new problem; for the past few days, she has been spending very little time on my breast and would actually push herself away from it after 8 minutes or so. I’d try to get her to relatch, but she’d refuse it and cry. Then she’d root around as if she were hungry, but won’t latch for more than a few seconds before she’d push away and cry again. It drove Mr. W crazy last nite when Allie wouldn’t go to sleep around midnight and screamed bloody murder again until 1am and we’d fed her, supplemented, burped her, changed her diaper, so we had no idea what else was wrong. This morning, she made a giant poopy so we were hoping it was just her discomfort working on that.

“It’s About to Get So Much Easier”
We put Allie on my right breast and just like at home, in under 10 minutes she pushed herself off. The nurse weighed her and made repeated joking exclamations. “Oh my goodness. OH my GOODness. Goodness!” She grabbed the calculator and started tapping in numbers. “She just took in almost TWO and a HALF ounces!”
“Whoa, in like 8 minutes? On just one side?”
“You are really, really lucky; this is about to get so much easier,” the nurse said. So here’s what’s been going on. Since my milk came in a week ago, the supply has increased. My muscles around the mammary glands that pump out the milk are highly efficient, so the baby is getting a good supply in very little time. She pulls off in about 8 minutes because she’s DONE in that time, without even touching the other breast. But she roots around like she’s still hungry because she wants to snuggle with the comfort of suckling, and yet can’t take any more milk, so she suckles a bit and spits it out, saying “I want to suckle without milk!” The solution to that is the pacifier.
“You’re giving me permission to use a pacifier? Would there be nipple confusion issues?”
“There’s no chance of that,” the nurse said. Because of the efficiency of my milk let-down, and the particular shape of my nursing body parts, “there’s no way she would prefer a bottle or a pacifier to your breast,” the lactation nurse explained. “And your breastfeeding is already well-established.” The nurse unwrapped an orange newborn Gumdrop pacifier and popped it in Allie’s mouth, who took to it immediately. The other lactation nurse there exclaimed over how well Allie was holding it in on her own.
So I have no need to supplement anymore (not that I’ve been doing it much), no need to pump anymore (unless it’s uncomfortable and I really want to, but I pretty much only do it once every few days now to not overincrease the supply, and the nurse said I’m doing exactly the right things). “And you’re so lucky, the feedings are soon going to be just 3-4 minutes long!” Wow. She also said that occasionally Allie takes in 3-4 ounces between the two sides, and that after that, she has her long naps.
So the spit-up the last few days is normal, it comes from laying Allie flat on her back (to change, to swaddle, to sleep) too soon after she’s eaten so much. I’ve noticed that a good way to quiet her into sleep is to co-sleep with her so that her head is elevated on my arm. She sleeps long and well like that, and I’m a little propped so I don’t roll. Then after a few hours and she’s up for her next feeding, she sleeps better and can be placed in her co-sleeper next to our bed. She’s really only getting 2 feedings between midnight and 9am, so it’s not THAT bad, it just feels bad cuz Mr. W is so miserable getting his sleep interrupted. She gets about 7 feedings per 24-hour period, so she’s already lower-maintenance than other babies who demand hourly feedings.

Growing Up Fast
Allie’s also been awake and alert for longer and longer periods of time, and smiles frequently. She has a lopsided Elvis smile, and a full-on dimpled smile that turns her eyes into adorable little half-moons. Developmentally she appears to be ahead. The nurses also observed how well her eyes track the toy butterflies hanging on the handle of her carrier. And, her umbilical cord fell off last week, when she was around a week old. We were told not to expect that until the 2-week mark. (The cord loss was announced to me as Mr. W changed her diaper, saying, “Uh-oh…where did her umbilical cord go?” Later he found it and tried to show it to me. I was so grossed out.) That means we could submerge her in water and give her her first home-bath, which we did this past weekend.

I guess she’s making up for lost time, considering I wanted her out a week or two before she actually came out to greet us.

Breastfeeding Tidbits
Interesting FAQs I learned today in the lactation clinic:
* Eating sushi is fine; that doesn’t go into the milk supply.
* Having a glass of wine is fine for breastfeeding also; the alcohol content gets recirculated out of the breastmilk. It’s best to drink at least 2 hours before breastfeeding to allow the body time to filter out the alcohol, but generally, if mom’s not feeling a buzz, baby isn’t going to feel a buzz. But if mom has more than 1 drink, or drinks on an empty stomach, or is feeling buzzed, it’s best to pump and dump.
* Mom can have up to 3 servings of caffeine (such as that in 3 cups of coffee) per day, spread out thru the day, without it affecting the baby, altho caffeine DOES go into the milk supply and stay there. But up to 3 servings/day is pretty harmless to the baby.
* Breastmilk pumped on different days can be stored together in the same container in the fridge/freezer, but can’t be poured together unless they’re the same temperature. So to add newly pumped milk to refrigerated milk, refrigerate new milk, then when that’s cold, pour new milk into old milk container.

“You Worry Because You Love Her”
I asked the lactation nurse to check on Allie’s frenulum, just in case a short/tight frenulum is why latching had been difficult; I asked her to see if the white coating on Allie’s tongue is thrush. I asked her why Allie’s breathing gets gaspy and sounds like sleep apnea as she falls asleep. The nurse’s response to all of those paranoia things were, “Nope, totally normal. She’s perfect.” And apparently, babies have really tiny airways and they make noise and snort and stuff, especially if the heater is on at night. As for sleep apnea, she assured me I have no risk factors; Mr. W and I aren’t obese, the baby isn’t obese, no one smokes around Allie, Allie’s super-healthy.

The nurse left me with this:
“You’ve only known each other for 13 days. You’re still getting to know each other. Soon you’ll learn what each of her cries mean and you’ll know immediately if she’s angry or needs to be changed or burped or fed. Right now they all sound the same, and that’s okay. You’re doing REALLY well and you’re one of those lucky women who could probably have twins and feed them well. Look at all the progress you’ve made. You’re a great mother for putting in all this effort now, and it’ll pay off. By 90 days, it’ll all be SO MUCH EASIER, and easier than formula-feeding. Studies have shown that babies breastfed for a year have up to 8 points higher on their IQ, so if you already have a smart kid, this could put them in the genius category.”

Ying Yang
The nurse walked me out with the baby to give her assessment to Mr. W. He was so relieved nothing’s wrong with Allie, that her super-short fussy feedings are because she’s FULL, not because she’s STARVING, that he started laughing, and then we went to Mimi’s Cafe to celebrate. Allie slept the whole time in her carrier, although the booth we were first seated, the framed oil painting of all things fell off the wall onto Mr. W, who reflexively brought his arm up and held it back against the wall to keep it from knocking into Allie on the head. The Mimi’s staff was horrified, reseated us with abundant apologies, the manager came out to apologize and check on us, and the waitress insisted, based on her manager’s orders, on giving us free dessert.

My friend Laurel: So how does it feel to be a mommy?
Me: Surreal, like when I was in Italy and things there resembled normal stuff at home, but no one and nothing was actually familiar, even the stuff I recognized from other people’s stories and photos, and I felt out of place, jet-lagged, lost, insecure and unable to communicate with anyone. And I’m not sure the strange people really cared for me to be there.
…I hear it gets better. Haha!
Laurel: That’s exactly what it was like for me at the beginning! For a new sleep-deprived mom you are remarkably adapt at being eloquent! Good job! And it is totally strange, and it does get better but it never is the old version of “normal” ever again

I bet.

I posted this photo on the social networking site when I announced Allie’s 1-week birthday, saying “Cindy’s Allie Cat is 1 week old today! Time flies when you’re sleepless in babyland.”

People on the site have been incredibly responsive and when I posted that I’d given birth, within 20 minutes there were 40+ responses and comments. For this one, I got a lot of comments about the bear, too, which is a gift from the Sheriff’s Department at work. I also got a rap from a DA at the courthouse:
“To see something as adorable would indeed be rare, as Allie dozin’ off without a care, all hugged up inside of a bear….”
My little Allie, inspiring music. haha

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.