Here we are on our last weekday together:
The other part of returning to work was getting the clear from my doctor and getting the authorization forms to our HR company. Thankfully, I was mailed the forms and was able to drop them off at my doctor’s office and they offered to fax them in for me. Check that off the list, whew, and another reason to love my OB’s office.
Another part of the back to work transition was getting Rowan enrolled at daycare (sob). I need to bring his clothes and cloth diapers (more on that in a different post) ready to wear to stock his cubby. Daycare uses Halo sleep sacks and thankfully I have a few at home so he can use one from home while at school. The final thing is the what causes me a little stress. Packing up the breastmilk…. The policy in the State of Wisconsin is that heated breastmilk has to be tossed even if it was unused. I hate this policy because it feels so wasteful to me. In our home, we utilize the “eat as you go” strategy and will start low and warm more milk if more is needed when bottle feeding. The policy at daycare required the bottles must be prepared at home and ready to go. Rowan is a 3 ounce – 5.5 ounce bottle eater and it spurs my questions of how big do I made these bottles? I could do 4 ounce to be on the safe side, but if he needs more it could result in almost 4 ounces of waste if a new bottle needs to be warmed. On the other hand, I can make 5 ounce bottles and likely only have 1-2 ounces of waste (if any at all). In my perfect world, I would love to send a larger container of milk and it can be warmed as needed…. However, I understand that regulations are needed, but as other breastfeeding mothers can confirm, we cry over spilled milk. I think that I will likely go for 5 ounce bottles and hope for the best. I am going to ask the teacher to let me know how much was consumed to I can make adjustments as needed. You may wonder why I am obsessing over this considering I did it with Kellen. When Kellen was in the baby room they still allowed containers of milk and they would pour them into bottles…. times have changed.
The other side of the work breastfeeding dance is pumping. I will be pumping at work and have my pump ready to go- flanges, bottles, nipple cream, mini Madela cooler, and mini ice pack for storage. I use a Madela Pump In-Style and actually have two of them, one from Kellen and one from Rowan. I am going to bring the newer one to work because it will be a bit more efficient and my older pump will remain at home. I figure that this is a good plan because I will not forget my pump….I just need to remember the bottles….. Actually, I am thinking of using the bags at work and keeping a supply there so it further eliminates the chance of morning forgetfulness (I just noticed that I mentioned nothing about pumping supplies in my rough morning outline above). I have my own private office at work and plan to pump twice while I am there. I am very fortunate to work in an office that values breastfeeding. They have special curtains for us to use on our windows and I have never experience any push back when I needed to take a break to pump. I feel very lucky because I know that this is very different from what many of my friends have experiences while trying to pump on the job. My only source of concern if a conference I have coming up in a few weeks and I hope the schedule is flexible for me to fit in my pumps. Last time, I called the hotel and they have me a hotel room to pump and it was so fantastic. I am hoping for the same thing this time, but this hotel is a little more modern and they may have space set aside.
So, this is my plan…so far. I know many of you do this every morning and some with multiple children….. You all should know that you make it look so easy and I know I will get my act together and this will become my routine….. I hope.
Next week my cloth diaper post is coming!
I have had a lot of interest from you guys about placenta encapsulation and my experience with it. It makes me so happy that you are interested because I found it so helpful and I want to tell you about my experience after using encapsulation after both of my children.
At the time, I had nothing to compare how I would be feeling to because this was my first child. However, there are things I can attest to while I was taking the pills. I had great energy for getting up multiple times per night and for needing to make multiple trips to the NICU each day while recovering from a vaginal delivery. I had some high/low mood swings and this is normal after giving birth while hormones are fluctuating (and having an inpatient baby), but I did not have extreme high/low or prolonged roller coaster type feelings. I gave birth to a 10 1/2 pound baby and I felt that I was able to heal quickly and did not have excessive bleeding. My milk also came in quickly and the amount multiplied relatively quickly for having a baby that was not with me 24 hours a day for the first 5 days. The most important thing to me was that I felt present, positive about myself, and connected to my role as a mom. From friends of mine that have had postpartum depression many of them described a disconnect to the world around them and/or to their child. I did not experience this, and I felt very in the moment and overall well. I think that my ability to process what happened to Kellen and I in those early days was because I had a pretty clear head and, how I always describe it, I was in a good place when it came to postpartum mental health.
Having the experience I had with Kellen it was a no brainer for me that I would do this with our next child. I hoped that I would have the same positive experience as I did with Kellen. When I was pregnant with Rowan I planned to have my placenta encapsulated into pills just as I had with Kellen. My friend Emily was my doula again and would process the placenta as she had the first time. However, the difference this time was that she was going to process in my home and not hers. I liked the idea of it being in my home because the placenta would be exposed to things I was living in each day and I know that my home is clean (not that Emily’s isn’t!), but sometimes you may not know the person processing your placenta as well as I knew mine or you may not have visited their house. I again spoke with my doctor about my plans and she had issues with my plan and I was excited to move forward.
My doula processed my placenta while I was at home and I could peek over and see what she was doing. I actually wish I would have watched the entire thing, but Rowan was in the NICU at the time and I was just trying to focus on resting before returning to the hospital. Like last time, I started taking the pills as soon as they were ready to ingest.
So what the second time as good as the first? It was better my friends. Seriously. I felt/feel really good and I think that speaks a lot to the effectiveness of the pills considering I had a child in the NICU for almost 2 weeks. My energy was really good and when Rowan came home I was still feeling good even with a newborn’s sleeping and feeding schedule. You will also remember from this post that we were struggling with breast feeding when he came home and I was very worried about supply. The pills, along with some supplements made by a friend, were so helpful….in fact I am now over producing, but that will likely change when I am back at work in two weeks. I, again, describe my mental health as present and good after Rowan’s birth. I also felt that I healed even faster with Rowan and that is a good thing considering what a large baby he was. This time I also opted to get a tincture from the powdered placenta in addition to the pills. I can use the placenta tincture after the capsules are gone as needed. By tincturing some of the powdered placenta in high grade alcohol I will continue to utilize benefits of the placenta. Tinctures can be used in times of change, emotional times, hormonal fluctuations, or later in life during menopause. I am still amazed at the amazing things this organ can do.
My placenta was processed by Emily with Green Bay Doulas. They have a great info and FAQ section of their website. Click here to read more about their encapsulation services. I also wanted to include another helpful link that addressed questions to ask your placenta encapsulation specialist. Click here for more details and FAQ answered by Green Bay Doulas.
A few tips from my experience being a consumer of encapsulation as requested by you guys:
1) Make sure that you know the process at the hospital with your specialist and that your partner is also aware. It is helpful to include this in your birth plan so it can be included in your chart and you will need to call the person processing if they are not a labor doula for you.
2) Ask about where your placenta is processed. I received this question from a few people about an unseen processing site. If you select someone that does it in their home ask questions on their process. It should not just be thrown in their fridge unlabeled next to a few juice boxes or processed next to dirty dishes. That is gross. I think there is nothing wrong with asking to see the storage site and processing site. I would never hire someone who told me no to that request. You could also ask if preparing in your home is a possibility. Like I said previously, I have had one in home and one out, but not everyone has the same relationship with their doula as I did.
3) The second comment I received from many of you was apprehension that you knew it was your placenta. Make sure that your placenta specialist has an establish “chain of command”. Many of these individuals have great relationships with the hospitals and are very aware of protocol and procedure.
4) Be a careful consumer and use referrals. Odds are that if someone is good at what they do lots of people will be happy to tell you about it! If someone does have negatives I think it is important to look at if it is of a personal nature or if it actually has to do with their processing procedure or customer service.
5) Finally, someone asked me if the pills taste gross. The pills will have a funky taste/smell- they are a dried organ after all! This is normal, but I don’t think I will chew one up anytime soon. Take it with food and lots of water. It is worth it!
I know there have been a few studies that have attempted to dispel claims of encapsulation’s success, but I really can’t put much stock into those because I have had two very positive experiences. For me, it made me a better mother from the starting gate and, like I have said before, I put weight on setting yourself up for success. I attribute my ability to be recover and enjoy my babies are much as I do to electing this option. I am a big believer in this and I am sure that it doesn’t work for everyone (nothing works for everyone), but it worked wonders for me and that is what makes me so insistent on telling other mom’s about this option. Again, I highly recommend reading the links I posted about the FAQ’s, and if you have more questions about my experience please feel free to e-mail me at email@example.com or leave me a comment and I will reply.
Since Kellen was born Emily and I continue to be amazing friends and knew she would be my doula for round two. There is something to be said about being a repeat client. My doula knows me and how I labor and knows certain things that are important to me, things I like, and things I dislike. My doula knows that I am a person who seclude and presence alone can feel supportive to me. Another positive of having a doula was that she knew I had two miscarriages in 3 months prior to becoming pregnant with Rowan and knew how to support me and my husband during my second pregnancy because I was more anxious and needed to talk things out more often.
I discussed my birth story in this post and don’t need to re-write everything in regard to that, but somethings have changed since Kellen’s birth. Emily now owns Green Bay Doulas and I was able to have two doulas this time around, Emily and Nakita. I really liked the structure of the agency because I was able to meet with both women and knew there would be no scrambling (not that there was the first time) and one of them would always be with me. Emily also has a great relationship with Dr. Swift and it was awesome to have a web of support when preparing to birth my baby. If you ready my account of Rowan’s birth you know that it did not go to my initial plan. However, I was so supported while making my decision by my team it was easier for me than the first time. Emily and Nakita also supported me while Rowan recovered in the NICU. I also had my placenta encapsulated for the second time and it was another positive experience for me. I again was lucky enough to recover from birthing my baby while being mentally healthy. I think a lot of this was due to support and ability to process the experience and birth.
I know many people hire a doula with the expectation it will be during labor. After 4 pregnancies and 2 births I have found the value of hiring a doula to be in the before and after for me (not that the labor is nor helpful too!). I know that is not the case for everyone but, for me, having to support in place and stable gave me the ability to make decisions during my labors and to feel good about them after. Emily is also my postpartum doula and helps me a few hours a week around our house to take some of the load off and allow me to focus on myself and our family. A postpartum doula was not something I opted to use the first time, but I am so happy that I did it this time and will do it again if we decide to have a third child. There are also sibling and bereavement doulas as well. We have not utilized those services at this point, but if we have a third child I will likely look more into a sibling doula to help with the boys.
I am a big believer in setting yourself up for success. Having a good team in your corner (in my case that was my husband Ron, my doula Emily, and my OB Dr. Swift- plus the amazing nurses at our hospital) makes the biggest difference in a labor and a recovery.
So, what do I think are important things to look for when hiring or considering to hire a doula? First, I think looking at certification is important. Not all doulas are certified and they are not required to be, but I think there is something to be said about a professional that values continuing education. In my line of work things are always changing and new ideas and strategies can be utilized- why wouldn’t I want that from the person who is on my team to birth my baby? Second, interview your doula before you commit. Be prepared with questions (no question is a bad or silly question- it is your birth) and don’t feel bad if you are not the right fit. Somethings you might want to ask about are birth plans, placenta encapsulation, postpartum care, laboring at home and hospital, renting a birth pool, when to call, how their business is set up, certification, costs, maximum hours before breaks are needed or a back-up is called, breastfeeding support, ect. Third, be skeptical of a person that is negative on the OB. Working as a team with your medical professionals will be a blessing- trust me. If you are birthing outside a hospital it is still good to have a working relationship because you never know what will happen. Finally, pick someone that you really like. The relationship between a doula(s) and a mother is very personal and they will know things about you that you would never tell anyone. They will see you in your most vulnerable state and potentially one of the best days of your life. A good doula will celebrate your victories with you and give you tools to review your options to make your best choice. You will grown to care very deeply about them because you respect and cherish what they have done for you.
One of my favorite sayings is a good close: “my doula was worth the moula!”.
Preview for next week: a case for encapsulating your placenta.
Fast forward 3 years and Rowan is here. Rowan had a great latch from the start, but was admitted to the NICU the night after he was born. His breathing was quick and he had a central line and a gavage feeding tube. A gavage is a tube feed that goes directly into the babies stomach. He needed this because nipple feeds were a little too much for him with his breathing. The first 6 Rowan was in the NICU we could not hold him and certainly could not put him to breast as he was using the gavage. I was not very worried about feeding him once we got home because his latch was great at the hospital and some of the latch problems I had experienced with Kellen weren’t there, or I was just able to deal with them better. I started my pumping routine of every three hours to build my supply for when he came home. In the back of my mind I knew that he may have a larger appetite than my supply because of the tube and eventual bottle feeding. Eventually, we were able to hold Rowan and able to feed him expressed milk and formula from a bottle. The NICU has lactation consultants and I worked with them prior to discharge and was given a few nipple shields to help with the transition from bottle to breast. I had previously tried them with Kellen and knew they could help with his latch after he was use to feeding from a rubber nipple. My view on the nipple shield was to use it for transitional purposes and hopefully move away from it after a few weeks. I felt really good about going home and started feeding him once we were home. However, I hit a bit of the roadblock. My great latcher would latch and then sit there. He would not eat. He would just look at me with his sweet eyes and hang out till he got a bottle of expressed milk. We had to give a few formula bottles because, as it also happened with Kellen, he was eating 4 ounces every three hours when he left the NICU and I was not at the same pace as him. I found this a bit stressful, but kept pumping and putting him to breast. Gradually, his volume went down and my supply went up and we were able to keep up with each other. However, I was pumping a lot at that point and still having issues with him latching and not eating. I was getting really frustrated because I didn’t know what to do. I actually almost threw in the towel and went back to pumping. However, I spoke with my Doula and also Rowan’s doctor after a few weeks and they both mentioned SNS. SNS means Supplemental Nursing System is basically a feeding tube outside the body worn by the mother to help babies latch and, in Rowan’s case, identify the mother as the food source. I met with the lactation consultant and learned to use the SNS. It is pretty tricky and I felt like I needed an extra set of hands to work it. When I finally got it working I looked down and my little baby had pulled the tubing off and was essentially drinking from the tube. Sneaky. I kept up with the SNS for a few days and hated it. I hated how hard it was to use and was getting very frustrated. I, again, contemplated just pumping but really wanted this to work and kept with it. After a few days Rowan stopped ripping off the tubing and started nursing. Actually nursing. I was so excited. I also was able to stop using the nipple shield and that was a big relief. Slowly, all these parts and assists we needed were going away. Rowan still preferred the bottle, but would actually nurse. I am still having to pump after most feeding because he does not always want to nurse long or will prefer a bottle in some cases. This was really challenging for both of us. Rowan needed to identify me as a food source and I needed to give him the time to learn without frustration of thinking how things “should” be. Currently, Rowan is 6 weeks and will nurse or take a bottle. He is a great little eater and I feel so lucky we can keep working on our nursing relationship and it is not a fight anymore.
What did I learn from both of these post NICU experiences?
1) The NICU is hard and if you can breastfeed your baby after you discharge you are awesome because it is a bbbiiiiggggg learning curve. It was not till Rowan that I realized how much it is essentially starting over for mom and baby once you get home.
2) Prepare that you will have to work to establish whatever breastfeeding relationship you choose while in the NICU. It will be hard because you are not in an ideal situation. Accept that you can’t control that and work on what you have the ability to influence or control.
3) Celebrate small victories often. My first was when Rowan latched for over 6 seconds. Relative to now that is very small, but at the time that was a big step for us.
4) Let people in who care about your goals when it comes to breastfeeding. Not everyone will care and that is ok- don’t hold it against them. However, the ones that do care, will support you and remind you of why something is important to you- especially if you begin to feel frustrated. They will also praise the efforts of you and your child. Most importantly, they will let you complain to them and you will need this. I think I complained to my friends Emily and Kayla for 4 days straight when I was working with the SNS.
5) Do not beat yourself up if something does not go how you want. Try again next time, or know that you made the best decision you could at the time. That’s being a parent- not every hand dealt is a great one and stand behind your choices. This is what I worked for when I was pumping for Kellen and now I am very proud of that choice.
That sums up my breastfeeding journey immediately after the NICU with both boys. My experience with Kellen taught me so much and gave me a lot of insight on what I liked and what I wanted to do with our next baby. Rowan and I are still very fresh out of the gate and still working together. I will keep you updated with another breastfeeding post as time goes on, but I am feeling really good so far.
Here is a quick preview of the next week: Hiring a Doula/ Placenta Encapsulation.