Saturday, February 23, 2013

weaning


I threw away the last of the frozen breast milk yesterday. There were just a few bags tucked in the back of the freezer, underneath a box of waffles. “We don’t need this anymore, do we?” Andrew asked. “No, you can toss it,” I said after a brief pause. But during that pause, my heart sank a bit and memories of weaning Harriet a month ago came back. I’ve been meaning to write about it for a while but have had trouble finding the words. I always try to be transparent when I write, and I want to be honest about weaning, but I’m sort of embarrassed about this topic because I worry people will think my reactions to it are over the top. I worry people will think there’s something wrong with me because ending the nursing chapter in my daughter’s life had such a profound effect on me. But because I don’t have much experience successfully masking my real thoughts and feelings, I’m just going to tell it like it is.

I still get choked up when I think about nursing Harriet. Right now, my eyes are filled with tears. Okay…one just fell. We finished the weaning process a long time ago but I’m still grieving it. I think it’s because nursing was such a big part of the past year and played such an important role in our bonding. I think I might have spent more time nursing over this past year than doing anything else. There were days early on when Harriet and I would literally spend all day on the couch or in the recliner in the nursery. There were times when she would stay latched on for two and a half hours straight. I treasure those moments. I treasure the fact that I could provide her with something that no one else could. I treasure the memories of those times when she got a shot or bumped her head or just felt really crummy and nothing would soothe her…until I nursed her.

Nursing also had its side perks. I gained thirty pounds during my pregnancy and lost forty-two pounds during the following year. For a while, I weighed less than I did when we got married. It was crazy! I also pumped way more than Harriet ever could have used, so I was able to give three big coolers of milk to a family who needed it. Unfortunately, I also threw away twelve gallon-sized Ziploc bags full of milk because I thought it “expired” after six months when in reality, it can last up to a year in a really cold freezer.

Nursing wasn’t always easy though. In fact, there were times when I completely resented it. We worked hard to get Harriet to latch and just when it seemed like she had the hang of it, I started overproducing. My milk let down really fast and literally choked her so that she developed a fear of nursing. I had to pump before every nursing session in order to get her to trust me again. She also had a lot of reflux in the early days. There were plenty of times when I’d finish nursing her and she’d immediately projectile vomit all of it right back up. But we stuck with it - talked to lactation consultants, read books, consulted our doula and our pediatrician, researched online. Eventually, we got into a great rhythm.  It became so easy and natural, something we could do without even thinking about it. We never had scheduled nursings. I just fed on demand. There were times when she’d nurse 15-20 times per day, and it worked really well for both of us.

We weaned really slowly, over the course of about three months. For the last week, I nursed her just once per day, right before bed, for about five minutes. After one especially wakeful night, I called my mother-in-law and asked if she could come over so that Andrew could sleep a little longer. She mentioned that maybe Harriet was confused by the fact that she was still nursing but on such a limited basis. I decided then and there that I was done, that I wasn’t going to nurse her again. It was kind of nice knowing that the dreaded last time was already in the past. I think I would have been a complete mess if I had to go into a nursing knowing it was the last time, so I’m glad we did it that way.

I figured weaning gradually would cut down on the discomfort. Nope. It was unreal how engorged I was. I didn’t get stretch marks during the whole year I nursed, but I got them from weaning. I went up two cup sizes. I was so uncomfortable that I could barely hold Harriet. And I couldn’t sleep because I couldn’t find a position that worked. It was ugly.

On the ninth day of misery, I stopped by a clinic to see a lactation consultant. I pulled up my shirt and she gasped. She just kept saying “oh honey” over and over again while shaking her head. She told me I was right on the edge of mastitis. So for the next four days, I took two types of antihistamines around the clock and spent every minute I wasn’t at work like this:



Those are ice packs, but I also filled my bra with cabbage. That was kind of gross. Eventually, the swelling went down. Way, way, way down (emphasis on down). I have to admit I was hoping to retain some of it, but nope. Oh, and the weight came back. In about two weeks, I gained nine pounds. And I’m thinking it was probably more like twelve pounds if you account for what I lost up top. Bummer.

I had a hard time talking about weaning while we were still in the thick of it, but any time I did, women would always say the same thing – “it was way harder on me than it was on my baby.” I hated when they said that because I didn’t believe them. I knew how much Harriet loved nursing, how much she needed it. I think I was right about that. I don’t think I overestimated how important nursing was to her. But I do think I underestimated how adaptable she was. She did great. There were definitely times when she wanted to nurse and I had to turn her away, times when she accidentally saw me getting out of the shower and would reach her arms towards me with a desperate look on her face, but for the most part, this baby-girl-growing-into-a-little-lady of mine seemed to sort of…get it. And she was okay with the change.

I, on the other hand, am apparently not so adaptable. I grieved hard during the weaning process. I actually think I went through all five stages.

Denial: For a long time, I just kept telling myself that she’d wean early on her own. Yeah…right.

Bargaining: I know that it’s possible for some women to get pregnant while nursing. I’m not one of those women, but I thought I might have a chance if we brought some fertility drugs into the mix. I did some research on the effects of clomid on a nursing child. Turns out, it’s very safe. So I called every fertility clinic in the area to see if anyone would see me. Not a single doctor would treat a nursing mom. Not one. I have a suspicion that it has something to do with not wanting to compromise their success rates, since a nursing mom’s chances of getting pregnant are lower. Some clinics said they’d call me back but never did.

Anger: It still makes me so mad that we had to wean at all. I know this freaks people out, but I would totally be that lady that nurses her three-year-old. Put me on the cover of Time Magazine. I don’t care. Here’s the thing I always tell people – if it was possible for women to feed their children from their elbow or the palm of their hand, there would be three-year-olds playing at the park and running back to their moms to get a quick drink. No one would think twice about it. Nursing toddlers creep us out because we think of breasts as primarily sexual. But they’re not! They’re multifunctional! And toddlers know nothing of their other functions. But all of this is besides the point. Back to what I was saying…I wanted to let Harriet nurse for as long as she wanted to. It makes me angry that my infertility stole my chance to do baby-led weaning. Infertility stealing from me is not a new thing, but this is the first time it stole from my daughter, and that left me furious.

Depression: My dad watched Harriet on New Years Eve so Andrew and I could celebrate with some friends. “Stay out as late as you want,” he said. But I assured him we’d be home by eight o’clock and then completely broke down in the kitchen. “I just have to come home before she goes to bed,” I said between sobs. “I need to nurse her.” I knew that this stage was coming to an end and I couldn’t bear the thought of sacrificing one of those precious times for a night out. I think the cause of the depression was two-fold – the grief over the loss of Harriet’s babyhood and the hormonal upheaval that went along with weaning. For about a month, I lost a lot of my motivation and interest in doing things. I felt down all the time. I cried super easily. I read that women can go through post-nursing depression, similar to postpartum depression. I think that’s what I was experiencing.

Acceptance: I think I’m there now. Not that I have a choice. There are definitely benefits to having a weaned child. I don’t experience those benefits when I struggle to put on a pair of jeans that fit me so well a month ago. I don’t experience those benefits when Harriet falls off the couch and isn’t easily comforted. But I do experience them sometimes. And I’m glad that we are now free to pursue a sibling for her. 

From the moment our children are born, we start letting go. First we release them from our bodies, then from our breasts. Eventually they’ll leave our homes for sleep-away camp. And then someday we'll have to let them go completely and trust them to other hearts, other hands.

I don’t want to be the type of mom who views every day that passes as something lost. In this way, I wish I was more like a man. My husband is always looking forward to the next stage, the next milestone. I want to live that way – looking forward, not back. I want to view past days as memories gained rather than moments lost. But this isn’t always easy. From what I’ve experienced so far, much of being a mom is bittersweet. The sweet is so much more powerful than the bitter, but there’s always that ache there, deep in your heart, in that little place where you keep the memory of first giggles and impossibly tiny toes.

I loved being pregnant, absolutely relished in it. I felt beautiful (even though I was growing out my hair and in reality looked like Justin Bieber). I felt strong and energized. I also loved those early days when Harriet still smelled of birth and rarely opened her eyes. I loved spending all day on the couch with her, nursing her and wrapping her tight against my body so she’d feel safe and secure. I think that one of the reasons weaning was so hard on me is that I have this deep fear that I will never get the chance to enjoy that again. I feel kind of panicky about the fact that we may have cut her nursing short so that we could pursue fertility treatments that won’t ever work. I am scared that I too easily gave it up and that I won’t ever get it back by birthing and nursing another baby. 

So I guess my natural tendency is to live in the past or the future. It takes conscious effort to stay present in this moment. But I'm really going to try. And it shouldn't be too hard, considering the present moment looks like this:



Wednesday, February 20, 2013

sweet dreams


I am so grateful for all of the texts, emails and phone calls I've received over the past few weeks, asking how our appointment with the sleep doctor went. It was so wonderful to be reminded that we have a lot of people praying for us and cheering us on. This sleep thing is a little problem, but it's good to know that if we ever have a big one, you guys and gals have our backs. Sorry it has taken me so long to write this update. Part of it was just the busyness of life, but I was also sort of nervous about reporting any good news about her sleep for fear I would jinx it. I don’t really believe in that sort of thing, but I still didn’t want to take any chances.

In case you're new, you can read about Harriet's sleep in this post. If you don't have time for that, the quick version is that our girl doesn't sleep. Well, didn't sleep, but I'm getting to that. Her sleep patterns were so bad that we ended up taking her to a sleep doctor at a children's hospital on February 1st. The whole experience was wonderful from check-in to discharge. Everything went seamlessly. Wait times were short. Everyone was kind. They moved us through their system quickly without ever making us feel like a number. We were already fans of the place, but when Dr. G entered the room, we were smitten. He has the ideal temperament for pediatric sleep doctor. He is gentle, kind, affirming, patient, understanding, and most importantly, knowledgeable. He listened to our whole story and got to know us before diagnosing her...well, diagnosing us...

with being wrapped around her little finger. 

He didn't really say that. But he did say that her frequent wakings and difficulty falling asleep is learned behavior. He also mentioned that kids with this issue are always very cute and very persistent. 

Check and check.

Once we had the diagnosis, we were ready for the treatment plan...He wanted us to let Harriet cry it out. 

I have been against the cry it out method from the beginning. Like, adamantly against it. I read stuff by Dr. Sears, Elizabeth Pantley and the La Leche League ladies, all of whom only cemented my anti-CIO status even further. I have really focused on parenting Harriet in a way that fosters attachment - nursing on demand, wearing her in a sling, responding to her cries in a timely manner, budgeting in way that allows me to be home with her most of the time. We even tried cosleeping for a while, but that didn’t seem to be the best arrangement for our family. We have been passionate about showing Harriet that she can trust us to meet her needs until she is able to meet them for herself. We have never viewed her as manipulative or demanding. I was so against letting her cry it out that I even got into mini debates with people over this (including Andrew's grandma who took care of 80+ foster babies...oops). 

But then I started noticing that our friends who let their babies cry it out seemed really attached. The parents seemed tuned into their babies' needs, and the babies appeared to get that. I was shocked. I guess that all of my research convinced me that if you sleep train your child, they won't attach to you very well. I was wrong.

A blogging friend of mine named Josey shared this website with me: 


As much as I hate the name of the website, I LOVE the content. It has changed my mind (and my life too). Alexis, who runs the site, insists that letting your child cry it out isn't the antithesis of attachment parenting. She even said something like - if you're exhausted all the time, what is there for your kid to attach to anyways? Another really good point she made was this - crying it out can take just a few nights. You have all of the days and nights before and after those CIO nights to work on attachment. These two points converted me. 

I found the Troublesome Tots website before meeting Dr. G, so I was pretty prepared to let her cry it out if that’s what he suggested. He also gave us some other recommendations to make the CIO process more successful. He suggested we mildly sleep deprive Harriet leading up to the first cry it out night. He recommended a solid, predicable bedtime routine (which we had been doing already). The Troublesome Tots website also offered helpful tips like telling your child, “You’re going to sleep in your crib tonight, and we’re not going to come back into your room til morning. We’ll be right downstairs. We love you very much.” She says that even very young children can pick up on enough of that message for it to really help with any confusion the child has about the new arrangement.

So the first night, we followed the plan exactly as Dr. G and Alexis suggested. Harriet cried (screamed) for twelve minutes. And then she went to sleep. Honestly! She did! After only twelve minutes. Andrew and I could hardly contain our excitement! We joked about wishing we had bottles of champagne to spray around the living room like baseball players do after winning the World Series! We laughed as we pictured Andrew dumping a cooler of gatorade over my head like players do to the coaches when they win the Super Bowl. That’s how victorious we felt!

The second night, she cried off and on for twenty minutes. The third night, it was about ten. The few nights after that, she cried for about five seconds before settling herself and falling asleep. Since then, she hasn’t cried at all. We just snuggle her as we walk around the room, praying for her and singing to her. Then we lay her down…and she stays put…for ten hours straight…every single night.

I cannot even tell you how much this has changed our lives. We feel better physically, emotionally and mentally. You probably won't be shocked to hear that rested people are better at marriage than crazy, sleep-deprived people. And we’re definitely better parents too.

Things aren’t perfect. That’s for sure. Ten hours isn’t a long enough night for a baby of her age, especially since her naps are still pretty bad. She only sleeps about 30-40 minutes at a time and it often takes 30-60 minutes to get her down. I talked to Dr. G’s nurse about this, and she recommended the CIO method for naps as well. We tried this several times. Harriet poops. She pukes. She screams her head off for over an hour…and then we give up. Andrew says that she just isn’t tired enough during the day, and I think he’s right. I’m hoping Alexis from Troublesome Tots will write a post about naps sometime soon because we’re stumped. But with Harriet sleeping through the night, the nap issue is more than manageable.

It’s interesting…the lessons I'm learning as a mom, the things I thought would be one way, but are just the opposite. It’s humbling and kind of transforming. It has helped me broaden my view of myself as a parent so that I can be both an attachment mama and a mom who sleep trains. I feel pretty good about that.

So next time around, what will we do differently? It might surprise you to know that we aren’t planning to let our next child cry it out from the beginning. Dr. G recommended waiting til the baby is at least six months old before doing CIO. I think we’d wait even longer than that. I want the baby to at least understand some of what’s going on rather than experiencing only confusion and betrayal. Dr. G describes CIO as an ultimate last resort, and we’ll use it that way…when nothing else works.

Also, just as a sidenote, we did some research on CIO methods. There are two main methods – Ferber and Weissbluth. The big difference is that the Ferber method recommends going back into the room at increasing increments of time to soothe the child without picking her up. The Weissbluth method is a cold turkey approach. You leave and don’t come back unless you really, really, really have to. The Weissbluth method seems a bit harsher, but Dr. G and Alexis from Troublesome Tots both prefer it over the Ferber method because returning to the nursery can send mixed messages to the baby and get them all riled up again. We had tried the Ferber method several times before our appointment with Dr. G, and it never worked. But the Weissbluth method worked the first time…in only twelve minutes. So anyways, that was the best way for our family, but lots of families swear by Ferber, and I can see the upsides to that method as well.

So again, thanks so much for your thoughts and prayers. I feel like a new woman.

----

Mini update #1 in response to this post: I mustered up my courage and tried to talk to someone in the waiting room at the fertility clinic yesterday. I picked someone who looked really nice and friendly. I smiled at her. She smiled back at me. I sat close enough to her to have a conversation but kept some distance between us to avoid freaking her out.

I took a deep breath and just dove in headfirst. 

"Are you here for blood work or an ultrasound?" I asked.

She didn't speak English.

At least I tried, right?

----

Mini update #2: I'm not really responding to clomid yet, even though I've been on it for 10 days (100 mg/day). The ultrasound tech said that there weren't even any follicles worth measuring. I also have over seventy (eek!) cysts on my ovaries, meaning that my polycystic ovarian syndrome is alive and well. This is a bit frustrating because I have been cutting down on sugar, dairy and processed foods considerably. Plus, I weigh less than I did when we were trying to conceive the first time around. I’ve also been using organic produce and meat as much as I can. All of this should be helping, but it doesn't seem to be. I go in for another ultrasound and more blood work in a few days. So for now, it's just a waiting game.

Monday, February 11, 2013

waiting room

I sat in the waiting room at the fertility clinic for 50 minutes on Saturday. Fifty whole minutes. I was getting annoyed. Maybe I'm crazy, but there's a weird vibe in fertility clinic waiting rooms. When you sit in a regular doctor's waiting room, the people around you are there for all kinds of boring reasons - sore throat, ear infection, ingrown toenail...but at the fertility clinic, we're all there for the same exact reason. We want a baby. Really, really bad.

I try so hard not to stare at the people sitting near me, but I can't help it.

There is a woman in scrubs. She is my age and has a kind face. There's no way she's infertile, I think. She looks way too normal.

There's a really tall guy sitting behind me. His wife shows up and they talk quietly together. I want to give them some privacy, but I also kind of (okay, more than kind of) want to hear what they're saying. Are they doing IVF? Is it her issue or is it male factor infertility? Maybe both? How is their relationship holding up under this stress?

Another woman walks through the door, checks in and sits nearby. She leaves her coat on. She looks tired. I wonder how long she's been at this, how many cycles she's done, what meds she's tried, whether she's miscarried.

This happens to me every time I go to the clinic. Give me more than thirty seconds in that waiting room and I get this urge to start talking to the people around me. I want to ask the woman in scrubs how her treatments are going. I want to ask her if she has PCOS, endometriosis or low ovarian reserve. I want to ask about her husband's sperm count and whether they have any friends who have been down this road. I want to ask if they've considered IVF, whether they've gotten second opinions. I want to ask about their insurance coverage and how she's doing with all of this. Like really, how are you doing?

And I want her to ask me.

I want it to be a conversation. I want us to sit next to each other and laugh about the crazy places our men have given us shots and all of those birth control pills we religiously took way back when. I want the tired girl with the coat to hear us and move to where we're sitting, join in with a story about a pregnancy test she was sure was going to be positive...and wasn't. I want to put my hand on hers and tell her I'll say a prayer for her every time she comes to mind. I want to stand up when the nurse calls my name, turn back toward them and smile as I walk away. I want to say, "Nice talking with you."

But none of that happens. We just sit there - on our phones, in our magazines, sinking deeper into the collars of our shirts. We keep our mouths shut because we've heard of HIPAA and there's that sign ten feet from the front desk telling us to stand back to protect each other's privacy.

For some reason, all of this reminds me of this one time when I ran a marathon. The first thirteen miles were a breeze. Thousands of people lined the streets, cheering for us til their throats were sore. The spectators' roar mingled with my adrenaline to create the sensation that my feet were barely even hitting pavement. It was like I was floating. But then mile fourteen hit. It got really hard. The crowds lessened a bit. The day got hot. And I wanted more than anything to give up.

But there was this lady.

Her race badge said she was in the 70-75 age category and she ran with a limp, almost like she'd had a stroke. She passed me, and as she did, she spoke a word of encouragement that kept my feet moving. I passed her later on and made sure I returned the favor - just a "you go girl!" or "you're doing great!" to lift the spirits of a fellow runner. She passed me again. And again, she used a bit of that precious, fleeting energy to keep me going.

She wasn't the only one. There was a middle-aged guy, a couple of teenage girls, a group of moms. All of us runners were finding the strength to look past our own journey and speak words of encouragement to those who were struggling beside us. This is the reason I ran that marathon. It wasn't just some crazy idea or something I wanted to check off my bucket list. Looking back, I know I was supposed to run that race so that I could feel that camaraderie...with total strangers.

And maybe this fertility stuff is kind of like a marathon. We're all running the same race with the same finish line. Some are young. Some are older. Some run with partners. And some run alone. Some run a little more smoothly and others really struggle. For some of us, it's our first race. And some of us know what it's like to cross that finish line. It can be exciting at first, even fun.

But then we hit mile fourteen. Maybe it's the realization that the money we set aside for treatments is running out. Maybe it's the third miscarriage, the eighth negative pregnancy test, the second canceled IVF cycle. And when we hit mile fourteen, we need more than we can offer ourselves. We need that 70-year-old lady. We need each other.

We're running the same race, with the same goal in sight, just an arm's reach from one another, but we're still really lonely.

So maybe someday, I'll do it. I might just speak up, take the risk.


"What are you in for?" I'll say to a woman in skinny jeans, clutching her insurance card. Maybe she'll be offended. Maybe she'll tell me it's none of my business.

Or maybe she'll take a deep breath and talk about it...actually talk about it. Maybe for the first time. Maybe she...maybe we...won't feel so lonely in that fertility clinic waiting room. Maybe I can be her lady with the limp. Maybe she can be mine.

And maybe someday, we won't really care how long it takes for the nurse to call our names.


Friday, February 1, 2013

let's get it started

We're headed back into the land of ifs and maybes...infertility treatments. Earlier this week, I had some blood work done at the clinic. The next day, a nurse called to tell me that I'm not pregnant and I have not ovulated.

WHAT!?!?!?!

Totally kidding.

They started me on a drug called Provera to force a period. Provera and I go way back. I've had less than ten periods in my whole life. Usually when I tell people that, they say something about how lucky I am. And they're right. No mood swings. No bloating. No cramps. No desperately digging through my purse for supplies. I'm a lucky woman...until I try to get pregnant. Not so lucky then. No period means no ovulation. No ovulation means no baby. So Provera comes to my rescue by making my body do what it can't do on its own. I'm supposed to call the clinic on the first day of my period...and I can't remember what happens after that.

It's odd. I feel like a newbie even though I've done this so many times before. I used to be able to talk shop with the best of them. But I just don't remember that stuff anymore. It feels like ages ago, like I was a different person back then, living a different life. In a lot of ways, I was.

It's exciting to be starting again. And scary.

This time around, it's going to be different. We have a child now, which on the one hand, will make things SO much easier. When I start to wonder if it's ever going to work, I can remind myself that it already has. When a pregnancy test comes back negative, I can hold my daughter close. My please God prayers will be tempered by prayers of thankfulness for what we've already been given. My daughter's presence will be the sweetener in this bitter process.



But on the other hand, having a child and working towards another will create some challenges. Children are not allowed at the fertility clinic. I am so glad for this rule and am more than happy to abide by it. I remember sitting in the waiting room during our IVF cycle and seeing a family come in with two little ones in tow. I was livid. Of all the rules to break!! So again, I'm a fan of the rule, but it does mean that we will need child care or at least rather creative scheduling every time I have an appointment. That means inconveniencing others and being away from Harriet more than I'd like.

Also, we now know what it's like to feel a baby move, to introduce that child by name to its tearful grandparents, to sing lullabies in the stillness, to provide comfort during sickness, to laugh at the silly faces, to celebrate the first steps. If our next baby does not come soon, we will know what we are missing. We will be fully aware of the specific, unparalleled joy that's being withheld. I have said many times that if I would have known how wonderful Harriet was going to be, I never would have been able to wait. Now I know, and I may still have to wait. This could be tough.

So here we go again...


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