The Long Haul

This post is going to be about me complaining about the challenges of chronic sleep deprivation as a new mom.  Now, I do want to preface this by saying that I have much to be grateful for.  2015 was the year of WZW.  I found out on New Year’s Eve last year that I was pregnant, and I’m very fortunate to have had a healthy pregnancy, delivery, and now baby.

On top of that, I have a Super Dad of a husband.  In addition to his normal full-time job, he does everything he can humanly do to contribute to our family.  Breastfeeding is probably the only thing he can’t do.  He takes WZW off my hands when he can, cooks, and takes care of the dishes.  He loves organizing our house and doing things that involve trips to Home Depot.  So he’s constantly adding shelves, organizing stuff in labeled plastic bins, and finding better ways to use our limited space.  Honestly, when I go back to work, I definitely won’t be able to do the equivalent of what he does.  And best of all, he makes me feel loved and appreciated for what I do as WZW’s mom.

I am very aware of all that I have to be grateful for, but I’m still human.  Which means that the difficulties that I deal with daily are what are at the forefront of my mind.  WZW is now 11 weeks old, and as of his doctor’s visit a couple weeks ago, weighed 11 lbs.  I’m also on my last two weeks of maternity leave, so I’m starting to feel anxious about what it’s going to be like heading back and adjusting to work life post-baby.

For me, as the weeks have gone on with me taking care of WZW nearly 24/7 during my husband’s work days, the fatigue has become chronic.  Although WZW goes at least 4 hours now between feeds, he often wakes up every couple of hours at night.  So my sleep is still very fragmented. Sometimes on his off days, my husband will take nighttime duty and give WZW a feed of my thawed breast milk and take care of putting him back to sleep.  I wake up feeling great, and it certainly helps, but it’s frustrating that it’s not enough.  I still feel tired, and I feel like I’m so behind on sleep that I’d need to sleep for days to catch up.

Based on friends’ recommendations, and as gifts, we’ve ended up with a ton of baby books.  One is the sleep book by the same guy that did the Happiest Baby on the Block DVD, Harvey Karp, MD.  He discusses how sleep (or more like lack of it) contributes to postpartum depression.  We OB/Gyn docs make sure to check in with our patients at their 4-6 week postpartum visit to screen for postpartum depression.  And we’re very aware that unfortunately it often starts early.  Our Pediatrics docs and social workers help us screen as well, particularly for moms whose babies are in the NICU since they’re at higher risk.  That helps us catch the moms who are at-risk, and at a time prior to their postpartum appointments with us.

Dr. Karp mentions, though, that postpartum depression can show up months later.  Moms (and dads) who have very fussy babies, and/or aren’t getting as much sleep have a higher risk for depression.  Now that I’m going through it, I can totally relate.  For me, the initial push was ok.  But now that I’ve been in the state of chronic sleep deprivation for months, I’m feeling it more.  And I notice that when I’ve had a rough night, I feel worse in terms of my mood.

A typical scenario is that I wake up to feed WZW.  By the time he’s fed, burped, and put back to sleep, it’s easily been 45 min to an hour.  When I first woke up, I was nodding off as I was feeding him.  But by the time I’m done, I’m no longer desperately tired.  Not only that, but I’m hungry.  So I need to stay up even longer to eat.  Sometimes I think I’m tired enough and not hungry enough, so I’ll lay down.  And then find myself still awake half an hour later.  So I get up, eat a snack, and at long last go back to sleep.

I then wake up to my son crying and look at the clock- it’s been an hour.  It’s not time for him to eat yet, so he’s up because of something else.  In that moment, I’m so exhausted and all I can think about is how badly I want to be back in the comfort of my warm bed.  Instead, I’m pretty much hating life.

When the morning comes and the sun is up, the desperately tired feeling gives way to just my normal chronic fatigue.  Possibly the most ubiquitous piece of advice for new moms that I’ve seen and heard everywhere is, “Sleep when baby sleeps.”  Sounds reasonable enough, right?  Ha!  Not with my son.  Thank goodness he manages to sleep on his own at night.  But during the day, he generally needs to be in contact with a warm body (usually mine is the one that’s available) in order to sleep.

He spends a lot of time in the Rock ‘n Play, and as he gets tired he’ll get cranky but never puts himself to sleep in it.  That means I have to hold him until he does, and then I’ll try to put him back down in it.  The majority of the time, as soon as I do so, those little eyes open up- gotcha!  Sometimes I’ll get lucky and he stays asleep, and I’ll have a blissful 10 minutes to rush about and take care of things around the house before he wakes up again.

The other alternative is a carrier.  Around the house, I’ve used our Boba wrap.  Our traditional infant carrier is great for taking him out in public.  It’s also fine for using around the house, as it gives us the use of both hands more easily than with the Boba wrap.  Once WZW is nice and snug in a carrier and has his pacifier, he will pass out.  But since he’s attached to me, that means certain activities like showering are not happening.

I’ve tried napping with him in the Boba wrap, but he tends to wake up if I try to recline.  At best, I can try to nap sitting up, which isn’t the most comfortable for me, especially since we decided not to get a recliner chair for now.

Napping during the day is a great idea in theory, and sleep-deprived parents should definitely do so if they can.  But the reality is that babies as it is will sleep for short spurts, and in my case my son needs to be in physical contact with me to sleep.

Of course anyone is gonna feel crappy with less sleep.  But my mind tends towards the negative.  I’ll dwell on negative stuff, get more upset about things, etc.  Part of that for me has been the challenge of my eating habits and weight.

I’ve mentioned the snacking at night.  During the day, since I’m so tired, I care less about what I eat and am drawn towards the “bad stuff.”  It’s known in general that people who are sleep-deprived tend to be more overweight/obese.  I know it’s normal to not bounce back like Heidi Klum, but it still doesn’t feel good to be 10 lbs heavier than I used to be pre-pregnancy.  Plus, my old clothes don’t fit, and it’s depressing to have to wear my maternity pants.

I also feel guilty since I’ve continued to stray from the Paleo lifestyle.  I have a blog with Paleo in the frickin’ title!  I feel like such a hypocrite.  And yet the sleep-deprivation wins out, and I go on eating my bread.  It was always an extra challenge at work to bring my lunch.  During my pregnancy when I relaxed on the Paleo thing, I must say it was much easier being able to eat the lunches provided on the days I had work meetings.

I’m not really sure how I’m gonna figure things out as I transition back to work.  It’s gonna be tough handling my already stressful work schedule, adding breast milk pumping, and then if on top of that I have to worry about preparing my meals each day?  I know I can do it, and it’s a matter of prioritizing.  But I do think of it as another chore as I go back to work.  Let’s face it- it’s much easier if on some days I can just eat the sandwiches provided at work.

I struggle with trying not to be too hard on myself- I already have perfectionist tendencies, and it’s not easy dealing with a young infant 24/7.  And sleep deprivation- man, is that stuff potent!  You can have the best intentions and plans, and they will be totally annihilated by a poor night’s sleep.  On the other hand, I don’t want to be making excuses for myself, and devolve into a lifestyle full of unhealthy choices.

I don’t have the answers.  It’s gonna be something that I figure out as I go along.  But I just needed to vent.  And I am still tired.

Happy Thanksgiving, everyone!  My ethnically ambiguous, gender neutrally outfitted little guy says hello:

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Fluoride

During my pregnancy, I bought a Primal toothpaste.  Or actually, a tooth powder that you add water to.  The same company makes a natural deodorant.  For the tooth powder, they advertise that it’s free of bad stuff like triclosan, SLS, and fluoride.  Well, I grew up being taught that fluoride in our tap water and toothpaste is a good thing for our teeth.  So during the pregnancy I used the powder in the mornings, and continued to use my regular toothpaste at night.

Now I started wondering more about it- what is the concern about the safety of fluoride?  And is it a legitimate concern?  Or is it one of those things like the anti-vaccine concerns that are not based on good science?  To anyone who is still concerned about vaccines- this is how we doctors feel about it all:

Back to fluoride- these days my time and energy are limited thanks to my son.  So I didn’t delve into extensive research.  But I did check to see what the ADA (American Dental Association) says.  On their website, I found an extensive document that details the safety of fluoride in drinking water.  Bottom line is that there is extensive research backing the safety of the levels of fluoride in our drinking water.  I didn’t find anything specifically mentioning fluoride in toothpaste.  But I figure so long as you’re not ingesting significant quantities of your toothpaste, it should be fine.

As with anything, in large quantities fluoride can cause harm.  And this is something that we’ve known for ages.  If infants and children ingest too much fluoride, then they can develop something called fluorosis, which causes changes in the enamel during its development.  It appears as mottling of the teeth.

At my recent dental appointment, I asked my dentist about it, and she confirmed the above.  Due to concerns about fluorosis in children, she says they should be supervised with dental care.  She says this is so even at an age when they’ve started to do other things independently (she meant early elementary school).  In other words, you don’t want to leave your kid alone to eat that yummy flavored kids’ toothpaste.

Otherwise, she wasn’t aware of any concerns about safety of fluoride in drinking water, in the amounts used in toothpaste (assuming you’re not ingesting it), and in the fluoride treatments used in the dental office.  For some areas that do not have fluoridated drinking water, she recommends supplements.

So for the avoidance of other ingredients, there might be a benefit in using a “natural” toothpaste, but as far as I can tell, there doesn’t appear to be a concern about fluoride if used in the normal fashion.

Mommy Can Drink Again!

WZW is 8 weeks old now.  He’s going to have his official weigh-in later this week, but a couple days ago we checked his weight using the poor man’s baby scale.  I weighed myself without him, then with him, and the difference was 11.5 lbs (our bathroom scale goes to the 1/2 pound).  Recently, his feedings have spaced out to 4 hours, which has been great.  At night, he’ll even sometimes go 5 or 6 hours.  The problem is, he doesn’t sleep the entire time between those feeds.  But still, we’ll take it!  I think now that he’s putting on more weight, he’s able to withstand more time between his feeds.

The nice thing about the greater spacing between feeds is that we can more easily take him out of the house without worrying about hurrying back as quickly.  Thus far, other than breastfeeding at friends’ houses, I’ve only had to breastfeed in public once, in the car in a parking lot.  Otherwise, we’ve regularly taken him out for short excursions, but we’ve always timed them right after his feeds.  So that’s how I’ve been able to avoid having to feed in public.

The other nice thing about the spaced out feeds is that I can drink alcohol again without worrying about it passing to WZW through my breastmilk.  I found out I was pregnant last New Year’s Eve.  Weird to think that a year ago, he hadn’t even been conceived yet.  We were having a New Year’s Eve party at our place, and I was expecting my period to start.  My boobs were tender, and I was having mild cramping so I totally thought I was just having signs that my period was about to start.  But since we were trying, I wanted to double-check that it was safe to drink that night.

I’d gotten one of the specimen cups from work (after realizing it’s not that easy to pee on a stick for 5 seconds as directed), so I peed in the cup and let my husband do the honors with the test.  So we were both in the bathroom together when we saw the plus sign appear.  Imagine our shock- even though we were trying, it was definitely still unreal to actually see the positive test.  We had to quickly gather our bearings and continue preparing for our party.

That night, I played bartender and made the cocktails.  But I managed to just take little sips and no one noticed that I wasn’t really drinking.  Initially after that, I did miss being able to drink fancy cocktails at some of my favorite restaurants and bars.  But soon after, probably thanks to the nausea of pregnancy, I can’t say I really missed alcohol.  I would take an occasional little sip of my husband’s drinks, but didn’t feel deprived.

Even after the pregnancy ended, even though my eating finally went back to normal, I didn’t immediately feel the need to drink alcohol again.  Also, on a practical level, since I was initially feeding often, it wouldn’t be recommended.

I didn’t find any specific recommendations from ACOG (the American Congress of Obstetricians and Gynecologists), but at my institution they’ve stopped telling breastfeeding women that they must completely abstain from alcohol.  They found that it was too restrictive, and frankly a lot of women were probably drinking anyway.  So they recommend drinking no more than one drink per hour, and to try to time it right after a feed (or pump and dump if it exceeds that amount).  My husband got me a product called Milkscreen which tests breast milk for alcohol.  You dip the strips in breast milk for 2 minutes, and it will change color with alcohol.  It’s similar to the urine dipsticks we use in the office for a quick urine check.

So far I haven’t tried the Milkscreen strips because I’ve avoided drinking enough alcohol for it to be a concern.  Initially, I would have a few sips of my husband’s wine after a feed.  Certainly nothing that would still be hanging around at the time of the next feed.

More recently, I just started having an interest in drinking wine again.  I think it’s because I tried a red wine that I really liked.  My husband had been drinking a lot of rosé, which I’ve never been a fan of.  He admitted that he still can’t tell the difference between different rosés, but it was more nostalgic for him since he drank it a lot while he was in Provence this past July.  There, because it’s so hot in the summer, it’s normal to drink it with ice cubes.

All of a sudden after trying a great red wine, I had this inclination to drink again.  Plus with WZW’s feeds spacing out, I now had the freedom to drink a glass right after a feed and not have to worry about it still being in my system by the time his next feed came around.  In addition to drinking wine at home, I had my first cocktail when we went out to dinner with a friend this week.

Spending time with my son is so fun and I wouldn’t trade it for the world.  But it is tough, and life is very limited compared to the good old days- I’m usually with him constantly and particularly on the days my husband is at work, it’s hard to so much as shower when I’m alone with WZW.  He likes to be in a carrier much of the time.  At home, I’ve been using the Boba wrap and my husband likes the Infantino carrier that we received as a shower gift.  The latter is definitely much easier for taking him out in public.  I’m sure most parents relate- we’ve definitely had to use the restroom (yes, #2 as well) while we have him attached to us on a carrier.  Being able to drink alcohol again more freely- just a glass of wine or one cocktail instead of sips- gives me some semblance of my old life before WZW.