My Body: Currently Out to Rent

As someone with little experience with babies (outside the uterus) before having one, I had a lot of misconceptions.  Like I knew I’d get woken up a lot at night with a newborn, but I had this image that I would feed him, put him back in his bassinet, and he’d sleep there while I was in the bed nearby.

The reality was that he’d wake up to get fed, but then he’d require a lot of holding and soothing to go back to sleep.  And he never slept flat until he was 5 months old.  By the time I was able to go back to sleep, it would be approaching an hour, by which time I’d be hungry and need a snack.  The reality of it all was very different than I’d envisioned.

I also naively thought that I wouldn’t be one of those women to gain a ton of weight after having a baby.  Especially since I’d done well gaining the recommended amount of weight during my pregnancy, I thought I’d be fine, and go back to my Paleo ways.  A good number of my patients are close to their pre-pregnancy weight when they come in for their postpartum appointment about 6 weeks post-baby.  So I was hoping to do the same.

The pregnancy weight initially came off quickly, then I plateaued at about 10 lbs heavier than my pre-pregnancy weight.  I came across this article, which granted isn’t the most scientific source ever.  It says that although breastfeeding does burn 300 to 500 calories a day, it can require you to keep ON an extra 10 lbs or so:

http://www.purewow.com/wellness/Breastfeeding-myths

When I read that, I felt vindicated.  YES!  I knew there was a reason I wasn’t losing those last 10 lbs.  I thought, ok I can deal with 10 lbs until I stop breastfeeding, and then I might have to work a little to get it off.

But then what I discovered was that the combination of chronic sleep-deprivation, being extra hungry all the time, and not having any free time is a deadly one.  It’s a well-known fact that lack of sleep is associated with weight gain, and there’s nothing like having a new baby to mess with your sleep.  Thanks to breastfeeding, I am always hungry- I’ll eat a meal that is a normal size, and then still feel hungry and end up snacking on more.  And with the lack of time (and energy), I don’t want to put any effort into food prep.  Plus when WZW is awake and needing attention, I can’t spend forever eating.  My husband makes fun of me for how long I spend chewing a salad- I definitely don’t have time to be eating one if I’m alone with the little guy.

Thanks to all of the above, my weight has slowly creeped back up, which is depressing as my clothes have been getting tighter.  I am now the heaviest I’ve ever been non-pregnant.  The small scrub pants that I was able to fit into until 30-something weeks are now tight after eating a large meal.  And frankly, after a large meal, I look like I’m still pregnant.  I can’t help but feel gross not just because of vanity, but also because I know my habits are less than healthy.

I struggle between reminding myself that this is common, and that working my full-time plus job and taking care of my little guy are already enough to test my limits.  It’s tough expecting to be able to do much more.  So when food is available, I’m happy to eat it, carbs and all.

And exercise?  Forget about it.  I haven’t done anything regularly since I was pregnant.  Thanks to my long work days, I need to come home as soon as I’m done with work, and there is definitely no time to exercise after.  If I don’t have a meeting at lunch, I’m trying to catch up on work so I’m not there as late.  So going for a walk at lunch is possible on some days, but probably means a longer work day.

What I also worry about is that at some point, we would like to have another child.  At 35, I don’t exactly have forever.  So I’m potentially looking at breastfeeding for a year, then getting pregnant again at some point in the not-too-distant future after that.  And then going through this whole process again.  I would definitely like to get healthy again before conceiving baby #2, but I also don’t want to wait so long that my fertility declines and I have trouble getting pregnant.

I didn’t realize until having WZW that it’s not just with the pregnancy that my body is taken over by the baby.  Breastfeeding is causing significant changes in my body as well.  If I end up having two children fairly close in age, that’s quite a bit of time that my body will be “out to rent” for the sake of the babies.  What I initially thought of as a brief temporary state is potentially going to turn into like 4 years of being pregnant or breastfeeding.

I know I should stop worrying so much and getting too ahead of myself.  I’m lucky to have a healthy baby, supportive husband, and a stable job.  But it’s funny how women and men react so differently to weight gain.  My husband gained about 20 lbs from all of the lifestyle changes post-baby, and his response was- I haven’t even been pregnant and I feel great!  In reality, he does intend to work on eventually getting back into running & cycling and eating better.  He looks forward to the process of getting back in shape.  Whereas for me, it sounds like a lot of work.

So, we’ll see.  It’s definitely too much for me right now to go back to eating strictly Paleo.  But I do want to see if I can work on not being quite so free with the carbs and sugar.

Sleep Training

Ah, sleep.  The Holy Grail for all new parents.  I feel exhausted most days thanks to my work schedule and WZW’s schedule.  My brain doesn’t function quite as well as it used to.  I’ll forget things my husband and I talked about.  I’ll lose my train of thought easily.  One thing that’s really noticeable is that I have a much harder time recalling people’s names.  Like a medical assistant that I’ve known for a while, but haven’t worked with lately- all of a sudden, they put her with me and I can’t think of her name right away.

But it amazes me how one adjusts.  Thank goodness despite the above, I’m still with it when it comes to patient care.  Some days are harder to drag myself through than others, but I don’t feel nearly as bad as I thought I would.  In the pre-baby days, this amount of consistent sleep-deprivation would have killed me.  But somehow I’ve adjusted and this is the new normal.

The other thing that amazes me is that I haven’t gotten sick (knock on wood).  Maybe a little sniffle here and there, but nothing like the flu, where I can’t go to work.  I haven’t looked into it, but I wonder if breastfeeding has a protective effect for mom as well as baby.

Like most parents, we would love for our little guy to sleep better at night.  I haven’t had time to read lately, but when I was still on maternity leave, I quickly went through the Twelve Hours’ Sleep by Twelve Weeks Old book.  It’s a fast read, and someone had told me to take it with a grain of salt, but that it has some good general advice.  I did find that reading it helped with general principles, but it’s too much to expect most 12 weekers to sleep that long, much less my 6 month-old.

My husband has been reading Healthy Sleep Habits, Happy Child.  He’s been giving me the verbal Cliff Notes, so all mentions of the contents of this book are based on that.  Given our N of one, we thought are little guy was pretty normal.  He’s not a super easy baby, but he’s not one of those “colicky” babies that just cries and cries for no reason.  Usually.  But according to the book, he’s on the fussier end of the spectrum.  That was news to us.

WZW is fairly needy, and has always needed to be held to go to sleep.  Until recently, soothing him to sleep without holding him was damn near impossible.  And even now, at 6 months, it is still hard.  We just recently started having him fall asleep without being held, but we still have to be there to help soothe him.  Once in a while, he’s really upset for no apparent reason, so we still have to hold him to sleep.

Many parents understandably have a hard time with the Cry It Out method.  It’s hard listening to your baby cry briefly, much less substantial amounts of time.  But we weren’t opposed to it.  The Healthy Sleep Habits book talked about it generally, as one option.  Some friends had described it, and it seemed easy enough.  First night, cries some and then goes to sleep.  Second night, cries longer than goes to sleep.  Third night, cries for what seems like an eternal amount of time (say, 45 minutes).  Then the fourth night they sleep through the night.  Sounds reasonable enough, if you can get past night 3.  Granted if you travel, or there’s some other major change, you might have to go through the process again.

I feel like we gave it a good go for a couple weeks.  Since he was still eating once at night, and plus I wanted to keep my breast milk supply going, we would let him cry if it was not yet time for him to eat.  In our ideal world, he’d sleep till past midnight, then wake to feed him, then wake up after 5:30 am so I could feed him before heading to work.  Well that never happened.

Despite what I think was a good effort at the Cry It Out (meaning we were being pretty consistent), on more than one occasion he ended up crying for an hour.  At that point, I had to go to him.  Turns out our little guy wasn’t one to give up easily.  One definitely learns a lot about their baby’s temperament when trying to sleep train.  I fear that his temperament may develop into a stubborn toddler.

So, back to the drawing board.  In general, after my husband read more of the book, we started making more of an effort to get him down for his naps earlier, before he becomes overly tired.  We started avoiding taking him out too much around our schedules, so we can maximize his sleep.  And over time, his naps have been getting longer.  Which is why I currently have the freedom to be sitting in front of my computer typing.

At exactly 5 months, he surprised us and slept 9.5 hours straight!  But that didn’t last.  Things are improving, but at night he still doesn’t sleep consistently.

What’s tough is the breastfeeding.  It’s great when he sleeps long in general- makes us happy.  But what kills me is that I never know if he’s gonna wake up soon, or if he’s gonna go long.  I pump if it’s getting long, but I’ve also gotten burned with that.  Once I pumped, then 30 minutes later he got up hungry.  Since I’d just pumped, my husband had to give him some of my thawed breast milk.  Sad part is, when I pump I get maybe 4 oz.  He’ll drink 6 oz.  If I were always with him and could breastfeed him all the time, it would be fine.  But since I have to pump at work, his schedule and my pumping schedule don’t always match up.  And so I play the game of, do I pump now or do I wait?

Ultimately, nothing is going to work consistently for every baby.  We definitely have not found the magical solution.  And part of it is patience and time.  When you have two parents working long hours, we can only expend so much energy.  We are lucky that he has always slept by himself at night, first in the Rock ‘n Play, and now on the bed.  So even though he needs us to fall asleep, once he does, it doesn’t have to be with us.  But still, there are times that you think he’s asleep, so you try to leave, and then he wakes up again.  Doh!

It can be overwhelming with all of the different and often contradictory advice parents get.  I saw this a while back- a frustrated mom who put together all the sleep “advice” into one contradictory and hilarious jumble:

http://www.today.com/parents/exhausted-new-moms-hilarious-take-expert-sleep-advice-goes-viral-6C9559908

Since this is technically a Paleo blog, I should mention what Mark Sisson has to say on the subject.  He has previously written about co-sleeping with one’s infant.  When done safely, he is a proponent of co-sleeping.

http://www.marksdailyapple.com/co-sleeping-risks-benefits/#axzz420Gb1fWD http://www.marksdailyapple.com/co-sleeping-how-to-do-it-safely/#axzz420GethKx

Interestingly, there was recently a lecture at work which also discussed the benefits of co-sleeping.  It was in the context of how co-sleeping increases rates of breastfeeding.  The lecturers said that when the American Academy of Pediatrics made the blanket statement discouraging all co-sleeping, it was based on shaky science, and that there is good evidence on the benefits of co-sleeping.  When an infant death occurs, the autopsies are not consistent.  For example, if they find that co-sleeping was present, they presume that contributed to the cause, and often no further evaluation is done.  There are factors that contribute to an increased risk of SIDS, such as smoking and parental use of substances that affect their awareness.

In other words, the AAP was being overly cautious, and the evidence does not show that ALL parents should avoid co-sleeping.  Mark Sisson mentions it as well, but essentially some of the main benefits are that moms tend to be more successful with breastfeeding, and that they tend to sleep better.

We decided in the beginning that since my husband tends to move around a lot in his sleep, that it would be ill-advised to put WZW between us in the bed.  We didn’t want to risk him getting elbowed by my husband or something.  He never slept flat in the bassinet or the Pack ‘n Play playard, so that’s how he ended up in the Rock ‘n Play rocker.  Initially, we had him in the bedroom with us.  But despite what they say about moms sleeping better when their infant is in the same room with them, I found that in those early days, WZW would often loudly groan for up to 30 minutes before he was fully awake and started crying.  I called it his snooze button.  Due to that, my sleep would be interrupted before I needed to attend to him.  So we ended up putting him in the living room just outside our bedroom.

Now that he’s graduated to sleeping on his back, we’ve just been putting him on the bed.  So the kid gets a king bed to himself most of the time, since we now sleep in the downstairs bedroom.  It is convenient, though, that sometimes one of us can sleep on it next to him.  One of these days, when he starts moving around more, I guess we’ll have to finally switch him to the crib.  I keep looking at it, and wondering if we’ll ever use it.

After listening to the lecture at work, I feel like the speakers were such strong proponents of co-sleeping that they made me feel bad for not keeping WZW in the bed or room with me.  But ultimately, each baby is different, and I still breastfed exclusively for the first 6 months as recommended.  We felt like it was safer not sleeping with all 3 of us in bed, and since WZW had reflux, having him inclined a bit in the Rock ‘n Play was a benefit for that reason as well.  Plus, until recently, if we tried to put him down onto a flat surface after he fell asleep, he’d wake right back up.

Ultimately, each family will have to decide what is best for them.  And in many cases, the baby’s behavior helps dictate that.  So long as the babies are safe, it’s all good.

 

 

6 Months!

IMG_1730

Normally my son’s milestones mean he gets to take a picture with one of his milestone cards.  But in this case, this is a huge milestone for Mommy as well.  Before doing it myself, I didn’t realize how difficult it would be to get to this day- 6 months of exclusive breastfeeding.

Some of it was luck- my son was born healthy, full-term.  He gained weight appropriately from the beginning.  I didn’t have any medical conditions that affected lactation.  Nevertheless, the hours upon hours spent breastfeeding and the sore nipples in the newborn days were a challenge.  Within the first couple months, I developed mastitis.

During my maternity leave, I was able to amass a frozen milk stash.  But as I returned to work, I wasn’t able to keep up with his demand.  He’d eat twice per day while I was at work, about 6 oz each.  I would pump anywhere from 2.5 to 4 oz per session.  So the supply has been quickly diminishing, and I wasn’t sure if it would last until 6 months.

I have lactation time built into my schedule at work, but sometimes my patient visits are running late, and I cut down the pumping to 15 minutes instead of 20 minutes.  Or there have been a few times when I was so busy I decided to skip the pumping completely and just pump after I’ve finished seeing all of my patients- which means I’ve delayed pumping by a couple hours.

Since WZW doesn’t have a regular feeding schedule, that also gets frustrating.  I’ll come home, and not know if he’s going to want to eat soon, or if he’ll sleep for a longer stretch.  It’s always a gamble- I’ll often pump for just 5 minutes to relieve my breasts and keep the milk supply going.  If he goes long, then I’ll think- If only I’d known, I would have pumped longer.  Occasionally I’ve gotten burned, thinking he was going to sleep a long time, and pumped for 20 minutes, only to have him wake up 30 minutes later.  That means he ends up drinking from my frozen supply, and depletes more than I just pumped.

I’ve also dealt with clogged milk ducts- some areas of my breasts would remain firm after feeding/pumping, so I’d need to apply heat and massage prior to and during feeds to correct it.  Thank goodness it never led to another bout of mastitis.

The other thing I’ve had recently are these little white spots where the milk ducts are located on the nipple.  I think it’s a variant of the clogged ducts, except just at the nipple.  In any case, they hurt like hell when he starts feeding, and they seem to take quite a long time to resolve.  I looked up some advice online, but honestly it’s hard to do any maintenance.  At first I thought maybe there was some candida (yeast) involvement, so I figured it would be easy enough to buy one of those over-the-counter Monistat type creams and apply it to the nipple.  Well, having to wash my nipple every time before feeding him and pumping at work is an extra pain.  And it didn’t seem to help.

There was various advice online about what to do for these white spots, but honestly it sounded like too much of a hassle with an already busy schedule.  So I’m just waiting for it to eventually resolve.

I’ve heard some moms really treasure their breastfeeding time with their babies- they coo, and it’s a special bonding experience.  I’ve never felt that.  My kid has always been a fussy breastfeeder.  He often comes off the breast and then back on.  These days his latch has devolved so he’s not on all the way.  As the milk flow is decreasing on the side he’s feeding on, he doesn’t hesitate to let me know.  This involves crying, or better yet screaming.  I tell him he has to work a little more for the good stuff- it’s fresh, never frozen.  He doesn’t seem to care.

Despite the hard work, breastfeeding has its benefits.  The most obvious one seems to be protection from illness.  Some of my friends have said their babies first got sick around 6 months after they stopped breastfeeding.  My husband was recently sick and had to stay home from work.  Meanwhile, both WZW and I were fine.  I’m amazed after 6 months of chronic sleep-deprivation that I haven’t gotten sick.  I’ll get a little sniffle, or tickle in my throat, but then it goes away.  I wonder if breastfeeding confers protection for mothers as well.

Since he’s 6 months old today, we gave him his first solid food.  A friend had given us some organic baby food as a gift, so we decided to go with the flavor that had one ingredient and sounded the least appealing.  My husband hates squash including zucchini, so we decided to go for the winter squash jar.  Despite his initial expression looking like it tasted bad, he went for more, and kept eating it.  So far this guy seems to like eating.  He took the first bottle of breast milk offered to him, and so far the solid food went fine as well.  Next up- the fun of seeing (and smelling) his poop!