BIRTH:
In early March, I became a mama for the second time. We have nicknamed our new little one Mau Man. Our home birth didn’t feel all magical like the pictures I see on the Internet but maybe after continued exposure to oxytocin while nursing I’ll change my story and in a few years I’ll tell you all about how magical it was (feel free to call me out on it!). It was intense and brief (he came within 3 hours but it felt like days). Similar to our natural hospital birth with our first Zo, the details are hazy and I feel traumatized. Did a human just burst forth from my body? Yup! He did. Did I feel like I would give up. Heck yeah, I felt like throwing in the towel a few times, but I didn’t. Was I scared. You bet I was! Did I feel powerful afterward? You know what, I sure did! And super tired too, just like with Zo. I feel like no matter where you deliver, birth takes over you, it takes hold of your being and you just have to submit to the intensity of the process.
LOW BIRTH WEIGHT, THE CONTEXT: Now we find ourselves with our newest little one who is healthy in every single way except he was tiny at birth. 2360 grams (or 5 pounds 3 ounces). Under the low birth weight cut off of 2500 grams. I have read countless studies of how Black women like myself, regardless of socioeconomic status, are at a higher risk of pregnancy complications, maternal and fetal mortality, preterm labor and low birth weight. At my Baby Sprinkle a few months ago, a group of my closest friends and I spent considerable time discussing this topic. Pretty morbid but we are all Black doctors, educators, and health care professionals. But somehow I thought, I would be insulated, I would be spared. I took my vitamins, exercised, meditated, saw a chiropractor twice a week. With all of the complications and losses friends and patients have had I realize that low birth weight is manageable but it still hurts. After our own loss last year, I realize that regardless of how small he was I get to hold him and touch him and smell him and snuggle him and nurse him and I will do everything in my power to get his weight up.
LOW BIRTH WEIGHT, THE COMPLICATIONS: Flash forward to Day of Life 3. His weight loss was more than what our Pediatrician and I liked and he was at risk of hypoglycemia and dehydration. He had a good latch but he just couldn’t muster up enough energy to transfer milk out of my breasts fast enough to grow. I had to start nursing and feeding him every 1.5 hours and start pumping several times a day to provide expressed milk to supplement him with. We worked with an amazing local Lactation Consultant friend first at our home and then in her office and started using a Supplemental Nursing System or SNS. This is a little tube that you attach to a syringe to feed babies at the breast or using a finger to help train them. This helps prevent nipple confusion by delaying the introduction of a bottle. Day of Life 4 was a blur with a ton of feeding and pumping. Day of Life 5 - he had begun to gain weight and his parents were exhausted. We were allowed to space him out to every 2 hour feeds. Day of Life 9 back to birth weight. Day of life 18 weight up to 6 pounds.
And this is where we find ourselves: Nurse and reposition the SNS 10 times. Pump. O finger feeds with SNS in the early evening so that I can sleep for a few hours (this is priceless! Many thanks to Lactation and our old school Pediatrician who made this a key part of our process). Smile. Cry. Have a melt down feeling guilty that I couldn’t make him fatter. Listen to a podcast. Take a lactation supplement. Play with Zo for a few minutes. Tell Zo to be gentle and not climb on me while I’m nursing. Get a pep talk from the hubby. Repeat.
I’ll keep you posted and can’t wait until I can throw this SNS out. I pray for the day he is exclusively breast fed and that breastfeeding soothes him.
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| My world at night: our 30mL syringe, the SNS premature baby feeding tube, my 2 pumps - my Spectra electric pump for daytime pumping and my NatureBond silicone manual suction pump for easy night time pumping - I pop it on the alternate breast while nursing/SNS feeding. |
REFERENCES:
Adverse birth outcomes in African American women: the social context of persistent reproductive disadvantage. https://www.ncbi.nlm.nih.gov/pubmed/21213184
Black Women Disproportionately Suffer Complications of Pregnancy and Childbirth. Let’s Talk About It. https://www.propublica.org/article/black-women-disproportionately-suffer-complications-of-pregnancy-and-childbirth-lets-talk-about-it
Racial Discrimination and Adverse Birth Outcomes: An Integrative Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206968/
What’s Killing America’s Black Infants? Racism is fueling a national health crisis. https://www.thenation.com/article/whats-killing-americas-black-infants/
My son was IUGR (premature <750 grams) and we wound up doing fortified breast milk for the first year. It was really stressful but he's a smart, interesting and healthy 6 year old now. Hang in there!
ReplyDeleteI'd be interested in how you decided on a home birth.
So glad to hear about your success. I will def write about the home birth. Moral of the story - I’m done having babies anywhere!!!
DeleteSo glad your little man is doing well!!! My guess is that being a doctor adds to the IUGR risk as well. I’d also be curious to learn more about your decision to have a home birth.
ReplyDeleteMy son was also borderline IUGR. (Heel sticks q2 hours for first day. Poor kid s feet were so bruised!) Probably because studying for and taking step 1 8 months pregnant doesn't grow babies. I did the same thing with breastfeeding/sns initially. You are a rockstar! . For us, after 3 weeks, he still had not gained his birth weight and I was so emotionally exhausted from the nurse attempt/pump/feed cycles that I switched to exclusive pumping. He had pumped breast milk exclusively for 6 months, I was able to monitor his intake, and everyone was so much happier. As hard as it was to realize breastfeeding was not the right fit for us, i (and my pediatrician) reminded me that "fed is best." Good luck on the process and sending much love, Power, sleep, and peace of mind your way!
ReplyDeleteThanks for sharing your success! I agree. Fed is best. Mau got a smidge of formula after colostrum due to shakiness/ hypoglycemia. I felt bad but shoot he’s alive and growing. We have freezer breast milk and formula for emergencies. All options are on the table.
DeleteSo impressed with your persistence and so happy for your family. Thanks for including the photo - I’m always amazed at the sheer amount of “stuff” that is required for pumping. I learned a couple new terms too (I had to google baby sprinkle) and now I can add SNS to my Family Med toolbox (after I talk a little more to my favorite lactation consultant too). We are cheering you all on and hoping for a good nap in your near future soon!
ReplyDeleteThanks for your response. I need all the cheerleaders and good vibes I can get. The ups and downs are intense. Nap time will occur shortly after I finish pumping and breakfast. I overslept last night and hubby let me rest 🙌🏾
DeleteIt sounds like you're getting things figured out!! We "graduated" from lactation the Friday before I went back to work. Baby girl lost 12% in the beginning, had her tongue clipped twice (10 days& 6 weeks), we triple fed for 6 weeks, and I was a pumping maniac. She's now 9 months, 20 lbs& definitely has noooooo issue getting her milkies. She was a 19 lb 6 month old, but so active now she's slowed way down. You've got this!
ReplyDeleteThank you so so much for sharing your success story. It is really inspiring when friends (and even strangers) share how things worked out for them. Keeps me encouraged. I can’t wait to see him at 20 pounds and I will write about graduating from lactation support. I have never heard it explained that way but I ❤️ it!!!
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