Mau Man and the Chronicles of a Low Birth Weight Mama

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.

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/

Bits n' Bobs~ Parenting 8 year olds; a fine needle aspirate.

A biopsy (FNA, not core) of  some recent parenting moments.

I have three children, ages 8, 8, and 2. My 8 year olds (girl/boy twins) are about to start 3rd grade next month which makes me feel really old--how did this happen already?! I feel like I was just waddling around HUGELY pregnant, then swaddling them, nursing them, rinsing off binkies dropped on the floor for the millionth time, changing their diapers, having delirium from the sleep deprivation, and all of that goodness and badness. And now we're talking about Big Issues In The World like homelessness, what is a mortgage, why Donald Trump is "not a nice man" (ok, so we're not subtle in our liberal tendencies. We're a West coast gay multiracial family, duh!), why it's better to compost food waste than throw it away, and on..and on. And last week my daughter saw a license plate frame that said "Army Mom" and asked me "Mom, are there any wars going on in the world right now?". What a heartbreaking and innocent question. Cue a conversation about war and conflict in the world, presented at an 8 year old level.

When did parenting suddenly get so complicated for our home? Does anyone just want to read a board book? Sing a song? Wrestle? Be totally oblivious sometimes?! And with two elementary school students, we're now entering into questions about the human body. And these questions usually come up either at dinner or at bedtime (of course).

The other night as I was putting my son to bed I reminded him that he realllllly needed a bath the next day (man, boys can be so DIRTY! Summer boy feet, oh wow); I also asked him if he was still retracting his foreskin while in the tub, to make sure he was cleaning himself properly-such a mom question. It truly astounds me that an 8yo child can get out of the bathtub after having "bathed" as dirty as when s/he went IN. He asked me "Why do I have to pull it back?" and I explained that for boys with foreskins, it's important to retract/clean because blah blah blah. He then says, incredulously "You mean SOME BOYS DON'T HAVE FORESKINS?!". Oh. I guess we never really talked about that specifically--never had a need. So there we were at 9:00 at night discussing circumcision, why we didn't circumcise him, whether most boys are circumcised (around here I think it's 50/50 for new births), penis growth (he said he thought his was "fully grown" by now....um...no, honey...it's not. So we did a bit of teaching there) and so on. It was hysterically funny, all in all.

And at the end of the conversation, my little man, being the budding biologist that he is (his obsession is mostly birds, so ornithology is actually his first love) also reminded me that foreskins are also important because they protect his penis from bad weather, bacteria, and insect bites. Oh right, but of course...

Until the next bedtime,

ZebraARNP