Thursday, April 30, 2015

Spilled Milk: What no one tells you about postpartum life, colic, and reflux

 *Note: This isn't written prettily and you'll probably get bored quickly if you can't relate. I know I would have a few years ago before babies were even on my radar. I write this like I would in a journal so I don't forget. I wrote it along my journey, in real time, so now, in hindsight I better understand certain things, but I haven't done much editing (of content). It better captures my experience.
About one week old, before colic and reflux kicked in. I didn't like many of the pictures of me in those first months, but now I realize they show the reality.

This is the blog that I wish I could have read before my daughter was born. No one talks about post partum life. They speak in vague terms of sleep deprivation, how it changes your life, postpartum depression, and you don't have time to shower or eat. Maybe it's something you can't fully grasp until you've lived it, but I plan to lay out some of the grisly details- the behind the scenes footage of the Annie Leibovitz newborn photo shoots. Not all of this will fit since it's my unique experience and my daughter had colic and acid reflux, but there's bound to be some common threads.

This is the experience I had been anticipating and for some it works out this way, but I have a hunch that for most it's not sunshine and glory those first few months. Don't get me wrong. I am fiercely in love with my daughter, but was it mostly blue skies and rainbows with a few stormy nights like this fellow blogger mom describes? No.

My daughter kept us in suspense during the weeks preceding her birth. She kept flipping from transverse to head down position. If only we knew this was a sign of what was to come!

4 Weeks

My daughter is 4 weeks old. I'm curious to see how old she'll be when I finish this post. Hopefully before she's 2 years old! As I write this, she naps. This is the first time she's slept that I've not fallen into deep slumber myself or gulped down a meal.

Sometime between one and three months

You hear "sleep while they sleep". Yeah right. My daughter's colic kicked in at 3 weeks.

She. Would. Not. Sleep.

Her and I would be awake when her dad went to bed (he had to work the next day) and we'd still be awake when he got up in the morning. I told him, hopefully we won't still be awake when you get home from work. That might have been one of the times she was awake for 20 hours straight. I was baffled. I knew you had to get up throughout the night with infants, but an infant that would be awake for 12, 13 hours straight, regularly, only taking mini catnaps? I thought they needed 16 hours of sleep within a 24 hour period? ...sound of me throwing out the textbook..

I thought the hospital was at least partly about recuperation. It wasn't. I was in labor for almost 48 hours and I only got 1-2 hours of sleep each day in the hospital. I was eager to go home so I could sleep while she slept (I still believed that myth!). In the hospital our little one didn't sleep at night and during the day we had constant interruptions from the hospital. Then add the challenge of learning (and teaching baby) the new skill of breastfeeding while sleep deprived. Breastfeeding is hard. I consider myself holistically oriented, but I came close to giving up a couple times. I got depressed when we had to give her a bottle (some pumped, some formula) during that learning period. I felt like a failure before I had barely begun. If breastfeeding is natural and has been done for centuries, why was it so hard?

Every lactation consultant has a very different approach. The one we saw right before leaving the hospital had us in a panic because my daughter hadn't had any dirty diapers since the day she was born and she said we'd have to supplement with formula if she didn't have one by midnight. (The little stinker produced one at the doctor's office the next day after we had called the after hours number a la new parents style). I wanted to burst in tears when we discharged from the hospital because she spent two hours bombarding us with gadgets, methods, and an overflow of information that was meant to be helpful but it felt like a semester course in breastfeeding that my exhausted brain couldn't absorb.

No one talks about how when your milk finally does come in days later that you will constantly be soaking through shirts, or that breastfeeding gets a little easier once that happens. No one talks about how sore you will feel and that it's normal, and it may last several weeks. No one talks about momma and baby anatomy and how that can affect the learning. I didn't realize that during this phase you're breastfeeding 24 hours a day, or close to it. Some of this was due to the reflux. I would spend an hour feeding (or trying to feed her), she was fussy for a couple hours, then I would try feeding her again, and this was all we did. It took about 8 weeks before we seemed to have a good latch and I wasn't gritting my teeth in pain.

The pediatrician repeatedly told me to try waking her up earlier so she would go to bed earlier and switch back her nights and days. I repeatedly told her about my infant's chaotic sleep patterns and feeding behaviors and it didn't matter what I did. The pediatrician and I were on very different planets. Missing over and over in our conversation. It was pretty apparent that she had no understanding or experience with a child who's suffering from colic or reflux. I wasn't being heard or understood. I balled after her doctor appointments. There was an attitude of sorry, you just have a challenging baby, you gotta tough it out, and it's just colic that the baby has to outgrow.

 I explained how I couldn't get a good feeding with her. There was no feeding nicely for 20 or 30 minutes, baby is soothed, and then falls asleep. I couldn't even get 10 minutes of a nice feeding in once an hour.  I explained how my daughter would act starved, fiercely suck for a few minutes all the while thrashing her head and body, pull off, then get on again all the while crying and fussing. I thought I was doing something wrong with latching her. I couldn't tell how much she ate, one feeding blended into another. She would spit up while feeding, and after feeding. We would do this for hours a day. I now know that this is typical acid reflux behavior and she was doing this from the pain.  This behavior also causes them to suck in more air and have more gas. I was given no explanation at her appointments when I explained how chaotic her feeding and sleeping were. I was given a script for Zantac and basically told to tough it out.

Is she gaining weight? Yes. Doctor is satisfied. It doesn't matter how difficult the feedings are or that she is in pain. Am I bitterly disappointed in the medical field? Yes.

My brain got weird during the sleep deprivation. I went several days with only about one hour of sleep a day. I started having weird thoughts and I was on the verge of hallucinating. I remember when the breast pump noise started sounding like muffled high pitch voices. One time I couldn't even fall asleep. I cried in desperation to my husband,  I can't sleep!  I'm going crazy and having weird thoughts!  When I finally got a solid 3 to 4 hours, it was heaven. I was certain I could last for days! And this is coming from someone who has ALWAYS needed her sleep, averaging 9 hours a night to feel rested.

Three months

I didn't know it at the time (my daughter is now 13 weeks), but her reflux was keeping her awake. It would constantly wake her. One of those days when she was awake for 20 hours, I was afraid I'd fall asleep holding her so I set her safely in her rock and play sleeper. I knew she'd be fine for 5 minutes before crying again. I slept for 5 minutes and I even had a dream. Amazingly it rejuvenated me for another 45 minutes before the fatigue hit me again.

During the pregnancy I wrote about my impending feelings of grief about the pregnancy ending.I don't know how common this is. Most of what I hear is about women being so uncomfortable that they try every trick to get their water to break. I was huge and uncomfortable but I never reached that point of wanting it to be over. I also hadn't anticipated the pregnancy grief would last for at least a month after she was born. It took my mind a little time to transition from pregnancy mode to new mother with a newborn mode. It seemed a bit foggy and dreamlike. I wonder if that's what it's like for the infant trying to transition to our world, not quite being able to fully leave the womb.

 The pregnancy bond with your baby is different from bonding with baby in your arms. I thought it was more of a timeline type of bond, like most relationships. It was the same little being, but different experience. There's much to learn about this infant. There's quirks to learn. It's a bit messy. I felt guilty when it was early in the morning after she'd only slept for a couple hours and I didn't feel lovey dovey toward her. I felt annoyed. Then I felt guilty for feeling annoyed. I'm still learning that it's okay to not always like your child's behavior. It's okay to be frustrated and irritated by your child, no matter what age.

When you have a fairly easy pregnancy and you get sleep, you eat, and you have time with your hubby, it's easy to focus on bonding with baby whose needs are all being met by your body. When you care for an infant you get snippets of bonding time, but most of it is intense hard work, especially with a baby who has colic and reflux. I've never been more challenged physically and mentally at the same time. I longed to be two people, one who could do the hard stuff and the other who could relax and bond with baby.

Time stopped when my daughter was born. I was in such a fog, so consumed by this little being, that for months it still felt like early September. Nights and days are mixed up, adding to the confusion. I might take a nap in the evening, brush my teeth at 11 pm and then be awake for 18 hours with a fussy baby, only to repeat the madness. It's like being a sleep deprived third shifter that doesn't eat and rarely leaves the house.

On the occasions I went to the store for half an hour to get a break, I fumbled to answer the cheery cashier's questions. My brain couldn't process or retrieve words and I'd somewhat lost my social skills. I wanted to retort "yeah right" when they said "have a nice night." They meant well, but I was going home to a screaming inconsolable infant. People tell you it gets easier and it doesn't last forever, but when you are tired, hungry, and irritable, it feels like it will never end and you will never feel rested. I felt like I wasn't living. That's the best way I can explain it.

Moods. I've never experienced such mood swings in my life like I did those first couple of weeks. It must have been a combination of sleep deprivation, hormones, and the 8 lb 9 oz. life changer. More so than what I experienced the whole pregnancy or during any menstrual cycle. Crying, depressed, and frustration sum it up. Then there's the bleeding- nine months worth of bleeding for weeks. Soreness. My tail bone hurt for weeks and I dreaded going from sitting to standing because it hurt so much. I thought I'd feel completely healed by 6 weeks but I didn't. 13 weeks postpartum and I finally feel mostly healed (no more babies yet though please!).

Then there was the first time I was separated from her. It took me a few weeks. I broke down to my husband (poor hubby) that I was desperate for a break (i.e. run to the store for 20 minutes) but I couldn't bear to part with my daughter. It would be the first time I would be separated from her, ever! I balled my eyes out as I drove the store. I knew though that I'd be a better mother if I took a little time to myself. In those first couple of months, taking time for myself sometime consisted of a ten minute break of going outside because I was too exhausted to drive anywhere. Panera Bread became a frequent spot for me to go for an hour, even if it was just for a cup of tea. I couldn't take breaks at home because even if I was in another room, I could still hear her crying and fussing while my husband took care of her, and I would immediately get tense.

I wish I had known about the 4th trimester. Infant aren't ready for our world after nine months, but their little heads would be too big to make an exit if they stayed in the womb for a full year. I love snuggling and holding my daughter, but I wasn't aware that you hold infants all the time, particularly if they are fussy from gas or reflux.

Then there was the time a week ago when I was nursing her and she suddenly popped off to give me the biggest smile and like any girl, wanted to chat. Then she gave a mischievous smirk and snuck back on to get a few more sips. Only to pop off and chat a little more. Yes, it sounds cliche but I'll say it. It makes it all very worth it.

I cried multiple times because I felt like I was missing out on her early stages. She was either crying, very fussy, or semi fussy 90% of the time she was awake. She would on occasion have a chunk of an hour or few hours of seeming content. At first I thought it was normal infant behavior but when I thought of other infants I've been around and as the weeks rolled by, I was perplexed. Why was she so unhappy and uncomfortable? We had to constantly walk with her while she would cry. I'm not exaggerating. My husband and I would switch off walking her all the time. Her feeding and sleeping were chaotic. The spitting up became worse around 7 weeks old. I could not set her down. She hated being on her back and tummy. The helplessness is heavy when nothing you do seems to soothe your baby.

Four Months

My daughter is 4 months old, the time when most babies outgrow colic. While her reflux medication seems to be helping and toned things down from screaming for hours to being fussy the whole day and I can't set her down more than five minutes. Some days it feels like we're still in newborn mode. After feedings are the worst. We do have some good days which constitutes of  being really fussy and crying after almost every feeding, and a good portion of the day she's not content. (I just reread that sentence three months later and thought wow-- I considered THAT a good day?).

I felt really depressed yesterday. I still don't know what's wrong or how to help or if there is any way to help. I drive myself crazy wondering is it the dairy in the cookie I had? Did I not burp her thoroughly enough? Was her medication given on an empty stomach? Maybe she has slowed gastric movement and her stomach isn't actually empty after two hours which is why the medication isn't fully helping? How do these moms do the full elimination diet to see if it's food allergy related? I'm happy when I get two full meals in a day that aren't total trash and processed. Did that probiotic help or did that give her more tummy pain and that's why she screamed again for five days in a row? Should I try a new one? Are we now in normal fussyness? What's normal? Is some of it her temperament...a high needs temperament baby? My. Mind. Never. Stops.

I was so depressed this morning that I couldn't smile back at my baby. I even avoided her gaze. I caught her looking at me questioningly.  She picks up on a lot. I feel depressed because I wonder if my baby will be fussy for several more months. I remember a night when the colic/reflux kicked in and I took a ten minute break outside and thought, colic doesn't last more than 4 months. I counted how many weeks that would be, took a deep breath, and went back inside. Now it's four months and I don't know when the end is in sight. Is it four months down, four to go since reflux usually is quite better by 8 months, or so?

Four and a half months

My daughter is four and a half months old and (knock on wood) over the last week, I have seen a lot of improvement. Reflux can be cyclic so I don't know, but the other night I cried out of joy instead of frustration. Finally! Finally, my sweet sweet baby. You are feeling better. Your momma has longed for this, for longer periods of savoring you instead of the two of us gritting through pain and simply surviving. I cried as I rocked you to sleep because it was something that felt normal. Rocking you. You falling contently to sleep. Us having had a day with longer spurts of you smiling and playing with toys. You being content after a feeding instead of it escalating into crying and screaming. You and me, connecting in a way other than desperately finding a way to lessen your pain.

You are calmer. I knew the doctors were wrong when they said, "she's just a fussy baby." You don't fuss to be difficult. It's not a fussy personality. You've been hurting and you're trying so very hard to express what's wrong. You still are sensitive, you still are quick to fuss/express when you are uncomfortable, you might still be labeled as a high needs baby who tends to fuss more than others, but it is not an all encompassing part of your personality. The other aspects of your personality were hidden by this raging discomfort you've been experiencing your whole life so far. I cried because for four very long months I have been so eager to meet these other parts of you. To just be with you. To have times I can relax with you. To look in your eyes when you are feeling peace. We've both been frantic and exhausted. So exhausted. You in constant frantic motion, going hoarse with your cries. Me rushing around the house to meet both of our daily needs and finding ways to soothe you. This was a marathon neither of us expected.

I do not know why she's been better. I've been cutting dairy. I started her on a new probiotic. I've started taking her to a chiropractor. She is still on prescription medication. She is older. Reflux can simply be cyclic.  I drive myself crazy not knowing the "why" but I will enjoy this time.

6 Months

My daughter is six months today. What a blur the past six months have been. I still feel like it's September, not March since I've been living in a bubble, solely focused on giving my daughter whatever relief possible and giving every last ounce of myself. She started sitting up on her own a couple weeks ago and she is much happier in this position. There's also been some improvement in her reflux since she started sitting. It's not gone, but she's no longer spitting up 50-75 times a day.

I'm still anxious and afraid to even say she's doing better because, well, over the last three months we've had spells where she seems to do better for about a week or so (like I documented above at four and a half months) and then it gets bad again. The reflux seems to be cyclic and it felt like we would take two steps forward and one and a half steps back. I think, though, that this might be sustained improvement. I can set her down now and she will even play with her toys, sometimes giggling and squealing. She can do this for 20 minutes!! This is a huge improvement. She hated lying on her back and belly so for almost 6 months I either held her or wore her in the Moby wrap. This gives me the freedom to do some things around the house although lately, I've been so happy to see her happy that I sit with her and soak her in. It gives me so much joy! I want to cry because I have longed so very much to see her happy and feeling well.

So, the "why" that I've been searching for. I still don't know for sure, but this is what I've noticed: She's happier sitting up. Her reflux has improved since her back started getting stronger about a month ago and even more when she started sitting on her own. We switched her medication from the Solutab to over the counter Prevacid. Her teething seems to have subsided for the moment (she hasn't been knawing on my arm). And she's getting more sleep. I think some of her fussyness has been from being overtired and difficulty falling asleep. As a high needs temperament, she's extra alert and sensitive and therefore, has a harder time settling down to fall asleep. I never knew it could be so hard for a baby to fall asleep and that her default was to just stay awake. It's crazy! So I've been working harder and longer (sometimes 2 hours) to get her to sleep in the evening and just in the last week she's sleeping 10 hours at night (still wakes a few times).

I feel like I've been under water and I've just come up for air.

Almost seven months

Now that life is feeling more normal and less fragmented, I can think. I can relax. I've been tense for so long that I still find myself going rigid sometimes, especially when she cries. Nearly a flashback.  My body has been so trained that I have to gently remind myself, I can relax now. She is doing much better. She is fine. It will take me some time to learn this.

I've noticed that I have finally started processing the labor, delivery, and the past six months. Maybe this is because I'm no longer living in constant fight or flight mode. Some of this processing is really hard for me. It brings up mommy guilt and other hard-to-face emotions. I'm working through it.

Even when I used to take breaks, I had a really hard time taking mental breaks. I would obsess about what I might be doing wrong and what I could do different for her.

I have a theory that reflux and colic babies get a little behind on learning self soothing and healthy sleep habits. This makes sense though, right? She became fully reliant on my husband and I, but that's the way it was supposed to be. She was in pain. She couldn't be expected to learn to self soothe. We're working on these things now.

She is still a high needs baby (more on that in a future post). She needs to be held a lot and she's particular about who holds her. Just recently she started crying again as soon as I set her down. It only escalates to screaming when I try to give it some time to see if she'll settle. I'm getting better at going with the flow, accepting the ebb and flow of a high needs baby. Here's the 12 features of a high need baby.

Sometimes I feel like I have whiplash. I went from a fairy tale pregnancy and deep bonding, to a zombie world where I suddenly lost my baby.  I gave birth but I couldn't find her. She couldn't be present with us. She was with us physically but only in anguish, and therefore, mentally could not be with us. As I write, the recurring nightmare that I've had (sometimes nightly) since she's been born suddenly makes sense. I kept having this nightmare that she was sleeping in bed with me and I couldn't find her. I would half wake up and rummage through my blankets, almost grasping her, but never quite getting a hold of her, losing her between my fingertips. I stopped having it about a month ago.

My words fail me. I cannot explain those six months. You would have to live them to understand. They were the hardest months of my entire life.

She is a joy!

She is very observant, sensitive, and feisty.

I love getting to know her.

She knows me well already.

Baby girl I have waited so long to get to know you-- well over a year when you count the pregnancy. I hope I did everything possible under the sun for you. I hope you sense how hard your dad and I tried. I hope you understand how much we love you.

I just wrapped this up and she's 7 months old today! It finally feels like the month it is: April instead of September.