i included a space on my to-do list to write a blog post about ramona’s third week of life, but she’s 25 days old now–halfway through her fourth week–& i want to write about something a little more immediate & relevant to my own life. guys, having a baby is difficult. not that i didn’t think it would be. it’s just difficult in a different way than i was prepared for. in a kind of a meta way, i was prepared to be unprepared for the difficulty, but it’s still tough.
the big news is that ramona really started getting the hang of mouth feedings last week. the main things she had to do to be released from the NICU were a) maintain her temperatures without help, 2) pass the car seat test, & 3) take all of her feedings by mouth. they delayed starting her on a bottle for a few days so that i could work on breastfeeding her. we did board one night so i could try her at the breast at every feed for 24 hours. sometimes she really took to it; more often she took a few sucks & then fell asleep or thrashed around until she got a bottle. but by saturday, she was taking entire feeds from the breast, no supplementation necessary, & she could suck down an entire bottle in like thirty seconds flat.
jared & i remembered different things about when her feeding tube could be removed. he thought they had said that a baby needs to take all feeds by mouth for 48 hours, but in the discharge binder (my source of info, considering how little i remembered of the discharge class, which i attended while still on two percocets every four hours), it said 24 hours. once ramona hit 24 hours with no tube feedings, i asked to speak with a nurse practitioner to clarify the issue. she looked at ramona’s chart & said she’d write an order for the tube to be removed that night. “& we might as well do the hearing test too. & the car seat test. & i’ll leave the paperwork for the hep B vaccine with you. &…do you guys want to room-in tomorrow? & then she can go home the next day?”
so, long story (well, maybe not so long) short, ramona was released from the NICU yesterday. she’s been home with us for a little more than 24 hours now.
& it is really hard.
rooming-in was hard too. i don’t know if all NICUs do this, but overland park regional medical center has some rooms actually in the NICU where parents can stay overnight with their babies in preparation for going home. the parents are responsible for all their baby’s care during the rooming-in period, just like they would be at home. they change all the diapers, take care of all the feedings, administer baths as necessary, dispense any medications or other tests. if all goes well & baby comes out the other side alive, having gotten all its medication, maintaining its temperature, & eating okay, it can leave.
the tough part is that we were still on the hospital schedule. in the NICU, ramona’s temperature was taken, her diaper was changed, & she was fed every three hours around the clock, since birth. if she pooped her diaper fifteen minutes after having it changed–tough luck, kiddo. unless the poop actually seeped through her outfit, she was left to sit in it until the next diaper change. (& the NICU nurses seemed surprised when she developed a diaper rash. go figure.) if she got hungry before feeding time–too bad. she’d have to wait. needless to say, this is NOT how i would have parented her at home. but we had to chart her temps, diapers, & feeds NICU-style during the rooming-in, so we had to more or less stick to their schedule. & it was hard because she didn’t eat that well at her first few feedings, so she kept us up half the night screaming for food. seriously, she screamed almost non-stop from 12:30am until 5:30am. when i did put her to the breast, she was too hysterical to take to it & we wound up giving her a bottle (of breast milk–i am still pumping around the clock & had milk in the fridge). she calmed right down for the bottle & slept like a log once she’d finished it.
anyway, now she’s home, so i can feed her at will & exclusively at the breast, right? my whole plan when i was pregnant was to exclusively breastfeed. when the NICU insisted we have a “bottle system” ready to go before they would discharge it, i kind of mentally dismissed the idea, thinking we’d buy some bottles to honor the request but just never use them (except for the occasional dad feeding).
but it’s just not working out. she cues for food, i offer her the breast, she latches on for about ten seconds, & then she whips her head away & screams. i try a different position & the same thing happens. lather, rinse, repeat until both of us are near tears & finally i break down & give her breast milk in a bottle. she polishes it off in no time & falls asleep like the happy, satisfied baby i wanted at the breast.
i have no idea what to do. she is capable of maybe two or three decent meals at the breast in a day (though none yet today), but no way would she be taking enough calories that way. & i have to admit, being able to give her a bottle & know she’s eating is a huge sanity-saver. she’ll nurse fitfully at the breast for an hour or more & take about the same as she’ll take from a bottle in three minutes. in the middle of the night, desperate for sleep, the bottle looks like my best friend. & i justify it by telling myself that she’s still very small & doesn’t have a lot of stamina, & my supply might just be too much for her to handle direct from the breast, & we have plenty of time to make the transition as she gets bigger & stronger & my supply evens out to adjust to her actual needs, & in the meantime, she’s still getting breast milk from the bottle. & it also means that jared & i can split feeds evenly, which gives me more time to myself (to think about what a failure i am as a mother, that i can’t even breastfeed my own baby despite having enough milk to fill the grand canyon).
i’m going to consult with my doula once the holiday is over, & i’m going to attend a la leche league meeting & see if anyone there can help me out. maybe it’s ramona’s size. maybe i’m not positioning her properly. maybe she needs some extra time to adjust to the sudden change in environments & caretakers. maybe this is normal for premature babies. maybe it’s okay to just keep pumping & giving her bottles of breast milk until she’s weaned. maybe this just isn’t a big deal. but it makes me feel really sad & crappy.