Babies

Welcome to the Pump House: Adventures in Fatherhood and Breast Milk Management

/ bperica / 1 Comment

A version of this post appeared on my blog years ago when London wasn’t even a year old. But I just tweaked it a bit, slimmed it down , and added here and there. I think it’s better now. Here it is…

Never in my wildest dreams, as I prepared for fatherhood, did I think I was going to spend so much time with lactation nurses, reviewing the intricacies of hand expressing (including motions), analyzing breast milk volumes, discussing engorgement, and just how much breast milk one could fit in a chest freezer.

A few hours prior to my meeting with lactation consultants, thinking there were three more months to learn these things, I didn’t even know lactation nurses existed. I knew that some babies were born prematurely, but I didn’t know my wife’s breast milk would still come in just as early as our daughter wanted out at 26 weeks gestation.

So it was that our 109-day stay in the neonatal intensive care unit (NICU) started with a crash course in breast milk. Within those first days of life for my daughter (London), my wife (Kate) and I spoke at great length with not just one lactation nurse, but several of them about breast milk and breasts, starting with a nurse asking my wife if she was going to pump breastmilk. Partly due to the trauma of the last 24 hours, and partly due to my complete lack of knowledge about breastfeeding, I had not thought a bit about breast milk or pumping. Kate was of a similar mindset at that particular moment, but we were both satisfied to know that there was a good chance Kate’s milk would come in. The early drops of colostrum, the nutrient-dense milk first released by the mammary glands, often come in shortly after the placenta detaches from the uterine wall, no matter the gestational age.

A couple of hours later a lactation nurse wheeled into our room something that looked like a medieval torture device. They were calling it the Symphony. They hooked Kate up to it and it hummed and sucked for 18 minutes. At the end of that first session, we could just barely make out two milliliters of colostrum. A few hours later Kate produced 2.6ml and then later that night 3.8ml. The next day, January 31, marked Kate’s first 24 hours of pumping. She produced 32.6ml that day, or 1.1 ounce. The lactation team handed us a log with the direction that we were to write down when Kate pumped, for how long, and the total volume.

We then received a DVD to watch, which would apparently help Kate get more milk by hand expressing and provide tips to alleviate the pain of engorgement. We were to watch it and return it to the NICU team afterwards. That same day, we popped the DVD into my laptop to watch some before going to bed. One minute into this educational video, the biggest breast and nipple either of us had seen appeared on screen. Kate laughed so hard she began to worry she might injure herself being only two days clear of a C-section. Everything hurt. If we continued watching, we put Kate’s health at risk. I slammed the laptop shut. Tears ran down our cheeks from laughing so hard.

Who knows who is responsible for making this particular lactation video, but may I make one small suggestion on behalf of my wife and all women who have recently had C-sections? Great. Do not make the first breasts on the video also be the largest breasts known to mankind. They should not be comically large, needing 3-4 hands to get them under control. In fact, this video is a danger to new mothers everywhere, they might literally bust open their gut laughing from it, like we almost did.

Thus, it fell on me to watch the lactation video alone, gleaning from it any helpful tips and then sharing them with Kate. She was impressed. It wasn’t like Kate’s breast milk volumes needed any help. Not long after London was born, I was spending part of everyday rearranging containers of breast milk in the chest freezer in the basement—the chest freezer we needed to buy solely to store breast milk. Kate and I would joke that I knew more about hand expressing breast milk than she did so I should print up some business cards and walk around the NICU offering my services to anyone who needed them. Hand Expressions by Bryce. Simple and to the point.

By day of life 57 for our little girl, Kate was producing 1,863ml a day, or 63oz of breast milk. To put that in perspective, London was fed a total of 800ml on day 57, the most she had ever consumed in one day. In fact, it took London a long time to drink as much milk in one day as Kate got from one 20-minute pump. A point was reached where no amount of rearranging the breast milk in the freezer would make room for more. I picked up a second chest freezer at Costco and Kate started to fill that, too.

For the months London was in the NICU we rented a Symphony pump, which at the time retailed for $1500-2500, and kept it in our bedroom. We started to call it the pump house. When at home, Kate disappeared every three to four hours to spend some quality time with the Symphony. As all moms know that schedule wreaks havoc on sleep and work responsibilities, but Kate did an excellent job. I did what I could by waking with her every time throughout the night, assisting in bottling of the milk, labeling and recording volumes, washing pump parts, and then delivering milk to the freezers in the basement. So, at our house, at least two times a night, Netflix and chill was swapped out for Netflix and pump.

As Kate tapered off the pump, we were just filling up the second chest freezer and the lactation nurses understood why Kate was putting an end to pumping. She had developed a reputation in the NICU as a super producer. At London’s discharge, on May 19th, 109 days after she was born, the NICU staff wrote messages to us. One of our favorites from the lactation team wrote, “Your mom was a rock star with pumping. She could have fed three babies in the NICU!”

Next week, London will be six-months-old and I can thaw breast milk from three months back. And right now it’s lunch time for the little girl, to the chest freezer I go.

Camden’s Birth

/ bperica / 2 Comments

Yesterday @ANNELAMOTT tweeted:

Okay everybody, it’s almost time to start writing. Main thing: put on some pants. Finish up your cup of coffee–no one here thinks you need more. You’re good. Now: butt in chair; deep breath; write something, badly.

Write something, badly. Too often I think I can’t write until I can sit down and write something, goodly. I have about four days a year, maybe, when I think that is a possibility. Thus, I don’t write that often. So, thank you, Anne, for tweeting this out like a punch to my gut. Here is something I will finish writing, badly. But I will not abandon the coffee. Not yet.

After a couple minutes of vigorous massage, Camden’s first cry pierced the atmosphere of the operating room. Life, new and loud, dirty and fragile, and a sweet, sweet noise, but what tugged at my heart was another noise I heard from elsewhere in the OR.

At 7am, that Saturday morning, we arrived at the hospital. Kate had gone into labor a couple of days before her scheduled C-section. Camden was breach, so as they would have done two days later, the doctors moved ahead with the operation, prepping Kate and handing me the biggest set of scrubs in the hospital.

Within an hour I was sitting outside the OR by myself as the anesthesiologist gave Kate a spinal block. The last time I was in this chair outside the OR, Kate was 26 weeks pregnant and we were having an emergency C-section. That time around I sat for two minutes as Kate’s spinal tap was administered, as doctors frantically scrubbed in, and as person after person filed past me through the double doors and into the OR. But this time I sat for 20 minutes as people casually prepared for another C-section, as I heard small talk and even laughter on the other side of those doors. The laid back, quiet atmosphere was surreal. The only thing familiar to me that Saturday morning was the chair, the door, and the closet-like feel to the space where spouses are made to wait until they are cleared to enter the OR. The expediency, the mood, the number of people in the OR, and the conversation were all different. All normal, I suppose. This is how C-sections at full-term proceed, we learned.

As I was allowed in, I started to take pictures. First of Kate on the operating table with a curtain rising up from her chest to shield our view and maintain a sterile environment. Then, a selfie of the two of us, five minutes before Camden arrived. From there, things moved quickly. The anesthesiologist and nurse anesthetist stood by Kate, telling her when she might feel tugging or pressure. I readied myself to stand up and look over the curtains to glimpse my son for the first time.

By the time I was told to stand, Camden had already been placed on a warming bed, out of Kate’s sight. I leaned over and kissed Kate and then walked over to meet my son.

As I stood and watched a small team handle Camden during his first minutes of life, I knew something was not entirely okay. He was not making noise. His color was a little off, not pink yet. There were six hands on him, firmly massaging his whole body. One doctor was sucking a tremendous amount of fluid out of his mouth and nose.

I tried to keep things in perspective while I stood there. I had seen much worse. I had seen these docs with a much different demeanor. They were not there yet. They kept busily working on Camden, but did not appear worried. I kept reminding myself that this is a full-term baby. He will come around. He will come around.

First picture of Camden. 7 minutes old. 8:55am. 10/14/2017.

And then, he took a deep breath, and let out his long, first cry, which was answered by the sweet sound of Kate’s cry, the sweetest sound I heard that morning. For Kate, Camden had been out of sight since the doctors pulled him from her womb. She knew nothing of what was happening for that minute or two. The noise that came from her is truly a noise replicated at no other time than when a mother hears her baby for the first time. I could hear in it the anxiety washed away, the instantaneous connection of mother to son. Hearing it, I knew she loved him so much already, in a way only mothers can. To bear witness to that love is one of the single greatest blessings of fatherhood.

Write Every Day

/ bperica / 3 Comments

Do I have a piece of advice for new parents? Heck no! I am flying by the seat of my pants, making things up as I go along, convincing myself I am doing it the right way until I find out I am doing things completely wrong. I haven’t subscribed to a parenting magazine and I don’t listen to parenting podcasts. Maybe I should do one of those things. I know I would learn something, but then there is always the time.

Do I have the time? No. Sometimes. I don’t know. I probably do have the time, but remembering every little thing I am supposed to do during that time–when she is sleeping or at preschool–is very, very difficult. Many of the tasks seem overwhelming or too time-consuming, like if I take time to peruse through a parenting magazine for an hour and London simultaneously takes a short nap, all I can say about my day is that I read a parenting magazine. Forgive me, but I want more out of my precious free time. By now I have probably given you the impression that I have no interest in learning about parenting or becoming a better parent. That is just not the case.

What got me on this topic of advice was a question a friend asked me months ago. It was not a blanket appeal for advice for new parents. The question was broader than that. What have I found to be helpful? What was a waste? What would I do differently? It was a multi-parter, but without the requirement of answering each part. I have got a simple answer for one part.

Screen Shot 2017-09-29 at 1.36.30 PMWhat have I found to be helpful?

Write a few words about every day you have with your child. When you are in the thick of it, you can think to yourself, I have no time or energy for this. This is often true. It’s okay if you get a few days behind and have to write an entry for a few days back. But there is another excuse, I’ll never forget this. Oh, how wrong you are. There is so much happening each and every day that there is no way to remember each and every day. Your kid can say something hilarious one moment and then the next you are rushing to get out the door and by the time you get back home you know that something great happened that morning but you can’t recall what it was that happened.

So, my advice, if you want to call it that, is to buy a one line a day journal that covers five years. I have written about these journals before. I just bought this one for my baby boy…arriving any day now. Name suggestions anyone?

For the days of firsts, you will likely have photos and videos of crawling, walking, talking,  and maybe even sitting on the pot. But if you don’t write it down, you will forget your kid’s reaction to his first popsicle, the name of a friend made at music class, or that day your kid takes a glorious three-hour nap (September 10, 2016).

Do not fret if you don’t write something every day. I do write something every day, but it took me a while to get into that habit. There are too many blank days in London’s first year and a half of this journal, but better to get into this habit later than never. Now, I am on a streak of 2+ years and her journal has become one of the most-prized possessions in my entire house.

If the house goes down in flames, I am getting my family out and then going back for this journal and, if I have the time, a backup of the hard drive on this computer (photos!). Everything else can be replaced.

But do not forget the journal. Even the sharpest of minds cannot bottle up all the precious days of infancy and toddlerhood.

Pictures of Preemies

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London. 8 Hours Old.

A Canadian photographer and father to two preemies, Red Méthot, has a popular project in which he photographs preemies holding their own baby pictures. I first saw this on Facebook and thought I should share it here. Follow this link to the Unworthy post.

This link leads to Red’s Facebook page, where you can view all of his photos in this project.

Particularly of note for me, were the two preemies photographed who are still on oxygen as toddlers. One of them was born at 23 weeks and the other at 26 weeks. Both boys. Kate and I are tremendously blessed that London, born at 26 weeks, is now 21 months old and approaching her one year anniversary of being free of oxygen support. Here’s hoping the two boys pictured with oxygen can lose that cannula for good sometime soon!