1 Week Postpartum

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What a week!

Our baby girl was born last Sunday, July 31st. In the week since then we’ve learned a lot about how to take care of her (and each other) despite uncertainty, weight scares, and a serious lack of sleep. But it’s all been so, so worth it – because she is absolutely wonderful.

Since the delivery was pretty uncomplicated (I’m actually working on a longer “birth story” post that gets into all the nitty gritty details) and our baby is healthy we only stayed in the hospital for two days. As promised, we got a private room on the maternity ward because of my CF, which was great. Overall the nurses and doctors were fantastic and it was reassuring to have a trained expert available at the push of a button if we had any questions. Also wonderful? Room service. Hospital food isn’t the best, but theirs was surprisingly good – and we could have as much as we wanted, anytime, billed straight through to insurance. Pure magic.

It was great to have food and medical care easily accessible because all of our energy had to be devoted to figuring out how to care for this little person. Neither of us had experience caring for very young babies and I don’t think we had ever changed a diaper before. Fortunately the diaper stuff is actually pretty easy (though the meconium poops are nasty). Less easy was finding a way to sleep when the baby had a meltdown every time we set her down in her bassinet. Since our hospital does “rooming in” (keeping the baby with the parents at all times instead of having a nursery) it was up to us to manage. We ended up essentially sleeping in shifts while the other person held the baby.

Each day we got a visit from the pediatrician as well as the OB. The baby passed all her tests with flying colors, which is absolutely fantastic. I actually surprised myself by how well I was doing, too. I was definitely swollen down there, but not very sore at all. The only real struggle was peeing. I had no idea how focused everyone would be on my bladder! The first few pees after delivery take place in the company of a nurse, who changes your (gigantic) pad and hoses you down with a peri bottle before settling in to wait for you to pee in a bowl inserted into the toilet to measure volume. I don’t know if this was because I had an epidural or not, but the first time we did this I literally couldn’t pee. I didn’t feel like I needed to either, despite the fact that I was apparently holding about a liter or urine. The nurse ended up having to catheterize me, which I would not recommend. Not fun. Luckily my bladder got it together and I was able to do it the next few times, after which you’re left to your own devices.

Much more fun was calling our families to let them know the baby had arrived. Everyone was surprised and excited since we told them it would probably be at least a few more days. It was really heart-warming hearing everyone’s well wishes by phone, text, and social media.

For those of you managing health conditions in postpartum, I heartily recommend bringing all your own meds and equipment with you to the hospital. The hospital staff had a full list of my meds, but inexplicably supplied only a few of them. They also brought me some that were just wrong (well, they were variations on things I take and probably would have been fine, but I would rather stick with my usual regimen). For example, they brought me my daily azithromycin, but no digestive enzymes, which I need with every meal. The respiratory therapist brought me pulmozyme and hypertonic saline, but no colistin – and they brought me some sort of nebulized albuterol combo drug I’ve never heard of instead of my albuterol inhaler. They didn’t provide any chest PT or equipment to use. This was kind of what I thought might happen since it’s pretty rare to have an adult with CF in the maternity unit, so I was glad I brought my own medicine and vesting device. No one gave me any trouble about using them.

Once we arrived home things were both easier and harder. It was lovely being back in the comfort of our own home and not being constantly interrupted for checks. However, there was no more room service and no one to reassure us that yes, it’s normal if the baby sneezes every once in a while (for example). The baby still refused to sleep alone in her crib, and since we’re not set up for bed-sharing (nor do we plan to) we were still getting very little sleep. However, I felt like I was on this crazy adrenaline high: despite getting roughly three hours of sleep a night I had so much energy and love for the baby that I felt like I could power through anything.

The day after we came home from the hospital we had our first pediatrician appointment. Everything looked great except her weight. She was born at 6 pounds 13 ounces, and at 4 days old she was down to 6 pounds and 1/2 ounce. It’s normal for babies to lose some weight, but losing 10% of her body weight is really the upper limit of normal. The doctor instructed us to bring her baby in two days for another weight check.

We spent the next 48 hours really doubling down on feedings. I think our initial mistake was that we expected her to cry when she was hungry, but she was so little and sleepy that she would easily go 4+ hours without waking to feed. In addition, she would fall sleep almost immediately once I got her to latch. So to get her to start gaining again we were strict about feeding her every 2 hours around the clock, even if she wasn’t making overt hunger signs. I also started pumping so that we could supplement her feedings with more breastmilk. Pumping had the advantage of 1) telling us exactly how much she was eating, and 2) reassuring us that she was actually eating something, since it’s hard to tell what’s actually going in when she’s just breastfeeding. She also was much less likely to fall asleep on the bottle than on the breast. I’m very thankful we had gotten the pump and some bottles before she arrived, even though we didn’t think we needed them!

It was a scary 48 hours, honestly. We felt guilty for letting her weight drop like that and worried about whether she was ok. I cried the first time I pumped because it seemed so unnatural and weird. We felt anxious about whether introducing a bottle so early would give her nipple confusion and make it harder to breastfeed. We even tried feeding her with a syringe instead, which was a total failure.

However, in the end, it was worth it. At our weight check on Friday she had gained 7 ounces in 48 hours! The doctor was thrilled and so were we. Since then we’ve fallen into a more relaxed rhythm of feeding every 2 hours during the day and every 3 hours during the night. I pump twice daily since all that early pumping had the unintended consequence of really increasing my supply. I breastfeed her for almost all of her feedings, but it’s nice to have a backup supply in the fridge so my husband can bottle feed her if I’m busy or napping. We’re freezing the rest and we’ll have a really nice “emergency” supply on hand. Yesterday, at exactly 1 week old, we weighed her again on a baby scale at a local nonprofit for breastfeeding moms, and she was up to 6 pounds 11.5 ounces. Almost back to her birth weight!

Over the last week she’s become a bit more wakeful (though she still sleeps almost all the time) and a much stronger breastfeeder. The bottle feedings don’t seem to have deterred her at all from latching and feeding properly. Mercifully, she started sleeping in her bassinet around 5 days old as long as she’s swaddled properly. For the time being, she’s actually a champion sleeper – as long as she’s not hungry, cold, or improperly swaddled, she falls sleep easily and stays asleep for the three-hour stretches between feedings. She’ll occasionally fuss but she’s able to calm herself down pretty quickly as long as those three conditions are met. It’s incredible. I have to credit Harvey Karp and the 5 S’s for getting her to sleep properly. If you’re pregnant and you’ve never heard of this, look it up before you give birth! My husband was highly skeptical of the technique when we read it before the birth, but was the first to admit it actually worked wonders on our baby.

Our pediatrician advised us at our first appointment to do our best to get out of the house at least once each day. “It’s a low bar to set,” he said, “But you’ll be surprised how hard it is to do some days. But it will really help you keep your sanity.” He was so right! Between the constant feedings, snuggling, and diaper changes, not to mention my regimen of medications, chest PT, and pumping, we usually don’t get much “free” time until the afternoon. But we’ve managed to get out for walks around the neighborhood, a stroller ride in the park, and even a quiet lunch at a local salad place yesterday. We’re careful to keep her away from strangers, sick people, and smokers, and no one has pestered us to touch her. She does pretty well in the stroller (as long as it’s moving) but absolutely adores the Boba wrap – she just snuggles in and conks out.

We’ve also had a few visitors. Some of my husband’s cousins who live here in the area have stopped by with gifts and flowers, which was sweet. On Wednesday my Dad is flying in for a quick visit, and on Thursday my Mom flies in to stay for the week. My in-laws arrive the following week. It will be a busy few weeks of visitors, but we’re looking forward to seeing everyone. They actually won’t be staying with us: because we only have a small one-bedroom apartment (which is now filled with baby stuff) we told everyone a while ago that they would need to get AirBnBs or make other arrangements when they visit. I felt guilty about this, but I think it will really help with our stress levels not to have everyone living on top of each other in here. I also mentioned a while back that we asked that our out-of-town family wait to fly in until the baby was at least a week old. That didn’t go over well with everyone initially, but they respected our decision and I’m really glad we set that boundary. It gave us this week to bond with our baby, figure out how to best care for her, and establish a routine without having too many cooks in the kitchen, so to speak.

Ok, this post is already really long, so I’m going to wrap it up. I’m planning to write postpartum updates pretty regularly, so stay tuned!

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Belly a few days before delivery and one week postpartum.
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