4 months

Ryder at 4 months old:
    -12 lbs, 7.5 oz. (5th % for weight)
    -24 in. (10th % for height)
    -Ginormous head... 53 %


Ryder had his 4 month check-up yesterday.  As you can see from the stats above, he is still a tiny little peanut.  But here is what is important: Dr. Friedman is pleased with his weight gain and happy with his growth and development (both physically and developmentally).  I really do think he'll eventually catch up in the height and weight categories (and hopefully he'll grow into his large head too...). 

Dear Ryder Dylan,

     You are such a joy these days.  Sometime around March 17, 2012 you turned into a little chatterbox.  It may sound weird that I'm citing an exact date, since these types of developmental milestones don't typically happen over night, but with you it did happen overnight.  Grandi arrived for a visit on the evening of Friday, March 16th.  She didn't get to our house until you were already asleep, so she had to wait until the next day to see you.  It was that next day that you started showing off your new favorite pass-time... talking.  You jibber-jabber, squak, and coo ALL.THE.TIME. now.  It's really freaking cute.  You were a pretty quiet dude prior to Grandi's visit, but perhaps you just weren't ready to share your "stories" with anyone until Grandi came for a visit.  She stayed for a glorious week, during which time she took over the night shifts and let your mama get some much-needed sleep, and you yak-yak-yakked the entire time.  Whenever you are in a good mood, you talk to us.  Daddy and I love it.
     I'm ready for you to start laughing/chuckling/giggling.  The baby books say that some babies start laughing at around 3 months, but Dr. Friedman reassured me at your check-up yesterday that some babies don't laugh until they are closer to 6 months old.  Maybe you are just a very serious baby, but I don't think so.  With a dad like Blake, there is no way you didn't inherit a silly side and a love of laughter.  Maybe we just aren't being funny enough, though I don't think that's the case since I've seen Grandi and Auntie Sammie sing and dance for you (if that ain't funny, nothing is!).  All in due time I guess.  For now, I'll just have to be satisfied with your generous display of smiles. 
     You still HATE tummy time.  I don't think you've ever lasted more than 1 minute on your tummy.  When we try to place you on your belly, your face turns red and you immediately begin to fuss.  Within 20 seconds to a minute, your fussing turns into a pissed off cry.  Because I've gone back to work and don't get to spend nearly as much time with you as I'd like, I don't have the heart to force you to do something that makes you so mad.  Thus, I've been a bad mommy and rarely ever instigate "tummy time."  Your head is still a little bit wobbly (tummy time is supposed to improve neck strength), but you get stronger and stronger every day.  Jill ("JuJu") and Cynthia, who watch you on Tuesdays, Wednesdays and Thursdays after school, have been working on "sit-ups" with you.  They lay you on your back and pull you into a sitting position by your arms.  Instead of letting your neck/head droop backwards, you are now getting really good at lifting your head up with your body as they pull you.  Point being, your neck strength is improving despite your lack of tummy time.
     You still aren't anywhere close to rolling over yet, but again, Dr. Friedman reassured me that lots of babies haven't started rolling by 4 months old.  Plus, we know that your milestones are still a bit delayed because of your early arrival into this world.  But hey- you can't use that excuse for forever!  Don't come to us with a "C" on an exam in 7th grade and say "but hey, I was a month early so I'm just a little delayed."  But I know you'll never receive a "C" on any tests anyway... you'll always make straight A's, just like your mama did! 
     You are starting to grab at toys (rather than just staring at them in awe).  I'm excited for you to start holding toys on your own, so that mommy and daddy don't have to continuously dangle them in your face.  Your favorite "toy" right now is your lovey.  You absolutely love to grab it with both hands and rub it on your face.  Actually, come to think of it, loving on your lovey is probably your second favorite activity right now.  There is nothing you love more than watching television.  You are such a t.v. junkie!  You'll sit in your bouncy seat and watch t.v. for quite a while.  We have difficulty drawing your attention away from the screen even when we try.  We often put the baby channel on for you so that you can enjoy shows that are geared toward babies, but you are perfectly content to watch grown-up shows as well.  If we lay you on our laps and try to play with you while a t.v. is on in the room, you'll crane your neck and wiggle around until you have the screen in view.  If the t.v. is off, you are much more aware of your surroundings.  You'll sit in your bouncy seat and follow mommy and daddy around the room with your eyes as we clean and fix dinner.  You are definitely exploring your surroundings these days.
     Oh, and even though you don't roll yet, it doesn't mean you aren't on the move.  On several occasions in the past few weeks, when I've come to your crib in the morning, you've been myseriously turned in the opposite direction from how we layed you the night before.  In other words, you've somehow done a "180" in your crib at night.  Here is photo evidence:

After the first time I found you like this, I had to take out the blanket and burp cloth that you see at the top of the crib.  We originally placed them there to protect the sheets from your spit-up (so we wouldn't have to change your sheets as often), but once I realized you were becoming mobile, I knew it wasn't safe to have anything extra in your bed with you.  Despite your night time acrobatics, you have just started sleeping through the night (as mentioned in a prior post). I know we may still have some rough nights in store, but I'm thankful to have some uninterrupted nights of sleep.
     As a side-note, I hope you don't inherit your daddy's distaste for reading.  If you do, then you'll probably never read this blog, which would be sad since it's intended to serve as your baby book.  But more importantly, I will NOT read your school books for you and then tell you what they're about so that you don't have to read them yourself.  Grandi may have done this for daddy when he was a kid... but mommy does not approve!  Hopefully you'll inherit mommy's love of reading and this entire paragraph will be moot. 
     Lastly, I cannot close this letter without thanking you for finally ditching the whole colic bit.  You made your first three months of life very trying for mommy and daddy.  We loved you just as much then as we do now, but we sure do appreciate your new and improved happy-go-lucky nature.  You still have pretty wild screaming fits when you are overtired and about to pass out, but for the most part, you are now a happy, smiley, talkative baby.  We love you to the moon and back!

Sleeping Through The Night

Today Ryder is one day shy of 4 months old.  Last night he slept through the night for the very first time.  Yipee!  My excitement cannot be overstated. 

I must clarify.  At around 12 weeks old, Ryder started consistently sleeping from about 7:30 p.m. to 3 or 4 a.m.  Technically, I think this was considered "sleeping through the night" (i.e. I think doctors and the baby books would classify it as such).  I get that it was an 8+ hour stretch of sleep, which is awesome, but in my book- it ain't "sleeping through the night" until the baby is waking up at a normal hour.  It's not normal (or even tolerable) to wake up for the day at 4:00 a.m., so I never considered that Ryder was sleeping through the night despite his long stretches. 

[Side note:  When Ryder woke up once per night at 3 or 4 a.m., I would feed him and he'd go back down in his crib until 6 or 7 a.m.]

Last night I fed Ryder at 8:45 p.m. (which is a little on the late side for us).  He thrashed around and fussed a bit until around 9:30 p.m. (but never cried), and then he was finally out like a light.  I didn't hear a peep from him until 6:00 a.m.  When my alarm went off at 5:55 a.m. and I realized that Ryder never woke me up during the night, I jumped out of bed (literally) and grabbed his video monitor.  It was only after I confirmed that his chest was still rising and falling at normal intervals that I allowed the excitement to set in.  My child slept through the night.  Finally. 

I have no delusions about what this means.  Ryder may not sleep through the night again for another week or even a month from now.  But he is capable.  For now, I'll keep my fingers crossed tightly and pray, pray, pray that this is a new trend and not a fluke.

RSV

On Friday, March 9, 2012, Ryder came down with a cough.  He seemed to be deteriorating pretty quickly over the course of that day.  I was concerned enough to take him to the doctor the following morning.  He was diagnosed with RSV, which stands for Respiratory Syncytial Virus.  Almost all kids come down with RSV at least once before they reach the age of two, so it's very common.  In toddlers, older children and adults, RSV typically presents itself as a common cold.  In other words, older kids and adults aren't even aware that they have RSV versus any other type of common cold.  However, RSV can be quite dangerous for younger babies, even fatal in some rare instances.  It's not uncommon for infants who contract RSV to wind up in the hospital.  At the same time, plenty of babies handle RSV just fine and don't require any major medical intervention. 

Because of Ryder's history and his small size, I was immediately nervous.  I had been to the ER with Ryder before, and the experience was beyond traumatizing.  The mere thought of returning there gave me heart palpitations and the sweats. 

Although Ryder was sick for a week and his congestion lingered for a good three weeks.  He fought the RSV like a champ.  His primary symptoms where a cough, deep chest congestion and wheezing.  He ran a low-grade fever for like 24 hours but that was it.  The pediatrician sent us home with a nebulizer and we had to give Ryder breathing treatments every few hours for a week straight. 

Luckily (or unluckily, depending upon how you look at it), Ryder was sick during Playhouse Academy's spring break.  This was lucky because I already had childcare lined up for Ryder since his school was closed.  Had he gotten sick when Playhouse was in session, I would have had to miss an entire week of work or desperately search for last minute child care.  I personally only ended up missing one full day of work (I wanted to stay home to be with Ryder on his sickest day), but my mom, Aunt Lisa and Jill ("JuJu") helped me with the remainder of the week.

Here is a picture of Ryder during a breathing treatment:

I did take Ryder back to the pediatrician to be re-checked on two separate occasions since it seemed like his symptoms were lingering, but apparently RSV symptoms tend to linger and the doctor felt Ryder was on a good road to recovery.

I know this is a boring blog post, but I figured Ryder's first cold was worthy of documentation.

Ryder's birth announcement

I find it too depressing that two out of three of my latest blog entries are doom-and-gloom personal rants, so I decided to hurry and post something sweet, precious and smile-inducing... Ryder's birth announcement:

The Truth About Maternity Leave

Now I know why they call it maternity "leave" rather than maternity "vacation."  I'm sure that many men have misconceptions about maternity leave, imagining that women sit around eating bon-bons and watching tv while their newborn naps for most of the day.  I think that many childless women also have misconceptions.  I know that I did.

Now don't get me wrong... I knew that a newborn was going to be really hard work and a huge adjustment.  But what I didn't now was that I might have a baby that DOES NOT NAP. AT ALL. EVER.  Let me correct that last statement.  I didn't know that I might have a fussy, colicky, chronically unhappy baby that DOES NOT NAP. 

[Side note: I'm writing this post a few days before Ryder's four month birthday, and it is important for me to clarify that he is now a happy, fun baby (that still hardly naps, but that's besides the point)]

Ryder's temperament for the first three months of his life most likely had a lot to do with his prematurity.  Because he was a little early, his little body wasn't quite mature enough for the outside world.  He was (and still is, to some degree) super gassy, which is often the case with colicky babies.

So, anyway- there I was with the most precious gift in the world that I loved more than life itself, and I was miserable during 99% of my 12 week leave.  Ryder wasn't happy unless he was being held.  Even then, he spent a good amount of time fussing in my arms.  And again... I didn't know there was such a thing as a newborn that doesn't sleep during the day.  The books and doctors will tell you that newborns often sleep 18+ hours a day.  So one would assume that even a difficult baby would sleep 12+ hours.  Nope.  Not Ryder.

Ryder's one saving grace was that he would sleep at night (thank god).  He was up every 3 hours to eat at night for a while, but that's pretty standard newborn stuff.  Inbetween his night feedings he would sleep like a good little baby.

During the day, I couldn't have possibly felt more helpless.  Many times I would sit in my bed with Ryder in my arms and pillows shoved beneath my elbow so my arms wouldn't break off for HOURS.  If Ryder fell asleep, I wouldn't want to budge since his naps were few and far between, so I'd sit there like a captive for long periods of time.  I'd get hungry but couldn't move, so I didn't eat.  I'd feel restless and my arm would fall asleep, but I wouldn't dare reposition myself.  Sounds pretty awful, huh?  And when Ryder cried... oh god, my stomach would turn and my anxiety would sky rocket.  He was so difficult to sooth!  And every mom knows how hard it is to listen to their baby cry.  It made my heart melt (and not in a good way).  But there was nothing I could do!  His diaper was clean, he had a full tummy, he had been given gas drops, he was warm and cozy but still he cried. 

I tried the swing, the bouncy seat, and the "Mamaroo."  No go.  Ryder wouldn't have any of it.  He only wanted to be held.  When you have a baby, everyone tells you to sleep when your baby sleeps (i.e. take naps during the day when your baby naps).  So what was I supposed to do? 

I must say that my mom was a huge help during my maternity leave.  She would come over and watch Ryder so that I could take naps.  Those days were heaven.  My mom would also take walks with me and Ryder several times a week.  The walks were great because Ryder slept when being pushed in the stroller.  So I could feel good about my baby getting some rest while also feel good that I was slowly burning away some of my pregnancy weight.

The most hellish part of my maternity leave was the first 9 weeks or so.  It actually got better after that because I finally had an epiphany.  Ryder would sleep peacefully in his moving stroller, so I realized it was best to keep him on the move.  I'd take him on a long walk every day and then I'd try to run some errands and/or go out to lunch.  Mommy and baby were both happier because mommy wasn't having to listen to baby cry and baby was getting some much needed sleep.  I wish I had started to get out more earlier on, but it was kind of counterintuitive in a way.  I felt like I needed to be at home with my colicky baby rather than out in public.  But it would have been better for both of us if I would have taken him out more in the beginning.  Don't get me wrong- I wouldn't have taken him out for the first 3 or 4 weeks no matter what because he was too tiny and vulnerable. 

Ryder's delays also made things hard.  Most babies start smiling at around 6 weeks.  Because of Ryder's prematurity, all of his milestones are expected to be a little behind the "norm" for a while.  Sure enough, Ryder didn't start smiling until around 9 weeks.  Baby smiles are like crack: totally addictive.  When your baby smiles at you, life is good.  But I had to wait longer to see that first smile. 

Let me end this post on a positive note:  At around 12 weeks (right around the time I had to go back to work. Go figure), Ryder started transforming.  He started smiling all the time and became much, MUCH less fussy.  He enjoyed his playmat and even let us put him in his swing and bouncy seat for short intervals of time.  Now, at almost 17 week, Ryder is a joy.  He has normal baby meltdowns of course, but he is so much fun.  He is cooing and playing and growing like crazy. 

I've loved that kid since before he was born.  I loved him every day of my maternity leave hell.  But the truth needs to be told.  Some babies are difficult beyond the normal baby challenges.  I have (had) one of those babies.  I'm sad that I didn't get to enjoy more of my leave.  Even though newborns are universally challenging, lots of mamas have sleepy babies that nap a lot and smile early.  Maternity leave is probably a different experience for them.  For me, it was the hardest 12 weeks of my life.  Yet, I wouldn't trade Ryder for anything.  He is precious and perfect. 

Surely God will grace Blake and I with one of those "easy" babies the next time around.  Right?  RIGHT!?!?!

Oh, and I apologize for bursting any bubbles out there.  I could have made my blog all about puppies and rainbows, but that wouldn't be the truth.  But I do promise that this entire blog isn't going to turn into one big bitch fest.  After my breast feeding blog entry and this one, some of you are probably ready to desert my blog for fear of becoming depressed.  Sorry!

I'll leave you with a picture from when Ryder was 3 months old (right around the time of his transition into the angel that he is today):

Sorry kiddos- "The Little Engine That Could" is a crock of sh!t

I also thought about titling this blog entry "My Breastfeeding Woes," but the title I chose is much catchier.

I'm going to do my best not to belabor my breastfeeding journey by rambling on and on and on in "woe is me" fashion. But the truth is: I'm still bitter, disappointed and depressed that I couldn't breastfeed.  I'm simply not "over it."

I told my doctor and nurses in advance of Ryder's birth that I wanted to do skin-to-skin time immediately upon his entrance into the world.  In other words, I wanted them to place Ryder on my bare chest as soon as possible after he made his exit from the womb.  Immediate skin-on-skin time is supposed to aid in your breastfeeding efforts.  I got my skin-on-skin time and it was lovely.  I had also read (during my fairly exhaustive breastfeeding research) that you should allow your baby to try to nurse within an hour of birth.  No problem- I did this too. 

Once I was moved into my postpartum room, I found out that my overnight nurse used to be a full-time lactation consultant.  Whoopee- extra help!!  While at the hospital, I did all the "right things" to try to help my milk come in and encourage Ryder to nurse.  Those first few days are hard for everyone, so I really didn't think much of it. 

I had Ryder on Monday night and was released from the hospital on Wednesday.  My milk still was not in.  No big deal... it can take 2-5 days for a woman's milk to start flowing and it's typically a slower process when it's your first baby.  Ryder was 5 pounds, 13 ounces at birth and he was 5 pounds, 4 ounces when he left the hospital.  I spent my first couple of days at home, pumping like crazy and trying to let Ryder latch and nurse.  By Friday morning, I was still only getting drops of colostrum (no milk) and I was starting to worry about Ryder.  He wasn't really latching, and he wasn't having very many wet diapers. 

We took him to his scheduled newborn pediatrician visit that same day.  He weighed in at 4 pounds, 13 ounces.  Dr. Friedman (Ryder's pediatrician) thought he looked just a tad dehydrated and voiced initial concerns about his weight loss.  He briefly mentioned that I might need to start supplementing if my milk didn't come in pronto.

Boy can things unravel quickly.  Within a few hours of Ryder's pedi appointment, I started feeling anxious and I knew something wasn't right.  Ryder wasn't latching at all, and he seemed lethargic.  It was after-hours by that point, so I called the on-call nurse line.  They suggested that I immediately begin to supplement with formula.  As much as I wanted to breastfeed, I had NO PROBLEM with the idea of supplementing.  If someone had told me to do it earlier, I would have done it earlier.  But no one seemed to think there was a problem until the problem was staring us right in the face.  We had formula on hand, so I made a bottle for Ryder.  He wouldn't eat.  He did not seem interested in the bottle whatsoever.  His coloring was bad, his lips were chapped and peely and he was very lethargic.  I called the nurse line again, and they suggested that I try pedialyte.  The nurse said that if he wouldn't take the pedialyte, I should take him to the hospital.  At this point, my mom convinced me to call Dr. Friedman's cell phone even though it was after 9:00p.m.  I voiced my concerns to Dr. Friedman and he told us to forget the Pedialyte idea and go right to Cooks Children's Hospital's emergency room.

Thus began a horrific nightmare of a journey that consisted of a week-long stay in the NICU, but I'll save most of those details for a later blog entry dedicated solely to Ryder's NICU experience.  For now, suffice it to say that it was hell on earth.

It was day 5 and there was still no milk.  I stayed in the NICU with Ryder nearly 24/7 and I pumped every 3 hours around the clock.  The nurses brought me a hospital-grade pump, which stayed in the room with me, and they were very supportive of my pumping efforts.  They were also supportive of my breastfeeding efforts.  They allowed me to attempt to breastfeed Ryder every 3 hours before they gave him his formula bottle by mouth and/or feeding tube, depending on the point in his NICU stay.  Understandably, they only let me attempt to breastfeed him for a few minutes at a time because they didn't want Ryder to burn too many calories by struggling with his latch and sucking. 

So this is what my week in the NICU looked like:  (1) try to breastfeed Ryder until he seemed frustrated or began to cry (usually 1-5 minutes); (2) help feed Ryder his bottle; (3) pump for 20+ minute intervals after feeding Ryder. 

Rinse. Repeat.  EVERY 3 HOURS.

Now, if other breastfeeding mamas are reading this, they may be thinking that this doesn't sound like anything out of the ordinary when you are breastfeeding a newborn.  Feeding and pumping every 3 hours isn't out of the ordinary.  However, I was doing this in the NICU with a super sick teeny tiny baby, while sleeping on a crappy pull-out couch and scared for my baby's life.  AND, I still wasn't making any freaking milk!  That's the kicker.  It may suck to breastfeed and pump every 3 hours.  But trust me, it REALLY sucks to "breastfeed" and pump every 3 hours and end up with NOTHING to show for it.

On day 6, I started making milk.  And by milk, I mean drops of milk.  I would pump both boobs for 20 minutes and get 1/4 of an ounce total.  If that quantity doesn't mean anything to you, you can just trust me when I tell you that it's practically nothing.  The Cooks lactation consultant wasn't working over the weekend, so I had to wait for Monday to see her.  By Monday, I was still in the same boat.  I was barely producing any milk despite my efforts.  By that point, I had begun taking copious amounts of Fenugreek, an over-the-counter supplement which is supposed to help increase milk production.

The lactation consultant did her very best to encourage me.  She helped Ryder work on his latch and encouraged me to keep pumping every 3 hours.  She told me all the things that I already knew from my breastfeeding research during pregnancy.

By the end of our week-long stay in the NICU, I was able to make about a half an ounce of milk per pumping session.  Whoopdee-freaking-doo.  Don't get me wrong- I felt good that I could supplement Ryder's formula with my breastmilk so that he was at least getting something.  But what was wrong with my body!?!?!  I was doing everything in my power to make this thing work and it simply wasn't working.  The only advice from the lactation consultants that I couldn't fully heed was to relax and sleep as much as possible.  It's impossible to sleep (or relax) when (a) you have to wake up every 3 hours to pump and (b) your baby is laying in an incubator with wires and tubes protruding from every inch of his body.  But I did the best I could and I followed all of the other breastfeeding/pumping advice that was given to me.

My sweet little boy graduated from the NICU after 7 nights.  It took him that long to start gaining weight.  He was admitted to the NICU at 4 pounds, 8 ounces and left the NICU back over 5 pounds.

Over the course of the next 6 weeks my breastfeeding efforts consisted of the following:

-hiring yet another lactation consultant (making a grand total of 3 lactation consultants) to come to my house and work with me and Ryder
-continuing to take maximum quantities of Fenugreek
-trying breast massage, hot showers, oatmeal, dark beer and "mother's milk tea" (all recommended as things that can sometimes help increase milk production)
-continuing to pump every 3 hours around the clock
-convincing my OB to put me on Reglan, which is a drug that is ordinarily used to treat reflux but has been found to increase milk prodution in some women
-convincing my OB to put me on domperidone (once it was obvious the Reglan wasn't working), which isn't even approved by the FDA for use in the U.S.  So I literally had to convince/beg her to write me a prescription to take to a compounding pharmacy.  She actually said "no" at first, but she ended up researching the drug some more and finally gave into my pathetic begging.
-blood work to test thyroid, testosterone levels and prolactin levels (these were the tests recommended by one of my lactation consultants to look for underlying conditions that could explain the milk supply issues).  Thyroid and testosterone were normal.  Prolactin levels were abnormally high.  WTF.  High prolactin issues + no milk production = just plain weird.
-Lots and lots and lots of crying



By the end of those six weeks, I had maxxed out at a grand total of between 1 and 1.5 ounces per pumping session.  This translated to feeding Ryder one or two breastmilk bottles (out of 8) per day.  Ryder still wasn't wanting to latch (can you blame him when I was barely able to provide him with any milk?). I was exhausted, emotionally drained and completely fed up with my defective body.  My loved ones and even my pediatrician had been gently encouraging me to quit for weeks, and I finally gave in.  I had exhausted all options and the truth was before me: my body would not produce milk. 

Not once during those 6 weeks did I feel engorged.  Not once during those 6 weeks did I ever feel my milk "let down."  Not once during those 6 weeks did I leak.  Nothing had gone as it was supposed to.

I'm still struggling to accept that I'll never know why I couldn't breastfeed Ryder.  There are two possible theories:
       (1) the combined trauma of going into labor early and having a baby that was admitted to the NICU traumatized my body and prevented milk production (it has been shown that high levels of stress can inhibit milk production); or
       (2) for some unknown reason, my body is physically incapable of producing milk

I won't know which theory is right until I have another baby and see whether I make milk for that baby.

Everyone told me that once I quit I'd be able to put it all behind me and enjoy Ryder more.  I certainly LOVED giving up the pumping marathons every 3 hours.  But I'm still waiting for that feeling of peace that everyone assured me I'd feel.  I don't know why it's so difficult for me to move on.  I know that formula is 100% a-okay.  I was a formula-fed baby and I turned out just fine.  I have no problem with feeding my baby formula.  I DO have a problem with inexplicable body failure.  I want to know why it didn't work out. 

It's only been 3 months so perhaps I just need more time.  Time heals all. 

So the moral of this story is that you can repeat "I think I can, I think I can, I think I can" until you are blue in the face.  But sometimes you just freaking can't.  I'm sorry to post such a depressing blog entry... but this has been cathartic.  And I want to remember my struggles in the future.  So even if no one made it past the half-way point of this sad, sad tale, I'm still glad I shared my story on this blog.  The end.