Wednesday, April 29, 2015

Ugh! I'm the worst infertility blogger!

So, I realized how horrible I am for not posting anything thoughtful last week about Infertility Awareness Week. I knew it was the week and I even changed my facebook profile picture to this quote.

And instead of posting something great here, I posted some goofy thing I wrote about infant sleep. Blah! I'm the worst!

I WILL say that even though we have two wonderful kids now, infertility is still a part of me. It will always be a part of me. I'm so incredibly grateful for it because without it we wouldn't have the children we do, but it doesn't mean it has left any fewer scars.

Infertility is really awful. Awful. I can't even come up with words to describe how gut-wrenching it is to go through. And the adoption wait is also no fun. Especially when it has been proceeded by infertility and the stress and huge costs that come along with it.

Infertility is exhausting and draining in pretty much every area of life. It's physically, emotionally, mentally, spiritually and relationally draining. It was hard on our marriage, on so many friendships and relationships that I don't think I will ever truly know the depth of the impact it had. It costs us so many gobs of money I'm glad I didn't keep track. It brought me to question so many things about God and my faith and led to many nights of crying myself to sleep.

Infertility sucks.

So, if you are still there in the trenches waiting for your kids to come into your life and are trudging through treatment, or adoption paperwork or the adoption wait I think about and pray for you often. I know what you're going through and it's hard. No matter how strong your faith or how resilient you are, it's a tough road and it breaks my heart that anyone has to go through it.

So if you ever want or need to talk to someone I hope you will reach out to me or someone else close to you. It's truly an impossible road to walk alone. You are not alone and I hope and pray you have people close to you to walk with you in the journey. I would love to be one of those people for you because I know what it's like and my heart breaks with you.

So this post certainly didn't come out in time for the actual week, but here it is now. And believe me when I say there IS hope and peace and joy on the other side of the struggle. I can't tell you how long it will take you to get there, but I can assure you the struggle won't last forever. And I can't wait to hear how your journey ends because it will be a story of redemption and love I'm sure of it.

Friday, April 24, 2015

Working with Waketimes

I know there are all kind of theories and strategies of baby sleep. There are those in the co-sleeping camp and those that put the baby in their own crib in their own room from the first night home. Some people wear their babies from the time they bring them home from the hospital, while like their baby to sleep in a stroller on the go.

For us, I'd like to think we're a mixture. I'm a planner and an organizer, so I will say I would prefer for naptime to happen at specific times and for certain lengths of time and for baby to sleep on my chest when it's convenient for me and in her crib when I prefer that (ha!). But, babies are babies and they will kind of let you know what they do and don't like by screaming at you until you get it. Or at least, that's how it has been for us.

If you've read some previous posts, Sweet P has been more of a challenge than Little Piñata was (he was sleeping through the night consistently at 12 weeks!), but one thing we have stuck with for both kids has been wake times.

Wake times was a concept I originally read about in the "Baby Whisperer," but have read other places like Weissbluth's "Happy Sleep Habits, Happy Child" and "Baby Sense" and in various articles and groups online and we're big believers! The theory behind wake times, is that you discover the "ideal" length of time your baby can stay awake at a time it makes putting them down for a nap MUCH easier. This period of time where it's easier to get baby to sleep is often referred to as "the window." This was definitely true about Little Piñata. For him, if we got him down for a nap in his "window" it was as easy as swaddling him, giving him a pacifier, putting him in his crib and patting him for a few seconds and he was out in less than a minute. So, as you can imagine we're big fans of finding "ideal" wake times. To put wake times into practice, it's also a good idea to have baby on a routine of eating, then some wake/play time, then sleep. The total wake time includes the time that baby is awake and feeding, so if you look at ideal wake time charts, young babies are often ideally not awake for long at all between naps!

With Sweet P it has been harder to figure out her ideal wake times. First of all, she took so long to finish a bottle from the get-go (which in retrospect we now know was likely due to her reflux), that after an hour of feeding her, she would be over-tired already and hard to get down for her nap. We experimented with shortening, and lengthening wake times at different phases, and ultimately realized that even though her first wake time of the day needs to be short, the rest of the wake times are best if extended a bit. It made it extra difficult to figure out a wake-time when she was fussing or screaming so much of the day, and to be honest, most of those first two months are now a total blur! But, around 2 months we settled on a 1-hr wake time after getting up for the morning and one hour and 15 minutes the rest of the day. When we discovered these "ideal" times, putting her down for a nap could mean 5 minutes instead of 20 minutes of soothing, which is a big difference!

Once we found these ideal wake times for her we were so scared to ever experiment at all! But, it's good to remember that wake times are a moving target and might need to be shortened or lengthened based on sickness, level of stimulation, length and quality of the previous night's sleep or nap, and of course, age. As babies grow they can generally stay awake for longer periods of time. Then we dealt with her tongue tie release healing and she would no longer take a pacifier at all (likely because sucking wasn't soothing) and soothing took forever no matter the wake time. After lots of "pacifier practice" and buying every single pacifier Target sells and trying them all out and finally trying to stretch out her wake times to 75 minutes for the first wake time and 1.5 hours for the rest of the day, we were able to just rock her instead of bouncing, shushing and patting and she would fall asleep so much easier! So, it's so important that as babies change, so do their wake times, so never be too committed to a wake time.

In addition to wake times, you want to pay attention to tired signs. For Sweet P, her wake time are pretty precise, but with Little Piñata, once we got close to his ideal wake time we paid really close attention to his tired signs, and as soon as he showed some we rushed him off to his room for his nap. We followed this pretty closely for at least a year, and he was always very good at napping and sleeping well at night.

According to Marc Weissbluth in "Healthy Sleep Habits, Happy Child" (pg. 63) some of the tired cues to look out for are:
- decreased activity
-slower motions
-less vocal
-sucking is weaker or slower
-appears disinterested in surroundings
-eyes are less focused
-eyelids drooping

If you miss that "window" of drowsiness where sleep is easier, you will probably find some signs of your baby being over-tired, such as:
-rubbing eyes

So, the goal is to catch baby's sleepiness before she gets over-tired. If baby gets to that over-tired state it's a good idea to check the clock to see how long your baby has been awake. Then, you will want to shorten the amount of time baby is awake before the next nap since your baby wasn't able to stay up as long as you anticipated he/she could.

According to "Baby Sense" (pg. 48)here are some general guidelines of wake times for little ones. Of course every child is different and some kids drop their naps earlier than you'd like them to, but I like to have a general sense of how long babies at each age can handle staying awake before getting over-tired and have a harder time falling asleep.

0-6 Weeks (45 mins)
6-16 Weeks (45-80 mins)
4-7 months (90-150 mins)
7-12 months (2-3 hours)
1-2 years (3.5-4.5 hours)
2-3 years (4.5-5 hours)
3-5 years (5-7 hours)

Anyway, there's what I've learned about wake-times. I obviously wrote this post for HelloBee, but thought I would share it here too. :)

Monday, April 20, 2015

Getting to the Bottom of Sweet P's Tummy Issues: Part 3

When I left off in Part 2, we discovered that Sweet P had a dairy intolerance and were trying to figure out what to feed her. I think that is the most stressed that I have been since bringing her home. I was very hopeful since we had found an "answer" to all of her discomfort, but since she had been given only donated breastmilk for her first 3 months I was nervous about formula and how she would take it. Our pediatrician gave us 3 options for feeding her. 

1. Find breastmilk from dairy-free donors.

2. Make our own formula using raw goat's milk. (Yes, our pediatrician is 'crunchy' and we love it!)

3. Nutramigen or Alimentum hypo-allergenic formulas

I asked about trying soy formula, but our pediatrician said that at least 1/3 of babies with a dairy intolerance also have a soy intolerance, so she wouldn't recommend it.

Our preference was definitely giving her breastmilk from dairy-free donors, but as you can imagine, it is hard enough to find donated breastmilk at all, let alone from someone on a special diet! We were out of our own supply, so unless we found someone immediately this wasn't a do-able option for the following day. My second choice was actually the goat's milk formula. However, this wouldn't work immediately either because we didn't have all the ingredients, some of which are pretty obscure; and we definitely didn't have raw goat's milk on hand! Most of the ingredients in the formula are not something you can just run to the store to find either. The goat's milk would have to be purchased at a local farm or at the Farmer's Market and I would have to order many of the ingredients online and wait for them to arrive.

So, this left commercial formula. I'm not opposed to formula, I just don't prefer it. To be quite honest, my main concern are the GMO ingredients in formula. I know they are considered safe by the FDA, but as a personal choice for our family we try to avoid GMOs as much as possible. So, if there had been an organic hypoallergenic formula it would have been an easy choice for us. Unfortunately there is not, but there IS a lactose-free organic formula and I had friends who had great success on it, so I thought I would try that first before moving on to try Alimentum or Nutramigen. It was a huge mistake! Sweet P actually took the formula quite well, but by Day 2 on it she became a disaster! Her screaming was awful, her spitting up was out of control and her poops were mucousy (which we actually only rarely had before, even on the breastmilk). So, on the evening of Day 2 I sent Mr. Piñata to the store to pick up some Alimentum since it was our best and only option at that point.

The first several days on Alimentum were rough. She continued to have the mucousy poops, was very, very fussy, kicked her legs in discomfort a whole lot, was incredibly gassy, slept horribly and spit up worse than ever. Mr. Piñata was convinced we should go back to breastmilk since she had never been this bad, but I knew we needed to give it at least a week to see how she would do on it. Plus, I had this horribly guilty feeling and suspicion that it was the lactose-free formula I tried for just two days (that still had dairy proteins in it) that was still wreaking havoc on her system and needed to get out.

So, we hung in there with the Alimentum even though it was still awful. Her spitting up was really bad and at her bedtime and nighttime feeds she was particularly screamy and difficult to feed. The pediatrician decided this was likely due to reflux and decided to add Prevacid, in addition to her Zantac to see if that would help these feeds. I didn't like doing two medicines, but the doctor wanted to wait until we were sure the Prevacid was helping before taking her off the Zantac. In the meantime I was also posting in several breastmilk sharing groups, seeing if I could connect with donors who were dairy-free and seeing some small offers come in. A friend of ours from church who just had a baby offered to go dairy free and start pumping for us! We seriously know some amazing and generous people!

Then, within about 5 days of being on the Alimentum and 3 days on the Prevacid we started to see a happy and contented baby again! It was glorious! She started smiling at us regulary and jabbering to her toys during playtime and started sleeping slightly better. Actually, one night she only had ONE night waking (then it went back to three, but it was still progress)! This confirmed that the formula I had originally tried with her for just 2 days was not good on her system and that she definitely couldn't have dairy. So, we have continued on the Alimentum and Prevacid and are moving in the right direction.

At this point I am so grateful that a formula like Alimentum exists! I'm not wild about the main ingredients, but if it makes our sweet girl comfortable and happy, I'm grateful for it! I would love for her to end up having more breastmilk than formula, so we are slowly building up our supply from generous donors. We even got a donation of 800 oz yesterday, which is about a month's worth of breastmilk and I love seeing our deep freezer fill up with breastmilk. Our pediatrician recommends making changes slowly, so we started with one and now we are doing two bottles of breastmilk a day with the rest of the feedings of Alimenum. But, if she continues to do well with it, we will keep adding in more breastmilk as we have it. The big question is if Sweet P will continue to do well on the breatmilk donations. We know confidently that she is intolerant to dairy, but don't know about other foods, including soy. And of course, there is always the option of trying the goat's milk formula now that we have time to get the ingredients. But, we will hold off on that for at least a month or so since we know she's doing well for now. Ideally she will do well on the breastmilk and donations will continue to come in and that will be her main food and we will supplement with formula. But, it's good to know that the Alimentum is here no matter what, so our sweet girl will definitely not go hungry.

It's amazing how long the first 3 months of her life seemed. It was so hard to have a clearly uncomfortable and upset baby and not know how to help. I know everything we have done along the way has helped her, from the baby chiropractic and natural remedies, to the tongue and lip tie release, the reflux medicine, and finally the switch to being dairy-free, but it was so tumultuous to get there! Before we were able to see how content she was off of dairy, we really thought that she had a temperamental personality (especially based on what our first pediatrician said), but now we are seeing her real personality and it's absolutely precious! She loves to give big smiles and even a few little giggles. She is so calm and loves sitting in our laps and looking around or playing contentedly with her toys. I feel so horrible that she went over 3 months feeling uncomfortable. But, I'm grateful we found answers and are able to enjoy this sweet girl more and more every day. And I'm told she won't remember those first few months so we can one day just tell her that she didn't like dairy and can leave out the details, right?

Thursday, April 2, 2015

Getting to the Bottom of Sweet P's tummy issues: Part 2


So, after I last wrote, we were leaving the ENT office and feeling confused about Sweet P's tongue tie and whether or not we should get the procedure done. We contacted the other specialist in town who is known for doing both tongue and lip tie releases and is the only person in town who adoes it with a laser. The crazy, miraculous thing was that they had a consultation later that afternoon because of a last minute cancellation! We thought that would be great to go in there and have her check out Sweet P and get our third opinion (the lactation recommended the procedure after being the person to discover it). The only reason we didn't go to this specialist in the first place is that she wasn't an in-network provider.
So, we headed in for the consultation that afternoon, unsure of what she would say and feeling pretty anxious. She said that Sweet P definitely had both a tongue and lip tie and that in her experience, every person she has done the release for has shown at least some improvement. She also said it was so quick she could do both then and there. We were also impressed with the difference in the laser technology and the quicker anticipated healing time vs. the release with a scissors. With the laser it instantly cauterizes the wound and there's no wound care (ie: bleeding) to deal with. She also wondered why we were told that bottle feeding would make a difference. She told us that how a baby sucks matters no matter which way they're being fed! We happened to agree, so, we bit the bullet and did the procedure for her despite the giant pit in each of our stomachs. (Who wants to do something they know will hurt their baby, even for the better in the long run? We had the same feeling at the buddy's circumcision at 2 weeks old.)

Thankfully, the procedure went well and Sweet P took a bottle right after the procedure and the next couple of hours she was only somewhat fussy. However, that night? Oh dear. It was non-stop screaming for at least 5 hours, despite the fact that we had given her Tylenol! The first few days of recovery were rough. We kept up with the Tylenol, but she still screamed through a lot of feedings (understandably so), and cried so hard when we did the tongue and lip stretches meant to prevent the ties from growing back. She was so, so fussy during the day and wouldn't even touch a pacifier, which was especially disappointing since we had finally found one she could keep in her mouth just a few days before the procedure. She had to re-learn how to use her tongue and take her bottles, so those early days required a lot of patience on our part during feedings. But, as she re-learned how to feed she was eating a lot more smoothly and not taking in nearly as much air.
Have I mentioned that drool is a side effect of the tongue tie release?
Around the week's mark we decided it was worth it as feedings had finally gotten easier. However, she was still a pretty fussy baby. Sigh. We didn't like how our current doctor had dismissed so many of our concerns, so we took her to Little P's previous pediatrician despite the fact that her office no longer takes insurance (which was why we changed in the first place). We trusted her so much and just wanted her opinion even if it meant paying out of pocket for an office visit. She was so, so sweet and thorough and didn't dismiss any of my concerns like our other pediatrician. She met with us for so long and asked so many questions to help us also "get to the bottom" of Sweet P's upset tummy issues.

At the end of the visit, her suggestion was that Sweet P likely has a dairy allergy, or at least an intolerance to it. Even though Sweet P had been on donated breastmilk since she was 2 weeks old, if the donors had dairy in their diet and she had an intolerance, then it could very likely be hurting her tummy. So, we decided that after the 2 week mark of her tongue tie surgery (to ensure she was no longer fussy from that recovery and that it had healed correctly) we would try out some breastmilk from dairy-free donors. We had enough from my sister and a friend to last for 4 days, so the plan was to try that breastmilk for 4 days and see if her fussiness improved. The biggest fussiness issue we continued to have was that she couldn't be laid down at night from about 7pm-10pm and just had to be held and rocked. We were also dealing with the reflux despite her being on twice daily Zantac, so we wanted to see if the dairy would make a difference.

So, the following week we did four days of the "dairy free" breastmilk. By the third day we had a much happier baby on our hands! She was falling asleep so much easier for naps, would let us lay her down at night for at least 30 minutes to an hour (a great improvement!) and she was so much happier during the day. Her reflux also improved a lot and she was spitting up so much less than before. All of a sudden I felt like I was enjoying this sweet girl in a new way. This was also right at the 3 month mark, so we thought some of this might be attributed to her just 'growing out of colic'. At least, that's what we were hoping because our supply of 'dairy-free' breastmilk was gone.

From here on out we weren't sure what to feed her! This is where we currently are now. We are trying different things, mostly with not-so-good results. However, since we have yet to really find a solution of what to feed her I will have to put off the rest for Part 3. And I'm seriously praying that Part 3 (figuring out what to feed Sweet P long term) will be the last part. Because honestly, if there needs to be a Part 4, I might lose my mind.