Wednesday, September 30, 2009

The Milk Blister (a.k.a. The Bleb)

We were in the midst of trying to resolve Phoebe's Sleep Issues, which meant encouraging her to nap as often and for as long as possible, and ensuring we got her to bed at her new early bedtime. We were also on our way to a party. This was a logistical challenge. How best to enjoy the party yet still get our little girl home and to bed. She hadn't slept before we left. On the way there we discussed whether to drive around and let her sleep in the car, somehow get her to sleep there or keep her going and let her catnap on the way home.

For some reason we settled on the latter. This involved pulling over and feeding her before we got there. After she fed from my left breast I thought it felt a bit sore and noticed the tiniest bit of blood on her chin which I thought could have come from my nipple. I didn't think much of it but the next feed at bedtime was also a bit painful. It felt like she was biting down but I could tell she was actually feeding. When she woke up later that night my breast was sore before I even put her on it. I found I had to hold it in position and even then it was almost unbearably painful. The pain was most acute at the top of my nipple but my whole breast hurt. This was much worse than vasospasm or cracked nipples in my experience. It was one of the most painful experiences I have ever had, with the possible exception of ear infection. I could have cried. Eventually I fed her from the other breast and when she seemed satisfied put her back in her cot without offering the left side again. I took some paracetamol and went back to bed, still in a lot of pain.

The next morning I was in so much pain I was almost dreading feeding her. I continued to take painkillers and read as much as I could about thrush, blocked ducts and mastitis. I seemed to have some symptoms from all of them but none of them quite fit. I was particularly concerned about the prospect of thrush and having to change my diet to fix it. I couldn't see any obvious signs and Phoebe didn't seem to have any symptoms either. I didn't know what to wear and felt best wearing nothing. All of the advice was to feed through it. Nice. I expressed a little bit as I could then control the suction myself which was slightly less painful. Amazingly I got quite a lot of milk.

Phoebe didn't seem to be enjoying feeding from that side either and would quite often pull off crying. This could have been because I was slightly engorged and was massaging the breast and trying her in different positions so it's likely the flow of milk was irregular and frustrating for her.

Then, on the fantastic breastfeeding website kellymom I found a reference to a milk blister, also referred to as a "bleb" (what a fantastic word that is). Earlier that day I had noticed a white spot on my nipple. It came and went and I'd wondered if it was thrush. But it definitely looked more like the milk blister on the web site. A milk blister occurs when skin grows over the top of a milk pore, perhaps due to a damaged nipple. Recall I noticed the blood the previous day. This can then lead to a back up of milk in that duct and engorgement. Engorgement can then lead to other problems including mastitis.

I treated my breast according to the advice: firstly use a warm compress before feeding, then gently rub at the blister to try to loosen the skin. After feeding I expressed as much as I could to empty the blocked duct and this relieved much of the pain in my breast. I then soaked the nipple in a saline solution before expressing a small amount of milk onto the nipple, rubbing it in and letting it air dry. Finally I applied some Lansinoh. It is recommended that you follow this rigmarole every time you feed but who has time for that? I did it once or twice and continued with the compress and rub until I was eventually able to remove the skin blocking the pore.

The majority of the pain went as soon as the engorgement was released and I felt completely better as soon as the skin was removed. A few feeds later my nipple stung a little bit but other than that I was completely fine.

I called the Australian Breastfeeding Association during this just to get reassurance that my diagnosis was probably correct and that I probably didn't need to see a medical practitioner. It can be difficult finding someone with the relevant knowledge when it comes to breastfeeding as it seems to be a highly specialised area. The counsellor I spoke to said that milk blisters are quite mysterious and no one really knows what causes them but she'd had one that kept coming back. They seem very common yet I had never heard of it. Three friends I have spoken to about it (probably the only three actually) had all had a milk blister but none of them seemed to experience quite the level of pain that I did. For some reason the blister didn't appear until the milk was already backed up and engorged, which is where most of the pain came from, whereas most other people seemed to find an obvious blister first and managed to burst it before any problems started.

Needless to say, as you may have gathered from my other posts, this didn't help Phoebe's Sleep Issues. And now she's Teething. Jeez... there's always something, isn't there?

Last night's experiment

Babies like to keep you guessing. One day they're doing one thing and the next they do something completely different leaving you scratching your head as to what the changed variable was.

As I mentioned in my last post Phoebe has been waking at 5am. Last week we put a rug up at her window in lieu of some blackout blinds which we'll buy tomorrow and install at the weekend (hopefully). Some nights it worked, most nights it didn't. Hopefully the black out blinds will be more successful but at the very least it helps to darken the room during daytime naps and it'll be much easier than hooking up and unhooking a rug. And I don't think it is doing the rug much good.

Usually after I have fed Phoebe at night I switch off her night light and open her bedroom door for air flow (her window has been shut due to the recent dust storms). Last night I didn't switch the light off and as her window was open I also kept her bedroom door shut. She slept until 6.45am! Woohoo!!

Wonder if it'll work again tonight.

We're also thinking of playing bird noises to her all night so that it isn't quite so apparent when the birds wake up and sing at 5am. I'll let you know how that goes.

And I haven't forgotten about the Milk Blister. I just wanted to tell you this first.

Thursday, September 24, 2009

The thing about sleep is...

... you don't know how much you need until you're not getting it.
"Nobody said it was easy; no one ever said it would be so hard."
The Scientist - Coldplay

In my last post I mentioned Phoebe's Sleep Issues so I suppose I should elaborate. The thing is it's been so long since then and so much has changed that I'm not sure I can remember what I wanted to say. So I'll try to start at the beginning.

A few weeks ago Phoebe seemed to be getting herself into a nice little Gina Ford-esque routine. She'd feed around midnight and again around 5am (I don't think Gina actually allows this but never mind) then wake around 7am and have some breakfast before heading off for a nap around 9. She'd nap for about 45 minutes then wake until around midday and nap for about an hour and a half. She sometimes napped for around 40 minutes in the late afternoon too. This lasted a few days. Not long at all really.

For some reason I found it really stressful when she snapped back out of the routine. All of a sudden she was all over the place. She'd wake up at 5am, nap whenever, if ever, and we'd spend ages trying to settle her at night. I decided she was overtired so one night about 2 weeks ago we moved her to her own room and brought her bedtime forward to 6.30pm. That first night it took us an hour to get her to sleep so she ended up going to bed at her usual bedtime but the previous night had also taken an hour which meant she went to sleep an hour later than usual, so perhaps we were getting somewhere. Gradually over the next couple of days she got into this new rhythm and things seemed to be going quite well until suddenly it all went pear-shaped again a few days after my chat with my boss.

I don't remember the details now as it is all a blur but it seemed very important to us that we get her into a routine and that she sleep well during the day and she didn't seem to be doing that. It's possible she was picking up on my anxiety regarding next year following the Return To Work talk.

Then again, it also seemed to happen around the same time that the milk blister occurred (see next post).

Now I don't know what's going on. I was going mad for a while. One morning, after spending an eternity trying to get her to take a morning nap, I took her for a walk in the pram out of desperation. It was hot, it was not the best time of day to be out walking. I had spent days, if not weeks, at home trying to help Phoebe into her routine, seemingly for nothing. Every morning that I struggled to get her to sleep signalled another day that she wasn't getting enough and another day I'd have to wait to get her Sleep Issues sorted. I phoned Toby and told him I was irrationally angry with him for not putting her into her cot for a nap that morning. (Toby had looked after her whilst I slept.) I cried. I was so fed up with it all.

Since then I've had to chill out and let her fit her naps into my day again, within reason. Perhaps I was feeling under pressure to get her into a routine before she was ready, in preparation for childcare next year. But then I was also convinced that she was ready for a routine. So what threw her out? The milk blister? My anxiety? Her vaccinations? Her cold? Her cough? Teething? All of the above? Toby had the nerve to suggest it might be to do with too much caffeine in my diet. HOW VERY DARE HE!

It's hard when sleep is out because it throws everything else out too and weaning is hard enough without not knowing when you should feed and whether it should be breast or solid. I worry that she can't settle herself, that she doesn't have regular naps, that her naps aren't long enough, that she's not eating enough, that she's having too many breastfeeds, that she's waking in the night for feeds when she shouldn't, that she isn't getting enough sleep.

So I have no idea whether I've covered what I meant to cover but the situation is currently this. She generally goes to bed well although we have to cuddle her almost to sleep. I've been sticking the sling on and walking around her bedroom. It's probably the wrong thing to do but I really just need her to catch up on sleep and get settled again. She often wakes up once in the night at quite random times. She then wakes up around 5am. For a while last week she was waking much later or she'd wake at 5am then feed and sleep again for an hour or two. That led me to wonder if her early waking is temperature related. A couple of times she's woken with a full nappy or because she's coughing but even then she won't go back to sleep. She's up for the day. This generally means she's only had 10 or 11 hours sleep. Today and yesterday she napped well but before that she was having three or four 30-40 minute catnaps, resulting in nowhere near enough sleep for a 7 1/2 month old baby.

It's frustrating because if a baby doesn't get enough sleep, it doesn't sleep well. I feel like we can't do anything else in terms of setting a routine and reducing breastfeeds until she's caught up on her sleep and is sleeping long hours at night and napping well during the day. I don't really feel in a massive hurry to establish a routine or drop feeds, but it can be very difficult for me to plan anything when I don't know when she's going to be sleeping.

Hopefully I'll find some time over the next couple of days to tell you about the milk blister.

Monday, September 21, 2009

To work or not to work: is that really the question?

"We are engaged, when we become mothers, in a new way of being in the world that involves another human being, where once there was merely the long shadow of the letter I."
Anne Manne, Motherhood: How should we care for our children?

Ah! The great Work-Life Balance debate. Once again it has reared its ugly head and I am embroiled in it.

After broaching the subject of my Return To Work with my boss the other day I have found myself at something of a crossroads. I want to Return To Work part time. My boss won't let me. There we were, two women on either side of a desk and of our child-rearing years; one of us being forced to choose between caring for her child and maintaining her career; the other remembering what it was like to be in exactly that position but being forced to put her organisation first. Each could see the situation from the other's perspective and understand her standpoint but that didn't change the fact that neither of us could really give the other what she wanted.

My boss was very understanding of my desire to work part-time. I simply do not want to place Phoebe in childcare 5 days a week. She was the same with her daughter and took 2 1/2 years out of the workforce before her husband took over as full-time carer. Added to the old childcare debate, which I could quite easily bore you with once again, is the sense that I don't have the mental timeshare to devote 37 hours a week to work. At the moment I can't even find the time to clearly think about what my options are for next year and, for that matter, what I might actually want to do. My boss suggested I might want to look for part-time work outside of the organisation or that maybe she could somehow delay my return, depending upon the project she needed me to come back to work on. To their credit, my managers had planned around me working in the area that I enjoy working in; I had been worried that I'd return to the crap that no one else wants to do. Instead it seems that there might actually be quite a good project to come back to work on next year.

The Director's response wasn't entirely unexpected but the alternative to working part-time was unthinkable so I chose to do exactly that: not think about it. Instead I convinced myself that I would be able to work part-time and that it wasn't worth thinking about what I would do if I couldn't. It seems the power of positive thinking isn't actually that powerful after all. Apparently it doesn't change reality, or other people's opinions. Either that or I just wasn't doing it right. Anyhow, I felt okay after our conversation. I knew she'd take that stance at the very least as a matter of principle. A precedent had been set for not allowing part-time work within the department and a few employees had left for that reason in the past. I didn't really think I'd be the exception to this rule. It is a difficult environment to have part-time workers especially as much of the work is support-based. I have worked on a project with a part-timer in a previous job and I found it very frustrating on the days that she wasn't at work. It occurred to me that this is why very few women, especially young experienced women in their thirties, work in IT. Most women are either young graduates, or mature women with their child-bearing years behind them. As my boss said, "it isn't very family friendly". If they want to recruit more women into the industry, as they seem to try to do every few years, they really need to shake this up and sort it out. I shudder when I think of the lost potential of women my age, who are degree-qualified with upwards of a decade's experience who "choose" not to work so that they can look after their children. We struggle to recruit employees with the required level of experience so it seems quite insane to me to force those women to make such a choice when surely we could all benefit from designing our teams and work in such a way that allows them to be employed part-time.

Toby and I went for lunch and talked at length about the various options open to us. I could get work elsewhere, maybe contracting work. I could see it as an opportunity to change careers, perhaps start earning money from my writing. Or, I could go back to work full-time and he could work part-time. After all, my maternity leave is worth a fair amount of money to us if we'd like to have another baby.

The following day, however, I lost myself. I went off to my mum's group and felt really out of it, like I didn't belong there for some reason. My dilemma was filling my head yet I couldn't think about it. I couldn't think straight about anything.

Then Phoebe's sleep issues, which we'd been working on that week, picked up. More on that later. Could she have been picking up on my anxiety? Whatever the reason, it did not help matters to have her skipping sleeps, catnapping, waking up at 5am and taking 40 minutes to an hour to settle at night. It all became way too much for me. We went to a party with my colleagues on Saturday night and had to leave after less than two hours to get Phoebe home to bed. It was so frustrating. I realised I actually missed them. My initial reaction after the chat with my boss had been to leave work. Now I wasn't so sure. How could I just abandon that part of me, the person I was before I was a mother? First and foremost I am a mother but I'm still the IT professional I was before as well. Why can't I be both? Why should I have to choose? Why should I have to spread myself so thin that I can't do either job particularly well?

Don't get me wrong. I'm not kidding myself that I'm the first woman ever to experience this dilemma. Professional and working women have been going through this ever since the feminists achieved so-called equality for us. I have seen countless acquaintances returning to work part-time and just assumed I'd do the same. I don't think I personally know a woman with a very young child who works full time. Why did no one tell me that IT was not conducive to raising a family before I became qualified in it? Would I have even listened if they had in my feminist career-oriented youth? I guess deep-down I knew it but I just thought things would work themselves out. My husband would support me, or I'd stick my children into childcare. Believe me, no one is more surprised than me about my sudden stance on this. Nothing prepared me for how I'd feel about someone else looking after my daughter rather than me. If I'm honest, even the thought of her father replacing me as her full-time carer is a bit disturbing. And let's face it, I will probably still be the person who puts her to bed at night, comforts her when she wakes in the night or when she's sick. But I also hadn't read much about childcare and its effects on babies and really young children. I'm still researching that but so far what I have read does not give me comfort.

So I'm in turmoil. On the one hand I miss the old me, I long for a proper tea break and to go to the loo without an overtired baby following me on hands and knees calling "mamamama". I miss my colleagues, I miss my work. I worry about money. I feel put out at the thought of giving up superannuation, holiday pay and maternity leave. On the other hand I love being a mum and spending my days with my daughter. I worry what state the house will be in if I'm working when I can barely keep it ticking over whilst I'm at home. I listen to Toby and his brother discussing the politics at work, complaining about demanding clients and unrealistic deadlines and I remember the crap that I had to put up with at times and how over my job I was before I was pregnant, how for years I yo-yo'd between being happy and feeling like I was making a contribution to my community and being completely hacked off and under-challenged. Starting something new now might not be the best thing as I really don't have a whole heap of brain space to take away from raising a family.

In short, I have absolutely no idea what I want to do, or what is best for Phoebe and our family. I feel selfish if I think about going back to work in financial or personal and professional terms rather than purely what is best for Phoebe. Then I wonder if I am being naive to assume that me being at home with her, rather than earning money for the family, is for her best. Am I just being lazy? Especially considering I feel like a bit of a useless housewife at the moment. I haven't even found time to plan meals and cook in the evenings. It doesn't help that I'm worried about money and feel like I should plan my meals a week ahead and then buy exactly what I need. Plus there's the whole weaning thing going on and the fact that I feel like I should feed Phoebe organic food. And then there's the milk blister... but that's a story for another post, which I really hope I find the time to write.

There are probably many options for part-time work but not necessarily ones that will pay enough to justify putting Phoebe into childcare for those days. And of course, it seems crazy to me that I have to go to work to pay someone else to look after my baby and clean my house. Why can't someone just pay me to do it? Okay so only one person is employed rather than three, but I'd be much better at it. I wouldn't have to travel and I know better than anyone else how to raise Phoebe and organise the house. And I'd probably cost less. It's at times like these that our market economy seems a bit crazy. There must be another way....

Friday, September 4, 2009

Weaning, daycare and the trip

This post is a bit of a mish-mash because I have so much going on in my head, and in my life, that I just need to get it out before it gets forgotten.

Firstly, weaning.

Phoebe has had a cold this week plus I'm now back into my mum's group and it's really hard not to compare her to the other babies who are all being fed pureed food; she doesn't seem to eat as much as they do. Two of them are now doing proper solid poo and they all polish off their little tubs of food quite neatly without much mess. Baby led weaning is actually quite difficult, not in itself but because it goes against conventional thinking. As such, it's actually quite difficult to get good advice or reassurance. My friend thinks I should try some puree along with finger foods; a child health nurse at a workshop the other day told us our babies should now be filling up on food during the day and not waking at night; the midwife from my health fund seemed to think it was great that I was still breastfeeding and Phoebe was able to feed herself and that I shouldn't worry about her not getting enough nutrients until she's 9 months old. So many different opinions.

She still loves her boobie and often doesn't eat a lot of food at all. I keep reminding myself that it's all about experimentation, fun and familiarisation with food but it's hard when everyone around you has gone down a different track, and of course one of the dominant hormones that you start to produce as soon as you're pregnant is the one that makes you worry. I worry that she isn't eating enough and I question my choice to try BLW. I worry that her poo isn't solid enough. I go from being uber-excited about finding chunks of carrot in her poo to being worried that the carrot isn't being digested and wonder if that's because she can't chew it and should I be spoon-feeding her puree instead. I worry that she is going to want breast milk (from the breast) forever and how that is going to work when I return to work. I worry that she's waking in the night when she shouldn't be. Deep down I know that BLW is the right way for us; I only wish I had more support and knowledge around me. It's no wonder that most mums go for the old Spoon-Puree method when there is so much more encouragement and help for it than BLW. The internet is my only BLW friend.

Later: Scratch that. I think I was just having a moment. We had a really nice lunch together and I fed her a few spoons of mush (steamed carrot and corgette minced together and a bit of my bolognese sauce also minced) then let her feed herself said mush with soldiers (that's toast fingers as if anyone doesn't know that). One of the best things about BLW is the fact that you can eat together. Once she got hold of the toast she chewed and sucked it to pieces and lost all interest in the spoon. I fed her similar mush tonight and she'd already been snacking on snow peas from the garden, which she loved. She would only take a couple of spoons of mush though. She indicated that she was done (she flaps her hands around then bangs them on her tray, splattering any food that might be there) but was then happy to continue munching on another snow pea when that was offered. I then placed the left-over mush in one of those food net things and she sucked the life out of it, and actually tried to bite through the net. I removed the dry mush remains from the bag and offered it to her. She played with it a bit then slapped the tray. She is slowly starting to eat more (getting over her cold I suspect) but still doesn't eat much. No matter; we'll get there.

Now, daycare.

I can't remember what I was going to say about daycare so I'll just make something up. I have seen another daycare facility which I'm reasonably happy with and will enrol Phoebe into (despite the fact there's a $50 enrollment fee). It came with a recommendation from someone who worked there, staff turnover is very low, it seems nice, has a nice vibe, children are away from babies so it's a lot quieter than some of the others, and it's on the way to work. However, I'm still not entirely happy with the idea and need to do a bit more reading on it. I have read that 30 hours or more in childcare can have negative effects on an infant and I really don't believe that babies under the age of 2 or 3 were meant to be in large social groups of other babies for long periods of time. I am also annoyed at the changes I feel I have to make just so I can return to work. Things like getting her to sleep through the night, worrying about how much food she's eating, getting her to drink milk from a cup (which I haven't even tried yet because I don't have enough milk to express because she still wakes up at midnight and 5am to feed because she doesn't eat enough during the day etc. etc.) If left to our own devices I know these issues would resolve themselves naturally over time with no anxiety required. Before I was pregnant 12 months maternity leave seemed really generous. Now it just seems ridiculous.

And finally, the trip.

How to condense five weeks and two mammoth journeys into one blog post. A brief summary would be to say that in general she was fine on both flights but on the way over I remember thinking that I was knackered, it seemed really hard, and I was glad I wasn't on my own yet wished Toby was with me.

I fed her on take-off and she fell asleep because by then it was way past her bedtime. Our flight was at 8.30pm and bedtime is usually around 7.45pm. She then slept for 6 hours in the bassinet until I had to remove her due to turbulence. This was more than she'd slept all week. She was pretty much in the sling on my lap after that and we dozed together a few times (it was surprisingly comfortable) but I really didn't sleep enough. On the second leg she was really grizzly and started crying inconsolably before we even took off. She slept a bit and was happy for a bit but in general she was quite unsettled the whole way.

We arrived in Newcastle around lunchtime and Phoebe settled in with my family really well. She was a bit overwhelmed in the airport but didn't cry. A few hours later she was playing happily with my sister and my niece, Lucy who both immediately doted on her. Lucy was so lovely with Phoebe and I get this feeling that they would be great friends if they lived near one another. Lucy was always hugging and kissing Phoebe and sharing her toys with her. We'll really miss her.

Phoebe hit a few milestones when we were over there. She mastered crawling and pulled herself up to standing for the first time. She has been getting very fast since we got home and now likes to crawl off into other rooms whilst I'm getting her dressed after her bath. She chases the cat around and tonight Zadie, rather amusingly, herded Phoebe back into the bedroom for me. Zadie, thankfully, is very tolerant with Phoebe and seems to know to just walk away when it all gets too much.

Phoebe also got her first tooth whilst we were away, which I found when we were staying with Nic and Ian in the Lake District a week. Since our return she has got a second and now has two bottom front teeth. She also seemed to grow very suddenly at the same time, about a week before she turned 6 months. She now weighs about 8.3kg.

By the end of the trip she was very comfortable with my mam and dad and definitely knew who they were. I think she misses them. They made a photo album for her which allows a message to be recorded for each picture. They filled it with photos of themselves, Clare, Alan and Lucy, and my grandparents. I show it to her every day. When she saw my mam, dad and Lucy on Skype the other day she seemed quite excited and kicked her legs about so I think she recognised them.

Phoebe slept most of the journey back. It was a less amenable time of flight for a young baby, leaving at lunchtime and arriving in the middle of the night. It was a much easier flight for me, partly because she slept so much but also because Toby was with me. She screamed most of the way home from the airport though, which took twice as long due to road works. Then when we got home we couldn't get her to sleep. We finally got to sleep around 4.30/5am. Ug! Needless to say we've all been a bit jet-lagged since.

And to end the post, some exciting news. A few days into my trip my sister announced to my parents and me that she was pregnant. I have kept it to myself for 7 weeks and finally she's had her 12 week scan, it's all looking good and the word is out. It's so exciting and it was lovely to spend her first weeks of pregnancy with her comparing notes. It was very special to be allowed to share that time with her when it was still top secret. It made me extremely sad that I will miss the rest of her pregnancy and the birth of another baby but I am uber excited by the whole thing. I don't know when I will see this little one as ideally we'll have another one in a few years (I feel like Clare and I are on some kind of baby conveyer belt, churning them out relay-style) so I don't think we'll fit another trip in before then. Who knows? Maybe the McCartneys will make it over to see us when the new one is a few months old. I can live in hope.