Better and worse

Things seem to be in a constant state of flux with my little newborn.  I guess that's the way that things will be for the next several years.  It seems like I get one thing straightened out (or nearly straightened out) and something else seems to go wrong.

On the plus side, Gwen is sleeping much better.  When I started the No-Cry Sleep Solution (on Feb 10), Gwen was waking up about 6-8 times each night (once every hour to hour and a half).  Now she is in bed for 12 hours and she only wakes up twice (kind of...).  She has been sleeping through the night since Saturday night (definition 5+ hours of uninterrupted sleep), and for the past two nights she has slept greater than 6 hours straight.

The only problem with her sleep is that over the past few weeks her gas has gotten much worse which sometimes wakes her up (often at 5:00 am).  Ever since she was born, she would cry whenever she would poop.  But that is a normal newborn thing.  Some have trouble coordinating all of the muscles in their bodies.  In order to poop they have to contract certain muscles and relax certain others.  Babies will often contract all of the muscles, however, and then the poop has trouble coming out and the baby will cry.  As she has gotten older, her crying has gotten worse each time she poops.  And starting a few weeks ago she started crying several hours a day whenever she would have gas (she would cry inconsolably for about 10 minutes, I couldn't figure out why none of my soothing techniques were working, and then I would hear the gas start that would usually last for about an hour or so).  I read as much as I could about the topic.  The question I got most often was "Have you been eating anything weird?  Have you tried cutting _______ out of your diet?"  Only about 2% of cases of colic are from food sensitivities, however the mother's diet is often blamed.  Since I knew that it is rarely the mother's diet, I figured I should try all of the other remedies first.  I sometimes spend 10-15 minutes after a feeding trying to get Gwen to burp, I do baby colic massage, I give her simethicone (anti-gas medication) with each feeding, but to no avail.  I finally gave up dairy a few days ago.  While only 2% of cases are from the mother's diet, my child may be one of the small number.  The only other advice I got from the pediatrician was to wait for her gut to mature and eventually she would grow out of it.  Since the only other course of action is to wait and see I thought I would try this one last thing.  Unfortunately, it could take 2 weeks for the dairy proteins to make it out of my body and for her symptoms to improve (at which time any improvement may be due to having a more mature gut rather than anything that I am doing).  She has been doing much better the past couple of days.  But are we just having a good day?  Is her improvement from what I am doing?  Or is she just getting better on her own?

Another problem that could be causing her to cry so much when she poops is that she has had diaper rash for about 1.5 months.  I took her in to the pediatrician twice for this so far, and still can't get rid of it.  At one point, her entire bottom was a red, bumpy rash.  On two other occasions, her bottom has been bleeding it is so irritated.  I tried everything that I found in books and online to try to treat it (not using baby wipes, but instead using cloth wipes with soap and water, running her bottom under running water with each diaper change, using cream - desitin, butt paste, triple paste, 12% zinc oxide, 16%, 40%, Aquaphor + Maalox - with every change, cloth diapers, using a hair dryer to make sure her bottom is extra dry before putting a new diaper on her, letting her go diaper free for hours sometimes).  Nothing worked.  The most effective treatment we've found is a mixture of 40% zinc oxide boudreaux's butt paste with cloth diapers.  But Butt Paste ruins cloth diapers, so I have had to use fleece liners to prevent the cream from depositing itself on the diapers.  At diaper changes I still use soap and water and then blow dry her bottom.  And I leave her diaper free quite often.  With all of these efforts, her diffuse rash has gone away, and the bleeding has stopped, however she still has a painful looking raised up rash where the bleeding used to occur.  Things have gotten better, but we still haven't been able to kick it.

I am very thankful that all of these things are going better.  However, I am really bummed out that I am struggling with one of the things that was most important to me.  I love breastfeeding Gwen, and feel so proud that I have been able to push through the hard times and provide my child the healthiest food possible.  A couple of weeks ago I noticed that my milk supply dropped drastically over the course of a couple of days (after being really good for Gwen's entire life up to that point).  I hadn't been taking care of myself, however.  I had become dehydrated and stressed.  I wasn't even making enough milk to feed Gwen, so I had to dip into the small stockpile that I had built up in my freezer.  I made sure to relax that weekend and drink plenty of fluids.  It took about a week and a couple of more interventions (spending about 3 hours each day pumping after breastfeeding to try to increase the stimulation to make milk, and taking fenugreek).  My supply was amazing this past weekend, and I was pumping like crazy.  I was making so much milk that I nearly became engorged at one point.  And then throughout this week my supply has dropped off drastically yet again.  I don't understand why.  I am well-hydrated.  I am still pumping often (after breastfeeding, since directly breastfeeding is a better stimulator of milk production).  I am still taking fenugreek.  I have still been feeding Gwen about 8-10 times each day.  But I could feel my breasts getting emptier and emptier as the day progressed, and I had almost no milk left for her last feeding (I felt very empty, so I figured that I would have Keith feed her a bottle and I would pump to see if I was really empty, since it is difficult to tell when Gwen eats directly from my breast.  She ate more than I was able to pump).  I am at a loss for what to do now.  I won't take any other supplements because of lack of data about safety and efficacy and I can't take the pharmaceuticals that can increase milk production.  The only thing that I can think of to do is to rest again this weekend.  I am really disappointed that I am struggling so much with something that is so important to me.

Mommy vs. Scientist

Nothing has had the ability to turn me away from thinking like a scientist more than being a mom.  This isn't necessarily a bad thing.  I tend to be way too analytical.  I do copious research into topics before making decisions. (I told the pediatrician at Gwen's 2 month appointment on Monday about all of the reading I've been doing about instilling healthy sleep habits in your children.  After I listed off a couple of books she told me I really need to stop reading.)  I have found that I am now much more willing to cling to anecdotal data.

I took a supplements class last year.  I have had a few people ask me if there are any supplements to increase their breast milk supply.  The answer is that there is no good data.  Part of the reason is that the major supplement that many women use and swear by would put no money into the pockets of pharmaceutical companies, so they do not have a vested interest in running the trials to determine if Fenugreek increases milk production.  But, since there are no positive trials, I would never recommend that a mother take Fenugreek.  I would also recommend women away from Mother's Milk Tea (a blend of Fenugreek, Blessed Thistle, Marshmallow Root, Fennel, etc).  I WOULD recommend Metoclopramide (Reglan).  Reglan is used for GI issues (I used it for delayed gastric emptying during pregnancy), but a common side effect is increased lactation.  It is, in fact, very effective.

Last week my milk supply tanked.  I was stressed and dehydrated, and not even making enough milk to feed Gwen during the day, let alone extra to store up for a rainy day.  Thankfully, I had been stockpiling some milk, so I was able to thaw one bottle a day to feed to her while I increased my fluid intakes and focused on me for a couple of days (I bought a magazine, took a nap, and spent the afternoon with some girlfriends).  Not only did I focus on me, but I scoured the internet to determine what people recommend for a low milk supply.  And what did I find?  Fenugreek.  Not all of my scientific sensibilities went out the window.  I went to Natural Medicines Comprehensive Database to determine the efficacy and safety of fenugreek (both rated as insufficient evidence to rate).  But I also realized that women have been using this spice for thousands of years for this very purpose, and the studies likely will not come since all that matters for many studies to take place is the bottom line.  So I went to Whole Foods, bought a bottle of Fenugreek, and have faithfully been taking it for a few days now.  I don't know which intervention increased my milk supply, but I went from not making enough milk to feed my child to pumping about 9 or 10 extra ounces yesterday.  I still would not recommend that others take it, but I am going to continue my fenugreek regimen myself.

For Gwenie's sleep, I have been focusing mainly on two different books.  Healthy Sleep Habits, Happy Baby, and The No-Cry Sleep Solution.  I appreciate each for different reasons.  Healthy Sleep Habits was written by a doctor who does sleep research for a living.  He has invested years into studying and understanding sleep.  I learned quite a bit from reading his book.  The No-Cry Sleep Solution was written by a breastfeeding, co-sleeping mom who was dissatisfied with the "cry it out" advice that she was receiving from everyone.  She spent, in her own words, "months" researching sleep and developing her system.  She had about 60 women test out her theories on their children (as opposed to several thousand studied for Healthy Sleep Habits).  But I like her theories better.  I don't want to make Gwen cry it out.  So I am willing to try the advice of the non-expert, who uses stories of the 60 women to support her case, before I jump into following the expert advice, supported by statistics.

I have also decided to give up dairy.  My sweet little cherub is lying on my lap as I write this crying in pain.  Many babies have trouble pooping and cry when they do so.  But most grow out of it by this point.  Gwen is over 9 weeks old and not only cries when she poops, but every single time she is gassy.  She is generally a happy baby, but she will suddenly burst into a miserable sob fest, followed within about 5 minutes with lots of gas passing and pooping.  She has had 4 bouts of gas today, each time crying like the world is going to end (and crying like she is in pain), and the gas sometimes wakes her from naps and during the night, resulting me in rocking her for about 20-30 minutes until the gas finally finishes passing.  As soon as she has pooped or passed all of her gas, she falls asleep, exhausted, with salt lines, from the dried tears, down the sides of her face.  I can handle fussy crying.  I can handle "I'm bored" crying.  But I can't handle the crying she does when she is in pain.  I have done quite a bit of reading about food intolerance in breast feeding.  While many women attribute it to problems in their children, it is a very small percentage of babies that actually have reactions to the things that their mommies eat.  But what if my baby is a part of that small percentage?  The odds say she's not, but I can't stand by and do nothing (I have already been trying simethicone, but it does not seem to be helping).  So I have picked the most common culprit, dairy, and am giving it up.  I have heard encouraging stories about it helping in other people's kids, so I am hoping it will help in mine.  I have read that it can take 2-3 weeks to get the dairy completely out of your system and to see results in your child.  I realize in those 2-3 weeks things may resolve themselves on their own, so any results that I might see could possibly be attributed to a maturing of Gwen's GI tract.  But I have to do something, and so I am willing to hold on to the hope that the ideas that I have heard from others will hold true for my daughter too.