Tuesday, September 14, 2010

Breastfeeding Part ?

How can I deny this face??
Just when I thought I was out of the woods and smooth sailing, 2 tiny objects entered my life and made me second guess this whole nursing thing again...
The first few months were very strenuous, but then things plateaued. I enjoyed the feedings, nothing hurt anymore, it was a blissful, enjoyable time with my little one. I was feeding once in the morning, pumping once at work, then feeding 2 or 3 times before bed. The little one supplemented formula at daycare besides my one pumped feeding. Life was good. Then the cutest thing happened, baby e's 2 bottom teeth simultaneously broke through his gums, exposing themselves to the world... and unfortunately, my nipples.
Six months is enough time, right? This goes through my head several times a day right now. 6 months was my goal, and we made it there. But something inside is telling me: don't give up, keep going for a whole year, like all the recommendations say. I am trying to find the strength.
Any words of wisdom or encouragement are more than welcomed :)

Friday, August 6, 2010


I tried several times to come up with a cute or hokey title to this blog. However, due to the sensitivity surrounding this topic, I chose not to. Religion, its a topic we are not supposed to talk about, much like politics and sex... shhh, keep quiet. Though, when it comes to baby blogging we find ourselves talking about many controversial topics (read my 3 previous blog posts on breastfeeding, medicating for GERD, and my traumatic giving birth experience) that are not meant to be shared. But hey, this is what semi-anonymous blogging if for! If you are still with me, please, read on.

I was raised Catholic and went through baptism, Sunday school, communion, and reconciliation... all before I knew I had a choice in the matter. I remember showing up for my first reconciliation with nothing to confess (and I really felt there was nothing). So I made something up about wishing that bad things would happen to my sister because she was mean to me (even though I really hadn't wished that). This may be the exact moment in time where I developed a public speaking disorder, where the smaller the group the more difficult it became for me to confess, er, speak. When I started confirmation classes, I really started paying attention. I had experienced some spiritual moments by then, had my own sense of God, and had A LOT of questions. At my last confirmation class, I was told that during confirmation I would have to stand before god and say that i devoutly believed all that was written in the Bible. I was to say "I believe in the existence of God and that Jesus Christ is my saviour and I believe in the Bible. " As we were rehearsing, I couldn't help but say that I wasn't so sure about all of this (I was what 15 or 16 years old?). Upon confessing this, my confirmation teacher blurted out that 'in that case, you are going to hell'. Are you kidding? I replied that if I was to stand up a make a declaration to God, it should be a lie. I had better be pretty damn confident in what I was saying. My first confirmation to God should not be based on uncertainty thinly veiled an absolute belief. I was then kicked out of confirmation class. I called my dad and told him that the lady told me I was going to hell and he had to come pick me up. This set the precedent for my 3 younger siblings, to whom 'confirmation' was never mentioned. (*my sister who is a year younger also dropped out of class in disbelief).
Today, I am an agnostic who is very fond of Christ and a loose interpreter of the Bible (I see what I want to see). Baby E's daddy is a Christian-Rastafarian-Christian (google Bob Marley Baptism). He was baptized and confirmed.
We do not plan on raising our child a Catholic, or under any organized religion, however, we both want him to be baptized.

What it Means
I consider baptism a blessing for my baby, a recognition that we the parents wish to invest a little Christ love into our baby's life. Technically, the Bible indicates that baptism be a personal choice for an individual, so maybe it is not right to choose that path for your child. But here's the thing, this is the only choice I will make for my child when it comes to religion. I will of course guide him spiritually and give him all the love in the world (and isn't love the greatest food for the soul?). Not to bring the sacrament of baptism down in anyway, but this is not a gateway to religion. To me it is the parents saying, "I want my baby to know Christ".

The Baptism
We are having a poolside casual party at my mom's house. A close friend of ours is a Catholic priest who is comfortable having the small ceremony outside of the church (after seeing Bravo's 9 By Design baptism episode I was determined to have an out-of-church experience). We are serving Christian Chicken, Holy Hamburgers (with onion 'halos'), Solomon's Salmon, Breakin' Bread and Jesus Christ Cookies. We are a theme based family, k?
Along with the traditional baptism rites and passages that will be read, we are including a few readings of our own:

Godmother's Blessing:
My blessings to you for...
Comfort on difficult days
Smiles when sadness intrudes
Rainbows to follow the clouds
Laughter to kiss you lips
Sunsets to warm your heart
Gentle hugs when spirits sag
Friends you can count on
Beauty for your eyes to see
Confidence when you have doubt
Belief if your Divine self
Wisdom to know and accept the truth
And the love of God, which is already yours.

Blessing from Father and Mother
Luke 15:11-24 (Prodigal Son)

Jesus continued: "There was a man who had two sons. The younger one said to his father, 'Father, give me my share of the estate.' So he divided his property between them.
"Not long after that, the younger son got together all he had, set off for a distant country and there squandered his wealth in wild living. After he had spent everything, there was a severe famine in that whole country, and he began to be in need. So he went and hired himself out to a citizen of that country, who sent him to his fields to feed pigs. He longed to fill his stomach with the pods that the pigs were eating, but no one gave him anything.
"When he came to his senses, he said, 'How many of my father's hired men have food to spare, and here I am starving to death! I will set out and go back to my father and say to him: Father, I have sinned against heaven and against you. I am no longer worthy to be called your son; make me like one of your hired men.' So he got up and went to his father.
"But while he was still a long way off, his father saw him and was filled with compassion for him; he ran to his son, threw his arms around him and kissed him.
"The son said to him, 'Father, I have sinned against heaven and against you. I am no longer worthy to be called your son.'
"But the father said to his servants, 'Quick! Bring the best robe and put it on him. Put a ring on his finger and sandals on his feet. Bring the fattened calf and kill it. Let's have a feast and celebrate. For this son of mine was dead and is alive again; he was lost and is found.' So they began to celebrate.

Thanks for Reading!!

Wednesday, May 26, 2010

Breast Feeding Part 1 (Hopefully)

The hardest thing that was the easiest to quit. Hanging in there for the sake of it... My take on breast feeding 3 months in:

The Decision
First it starts with a choice: to breast feed or to bottle feed. For me it was an easy. As a pharmacist and semi-hippie, breast feeding was the smart and obvious way to go. So it was settled. The next question is: how long? I started with my mom, who told me she breast fed us until we could look at her with a mischievous, 'put your boob in my mouth' smirk (at about 3 or 4 months). I laughed, unsure and I still don't know what she meant. Perhaps I haven't seen that look yet and I will soon know this perceived creepiness. The various pediatrician groups recommended breast feeding for one year. Whoa, that just seemed way too long. So I set some guidelines for myself. My goal: to breast feed for 6 months, and to do so exclusively for the first 3 months. Easier said than done.
Starting Out
No one told me the difficulties of breast feeding! It is amazingly difficult. A c-section was my first set back, and I have the memory of a temp nursery staffer plopping the baby on my lap *ouch* not realizing I'd had a c-section and me just crying and crying in pain attempting to get my crying baby to latch on (dammit!). I was delirious with frustration and pain. My nipples were raw and exhaustion had the best of me. Just quit, I thought, Its so easy to just give up, save yourself now! But no, I was determined. I stuck out those first 2 weeks of hell. Yes, breast feeding was hell for me.
Then things either got easier or I got used to the difficulty. The nipple destruction subsided (I seriously thought at one point that my nipples had been permanently chewed off) and 4 hours of sleep was plenty of rest. Then it was time to go back to work...
Pump Pump Pump
I was back at work full time 7 weeks after the baby was born, and at first I was a pumping champion. Every 3 hours I was pumping away, creating delicious feedings for my little man. But then a funny thing happened. I got busy. At work. Go figure. Pumping became more and more of an inconvenience, and I was getting to the point were I couldn't keep up with his demand. It happened during a particularly stressful time at work. There was the Women's Expo, my 2 hour presentation to a women's group that I hadn't prepared for, and a full work week that we happened to be short staffed. I was pulling my hair out. I had a mini panic attack at work. I was NOT O.K. It wasn't until later, when I prepared baby E's first bottle of formula (in tears mind you), that I realized the real source of my stresses. I was giving him formula prior to the completion of my 3 month exculsive breast feeding plan! As he happily devoured the formula, all of my tension melted away. It was ok, he was fine. One bottle of formula didn't hurt him or any other baby who had ever recieved formula! He continued to breast feed just fine after that. Whew. What a relief.
Where I Stand
Breast feeding is probably one of the biggest stigmas when it comes to having a baby. If you say you won't, you will likely meet opposition. If you choose to do it, you might not make it. Most days I still think about quitting. So for me, it really is a daily struggle. I hope to make it to 6 months, and at that point I will probably dabble in breast feeding, but I want to get away from pumping all the time. I am still looking forward to it getting easier, and I think the key (after some reflection) is letting go and not putting so much pressure on yourself. Go ahead and give the little one some formula if you need to! Don't stress about it. Here's to me taking a bit of my own advice.

Saturday, April 24, 2010

PPIs (Prevacid, Prilosec) in Pediatrics

As a pharmacist at a compounding pharmacy, I see proton pump inhibitors (PPIs), most commonly Prevacid and Prilosec, prescribed to pediatric patients as young as 7 days old. Based on current evidence, I urge parents to be vigilant not to give these drugs to their babies! I have listed several reasons, including long term side effects below.

1. Current guidelines state that safety and efficacy (how well a medication works) have not been established in infants.

2. The following serious side effects in children after long term use 2 to 11 years have been reported:
-Increasing evidence suggests that acid suppression is associated with increased rates of pneumonia and gastrenteritis in children, and candidemia and necrotizing enterocolitis in preterm infants.
-PPI's have been shown to alter the gastric and intestinal flora.
-Animal studies suggest that acid suppression may predispose to the development of food allergies.
-Decrease in absorption of iron and B12
-Other side effects of PPIs include headache, diahhrea, constipation, nausea, hyperplasia and acute renal failure.

-Lansoprazole: No more effective than placebo in patients 1 month to less than 1 year of age with symptomatic GERD in a multi-center, double-blind, placebo controlled study (Micromedex)
-Omeprazole: Used for the treatment of erosive esophagitis and GERD, or the maintenance of healing of erosive esophagitis has not been found safe or effective in pediatric patients less than 1 year of age. The safety and efficacy for other pediatric uses have not been established (Prod Info PRILOSEC(R) oral delayed-release capsules, suspension, 2008)

4. A study on PPIs in Pediatrics:
-Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children. Canani RB, Cirillo P, Roggero P, Romano C, Malamisura B, Terrin G, Passariello A, Manguso F, Morelli L, Guarino A; Working Group on Intestinal Infections of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition
-OBJECTIVE: A prolonged gastric acid (GA) inhibitor-induced hypochlorhydria has been suggested as a risk factor for severe gastrointestinal infections. Recently, an increased risk of community-acquired pneumonia associated with GA inhibitor treatment has been reported in a large cohort of adult patients. These findings are particularly relevant to pediatricians today because so many children receive some sort of GA-blocking agent to treat GERD.
It is a multicenter, prospective study. The study was performed by expert pediatric gastroenterologists from 4 pediatric gastroenterology centers
-Inclusion criteria: Children (aged 4-36 months) consecutively referred for common GERD-related symptoms (for example, regurgitation and vomiting, feeding problems, effortless vomiting, choking)
-RESULTS: Total 186 subjects: 95 healthy controls and 91 GA-inhibitor users (47 on ranitidine and 44 on omeprazole). The 2 groups were comparable for age, gender, weight, length, and incidence of acute gastroenteritis and pneumonia in the 4 months before enrollment. Rate of subjects presenting with acute gastroenteritis and community-acquired pneumonia was significantly increased in patients treated with GA inhibitors compared with healthy controls during the 4-month follow-up period. No differences were observed between H2 blocker and PPI users in acute gastroenteritis and pneumonia incidence in the previous 4 months and during the follow-up period. On the contrary, in healthy controls, the incidence of acute gastroenteritis and pneumonia remained stable.

5. Current adult guidelines suggest these medications be used on a short term basis only. If you do decide to put your child on a PPI, please consider doing it short term only (less than 28 days).

If your child is being put on a PPI because he is not putting on weight/having violent spit ups, etc., consider that PPIs may cause malabsorbtion of nutrients by creating an alkaline environment in the stomach and small intestine.

Coming soon... Alternates to PPIs and natural assistance with GERD.

Note: This is not to be used as medical advice, please see you healthcare professional when treating your child for any condition.

Friday, April 16, 2010

Birth Experience

Being pregnant for the first time is all about firsts, most notably so, your first labor experience. Girlfriends with children told me, its only max one full day of your life, compared to how long you've been pregnant, its really nothing. This helped me in only one way, I had no anxiety about going into labor. I did not write a specific birth plan, but I knew how I wanted it to go. Preferably no pain meds, including epidural, no induction. Just keep it as natural as possible. For my last 4 weekly visits to the OB, baby was "locked and loaded" as I liked to say. The 2 visits before my due date, they asked if I would like my membranes stripped, which after some research, I declined. I didn't want to speed up the onset of my labor (it being my first I was anxious about having a real live baby to care for).

The night of due date, early labor started and I was able to go to bed. Starting at 1am the contractions were strong enough to keep me up. I woke my boyfriend up at about 3, and by 5am, we were on the way to the hospital. My contractions were about 4-5 minutes apart.
At 7am I was 5-6cm dilated and 100% effaced. It seemed things were moving along quickly. The rest of the day went something like this:
-10am still 5-6cm, they want to break my water. I decide to wait.
-12pm still 5-6cm, I agree to let them break my water.
-2pm 8cm, contractions are very strong, and I am involuntarily baring down.
-4pm still 8cm, my baring down has caused my cervix to swell. I am told I need an epidural in order for the labor to proceed due to the swelling/baring down situation. I reluctantly agree.
-4:30pm I wonder why I didn't have an epidural the whole time! I was feeling great.
-5pm 10cm!! We can start the pushing process. The epidural has made it so I don't have the urge to bare down. I push based on sensing my contractions.
-6pm my contractions have slowed down, they load me with pitocin to increase the frequency and strength of my contractions.
-7:30pm still pushing, they make an attempt with a vacuum pump, which becomes unsuctioned as the doctor pulls with all her might and blood splatters on everyone, including my terrified boyfriend.
-7:40pm they try to vacuum baby out again. Not ok at this point, as it is another massive fail.
-7:50pm doctor tells me I need to have a c-section as I am not delivering vaginally.
-8:10pm baby boy is born via c-section.

As it turns out, the babies head was turned just slightly to the side and during my delivery I was pushing out not the crown, by the side of his head (which looked awfully mutilated after all the pushing and vacuuming). In that position it would have been impossible to vaginally deliver him.

So basically, everything I didn't want to happen, happened. I could not believe that after 17 hours of labor and 2.5 hours pushing I end up having major abdominal surgery to deliver my baby. I felt defeated. The whole experience was so far from ideal that I am officially traumatized (even up until writing this I forgot about the several times I vomited during labor!)

Friends told me, don't dwell on it, look what you have a healthy baby boy, etc. Ok fine, I will admit its hard to be mad when you have a little bundle of joy. But as I am still recovering, nearly 6 weeks after the fact, rehashing the memories of labor can still bring tears to my eyes.

Looking back, I would have never let them break my water. That was the first mistake by which I think the rest became inevitable. Perhaps my body knew the baby was slightly turned and not ready to come out. Its anyone's guess, but I was very disappointed with the whole process, and will have a forever anxiety about childbirth from now on. How was your experience? Is this typical of first babies, or can this happen with any childbirth? Just wanted to share my experience, and find out yours.