Dear Lactnetters, here's the birth announcement, after bedrest at 32
weeks, we made it almost 39 and my third son, Lachlan Christopher Hayes, was
born Friday March 3 at 2243 weighing 7lb 4.8oz. I had the most wonderful
incredible labor and birth experience imaginable. My nipples were sore for a
week because of his tiny mouth and some oroboobular disproportion that
needed a lot of work on the wide deep asymmetrical latch, and I feel humbled
as a new mom again, but now we're both on autopilot and nursing is
comfortable and extremely enjoyable. Now I turn to you all for help because
he initially stooled normally but has gotten irregular and gone days at a
time without any poop. I was initially unconcerned to the point that I felt
they would revoke my IBCLC letters :-), but right now my letters are only
"NEW MOM."
Here's the background: 38 6/7 weeks, weekly appt in CNM's office that
morning, I was 6cm, 90%, +1 to +2, bulging bag, plan made to admit me and
break my water, expecting another very fast labor. (labor with 2nd baby was
2 hours- had been 6cm in midwife's office, started a little pitocin, broke
my water, complete 30min later, pushed another 30 min for an 8lb 13oz baby).
this time I had been adamant about no Pitocin or IV fluids, as expressed on
my "birth preferences" [birth plan]. there was no empty room available in
our 36-LDRP unit so my husband and I went grocery shopping down the road,
stocked up on yummy healthy food to eat in labor, and came back to the unit
an hour later. Midwife broke my water at 1300, but I didn't feel any gush or
even trickle. I tried all day to induce labor naturally, wore out the
carpets on the unit, walking with my arms across my chest giving myself
nipple stimulation, went up and down the 6 flights of stairs, used the
breastpump twice and gots lots of colostrum!, husband did his part on the
nipple stimulation too....back to the room every hour or so for a few
minutes of hand held fetal heartbeat monitoring. had a BM. kept eating.
contractions slowed or stopped if I sat down, so I kept walking all
afternoon and evening, kept contracting but never got uncomfortable. 8 1/2
hours later I was still 6cm and had been walking and talking and laughing
through every contraction , and listening to nurses asking me "when are you
going to have that baby?" "aren't you ready for some pit?" "we want to see
him before we go home (change of shift at 1900)" I patiently responded to
everyone, "he'll get here when he's ready.... we're anxious to meet him
too.....I'm having a wonderful time." if this is labor, wow, I'll do this 5
more times! and I'm glad nothing happened til later that night, there is a
certain ambience having a baby at night. My room was darkened to the
equivalent of candlelight, listening to Braveheart and RobRoy soundtracks.
Midwife telling us a story about one birth experience in which she caught
the baby wearing only her bra, all of us-me, hubby, labor nurses (a friend
of mine training labor, and her preceptor), and my coworker Marie Witherell
(RN, IBCLC, ICCE, there with us the the whole afternoon and evening as
friend/doula/photographer)- all laughing so hard and loud another nurse
popped her head in because she thought it was screaming and was worried. we
said, no we're having a birthday party.
finally that night my midwife discussed her concern about higher risk
for postpartum hemorrhage (which I had with my first son, lost 5 liters but
that resulted from an inverted uterus with attached placenta- O.R.,
transfusion, ICU, only happens 1 in 200,000? births but that's why I didn't
do home births for number 2 and 3). She was worried that because my
contractions weren't strong/ frequent/ effective, enough, what would make my
uterus contract after delivery? the usual, breastfeeding, might not since I
had been pumping and doing nipple stimulation all day and that didn't seem
to work. so I went ahead with a "whiff of pit"- with the promise that that
IV would be removed immediately after I delivered the placenta and had a
firm uterus. about 30 min of pit and I was slamming out stroooong
contractions, midwife checked me and I was 9cm, she broke my forebag and I
felt the familiar huge warm gush, and then I needed to push. squatted on the
bed with the bar, pushed for 2 contractions, and hubby guided Lachlan's body
out. still candlelight-dark in the room, just a portable spotlight shining
on my perineum....new age music.... and Marie sitting on the floor under me
squatting, taking photos. she took literally 100s of pictures of the labor,
birth, skin to skin, even the pictures of delivering the placenta are
beautiful. I told her to use any and all of them that she wants for
educational purposes- if anyone wants to see any, let me know.
My midwife and nurses and I had discussed my "birth plan" (which seemed
funny to have, working at a BFH, being a LC, having CNM care, but back when
we thought he I was going to have a 32 weeker, it was important to include
considerations for if he was preterm and went to SCN/NICU: start me pumping
within an hour, no formula, no bottles or nipples, only hand expressed
colostrum by dropper, syringe, spoon etc. or if I had a C/S: skin to skin in
the O.R. on me or Ryan, no warmer, no assessments or interventions until he
nursed, preferably while they were sewing me up). my "birth preferences" for
term, healthy baby, vag delivery, included: decline eye ointment, delay
weight and bath, immediate skin to skin/ not to a warmer, no interventions
or assessments until he nurses, can give shots while nursing, if LGA no heel
pokes for glucose, save placenta for me to look at, no circ in hospital...
so he went immediately skin to skin, self attached at 9min of age,
nursed on and off for an hour and a half, got his shots and head
measurements on me while nursing, he had a void and stool, then got on the
scale at about 2hours of age (7-4.8, much smaller than the last one!). He
stayed skin to skin on me all night (I got up for my first void with
attached and I did the one-handed-pee thing). He slept from 0300-0730 and I
was wired and just walked in the halls, ate, read, took pictures and video
of him... finally Saturday afternoon he and I got in the tub together for a
bath. went home that afternoon with a 3% wt loss and lots of voids and
stools, nursing beautifully.
**okay so here I finally get to the "problem" **He had 5 stools during
first 24 hours of life and they were transitional by the 3rd poop. 4
transitional stools on 2nd day of life, a few more green-to-yellow stools on
day 3. One yellow curdy stool by day 4. Didn't poop at all days 5 and 6,
and I wasn't worried because I knew he was taking milk in- my breasts were
full and heavy by 3rd day, (that's what I get for pumping to induce labor ha
ha), watching, feeling, listening to the suck, I know he's tranferring milk,
listen with a stethoscope and hear it going in his tummy, milk pours out his
mouth if he falls asleep and falls off, my breasts look and feel much
emptier pc, milk drunk look for him, cramping and drowsiness for me,
everything about his jaw and mouth is effective suckling. I had tried some
gentle rectal stimulation with a Q-tip and then rectal temp- no results. My
ped wasn't concerned at his first checkup on his 6th day of life (Thursday),
and had us give him a glycerin supp, which he blew out that night with 2
huge stools that looked like butterscotch pudding or just mustard, but then
went another 2 days (Friday and Saturday) without a poop until I gave
another supp Sat. night and he immediately had a huge poop of the same
color and consistency - still wasn't curdy, with both of my other breastfed
sons and in my work experience, I'm used to mustard&cottage cheese, and
these were just the mustard and no cottage cheese. And now he hasn't pooped
yesterday Sunday or today Monday. His belly has been soft and round, great
bowel sounds, passing gas, absolutely no vomiting or even spitting up. No
jaundice. At least 10 voids every day, heavily saturated wet diapers or he
pees on us. He was 2 oz above his birth wt on 7th day of life (after the 2
big poops). Weight at our Postpartum Care Center appt with IBCLC (the clinic
where I work, so I had about 10 LCs come in and visit or help or oooh and
aaah) on 3rd day of life Monday March 6 was 6-15 and then on exact same
scale in the clinic on Friday March 10 was 7-7, and this was after 2 huge
blowouts so I don't think that 8oz wt gain was just a bunch of stool in his
system weighing him down.
He's feeding well, lots of clusters, sleeps in bed with us and wakes up
at 3-5 hours intervals with hand chewing and cute noises and gets latched on
within a minute of waking me, I wear or carry him all the time, we've taken
2 very nice baths together since he was born (I know the night shift at the
hospital wondered when I was ever going to bathe that baby ha ha), lots of
skin to skin. He doesn't have an obstruction, my ped isn't concerned even
though I told her he hasn't had any formula, he acts healthy, comfortable,
and happy, has never been fussy or cried excessively. I eat the same vegan
diet and am taking the same prenatal vitamin, B-complex supplement, and iron
supplement, that I took through the whole pregnancy and first few days
postpartum when he was stooling normally. No complications at all postpartum
(and removed the IV about 15 min after birth, yeaaah!). Taking stool
softener, ibuprofen and tylenol once or twice a day.
My husband was and still is much more concerned than I was/am, my
initial lack of concern is related to experience that usually lack of output
usually signals lack of intake, but I know he's taking milk in. My ped is
out of town so I'm not calling to talk to someone else in her office and be
told some crap like "give him some formula." The only reason I'm starting to
get concerned is the immediate results from the glycerin supp, twice, as if
he needs rectal stimulation to go. Sorry this is so lengthy, but in addition
to wanting input, ideas, reassurances, and suggestions from my fellow
Lactnetters, I wanted to contribute to the recent discussion about birth
experiences/procedures by sharing my own, and mention how I can empathise
with all those new moms, bumbling and fumbling trying to get latch a baby
when you don't move fast enough and don't have enough hands, etc. As an
experienced mom, working as a LC, hearing from everyone "oh you know exactly
what to do"- well my nipples were excruciately uncomfortable for several
days, I was uncomfortably full for a couple of days, my let-down feels more
like rocks pouring down than pleasant and tingly ha ha. I knew what to do
and had a low intervention birth experience, but my son needed help learning
what to do. It's humbling and reminds me why new moms doubt themselves.
Again, sorry so long, especially if you all (hopefully) tell me, oh,
everything is normal. But is there anything I should be worried about-
malabsorption, anatomically (all his oral anatomy is perfect and my breasts
and nipples are great)...?
Thanks so much,
Vicki Hayes RN IBCLC, mom to Sean 5 1/2, Harrison 2 1/2, and Lachlan! 10
days!, in WA
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