Monday, January 30, 2006

On Demand Nursing and the Pacifier

"On Demand" Nursing and the Pacifier: Which One Am I?

Nuvy is now about a month old and we are, right on schedule, experiencing "periods of fussiness" which I would characterize as the clean, recently fed child screaming her fool head off for God knows what reason. Now there are many professional and lay opinions in the comfort/cry-it-out debate, and I am trying very very hard to avoid what I think is a poor compromise: cry it out until I can't take it anymore, then I'll pick you up.

If you don't have kids, let me tell you. This is way harder than you think. If you do, well, then you know what I'm talking about.

They say that, by now, I should be able to distinguish the wet cry from the hungry cry from the just-a-little-whiny cry. Of course, in the course of a cry-it-out, it always comes down to the hungry cry. She may be young, but she's not stupid. She knows what cry will get me to pick her up, even if the clock tells me she can't possibly be hungry, she wets and soils 15 diapers a day, and her little thighs are so fat and dimply I could just eat them up.

So when should I feed her? The AAP breastfeeding manual answers "as often as she's willing." Ok. Are you kidding? I have never seen this child turn down a lunch ticket. She will nurse until she's literally overflowing--not swallowing the last mouthful, but letting it run down her cheek, still hanging on. The AAP further states that "sucking is comforting to infants, and they may require more sucking time than feeding time unless you are strongly opposed to pacifiers, offer your child one."

Well, guess what?

I'm strongly opposed to pacifiers. They're gross, they get dropped, lost, you eventually have to take them away, and they say "Put a sock in it!" very clearly not only to the child, but to everyone else you meet. Everyone tells me that this is "so first-time-mommy", which may be true, but I maintain. I can hang on until she finds her thumb. I swear I can.

Of course, I have a bag in the closet full of brand-new binkies, sort of like an emergency carton of cigarettes after you quit smoking, you know, just in case I turn out to be spineless. But I digress.

So if I choose to quiet the baby by nursing "whenever she's willing", have I made myself a human pacifier? Am I saying "put a sock in it" just as clearly as if I popped a binky in her mouth, and if so, why fight it? Alternatively, can she really be this hungry? Does she have worms or is she playing me for a chump? Am I really "honoring her feelings" by letting her scream?

Follow the child. Follow the child.

It seems like following the newborn child is a little like following the ghost of christmas future. It doesn't say anything intelligible, just makes funny noises and mysterious gestures.

Saturday, January 28, 2006

The Daddy Factor

The Daddy Factor: Can The Infant Care Gurus Stand Up to Paternal Instinct?

Kent is a natural daddy. He's a big boy. He can stand a little screaming-meemie time, is able to enjoy changing diapers, sings to the baby with abandon, catalogs her every breath in pictures and video, carries her around everywhere in his Baby Bjorn, and can't wait to show her off to all his friends and colleagues. He's the daddy for the new millenium. Sensitive, loving, involved, and working hard to make it a fifty/fifty, two-parent show.

So, can my Montessori Baby experiment survive him?

The Montessori Baby is "respected" above all. The gurus teach us how to demonstrate respect for the baby by how we touch and talk to her--mostly by giving her what is, to many parents' natural instincts, way too much personal space. We, the Montessori Baby club, speak to the baby in a natural, adult tone of voice, tell the baby what we're going to do before we do it (as in "I'm going to pick you up now." or "I'm going to put this fresh diaper under your bottom, can you help me by lifting your legs?"), and say meaningful, true, and respectful things to the baby, as if she could understand our every word--because you never know when she will.

We move slowly around the baby, speak softly, carry her "respectfully" and only sometimes, not constantly. We give the baby "space" in which to move her body independently. We give the baby time and loving support in working through her feelings (i.e. we sometimes let her cry) We watch her and broadcast her accomplishments back to her in a calm, not-too-impressed voice.

In other words, we are no damned fun at all.

Kent often handles Nuvy, our daughter, as you would a cute, scruffy dog. He raises her high in the air, then brings her very close to his face and wiggles her a little, saying in that puppy-talk voice, "Who's just the most perfect f-ing thing?", or "I love you SO MUCH, you f-ing little sh-t!" He bounces her and swings her to quiet her, dances her around the house, and generally has such fun playing with her that I can't bear to tell him that he's outside my experimental protocols.

I have a feeling it would sound like a big load of crap to him. He might be right.

Don't get me wrong. I am a true believer. I have drunk the Montessori Kool-aid. The kids I've seen respond beautifully to the methods, the baby-groups are unquestionably successful. So why can't I insist on his "respectful handling" of our child? I mean, it's impossible to tell if a one-month-old child "enjoys" one style over another, and that may not be relevant anyway. After all, don't we all "enjoy" ice cream over steamed broccoli, or a good movie over two hours at the gym? Does enjoyment make it better? Or am I some kind of sicko for "experimenting" on my own child by trying to raise her according to some wacky theory?

Will I lose my mind as I watch all my hard work in "respecting" my child come undone as she and her Daddy enjoy hours of natural, unschooled, scruffy-dog fun? Will I lighten up and give it a rest? Will she be orphaned after Daddy and I kill each other over disparate parenting strategies?

Stay tuned to find out.

Day Three: The First Big Goof

Day Three: The First Big Goof--Following the Child Into Medical Hell

Never did a brand new mommy come home from the hospital with more confidence in her personal competence, knowledgeable support network, and careful preparation for the delicate work of caring for a new infant. I was unstoppable--ready to take my brand-new baby out on the open road.

And in for a hell of a ride.

Now the Montessori mantra is "Follow the child. Follow the child." So when everyone from the midwife to the pediatrician to the lactation consultant counseled me that newborn infants need to eat every two to three hours, I smiled politely and trusted my Montessori newborn to let me know when she was hungry. This was the first wrong turn on the road to nowhere good.

The first night passed without incident. She woke me up to eat twice, maybe three times but after all, who was counting? Follow the child. Follow the child. How sweet and perfect she was, and how not-very-hungry. So sleepy, and cried almost not at all. What a dream baby!

Next day, Mom and I spent the day dismantling the overdue Christmas tree and watching the perfect baby sleep the day away in her picture-perfect little basket. No mother could be as lucky or as perfectly competent as I. I continued to follow her lead and let her sleep, as she was clearly very sleepy. She slept for seven solid hours. When I did finally find the good sense to wake her up, she was jaundiced to her tender little umbilical stump, unable to stay awake for more than three minutes of nursing, and beginning to squeeze my mommy-insanity button. I called the pediatrician. You know, just to be on the safe side.

The pediatrician recommended we swing by a nighttime clinic or the ER, you know, just to be on the safe side. I was beginning to suspect that it was too soon to start following this particular child.

What I expected from the hospital experience was a few minutes under the bili-lights and a patronizing pat on the head for being a neurotic mom. What I got was three days in the joint with IV fluids and antibiotics through the scalp (the ER nursing staff managed to blow out every vein in both arms, both legs, and one side of her head trying to establish IV access) plus a lumbar puncture for my perfect little pigeon. This is apparently the standard protocol for "lethargy and sepsis ruleout" which is what they call anybody under 2 months of age who comes in with this set of symptoms. Imagine my surprise.

To my chagrin, several of the hospital staff, including one NICU nurse and an attending doc, reported having had just this delightful experience with their own first children. I learned little tricks like applying icy washcloths, blowing in the baby's face, and sundry other unpleasantries designed to keep a sleepy little one awake and sucking. Back on the outside, several more friends offered sympathy and their own little tricks for avoiding the apparently bonehead pitfall I had, in my infinite wisdom, walked right into.

Of course, she's just as perfect now as when she went in, only less yellow and more perforated...

Friday, January 27, 2006

Obligatory Montessori Birth Story

Our Amazing Birth

With apologies to those who have read this already...

Ok. So I went into labor (as in contractions every 2-5 minutes--can't talk during a contraction labor, not "oh, maybe that was a contraction" labor) at 11:30pm DECEMBER 29TH!

You can see where I'm going with this, right?

Well, since I planned to do this cold-turkey, I figured there was no screaming hurry to get medical attention. I waited until 7am, then I called the birthing center and let them know I was in labor, and we decided I'd work on it at home for an hour or so more, and then come in when the office opened, for our already scheduled 41-week prenatal visit (!)

So at about 8:30am, they checked me for dilation (2cm) and watched my contractions on the monitor. Long story short: congratulations, you're in labor. now go on home and get that cervix to 4cm so we can admit you.

We went home. It was about 11am. Slept (sort of) between contractions until about 4:30pm. Went back. It was now 5:15 or so. Cervix check: 2cm. You have got to be kidding me, right?

It was suggested that I go walk around the mall for a couple of hours and get the old cervix open. Surely a couple-three hours on my feet would have us good and born by morning. I labored in the Montgomery Mall for three hours until 8:30. Cervix check: 2.5cm. No dice. Go home and try to get some sleep. Right.

6:00am and we're back. Surely after 10 hours of mooing like a cow every 4 minutes or so, we are almost ready to push, right? Cervix check: a tight 3 cm, and the cervix is now getting thicker (as in swelling from baby mashing her little head on it...) not thinner. We sit on the fetal monitor again for a while--baby is happy as a little clam in there, kicking around, mashing her head on my poor swollen cervix, looking for a way out. I'm pretty tired and dehydrated, so they hook me up to a bottle of lactated ringers and let me labor in the birthing center for a while--even though I'm still too tight to be officially admitted.

At 7am, I exhaust the shift of my first on-call midwife.

Midwife #2, sends me home again at 10:30am to rest (!) and sit in a hot bath until the afternoon, when I can come back and she'll break my bulging water bag for me--the only thing that seems to be progressing out of my body at this point. I am about to lose my mind, but I go. I have now been in labor for 36 hours.

I come back in at about 1:30pm, now December 31st, nearly 4 cm--close enough. Midwife #2 is reaching for the amnio-hook when my water breaks on its own at 2:00. Now we can get this show on the road. The baby will be out in a couple of hours. Contractions are good and strong, baby is doing fine. I am trying to suck back coca cola between contractions to stay out of IV fluidland.

4:30, time for a cervix check--I must be in transition now, because the pain is experiencing me, rather than the other way around, and I feel like I'm going to puke.

4 cm. Incredible.

I am now sobbing that I can't do it anymore, Midwife #2 says do it for another hour and you can get in the Jacuzzi tub for a while to rest. Well, OK, what's another hour anyway?

5:30pm. 4 cm. Very disappointing. I go into the Jacuzzi tub anyway, just for a little pain relief. Midwife #2 reaches in and determines that the baby's angle of engagement (head mashing angle) is unfavorable, and that that is slowing us down. She has me sit in the Jacuzzi tub on my hands and knees like a frog to try to move the baby to a more forward position. I can barely sip my coke anymore, My poor husband is splashing water on my back, wondering what new circle of hell is this, and I am sitting with my face about 3 inches from a big warm tub of water and thinking I could put myself out of my misery with one big underwater breath...

The contractions are getting farther apart, which is not good, but I don't care, because I'm getting a little break--they're around 6 or 7 minutes apart now. Baby is still happy as a lark, thumping around like no sweat. Midwife #2 and husband haul me out of the tub at 6:30pm, and hook me up to another bottle of lactated ringers. Cervix check: 4.5 cm, but a little less swollen. Position is better.

Of course, at this pace, in this age of modern medicine, we are never going to make it to 10 without some intervention. Midwife #2 says I can try for another hour before they send me to the hospital. I tell her to go ahead and get the ball rolling. She says my best shot at a vaginal delivery is to have an epidural and rest a little. I would settle for a sharp blow to the head at this point. Sign me up.

We are at the hospital by 8:30, the epidural is in place by 9:30, and for the first time in 46 hours, I can speak in sentences! Nobody can shut me up. Even while I'm on oxygen and my third bottle of lactated ringers solution (I came in dehydrated, with a fever, and baby starting to depress a little).

I watch my painless contractions go by on the monitor and think "Oh, that was a good one. Glad I didn't have to breathe through that!" For a few hours until about 12:30, when all the happy new year business is done, and my father and father-in-law are through sneaking champagne into the labor and delivery room. On call midwife #3, checks my cervix, 7 centimeters. Not tremendous progress, but a dramatic improvement for me! She anticipates that the baby will be out by around 1:30 or 2:00am, January 1.

At 1:30, I'm still 7.5 centimeters, and still a little swollen, but going down pretty well. Midwife #3 rescinds her prediction about time of birth and tells my parents they'll give me a bag of pitocin for one last try before sending me down for a c-section.

Well The Diva must have heard that, because she took the opportunity to move right on down until about 3:30am, when my epidural wore off. Welcome back to hell! Did you miss us?

I called for the nurse, who checked me out--9.5cm! getting there! She called for more juice for the epidural. Another massive contraction. "Hey, um, I think I have to push!"

Another check. 10 cm! Done! The L and D nurse is running around, yelling "Don't push yet!" She goes to wake up Midwife #3. She comes in bleary-eyed and settles in for the pushing part. She asks if I need them to tell me when to push, or if I can feel it. The L and D nurse explains that my epidural is conveniently out of juice and that I can feel EVERYTHING. I cannot, of course, explain this myself, because, once again, I can only make mooing sounds.

For my part, I am DONE! When the midwife says push, I resolve never to breathe again until this kid is OUT! In fact, it took 4 pushes. She was out at 3:56. Amazing. A whopping 52 hours of labor. No tears, No stitches. Thank God for great and small favors.

Even though we didn't make it all the way, frontier-woman style, I couldn't be more glad I used the midwives at the birthing center. No doctor in his right mind, on new year's eve at that, would have let me go on so long. I would have had a c-section by midnight on the 30th, and not spoiled everyone's party, and STILL would have been able to squeeze some sympathy for my 24 grueling hours of labor!

Naturally, she's worth every minute, and I'd do it all again for the first moment I saw her.

Testdriver Hits the Road!

Testdriver Hits the Road!

Ok. I've read all the manuals, pored over all the catalogs, and now, armed with what feels more and more like a cardboard sword and a newspaper hat I'm strapped in and flying down the freeway of motherhood at what must be, by all accounts, breakneck speed. It's the baby road-test, and I'm afraid there's no closed course.

I'm an administrator in a small Montessori preschool, and as such am supposed to have a certain "expertise" when it comes to young children. In my Montessori Infant and Toddler training, all the old-hand mommies said over and over, "I wish I'd known all this when I was having babies!" Well, I'm heading out with all the information they wished they'd had, and I'm here to see just how far it'll get me.