Thursday, May 31, 2007

Why "Superpower"

I make milk. What’s your superpower?

This should rightfully be the battle-cry & mantra of all nursing moms in the world. Mothers’ Milk is the gold standard against which no other source of milk can come even as a close second. Do not get me wrong: formula is not bad (I myself was a formula-fed baby). It is just not the best food.

So many books and websites have a list of the one million and one reasons why mothers’ milk is the top choice. Below are my personal favorites – the ones that inspire me to keep on being the Goddess with a Pump…

  • Free and saves us a lot of money. The cost of my pump is roughly close to that of 1.5-2 months worth of formula. I’ve been providing milk for three months so for the past month, we’ve been feeding Teo “at no cost.”
  • Makes Teo smell fresh and clean. Mothers Milk does not emit any odor that secretes thru baby’s skin.
  • Keeps Teo’s poo from being stinky and, thus, bearable. It also promotes regular bowel movement so I know that he is getting just what he needs.
  • Has protected Teo from getting sick. Despite the cold weather that welcomed him after coming out of the womb, Teo did not get sick while we were in the States. He also stood pretty well against the heat and humidity of Manila – he had a ONE day bout with upper respiratory infection. That’s it. Unfortunately, he passed the virus on to mommy who had to battle it out for more than two weeks!!!
  • My milk will adjust to Teo’s age. By God’s brilliant design, my milk will alter itself to the age of my baby and will provide him exactly what his tummy, immune system and brain
  • Obesity is something Teo will unlikely experience.
  • It has helped me shed pound after pound. Just have to deal with the tummy bulge! Ha!

Day after day I learn about the other powerful things that my milk can do that I may possibly move my EP-ing goal further. That is, with God’s Grace.

Sunday, May 20, 2007

Becoming the Goddess with a PUMP

While pregnant with Teo, I learned that all new moms would have milk and that it is a fallacy that some women do not produce enough or at all. Armed with this knowledge, I was determined to breastfeed Teo exclusively for at least six months.

However, along with every single item in my birth plan, our breastfeeding relationship did not progress as I expected. Yes, breastfeeding (BF) is a learned skill for both mommy and baby -- given the right start, a good support system and lots of information. I had the last two but not the first. L My little angel was born stressed and so the hospital staff felt that he had to gain strength: Teo was given formula in bottles at the nursery even when I said I wanted to exclusively BF. I did not have control of situation because I was sedated that first night leaving the feeding and changing to my fearless husband (in itself a story I would be proud to tell)! I tried to get him to latch on before I completely fell asleep, about six hours after birth, but he did not.

Two days after delivery, upon the encouragement of relatives, I rented a hospital-grade Ameda Elite breast pump from a local hospital and started pumping 10 times a day to get my supply going – and that is on top of attempting to nurse him.

Even after two visits to a lactation consultant, a rigid pumping schedule and the full support of Ale and my folks, BF still took a toll on Teo and I. I became an unhappy mommy who felt like all I did all day was nurse. Teo must have felt the same, too, because he did not seem to be satisfied or he would fall asleep without draining me well. It also came to a point where I was in so much pain already that I cried each time Teo would latch on. Stressing about all this definitely caused my supply to be on the low-end.

Ale then suggested that I just pump milk and give it to Teo in a bottle. That’s when I discovered Exclusive Pumping (EP) and learned that there were lots of moms in a similar situation as I! I found an online support group and lots of information off the internet.

EPing meant…

Investing in my own high-grade electric pump
Hooking up to a pump every 3 hours for 15-20 minutes almost round the clock
Taking every single galactagogue possible (fenugreek tablets, old-fashioned oatmeal, mothers’ milk tea and, now, malunggay capsules)
Twice or thrice the work: pump, feed, wash parts and bottles
Seeing only 1-2 ounces every session for the first few weeks from BOTH boobs (when Teo would take 3 ounces)
Supplementing with a little formula for a week or two just to get ahead of Teo’s needs
Experiencing a plethora of emotions: boredom, tiredness, fulfillment, etc.

Teo is now three months old. He smiles, giggles and is very active (thus, the slender physique on his almost suprisingly long 25-inch long, 11-pound frame). Every time I feel that I want to throw my pump into the trash or simply skip a session, a peek at my little boy, the sound of his incessant cooing is more than enough to get me going!

Thursday, February 22, 2007

Signed, Sealed and Delivered


16 February 2007
Ale and I were going through the motions of a typical, busy Friday which, for the past two weeks, meant back-to-back visits to Sweet Success at St. Mary’s Medical Center in Long Beach for my gestational diabetes treatment and then to Los Alamitos Medical Center to see my O.B. However, this time around, we were sent home from Long Beach and asked to get ready to go to the hospital.

My Sweet Success program required me to go through a frequent Non Stress Test and Ultrasound. That day, the sonologist found that my amniotic fluid level was very low but the baby was doing very well despite it. The staff then called my OB and my doctor said, “Jen, you don’t need to see me today. I want you to go home, prepare your things and check yourself in the hospital at about 12:30 a.m., Saturday. We have to induce you.”

Ale and I did just that. We went home, finished packing my bags and waited. Some of my titas and titos came over and waited with us. Thus, we had a loving entourage upon checking in at Los Alamitos Medical Center to cheer us on.

17 February 2007
Birthing Suite 214 was already waiting for me. The minute I changed into the hospital gown then was strapped into the fetal monitor and got hooked into an I.V. machine, I knew that God definitely had plans other than what was written on our birth plan! Ü Instead of the active labor I was anticipating and physically prepared for, I was about to be confined to a bed and not allowed to walk around. Here’s why…

At 1 a.m. I was given medicine to help my cervix efface and thin out. It took 4 tablets every four hours for this to happen. The frequent internal examination was quite painful but, other than that, it was a night of uninterrupted sleep for Ale and myself.

My doctor expected that the procedure would help start my contractions without the need to inject me with the labor-contractions-inducing drug Pitocin. I did have some contractions but it wasn’t enough to dilate me.

At 1 p.m. I was given the initial dosage of Pitocin via I.V. and that was when my labor officially began. I started to feel light contractions which progressed to stronger but still tolerable ones (my threshold for pain is quite high). I was at 1-2 cm. for what seemed like forever (you need to be 10 cm to be able to deliver)!

By 10 p.m. there was still no progress but the contractions already reached a point where I needed some form of relief. My Lamaze breathing and Ale’s coaching and massage helped but going through just that meant no sleep. So, after my parents left for the night, Ale and I asked for a pain reliever and I was given one through my I.V. The medicine left me groggy and hallucinating but it allowed Ale and I to sleep for at least two hours.

18 February 2007
I woke up to sharp, frequent pains at 2 a.m. I woke up Ale and we went through the Lamaze breathing, imagery and massage but it was no longer working. I was blessed to have a team of Filipino nurses that night so they gave me a second, stronger round of pain medicine but it was no longer as effective as the first. I would have short dreams and each ended with excruciating pain.

When the nurse came in to examine me, I had finally moved to 3-4 cm and all of my water had finally rushed out which meant I could already ask for an epidural. I held on for another hour but within that time I was already suffering and I could see it in Ale’s eyes that he it pained him to see me in that state. We requested for an epidural but I was in so much pain that I felt that it took so long for the anesthesiologist to arrive. When he finally did (and he asked Ale to step aside because the last husband he allowed to watch him just fainted), the contractions were so strong that I no longer felt any of the pain that should have come with having a loooong needle inserted on one’s spine. A catheter was attached to my bladder since I could no longer stand. In less than five minutes, I was in numb heaven!

I woke up at around 7 a.m. to the news that I was already 6-8 cm dilated and that I would deliver before lunch. My mom and dad arrived to see me sleeping soundly with an oxygen mask attached to me (to make sure that the baby got the best oxygen possible).

By 10 a.m. I told the nurse, Katherine, that I was feeling pressure every time that monitor signaled a strong contraction. She checked and found that I was already almost there and she prepped me for pushing.

I was very groggy and my arms ached from lying down too much that I didn’t feel I had enough energy for the work that I was about to do. When Dr. Dikio arrived at 10:30 a.m., my mom was on one side, Katherine & Ale on the other side of the bed holding on to me to help me push. And push I did! The baby was facing up, the wrong position, which made it very difficult for me and which required a pretty big episiotomy and the use of a vacuum. With whatever energy I had left, I breathed my little angel out into the world.

Due to the stress of pushing and pulling out of my womb, Teo came out grayish and limp. He did not cry right away and the vacuum left a circular wound on the crown of his lovely head. So, after he was put on my chest and Ale cut his cord, he was examined and taken to the nursery to recover.

I was left in the room with my mom and Ale shivering and shaking from exhaustion and lack of food and water for 11 hours. But God is good because I was able to eat and drink and sleep right away although I was beset with a slight fever. In the afternoon, Teo and I were both better so they roomed us together in a post-partum room and were discharged the next day.

Ale and I are adjusting quite well to the schedule of having a little man with us. We take turns walking up in the middle of the night to feed and change him.

I had planned to fully breastfeed and we are on the way there! The hospital staff was not supposed to give him a bottle but it was medically imperative that to give Teo formula for him to gain his strength so we are just finishing his supply from the hospital (Similac ready-to-drink) and will switch to breast milk completely after that. Praise God that I have already my initial milk supply (Colostrum) to feed the always-hungry tummy of Teo! We rented a hospital-grade breast-pump to help me out with ‘production’.

For the ladies, well, the pain is indescribable and all throughout I kept this in my mind and heart: When God brings me to it, He’ll bring me through it. After that, I think I can physically handle anything – and I know that includes gaining my pre-preggy body back slowly but surely (I still look 4 months pregnant).

Thank you for praying with us during our entire pregnancy and especially when I was in labor! We cannot wait to bring Teo home so he can personally thank you! Ü

Friday, February 9, 2007

sweet success

I am now undergoing "Sweet Success" which is a special program for gestational diabetics.

Ale and I attended a 3-hour class last Monday to get more knowledge of my condition, the diet and blood sugar checking. They gave me a kit with a menu, a blood sugar tracker, etc. I am due to see the dietitian today so she can give me a customized meal plan because the one I am currently following is just a general guide. I eat a variety of food in different combinations and have had to forego of some of my favorite food: apple pie, cold cereals (bye-bye Cheerios) and catsup. :( Boohoo.

So what is the day like for a gestational diabetic?

1. Test urine first thing in the morning with a Ketone stick
2. Check blood sugar
3. Eat breakfast
4. Walk for 20 minutes
5. Check blood sugar
6. Snack
7. Lunch
8. Walk for 20 minutes
9. Check blood sugar
10. Snack
11. Dinner
12. Walk for 20 minutes
13. Check for blood sugar
14. Snack
15. Fast for 8-10 hours

Hectic or what?! But so far, so good. I am getting adjusted to this thing. And, yes, I prick & draw blood by myself 4 TIMES A DAY!!! Waaaaaaaaahhhhh!

We are off to the OB for my ultrasound today to check on Teo and how far he is. :) Then tonight we have our last Lamaze class. :) So many funny stories from that, too!

Monday, February 5, 2007

Another baby shower


My aunties and uncles (my dad and my mom's brothers and sisters) hosted a second baby shower for us here last Saturday, February 3rd.

We celebrated amidst great weather (warm 80s F), feasted on a merienda-cena of Pinoy food, played a gazillion games and, of course, we opened a lot of gifts (a lot of which we registered for on Babies R Us and Target). With these gifts, Teo's nursery is almost complete! :)

It was a blast! Photos are posted in my kodakgallery account http://www.kodakgallery.com/I.jsp?c=3ktlf40v.9uq4ya4b&x=0&y=-gfqxoc. :)

Friday, February 2, 2007

coping...

...with Gestational Diabetes (GD), that is.

I just came from my OB today and got the news that I have it. Thank God that I already prepared myself for the news and I thank him that Ale and my mom were with me when the news was relayed. When I failed the first test, I was really disappointed because I watched what I ate this whole time. I mean, I wasn't always good but I knew I was more conscious than other pregnant women -- I barely ate white carbs, I almost completely cut off fruits, pastries, cookies, I didn't drink soda or juice. However, after taking the 3-hour test last Monday, something my beloved dad said struck me. He said "Anak, finding out whether you may or may not have this condition truly made travelling all the way to the U.S. worth it. Kung para dun lang tama lang na pumunuta tayo dito." :) We would not have been able to figure this out if I was in Manila but God sent me here and rang a bell on my doctor's head to have me tested. :p

My condition may have been triggered by the little sweets that I still ate but the doctor said it's a combination of a lot of things. There's heredity and there is the reality that my pancreas do not produce enough insulin due to the many bodily changes that come with pregnancy.

The "bad" news is that I am now on a strict diet (as in ala South Beach!) and am required to test my blood several times a day via a Glucometer. I have to control what I eat to make sure that Teo doesn't get too big.

The good side of this, at least if you ask me, is that my weight gain will stop! YEHEY! The baby is already big enough that the controlled food that I will take in the next few weeks will be enough to sustain his growth. :) We found out today that even with GD, Teo's size is normal!!!

The GD should be gone 6 weeks post-partum. :) After that, however, I will still need to control my sugar intake just to make sure it doesn't develop into the real diabetes.

Wednesday, January 31, 2007

drafting our birth plan


Birth Plan for Maleen Mayuga-Cruz

ESTIMATED Due Date: 26 February 2007
Patient of Dr. Nicholas Dikio
Scheduled to deliver at Los Alamitos Medical Center
Drafted on 27 January 2007

--------------------------------------------
Dear ________________

Following is a statement of our birth plan and childbirth choices. We have educated ourselves prior to making these decisions and hope to carry them out, but we realize that complications do arise and in such instances trust our caretakers to make necessary decisions on our behalf.
Thank you for taking the time to read this and helping us realize our birth plan.

Sincerely,
Alejandro & Maleen Cruz

---------------------------------------------------
Labor

I prefer to go through the first stage of labor at home.
I would like to be free to walk around during labor.
I would like to use a birthing ball if possible.

I wish to be able to move around and change position at will throughout labor.
I would like to be able to have fluids by mouth throughout the first stage of labor.
I will be bringing my own music to play during labor.
I would like the environment to be kept as quiet as possible.
I would like the lights in the room to be kept low during my labor.
I would prefer to keep the number of vaginal exams to a minimum.
I do not want an IV unless I become dehydrated.
I would like to wear contact lenses or glasses at all times when conscious.

Monitoring
I wish to have continuous, external fetal monitoring that would keep me mobile.
I do not want an internal monitor unless my baby has shown some sign of distress.

Labor Augmentation/Induction
I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.

Anesthesia/Pain Medication
I realize that many pain medications exist I'll ask for them if I need them.
I would like to have a standard epidural offered to & be made available to me.

Caesarean
Unless absolutely necessary, I would like to avoid a Cesarean.
If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.
I wish to have an epidural for anesthesia.
If my baby is not in distress, my baby should be given to my husband, Ale, immediately after birth.

Episiotomy
I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch.
I would like a local anesthetic to repair a tear or an episiotomy.

Delivery
I would like to be allowed to choose the position in which I give birth, including squatting.
I would like my husband and/or nurses to support me and my legs as necessary during the pushing stage.
I would like to try to deliver in a squatting position, using my husband or a squatting bar for support.
I would appreciate having the room lights turned low for the actual delivery.
I would like to have my baby placed on my stomach/chest immediately after delivery.

Immediately After Delivery
I would like to have my husband cut the cord.
I would like to hold my baby while I deliver the placenta and any tissue repairs are made.
If my baby must be taken from me to receive medical treatment, my husband and my mom will accompany my baby at all times.
I would like to see the placenta after it is delivered.
I would like my baby to be handed over to my husband and my parents as soon as possible.
I would like my intimate area to be thoroughly cleaned after I deliver.

Postpartum
I would like to have my baby 'room in' after I have had some time to recover.

Breastfeeding
I plan to breastfeed my baby and would like to begin nursing very shortly after birth.
Unless medically necessary, NO bottles should given to my baby (including glucose water or plain water).
I DO NOT want my baby to be given a pacifier.
I would like to meet with a Lactation Consultant.

Circumcision
I would like my baby to be circumcised before we check out of the hospital.

Photo/Video
I would like to take still photographs during labor and the birth but not from a graphic angle.
I would like to make a video-recording of labor and/or the birth but not from a graphic angle.

Other
I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.
I would prefer to check out of the hospital as soon as possible.