Thursday, December 24, 2015

2015 - The Year in Review

2015 has been an amazing year!

TheMan has been enjoying his job at FreightQuote where he continues to be an integral part of their organization.  He lost his beloved 12 year old Honda Accord at the end of December, when the axel broke on his way to work. He has moved into the future with a 2015 Mazda6. He's greatly enjoying his new ride.

Meanwhile, I've been working the stay at home scene and I am looking forward to adding back in contract programming. I'm looking forward to spending some time setting up a company website and refocusing on updating this blog regularly. We're having some new and interesting learning experiences as we explore C and R's personalities and challenges.

C was diagnosed with autism at the end of 2014 (What would have been Asperger's Syndrome under the DSM IV). We started ABA at the end of summer and it has been helping him grow and understand these crazy social rules. We honestly don't notice his quirks until we're around other more typical children. Our foster son T was an integral part in helping us decide to move forward with more targeted social assistance for C. Our family isn't really neurologically typical, so his quirks fit well within our world.

C has always been highly focused on reading, math and understanding the symbols in the world around him. When he started Kindergarten this year, I knew there would be challenges and he sure didn't disappoint. His teacher called almost every day for the first few weeks of school as we worked to figure out how to best help him thrive within the structure and activities of his Kindergarten class. His teacher said that academically, he's a challenge like none she's had previously.  C tested out of all the sight word pools for Kindergarten through Second grade in the first month of school. They gave us his end of year Kindergarten exam with a 100% score at our first parent teacher conference. The teacher assured us she's working hard to ensure his continued growth academically while focusing on the essential Kindergarten skills that he has absolutely no interest in (coloring, using scissors, etc). We are very pleased with C's education goals and are also supplementing his studies at his request at home. C's favorite activity continues to be math where he has moved on to Basic Algebra and Geometry as his current learning focuses.

Along with C's diagnosis of Autism, he also was diagnosed with Developmental Coordination Disorder.  He's been working with OT both at school and at a private practice to gain skills and strength to help him with his motor planning and coordination issues.  I'll talk more about this in future blog posts.

I've been in contact with T's adoptive mom and he's doing great.  She has a lot of great plans to get him into some hippotherapy programs, music lessons and dance classes.  She's a huge supporter of him and is an all around fantastic person.  I'm so glad he was able to find his forever home within his own family with someone so wonderful, caring and responsible.

R has grown so much over the last year.  She continues to amaze us with her gross and fine motor skills. When she was released from the NICU last year on 12/13/14 she was automatically enrolled in our county's early intervention program. Her Occupational Therapist has been amazed by her strength and tenacity as she masters skill after skill in the gross and fine motor categories. She defies the 25 weeker stereotype at every turn and amazes us all. Verbally and socially, however, are a bit of a different story. She's not shown as much interest in these areas, so we have added a speech therapist. We work a lot on eye contact and mimicking at this stage in development. Her independence is shining through, which makes those skills somewhat harder to attain. Because she is at high risk for an autism diagnosis due to her brother and other family members, she will be closely followed and given a lot of support as she develops. R amazes us every day as she continues to show the indomitable spirit that allowed her to sail through her time in the NICU.

Wishing you the very best for 2016!

Friday, December 18, 2015

Transitioning from Pumping to Breastfeeding

For those of us lucky enough to transition from pumping to breastfeeding, there can be some unique concerns.  We're so used to being able to measure output, it can be difficult to trust our bodies and our babies now that the process will be more organic.  Babies are born with an instinct for nursing.  When a newborn baby is placed on the mother's body, they will naturally gravitate toward the breast and begin suckling.  When you are ready to begin trying to latch, you can use that instinct to your advantage.

When bottle feeding, you want to be sure to use paced bottle feeding techniques to avoid flow preference.  This will better enable you to transition to breastfeeding.

Start when baby is hungry, but not ravenous.  When baby is too hungry, all they will want to do is eat right then in whatever method is fastest and most familiar.  Aim for about 15-30 minutes before you'd expect baby to want to eat.   Get comfortable and hang out skin to skin and tummy to tummy.  If possible, plan a nursing vacation.  Pay attention to your baby's cues.  When baby is ready to nurse, allow them to lead the way with a baby led latch.  Here is a great article on awakening your baby's breastfeeding instincts via baby led latching. For visual learners or if you just want to see this in action, check, out this video:

Note the breastfeeding position with the baby in the video above.  Recent research indicates that the tummy to tummy positioning is a far more natural feeding position and is far more conducive to a relaxed and successful breastfeeding session.  Check out this article for more information

I have transitioned both a 5 month old and a preemie starting at around 34 weeks (once the suck/swallow/breathe instinct kicks in).  I found with the preemie that I fully experienced the newborn nursing period.  The newborn feeding period, which goes up until they are 6 weeks adjusted can be super exhausting because it feels like all you do is feed them... for hours... just sit, and feed them... but that is totally normal... and it is all you are doing... it can make you crazy, but it is their instinct to build supply.

We were lucky with my micropreemie to be in a NICU that prioritized breastfeeding.  The doctor's prioritized breastfeeding over bottling.  The goal was to breastfeed for 10 minutes.  This counted as a full feeding.  The doctors gave us a couple of weeks breastfeeding 1-2 times per day with the other feedings by NG before adding bottles in.  Generally speaking, they found this avoided nipple confusion.  The nurses and anyone else who fed baby used baby led bottle feeding strategies and the breastfeeding mom was never the one to give the bottle.

With my older infant, I found that starting with a late night feed where he was mostly asleep gave me the best opportunity for introducing breastfeeding, he was snuggly, relaxed and sleepy and wanted to eat but was also comforted by sucking.  For a few months, the only nursing session we had was at 3 am.  The rest of the time was bottle.  He gradually opened up and we added more nursing times. Our breastfeeding relationship continued until he was almost 3 years old.  I'm still nursing my daughter as of this blog post.  She's 15 months actual, 11 months adjusted.

Mothers, especially those of us who have been obsessed with supply and tracked every milliliter we've produced, find it hard to not be able to quantify consumption.  The biggest thing to remember is if baby is latching and you see swallowing, you have to trust them and trust your body.  As long as they gain weight, you are doing great.  Check out this video (again from Jack Newman's breastfeeding clinic) that shows what swallowing looks like. 

Jack Newman has a lot of great videos over on his website.  You can check those out here I did e-mail him once in desperation while working to get my 5 month old to latch after his open heart surgery.  He answered my questions completely and was very kind.  He can be a great resource.

If, like me, you built a really GREAT supply over the months you were not able to directly breastfeed, you might run into another problem.  Oversupply.  What you once counted as a blessing can now work against you.  Baby can be overwhelmed by the volume of milk and can have trouble drinking enough to get to the hind milk.  I have talked with a number of moms who have had the experience of a baby nursing for a few minutes, then pulling off and screaming with rage.  Some of them thought this was baby getting angry because they wanted milk faster, but in reality, they were experiencing oversupply issues and baby was angry there was TOO MUCH milk... Here is a great article from KellyMom on Overactive letdown/Oversupply and how to manage it.  If you have an oversupply issue and try to decrease your supply to better match baby's needs, be sure to take lecithin and be careful with breast compression to mitigate your risk of blocked ducts.  One risk for blocked ducts is an underwire bra.  I'm a bigger girl and I have found the best, non-underwire supportive bra is this Goddess Women's Keira bra.

I hope these resources can help you as you begin your breastfeeding relationship.  Good Luck!

Other posts in this series include: