Resolution fun, and a book for you

I love making resolutions, but I always make them on a monthly time scale instead of for the whole year. And also they aren’t pass/fail – I give myself a grade, incorporating how hard it was and how well I did. My blog actually only existed to document resolutions for a while, but then I got pregnant with Eliza and have been mostly derailed for the past two years.

In college, one of my best friends and I used to come up with food challenges – that’s where this started. We would give up or add a specific food item or class of foods, for just a month. So, I’ve given up diet coke for a month, or given up cheese, or added in vegetables at every meal. That sort of thing. It wasn’t a means to an end, really – we weren’t trying to lose weight or even specifically change our habits forever – it was just fun. And while it wasn’t a stated goal, it helped us behave more intentionally in general – like, I am a huge mindless eater, and it made me pay more attention, even just a little bit, to what I was eating. Which is a good thing for me, but also just fun.

So over the past five ish years, I expanded the game to include behavioral stuff too – like one month, I wasn’t allowed to use my smart phone in social situations. That was a fun one! The month I found out I was pregnant with Eliza, I was in the midst of exercise month – I was working out before work four days a week. That one was HARD, but I did it.

Anyways, I’m trying to pick the habit back up again, but I’m doing littler things than I used to. I have some good friends who are playing along, and we just had a “how’d January go?” chat (yes, even though there are still several days left, whatever, you’re not the boss of me), and it was really fun. My January goals were:

1. No more starbuck’s froofy drinks – I’m giving myself an A, because I haven’t had any, but it ended up being way easier than it would have most months, due to life craziness. We didn’t take any of our usual weekend walks to Starbucks, so it didn’t even come up until Sunday, and I aaaaalmost got one just because I would still have gotten a good grade for the month, but that didn’t seem in the spirit of my intention.

2. 2+ chores every day – I have no idea. I know I have done chores, but I haven’t been paying any more attention that usual, and didn’t even print out a new chore chart for the month, so I think I get a big fat F on this one.

I also have some annual goals that I made reasonable headway on:
1. Cook 12 recipes - I know I did at least this one, and it was delicious (have had it 3x this month!).
2. Exercise 100 times – I hit 5, which is low, but I didn’t want to do it at all, so I’m giving myself a pat on the back anyways.
3. Go on six family adventure – we went to Denver, which I’m counting, even though Kevin had to work the whole time.
4. Blog more – Well, ok, nope.
5. Read 30 books - I read three:
The Unlikely Romance of Kate Bjorkman – A dear friend gave this to me for Christmas, because it’s her favorite Christmassy book. It’s a YA novel set at Christmas time, and it’s just a very sweet and funny and well-written romance.
A Dance for Three – Same author, but the subject is teen pregnancy and mental health, so a bit heavier. It was still pretty good, but not as light.
The Sinner’s Guide to Natural Family Planning – I won Miriel’s contest for this book, which was pretty exciting – giveaways are fun! So this book is by a prominent Catholic blogger, Simcha Fisher, and it’s about NFP, and the struggles and unexpected gifts inherent to that practice. As a non-Catholic, I found that Miriel was right – as long as I approached it “in the spirit of quiet truth seeking,” there was a lot of useful info about love and communication, good food for thought. In fact, go read Miriel’s post on the book, and if you’d like to read it, leave a comment here. And on Fridayish, I’ll pick someone and pass it on.

I am still deciding on my February goals – I have limited free time and attention span these days, as Hazel is still cramping my preferred sleeping style, so I don’t want to set myself up for failure. So, I don’t think it’s the right month for me to stop swearing, which was evidently the goal I had picked for February last month. I’m thinking about bringing my lunch to work every day, and maybe a budget goal – reduce our shopping category by 25%? I’m not sure yet. But it’ll be fun!

Posted in resolutions, you you you | 12 Comments

Bears go to Denver

The ladies and I tagged along with Kevin on a business trip to Denver last week, viewing it as a lovely excuse to hang out with Jess and family. Last time we went, Hazel was three months old and Eliza was just shy of two. Hazel slept as well as she normally did, and Eliza woke up one of the days – FOR GOOD – at 2:17 am.

This time, Eliza did great – we brought her OK to Wake clock, which was, I think, a very good move – she totally loves that thing. “Clock turn green? Play? Go upstairs? Green came on! Play!” Hazel, on the other hand, went in for a full on sleep regression, starting the night before we left. She went from sleeping through the entire preceding week to waking up HOURLY, and sometimes more. Was bananas.

Over the course of the week, though, she cut her first two teeth, and learned to say/wave hi, clap her hands, and give kisses. So basically ready for college. Also she is so, so close to crawling and pushing into sitting. Things are about to start moving real fast over here.

I was totally in denial about the saying hi thing, even after Jess got this seriously convincing video, but she has kept doing it pretty consistently.

Despite the sleep deprivation, I managed to have a good week – I got to squeeze Annika AND Reagan, watch Callum and Eliza play together, and shoot the shit with Jess all day (and Liz, some of the days). Can’t argue with that.

Also, while Hazel probably would have slept at least marginally better at home, and I would have been at work every day till 5:00 rather than wrangling both kiddos mostly myself, I don’t think I would have handled the sleep deprivation as gracefully. I seem to parent a little better with an audience. I was able to stay pretty patient and chill with the kiddos all week, which is not my strong suit. When I’m tired, I usually turn into an impatient screamer, but I mostly just rolled with it. When we got home on Saturday afternoon, even though the ladies weren’t being any more challenging than they had been all week, I was DONE. I immediately got snappy and short and yelly and, oh, I hate that.

I mean, it’s sort of understandable – I was getting like five 45 minute chunks of sleep each night, assuming I could pass out immediately. But I hate, hate, hate it when I am impatient. It makes everything worse – it throws off the kids, so they get needier, which makes me screamier, and eventually everyone is crying and wishing for a new day.

But! I guess Jess is my antidote. Jess, please move into my living room.

Anyway, Hazel has been sleeping better the past couple of nights – undoubtedly traveling wasn’t helping her sleep regression nonsense – and I am feeling much better rested. I AM concerned about upcoming trips with Hazel though, because good heavens that was rough.

Some Eliza tidbits from recent days:
1. She just learned to (sort of) play hide and seek. She will count to 10, or just to 3 when she gets too excited, and then come find you, giggling hysterically the whole time. We played this with Callum too, and it was so fun. You can’t hide very well, and sometimes you have to give her hints, but it’s pretty funny. Also, hiding in 10 seconds is kind of hard.

2. Marie said on twitter (https://twitter.com/Lifeinatinytown/status/425085132924391424) the other day that two year olds love to put shit in shit and carry their shit around, and well, truer words, my friends. Eliza loves to carry her little backpack, or zipper bags filled with magnetic letters, or maybe some dinosaurs. She is forever filling up bowls or bags with her toys, and then emptying them into other receptacles, and then carrying them around. It’s hilarious.

3. She is also super into pretending lately, and I love it. She has squatter’s rights on a cabinet and few drawers in the kitchen, and the cabinet does quadruple duty as an oven, a shower, a bedroom and I don’t know what else. She cooks pretend food in there, she puts Pooh Bear to bed, she makes her Ariel lego take a shower. She goes in the cabinet and plays knock knock. Very busy.

4. She loves cartoons. Mostly Disney movies – Pooh was the first one that she latched onto, and that remains a favorite, followed closely by Cinderella. We have tried other movies, and none have come close to these two. She doesn’t like anything live action (except football/sports), and isn’t really into Pixar style animation either. I bet she would also love Snow White and Sleeping Beauty – the older Disney stuff. Her favorite part of Cinderella is the cat/mouse parts.

Cheers!
Cheers!
Snow
Then she went face first down the slide. Twice.

Bath time!

Coordinating babies
Color coded.
Posted in ephemera, little bears, Me me me | 3 Comments

Every Year, Happier: 2013 Wrap Up

Got it from Linda, just like everyone else. (20122011. Previous years buried in my email account rather than published.)

1. What did you do this year that you’d never done before?
Got acupuncture. Ate pub cheese at a pajama party. Got a real (not limited/temporary) job. Ran regularly, and enjoyed it. Stumbled upon a pile of best friends. Waited to find out our baby’s sex until she was born (this was so, so cool). Introduced my daughter to her sister. Successfully nursed a baby. Co-slept. Went camping with two (2) children. Took my girls to the beach their daddy grew up on. Took Eliza kayaking.  Lots of tiny, wonderful things.

2. Did you keep your new year’s resolutions, and will you make more for next year?
Had to check last year’s, but I made a few mostly easy ones for 2013.

  • Read 25 28 32 books. Some of them aren’t on Goodreads, because reasons. Ahem.
  • Cooked some new recipes (no idea if I hit 12, as I definitely wasn’t keeping track. I bet I did.).
  • Wrote here more, though I wouldn’t say regularly, exactly. 60 posts, versus 47 in 2012, but 30 were in November. Heh.

I’ll keep basically the same ones for 2014, with the addition of exercising 100 times, and going on six family adventures. I used to do monthly resolutions too, but I’m not sure I’m capable yet – still a little baby hazy. We’ll see.

3. Did anyone close to you give birth? 
So many people! My sister in law. My proximal BFF. Several of my favorite internet ladies. There were a slew of internet babies, in fact. #oprahvoice

4. Did anyone close to you die?

Kevin’s grandmother passed away. She was in her 90s, and had lived a very full life, but of course her passing was still very difficult on Kevin’s mom.

5. Whose behavior merited celebration? 
I’ve said Kevin the last couple of years, and that remains true, but for variety, let’s also say…. hmm. You know what? Me. ME. I think I’ve done a damn good job handling the middle of the night baby stuff mostly myself.

6. Whose behavior made you appalled and depressed? 
Oh most current events. Also me, every time I lost my patience with Eliza.

7. Who did you miss? 
My brother and fam, haven’t gotten to really see them in a year. My college buds. My far flung friends, even if I DID get to see some of them a good bit this year.

8. Who was the best new person you met? 
Hazelnut.

9. Where did you travel?
Let’s see here. We went to LA again in January for frisbee/friends (and I got to meet some internet folks!). I went to Arizona in February (pub cheese! friends!), San Antonio in March for work (and to say hi to Meggles). Denver in May to see friends. In September we went to Georgia to see family, and me and the ladies tagged along with Kevin on a work trip to Denver (and Jess’s house). Written down, this seems like a lot, but it felt like a slow year for travel! We also had folks come visit us a good bit, which was a nice change of pace (and good to get it in this year, because it looks like Hazel will lay official claim to the guest room soon.)

10. What would you like to have in the new year that you lacked this year?
More sleep, more patience, and more motivation.

11. What dates from the year will remain etched upon your memory, and why?
June 13th. I hope. Honestly, I keep forgetting the actual day, because Eliza’s birthday is the 14th of October, and gah. But, you know, mid-June.

12. What was your biggest achievement of the year?

On paper, getting hired on as a staff scientist. And making a person, that was pretty solid.

13. What was your biggest failure?
Each and every time I lost my patience with the ladies. Seems like patience in the face of insane children will be the hardest part of parenting, for me (how unique!).

14. Did you suffer illness or injury?
Oh, a variety. Let’s see. I got bronchitis in my third trimester, which was both unpleasant and embarrassing (cough pee!). I sprained the hell out of my ankle a week before Hazel was born, which was both unpleasant and inconvenient. I got norovirus, along with everyone else, on our September beach trip, which was the wooooorst thing eveeerrrrrr. And then I’ve had a bunch of little colds and whatnot in amongst the more notable illnesses. Not a banner year for health, but not bad either – nothing was actually serious.

15. What was the best thing you bought?
Plane tickets. No question.

16. Where did most of your discretionary income go?
Travel – and it was well worth it! Travel seems to be the theme of 2013.

17. What did you get really excited about?
Hazel being born, and being awesome, and our newly embiggened little family. Visiting friends and family. Most recently, a Secret Santa thing some friends and I did that was just really fun, somehow.

18. Compared to this time last year, are you:

– happier or sadder? Happier. Every year, happier. So lucky.
– thinner or fatter? Thinner, because not pregnant.
– richer or poorer? A wee bit richer, thanks to a promotion.

19. What do you wish you’d done more of?

Sleeping.

20. What do you wish you’d done less of?

I wish I’d lost my patience less.

21. What did you want and get? 
Hazelnut bear. More close friends, and opportunities to see them. A promotion.

22. What did you want and not get? 
Sleeeep. More free time.

23. How did you spend Christmas?
My parents visited for the week, and we spent the day watching Eliza go nuts with everyone’s gifts. She loved to help everyone open them, and she was so excited by the toys she got.

24. What was your favorite TV program?
Doctor Who!

25. What were your favorite books of the year?
Eleanor & Park (Rainbow Rowell), Flight Behavior (Kingsolver), Daughter of Smoke and Bone (Laini Taylor), Unbroken (Laura Hillenbrand), and the Divergent trilogy (Veronica Roth).

26. What was your favorite music from this year?

My running playlist.

27. What song will always remind you of this year?
I’m not sure I have one this year – usually my song of the year is from Potlatch, but I was a little too distracted to fully participate this year, as Hazel was only three weeks old. I do really love Lorde’s Royals, but I’m not sure it will have left that big an impression compared to the songs from previous years.

28. What were your favorite films of the year?
Uh, we saw Catching Fire recently, and that was pretty good, I guess.

29. Which celebrity/public figure did you fancy the most? 
Joseph Gordon Levitt, I think. Yes.

30. What political issue stirred you the most? 
Marriage equality, and equal rights in general, will be my answer for this until it ceases to be an issue, I think.

31. What did you do on your birthday, and how old were you?
I turned 29. We had a quiet weekend, punctuated by Eliza trying to give me a heart attack by falling off a play structure. I also gave away a necklace on the ol’ blog, which was super fun – I should do that kind of thing more often. One thing we didn’t have was delicious cake. Kevin, you are already on notice for 2014.

32. What one thing would have made your year immeasurably more satisfying?
A TARDIS.

33. How would you describe your personal fashion concept this year?
Stretchy/pajamas.

34. What kept you sane?
iMessage and my husband.

35. Tell us a valuable life lesson you learned this year.

It can probably wait till tomorrow. Or the next day.

Posted in ephemera, Me me me, milestones, retrospect | 6 Comments

Hazel, five and six months

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Stats from 6 mo Well Visit:
16 lbs 2 oz (52%)
26″ (58%)

Sleep:
Hazel’s 4 month regression lasted about a month, resolving in fits and spurts in November. She is fairly predictable now. She nurses pretty steadily from 7 pm until she goes down, between 8 and 9, usually. Once she is sleepy, Kevin swaddles her, I nurse her once more, and down she goes, completely asleep.
On a great night (infrequent but occasional), she sleeps through till I wake up.
On a good night (most nights, lately), she wakes once, between 2 and 5 am, and goes back to sleep until a) I wake her again to nurse before I leave for work, or b) 8ish.
On a bad night (once a week ish), she wakes two or three times. What makes it bad, though, is that she wakes up before midnight. I get desperate and wild eyed, assuming I will never be well rested again in my entire life, and that the rest of that particular night will be spent getting up as soon as I fall asleep, even though that hasn’t happened in months.
I am much, much better at handling a 4:30 am wake up time, which means I can’t go back to sleep before I need to get up for work, than I am at a single 11 pm wake up. Even if the latter might mean more continuous hours of sleep, I just can’t handle it.

I do think she doesn’t NEED to eat in the middle of the night, usually, but just has trouble self soothing back to sleep. She isn’t howling or anything when she wakes up, just yipping a little bit – enough to wake me, and keep me awake, but not in any kind of urgent way. I know that I can nurse her back to sleep and that’s the fastest route to ME getting back to sleep. I think once I’m feeling generally better rested, we might sleep train, but this is working fine for now. Also, I nurse her down every night in the first place, and eventually we’ll try to move that last feeding away from bed time, but not yet. It works well, but I do spend most of my time in the evenings nursing her on and off, can’t do too much else.

With Eliza, we abandoned the swaddle just after 5 months, because she was able to turn over pretty easily. Hazel seemed like maybe she was going to be done with it a month ago – she was breaking out of it every night, and I wouldn’t re-swaddle when I nursed her back down, and that was fine. Then she had kind of a rough week sleep wise, and stopped breaking out of it completely. She hasn’t shown any interest in rolling over, so we’re sticking with it for now. We still use an Aden + Anais blanket to swaddle her, and it’s sort of hilarious because she is so big. I’m curious to see if we eventually stop because she gets too big, or what. Not worried though, which is a nice change – I was so concerned about how we would kick the habit with Eliza!

Tricks:
Hazel is sitting up for basically as long as she wants now, only falling over when she tries too hard to get something – and usually ending up on her stomach when she does. She scoots around a little, but not in the direction she wants – usually the opposite, or in a circle. But she is starting to push up into crawling position. I can see the wheels turning. I imagine it will still take a month or three for her to figure it out, based on how it went with Eliza – I remember feeling like mobility was IMMINENT, but it ended up being awhile. I am enjoying the stationary phase quite a lot – there has been a distinct shift, in the past few weeks, to where I can put her on the floor to play for longer stretches. I feel like I have reclaimed myself a bit, between that and her improving night time sleep. I have a tiny bit of free time! Anything is possible! If anything takes 15 randomly available minutes!

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Timber!

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Tummy time is fun for a few minutes, anyway.

She also just started making a bunch more sounds, and blowing raspberries. She has no interest in rolling over, not even a little bit, but she’s strong and coordinated so we aren’t concerned.

Food:
Between me working full time, and her getting more efficient, Hazel has gone from nursing an average of 3-4 hours per day down to 2 or so (still 3-4 on the weekends, down from 4-5+). Girlfriend likes to eat. I should probably cut her off when she is half asleep nursing, but we still suck at getting her to nap, so sometimes that’s all she gets.

She’d been super grabby and keenly interested in food since about four months, but solids sounded like a pain in the ass, so we held off feeding her any until just shy of six months. Kevin’s parents were visiting, so I gave her a giant peeled carrot to play with, and she was So! Excited! Since then, I’ve given her roasted carrots, peas, green beans, black beans, sweet potatoes, broccoli, and who knows what else. She gets SUPER PISSED if we eat without her, and so far has voraciously hoovered up anything we’ve given her. She’s quite good at it too – chewing, no spitting anything out, no WTF faces when she tries new foods. I’m hoping to avoid purees this time because I’m lazy, but she did end up incredibly constipated and we had to apply prunes and miralax. That’s what happened with Eliza, too – seems like it might just be a thing? I thought maybe we’d avoid it if we only gave her veggies, but evidently not.

Reflux:
Still has it, based on a) me forgetting her meds a few times here and there and her resulting fussiness/puke, and b) the increasing spit up as she has gotten bigger and we haven’t changed her dose. She barfed on the pediatrician a couple times and he suggested we try increasing the prevacid. Heh.

Siblings!:
Eliza is starting to interact with Hazel more, unprompted, and that part is AWESOME. Just this week, she has been walking up to Hazel and engaging her more – not just taking a toy away and going about her business, but starting to play. Spontaneously giving her a kiss, or brushing her nonexistant hair, or pretending to feed her. Hazel LOVES it. I think Eliza is finally starting to notice the giant smiles and belly laughs she gets when she pays attention to her sister. Very cute, with the added bonus of giving Kevin and me a break!

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Sisters!

Posted in little bears | 4 Comments

Breastfeeding: Lessons Learned

I had a lot of trouble breastfeeding Eliza, and it was an enormous source of emotional and physical stress for me. I was 99% pumping, and ended up weaning entirely and stopping pumping around five months after she was born. I have babbled endlessly about this in the past, but the take home is: I had inadequate supply (I was pumping about 75% of what Eliza was drinking, at best), Eliza wasn’t a great nurser, nursing was extremely painful (partially because I have Raynaud’s), and I felt like an awful failure at life for a while.

It’s been a completely different ballgame with Hazel, for a variety of [likely interrelated] reasons – girlfriend doesn’t like bottles or formula, she was born during the summer so Raynaud’s wasn’t as much of an issue at first, my supply is better, and importantly, I am so, so secure in my understanding of breastfeeding and all the surrounding BS. I know formula is a wonderful invention. I have access to lots of things to help support breastfeeding. I can weed out the bullshit messaging that comes along with a lot of breastfeeding info and advocacy.

I have a few friends who are dealing with breastfeeding for the first time, and I’ve found myself repeating some of the same suggestions and recommendations, so I figured I’d compile them here.

First of all, a lot of the literature on nursing, as well as many nursing advocates, will say that breastfeeding shouldn’t hurt. I want to burn all of them in a fire. At first? That shit hurts. Like, toe curling, tears streaming down my face, even crying at the THOUGHT of nursing the baby. Who, of course, wants to eat all the time, those first few weeks. I think of the considerable number of women I have talked to about this, perhaps 5%, at most, have claimed that it never hurt at all, not even in the beginning. Which is great for them! And I would say for most people, once nursing is well established, it doesn’t hurt. But the first few weeks? HURT OMG. Based on my informal polling, it sounds like it is very painful for most women for about a week. For many women, two weeks. For some, three or longer. The pain seems to be a combination of needing to toughen up a body part that is usually handled gently and infrequently, and of poor latching. The latter can sometimes be fixed easily and immediately, just by learning better ways to hold the baby and facilitate the baby latching correctly – from an LC, or the internet, or more experienced friends – but sometimes there is a mechanical issue. Like a tongue tie, that might require a minor surgical intervention (super easy when caught early!). Or, very commonly, the baby might have a teeny tiny mouth, and might be physically incapable of taking the nipple deeply enough to get latch the areola rather than the nipple, causing pain – especially over time. This last one seems to be a big factor when pain continues for two, three or more weeks – you’re basically waiting for the baby to GROW. Bigger mouth means better latch means less discomfort. Also better stimulation of milk supply!

For me, based on my statistically insignificant n of 2, the timeline seems to be: the first three weeks are lots-o-pain, accompanied by emotional turmoil and sleep deprivation, especially after the initial new baby high wears off in the first few days. Then, the next three weeks, the pain has improved but the mounting sleep deprivation almost nullifies that improvement. Then magically, around six weeks, things get a lot better all around.

That said, there are a lot of things I felt helped me during those first six weeks, as well as subsequently, with both nursing and pumping.

Stuff worth buying for Nursing:
My Brestfriend nursing pillow – I am EVANGELICAL about this thing, despite the absolutely wretched product name. And at less than $40, this thing is WELL WORTH IT. I would pay twice as much for this, without batting an eye. It is more supportive than a boppy, but lighter – it has structured foam, rather than … stuffing? The angular rather than rounded form means baby – especially tiny floppy baby – doesn’t roll into your belly too much. It keeps me from hunching over when I’m nursing. There is enough extra space to rest my phone on the pillow so I can read. There is a silly little pocket, that I can keep chapstick or a snack or some boob stuff in. It straps on, so when Hazel was cluster feeding like a crazy baby in the beginning, I didn’t have to bother readjusting everything when I went to refill my water really fast (yes, I walked around with a baby shelf attached to me. Whatever, it saved me minutes of fiddling!). Kevin actually used it a lot at first, too, to rest the baby on so he could have his hands free to play video games or whatever else. Tiny babies are adorable but boring and floppy.

Medela soft shells – these allow your nips to hang out in air, protected from any kind of friction. Super helpful for the first three-ish weeks, when there can be some serious trauma. Three weeks doesn’t sound like long, but it IS. And even the softest nursing pad can be AWFUL.

Lansinoh Gel Soothies – these feel good on traumatized boobs in the first few weeks. I tried some other brands that were a bit cheaper, but these ones are a much better product. However, if you find yourself running through them like mad, Medela’s are a bit cheaper, or you can get hydrogel pads marketed for burns.

Ocalette nursing cups – Ok, these are awesome. They are a hard plastic cup that, like the soft shells, let your nips recover in an air bath, and more importantly, collect and save any milk that leaks out. (I still recommend the soft shells, because the hole is larger in those, and the material against the breast is softer/more comfortable at first.) These work because they exert light pressure on the areola, but not the nipple, kind of like how a well-latched baby is actually nursing on the areola. When you nurse on one side, and have just a nursing pad/bra on the other, the pressure on the nipple keeps too much milk from coming out. With these, there isn’t any pressure on the nipple, so a bit more milk comes out. I was curious, so I weighed a nursing pad to compare the leaking to the volume I get in a cup, and found I only leaked about 5 mL tops in a nursing pad, versus 15-45 mL in the cup, depending on time of day, how long since I’d last nursed, etc. I wore these a LOT right after Hazel was born – on both sides to catch the random let downs before things regulated, and certainly when I was nursing. I managed to save up about a liter of milk this way, without having to pump after nursing, which is a soul crushing and terrible way to spend time those first few weeks. I actually wonder if these might have contributed to my better supply this time around, just encouraging a little extra production. I also have a Milkies milk saver, but much prefer the Ocalettes – the Milkies is much bigger, so I couldn’t wear it in my bra under my shirt. It’s also completely open on top, and I spilled it a few times in the middle of the night, or forgot to remove it before putting the baby down, so all the milk spilled out in her crib. (The Ocalettes have a little air vent, so if I leaned over before removing it, a few mL might leak out, but not the whole thing.)

All Purpose Nipple Ointment (APNO) – a combo of topical antifungal, corticosteroid, and antibiotic that you can get at a compounding pharmacy by prescription. Very helpful in the first few weeks of trauma – feels soothing like lanolin, with bonus healing properties. Totally safe for baby.

Domperidone – if you are having supply issues, this is what you should do, hands down. I mean, pumping and nursing like crazy will help, yes, but depending on the level of inadequacy, might drive you bananas before they work. Fenugreek and Blessed Thistle are herbs that have been scientifically shown to help a little bit – but in addition to not working that well, you have to take so much of them that you reek of maple syrup. That is how you know you are taking enough, seriously. When your spouse starts calling you Pancake Pits. And that just means it MIGHT work. Mother’s Milk Tea is vile, and you have to drink LITERS per day for it to help, generally. Domperidone, on the other hand, works incredibly well. It isn’t FDA approved for use as a lactation inducer in the US, so I did a good bit of research on it before deciding it was safe for my own use. My OB prescribed it for me, but I ended up getting it online because it was much, much cheaper. Some doctors won’t prescribe it because it is an off label use, so then you’d need to get it online as well. I had a bunch of this on hand when Hazel was born, expecting supply issues again, and being completely unwilling to just deal with them. I didn’t end up needing it, but did take some for a week a few months ago, after a bad stomach bug and cold leveled my supply, and I wanted to see if it worked. It helped quickly. I could write like 18 blog posts about this specifically, but won’t – ask me if you have any more questions about it.

Stuff to buy for pumping:
Hands free pumping bra – I have a Pumpease brand, which I like fine. You can also make one out of an old bra, though I prefer the bandeau design so I don’t have to put it on over my clothes, or remove my shirt completely. Anyway, it lets me do other stuff while I’m pumping, worry less about accidentally spilling, or losing suction (which drags out the process), or I am free to massage the ladies to work out any clogs or speed up milk collection.

Pumpin Pals flanges – I love these. I have two sets in my size, to complement the two sets of regular Medela flanges, and I get more milk on the days I use these. Also they are a bit more comfortable, and I don’t have to sit up as straight, and I lose less when taking everything off. Worth it to me, since I had to buy extra flanges anyways.

Extra parts – ok this might be my biggest suggestion for pumping. I have four sets of flanges, valves, and bottles now. I use one set per day at work, where I pump three times. I refrigerate the parts in between pumping (actually in the cooler I keep the milk in, because I’m too self conscious about putting boob stuff in the office fridge), and then wash all four sets once I run through them. This is HUGE. I nearly lost my mind when I was pumping exclusively with Eliza, because washing all that shit was such a process. Every time I pumped – get all set up, pump for 10-20 min, get the milk put away, wash all the parts. The whole process took a minimum of half an hour, once I was good at it, and that was at home where the sink was close and there weren’t any coworkers making me feel awkward, and even then it made me RAGEY. I mean, it takes me half an hour to nurse Hazel in the middle of the night, but she is a LOT warmer and snugglier and cuter than my breast pump, and I don’t have to wash her off afterwards. So – definitely have extra parts.

Other tips and info:
For pumping, having the right size flange is important – if you can, get an LC to take a look and fit flanges. The right size will be more comfortable and more efficient. There are a wider variety of sizes available on the internet than in stores. Also, Pumpin’ Pals will suggest getting the variety pack and trying them all, because their sizing/design works a bit differently than traditional flanges.

Using something to lube the flanges – I use coconut oil. This makes pumping more comfortable/less painful, as well as more efficient. I get a lot more clogged ducts if I don’t do this. I used to use olive oil, at the suggestion of my original LC, but switched to coconut this time and much prefer it. You don’t want to use lotion – edible, food grade oils are better, because a little might end up in the milk.

Introduce bottles ASAP, if you are going to go back to work. When I was first nursing Eliza, I had heard a LOT more about nipple confusion, and babies refusing the breast after even a single experience with a bottle or pacifier, than I had about babies refusing bottles. I think nipple confusion CAN be a thing, but from the research I have done at this point, it is very rare that a baby will develop a preference in the first few weeks of life – they will suck on just about anything, then. Some babies eat better from bottles than boobs, that is certainly true (as is the reverse), but most newborns won’t refuse a boob just because they tried a bottle once or twice. BUT – many WILL refuse a bottle, quite vociferously, if you wait too long to introduce them. From my research when we were trying to get Hazel to accept bottles, it sounds like you should use a bottle regularly – say, a few times a week – starting in the first few weeks of life, so the baby is familiar with it from the get go. Babies will suck on anything at first, and then are much less inclined to readily accept something new after the first several weeks. This isn’t to say they won’t – hunger is an impressive motivator – but it might be an enormous headache/source of stress.

So, with Eliza, I pumped a LOT – almost exclusively – those first few weeks to manage pain, and she got used to bottles and was impatient with my subsequent clumsy attempts at breastfeeding. With Hazel, we tried a bottle a couple times the first week or so, but breastfeeding was simpler so we abandoned the bottle until she was a couple months old – and by that point, she didn’t know what the hell we were trying to pull on her, seriously, please stop with that nonsense. Balancing the two approaches is hard, and who knows if I’ll get it right next time. (And, of course, the individual baby plays a significant role in all of this!)

There are a number of common medicines that can negatively affect supply – certain oral contraceptives and pseudoephedrine are the most commonly encountered. For the former, this is why a lot of nursing mothers choose the mini-pill, IUDs, NFP, or some other method of birth control (or none, choosing to hope that nursing will keep ovulation at bay – aieee!). For pseudoephedrine, I’ve had a few colds bad enough that I’ve needed to take some or risk death by snot, and here is what I’ve personally found: I can take it at night for about three consecutive days without any effect on my supply, assuming I’m also drinking lots of fluids, etc. I take diphenhydramine (benadryl) during the day, even though it makes me incredibly sleepy, rather than just drowning in snot. I also alternate with a nasal spray decongestant, which doesn’t affect milk supply. You aren’t supposed to use that for more than three consecutive days either, because they can cause rebound congestion. So. Lame, but it works.

A note on supply changes in general – I have been pretty hyper about this, because my supply was inadequate with Eliza. BUT. In my experience, it takes days of some change in behavior, diet, medicine, etc. to have a measurable impact on supply. That is, it takes a few days before anything changes it – when Hazel sleeps longer stretches, it takes days for me to regulate. When I skip a pumping session at work for a single day, it’s no big deal – I don’t have less milk the next day. But if I do it for a week, I might have to work to get things back up. When I AM trying to get it back up, Hazel will nurse a whole lot for a few days and then go back to normal. The only thing that has effected a drastic, noticeable change in my milk supply was a very bad stomach bug, where I was so dehydrated I was dizzy. And it came back easily even then, once I started drinking more water, etc.

This jives with my experience weaning Eliza/stopping pumping – it took time to turn off the faucet, especially completely. This revelation has eased the mental game of pumping at work, or leaving my kid to go hang out with friends. I don’t feel as married to a schedule – nothing bad will happen if I wait four hours instead of three, except I might hope I’m wearing nursing pads.


Amazon links are affiliate. I will use any tiny proceeds to buy myself kindle books to read while nursing, probably, or maybe to fund my evangelical distribution of Brest Friends to all the pregnant women I know.

Posted in gestating, little bears, Me me me, retrospect | 18 Comments

Limping across the finish line.

I have a man cold. Everything is terrible.

Oh, Jen had a bunch of Christmas book suggestions, and mentioned I should order them used off amazon, and as usual, she was super right. I got a big pile of Christmas books for about $4 a pop. I might be most excited about Angelina Ballerina, as I remember that one fondly from when I was little.

We went and saw Santa and the reindeer today at our local nursery. Last year Eliza surprised us by screaming when she sat with Santa – we weren’t expecting that, since she has never displayed an ounce of social anxiety or stranger danger. This year we talked it up a bit, and took a family picture with him first. She didn’t get upset, but she breathed like Darth Vader the whole time.

All right, my man cold and I are passing out now. Thanks for stopping by.

Posted in ephemera, Holidays, little bears | 2 Comments

Now that THAT’s over with…. Christmas Movies

Eliza is right on the cusp of “getting” Christmas this year – I think she definitely could, if we introduce and reinforce the concepts, but right now she has no clue about any of it. We also haven’t exactly landed on our holiday approach – I mean, which traditions we will try to have in place for our little family, versus what we grew up with, etc. I feel like we need to have that reasonably well figured out by next year, but that this year we still have a pass. This year, she’ll get it a little bit, the parts we make a big deal out of, but the whole anticipation and understanding and so forth will still be beyond her.

OK, there is a huge rabbit hole I can go down here, about which traditions we want to stick with, what we believe in, all of that, but I have a point here and that isn’t it.

I am excited about showing Eliza Christmassy movies, and reading her Christmassy books. There are tons of both, of course, and to help narrow down what I’d like to show her, I figure we can use them to reinforce the Christmas stuff we’re hoping she can understand this year: that Santa is going to come one night and bring some presents. That he flies around in a sleigh drawn by reindeer. Magic. That part.

I know, I KNOW that is just the materialist entitled privileged part. We will build on that, I swear! I will add in charity and maybe tell her about some religious stuff (we aren’t religious really, but that is obviously a huge thing for a lot of people) and add in holiday cheer and I swear, we will do all of that. (I am feeling a wee bit defensive about this, apparently? I got into some coffee earlier, I’m betting that’s why.) BUT this year we are just doing a little dose of Christmas magic.

SO HERE IS MY QUESTION: Can you recommend any Christmas movies (cartoons, preferably) or little kid books that focus on that part? The magic? Santa? That would be good for the toddler set. I have How the Grinch Stole Christmas and Frosty the Snowman, and I’m working on getting the claymation Rudolph movie (which, by the way, go read this, it is my favorite thing on the internet), but I’m wondering if there is a PERFECT movie or show for this purpose. Because my kid LOVES MOVIES OMG (cartoon ones at least).

And here is another question, for people who don’t care about that, or to make up for my little temper tantrum a few paragraphs ago: What are your favorite holiday/winter movies?

I personally have a major thing for Bing Crosby movies – The Bells of St. Mary’s, White Christmas, Holiday Inn. Except not the part where they do black face, omg. Also every year, as the holidays ramp up and Bing Crosby music reasserts itself in my daily life, I look him up on wikipedia and am devastated anew to learn that he was perhaps kind of a jackhole in real life. One should not be allowed to have twinkly eyes and a delightful affect if one is also a douchebag.

Also, I love It’s a Wonderful Life, and The Snowman. Walking in the Air is the song I think of when I think of Christmas.

Posted in Holidays, little bears, Me me me | 10 Comments

Happy Thanksgiving!

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We celebrated by giving Hazel a carrot.

We had a lovely day – Kevin’s parents are visiting, so the girls are in heaven. We walked to Starbucks this morning despite the cold (it was about 20 when we left the house, foggy with hoarfrost on everything), then played all day, and had dinner at a friend’s house. Somehow I didn’t eat dessert, so I declare Thanksgiving will continue until I find some pie. Hope y’all had a lovely day!

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Posted in ephemera, Feed me! | 6 Comments

Family History, part II

So I wrote a post a few weeks ago about what I know of my parents’ lives, hoping my mom would swoop in and fill in the blanks. Wellllll she totally did. It’s a work in progress (apparently it takes some time to chronicle an entire life at the whims of one’s daughter, who knew?), but I can parcel out some of what she told me today. I asked about a lot of stuff, including my grandparents, so we’ll start with them.

—-

My maternal grandfather, Russell Borus (“Pop”), was born in 1912 in Chicago. His mom (Helen) divorced his dad (Arthur) and moved with Russell and his brother Frank to Jersey City, NJ.

“That part is really murky, because no one knows and no one would ever talk about it. His mom remarried, and Richard Bennewitz (“Dickie”) worked for Bethlehem Steel in Newark.

“Pop graduated from high school in Jersey City. He used to drive the ice wagon, which was pulled by a white horse named Babe. He later had a sales job of some sort in Manhattan. He spent a year working on a boat, swabbing decks and whatever else, some trader marine vessel. Traveled all over the world on that boat.

“Pop enlisted in the Army in the early 40s and trained in the signal corps at Fort Pendleton in California. There were always stories about how people gave him their gas rations to go check on their homes near Yosemite and other places in the winter. He had a girlfriend that is in some old family movies. Nancy [Ed.: my aunt, my mom's older sister] would remember more details and have names, dates. Pop served in Tinian [Ed.: one of the Northern Marianas, along with Saipan, very near Guam. In the middle of the Pacific] in the signal corps and always had stories about diving for cats eyes (I have some in my jewelry box) and he had a small sail boat. He never saw combat and always said he had a good war.” [Ed.: I hope we can find out more about all this - that chain of islands was the site of a lot of critical occurrences in the Pacific campaign of WWII. Tinian was where the Enola Gay took off from, and there were big battles on Saipan, Guam, and Tinian.]

My maternal grandmother, Viola Babcock, was born in 1916 in Jersey City, NJ.

“Viola grew up in Jersey City, an only child. I really know nothing about her childhood although I learned as an adult that she considered herself abused (locked in closets and hit with a hairbrush. I don’t know of anything else along that line). Viola had one year of art college (Beaver College) in NY somewhere. Her mom was ill and she had to quit and help care for her, I think. Her mom was in a wheelchair and had MS. Her parents lived in Rumson, NJ, and her Aunt Lillie and Uncle Harry lived in a house right next door. Viola’s mom died in 1951 [Ed.: the year before my mother was born]. That was also the year that Viola’s Uncle Harry and Pop’s brother Frank died in a commuter train crash, on the line that went from Red Bank, NJ to NYC every day.”

Viola worked as a secretary and a portrait artist, though I’ve only seen the landscape paintings that are hanging in our house and my Aunt’s house.

“Her paintings were oils of landscapes, portraits (some done in a chalk kind of medium?), and watercolors of roses, mostly. I like the snow scenes best.”

I never knew my grandmother – she passed away when I was little, in 1986 – but I have heard that she was sort of a difficult woman, stern, had a lot of rules.

“Viola had an awful temper and didn’t like Pop’s parents, and begrudged him visiting his mom on Sunday afternoons, when she lived five minutes away. Viola would throw things when she was angry. After an argument with Pop about his mom, she threw a cooking pot at Pop and it made a circular dent in the kitchen cabinet. Holidays were never a nice family affair, as Viola complained a lot about having the relatives over at Thanksgiving or Christmas.” [Ed.: I am SO THANKFUL that Kevin and I both get on well with each other's parents, and even more so that our parents get along with each other. We are so lucky.]

“I realize I don’t know how my folks met, or how long they went out before being married in a small ceremony at home, Oct 2, 1947. My folks were a lot older than the folks of my friends. It always seemed like they were ten years older somehow. Maybe they met after the War; I don’t know. They did grow up in the same city, but I don’t know what high school Viola went to. Pop went to Dickinson HS.”

Pop had a sales job by then, selling insurance in Rumson, NJ. My Aunt Nancy was born in 1949, a couple years after my grandparents married.

In 1951 (apparently a watershed year for my grandparents),

“Pop opened his own real estate and insurance business in Fair Haven at 600 River Road, right in the center of the business area. He worked at that business all while I grew up and eventually sold off the insurance side to his partner, just keeping the real estate business (The Borus Agency).”

—–
I’ll stop there, before getting into my mom’s childhood.

Posted in Me me me, retrospect | 1 Comment

Plan B and Pharmacokinetics

On my way to work this morning, I heard a story on NPR about Plan B emergency contraception (Levonorgestrel), and how the efficacy at preventing pregnancy is reduced in women who are overweight or obese. The story reported that levonorgestrel, the active ingredient in Plan B…

starts losing its effectiveness in women weighing as little as 165 pounds and loses it completely in women who weigh more than about 175 pounds.

A later airing of the same segment I heard on my way home stated that this effect was independent of BMI – so a tall woman who is not even overweight might also experience a reduced efficacy. This text doesn’t appear in the linked story, and I haven’t read the primary study the story references – I didn’t have time today.

Because I was busy making a quick PBPK model to illustrate the impact of differences in weight on levonorgestrel pharmacokinetics.

*record scratch*

All but approximately three of my readers just got really confused, so here are some key terms and a very fast primer. Pharmacokinetics is the fate of a substance of interest once it is introduced to a living organism. For example, when you take medicine, say a pill that you swallow, how that drug is absorbed through your GI tract, distributed through out your body, metabolized, and eventually eliminated in your pee or various other routes. PBPK models: physiologically based pharmacokinetic models are mathematical descriptions of all the physiology and biochemistry that influence pharmacokinetics. So to make a model, I describe physiological aspects of the body like the volume and composition of organs of interest, and rates of blood flow to those organs. Then I add biochemical details, like how water or fat soluble the substance of interest is, how quickly it is metabolized and in what tissues, how quickly the substance is absorbed or eliminated in various tissues, and so forth. I incorporate all of that information into differential equations (calculus! fun!) that allow me to simulate exposure scenarios I am interested in.

For levonorgestrel, I was interested in what the blood concentration might look like based on changes in body weight (and associated organ volumes, blood flows, etc.). I focused on three scenarios for a 5’4″ tall woman: a normal BMI, overweight BMI, and obese BMI. I used the low end for each (18.5, 25, and 30, yielding body weights of approximately 109 lbs, 147 lbs, and 176 lbs).

I built a model with explicitly described liver and fat tissues, as well as arterial and venous blood, and the rest of the body lumped together into tissues that are slowly perfused (bone, skin, muscle) and rapidly perfused (brain, visceral organs, etc.). I incorporated chemical specific information for levonorgestrel from the wikipedia page (protein binding, bioavailability) and from the literature (rates of metabolism, Kuhnz & Gieschen 1998).

I made a pile of assumptions that, given enough free time, I could vet against the available literature (i.e. actual data). For one, I assumed that in a 5’4″ woman, as weight increased, some tissue volumes increased and others did not – for example, I assumed that the liver size would be similar in a woman with a BMI of 18.5 or 30.0, but that fat, muscle, and blood volumes would be greater in a woman with a BMI of 30 than a BMI of 18.5. I would need to revisit and expand on these assumptions, especially if I get a look at the original study and it DOES say the observed (lack of) effect was independent of height. I also had to estimate rates of absorption, which I did by visually fitting them to data on blood concentrations in the drug pamphlet (you know, that thing that comes with your prescription drugs that is covered in teeny tiny writing that you immediately throw away). I can provide a lot more detail here, but I think I’ve already provided more than all but three of you care about.

SO ANYWAY. I did a couple of simulations to illustrate my point. Did I ever say what my point is? It’s this: I WAS NOT SHOCKED BY THE NEWS STORY. If you give the same amount of a drug to people of different sizes, without accounting for the size difference in the dose given, you will sometimes see a change in efficacy. That is: if you give a 1.5 mg of levonorgestrel to a 109 lb woman, a 147 lb woman, and 176 lb woman, they will have different blood concentrations of the drug. THE DOSE IS NOT WEIGHT ADJUSTED. Thus, if there is a threshold below which the drug ceases to be effective (LIKELY), it is possible that this might be breached, resulting in some effect (or lack thereof), like…. pregnancy, here. Look, some pictures.

First, here is some evidence that the model I whipped up isn’t complete crap. Predicted blood concentrations of levonorgestrel following a 1.5 mg oral exposure. This is where I visually fitted the oral absorption parameters. If I have time, I can find more pharmacokinetic data to better optimize these parameters, but this is sufficient to support my point.

Model fit (109 lb woman) to reported data on maximum blood concentrations of levonoregstrel in 30 women (mean +/- standard deviation).
Model fit (109 lb woman) to reported data on maximum blood concentrations (nmol/mL) of levonoregstrel in 30 women (mean +/- standard deviation) over time (min) after 1.5 mg oral bolus.

Next, the point: here you can see model predictions of blood concentration of levonorgestrel after a 1.5 mg oral dose in women with three different BMIs (18.5, 25, and 30).

BldBMI
Predicted effect of BMI on blood concentrations (nmol/mL) of levonorgestrel following 1.5 mg oral bolus exposure in 5’4″ women weighing 109 (red), 147 (blue), or 176 (green) lbs.

So there is definitely more fiddling I can do to make the model a hell of a lot better – for instance, if I can get my hands on the weight info for the women represented by the data in the first graph, as it is pretty unlikely that they had an average BMI of 18.5 (109 lbs! That was me in 9th grade! Haaaa!). But, my point is that body weight exerts a SIGNIFICANT impact on maximum blood concentration – it is almost 50% higher in the BMI 18.5 woman compared to the BMI 30.0 woman. That’s potentially a big deal, depending on what the therapeutic index is, and what the outcome is.

Now, as I said, I haven’t read the original study, which is kind of a big oversight. I will. I do think that the pharma company that makes this drug should have addressed this issue before the drug made it to market, but you need a large population exposed before some of these effects come to light – human variability is a big deal, and it’s not like you can do clinical trials for a drug like this on zillions of people.

BUT. Think about all the medicine you take. SO MUCH of it never takes weight into consideration – it’s just “for adults, take two pills” or whatever. Kid medicine does – you choose the dose based on which weight range they fall into – but not grown up medicine!  For most stuff, it’s ok – the therapeutic index is wide enough that it doesn’t matter. But it ticks me off. Imprecision BUGS THE SHIT OUT OF ME. Dose matters! Look at the graph! Yes, it is impossible (at this point) to account for all of human variability, but that doesn’t mean we shouldn’t at least TRY to account for something as simple as BODY WEIGHT, does it? Maybe my friend Robin can swoop in here and tell me why I shouldn’t care this much. I hope he does. As it stands, I have had way too much coffee and spent way too much of my day on this mess.

Also, I accidentally saw some of the comments on the article on NPR.org, and now I think humanity is a lost cause, someone please get me some cake.

Posted in Grumpy Toxicologist, Science!, soapbox, times when people annoyed me | 14 Comments