Best Laid Plans
Jacksonville FL USA
From NEW BEGINNINGS, Vol. 24 No. 6, November-December 2007, pp. 257-258
During my pregnancy, I read several books on breastfeeding. I took a class. I wanted to be ready. Several sources recommended I write a birth plan so my doctor would be aware of my wishes regarding the birth and breastfeeding. So I wrote one. I reviewed it with my doctor and he clipped it to my chart. It went as follows:
- No drugs
- Lidocaine: yes; Episiotomy: no
- Do not break water or otherwise induce
- Cord: cut only after stops pulsing
- Place baby directly on me after birth
- Want baby to breastfeed within first 30 minutes
- No pacifier or bottles
- Lactation consultant present
- I'd like his footprints stamped in my book
- Have baby in room with me at all times
The evening before my son was born, during a scheduled doctor visit, it was decided that I would have a cesarean first thing the following morning. My blood pressure was high and my feet so swollen that it hurt to walk. My baby's weight was estimated at nine pounds and his head was large. I was a week past my due date and had an "unfavorable" cervix. I was 42 and this was my first child. I did as my doctor advised.
The cesarean was a frightening experience. When I finally got out of recovery, I immediately asked for my baby, Grayson. In my room, aided by his nurse, we had our first go at breastfeeding. He latched on like a pro. I was so happy. I thought, finally, everything will be fine from here on out. But it was not to be. Two hours later, he was taken to the NICU due to low blood sugar. I was told that he was going to be "monitored closely" for 24 hours.
The cesarean wiped out numbers one through five of my birth plan. Number six did not happen because I had to stay in the recovery room for three hours. I watched the video days later that my husband took during this time and cried. The nurse was less than gentle and Grayson was given sugar water and a bottle of formula. My wishes were completely ignored. As for the remaining points of my plan, no lactation specialist was available until the third day, and Grayson was not with me at all times (number 10). In all the chaos, the footprints for his baby book were entirely forgotten. So much for planning.
At midnight on the day Grayson was born, my night nurse conspired with me to let me see him in NICU. She said that. technically, I had to wait until the following "day" after my surgery before I could get up. We counted 12:01 am as day two. Bless her. After much effort, my husband wheeled me down to our baby. I wasn't prepared for what I saw. He was on an IV of glucose. I told his nurse that I was there to start breastfeeding. The wires and tubing along with my inexperience made it challenging. Even though he had nursed like a pro just that morning, he wanted nothing to do with breastfeeding that night. After questioning his nurse, I learned that he was getting formula with a regular flow nipple every three hours in addition to the glucose. I thought my hopes of breastfeeding were lost.
Nothing I read advised me on what to do regarding breastfeeding should I not be able to be with my baby. Everything assumed baby was with mommy. On the evening of the second day, I was brought a breast pump. I was told that whatever I pumped, they would feed my baby before feeding him the formula. Every three hours, I wheeled down to NICU with my thimble full of colostrum. I thought I was really doing something. It wasn't until the third day that my sister intervened and told me I should be pumping through the night. She also gave me some information stating that the treatment they were giving my son—the IV of glucose and bottle formula feedings -- was controversial. The best thing for Grayson's low blood sugar was my milk! The doctors in NICU were unavailable and could not have been less supportive of my desire to breastfeed. Surely there was some way we could have worked together. During the time Grayson was in NICU, I had to explain to each of his nurses (in six days he never had the same nurse twice) that I wanted to breastfeed and to use a slow flow nipple.
On day three after Grayson's birth, my sister gave me the phone number of a La Leche Leader in my area. She was adamant that I get someone to help me. I was afraid of nipple confusion and thought Grayson might never breastfeed again. I was a wreck without my baby and found it difficult to speak of him without crying. However, the Leader, Lisa, was patient and kind and reassured me that if I stuck with it and breastfed the baby in NICU as often as I could, he would be fine.
On the day I was discharged, Grayson's IV was gone and we were able to nurse unencumbered. My little pro was back. I had to leave the hospital without him that day -- a very difficult thing to do -- but the following afternoon we were able to bring him home. Once home, we got in a comfortable chair with our nursing pillow and went to work.
My little man is doing beautifully now. He nurses very well and is thriving. At eight months, he's a healthy 25 pounds and 30 inches long.
Even my best laid plans fell to ruin, but what matters is the end result and I couldn't be more pleased. I'm a La Leche League member now, attend meetings regularly, and write our Group's monthly newsletter.