We are still alive!

I've been busy and mainly using phone as computer outside of the office, so I really haven't updated.  A couple of you who are commenters/readers have found me on Facebook or emailed me (see right bar) and had me find you on Facebook and that is actually probably the best bet for right now since I don't know when I'll get back to updating in a timely fashion...

I'm sure there are lots of cute pictures and interesting anecdotes in the last three months, but it seems likey I'll never really update them.

Brief updates:

Trajan started kindergarten at the end of August at our local neighorhood school.  He has a great teacher that it turned out we already know as her son was in Chiron's infant class.  He's had some behavioral issues and adjustments, but is doing really well academically.  He has been the most amazing brother that I can conceive of.  The devotion and love he shows his siblings is absolutely amazing.  It is definitely worth getting myself to take the time to come here and write a real post to document some of it so that I never forget how he has been with all of them. 

Poppins quit, by text, when the girls were a couple weeks old for reasons relating to her being pregnant, Medicare, WIC and other factors that aren't worth my time to bring up.  We were trying to find a quick nanny from an agency, but my mother volunteered to stay with the girls for August and September rather than have us leave newborns with someone that we wouldn't have the time to really vet.  That was great and really awesome for them.   Chiron started back at the daycare he was at before on August 1 and the girls joined him at the start of October.  Seems to be going pretty well.

Chiron is really blossoming into himself and starting to communicate with more words in the last few months.  His brother is still his favorite person in the world and it is really cool watching Chiron imitate Trajan (well, at least in most things).  Yesterday, I was running late and so I had Paul go pick up Trajan and I just went and got the littles.  Normally I pick up Trajan first and he helps me pick them up including rocking and kissing each sister as we put our shoes back on in the front room.  Chiron did this yesterday, I guess becuase Trajan wasn't there! 

The girls are doing well.  At the beginning of September, we got Ari in for a swallow study after the gastroenterologist agreed with me that something wasn't right about how she swallows and we found that she was aspirating with each swallow.  So she is on thickened expressed milk and should be in speech therapy, but getting all the ducks in a row with the hospital has been insane.  The GI nurse says that I should hear with her first appointment by Thursday at the latest, but since we have been working at this for a month, I'll believe it when I hear it.  Allie is following in the boys fine footsteps with extremely severe reflux, but so far no indicators of either milk soy protein intolerance or congenital lactase deficiency.

I was talking to a friend earlier today and realized how much has happened in such a short period of time.  Two years ago today, I was almost 20 weeks pregnant with Chiron and Aurelia with no idea of any problems on the horizon.  Since then, either Chiron or I has been in the hospital for six months and three children have been added to our family.

I still think of Aurelia often.  She is real to me even though she isn't to the rest of the world.  I held her in my arms, she was formed and perfect and complete.  She may have never breathed a breath, but she still was to me.  I don't know if it should matter when she died, but it does for some reason in my head.  She was very potentially viable had she been born instead of died on November 11, 2011.

That said, I think I've come much more to terms with her life and death.  I can mention her without sounding as awkward and don't avoid her when her inclusion makes an answer stronger or better.  I have had some odd thoughts relating to her and the girls.  They look so much alike that it leaves my wondering more of how she would have looked.  You may have noticed that all of their names start with an A.  Aletheia was actually the second name we had identified before we knew Chiron and Aurelia's genders and after a lot of discussion and research, I came back to it this time.  At that point Paul suggested that we make both of their names start with an A.  So all three girls are A's, and I like this.  I still mourn not getting to use and hear Aurelia's name though independently of mourning her, as odd as that may sound.

I've come to the conclusion that you should never make a comment on someone's gravid status, their children's spacing or their genders.  Because I can not count the number of times someone has volunteered that our family is perfect since we have two boys and two girls.

Paul is doing well.  He's always been good, but having the two littles has really resulted in him stepping up to amazing.  He gets the girls down each night while I put the boys down and actually takes and drops off all three littles at daycare on his own.  And he keeps us all fed in addition to all the normal household tasks of laundry, dishes and cleaning.  I've been overwhelmed a couple times by the situation in which I find myself that is my life, but he's plugged through like a pro this whole time.  I'm lucky and blessed and should probably remember to tell him that more often.  And to find the time to just sit and listen and talk instead of feeling like I always need to be running and doing.

Thank you all for caring about me and my whole family.  Here's a couple random shots:

Very random assortment, but I figure I'm unlikely to ever go fill in unless I get smart and use my Facebook to provide structure, so here's for now!

Oh, and I figure since so much of my life is filled with breastmilk that I should add something here.  Ari went up to the NICU for apnea which was probably related to her swallowing disorder, so she had a slower start to breast feeding, but I had both of them feeding pretty well as long as I tandemed at the time Ari was moved to the thickened milk.  Now all of her milk has to be expressed so it can be thickened.  And these girls drink a ton.  I was having to thaw some for a bit a couple weeks ago, but I think I'm back to keeping up with them.  Since Allie direct feeds in the evenings and nights, it's hard to know exactly how much they are going through, but it is dang close to two liters a day if it's not over. Part of my stress came because I gave away the vast majority of our freezer stash early on because until Ari stopped direct feeding I was staying well ahead of them.  But things are looking alright now.

I smell like cabbage...

My body is apparently constitutionally incapable of being typical.  Conceiving twins, who are likely fraternal, with a Mirena IUD in place is a good example of this, but the current issue is actually perhaps even a bit weirder. 

Two nights ago when I went to change out of work clothes before dinner I noticed that my right breast hurt and doing things with that arm was a bit off.  I explored a bit and came to the conclusion that I somehow had a blocked duct.  Now, I haven't pumped AT ALL in over three months and it has been a bit over four since I was exclusively breastfeeding, so this struck me as a bit odd.  The OB had mentioned leaving my breasts entirely alone and being careful to avoid any sort of nipple stimulation, so I found myself in a bit of a quandary.  I had a visibly hard area on my breast that was full of milk.  Those of you who have breastfed probably know the big risk of this, mastitis.  The normal treatment?  Getting the milk worked out.  But I wasn't supposed to interact with my nipples at all!

So, I called the on-call nurse who said to go ahead and hand express it as the risk of mastitis was worse than the stimulation.  She also said to call my nurse in the morning and they might want to see me. I did and they did.

My OB remarked how weird it was, but her best theory was that my body had decided it was time to start producing milk.  She said to NOT hand express any more as that was likely to encourage the production of more milk and instead to wear a very tight sports bra with cabbage on the breasts and replace the cabbage every three hours.  Her goal is to get me to stop producing and dry up.  As I'm just past ten weeks, this sounds like a wise idea.  The only other aspect of the plan is that we will add Bactrim DS if I show any signs of mastitis.

Thus, I smell like cabbage. So far it doesn't seem to be working at getting my breast to stop producing the milk [TMI warning: I'm slow to completely stop lactating, so both breasts were capable of producing a couple drops, but the right one is currently capable of producing an across the room stream -- not what you are looking for in a non-breastfeeding mother with a history of a preterm delivery], but the cool of the cabbage does make the painful area feel a lot better.

That's the end of my ramble on my breasts, aren't you glad you now know more than you ever wanted?  But I learned some other interesting information at this appointment.

I was taken to a room without an ultrasound and the medical assistant took my blood pressure.  It was 120/65, more or less normal.  Then, my OB came in and said that based on my blood pressure she was guessing that I didn't want her to look at the babies, but she was planning on it and only wouldn't if I asked her not to.  I agreed that my blood pressure was lower because I had no expectation of seeing them and thus no need to prep myself for information on their possible demise, but said that I was fine with getting an ultrasound.  They brought in the quickie machine then and while they didn't check it, I'm thinking my blood pressure went up.

I'm glad my OB did this experiment as it helped give her more evidence that I don't have hypertension and also because it helps me to know that the reaction should be within my control.  It's physiological and fight or flight, but if I can get myself to not be as worried about protecting myself, perhaps I can keep it down.  Going to try to play with that.



Both babies were beating their hearts like pros and while I didn't expect there to be much change from the ultrasound I'd had three days earlier, there was.  They are now moving their limbs and bodies obviously!  Was great to see.

It's a bit wacky that I've now had five ultrasounds of them at 10 weeks and change and have two more scheduled for a week and a half from now.  I find it reassuring, in perhaps a morbid way, that if something bad does happen, I won't have to live on for a long period of time not knowing.


And I really do smell a bit like cabbage.

Slowly killing my children with breastmilk

While this may sound like an exaggeration, I think this title is a fair medical description.  My obstetrician, who is very pro-breastfeeding, actually said at the first appointment where we found out that I was pregnant something to the effect of “you’re not even going to try this time”. 

My mentality from the time of Trajan's birth was that while there might be some debates over how strong the merits of breastmilk are, there’s pretty much universal agreement that there are benefits and that’s what I was going to do, dadgumit.  I had a great supply and with a nipple shield to help with inverted nipples, we were gangbusters. 

Then, the day he turned two weeks old (two days after we were finally able to get him off of the biliblanket for jaundice), I became convinced that stooling more than once an hour with mucus was not right.  The doctor agreed and sent us to the hospital where we stayed for the next six days.  They found blood in his stool and the conclusion was that he had protein intolerance issues.  I immediately went on a diet elimination and pumped for three days while he got formula and then they put him back on breastmilk.  The blood and mucus improved, but he still had some of the telltale signs of protein intolerance: skin issues, sinus/ear infections, and stools that were just a little off. 

By four months, I was eating brown rice, lentils, sweet potatoes, spinach and water.  He was still dropping on the weight chart having gone from 50-60% to under 10%.  I was underweight.  His pediatrician looked at me and said, “we are done.  Both of you are starving.  We are moving him to an amino acid formula.”  The change was amazing both in his health and my sanity.

Then Chiron came along.  I was concerned about protein intolerance and talked about it to the doctors and neonatal nurse practitioners in the NICU.  They all said that there’s not a high incidence of recurrence and that actually being premature makes it less likely as the immune system isn’t fully developed.  And he had no issues the entire time he was in the NICU.

About two weeks after his discharge, right around his due date, he started having reflux issues.  Was checked for pyloric stenosis just like big brother and came up clean.  We immediately went to the pediatric gastroenterologist we had used with Trajan and the conclusion was no protein intolerance, but severe reflux.

Fastforward to September, when Chiron was almost nine months old.  He had always been low on the chart, but at this point had literally not gained in over a month and a half.  And just didn’t look great.  His gastroenterologist still thought reflux and we had done all the imaging possible and so decided to adjust his meds and see what would happen at an appointment the next week.  It was literally the next day that he finally completely tanked.  He became lethargic to the point of being non-responsive.  He had extreme pallor.  Again, we returned to the same hospital big brother had gone to.

They drew blood and he was extremely anemic with some other liver and vitamin levels off consistent with malnutrition or malabsorption or something like that.  His gastroenterologist decided to try an experiment and put him on Neocate since it had worked well for his big brother.  His one condition was that I had to keep pumping through it as he anticipated returning him to breastmilk after the three days.  Chiron went from throwing up over 30 times a day as recorded in the hospital on breastmilk to barely 14 on Neocate.

Chiron had literally no symptoms of protein intolerance, but he did so well on the Neocate that it was obvious that he should be left on it.  At the same time, his doctors decided that we should remove all other food sources from his diet to start fresh.  He had deteriorated so badly on the breastmilk that it was still necessary to give him a blood transfusion before discharge despite the improvement with Neocate.

While the reflux/vomiting improved, his weight didn’t.  So, he was again scheduled for a scope called an EGD.  The results from that was the surprising diagnosis of congenital lactase deficiency.  Good news was the same Neocate formula worked great for it.

So, breastmilk caused both of my living children to deteriorate in nutritional status, develop system-wide symptoms and become failure to thrive. 

At the same time, I have a very rare condition called lactation-induced hypoparathyroidism.  Basically, something about the process of lactating causes my body to attack the parathyroid and shut it down like an autoimmune disorder.  This in turn impacts my ability to regulate calcium in my bloodstream.  We didn’t figure out what was going on with Trajan, who stopped breastfeeding at 4 months, but we did figure it out this last time.  It’s treatable with monitoring and medication and knowing about it makes it less of an issue.

Add to it by over 105 degree fever with antibiotic mastitis while Chiron was in the NICU and the 6-day readmit that I earned and you can see why several people have questioned whether I’d even consider breastfeeding these two.

[Note: be proud of me, I just didn’t write a statement such as if they make it to that state.  Great progress!  No really!  And I should write about it.  The appointment with the grief counselor that my OB recommended that I do was really a good idea.]

So, what is my plan?  I’m only at 9 weeks, so have time to work it out, but my plan right now is to first consult with the pediatric gastroenterologist that both of the boys have seen and who is wonderful and ask his opinion about what the best thing I can do will be.  My gut is leaning towards breastfeeding them for a period of time, perhaps six weeks (?) in an attempt to get some of the immune benefits but not risk the longer term issues?  I have promised Paul that I will not be as gung ho crazy and insistent about it this time.  Our general pedi and I discussed it briefly yesterday and she said that I should definitely talk to the gastroenterologist at Chiron’s next appointment in case he wants me to consider diet elimination during pregnancy.

This is obviously predicated on the idea of them being reasonably full-term.  If they aren’t, I imagine the risks of not giving them breast milk will be greater in that period and I will provide them breastmilk.

So, yes, I slowly killed my children with breastmilk, but do I regret it?  No.  It was an attempt to provide the best for them and I am glad I did it.  I’d do it again and if I’m being completely honest really hope I am able to try.

One last fact.  Despite the difficulties we had with our boys, I donated excess expressed milk with both pregnancies to the milk bank and I am happy to say that it was thrived on by recipients and I know from my time in the NICU may have literally meant the difference between life and death for some preemies.

And I own a Medela Symphony folks, it would seem a shame to not utilize it!

BM Dump isn't what you think

Refrigeration is important. 

Sunday, I made a quick trip to the grocery store to grab something we needed for dinner and came home to Paul fiddling with the longest extension cord I'd ever seen indoor.  Turns out that the deep freeze in the garage had lost power at some point.  Yes, the deep freeze holding a couple thousand ounces of frozen breast milk.

It was still cool, but all was melted, so this meant the milk got to go in the trash:

And yes, that box is completely full of milk too:

And here's what you see when you remove the box to take one more picture, just because you are a bit crazy:

I didn't cry or suffer a breakdown and I am veryproud of this fact.

Now, you might be asking yourself why did I still have this milk?  I guess I was thinking somewhere in the back of my mind that maybe the gastroenterologist would put him back on breastmilk at the three week followup and so I was holding off taking it to the milk bank, just in case?

Sorry milk bank!

The trash got picked up this morning, so it's gone.  Sigh.  I am proud of myself though.  I have intentionally avoided grabbing the data and calculating what amount of time that quantity of milk translates to.  I also didn't actually go through the milk and systematically add up the volume.  See, some sanity!

I pumped to:

I pumped to feel competent, to escape feelings of failure, to assuage guilt. 
I pumped to give action to grief, to honor the existence of a person who died before she was born.
I pumped to feel control, to do something, the one thing uniquely in my power to give my son.
I pumped to feel security in the milk stockpiling in the deep freeze.
I pumped because of the mothers I met in the NICU who weren’t able to provide their fragile child with the milk that was needed despite giving their all
I pumped because of the seemingly stable preemies who are lost to NEC every year. 
I pumped for all these reasons, but first and foremost, I pumped because access to breast milk matters.  So for both my son and other babies in NICUs, both met and unmet, I pumped and my grief, my fears, my hopes and my strength all flowed into the bottles.

I pumped to honor our stillborn daughter, to protect and grow our premature son, to help their four-year-old brother learn more of the gift of giving and to help provide access to breastmilk to other babies needing it. 

As I'm closing out my pumping career as Chiron is on Neocate and I just can't justify the time and medication restrictions to keep pumping just to donate, these are my thoughts.  Over 40 gallons of milk to the milk bank and even more than that into Chiron.

Pumping

So, I finally broke down and asked the question of what am I supposed to feed Chiron if I stop pumping.  Doesn't mean that I've stopped or have identified a time to stop, but does mean that I'm closer.

Here's a crazy graphic that shows a positive.  I am not pumping as much or as often.  I am not pumping during the night.  Each line is a day with the most recent at the top.  See the big gap on the left?  That's sleep!  It's updated through the morning of 7/29/2011.  I mainly put this graphic together because I knew it would help give me a push towards more pumping, and I think it has.

So, I did this a couple weeks ago and it has had two effects.  One, it has made me have a better attitude towards pumping and two, it has motivated me to pump during the night if I do happen to wake up.  I'm not seeking to wake up, but if I do, I'm sucking it up and taking a little time and pumping.  And it's had a DRAMATIC effect on supply.  The week of July 29 I was at a 1036.3 daily average and this week I'm at 1231.8 and still going up a little.

I really should write a post some day of my tips for pumping.  I wrote a word document with Trajan that I gave a couple friends, but I can't find it and I wasn't as much of a pro then.  But, for now, I will go with my short three most important tips.

1. Get hands-free.  Seriously.  Chiron was hours old and I sent someone to buy a hands-free strip of cloth (normally sticking them in a bra works)

2. USE your hands.  You don't have to the whole time (I find doing something else with them keeps me pumping longer), but for at least part of the pump, provide pressure to the breast and help express.  Also, particularly if you are establishing supply or worried about it, take a little time to hand express without the pump at the end as well.  Good motivating video for upping your production with a pump.

3. Hydrate.

And a bonus because I'm not sure this applies to most people, but is huge for me, document.  I use Trixie Tracker.  You can use a log book, google docs, or whatever, but keeping these stats has really helped me.  In particular, it has helped me get comfortable with pumping less often which is great for the sanity.  Trixie Tracker is nice because it is phone friendly, produces some useful graphics and also exports to excel great.

Speaking of which: here's the same visual but for the time since July 29:

See the four middle of the night pumps!

Oh yeah, for the sake of disclosure, Trixie Tracker does charge.  For me, it is well worth it for the pumping data.  We actually have stopped keeping stats on everything else in the last couple weeks, but our original six-month subscription after the free trial is about to expire and I'm definitely going to be renewing and I think probably even the six month version...

Breastfeeding doesn't follow the Laws of Thermodynamics

Something has bothered me since the NICU and I'm wondering if someone has an answer.  In the NICU, they said the typical breastmilk contained 2/3s of a calorie per milliliter or 20 calories per ounce.  They also said the average woman makes around 30 ounces a day.  All seems reasonable, right?  Add in a third factoid that it is important to get an extra caloric load of 200 to 500 calories. 

This would seem to say that the average woman produces about 600 calories of breastmilk a day.  And that is 600 calories contained within the milk without accounting for any calories used in the creation of the milk.  This is HIGHER than the 500 calories they give as the high end of the caloric load.

I recognize they were just trying to get some basic facts in with a pumping log, but this seems to clearly violate the laws of thermodynamics.  Breastfeeding mothers as perpetual motion machines? 

My guess is that these amounts are due to an assumption that lactating mothers will also draw upon their maternal stores.

Other interesting trivia fact: based on this, I've produced 190,000 calories worth of breastmilk just counting the amounts that have been pumped and logged, excluding direct breastfeeding and the first two weeks that I don't have my pump log for.

Dagnabit and Decisions

This is the trend of my total milk production (I lost the first two weeks of data so this is 1/5/11 to now.  Also, the dip at the beginning is dual mastitis that earned me my six-day readmit):

I thought it was because of the passage of time since he was born plus the evidence from this graph of my total daily pumping time:

(odd trivia fact: I always subtract three minutes from my pumping time... originally I think I had some theory about it being letdown time, but now I just do it to seem consistent with other weeks.  Well, and the real reason is to probably make it seem like less time.)

I should have been suspicious that the drop was too much to be explained by just the pumping time because after an initial drop, the number of times I have pumped a day has stayed pretty even:

Today I finally figured out what is going on.  I use two pumps: a Medela Symphony at the house and a pump in style at the office.  The pump in style seems to have reached it's last leg.  I had thought this a few times in the last months, but I convinced myself I was crazy.  Today it was obvious that it just ain't cutting it.  Pumped twice so far today and under 50 mL total each time.  And after the second time I experimented with hand expressing.  With a good pump with the Symphony, I can then remove maybe 5 mL per breast.  I got over 30 mL from each breast working less than three minutes per side.

I think I should have been suspicious based on the change in the ratio between the two sides (this is right divided by left):

When I was falling off more naturally, it seemed like the right deteriorated my quickly, but despite the serious decrease in each breast over the last two months, the ratio stayed pretty constant.

So Decisions....

• Do I cart the symphony back and forth?  This is one I bought myself, so it doesn't have a hard case, so I worry about damage to it.  Also it would be huge, I really don't want to do that.
• Do I try just pumping once or twice during the work day and running home?
• Do I rent a second symphony and leave it here?
• Do I just buy a new pump in style as it's handy... Also, I have a trip to Canada coming up that I was considering taking the pump in style instead of the symphony just due to size anyway.
• Do I declare myself done/incompetent and just quit?

Seriously, how did I not notice earlier?  Despite an average of less pumps on the weekends, the production is better... Argh.

I'm leaning towards just buying another pump in style.  If I remember right, that's around $300?  I feel like I've tried everything.  Replacing all the membranes has seemed to improve the performance of the Symphony, but the PIS is just getting worse and worse.

I went home and pumped (just finished) and got more than double what I had gotten from the two pumps I had done at work today!

For the sake of visual completeness, here's total broken down by left and right to make the problem a bit more obvious (yes, I know I should make more useful graphics given the data, but these are fast to autogenerate):

I really do need to take some sort of action, like today.  Thoughts?

Pumping

Pumping as guilt.


Pumping to prove something.


Pumping as a karmic payment to the universe.


So many reasons, but it comes down to I pump. And pump.

I wrote down this quick thought as a note the other day and while it's short, I'm impressed with the "trueness" of it.  I pump to assuage guilt for an early birth, I pumped to prove that I produce enough for two babies and could have fed them (in progress, I've let go of feeling the need to do this), I pump as some sort of payment in my mind for Chiron being so lucky in the NICU.  Who would have thought that one action could be rooted in so many different psychological explanations.

I've now logged over 64 gallons of milk (8199 ounces and 242482 mL) with the first week and a half of my pumping missing from my log.  I've got 1137 recorded puming sessions and since I was pumping 10-12 times a day those first days, I have definitely pumped over 1200 times.

I haven't gotten an update from the milk bank recently of how much I've donated, but it was right around 3000 ounces the last time they called me.

Moo. 

I honestly have considered stopping some in the last few days, but I don't think that I'm there yet.  Chiron has issues with reflux (Zegerid and Bethanochol improve it though) and the gastroenterologist said that it's likely to be best with breast milk.  He doesn't seem to require that I do the diet elimination that his brother did, so I think it's best that I keep on carrying on. 

To help motivate myself, a list of reasons to keep it up:
1. best for X-man's stomach
2. address all those psychological explanations
3. the excess really can mean the difference between life and death for preemies
4. can't really start up again if I change my mind and while the pumping exists only in the now, the decision is forever
5. I think he may be supposed to take special caloric formula if we move him to formula and that looks expensive
6. don't have to deal with formula diapers!

Anybody else have any other items I can add to my list when I feel whiney/when I'm up in the middle of the night/when I'm figuring out where to pump at a conference/when I'm exploding because I got caught up in meetings/when I'm working out a plugged duct/when my work shirts don't fit because of said lactation?


- Posted using BlogPress from my iPhone

Dairy Cow Express!

Much like the Pony Express, but with breastmilk.  I've been working at figuring out the logistics of shipping breast milk and it is complicated!  The excess milk is currently in our deep freeze, but we have to figure out getting it packaged so that it will arrive on the west coast still frozen. 

I'm thankful for surrogates, because websites dealing with surrogacy have a fair bit of information on breastmilk shipping.  It looks like the method we are going to try first is a styrofoam cooler lined with aluminum foil filled with the  breastmilk containers (I'm going to select out the ones that are full rather than half way to cut down on the dead space) and then broken up chunks of dry ice.  If there is any space at the top, I'm to fill it with newspaper.  Then the cooler gets packed into a cardboard box and shipped overnight.

Still need to talk to the UPS store to find out what time I should pack it and drop it off to achieve the least "extra" time the milk is out before being overnighted.

Dropping it off at the milk bank is much simpler.  How I wish milk banks had reciprocal arrangements like blood banks so I could donate here and they could extract there!

I'm hoping that only this first time is difficult and then it gets straight forward, because otherwise I can't see myself being able to pull this off going forward.  Particularly during the time that Chiron can't go inside places...

“Psst… got some breast milk, step into my alley”

I’ve got an oversupply.  In the time since Chiron was born, I’ve fed a stranger’s baby from an hour away who needed to fill a temporary lull in supply, I don’t know how many numbers of babies in the NICU or with prescriptions through my almost 20 gallons worth of donations to the milk bank and one baby who was born “too old” to get donor milk in the NICU whose mother really did not want her to have formula and whose milk came in slower than what the NICU wanted for her daughter’s intake (this was done completely under the table, i.e. she labeled it as her own).

I’ve been kind of hush-hush about this, but suddenly it hit me that I had no idea why I was!  Or why I was relatively (for me) hush-hush on the whole topic.  We don’t bat an eye at cow’s milk, why should breast milk be a big deal?  I am blessed to have an oversupply in that I CAN help others.  Why not celebrate and embrace this?

Similarly, why is breast milk a biohazard whereas spilling cow’s milk would just be an annoyance or a mess?  Only thing I can come up with is the slight risk of communicable diseases?

We have two friends who moved to another part of the country a few years ago.  They have a daughter who was born just a little after Chiron (full-term), and while the mom is supplying most of the milk their daughter needs, her supply just isn’t quite keeping up with the demand.  From Facebook she knew I was donating to the milk bank (see the relatively hush-hush comment), so she sent me a message that rather tentatively asked if we would consider sending them some of our excess if they’d cover the costs.  I hate that this was tentative.  Knowing that I had an oversupply, I wish she had been confident that we wouldn’t see this as a weird request and would be eager to help and share. 

Why is milk such a taboo?

As part of my answer to that, I must admit that I am a hypocrite.  I avoid discussing this topic, and in particular pumping, at all costs with my boss.  Actually, despite pumping with both pregnancies in the office, I have never once discussed it with him.  I just flip the lock on my door and shut it.  In fact, we have a conference coming up in a couple weeks and while it is in town, the hours are long enough that I absolutely will need to pump while there, so I have booked a room at the conference hotel.  I feel confident that the firm would reimburse for this (though perhaps ask that I attend the hospitality suite as long as I have a room there), but I’m so hesitant to discuss it that I’m considering just eating the $170 or so for each of the two or three days.  Sigh, I really think I need to man up on this.  And I’m this level of a hypocrite with a great firm behind me.

Similarly, I forgot a cooler this morning, so I ran home to get one.  It did not even cross my mind to just store them in the refrigerator.  Albeit, I live about a mile from the office and I needed to go home to trade cars with Paul at some point during the day anyway, but what amazes me is that I honestly didn’t even think of the possibility of getting through the day without a cooler until I was driving to the house.  I could easily have grabbed a grocery sack from the stash in the kitchen and stored the milk in the refrigerator.  But I didn’t.

My honest guess is the hush-hush nature is the result of two things.  First, it is a bodily function/fluid and generally we don’t discuss those much in society.  And second, it relates to BOOBS.  OMG, I just said BOOB.  BREAST, hehehehe.  I don't think wetnurses were Ishmaelites though, so it can't have always been this way.

So while I get it, I think perhaps we should get over it.  While it might be a bodily fluid, it’s also a food option for babies.  There is no problem talking about formula, so I’d like to see that courtesy extended to breast milk.  Perhaps even more so, because in some cases breast milk can be a life saving alternative to formula such as where it prevents the development of necrotizing enterocolitis in micro-preemies!

I’ve got no plan to make this happen other than to try to cut back on my own hush-hush behavior.  And honestly, I’m labeling that as “try” because I’m not sure I will pull it off. 

Random Short Thoughts

• I heart Trixie Tracker.  Main reason is for the pump logging, but the sleep and intake/output logs are definitely useful as well. There are definitely some things they could do to improve and clean it up, but it's good enough to justify my use already (even after the free trial ended!).

• What's the likelihood that both the delivering obstetrician (my actual one :-) ) and the last antepartum nurse that I had (who administered the last Terb protocol because L&D was full) would both be named Felicia?

• My phone is back to correcting og to of instead of OG and this makes me smile.

• Chiron's appearance no longer hints towards an alien chimpanzee and really not even so much a chimpanzee at all anymore.  He was cute as heck, but definitely open for a bit of humor.

• I was looking at the few posts here and it seems disproportionately shifted towards Aurelia.  That's not because it's the focus of our lives, but because she does only exist in our minds.  The boys are a part of our every day.  That said, I'm working on something as a followup to a conversation with a friend that is Aurelia based.

• On that note, I was told to guard myself against twins, but they haven't ever bothered me.  Saw a bunch in the NICU and seem to see them nearly daily.  I would say I'm more cognizant of them, but not bothered.  However, this did upset me a bit, proving that I'm totally random.  Just a moment of pause, but enough that I noticed it.  They are cute as heck though, so go look.  These lions were born the day after Chiron and Aurelia.

• Wonder if there is any developmental effect on Trajan of all his work with breast milk.  How many 3.5-year-olds can assemble a breast flange including the membrane and getting the tubing in?  Know the location on a breast milk storage container where the NICU likes the label to be placed?  Practice their counting by putting 20 containers into each bag for breastmilk drop-offs to the milk bank?  He really is helpful though and it is great because it gives us something to work on together that also gets something that needs to be accomplished done.

• I really want breast milk to be one word instead of two.

• How does my boss magically know just when I have hooked up the breastpump two minutes before?  And then I can't bring myself to bother to set up again, so just stick with the partial pump.  Oh well.

• Maybe I should be worried about my development instead of Trajan's considering how much time I spend thinking about breast milk!

• On a final random breast milk note, Chiron actually ate enough at the breast yesterday to need no top off and to leave over a 100 mL deficit in my pumping on that side!  Woot :-)