The First Week

This photo was taken when Max was one week old. We celebrated by making box-brownies (aka ready-to-go, in a box, brownie kit), which I decorated with writing icing. A large pink “1” surrounded by hearts and stars. Of course it was more for me than for Max, or anyone else. I needed to celebrate. I needed to eat a ton of gooey delicious brownies! The first week had been difficult. More than that. It was traumatic. It’s painful to look back, to really remember.

After bringing Max home from the hospital we were in a whirlwind trying to figure out what he needed at any given moment. Feed, change, try to put down to sleep. Repeat. After one night alone in the hospital, I was grateful to be with Steve and my parents at home. It was comforting to be next to Steve during the night and have his support. 

Exhausted

Max fed often, day and night. He was especially awake at night. He would have 45 min - 1 hour naps and wake up hungry again.This is normal for newborn babies. Sometimes he would be awake for hours, unable to settle. 

When he was able to finally sleep, I would lie back in bed with my body fiercely aching from my operation. I had a dark purple bruise on my back where the spinal needle had gone in and the whole area hurt. My abs ached with any movement. My arms throbbed from the tension in my shoulders built up from hours of holding Max in awkward positions to breastfeed. 

I remember lying back down in bed in the early hours of the morning after the first night home and starting to sob. My whole body felt awful and I felt like I could never satisfy Max’s hunger. Steve rolled over, asked me if I was crying and pulled me close. “It’s going to be OK,” he said, “you’re doing a great job.”

For the rest of the first week, I pretty much just lived in my parent’s living room. I didn’t bother going to bed at night because I knew that Max and I would be up so often to feed. He slept in the bassinet on our stroller and I took occasional naps on the sofa. 

I’m not sure why we ever thought this was a good idea. It was not a good idea. 

The Amygdala Effect

That same first night, after getting back to sleep, I woke from a nightmare. I had a dream that Max died. His lifeless body floated in an ice cold tub of water in an underground cavern with huge stone walls. A Gringotts Goblin, who worked this magical water bath that was meant to help bring people back to life, said plainly, “It was too late, he’s dead”. 

I woke with my heart racing, again in tears. “Stupid amygdala!” I said to Steve after explaining my new tears (he didn’t want to know the details of the dream though). The amygdala is the emotional part of the brain, where worry and anxiety live. I had learned recently that when a woman has a baby, activity in her amygdala grows significantly. We’re hardwired to worry more. Research has also shown increased activity in the non-childbearing partner, and new parents who adopt, but to a slightly lesser extent. I knew that this dream was a sign of my forever altered brain. 

I honestly thought Max was going to die for the first two weeks. I worried about it constantly. I read so much about Sudden Infant Death Syndrome (SIDS). I got up from bed repeatedly to check he was still breathing in his cot. I asked Steve to double check when I didn’t trust my own assessment. I think some of it was caused by his loss of weight after birth and our difficult journey to feed him enough. 

Weight Loss

On day 3 of his life, Max was weighed by the maternity support worker (not a midwife, but someone who is trained to support women pre- and postnatally). The MSW was a middle-aged woman who spoke in a kind, soft voice. She reminded me of a nursery teacher. I had met her before, she taught the breastfeeding class I had attended weeks before Max was born.

I told her how exhausted I was with the constant night feeding. “Remember what I said in the class: babies are programmed to be awake at night. Many millions of years ago, they would have been kept in the caves to feed all night, safe away from the wolves and the dinosaurs and what not.” Yes, she said dinosaurs. 

Some weight loss is normal, but Max had lost 12.1% of his bodyweight. Anything above 10% they are concerned about, above 12% usually requires a trip back to the hospital. Given the situation with COVID-19, the MSW and her supervisor (a midwife, consulted by phone) agreed not to send us back to the hospital. Instead she discussed a feeding plan with me and would see us every two days to track his progress.

The MSW had listened to me describe our breastfeeding experiences, how sometimes Max would suckle for almost an hour at a time. Because he was so small (6lb at birth and now 5lb 4oz) this was too long and he was probably tiring himself out. Expending more energy sucking than he was taking in. My milk hadn’t come in yet, I was still producing mostly colostrum, not mature milk. The plan was for me to hand-express (in other words, milk myself like a cow!) and feed Max with whatever I was able to express via a small cup after 30-mins of breastfeeding. Give him some “easy food.”

Steve hadn’t been allowed into the appointment with the MSW. They were trying to keep foot traffic in the building low. When I walked out to meet him, I burst into tears while trying to tell him what had happened. 

I felt a whole mix of emotions. I felt shame. Shame that I wasn’t feeding my son adequately. Shame that I had somehow failed Max. I was also afraid and worried for him. He was so tiny and vulnerable and I was 100%, wholly and completely responsible for him. But I had no idea what I was doing. He was a complete puzzle to me. Where’s the manual when you need one?

On top of all this, the COVID-19 pandemic was growing worse in the world around us. It was painful that my sisters were not able to come over and meet Max. We were all isolating separately, and one of my nieces had a cough. My younger sister came to the back of our house with two of my nieces and saw Max through the window. I had to hand him off to Steve though because I couldn't take it. I walked away from the window and burst into tears, sad that they couldn't just come in and hold him.

Exhausted with puffy eyes from all the crying. Tiny Tiny Max.

The F Word

On day 5 we went back to see the MSW. He had gained 30g, which babies are expected to gain daily, not every two-three days. I was anxious that he still wasn’t gaining weight quick enough. The MSW assured me this was a step in the right direction. She said, “Imagine a boulder rolling down a hill, now you’ve turned it around and he has to push it right back up that hill. It’s just going to take some time”. 

She gave me an electric pump to use instead of hand expressing and suggested that we give Max either the expressed milk or formula to top up after every breastfeed. 

The F word. 

Formula. 

I was desperate to exclusively breastfeed Max. Everything I had read told me that introducing formula would threaten my milk production. Every drink of formula is him drinking less from me, and therefore I’ll produce less. Introducing a bottle before 6 weeks could threaten breastfeeding by causing “nipple confusion” - where the baby would have trouble latching properly on me. 

And that’s not all. There’s so much thrust in your face about how formula fed babies are at greater risk of SIDS, and of X,Y,Z diseases, including obesity. Formula has a real bad reputation. I had never judged another mother for use of formula. I didn’t realize how ingrained “Breast is Best” was in me until I had to face this big question for myself. 

What if breast wasn’t enough?

The day before Max’s 1 week birthday celebration, I was destroyed. Exhausted. Constantly weeping. When we sat down for dinner, I couldn’t eat. I was too tired. Steve urged me to take a break, go to bed for a few hours of real sleep. He would feed Max some formula at the next feed. I knew I needed sleep, so I reluctantly accepted that we needed to use formula and I went to bed. I woke again 5 hours later in panic with leaking boobs. Max slept a little better that night, though at first the increased amount of formula confused his digestive system and he was pretty fussy. 

I felt a thousand times better the next day. I danced around the living room with him. I smiled. We had another appointment with the MSW, but this time a new person saw us. He still wasn’t gaining a lot of weight, but she assured us we had up to a month for him to get back to birth weight. It was OK for it to take some time. I didn’t even cry.

Celebrating the little things

So that evening, my Mom and I stood in the kitchen making brownies. I had Max tied to me in a colorful yellow sling. Often when he wont settle in the cot, I can settle him in the sling, wrapped up close to me. He can smell me, feel my warmth, and listen to my heartbeat.

After dinner, we brought out the brownies that I had decorated. We took a photo to mark the occasion. We called Steve’s parents in America and all sang happy birthday. It might sound ridiculous to celebrate the baby's first week, but that week felt like absolute crap. And I needed this celebration. That evening, I felt like, OK we got here, let’s take it one day at a time.

I didn’t move back upstairs to sleeping in a real bed for a few more weeks. Finally, with the help of formula and increased pumping, Max was sleeping better and I was able to get more rest. 

I’m really happy to say that eventually, after significantly increasing the formula we gave him, Max made it back to his birth weight. He’s now growing really well, although he’s still on the second percentile. At 7 weeks old he weighs 8lb 11oz (we use luggage scales to weigh him every week!). Despite many efforts, and advice from breastfeeding experts, I wasn’t able to increase my milk supply for him. There’s a lot more I could say about my feelings around that. I think it would be a whole blog post by itself and I’m not ready for that. Not yet. 

I’ll just say that now, Max sleeps really well, I don't feel exhausted all the time and I am grateful for those things. I’m also pleased to say that I haven’t had any more terrible nightmares like the one that first night. And I no longer double check his breathing... OK, maybe once or twice a week I do!