Monthly Archives: October 2008

A Jamie Story

(With backdrop of Sodor Adventureland)

'One day, Diesel had a square face.  He went to visit James who had a round face and Spencer who had an oval face.  They were on the turntable.  Diesel went on the turntable.  The turntable was switched off so they went to see the Fat Controller, who said they had to press the big white button three times to make the turntable work.  They pressed it <press press> 1 <press>, 2 <press>, 3 <press>.  No! That's too many times!  You must press it 3, 2, 1!  Then they could press it 1, 2, 3.  Then the turntable turned round and they could all go into the sheds and go to sleep.'

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Mammalian

Katie, at almost eleven months old, is still breastfed.  I don't think she's actually taking more than a token few ounces a day now, and, with a horrible cold and incipient tooth dampening her enthusiasm for the whole thing, currently I'm not sure she's even getting that much.  However, while it would be an exaggeration to say that we're still going strong, we are certainly still going; and I am very pleased about that.

Lately, she's been getting nursed around four times a day on the days when I'm at home (I'm not strict about scheduling, so there are probably days when it's a feed more or less than that), and given top-up bottles of formula as well as her solids to make up for the shortfall in supply resulting from months of pumping at work and the recent night weaning.  On days when I'm at work, she gets formula during the day and I nurse her in the evenings before bed, topping her up with a last bottle of formula after that.  (I do pump at work, but we discovered some months back that she's actually far happier on the days without me if we give her formula instead of the milk I'm expressing.  We can only assume that the breast milk has a "Don't taunt me with what I can't have!" effect, and that she's happier not being reminded of me when I'm not actually present.)  She also still gets one night feed on some nights, when she can't make it through without one. 

What with the way her intake has dropped off in recent days, it's quite possible that the end is imminent.  However, if she does pick up on the nursing again, I'm going to aim to keep going on that sort of schedule until she hits her first birthday.  I do recognise that that's a bit arbitrary as a goal, but it's the goal recommended by the American Academy of Pediatrics, which gives it a general feeling of validity, and it feels like a reasonable compromise between wanting to get as much breast milk as feasible into her while she's still so small and has so much developing to do and wanting to be done with the whole hassle of pumping at work thankyouverymuch. Given the latter consideration, I'm not planning to keep up with the daytime feeds any further past one year than it'll take for me to wind down production without putting myself at risk of mastitis (unfortunately, my working days are so long that I won't be able to give up daytime pumping without also giving up the daytime feeds on the days when I'm not with her), but, if she's happy to continue to nurse at her evening feed, I'll be happy to keep that one going for a bit longer.

Ideally, I'd like to keep going until she's around sixteen or seventeen months.  That'll take her through the winter, and it seems reasonable to believe that the various immune factors in the milk will give her some extra protection against the various germs flying around during that time.  (Incidentally, despite what extended breastfeeding advocates claim, this hasn't actually been proved to be the case; the study that I regularly see cited as showing lower rates of infection in nursing toddlers actually proved, when I dug it out and read it, to be a study looking at weaned toddlers.  I'm coming back to correct my own post here as that originally went on 'and showing that they got infections just as often as toddlers who'd never breastfed', which is also not quite accurate – the group weren't compared to a never-breastfed group but were compared within-group to see whether duration of breastfeeding was related to rates of infection post-weaning, which it wasn't.  The point is, the Gulick study isn't about breastfeeding toddlers despite being commonly cited as such, and tells us nothing about infection rates in breastfeeding toddlers compared to non-breastfeeding toddlers.  Moral: Be very wary of people who claim that the science just conveniently happens to back up what they believe in, because it's truly unbelievable how things get mis-cited when an agenda comes into play.  However, it does seem reasonable to believe that all those oft-touted antibodies and immune factors are doing something, and I'm quite willing to keep up that one feed a day through the winter months in the hope that it might help.)  But it'll also be an age at which weaning from that last feed hopefully won't be too difficult; that's about the age Jamie was when I stopped nursing him, and, when I looked
back afterwards, I felt it had been the right time.  I think that if I'd
nursed him into his third year (which was what I'd originally planned
to do) then weaning him at that time would have been much harder.  I don't really want to go for child-led weaning; sixteen or seventeen months, if I do make it that long, seems like the right sort of time to stop.

So, that means that I'm likely to be all done with breastfeeding within the next six months or so at most.  As things stand, I don't know whether I've currently got days, weeks, or months left as a nursing mother; but it seems fair to say that, one way or another, the days in which my breasts are of use as well as ornament are numbered.

Inevitably, I feel a pang at the prospect of closing the door on that part of my life.  Breastfeeding is fun, and convenient, and has lots of advantages beyond the heavily touted health benefits – the way that it allows me to be simultaneously Doing The Best Thing For My Child and catching up on my favourite blogs (multitasking doesn't come any better than that), the comparative ease of getting out and about even when mealtimes are imminent, the lack of associated washing up.  I'll miss the sense I had of doing something just that bit unusual and daring and controversial just by feeding my child in public.

Most of all, I'll miss the thrill of being able to do it, do this amazing yet everyday thing: make milk. I can make milk.  My body works.  I fulfil the definition of the word 'mammal' on an individual as well as a species level.  If my baby and I were left together in a jungle or on a desert island I would be able to keep her alive.  (At least until I starved to death myself, having not the first clue about survival in the wilderness, but my mind glosses over that detail.)  On the PumpMoms mailing list, one woman had a quote in her signature that I loved: "I make milk – what's your superpower?"  While I fully recognise that that doesn't stand up on the logical level (and, no, it is certainly not something I would ever put on a T-shirt), on an emotional level it perfectly captures how I feel about this ability.  I make milk.  My body will never be able to make me an athlete, a supermodel, or a sex goddess, but it can do a damn good job of making my baby some milk.  I make milk.  Is that cool or what?

And, in amongst all of this, I do feel at least a twinge of nostalgia over the thought of giving up the nursing itself.  It's not an unmissable part of my life – I'm not in the camp that sees it as some sort of Amazing Mystical Indescribable Irreplaceable Bonding Experience. But it's something I've done a lot of, and enjoyed doing, and, at some point sooner or later, will have to say goodbye to ever doing again.  It will be yet another part of life and parenthood that moves into the past.  Already, I can't remember exactly how it felt to nurse a tiny baby; one day, all the memories of just how breastfeeding felt will have faded away.

So, for now, I try to memorise exactly what it feels like, to impress every detail on my brain.  The way her head rests on my forearm and my hand curves round her back.  The way her hand grips and kneads and pushes at my breast, or twists round my finger, little and strong, when I try to hold it out of the way.  Sometimes, her other limbs will try to get in on the action; her leg will wave aimlessly in mid-air or I'll feel her other hand, tucked down under my arm, twisting and turning against my side.  I can look down and see her jaws working away energetically, chin moving up and down, a textbook latch with her wide-open lips flanged outwards and her tongue visible over the bottom lip.  The intent look in the one blue eye I can see, as she looks up at me.  I notice all these things and try to store as much of them as I can in my brain.  I try to remember everything I can about how it feels, about what it's like, right here and now, to be a nursing mother.

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Ten months – Stand up clap hands

Katie can now pull herself to standing.  She will imitate us when we clap our hands for her (a cute milestone for any parent to see, but with extra significance for us; Jamie never did this, and the fact that Katie does is another indication that she probably isn't on the autistic spectrum).  She loves her baths and howls disconsolately when it's time to be lifted out and dried.  She likes helping me pull the cord on the light switch in the bathroom and, when I say to her "Can we switch the light on?" she understands me and looks round for the switch.  She has a grand total of five toofy-pegs – all four of the front ones and the bottom right incisor.

She has started in Gymbabes (the baby version of Tumbletots).  This involves a certain amount of awkward timing; Gymbabes/Tumbletots classes run throughout the morning in age group order, starting with the Gymbabes class and moving on through progressively older groups of Tumbletots.  Therefore, we now have two children to get to two different classes at different times of the morning.  We work it by splitting up the children (fortunately, the classes are on my day off each week); I take Katie while Barry stays home with Jamie (both of them normally still in bed at the time I leave), and, later on, Barry takes Jamie while I stay home with Katie.  Since this is also Barry's day for going shopping, he does this between the two classes, while I stay home with both children.  The effect is a bit box-and-cox, but rather fun – I get a bit of uninterrupted time with Katie at the class, and then, since Jamie's class pretty much coincides with one of Katie's somewhat erratic nap times, I get a bit of uninterrupted time to myself at home.  That really is good, even if I do spend most of it emptying the dishwasher and putting the laundry in the dryer.  Katie, meanwhile, took a while to warm up to the idea of the classes, but rapidly got to like them.  Especially the ball pool and the giant green ball that's bigger than she is.

The other adventure of Katie's tenth month was night weaning – cutting out her night feeds.  I started writing all about the whys and wherefores of this, but it seemed to be taking over this whole post and in the end I decided to consign it to the vast mental heap of Things I Really Will Write A Post About Some Day, Honest.  The how was simple enough – I switched her onto the bottle for night feeds so that I could tell how much she was taking, and then reduced the amount gradually over several nights while increasing her daytime intake, so that she wasn't actually hungry at night during the transition. This was, of course, a complete and utter pain – instead of simply hauling her into bed with me and nursing her when she woke up, I had to get up and warm bottles – but it avoided all the crying that seems to happen in most of the accounts of night weaning that I've read, and it worked.  A week after starting – four nights before turning ten months old – Katie made it through from bedtime to breakfast without sustenance, and has done so on a regular basis ever since.  (She does still occasionally need a few ounces to get her through, but that's now the exception rather than the rule.) 

She does still wake up each night, but that's not a big deal – I still take her into bed with me, only now without the feeding.  I shall change that too, in due course, if she doesn't grow out of it spontaneously in the near future (which is quite possible – Jamie did, within a week or two of me night weaning him, and Katie has been waking up progressively less often since being night weaned and has been noticeably easier to settle when she does wake, so I shall see how it goes), but I'm happy to wait a bit on that one and rest on my laurels for now.

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Checks (and possibly even balances)

Update on the latest of the perennial assessments of various aspects of the children:

10th September was Jamie's latest orthoptist appointment.  It was a joint appointment with the ophthalmologist, which meant it was on a different day of the week from usual and hence at a time when I was at work and had to leave this one to Barry.  As much as I love being involved in every detail of my children's various assessments, not being at this one did have the advantage of sparing me a confession; my excellent intentions of persevering with the patch had almost completely gone by the wayside, for the simple practical reason that getting him to keep it on for more than a second or two is now a feat of near-impossibility.  He can rip it off faster than I can replace it, and more often.  Since this involves pulling his glasses off as well, and he doesn't put them back on after ripping the patch off them, this means that putting the patch on him was not only not resulting in him wearing it; it was resulting in him spending less time wearing his glasses.  Since correcting his vision is also important for keeping his left eye working (if he can't see as well out of that eye, his brain is more likely to tune out the image), my attempts to patch him were actually backfiring as far as his future visual acuity was concerned. 

Of course, I could have tried harder.  I could have found time to hover over him intensively, putting every effort into stopping him from removing it and distracting him onto other things.  While doing this for the prescribed hour a day would simply not have been possible short of leaving Katie to fend for herself during that time, I could have managed a bit more than I did.  Mea culpa; I gave up on trying.  Pat had, after all, initially said that we could have a go of not using it for a bit; how important could it really be?  I was, it seemed, about to find out. So I awaited the verdict from the appointment with some trepidation. 

The verdict, fortunately, was favourable; I'd made the right choice.  His left eye was still doing OK, and we could move from dispensing with the patching unofficially to dispensing with it officially.  We have also been told that his lens prescription has changed.  This may account, at least in part, for the fact that he has recently developed the habit of taking his glasses off all the time, even when we're not trying to patch him.  This has also been rather a problem given that when he takes them off he tends to chew the nosepieces – those little rubbery translucent things that cushion the seat of the frames on his nose, due to child-shaped noses not holding spectacles as well as adult-shaped noses.  When they're chewed, they often come off (or split).  So we spend a lot of time groping round on the floor trying to find missing nosepieces, or making trips to the opticians for spares.  Fortunately, getting his new glasses does seem to have diminished his tendency to do this at least somewhat.  (And who cares?  We no longer have to put eyepatches on him!  Hooray!)

The other recent assessment-type thingy was Katie's eight-month check-up (at least, I think that's what it was officially called, although she was more like nine months and change by then), which was on September 16th.  I hadn't realised that eight-month checks still existed locally – I'd thought that they'd gone the way of the three-year checks, into the black hole of Insufficient Funding.  However, it seems they've survived, although somewhat abbreviated from what I vaguely remember them being back in the days when I had to learn about them for the MRCGP.  It pretty much consisted of the health visitor putting a couple of small cubes down on the table in front of Katie to observe her reaction.  Katie duly grabbed them and played with them appropriately, demonstrating such behaviours as hand-to-hand transferring and whichever type of grasp it is that babies learn just before learning pincer grasp (there's an official name for it, but I've forgotten it), and was pronounced in fine shape developmentally. 

"With Jamie in mind," Carol added, "her looking for approval is absolutely spot on."  I'm not keen on that particular phrase – 'looking for approval' has undesirable connotations of being excessively dependent on the opinions of others – but, in this context, it refers to the way a child will look up at the adult interacting with them, checking in, sharing the experience. One of the many clues to Jamie's ASD diagnosis was that he did very little of this during his assessment with her.  The fact that Katie does do this is a significant sign that – as we already thought – she probably doesn't have ASD.

Carol asked us if we had any concerns (we did not), gave me a copy of the Edinburgh Postnatal Depression Scale to fill in (it's a screening test for postnatal depression), and gave Katie a bag of books from Bookstart, which Jamie immediately ransacked.  (He found a laminated placemat with nursery rhymes on it and promptly started reading them aloud, to Carol's surprise – she was impressed with his reading skills.)  We then went out to the main waiting room and weighed Katie, who is now approximately 19 lb 10 oz, or approximately 8.88 kg if you want to be metric about it.  You may notice that those figures aren't even exact conversions of each other, which gives you an idea of how approximate the weighing process was – getting an exact weight would have involved her sitting still for a minute, which was not really on the cards, plus I forgot to take her nappy off when I undressed her – but they're ballpark figures.  She is, in any event, still trekking comfortably up the 50th centile, her growth going as nicely as everything else.

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