Monday, June 25, 2012

A Mother... or Friend?

Today is about a month after the birth of my child.  What does it feel to be a "mother"?  I put inverted commas to the word mother because I have yet to experience motherhood in the full sense.

Summary of progress
My child is currently no longer on CPAP and long lines, with only the OG tube attached for feeding.  He feeds on expressed breast milk (EBM) and fortifications.  His weight gain isn't really significant, though he beginning to look more like a baby rather than a fetus, unlike on Day 1... if I were to ignore the size aspect.

"Wow, we finally get to see what you look like" was the first phrase uttered when my husband and I saw our child's full face for the first time ever when the nasal cannula was removed.  

Against our usually compliant nature, we went against the prohibition to take photos.  I'm pretty excited to share some of the photos, but after a few considerations, I think it's better to do so only when the time is right.  But I'll definitely not say no if you come to me privately and ask to see the photos.  I'm amazed that he looks like my brother during his baby days... oh, you can never miss on what's genetically-connected!

Nevertheless, I'm still not free of concerns about my child because premature babies face more risks than full-term ones.  

Providing milk
What is a mother to do when her child is kept in an isolette in hospital while she's free to go home?

My daily routine now comprises expressing as much milk as possible, and then storing them in the freezer.  Each time I go to the NICU, I'll bring along with me bottles of EBM in a cooler bag, which I then keep in the freezer at the Bilik Penyusuan.

.....

What's natural and what's not
Basically, a baby who suckles on its mother stimulates the production of the hormone called prolactin.  Prolactin thus stimulates the production of milk.

Since I have yet to enjoy the opportunity of letting a baby suckle on me, I have to go by the artificial way.

Electric or manual?
The general rule in determining which type of pump to go for depends on how frequently do you need to express your milk.  If you need to express milk once or twice a day, a good-quality manual pump should be able to do the job fine enough.  But if you need to do it more frequently, or if you require better simulation of a suckling baby, then an electric pump may be a better option.

The lactating room at the NICU in Hospital Ampang has a high-end electric pump for mothers whose babies are there.  However, due to time and distance factors, I have yet to try using it although I'm sure it will do a much better job than my mid-end pump.  Initially, I had intention to buy a brand of pump.  But since the nearest baby accessories shop to my house only has one other brand, I have settled on the latter.  It's not too bad after all, it still does a reasonably good job although it would be better if it operates without sound.

Doing it differently
I believe that a mother's milk production goes higher with the availability of a baby who suckles on her.  No matter how high-tech is one's pump, it can never defeat what's natural.  What is there for me to stimulate more production?  So far, I've never exceeded 300 ml per day... an amount that's still adequate for the time being, but surely won't be enough for a bigger baby.

My EBM experience so far
When expressing milk, I've tried doing it under different environments.  In the end, I notice that the following conditions as conducive to a greater productivity:

1. An environment that's free from distractions such as the computer and Internet.  Don't know for what reason, I always ended up with an unproductive session when I had access to the above.

2. Thinking of my child.  That I must provide him with sufficient food to grow up, more so when he's so small right now.  The best way is by looking at those photos taken against regulation.

3. Listening to music.

4. A gentle self-massage with the help of a warm towel before expressing milk.

Ideally, one should express milk at least once in 4 hours, which means 6 times daily (24 hours divide by 4).  But so far, I only managed to do 3 times per day - usually from 7.30 - 9 am, 2 - 3.30 pm, and 8.30 - 10 pm.  I wish  soon to be able to wake up in the middle of the night for one more session so that I can start training myself to stand with less sleep.

It gets boring at times to sit through an afternoon session, post-lunch time is always tempting for a siesta instead of expressing milk.  I have no choice but to do it first and then take a nap if I have time rather than vice versa to avoid waking up engorged and painful later.

I notice that I have little time to waste i.e. time management is crucial, in which I've not been really up-to-the-mark at home - like how I'm wasting time writing this note when I should be pumping right away (and later complain that I have no time to take a nap).  

After all the effort, it gets really frustrating when milk accidentally spills, no matter how little... like what happened last night.


How was confinement?
I hardly spent a day without going out.  If not to the NICU, I'd be doing my usual chores.  To me, doing chores keeps me occupied, helps alleviate stress, and probably contributes to a speedier recovery.  

Other than the consumption of red dates tea for a month and taking herbal bath for 2 weeks (my mother-in-law prepared them), I did not adopt other traditional Chinese confinement practices such as the consumption of rice wine chicken and pig's trotter (I have a strange phobia for various parts of pork).  I took my bath and washed my hair as usual, and consumed some cold drink (when no one's looking) when I feel hot because cold water provides instant hydration.  The herbal bath feels a little spa-like due to the pleasant scent produced, surprisingly relaxing.

My take on "wind", a much-feared element as per traditional Chinese confinement belief is that it's neither entirely correct nor wrong.  While the uterus contains some gas after becoming suddenly emptied post-delivery, such gas is only limited to inside the uterus and will not pass to other parts of the body.  And thus, practices such as fully covering up the body when outdoor, refraining for bathing and cooling food are actually of no real necessity.  Like others, I felt slightly bloated during the early days, but I just "tahan" the discomfort and tried to relax.

Just in case if you thought "how come you're so lucky that you didn't get reprimanded for going against traditional practices", it's actually because I didn't bother listening to what people told me.  Although I didn't argue with anyone, I thickened my face and did not take notice of what I was told to do or not to do by my elderly.

The sensation each time when I visit the NICU
Each time I go there for my visit and to deliver stuff, I'd get that pre-examination sensation.  I'd have butterflies in the stomach before I go in, and if I'm pleased with what I see, I'd regain my appetite and eat happily.

In view of the shocking incident last year, gone are the days when I used to be very positive whenever I go to hospitals.  So, it surely will take time to regain those positivity.

To my dear child, you better grow up to be good... see how stressed am I, always in fear of you not catching up with other full-term babies.

Mother or friend?
Unlike the majority of mothers-and-babies who get to be together since Day 1, the case of my child and I is different.  I don't get to feed him directly since birth, I don't get to cuddle him a lot (I've only carried him not long ago when the nurse let me to do so recently).  Carrying my child feels more like carrying a cat due to his tiny size.  During other times, I'd touch him (by opening the isolette and putting my hands in after a thorough wash), which also felt like petting a cat.  My child will surely "curse" me for always equating him to a cat!

As my child is not with me most of the time since birth, I guess he may not have the same type of attachment to me as other babies with their mothers.  I always feel the void of physical attachment, although my emotional attachment for him has never diminished even for a heartbeat.  I do miss him on certain days when I don't see him.  Perhaps it may not be so bad.   For instance, maybe he won't cry in search of me when I'm not at home during the day due to work.

At this time, I feel more like a friend, or a playmate rather than a mother to this little child... I feel that the relationship is still casual at this stage because I only provide milk and play with him whenever I see him, but I've never really fed or changed his diapers like what most mothers do.  Perhaps I have no reason to fret yet, because at this point in time, he should by right still be in my womb rather than out so soon to the world... so I must be patient until he's big enough to come back to me.  Poor little fella might have thrived much better if he's still inside - bigger, more developed, and less vulnerable.  But he's on the similar path as me... and my only prayer is for him to fare better in life than me