Hyperbilirubinemia & Breastfeeding is Hard

After a few days in the hospital, on November 1st, we brought Ollie home. 

 

At his check-out exam, the doctors expressed concern at his bilirubin levels. They were higher than normal, and we were advised
to watch him closely. If his legs and feet started turning yellow, we needed to take him to the emergency room.

Maybe if it had not been winter in Portland, we would have been able to find some sun for him to lay in to help clear the bili from his system, but sun is a rare site in winter.

 Late (or early) November 2 or 3, Bran and I took him to the E.R. because his yellow color had spread to his feet. 

Getting Ollie ready to take to the emergency room.

After testing blood samples, they admitted him into the hospital for hyperbilirubinemia and placed him on the Biliblanket for light therapy.

He was not a big fan. He was supposed to wear these soft sunglasses to help protect his eyes, but he hated them and kept tearing them off whenever he was awake. Nursing, which is pretty much all he wanted to do all the time, was super awkward trying to keep the blanket (which was shaped more like a heating pad than a blanket) in place, and this huge, gigantic cord attached to the machine limiting my movement and positions.
                                       

The room Oliver was set up in had a padded window bench that served as my bed (and alternately, Brandon's or my mom's).

I just remember crying most of the day or two we were in the hospital: crying because I was freaking out about Oliver and wanting him to be ok, crying because I was so tired and couldn't sleep, crying because my breasts hurt and nursing was stressful, crying because Brandon had school and needed sleep as well so couldn't be there for me, and crying because I didn't know how I was going to do this mother-thing without my mom being there to help me when she left. I felt completely overwhelmed and terrified.

Up to this point, I hadn't had more than a few hours of sleep since my 30 hour all-night labor. Right after Ollie was born, I remember struggling to stay awake while the nurse tried to teach me how to nurse him. Then they had to move us to the mother/baby unit, and settle us into our room. Oliver and I shared a room in the hospital, so not only was I was feeding him every couple of hours, but it seemed just as I managed to start drifting off to sleep, the hospital staff would come in and check our vitals and give me my meds (which they did every 4 hours, all day and night long). Then there was all the paperwork and tests and nursing help and diaper changes. When we finally checked out, and we got to take Oliver home, I don't think I got any sleep then, really. I was so excited to be home, I guess I couldn't settle. I don't nap well, unfortunately. If that is a skill you have, then you are among the blessed. So when we had to take Oliver to the ER late Saturday night, and were up getting him checked in and settled until 3 or 4 in the morning, I had had ridiculously little sleep in the past 5 days.

In addition, the doctors told me that in order for the bilirubin to clear from his system, he needed to start pooping, so they really stressed the importance of feeding him and told me to feed him every 1-2 hours. Just thinking about it makes me feel stressed out. Looking back on it now, this is when I mark the beginning of my descent into postpartum depression and anxiety. I think a lot of it had to do with my complete, utter exhaustion, the stress of wanting Oliver to be all right, and feeling completely inadequate as a mother. I'll talk more about my experience with postpartum depression in another post.

Oliver was on the biliblanket for at least 24 hours before they discharged us from the hospital again the afternoon of November 4th. The therapy had seemed effective, but he still needed close monitoring by his primary care physician over the next couple of days.

Ollie getting a bit of rare sun.

So we were able to go back home, though we took him back to the clinic the next day and then the day after that for more blood work. 

We also had several appointments with the lactation consultants (both while in the hospital and then after) to help me and Oliver figure out how to breast feed. I had always thought that nursing was an instinctual behavior. I thought it might take a couple of tries to figure it out, but that he'd instinctively know how to latch on, I'd instinctively know how to hold him and what he'd want, he'd instinctively know how much to eat, and everything would magically come together. 

This. Did. Not. Happen. I don't think it ever really does.  

Apparently I have (had?) flat nipples (didn't know that was a thing), so I had to wear a nipple shield to help Oliver latch on. Though it makes it easier for him to latch on, it is a bit more work for the baby to get the milk out. He would exhaust himself trying to eat, and fall asleep eating after only a few minutes. When I tried to remove him, he'd wake up and start crying because he was still hungry. Feeding him, which should have only taken 20 minutes at the most, took an hour, and he was still hungry at the end of it.

When we took him in for his lactation appointment, they helped us figure out what was going wrong, and were concerned because he wasn't gaining any weight. His two week check-up was in less than a week and he needed to get back up to his birth weight by then.

My mom had left for Italy by then, but Brandon and my sister Amanda, who had come out from Texas to help for a week, were absolutely amazing.

The lactation consultants helped us come up with a plan. I would try and nurse Oliver first, no longer than ten minutes on each side. If he started falling asleep, I'd try and wake him up by any means possible: taking off all his clothes, tickling his feet, getting a cold washcloth and dabbing his body periodically, etc...If he kept falling asleep or if he'd finished nursing the full 20 minutes, whichever came first, I'd give him to Brandon or Amanda, and they would bottle feed him at least a couple of ounces while I pumped. (My mom had rented a hospital grade pump for me, which you can see in the picture above [My advice to all new mothers out there: if you're planning on breast feeding exclusively, rent a hospital grade pump, as least for the first couple of months. It is totally worth it]). Lastly, once in the middle of the night either Brandon or Amanda would feed him solely pumped milk so that I could have a 4 hour stretch of unbroken sleep.
 
 When Bran, Amanda and I went in for Oliver's 2 week check up, he had passed his birth weight weight by 1 oz. Yay team! It was definitely satisfying and relieving that all of our hard work had paid off.

By then the scare with his jaundice had passed, and it seemed Oliver was doing well.

As a side note, I'm really glad I stuck with breastfeeding Ollie. It got easier, and I feel like it has helped solidify our bond. I like breastfeeding him. I'll admit though, I will be happy to wean him when the time comes. I can't wait to choose shirts/dresses with the mind of what I want to wear, instead of "how easily can I pull my breast out?"