Monday, August 11, 2014
Last August 2, we attended Hakab Na! 2014, an event or campaign initiated by a group called Breastfeeding Pinays in celebration of Breastfeeding Month. The campaign aims to promote breastfeeding and all its benefits not only to the babies but also to the moms, to the society and to mother earth. This is done simultaneously in different parts of the country.
This is the second time, last year Rafa and I weren't able to attend. So this year, with Mack being the last of the David- Marasigan brood, I made sure we would become a part of it.
All of our kids were breastfed, although Gabbie and Rafa were not really 100%. With Gabbie, I was less informed, I wouldn't say uninformed, I was. It's just it was not enough. And being a first time mom with no breastfeeding advocate surrounding me (even the pedia!) I felt like I was alone in pursuing my dream of exclusively breastfeeding my firstborn. That was something I will forever regret. I could have done better, I could have resisted the temptation and I could have spent the duration of my pregnancy reading and searching the net for everything about breastfeeding. But then, I was still thankful that even if it was just 85%, still I was able to breastfeed my daughter for up to 22 months. I just had to wean her because I had to take medications (steroids included) for my osteoarthritis.
With Rafa, I was more determined. I didn't pack feeding bottles in our hospital bag, I even told and emphasized to the attending nurses and resident doctors that I plan to exclusively breastfeed (the hospital was not a breastfeeding friendly hospital as well). But then two days after we went home, I had bleeding (my uterus relaxed) so I had to go back to the hospital and leave Rafa at home under the care of my mother in law. She was given formula while I was away. And more when I was given medications because I was advised to stop breastfeeding. I would later found out that most medicines are breastfeeding safe. If I had known, I would have continued even when I was taking antibiotics. But after that, I threw the formula away and went back to breastfeeding. And so Rafa was breastfed for up to 22 months as well. I just had to stop because I became pregnant with Mack. If Gabbie was 85%, Rafa was 95%. Still not exclusive but at least, they were breastfed.
Now with Mack, I am determined to exclusively breastfeed him at least for the first six months. We're already four months along the way. And despite what we have been through, I promise myself that whatever happens, we will never resort to formula feeding, even if it meant asking for breastmilk donations from other mommies during that time that he was losing weight because of the bacteria.
This time, being 100% equipped with information and support, I will exclusively breastfeed and join my friends and the Breastfeeding Pinays Group to promote breastfeeding and encourage more mommies and help them understand that indeed, breast is best.
The first three months of Mack had been a struggle for us. It was one heck of an ordeal which cost us not just a hefty amount of time, effort and money but also a lot of worries and anxiety.
For one, Mack was a sleepy baby. On his second day of life, he was given Benadryl for his rashes (caused by the oil bath) and this made him "sleep" for almost two weeks. And because he was "sleeping", he wouldn't feed. And because he wouldn't feed much, he wouldn't pee and poop normally as a newborn would. It took him several weeks to get rid of jaundice. His eyes were yellow for a few days less than two months, all because he didn't get rid of the meconium immediately.
A week after we went home from the hospital, I noticed pink and orange stains in his diaper. Pedia said it could be allergy; he was breastfed so I was advised to ditch eggs, seafoods, dairy, chicken and nuts from my diet. So I did. By then I was also advised by a breastfeeding counselor Velvet to give Mack a 6-8oz supplementary feeding of donated breastmilk, to be given at 2-hr interval at 1oz for each feeding. This is to "awaken" his calories and help him to suck effectively and produce the normal urine and stool output of a newborn. The pedia also advised me to "exercise" the tip of my baby's penis with my fingertips because the opening was small and that it could cause UTI. Again, I did, as soon as we got home. But then the very little pee with the pink and orange powdery stain in the diaper continued and so we went back to the pedia again and right then, she issued a Urine Culture Test for Mack to check for possible bacterial infection. And because he was also "constipated", we were also referred to a pediatric surgeon to check on his intestine.
One by one we followed pedia's order. We submitted Mack's urine sample to culture test and then we brought him to a pedia-surgeon in Children's Hospital in QC where his rectum was examined internally to check if it was "functioning" properly. He was requested to have Barium Enema (Barium was injected to his rectum and was observed for retention via XRay machine) and when the results came, it had a remark that Hirschsprung's Disease was not ruled out because there was a portion (albeit very short) in his large intestine where there was retention (meaning he didn't poop everything out within 24 hours). Because of this, we brought him back to the pedia-surgeon who recommended a Suction Rectal Biopsy on our baby boy to rule out the H disease. SRB was done by getting tissue samples from his rectum by suctioning, to check if that part of his intestines had nerves and working properly. It was relatively painless but it made him feel uncomfortable. After a week, results were out- he was positive for Ganglion cells thus negative for H disease (lack of nerve cells in that part of the intestine where the stool gets stuck causing constipation). And so we were cleared as far as his stool problem was concerned. But by this time, his weight went down from 7.7lbs at birth to 6.8lbs (we bought our own digital weighing scale to closely monitor his weight gain/loss).
Meanwhile, his urine culture test showed he was positive for ESBL bacteria (commonly known as E.Coli) so he was given oral antibiotics for 10 days. As soon as he started taking antibiotics, his weight improved a little. While he was on medicines, we continued with supplementing with donated breastmilk, on top of feeding on demand and unlimited latching. We had his tongue and lip checked by a dentist as well to check if there's lip or tongue tie; thank God there's none. I, on the other hand, had lactation massage to also check if our latch is correct and to improve my breastmilk supply.
After the 10-day antibiotic, we did urine culture test again. The result was the same- positive for E.Coli bacteria and resistant to certain types of medicines. He was given another round of antibiotics. His weight went up by 0.2 lbs each week. Slow for a typical Filipino breastfed baby. After 10 days, we sent another urine sample for culture test again.
Despite what was happening, he was thriving and had a happy disposition. He started responding when his name was called and smiling back when I talk to him.
And then the results came- still positive for bacterial infection. I was already getting worried and I kept asking my friends to offer a short prayer for our little boy. The pedia then suggested we have his bladder, kidney and the whole urinary tract be examined by a pedia-urologist. She gave us a recommendation along with an order for admission. Yes, he was requested to be admitted because apprarently, the oral antibiotics were not working for him; he had to take a new round of a stronger kind of antibiotics via IV. Imagine my shock and apprehension when I heard IV. But we gotta do what we had to do, and that was for his own good. That same day, we brought him to a urologist. He was again subjected to Ultrasound where his kidney was checked. Result was on our favor, his kidney was healthy and normal. So we went on to the next procedure where his urinary tract where examined. The procedure was called V--- (ops, I forgot) and it was done in National Kidney Institute. But thank God that right there and then, after the procedure, the doctor assured us that everything was perfectly normal. His kidney, bladder, urethra, etc are working just fine and not affected by the bacteria at all and that his urine do not do counterflow or backflow (the term escpaed me again, will edit this once I remember everything). Thank God!
While he was confined to properly administer the medicines, he was circumcised. That was our last draw. The infection could be coming from Phimosis, as discussed to us by the pedia-uro. Phimosis is a condition where the opening of the penis is not enough that the urine is not emptied and gets stuck inside which causes the growth of the bacteria (why hadn't they recommended it from the start?). It is congenital.
On the day he was to be circumcised, he had to do fasting. Imagine how to stop a baby from eating or feeding for six hours- yes, six gruelling hours- without wailing? That was the longest (well 6 hours is really long) 6-hour of my life. I stopped feeding him at 12:30 AM. His scheduled operation was at 6AM. He slept in my arms. It was only me and him in our hospital room. I prayed that he wouldnt wake up until 6AM although I knew it was not possible. He was a newborn. He was supposed to feed every hour or two. I stayed up the whole time; I was scared I'd drop him when I dozed off. I was switching channels all the time. At 2:30 AM, he woke up, I pacified him with a gentle tap and I was more than thankful that he went back to sleep easily. But at 4:30AM, he started rooting for my breasts. I knew then that no amount of cajoling or rocking or tapping can pacify him. I stood up and offered him my left breast (less dominant, less milk producing breast) but I stopped him from sucking. It was only to comfort him so he would go back to sleep. He was crying. I sang to him Jesus Loves Me a hundred times. I cried with him. I prayed while crying. I stood beside the bed rocking him to sleep and telling him we only had an hour- then 30 minutes, then 15 minutes, then five- to wait and the doctor would be coming anytime to get him.
And then they came to bring him to the operating room. I was there when he was sedated. I saw him wailing and I heard him cry from loudest to loud to soft until there was no more sound coming from his mouth anymore. He was starting to get dizzy and I couldn't bear to look at him that way but I told myself that everything happening there was for his own good.
I left the OR and waited in the waiting area for an hour. When they called me in to see him in the recovery room, I was already leaking, my breasts were already full and painful. But more than the pain, I felt pity over my newborn trying to fight off the effect of anesthesia and crying silently longing for mommy's milk. But I couldn't feed him just yet. They told me to wait for another 30 minutes. I asked if I could carry him. I was allowed but when I held him, he was chilling. I literally begged for the doctor to allow me to feed him already. They were hesistant but I was already crying. When they finally gave me a go signal, I fed him only to cry more because he was choking! I thought I'd lose him because he was gasping for air and he couldn't breathe. I called the nurse and they told me to stop and wait a little more. I tried again after a few minutes. He latched and unlatched when he needed to breathe. It was a sight that really tore my heart into pieces.
When we were finally released from the OR and sent back to our room, Mack fell asleep. He still choked a little when I fed him but he looked so stressed and tired he immediately fell asleep. He slept for several hours and I hand expressed the milk. Save from the routinary nurse and resident doctors visits, he spent the whole day just resting and sleeping.
The antibiotics went on for the whole week. But again, despite everything, our was son was a happy baby, full of life and he continued to give us joy and hope and everything positive there is in life. His big sisters Gabbie and Rafa would come to the hospital every day- Ate Gabbie (with Lola Belen) in the afternoon to review and do homework with me and then went back home in the night after dinner so that they can sleep early for the next day. Daddy and Rafa came in the morning after bringing Ate to school.
On the day he turned three months, he weighed 8.6lbs already. We celebrated in our hospital room. Daddy bought a cake and pancit; Lola Belen and Tito RJ celebrated with us.
The same day as the last dose of medicine was given, we went home. Three days after, we sent his urine sample once again for culture test. While waiting for the results, life went on. Mack continued to gain weight and continued being a jolly and happy baby who smiled when called and giggles when we play with him.
The day he was released from the hospital, he weighed 8.5lbs. At home, we still continued giving him supplementary feedings of donated (sometimes my expressed) breastmilk. A huge thanks to all the mothers who shared their precious milk to us, Mack was able to get through it all without losing much. And although he is still severely underweight based on the weight chart, still we are thankful and happy that he is already gaining weight albeit slow. What matters is that the UTI has already been cured and that he is growing to be a happy and active baby who meets and hits milestones despite being underweight.
A big THANKS goes also to our friends and relatives who prayed and wished our baby boy speedy recovery and good health. And above all, we thank GOD for taking charge or everything. We couldn't have done it without His grace, without His love and without His help.