Update: 17 months

I haven't been updating this blog, and I fear that I'm kinda done with it.  I no longer need it, since MCAD isn't defining Cupcake's life the way I feared it would.  Our life situation has changed, with moving, I'm going back to work, etc.   Though I want to throw out the occasional update, because I've noticed people who google MCADD end up here, so I want to put out good vibes on the Internet.

Cupcake is now 17 months and she's walking, climbing, and starting to talk.  She plays with crayons, blocks and looooves reading books. Also, her latest obsession is babying her stuffed animals, she holds them, tries to feed them and walks them on her doll stroller.  It melts my heart.

She's also doing great health-wise.  At her 15 month check-up, she was at the 98% percentile for height, and over the charts for weight.  Because of that, we have been officially switched to low-fat (2%) dairy products.  We talked with our nutritionist, and we are on a heart-healthy diet, but  without any major restrictions beyond that.

Nutrition-wise, we have a little foodie.  Cupcake will try all sorts of new foods, and seems to have few texture problems.  Risottos, fish, soups, chicken, veggies, grilled meals, sandwiches, fruits, tacos, Thai, etc, she'll eat all of it.  Great for us, since we can cook one meal for the whole family.  We still stick by the old staples that she loves for snacks and lunch: bananas, blueberries, oranges, low-fat Greek yogurt, pita bread, turkey sandwiches on whole-wheat bread, cooked carrots, peas and bell peppers, chicken.  But she's cool when we want to try something else for dinner.  She's getting more opinionated about not wanting to sit on her high chair, but we're letting table manners slide.  It's more important that she eat a proper diet and develop varied taste buds.

On the breastfeeding front, we weaned at 16 months !  It was easier and harder than I was expecting, though one thing is for sure, it was the best thing for our family.  Cupcake now drinks cow's milk from a bottle.  We weren't able to transition her to a sippy cup, and thinking more about it, with her feeding requirements, we need her to still take a bottle at night.

We are still not taking L-carnitine.  Cupcake hated the taste (would violently reject it), and we had decided with our previous doctor to only take it when she was sick.  We've moved and have a new specialist in Texas, and on our first appointment he did full blood work.  Her numbers came out good (though she still has the genetic mutation for MCAD), so we concluded that she doesn't need any carnitine supplements.

We've made it 17 months without any ER visits or metabolic crises.  Luckily, Cupcake seems to have a tough immune system, and has managed to stay away from major illnesses.  To this day she's never had the stomach flu, RSV, or coxsackie, and for that, we're very grateful.  We take her out everywhere.  She's been in the NY subway several times, and goes to her fair share or playdates, library story times, grocery stores, etc.   We even took her abroad (more on that later).  We haven't done anything particular to protect her from germs, and we've been lucky that she's responded well.

Last month, we had our first ear infection.  Went to the doctor, who prescribed antibiotics, and commended us for catching it so early.  Nice.  She was on antibiotics for 10 days, and it was uneventful.  Her medicine tasted like bubble gum and she loved it; she'd even ask for more.   During this time, she didn't develop any major fevers, or have any appetite problems, so her MCAD was a non-issue.  Thank Dog.

Also, we have started part-time daycare.  The goal is to have her go full time eventually, but baby steps.  My main concern was how seriously they would take her feeding requirements (since MCAD sounds made up when you try to explain it, doesn't it?), and though the daycare was very accommodating and understanding, it took a few tries for all of us to be on the same page.  I had the daycare menu approved by our nutritionist.  The next issue is that in the toddler classroom, they expect kids to self feed.  Cupcake has been refusing to, so they have to spoon feed her.   I'm hoping she'll get the hang  of self-feeding soon, but currently our main concern is that she eat regularly.  It's one of those MCAD concessions, I guess.  We also send a banana daily in her bag in case she doesn't like the menu.  So far, they've had to give it to her a few times.

It's been quite a transition. Cucpake cried the first couple of weeks during drop-off   It broke my heart, but I knew it was a good place (I had personal references and just got a good vibe from the teachers). By now, 6 weeks into it, she's fine when we arrive, and is well rested and happy when I pick her up.  This decision has been good for our family, and she's learning new skills and socializing very well.   She's had a couple of colds and the aforementioned ear infection since she started, but that seems to be par with the course.

Her current sleep arrangement is a full-sized futon mattress in her bedroom floor, Montessori style.  This way, we can lay down next to her to help her fall asleep without braking our backs.  It's an in-between to co-sleeping. At night, we transitioned slowly to less feedings by gradually adding water to her bottles.  Cupcake has been cleared to go 8 hours at night without food, so we give her only water if she wakes before the 8 hour mark.  After the 8 hour mark, we give her some milk diluted with water.  The theory is that the water satisfies the sleep association and thirst, while slowly retraining the body's hunger cues.  I think this is why she STTNs some nights, but who knows for sure? 

When she's sick, we go ahead and give her some milk in her nighttime bottles, just to be on the safe side.

One last thing, Cupcake went on her first international trip to a South America!  The flight was exhausting (toddlers don't like staying on their seat), but she did very well during the actual stay.  We were visiting family, so we had lots of extra hands to keep her entertained and active.  Our concern was food, as lots of people get food poisoning when visiting South American countries.  It's just a fact, no judgment here.   We were extra careful to keep her away from uncooked foods, and poor Cupcake missed out on amazing tropical fruit and fresh fish.   Instead, she ate lots of chicken soups, cooked veggies, mostly homemade stuff, and what do you know, she never got sick.  I was still breastfeeding her then, so we knew that no matter what she'd have a calorie source at hand.  I'm really glad we were nursing, as there were many times we found ourselves with weird schedules because of all the family obligations, and I was able to keep her fed every 3 hours, no matter where we were (house, beach, park, car, etc).

Ok, this was way longer than I intended, but its been a while. 

Breastfeeding and mole scratching

I am in need of some advice. Cupcake is at a phase where she's started to pick at some of my moles while breastfeeding.  I originally tried to distract her , but she's pretty relentless.   I've tried to cover up, but unfortunately, I have a large mole above each boob, and another right below them in the middle of my stomach.  So no matter what one of them ends up uncovered at all times.  And these are the slightly bumpy moles, they hurt when she scratches them.

I've read that nursing necklaces are recommended for this.  For the uninformed, this is a necklace who's sole purpose is to give the baby something to grab while nursing, not to be confused with a teething necklace, which we have, and they rock.  Anyone have experience with these?  Have they worked for you?  Any easy ways to make one at home?  I hate the idea of buying yet another baby gadget, specially if it doesn't work.  We have enough craziness at home without having to add a shopping trip to our day.   (I don't like shopping, unless it's for home wares and furniture, it's strange, I know.)

I'm feeling a bit frustrated with this development.  I originally figured I'd let her play with the mole and she'd get bored of it. But it seems moles are like cell phones, babies can't get enough of them. I've thought of covering them with band aids, but it doesn't seem like that would solve the actual problem.

I've made it 11 months now, and there's no reason to stop breastfeeding at this point.

Breastfeeding - How to deal with a biter

This seems to be a current topic of conversation in my mom-baby group, as many of our kids have multiple teeth.  Cupcake still only has her 2 bottom teeth, but they're razor sharp.  And yes, sometimes she bites.

We went through a bad biting stage for a while, and I asked my local La Leche League chapter for their advice.  They are such a great source of information, even if I still find them overly AP for my tastes.  Also, through asking other people, I've come up with a brief summary of some techniques to deal with a compulsive biter.

Here goes:

Reprimand : Pull them off the boob and say NO! very firmly.  Then put the milk (boob) away.  This didn't work for us.  Cupcake found it hi-la-rious.  Which then would make me laugh, and well... it wasn't getting the point accross.  At the LLL meeting, many ladies said that this technique works in theory, but not in practice.

Distract and underplay the reaction:  Many times, yelling Ow! in pain or telling them a firm NO! can be counterproductive, because most babies laugh at the attention.  Instead, try to have a non-reaction.  When they bite, pull them away (making sure to insert your finger in their mouth so you're not pulling your nipple out while biting, ouch!), and cover your boob.  They will cry, and you distract them with a teething toy in their mouth, or something else in their hands.  When they're calmed down a bit, start breastfeeding again.  Repeat for as many times as necessary until they seem to get it.

Know that this too, shall pass.  Just because the baby has started biting all the time, it doesn't mean this is the new normal.  Like everything else, they go through phases.  Cupcake had a terrible week right before her first tooth came him, and I was basically ready to end our breastfeeding relationship.  I gave myself a deadline for a week away, if she wasn't done biting by then, we'd have to use formula. Her tooth came in before that time (lucky girl) and she stopped biting.  Still bites once in a while, but it's very seldom.  Right now she's teething again, so she'll bite more, but it's not a chronic issue.  

Prevent the bite.  Observe their biting habits.  Are they biting at the end of the nursing session, before the let-down, when they're done with one side?  Maybe they're done drinking for a bit and need to teeth.  Have a cold teething toy close at hand.  And when they're drinking, observe closely if the sucking motions are slowing down, then pull them off the boob and insert a teething toy in their mouth.  As in, try to pre-empt the bite.  I've never been able to actually do this.  Cupcake always catches me by surprise.

Nurse when well rested.  Many times, they bite out of frustration or tiredness.  See is you can feed them at times when they're not dying for a nap.  This has really worked for us.

Change nursing positions.  For example, Cupcake will only bite me when she's laying down.  If she bites, I switch her to sitting.  She sits on my lap, facing me, with the boob on her face.  Looks hilarious, but it seems to distract her enough.

The boob smother.  The Dr Sears recommended method of pushing the biter's head into your breast.  Effectively, this smother forces them to have to open their mouth and they can't bite (it saves your nipples too) Repeat as many times as necessary until they get the point.

Any other techniques you would like to share?  I'm always open to breastfeeding advice.

On weaning

Man, I think I'm gonna have to make an appointment with our Metabolic doctor soon, because Cupcake is showing sings of weaning.   At the ripe old age of 9 months.  

I'm having very conflicted feelings about this, which I'm sure it's normal.

Currently we nurse at 9 am (wake up time). 12:30 or1pm, 4pm, 7pm and 9:30pm (bedtime), 12:30 pm, (dream feed)  4:30 ish (if she only wakes up once a night, which... riiiight... it's the best case scenario).

(As an aside, I'd like to share that technically, Cupcake can go longer between feeds - we're at 8 hours overnight- and doesn't metabolically need the midnight feed.  But we do it anyway, because otherwise she'd wake up at 2am, just as I am reaching my own REM sleep.  We have to work together, child.   But even though medically she could sleep longer, she seems to still get hungry during the night, after about 5 hours.  You can't convince me that MCAD is unrelated to to appetite.  I was told that the only issue with her MCAD is to feed her, so if she's hungry, homegirl is getting milk.  Hopefully this will sort itself out as she gets older.)

Aside over.  

So we've been having lots of trouble with the bedtime feed.   Cupcake is tired, fussy, and my letdown is super slow at the end of the day.  Also, and this might be the biggest factor, she usually has dinner with us at about 8 pm.  I'm beginning to think that milk at 7, solids at 8, and then again milk at 9:30... maybe not such a good idea.  By the time bedtime comes along she's probably not that hungry.  She'll usually eat, but more and more often she likes to be at the boob, but gets frustrated after a few minutes.  We go on with the routine and read books instead, and she doesn't seem too upset about it.  Seriously, sometimes she skips her bedtime milk,  which I thought was supposed to be the sacred one.

I'm thinking of combining the 4 pm and 7 pm nursing sessions.   As it is, the 4 pm is a complicated one too.  The way her naps work, I end up combining her 4 pm milk with her solid lunch sometimes.  And as we are usually out at the park at this time, she doesn't seem to interested in breastfeeding.   So maybe I'll just do one nursing session at about 5:30 or 6 pm, so that by the time bedtime comes along she'll actually hungry.

We'll see.  I'm hoping that in response to this adjusted feeding schedule, her naps will reorganize as well, and she'll go into two longer naps, instead of the current three.

Next week there's a La Leche League meeting.  I'll be curious what they have to say about it.  I'm fine with weaning.  Though I love breastfeeding, I'm not particularly interested in extended nursing.  I mean, if Cupcake has a hard time letting go, I'll keep giving her the boob as long as needed, but I have a feeling that won't be THAT long.  She likes real food way too much.

Wedding Reception

Today we went to an afternoon wedding reception, the first time we've gone to a formal event as a new family.  I wasn't too worried, because it was an afternoon event, (as opposed to an evening full out gala), a nice party with food and drinks for all the people who weren't able to fly across the country for their actual wedding 4 months ago.

And Cupcake looked a-dora-ble!  I know I'm biased, but she was the cutest baby within a 10 block radius.  She had a white dress some Argentinian friends got her from a nice boutique there (so it has that wonderful handmade quality), and a white headband.  Usually I'm against headbands, and think the poor babies in them look like their head is split in two, but I take it all back, the headband really tied the outfit together.

Also, another gigantic milestone: I fit into my pre-pregnancy lil' black dress!  Just one of the many amazing things about breastfeeding, at least in my case I eat, eat, eat, and I keep losing weight.  I want to keep nursing her if only for the extra calories it burns (and the health aspects for the baby, of course, I'm not THAT shallow).

I don't know what the bride and groom's family must have thought about us, though.  We were the only people with a baby, we sat her at the bar while she was munching on apple slices, then put her on a baby carrier so she could nap while we still mingled, I drank wine, then we found a quiet side room and breastfed her (while still in my cocktail dress), then we danced around with her.  Did we achieve looking carefree and delighted with our own daughter, or were we those crazy parents that start the cautionary tales?  I don't want to find out.  We had fun, our friends were happy to have us there, and it was a wonderful afternoon.

At the end of the day, we are true attachment parents.  Our baby goes wherever we go, and as long as her needs are met (food, sleep, clean diapers), her entertainment can be following mom and dad around.  I think she had a blast, and the moment she began to be fussy I put her in her baby carrier so she could feel close to me and protected.

New Schedule

I'm trying to figure out a new schedule for Cupcake, and I'm still hesitant to try it out.  I'm not sure why.  

She's fine, we're fine, let's not rock the boat, right?  Except that now she's sleeping longer naps (finally!  hour long naps!), and because of solids we need longer time between feeds.  I'm trying to not interfere with her breast milk intake, so I'm not feeding her food less than an hour before she's due to nurse.  This, of course, presents it's own set of logistical problems, because she'll oversleep, or we have plans out of the house, etc etc.  If my entire life was only about her food and sleep we'd be fine, but as I've discussed a couple of days ago, I need some other distractions in my life. 

Thankfully, her MCAD hasn't presented itself in a dramatic way, so we can be a bit more flexible now with her feeds.  We can go 6 hours without food, which gives a gigantic leeway throughout the day, and it's a bit overwhelming to have such freedom.  I'm realizing now that many of our early schedule/parental decisions were based on her medical condition.  I'm also realizing that we set up a day schedule about 5 months ago and haven't updated it too drastically.   It's time.

For starters, she's waking up earlier now.  Her nighttime sleep is now about 10pm - 9 am.(not straight through).   I'm thinking of going 3.5 hours between daytime feeds instead of every 3 hours, and I'm hoping that the extra half hour will give us more breathing room between nursing sessions.

I'm also torn because I always wanted to be one of those attachment parents who feed on demand (it's the best for milk supply, right?), but when we got the MCAD diagnosis we had to change our plans.  Not that you can't feed on demand with an FOD, but the practical implications were too much for me.  In order to make sure she wasn't going longer than 3 hours throughout the day (we'd been told 3 -4 hours, and we decided with our metabolic doctor to do 3 during the day and 4 at night), I would have to keep track of every time she was eating.  It was so stressful to have to worry of when she ate last, where the notebook was, had it been too long, not long enough, finally I just decided to set up a schedule and stick to it.  It was the best decision we could have made.  We had regular nursing sessions, I knew what to expect, and I wasn't constantly concerned that she would go into fasting mode.  However, now that she's 7 months old I can actually feed on demand, since the threat of fasting isn't as imminent, but I fear that I won't recognize her hunger signs and I'd be overwhelmed by deciphering is she's hungry, tired, bored, achy, etc.

So.... I'm gonna run through some options and see if they logistically work.

9 am wake up ... 9:30 milk  ... 10:30 food ... 10:45-11:00 am nap (wake up at noon?)  ... 1pm milk ... 2pm food  ...  2:30 nap (wake up at 3:30?) ... 4:30 milk  ...6 pm nap (wake at 7pm?) mmmm... usually she nurses at 9:30, but that would be 4.5 hours from her last session, and though that's acceptable by MCAD standards, I don't think it's gonna work for for her.     

9am wake up ....  Milk between 9 am - 10 am based on hunger cues  ... 10:30 am food  ... 11:00am nap (wake up 12?)  1:00 milk  1:30 food   2:30 nap (wake up 3:30?)  nurse 5 pm  6 pm nap 8:30 milk? .... won't work, it's not her bedtime.

I'm gonna try working back from her bedtime.

9:30-10  pm last milk.....   7 pm milk   6 - 7 pm last nap.  3:30 pm milk  nap 2:30-3 pm   12 noon milk  9-10 food.... this looks all scrambled, but to put it in order:

wake up: 9 ish.   

Milk: 9-9:30am   

Nap: 11 - 12  

Milk: 12 noon   

Food: 1 pm   

Nap: 2:30-3:30pm   

Milk: 3:30pm   

Food: 4 pm  

Nap: 6-7 pm  

Milk: 7 pm  

Food Snack: 8:30pm    

Last Milk Feed: 9:45pm

Bed: 10 pm

Dream Feed Milk: 12midnight

Milk: 6am

I realize that the 6 hour span between midnight and 6 am is a bit of a joke at the moment, but that's what we're aiming for.  Let's give this slightly modified schedule a try... since it's based on the natural schedule she seems to be taking.  We shall see how it works.

On milk supply

I'll be the first to admit that we've been very lucky regarding breastfeeding.  Cupcake always had a good latch, and though it might have been painful at first, she always got the milk she needed.  And when you're told your baby can't go into fasting, that latter point is very important.  I also had a ridiculous amount of milk.  My letdown was forceful, and would spray people a couple of feet away, and I just has milk.  Oodles of it.

Ahhh, the early days.  I would pump just to relieve the engorgement, and we ended up with 15 extra bottles of milk in the fridge.  Things didn't settle down until about 2 1/2 months, when I still had tons of milk, but it was a lot more under control.

Luck.  Just luck.  Sure, we did our part, having Cupcake feed within an hour of her birth and feeding around the clock on demand those first couple of weeks.  But we also gave her a pacifier within a week (baby loooooooves to suck suck suck) and put her on a feeding schedule once we got her MCAD diagnosis.  I'm also bad at remembering to drink water and eat.

And maybe it's all catching up with me now?   I seem to be having some milk supply issues.  I don't know if I have a "problem" per se.  All I know is that Sunday night, at Cupcake's 10pm feed, I had no milk.  Nothing.  No let down.  Nothing was coming out.  And Cupcake is frustrated, crying, and refuses to keep sucking on an empty boob.  I freaked out, and Cupcake was crying, and it was horrible.  We ended up giving her the last bottle of expressed milk we had in the fridge.

I had all these fears of my body failing me.  Similar, in many ways, to how I felt my body let me down after the C-section.  I imagined all my fears of Cupcake going hungry, of having to switch permanently to formula, to having her reject my boob.  In reality, none of these are tragic, and 7 months is not a crazy time for a baby to wean to formula.  I just wanted to be more in control of that process.

 By the time I dream-fed her at midnight, after two hours of feeling very upset and down, I had milk again.  And the next morning my milk seemed to be back to normal.  Or normal enough to satisfy my baby.  So... I make milk again?  The what....?

I'm not sure what happened, but I have theories on the culprit.  On Saturday Nate and I had some wine, I forgot to stay properly hydrated the whole weekend, I'd worked out earlier that day (which, once again, hydration), my time of the months had just started that afternoon (blegh), and Cupcake is now eating solids, which is supposed to affect milk production.  This was probably a perfect storm of milk problems.

I know the weaning process starts with the first bite of solid food.  I know that as time goes by she'll need less and less milk.  It was just so scary to have no-thing come out.  I've been drinking water like crazy, so hopefully this won't happen again quite so dramatically.

Breastfeeding and biting

Cupcake has two bottom teeth. And yes, they are adorable, and we are in awe of how well she's growing.  She's eating food, getting teeth, trying to stand, babbling left and right, and still seems to have absolutely no interest in tummy time or crawling.

So what's the problem?  She's started to bite.  Hard.  When I'm nursing her.

I always told myself I would breastfeed for 6 months, and if everything was going well we would continue to a year, at which point she would wean to cow's milk.  (Dont tell the La Leche people!  They'll tell me to not wean so early).  So the question is, would biting be considered "not going well"?  Because it hurts.  Really, it does.

She'll usually suck normally, but sometimes she just chomps down, and I pull her off the boob and try for my most authoritarian "no!" like the books say to do.  And she just finds this hilarious.  I don't think 7 month-olds understand the concept of consequences yet.

I like my boobies.  I want to preserve them.  So Nate and I have decided to give it a week.  Cupcake has 'till this Saturday to get used to her new teeth and stop biting the boob that feeds her.  Otherwise, I think we're gonna have to start weaning to formula.   I want to keep breastfeeding, but enough is enough.

Sleep regression

I'm at the end of my rope.  I just can't be an effective night-time parent.  From everything I've heard of how motherhood changes you, I guess I was expecting that my body would go through some chemical adjustment that would let me be sleep deprived but still functional.

No such luck.  I still struggle at night, and if I don't get 7 hours of sleep I'm an emotional mess.  When I was pregnant we were aware of these issues.  Nate is a total superhero who can function on 4 hours of sleep, then go to work, come home and fix all the door hinges and still have energy to listen to me go on about my day.  So before Cupcake came into this world we agreed that he would be on night duty, while I was in day duty.  At the time we imagined him resettling cupcake a couple of times a night and maybe giving her bottled breast milk.  Meanwhile I could sleep and not get migraines. 

Then reality hit.  Cupcake needed to feed around the clock, so I was just breastfeeding her around the clock.  And because I was feeding so often, I couldn't really get enough pumped reserves, which meant I wasn't getting a break at night.  And so on, and so on.  All of the sudden our nighttime plan wasn't really working.

Before I ever thought of having children, I remember talking to a couple of women with babies who said that after giving birth your relationship to sleep changes.  You no longer *need* as much sleep, your needs just shift naturally.

This is not biologically true, in my experience.  I still need sleep to function as a sane productive person.  And after almost 7 months of getting up during the night no matter what, my body is giving up.  It's done.  Finito.

Last night Cupcake woke up and cried for about an hour and a half.  We have no idea what was actually wrong with her.  Teething?  Growth spurt?  Allergies?  Cold?  Gassy?  Digestive issues?  Separation anxiety?  She'd cry, and our usual system of patting her wouldn't work, so Nate would pick her up, and she'd calm down, then the second he'd try to lay her down on her crib she would start the crying again.

After 45 minutes of this he also gave up (I had thrown in the towel a long time ago and told him I was fine with just letting her cry).  And we did what I swore I'd never do, attempt to let my baby cry herself to sleep.  We were there, next to her, and Nate had his hand on her chest, but still.... I can't believe I was ok with it.  I was just sooooo tired.

She whined and moaned for about 20 minutes, then it looked like she was going to sleep, then she started to cry loudly, went back to sort of sleeping and then she started screaming hysterically at about the 35 minute mark.  And my husband is much more sensitive than I am, because he just couldn't take it.  I ended up feeding her at that point and she zonked out (and stayed asleep for over 4 hours!).  Too little too late though.  And I honestly don't think feeding her at the beginning would have helped, she'd just eaten an hour and half before, she wouldn't have been hungry at the beginning.  After the hour and half, then yes, totally legitimately  hungry.

I don't know what to do.  I don't want to keep co-sleeping.  I was happy with it before, but now she likes to stick her hand in my mouth as she drifts off to sleep and it just hurts. The crib next to our bed was working, but now she doesn't seem to be ok with it.   I don't have the stamina to get up at night, but I don't agree philosophically with CIO as a means to self sooth.  I'm at an impasse.

This little 18 lb princess is kicking my a$$.  Though she didn't seem happy with last night's fiasco either, at least she had the decency to wake up cranky and not well rested.  I know, I know, it wasn't pleasant to deal with her in that mood, but I think I would have been really annoyed if after such a horrible night she was all smiles as if this was the most natural thing in the world.  The fact that she didn't enjoy it either gives me hope that this is not the "new normal."

I have faith that at some point this will all sort itself naturally.  After all, my parents never sleep trained me, and at some point I learned to sleep through the night.  And I've never met a teenager that needs to be rocked to bed, so it does stop.  Just... when?  How much longer will this go on?

On getting more hours of sleep

Last night she slept for 5.5 hours!  Or rather, we also got 5.5 hours of sleep.  Now that the doctors have cleared us for 5 hours, we seem to be having trouble getting Cupcake to also want to sleep for that long.  And we haven't pushed too much on it because she's been teething, then had a stuffy nose, and then had to adjust to having grandma visit for a few days.

That last one was a particular adjustment, as we took the opportunity to go out for three nights in a row and have my mom put Cupcake to sleep.  During those evenings, she drank from my pumped reserves, so it seemed cruel to keep her from getting the boob in the middle of the night if that's what she actually needed.

Also, I have no idea how much she nurses each sitting.  Really, I have no idea.  I left my mom with 4 oz bottles, but I don't know if that was enough or not.  So if she woke up at night, I fed her.

Last night, for some inexplicable reason, she slept for 5.5 hours, and then another 4 after nursing.  Could she just be maturing in her sleep patterns?  She's done something similar 4 times since we got the approval from her doctor.  I don't want to jinx it by being excited, but I totally am.  Excited, that is.  I know with MCADD and sleep the first year is the hardest, and we are over halfway through.

To supplement with formula, or not? That is the question

I've been having some serious thoughts of adding formula to Cupcake's diet.  Which is difficult for me, because I've been staunchly against it. The La Leche League people really did a number on me.

The thing is, a few days ago she had her first bottle of formula ever, and the world didn't collapse like I expected it to. I've run out of pumped reserves.  I'm at a loss.  My milk supply has stabilized to the point that the only times I have extra milk to spare is in the middle of the night.  So a couple of nights per week, I get up after Cupcake's 2 am and 6 am feeds and pump the other side.  Not a sustainable system, I know.

We've managed to only consume what I was storing until the last migraine.  (I should share at this point that my migraine medication is not compatible with breastfeeding.  So for 12 hours, I have to give Cupcake bottles, while I pump-n-dump.)  So the other day, when I was feeling like doodoo and had to take my meds, we had no choice but to give Cupcake some of the emergency formula we had stashed around. 

To my utter surprise, I was okay with this decision.  I think it's because I made it to to 6 months exclusively breastfeeding.  And a pat in the back to me, it was no easy task.  I am so glad we struggled through it, as it's been an incredibly rewarding experience.  At this point the weaning process has already started, because she's exploring solids.  So while I want to keep breastfeeding for a year, the idea of giving her formula here and there doesn't feel as tragic. 

Lo and behold, Cupcake took it with no problem.  I'm lucky that if  I'm gonna have an FOD child, at least she's one of those kids that seems to eat whatever is in front of her.  And heartily.  Formula, bottled breast milk, mashed bananas, pureed veggies, they are all good. 

So now I'm at the weird place where I'm wondering if we should start giving her a bottle of formula for her 3 am feed. It would be easier for all of us to just give her a dream-feed bottle while she's still in her crib. (Yes, her oral hygiene be damn*d, at this point we have more important metabolic things to worry about.)  And it would take some of the pressure away from me, as Nate could give her milk half the nights.

I struggle with this, because I know that giving formula on a regular basis can affect my milk supply.   And I love breastfeeding.  I really do.  I cherish being able to provide for my own kid, and feel very lucky that we were successful with it.  What if I end up compromising my supply?  What if she ends up weaning to formula against my wishes?

I don't want to sabotage my breastfeeding.  I also need a break. Then again, it's only a few more months until she's drinking cow's milk, so maybe I should just tough it out for 5 more months.  I have a feeling that I'm going to go back and forth with this, and by the time I make a decision, it'll be almost the 1 year mark and it will be a non-issue.  Or so I hope, at least.

6 month MCADD appointment

I'm not a fan of doctors offices, in particular with specialists that tend to overreact and make my life dramatic.  But I couldn't be happier with Cupcake's metabolic team at Mt Sinai, though.  They are easy going, warm, and very reassuring. 

Cupcake is 6 months now, and she went for her mid-year appointment.  She's doing great!  No metabolic crisis so far (which we don't know if it's because she's asymptomatic, or because we've been diligent with her feedings; in either case, yay!!).  She weighs almost 18 lbs, and is tall for her age.  Which is unrelated to MCADD, but it's reassuring to know that she's growing rapidly.  Then the doctor played with Cupcake a bit, to get a sense if she could respond, babble, sit on her own, had a good grip, etc.  And of course she can do all those things!  So to our immense relief, they decided they didn't need blood samples.  Cupcake is hitting her physical milestones well, and is fat and growing, so there's no point in getting a metabolic breakdown at this point.

Also, we've been cleared to have her go 5 HOURS without feeding.  And another hour every month until we hit the 8 hour mark.  Our doctors here don't feel comfortable having her go longer than 8 hours until she's about two, mostly because her initial C8/C10 numbers as a newborn were really high (or was it low? whatever it was, it was not the desired amount, lol).  So now we have the luxury of sleeping one whole hour longer, and a baby that probably will not cooperate.  Whatever, I'm just excited to join the throng of parents that can complain about normal night wakings. And isn't 5-6 hours technically considered sleeping through the night?  Music to my ears.

The older cupcake gets, the less MCADD scares me.  She's 6 months now, she's eating solids and still breastfeeding wonderfully.  Her body is strong, and she's getting more and more antibodies as she's exposed to the world.  She's up to date with her vaccines.  She'll have stronger defenses to fight disease.  I know that with an FOD you're never out of the woods, but as she gets bigger and older it feels much more manageable.  My heart goes out to all my fellow mamas that had to take their weeks-old babies to the ER.  It must be very scary and you have my utmost admiration.

So now we are diving into solid foods, and our doctor told us not stress over it too much.  Keep nursing Cupcake at our normal times, and she will naturally take less milk as she eats more food.  It's easy during the day, when we can observe if anything is different.  The danger is at night, when we wouldn't notice if she's lethargic because she's sleeping, and we are too tired.  We were even told to not worry about her diet too much at this point, since she'll still be nursing and getting all her proteins from me.  We'll go back to see them in 3-4 months, once Cupcake starts taking protein and her eating habits shift to solid food.  At that point, we'll meet with a nutritionist to give us some tips.  But even then, it seems that as long as she's not fasting, MCADD doesn't require a strict diet.  Just make sure it's low fat, but that's what ALL of us should be eating anyway.

Sleep training an MCAD baby?

MCAD and sleeping through the night don't go hand in hand.  So while many fellow moms are debating their parenting philosophies regarding nighttime, we are secure in knowing we are not going to get a full night sleep for many months.  Whether Cupcake wants to or not.

It's surprisingly freeing, and we also figured we wouldn't have to deal with sleep training.  After all, the ultimate goal in all the techniques is getting the baby to sleep through the night uninterrupted, so it didn't apply to us.

And yet....

Originally we had to set the alarm and dream feed Cupcake, as she would sleep the whole night with no problems.  Back in those first three months we though we had the best baby EV-ER, and we would curse the MCADD that wouldn't let us sleep.  Then the 4 month sleep regression happened, and she started waking up a couple of times a night before the alarm clock.  This was fine, as it felt much more natural to feed an awake and hungry baby than a sleeping one.  But waking 2 times a night begat 3 times a night, and before we knew it, she was waking 4+ times and I was feeding her every time.

It made sense to nurse her for every night waking.  Firstly, its the fastest way to get her back asleep.  But mostly it was a way to make sure she wasn't fasting at any point in the night.  However, this system is not sustainable, and even the most dedicated of moms needs to get sleep once in a while.  We had to figure out a way to get her back to the 4 hour nighttime schedule.

We started our own version of sleep training.  No crying, lots of rocking and soothing, and eventually, at just about the 4 hour mark, we'd feed.  The idea is that she'll be actually hungrier then and eat more, which will hold her over for another 4 hours.  I just can't have her lightly grazing every night, it's too much for me and I end up being a snappy mom the next day from sleep deprivation.

It's not a fool proof system.  One of the nights we managed to soothe her back to sleep at 4:30 am, only to find her asleep at 6 am when she was due to eat.  Which then gets us in the never-wake-a-sleeping baby conundrum.   So... should I feed her at 4:30 have her graze every 2-3 hours (and she'll eat when she's awake, yay), or try to get her in a schedule but have to make sure I'm setting the alarm?  I like the stability of her eating on a schedule at night; I don't have to worry about tracking when she ate last, which is hard to do when one is half asleep.

The books don't have answers.  There doesn't seem to be any advice out there for this type of situation.  So we soldier on, doing our modified sleep training, and as we rock her, we imagine the Rocky theme in the background.  Actually, I have sung her to Rocky music to sleep before. She seems to like it.

La Leche League meeting

I'm officially obsessed with parenting.  What can I say, Cupcake just turned 5 months, and she's just so .... awake, aware of the world, and opinionated.  And those opinions include not wanting to nap longer than 40 minutes at a time, a dictator-like control of exactly when she wants to be held and for how long, and waking up several time through the night to... hang out, I guess, I'm not sure what her agenda is there.

The night wakings are of particular stress to me.  Not just because I'm someone who enjoys my sleep (will I ever get to experience the wonders of sleeping in again?), but because they intersect with parenting philosophies and her MCADD needs.   Most of the people in our Mom group seem to be going through sleep training, or at least the most vocal moms.  And I hear them comparing CIO stories, or how their babies are now sleeping 10 hours straight, or whether it was hard to give them tough love but now they're sleeping in their own room, etc.  Why does it feel like they all joined forces and did this at the same time?  Did I miss the sleep training memo?   I was beginning to feel like the odd duck.

Then I met the lovely ladies of our local La Leche League chapter.  What an amazing group of women dedicated to breastfeeding and helping each other through the process.  And also,we  finally saw the crazy attachment parents I'd been waiting to meet since I found out I was pregnant.  I was beginning to think Brooklyn had become mainstream.  And boy, they were incredibly reassuring to  my parenting instincts.  Sometimes it's good to see the extreme version of your parenting philosophy, and have that mother content and functional, to appreciate your own position in the middle.

Their attitude towards nigh wakings was refreshing.  I'm paraphrasing the things they would say:

- I love the night feedings , its my chance to bond with my baby, just the two of us without all the distractions of the world

- Its how I make sure she's getting all the nutrition she needs

- You must feed regularly through the night to keep your milk supply, what, you don't feed 5 times through the night, oh you poor dear!

- Of course I co-sleep, it makes it so much easier to feed those 5 times per night that the baby needs for nutrition and bonding!

Finally!  People who respond to night-parenting by breastfeeding and think it's great!  When talking to other people who are sleep training, I'd always felt that MCAD was the only reason why I was staying up with the baby.  Now I realize that there are many many wonderful (not insane) mothers who also feed on demand at night.  It's a way of seeing our night routine as a parenting choice rather than the consequence of Cupcake's disorder.

Next meeting is in a month.  I'm looking forward to it.

I'm torn over whether to use nursing covers

Before Cupcake was born, I used to be appalled at the mere idea of using nursing covers.  Breastfeeding is natural, I would say.  Who are these backwards women who feel like hiding a beautiful experience with their children.  And even less idealistic, why would you go through the trouble of putting on a cover,if it's so uncomfortable and gets in the way of you kid feeding.  And what's more basic and functional than that?  I thought those mothers were setting back the women's movement, and that I would never belong to their ranks.

Now that I have a four-month old baby, I'm not as judgmental.  It's amazing how actually being in a situation will make you more sympathetic to what other's may be going through.  Duh.  And I feel thoroughly embarrassed by how adamant and judgmental I sounded about nursing covers.  I'm gonna chalk it up to pregnancy hormones, and leave it at that.

Breastfeeding is hard, though.  There's a steep learning curve.  And once you have figured out your vibe with your baby, something changes (growth spurt is usually the culprit) and it becomes complicated again.  As a result, nursing isn't always this easy understated thing.  I much prefer to nurse at home than out in public, if only because I have my boppy pillow at home. (As an aside, the boppy pillow might be one of the greatest items we got, it was so surprising to me.  We use it for feeding, naps, airplane riding, when she was smaller to elevate her head for reflux, it's a jack of all trades.)   So I've had some times when I felt I'd rather go home and feed her than be out.  Not because I"m embarrassed about my nipples, but just because it a bit stressful to have you boob out, while you're burping and have a squeamish baby.

So, after seeing the mom's in my mom group have some really stylish covers, I caved and got a bebe-au-lait.  Cute name, nice prints, awesome wire frame that allows you constant eye contact with your feeding baby.  And I even used it, because  around week 12 - 15 Cupcake started being a very fussy eater, and using a cover was a good way to nurse outside.  I even used it when we went to Texas and had to feed Cupcake at Hobby Lobby, multiple restaurants, the art museum, and in front of Nate's grandmothers.  Happy mom and happy baby.

But now I feel weird about using it.  Cupcake and I have reached a groove again.  She's efficient, doesn't need to bu burped till the end, and I have a good hold.  The cover only makes things more difficult, take longer, AND I've been feeling like I failed my ideals by using it.  Like I should put my money where my mouth was.  Because while I"m no longer judgemental of other moms, I still feel like it's not right for me.  So we'll see what happens to the cover.  Will I use it again?  Was it a waste of money?  Was it an item that was relevant for a few weeks but is no longer necessary?

I'm happy to nurse whenever, wherever.  The way I see it, it's better to have a happy baby than make sure everyone around you doesn't have their sensibilities affected.

Parenting philosophies

It seems that every parenting instinct has a name theses days.  Not just a name, but also a title, a website, and rabid advocacy on the internet.  While trying to figure out some standard timetable for developmental milestones, and also browsing through the many many parenting blogs, I've come to the conclusion that I'm not sure in which category I fall.

Does the fact that we co-sleep, breastfeed and I baby-wear cupcake mean we are attachment parents?  I mean, I related to many of the basic ideas of Attachment Parenting, but then again, we dont really subscribe to the green/cloth diaper aspect of things.  I would like to, but my sanity has its limits.  We also use pacifiers, and have no issues with strollers, swings, and the like.

What does it say about us when we decided to not let Cupcake "Cry it Out".  Is this a reflection of our parenting philosophy, or simply the result of having a baby that never gave us serious sleep problems.

Where do we fit the fact that cupcake got her ears pierced at 3 months?  We messed with the sanctity of what "god" gave her.  (I use the word god loosely, as I am a devoted Atheist yet Nate is a spiritual Christian,  so who knows what will happen with Cupcake when she's older?  That's a topic for many many more blog entries in the future).

And then there's the issue that one's attitude towards a small baby is very different from that regarding a toddler, preschooler, newborn, teenager, adult, etc.

So far I want to address Cupcake's needs as she  needs them.  Because of MCAD we have a feeding schedule (rather than feeding on demand, like La Leche League and similar lactivists advocate).  But she sleeps and wakes on demand.  The only real sleep training we're doing is that we've made no effort to make her bedtime any earlier, so she goes down for the night at around 10 pm.  But I hold her when she needs it, try to give her space when she needs it, change her as she needs it, or at least I try to do all these things when she seems to need it.  Seriously, who knows what she actually needs.

So... do we qualify as Attachment Parents?  And based on how exaggerated and controversial so many of them tend to be... do we even want to?

Napping and schedules

I feel like my life has been taken over by Cupcake's naps.  Is she sleeping?  Is she tired?  Did she just wake up?  Did she sleep enough?  Is she due for a nap? And why, oh why, will she not go down on her crib anymore?  I mean, I love the idea of cuddling with her, but I've been feeling worn out from having to always hold her.

The good news of all this is that I am now so worried about her sleep that I no longer worry about her feedings and MCAD.  I used to be in a constant state of stress of whether she was eating enough, if she'd go into metabolic shock, her feeding schedule, did I have enough milk, were we breastfeeding right, etc.  Now she consistently gets hungry after 3 hours during the day and 4 hours at night, and we don't have to really think about it.  We have her feeding times, which are now ingrained in our routine.   And its nice to not have this be an issue.

Cupcake will be 4 months in a couple of days, and so far we have avoided any major illnesses or diarrhea or MCAD crisis.  I'm not sure if it's because she's asymptomatic, or if we've just been doing good in feeding her frequently, but either way, it's a relief.

Meantime, we can worry about the same things everyone else does.  Napping, sleeping and crying.  It's not that I enjoy these "problems", but its nice to be able to vent with other moms and all be in the same page about it.

Schedules

So Cupcake seems to be favoring an earlier bedtime.  I don't know, we can't really tell.  So far her bedtime has been closer to 11:30, with a bath and bed routine at 10:30, but I think we are ALL ready to move this a bit earlier.  Not too early, mind you, I still don't want to get up at 7 am in the morning.  But I was thinking of her going to bed at 10:30 or so, rather than sometimes at midnight.  Nate and I need an hour a day on our own too.

But nothing is easy.  Because of MCAD (and isn't everything because of MCAD), it makes it trickier to set up a schedule.  Mostly because I want to keep my sanity overnight and not have to feed her 1 hour after I've gone to bed.

So... I don't want to cluster-feed at night, because that's the time we are spending as a family and I want Nate to hang out with his daughter rather than me feeding her.  But just by virtue of the 3 -4 hour schedule, something has to give.

Currently her schedule is:  10 am wake up.  10:30 breakfast with mom.  1:30pm lunch.  4:30 afternoon snack.  7:30 dinner.  10:30pm dinner with mom and dad.  11:30 sleep.  2:3o am midnight snack.  6:30 am breakfast with dad.  And start the day all over again.

So... if we want to move her bedtime to 10-10:30.....  we could feed at 9 pm and then bathe her and set her to bed.  And feed at 12 am.  4 am - 8 am - 11 am - 2 pm - 5 pm 8 pm....nope doesnt work.  At some other point I need a 4 hour stretch.

 

9 pm - 12:15 - 4:15 - 8:15 - 12 noon - 3pm -6 pm - 9 pm    that could work, though I worry about the 8 - noon bit, she might gt hungry before that, since she wakes up at about that time....

9pm - 12am- 4 am - 8 am - 10 am - noon - 3 - 6 - 9... and the 4 - 8 - 10 are one boob only.... that might work.  Have a cluster feed in the morning....

Or 10 pm - 12am - 4 am - 8 am - 11 - 2pm - 5 - 8 - 10....arghhhh, this is still not really working.....

I find her max of 4 hours to be really frustrating

Overslept at night

While were on vacation visiting family for the Holidays we had an unfortunate oversleeping incident.  Happily, it ended up having a happy ending.

On January 3rd, we were victims to the Iphone  clock glitch and the alarm didnt go off for Cupcake's 2:30 am feed AND the 6:30 one.   I guess that answers the question if she sleeps through the night.  Yes, she does.  She slept for 8 hours without as much as flinching.   When I woke up and noticed that it was after 7 am, I freaked out.  I had images in my head of Cupcake not responding, or having to take her to the hospital for a glucose treatment.  But instead, I picked her up and put her to my boob, and she ate, as if nothing had happened.

We called her doctor the next day (it was a Sunday), and she said that this is very reassuring, and shows how Cupcake is dealing well with her MCADD, but to still feed her not more that 4 hours apart just to be on the safe side.  After all, we can't know when her body is passively fighting an infection and burning more calories.  So... even though this was fine, it shoudl'nt happen again.

As soon as she started eating, I began to cry.  Its so exhausting, having to think about the ramifications of feeding her on schedule.  The fear of what could happen.  And what it means that she slept for 8 hours and nothing happened.  Did we get lucky?  Does this mean her MCADD isn't really symptomatic?  What gives?

Overnight feeds

Last night I overslept and ended up feeding Cupcake at 3:15 am instead of 2:30.  Her previous meal was at 10:30 pm, so at that point it had been closer to 5 hours between meals.  The doctors told us to not wait any more than 4 hours.  This is not the first time this happens.

I have an alarm, but in all honesty, its easy to snooze while still in deep slumber.  I've tried putting it in different places, but somehow, my arm manages to move on its own and turn it off.  Or maybe I set the alarm wrong.  Who knows, at 3:15 in the morning its hard to think about things rationally.  I do know that as soon as I saw the time I woke up fast in a fright.  I definitely don't want Cupcake to go into metabolic shock, and even though we have a 6 hour window, this was too close for comfort.  I put her to my boob and she ate, calm, as if nothing was happening.

I hate the middle of the night feeds.  Hate them with a passion.  Hate them because Cupcake seems perfectly happy to sleep through them.  Hate them because she probably would be sleeping 6 hours straight if it wasn't for me trying to dream feed her.  Hate them because its been about 9 weeks since I get more than 3.5 hours of sleep straight.  Hate them because Cupcake has been spitting up a lot, so I need to keep her head elevated for about 10 minutes after feeding, which means that for ten minutes, Nate is asleep, Cupcake is asleep, and I'm the only fool needing to keep some semblance of wakefulness.  Hate them because of what they represent with her MCAD.  Hate that I can't aspire to a full night sleep for a long time, even if my baby was more willing to.

Next week we have another appointment with her Metabolic doctor.  This is her first follow-up since she was diagnosed with MCAD some 6-7 weeks ago.  Hopefully they will see that she is gaining lots of weight and is in the high percentile for her age, and adjust her feedings accordingly, or give us some reassuring new regarding her dietary needs.

Meanwhile, I feel extreme guilt for hating her 2 am feed.  What kind of mother am I?  I have been given the means to keep her healthy and free of MCAD symptoms, and the only drawback is that I have to suffer in my sleep for a few months.  Shouldn't I be doing it more willingly?