Weighing in on everything from avocados to Zimbabwe

Weighing in on everything from avocados to Zimbabwe

Breast is best, but what is next?

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As I prepared to give birth to my son a few months ago, I took for granted that I would breastfeed him. "At least six months," I confidently told my husband, "and up to a year if possible" -- reciting the recommendations of the American Association of Pediatrics. It never occurred to me that this might not happen; I had read all about the evidence for the benefits of breastfeeding, and wanted badly to give my son that gift.

Once I gave birth, however, various factors conspired against this noble ideal for me. I delivered my son via Ceasarean. He had a small tongue tie that went unnoticed for the first week of his life. Possibly because of the tongue tie, he was also an aggressively "chompy" eater, resulting in excruciating pain to me every time he would eat. Nonetheless, I persisted, and faithfully nursed him every 2-3 hours. He cried all the time, and I became worried when he stopped peeing; at the doctor's I was informed that he had become dehydrated in a few short days since birth because my milk supply was low, and we needed to give him formula supplements. The next few weeks were filled with an intricate dance of breastfeeding, pumping, and formula supplements. I scoured the internet for information on boosting milk supply (lactation cookie, anyone?) and followed the accepted regimen for weaning a breastfed baby from supplemental formula.

But despite my best efforts and all the power of my will, still he cried and was hungry all. The. Time. Finally, we sadly made the decision that breastfeeding was not feasible for our situation. He is now a primarily formula fed baby with some breastmilk supplementation (probably 65/35%, respectively, with effort), and is thriving far more under this regimen than ever before.

Without a doubt, I can say that feeding was the central drama of the first five weeks of my parenting experience. When I found out my son was dehydrated, I felt despondent that my body was not providing for him. I knew (and know) that exclusively breastfeeding is the best nutrition for an infant. But I felt unprepared by the medical community for what to do when exclusively breastfeeding was no longer a possibility. While I appreciate the respect shown by our medical professionals toward my wish to exclusively breastfeed, I now wish that someone would have oriented me sooner to other feeding options, and emphasized *that those were OK*. I wish that those other options did not carry such a stigma (honestly, you'd think I were feeding my baby poison instead of life-giving nutrients when I put a bottle in his mouth).

As my wise and empathetic OB told me at my post-partum appointment, "FED is best". Parents will have all sorts of reasons that breastfeeding may not work for them, medical or otherwise. Stigmatizing non-breastfeeding options or restricting the conversation to breastfeeding only does a disservice to parents, all of whom strive for the same thing: choosing safe feeding options for their babies.  

2017 New Year's Goals: Better Late than Never

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Well, it's already April, and I'm only just getting around to posting my New Year's goals. They have been written since, well, New Year's, but it turns out that there are more pressing things to do during late pregnancy and early parenthood! Here they are now; as an added bonus I can check in on my progress so far (while this might not count as a "prespecified analysis" in my line of work, the stakes are low enough here that I can do it!). 

1. Have a successful delivery of our son. My son Sam was born on January 31st after an exciting entrance into the world. I was induced a few days early after feeling decreased fetal movement, and when doctors recommended a Ceasarean following signs of fetal distress, they found his umbilical cord wrapped around his neck FOUR times. Needless to say, I feel grateful every day that this goal was met and that I have this precious boy in my life intact.

2. Keep a sense of humor in parenting. Being in charge of another human's development and survival is stressful. Being able to laugh about it seems key. I've done lots of laughing so far, and hope to maintain this in the face of mounting and conflicting obligations, which brings me to...

3. Try for work/life balance. It's been easy so far, since I'm on leave from work for another three and a half weeks. Beyond that I have no idea. Is there such a thing? I'm always up for advice from those who have come before.

4. Get back to fitness/stay active even with a baby. It will be a long road back to pre-pregnancy weight and fitness. In the meantime a more manageable goal is to stay active each week: my usual goal is to walk/run at least 15 miles. I've just been cleared to run again, so I'm gradually trying to incorporate that again into my routine. But I also want to...

5. Be kind to myself. Having a baby is hard. Having a baby, a family, a career, AND an exercise regimen feels just about insurmountable at times. So I'm trying to give myself grace about the things I can do with the energy I have.

6. Have less idle screen time. In recent months I've been realizing how much time I spend mindlessly on social media. While it is fun to stay in touch with old friends online and meet new virtual friends, I worry that I engage less with the real world as a result. My hope is that the 'new normal' will prohibit much of this. (Thus far this has not been the case; often when e.g. pumping I'm so tired that all I can muster energy for is social media.) I'd love to hear other strategies for managing social media both in terms of time and emotional energy.   

7. Double down on my core values: love, family, community, hard work, and decency. In a time and political environment where these seem in short supply, I want to bring it back to my core values. To remember who I am, outside of the outrage I feel most days reading the headlines.

Time to check in: how are you doing on your New Year's goals? 

Introducing Samuel John

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Born Jan. 31, 6lbs 15oz, 20 inches long. Photo credit: Bella Baby Photography.
He's here! It has been two and a half weeks since my world changed, and I'm only now with it enough to reflect a little on what happened and how our lives have changed as a result. Here's my rough recollection of how it went down (my husband Greg's take on things can be found here):

For a variety of reasons, including borderline high blood pressure, my OB had decided in advance to induce my labor at 39 1/2 weeks. Two days before my scheduled induction, I went in for a routine appointment and fetal monitoring. Although every metric on the machines looked fine, something felt... off. Sam wasn't moving as much as usual, as much as he had even the previous day. A hot chocolate and almond croissant from Bakery Nouveau didn't change things, and neither did a quiet afternoon paying attention to his movements. When we spoke to our OB on the phone that evening, she recommended we come in for induction that night -- acknowledging that the decision was at least partly driven by our (non-evidence-based) anxiety. We got the call at 6:15 and were to report to the hospital by 8:00 -- oh, and hadn't eaten, packed, showered, or picked up my stepson from his after school care. After a whirlwind couple of hours, we arrived (barely) on time, ready to do this thing.

Once we got settled in to our birthing suite, things were much calmer. We delivered my stepson to his mother. We organized our belongings, having been told that induction can take days. My cervix was checked, and I was hooked up to a fetal monitor and given a couple of doses of misoprostol, a cervical ripening agent. I was checked periodically throughout the night as I began to have period-like cramps, but they were easy enough to sleep through, for the most part.

In the AM, they started me on Pitocin, which by noon had ramped up the contractions to fairly uncomfortable. I ate lunch and walked around the nurses station a bit. Greg went for a run, and by the time he got back I had quickly devolved into a bad place, vomiting and shaking with the contractions. Our doula was invaluable, suggesting positions and coaching me though the contractions that seemed to be coming fast with little opportunity for rest. After some time I labored in the bath, where my water broke, I continued vomiting, and ultimately managed to mutter the word "epidural". What felt like five minutes later the anesthesia team was there, providing blessed relief (I had gone into labor wanting the "opportunity" to labor unmedicated -- and as it turns out 5 hours of that is plenty for me). I was able to sleep for a couple of hours, which felt like heaven.

Around 7:15PM, the OB team came in and told us they were observing signs of fetal distress that they didn't like to see. They gave us a metaphor we could relate to: "Your baby is running a marathon at a 100m pace." They gave me 15 minutes of low-fi interventions to change things: an oxygen mask for me, extra saline in the IV, turning me on my side. When these didn't change the fetal monitoring metrics, they made the call: a C-section.

I was a little teary at the prospect of surgery and the change of plan from what we had anticipated, but also intensely focused on doing what was best for our son. The decision was made around 7:30PM; after a flurry of activity on many fronts, Samuel John was born via C-section at 8:15PM weighing 6lbs 15oz and measuring 20 inches long. Everyone in the operating room expressed great surprise when they found that the umbilical cord was wrapped around his neck four(!) times -- the purported cause of the fetal distress. The neonatal team toweled him off and checked him over, then he was brought to me to nuzzle while the surgical team sewed me up. He came out hungry and tried to feed on my chin and cheek, to no avail.

The ensuing two and a half weeks have contained lifetimes for me and Greg. New parenting is hard, recovery from abdominal surgery is hard, breastfeeding is hard. There have been (blessedly few) moments of near despair. Overwhelming all the sleep deprivation and bewilderment, though, I have a fierce love and desire to protect this little peanut, come what may, and to fix these fleeting moments in my mind.

Tiny feet.

2016 Goals Recap

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As usual, the evening of December 31 has got me thinking about goals. Goals for the new year, goals from last year. I've been AWOL from the blog for many months, but there's always time for an eleventh hour check in, right?

Last year I decided to make a public goals list, hoping for some accountability. Here's how I did:

1. Run consistently, including one speed session per week

I did this! Well, for a small part of the year (January, March, and April) -- and those were really great. I felt fast (for me) and fit. I had to take time off from running the remainder of the year because of injury, medical procedures, and pregnancy. Once the first trimester was behind me, and I could peel myself off the couch, I had another month or so of running without speedwork before things were too uncomfortable and I started walking my mileage instead.

But I remember how good running, and speed, feels! I'm excited for 2017 for lots of reasons, and one of them is getting back to that feeling. Here's to mama fitness in 2017!

2. Strength training two times per week

This was the goal that ended up most like traditional resolutions for me in 2016. I had about 6-ish weeks of good behavior on this one (Oiselle dirty dozen, among others), then fell off the wagon. I'm hoping to incorporate this again into my fitness routine as I get back to running post-partum.

3. Save for a down payment on a house

This one was a home run! I have to admit I unironically *love* saving. We are almost there, although we've decided to wait on the actual purchasing of a house. My husband is going back to school and we can make our current situation work for a while even with a new baby, but the nest egg is there waiting for us (incubating?) when we need it.

4. Be vulnerable and Wholehearted

This is a hard one to assess (no milestones, ya know?), but I think I've done a good job here, too. There have certainly been lots of tears (both before and after getting pregnant), and I've tried hard to dig deep into my values: love, family, hard work, decency. I know lots of people are fearful and cynical about what might occur in 2017; I'm going to double down on these values and try to live them louder than ever before.

5. Blog at least 1-2 times per month

This post brings the grand total to 7 for the year, so... not great. Not sure it will be more frequent with a new baby, either. Oh, well... the blog is still here for when I need a (very small scale) platform, I suppose.

Taking stock of the past year inevitably leads to thinking about goals for the new year... coming soon!

UW Fetal Brain MRI Study

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I do (kidney) research for a living, so when I found out I was pregnant, I was excited to experience clinical research from the other side. A few weeks ago baby Z and I participated in a cool study currently being conducted at the University of Washington that was seeking pregnant volunteers to build a high resolution fetal brain MRI database.

When fetal brain abnormalities are detected via ultrasound during a pregnancy, an MRI could provide additional useful information to women and providers. However, since you can't instruct the little nugget to stay still for an hour, up until now 3-D imaging has been of limited use. But researchers at the University of Washington have developed technology that is both high resolution and that can capture images even when the baby is moving (I'm imagining something like video stabilizing technology, but who knows?). This project aims to build a database of different baby brains throughout pregnancy for comparison. 

A few weeks ago, in my 19th week of pregnancy, I spent about an hour in an MRI at the UW Roosevelt clinic. I changed into scrubs, got rid of my jewelry (no metal allowed except rings), and was fed into the machine. It was rather close, although I was only enclosed up to my mid-torso. I was also provided earplugs and earphones with which to listen to my choice of Pandora stations (Gillian Welch). There was a rather loud clanking noise from the machine the majority of the time, but honestly my life is so hectic I welcomed the opportunity to lie there doing nothing for an hour, and I almost fell asleep. 

For me, the best part was after the MRI (and getting the $50 Amazon gift card!), when the radiology technician showed me some of the images and even a video (I also received a CD with images/video a couple of weeks later). I was astounded to see my favorite little alien moving around in there -- it looked like he was having quite the dance party! It put a huge smile on my face the rest of the day to have a mental image of what was going on down below every time my stomach turns and tickles. Here is the video -- taken over about 90 seconds but speeded up slightly below. I figure that, with those moves, he'll either be a runner or a dancer, or maybe both!

If you are interested in participating in this study, you can find more information here. Women must be between 18 and 36 weeks pregnant and between 18 and 45 years old to enroll. You can participate in the study up to three times, and there is an optional "phase II" to the project when your child is 19-21 months.

Update: we did the study again at 24 weeks! Here's our little guy, much more developed but much less active on this particular day:

Happy birthday, baby!

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Yesterday I celebrated my 38th birthday. As is my tradition, I spent part of the day taking stock of the year that has passed, and part of the day taking stock of the things I want/hope/expect will happen in the coming year. And this year has been a big one. Apart from the small daily triumphs and tribulations that make up a life, I finished my PhD (at long last) and got a "big girl" job, struggled with infertility, and ran faster than ever. In terms of having the opportunity to experience the full range of human emotion, it was a slam dunk of a year. It was a year full of being rewarded for years of hard work, and of learning to let go despite my best efforts to control outcomes.

My birthday afternoon, and the forecast for 38 looks just fine by me.

And now: what's new and what's ahead? Well, there's one small clue in my birthday present from my beloved husband: an original composition entitled "Here We Go".

Another clue is that I've spent most of the summer on our couch, and that now I'm finally feeling well enough to get excited about the fact that I'm 17 weeks pregnant! It's only just sinking in that this is for real, and that there will be a project deliverable at the end of this process, on or about Feb. 5. There's much, much more to say; but for today, let's leave it at next year's birthday reflection: 38 -- that was a very good year!

2016 Pre Classic

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I so wanted to attend the US Olympic Trials for track and field happening the first week in July, but we have (awesome!) family commitments in Eastern Washington, so it was not in the cards this time around. I unilaterally declared that we should still have some hot track action in 2016 as a consolation prize, so we headed down to Eugene over Memorial Day weekend to attend the Prefontaine Classic.

Greg in front of historic Hayward Field
Traffic out of Seattle Friday afternoon was extra horrible (2.5 hours from Seattle to Olympia), and we were lucky to make it to Hayward Field in time. First up Friday night were three tasty races (plus some field events): a W 800m race composed of all US studs, and a Diamond League W 5K and M 10K. They were all amazing in their own way. In the 800m, Oiselle athlete Kate Grace (2:01.16) came in second behind Alysia Montaño (2:00.78), aka "the Flying Flower"... two of my favorite athletes, so I was delighted! Next up, Molly Huddle ran 14:49.14 in the 5K and came within a few seconds of her own American record.
Kate Grace gets ready to roar.
Women's 5K flying with Lauren Wallace out front rabbiting.
The final event Friday night was the men's 10K. Although it's a lot of laps around the track, I found it thrilling to watch the race gradually unfold, building to a fantastic finish of Mo Farah and Williams Malel Sitonik sprinting neck and neck the final 200m. Mo Farah eked out the victory in 26:53.71, extending his 10K winning streak that extends back to 2011(!!!). I've heard it talked about endlessly, but it was incredible to hear an entire stadium of true track fans urging the athletes on in full voice... Hayward Field -- respect. 
Mo Farah gets ready to go!
Saturday was no less amazing (except in that Friday was FREE, y'all!! And Saturday we had to pay), but for me the standout race in a day of standouts was the women's 3K steeplechase. We stood near the water barrier and it was so inspiring to see the grit, speed, and grace with which the athletes leaped over it. Ruth Jebet ran 8:59.97 (holy guacamole!!) for the win and Emma Coburn ran a new American record of 9:10.76. Chills, y'all.
My favorite event, the steeplechase (Shalaya Kipp rabbiting)
Two other extremely cool things about spectating at Pre was that 1) we got to meet up with fellow Oiselle Volee members Liz Anjos and Sarah Matsumoto (thanks, Twitter!) and 2) we spent the day spectating just a few feet from a bunch of profesh runners including Will Leer and Alan Webb (American record holder in the mile). As you do. And you know what? They were cheering just as hard as anyone.
Cheer squad!

Eugene, I'll be back. :)