Weighing in on everything from avocados to Zimbabwe

Weighing in on everything from avocados to Zimbabwe

Baby Present

posted by Leila Z.

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One of the things I have been proud of in the ten and a half months since my son Sam was born has been my ability to focus on him and what he is doing in the moment. I'm not sure why this has been so easy -- I generally am infinitely distractible. Maybe it's because -- given my struggles with infertility -- Sam is likely the only chance I'll have to parent a baby, so I want to fully engage in and remember these days. More likely it's an evolutionary advantage to have a mother who's highly attentive to the baby's needs and actions. In any case, I have found it relatively easy to spend hours playing with him, singing to him, reading to him, and acting as a human jungle gym for my adventurous boy. I can't help but watch carefully and admire his intense concentration as he explores the world around him, and his joy at finding his favorite toy or being surprised by a funny face. (His rage can also be impressive!) It feels decadent and I sometimes feel guilty over my neglected emails, the pile of laundry on the table, and the dishes in the sink.

Sam also lives in the present.

A few weeks ago, we borrowed a book called Baby Present by Rachel Neumann -- inspired by the work of Zen teacher Thich Nhat Hanh -- from the Seattle Public Library, which I love to read as much for me as for Sam. It features lots of cute and cuddly babies (I'm told babies are fascinated looking at pictures of other babies) and the entirety of the text reads:

"Breathe in, baby. Breathe out.
You are perfect just as you are.
Sitting in the here and now.
The past is gone. It was pretty short to begin with.
The future is tricky and a long way off.
Right now is just right.
There is nothing you have to do.
There is nowhere you have to go.
Feel your belly rise and fall.
Present moment. Wonderful moment."

Each time I read it to Sam, I am reminded that babyhood (heck, life!) is short, and that I'm in the right place, dishes be damned. I especially like the lines about the past and the future. I am reminded to focus on the present moment/wonderful moment of now, and not anticipate the grief I will have when my baby is too grown up to delight in climbing back and forth over my body. I am reminded that this action -- making Sam laugh, or rocking him as his body curls into mine and eyelids flutter -- is both what I am doing, and all I want to do.


Mother's Day 2017

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What a difference a year makes, no? Last year at this time I was on the difficult infertility journey, this year I'm chasing around after this little guy (pretty easy for now since he's not mobile yet):

Ladies go crazy for a sharp dressed man.
While I loved the flowers and the cards I received yesterday, let's just say that for Mother's Day and me, it's complicated. Certainly I love being able to celebrate my own wonderful mother on a day solely dedicated to the exercise (this year with a hastily assembled brunch after an early morning flight). But at the same time I remember all too clearly the pain the day caused me in recent years. To every person who gave me a cheery "Happy Mother's Day!" in the airport yesterday morning because I was carrying Sam, I wanted to explain what a miracle it was that he is even here. And how this isn't my first Mother's Day, as I have parented my 10 year-old stepson for many years now. Furthermore (if I were really to bend an ear, and the flight were delayed), I might possibly explain how I wish "mother" were defined more broadly on this day to include mothering spirits of all sorts, and how I recognize the complexities of the maternal relationship for many people. Overwhelmingly, though, for Mother's Day I wish people knew how, for me -- most days -- it feels like a such privilege to influence the next generation in such an intimate fashion.

I read this description of (narrowly defined) motherhood the other day from Caitlin Moran's Moranifesto; it resonated with where I am right now, made me laugh, and seemed as good a definition as any:

"As an exercise, I'm just going to run through, once again, what becoming a mother consists of. First of all, you casually make an extra internal organ -- the placenta. Like you're some goddamn intergalactic robot UPGRADING ITSELF.

Then you spend the next nine months being a LIVING, WALKING FLESH NEST: casually absorbing your fetus's endless excreta while you're busy running an international business -- something which, in later years, you will find the perfect metaphor for raising a teenager. Then, at the point where you've grown a skull and a brain big enough to make humans the dominant species on earth -- but still just small enough to emerge from your pelvis without blowing both your legs off -- a homunculus will effortfully punch its way out of your 'special flower'.

Here -- at the point where, in a comparable exercise, a man who'd just passed a microscopic kidney stone would be wheeled onto a ward, dosed with morphine, treated like a brave hero, then left the hell alone -- you magically turn your tits into a milky heaven buffet, and start cranking out fifteen meals a day into a tiny, screaming, ungrateful creature who resembles an enraged otter in a jumpsuit.

Just to, again, get this into perspective -- when the most magic man who ever lived, Jesus, turned water into wine once, for one party, people went on about it for two thousand years, and formed a major man-religion around it.

Meanwhile, for millions of breast-feeding mothers every day, turning their bodies into lunch, the reaction is, 'Bitch, please -- don't do that in Claridge's.'

And then, of course, after the first year, the really difficult bit starts. The fevers and the ghosts and the sleeps that won't come -- the terrible falls, and the bullies, and the boy who breaks their heart, and the hair that makes them sad. And you have to teach them what jokes are, and what death is, and how to charm -- all while putting three meals a day on the table, and money in the electricity meter, and joy between every wall in the house, and never, never, ever forgetting to try and love every minute, because suddenly, ten minutes after they were born, they slam the front door for the last time, and you are sitting there, going, 'Where did the baby go? Where is my baby?'"

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 Greg and me. 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: