Now We Are Six

I asked her what she wanted for her birthday meal. She said she wanted tacos.

“With taco meat or salsa chicken?” I asked.

“Just beans,” she said. “And corn.”

“And lettuce with ranch?”

“No, kaleslaw with Myrtle’s.”

So that’s what we had the day she turned six.

And bunny cake. We also had bunny cake.

Tirzah Mae and her bunny cake

I asked her what color. She said she wanted gray. “Like a real bunny.”

I’ve lost my cake decorating stuff, including my gel dyes, so we compromised with brownish from half-toasted coconut.

And that’s what we had the day she turned six.

Like Mama, Like Daughter

It was little more than a whim – I was feeling as though Tirzah Mae had been wearing the same dresses to church week after week, so I pulled out the bag of clothes I wore when I was a child…

I was thrilled that I had, since I discovered that this little jobber – what I’ve always referred to as the “Bavarian dress”, brought back by my Grandma from a European tour – was already almost too small for Tirzah Mae.

The "Bavarian" Dress

She wore it that day – and posed in it that afternoon.

Here’s me, wearing the same dress some 30 years before.

Rebekah in the "Bavarian" dress

I also had Tirzah Mae take advantage of some of the last cool days of the spring to wear the little jumpsuit my mother made me.

Jumpsuit should fit in the fall?

As you can see, the jumpsuit is definitely on the long side for Tirzah Mae – and since I wore it sometime right around my 2nd birthday, I’m thinking that bodes well for getting a good deal more use out of it come fall!

Rebekah with her Grandma Menter in the jumpsuit Mama made her

**Side note: See how little hair I had in the Bavarian dress – and how much I had by my second birthday? Perhaps there is hope for Tirzah Mae yet.**

Tirzah Mae is Eight (Six) Months

As of yesterday, Tirzah Mae is eight months old (corrected to six.)

In some ways she’s exactly at her age-by-birthday. In others, she’s maybe a little behind her age-by-due-date. But she’s growing healthily, normally, well.

Gross Motor Skills:
Tirzah Mae is rolling, rolling, rolling – and she can back on her hands and knees as well. Unfortunately, she hasn’t figured out any way to move forward. So, for now, this means she’ll frequently scoot herself underneath one of the couches so that just her head is peeking out – then she’ll cry for help because… forward, mom!

She’s still not sitting by herself – I’m not sure exactly whether it’s lack of muscle control or simply interest in moving around. She’ll sit for about ten seconds before she topples – except that topple isn’t quite the word for it. She’ll sit for about ten seconds until she lunges for some object a couple feet away.

Fine Motor Skills:
Our girlie has just about got the two finger grasp down. When she gets really quiet on the floor while I’m reading a book, I’ll look up – and, more often then not, she’s delicately picking up a piece of lint between two fingers and placing it in her mouth.

I started her on solids around 7 months (5 adjusted) since she was grabbing at our plates and wouldn’t give us any peace at mealtimes unless we fed her (and no, breastfeeding would not do.) She generally has some fruit for lunch (or what I’m eating if I have enough leftovers for two), and eats what we eat in the evening.

I haven’t worried about introducing foods slowly (even though I have routinely encouraged moms to do that in the past – mostly because I had just enough moms come to me after the fact worried that their kids had intolerances and ended up doing elimination diets in an unsound manner – far nicer to add slowly while a baby’s getting good nutrition at the breast than to eliminate things when those are providing the bulk of a child’s nutrition). Anyhow – I haven’t worried about introducing things slowly, have just been giving her what we eat.

So she’s eaten enchiladas, curry, turkey and broccoli over biscuits, Great Grams’ spaghetti, Szechuan chicken, you name it. And she likes it all. (I won’t get too triumphant yet and pronounce this to be because of my expert child feeding practices – but I *will* say that if I’d stopped when she made faces on the first few bites, she’d have a much more limited palate.)

This continues to be a struggle. Tirzah Mae sleeps “through the night” (meaning a five hour stretch) most nights, but she doesn’t often do more than that. She’s mostly in her crib, but still occasionally ends up in bed with us.

I think teething may be the cause of our most recent nighttime woes – she’ll wake up and want to nurse and then eventually fall asleep at the breast. But as soon as I take her off the breast, she’ll wake up and want back on – she’s not swallowing anything so I know it’s just for comfort. If I refuse her the breast or try the pacifier, she’ll be wide awake and screaming. I took her to bed with me a few nights, but she was on the breast absolutely all night long and I didn’t get any sleep. On the other hand, spending an hour and a half up with her trying to get her to sleep and finally resorting to graduated extinction (which means I don’t sleep for another hour after she goes to sleep because I’m still hearing her scream in my head) isn’t exactly ideal either.

This is a stage, I remind myself. I signed up for this, I tell myself. And it’ll only be another twenty years or so :-)


When are those teeth going to finally pop out? This is the question of the month. She chews on everything, rubs her gums with a fervor I’ve never seen, is fussier than she’s ever been, isn’t sleeping very well again. It’s GOT to be teething (right?) But the teeth remain stubbornly hidden and the teething process seems like it’s lasting forever.

This is a stage, I remind myself. I signed up for this, I tell myself. And it’ll only be another twenty years or so :-)

Social Skills:

Just yesterday at the library, one of the librarians came running (as she usually does) when Tirzah Mae and I walked in. Tirzah Mae took a little while to warm up before she smiled at the librarian. But, after a little bit of playing on the floor while her mama looked at books, she was ready to laugh at everyone she met – a girl near the computers, an older gentleman in the stacks, and the same librarian as we checked out.

It’s tremendous fun, being her mama.

Thankful Thursday: Six months ago today

Six months ago today, I was sicker than I’d ever been in my life.

Prepping for the c-section

Six months ago today, I made a decision I’d never thought I’d make.

Six months ago today, my infant daughter was delivered via C-section, eight weeks before her due date.

Weighing in

Six months ago today, my Tirzah Mae was born.

She spent her first 26 days outside the womb in the NICU. She was fed through her veins at first, and then through a tube into her stomach, finally at the breast. She went from an incubator under bili-lights to the incubator without then to an open crib.

Tirzah Mae under the bili lights

She’s spent the last 155 days with us. She is fed at the breast, sleeps near us, is warmed by our warmth when she needs it.

Tirzah Mae and Papa enjoy each other's company

Five months out for just the one month in.

The books say that parents never forget their preemies’ births, their hospitalizations, their difficulties. And maybe the books are right.

But already, the memories start to fade. I forget how tiny she was, how helpless. I forget how desperate we were. I forget that she isn’t just another baby.

Snuggling inside mama's dress

When people ask her age, I tell them she’s about six months – starting to leave off “but she was born two months early”.

Tirzah Mae smiles as she swings

Six months makes a big difference.

One thing hasn’t changed in those six months though.

I still look at her little fingers, so perfectly formed, now full of flesh where once was only skin and bone. I wonder at them – how perfect, how delicate, how complete they are.

Setting her to scale

Eight weeks early, she was still complete. She was a baby, a human fully formed though immature.

I become sentimental, my thoughts meander.

What can I say that means anything, on this day six month out?

Perhaps the only thing I can say is to sing:

“‘Tis grace hath brought us safe thus far
And grace shall lead us home.”

Today, I am thankful for God’s grace. God’s grace in granting me life, in granting Tirzah Mae life. God’s grace in eight extra days in the womb. God’s grace in 26 short days of the NICU. God’s grace in 155 long days at home. God’s grace in sleepless nights, in pumping and shield use. God’s grace in spit up and diapers. God’s grace in baby laughter and Tirzah Mae recognizing herself in the mirror. God’s grace has been omnipresent.

Tirzah Mae plays in the mirror

Thank You, thank You, Gracious God.

Rice Cereal Time?

Tirzah Mae had her “4 month” appointment today (Born five months ago and due 3 months ago) – and her doctor went through the standard four month advice, ending with “You can also start rice cereal now.”

To which Tirzah Mae’s dietitian mother answered, “Thanks but no thanks.”

Despite what your next door neighbor, the label on the baby cereal, and maybe even your family doc says, you do not need to introduce solids at 4 months. Most babies don’t need anything but breastmilk or infant formula until they’re six months old – and both breastfed and formula fed infants are at a disadvantage if they start solids too early.

For breastfed infants, the risk of adding solids before six months is related to what we breastfeeding people call the “virgin gut”. As long as Tirzah Mae is only receiving breastmilk, her gut has a protective layer (a simplified explanation that isn’t precisely correct, sorry!) that practically sheds pathenogenic bacteria and other icky stuff. Once that layer has been broken, baby can get sick more easily (now, don’t get me wrong – this does not mean that breastmilk is no longer beneficial after the gut’s barrier has been broken – keep breastfeeding even if you introduced solids prematurely!) The longer the breastfed baby waits before breaking that barrier, the better off she is – to a point. That point is right about 6 months , when an infant’s iron stores from birth are depleted and she needs some extra iron (this is why iron fortified infant cereal is recommended as baby’s first food).

For the formula fed infant, there’s no gut barrier to break – it’s been broken long ago (after that first two ounces of formula), but that doesn’t mean that we should be gung-ho about starting those solids right at four months. A few babies are developmentally ready at four months – but the vast majority develop the head and neck control needed to safely eat solids later. And introducing solids too soon can risk replacing the relatively nutrient-rich formula baby has been receiving with the (mostly) “empty calories” of (most) “Stage 1” baby foods (as well as increase risk of allergies).

So, when SHOULD you start solids?

If you’re breastfeeding your baby, when your baby shows signs of developmental readiness, no sooner than six months. If you’re formula feeding, when your baby shows signs of developmental readiness, no sooner than four months.

What are these signs of developmental readiness I speak of? I’m so glad you asked.

First, your baby should be sitting up with minimal support. This means with a pillow behind him – not strapped into a seat with a five point harness or sitting in a Bumbo.

Second, your baby should be able to hold his head steady and make controlled head movements in the sitting position. If I had a dime for every parent who has told me their two week old already has great head control… Remember, I said “in the sitting position”.

Finally, your baby should open his mouth wide for a spoon of food and close it once the spoon’s inside. If your baby is still sticking out his tongue when the spoon touches his lips, he’s not ready for solids. His tongue is under reflexive control – it needs to be under his control before he starts eating solids.

As for Tirzah Mae? We’ll be breastfeeding with nothing else added at LEAST for another month (six months from her birthday) but probably closer to three more months (until six months after her due date).

Sanity Saving Stuff: Preemie and Newborn

Don’t you just love those lists of baby “must haves”? My favorite of all is Pop Sugar’s list of 100 (yes, you heard me right, 100) Must Have Baby Products. It was like the car crash you can’t help but watch. Tirzah Mae probably doesn’t have 100 items total, much less 100 separate items.

That said, I have found a few products that have absolutely saved my sanity during these preemie and newborn months (months we’re now leaving behind!)

Hospital Grade Electric Breastpump

Tirzah Mae received expressed breastmilk almost exclusively in the hospital and during the first month at home (we breastfed one to two times a day “straight from the tap.”) This meant that I was pumping a minimum of eight times a day. The Medela symphony the hospital loaned me during Tirzah Mae’s NICU stay saved me. It was fast, quiet, and comfortable.

Once Tirzah Mae was home, I used the Medela Pump-in-Style my insurance provided – and let me tell you, it’s a world of difference. I did everything I could to avoid pumping. I’d pump a couple times a day, hand express a couple more, and empty myself as best I could in the shower. Thankfully, I had plenty of breastmilk in the freezer, so the fact that I let my supply dwindle didn’t hurt Tirzah Mae (I worked intensively over a week to get it back up after I realized what I was doing). But if I’d have had less of a supply initially and was trying to exclusively pump after I returned, I’d have ended up quitting. The Pump-in-Style took longer, was noisy, and gave me blood blisters on my breasts (probably because I was increasing the pressure too much in an attempt to make it as efficient as the Symphony.)

By the grace of God, we were able to switch to exclusively breastfeeding (at the breast) around Christmas-time, meaning an end to my pumping days. I know many mothers of preemies are not so fortunate. I’ve got one word of advice for those mothers – RENT A HOSPITAL GRADE PUMP. It’s totally worth it.

Hands Free Pumping Bra

Despite Tirzah Mae being born early, I had an abundant milk supply – which meant that I only pumped 15 minutes at a time (with the hospital grade pump). But even pumping for a shorter time than many women, I still spent at least 2-3 hours a day pumping (and much more than that cleaning parts and labeling and storing the breastmilk). That’s a fair bit of time to spend doing nothing with your hands. Being able to pump hands-free meant a lot to me. (Initially, it allowed me to massage my breasts while pumping – relieving the clogged ducts I had from the beginning and helping to increase my supply to prodigous amounts. After my supply was established and clogged ducts were less of an issue, it let me email my family updates on Tirzah Mae, read a book, or browse blogs.)

Now some of you may wonder about the best hands-free pumping bras. I can’t help you with that one. I just had my husband buy cheapo sports bras, which I cut slits into to allow the flanges through. I wore them alone at night and over my nursing bra during the day. It worked great for me (although if I were to have needed to continue pumping exclusively, I would have done a buttonhole stitch around the slits and possibly used a tube top for the same purpose during the day for increased wardrobe flexibility.

Supportive Nursing Bra

At first, I thought maybe the backache I had almost immediately after delivery was from the c-section weakening my abdominals. And undoubtedly that contributed. But the biggest contributor was swollen milk breasts and insufficient support. Having delivered two months before expected, I didn’t have any nursing bras already ready – and there was no way my mom-breasts would fit into my second trimester bra (I hadn’t yet gone shopping for a third trimester one despite the fact that it was becoming clearly necessary.)

Since no one carries nursing bras my size (actually, very few stores carry bras, period, my size), I had to create my own nursing bras. I went to my local Dillards to get fitted and was delighted when the salesclerk announced that they’d just increased the size range of my favorite bra up to the size I was currently at. I took them home and used this tutorial to make myself some well-fitting nursing bras (I used the hooks and eyes off of several old bras, how’s that for being a frugal genius – or a packrat who can now justify herself?)

My back felt better almost immediately.

Get a good bra. Your back will thank you.

MOBY wrap

I’ve known for years that I wanted to be a baby-wearer. But I was plenty willing to admit that babywearing is just one of many legitimate ways to carry and care for a baby. Now I’m convinced that the MOBY has absolutely saved my sanity.

Tirzah Mae in the MOBY

You see, when we were in the hospital and when I was reading books about preemies, I kept hearing one thing: preemies must NOT be exposed to crowds. No shopping malls. No movies. No church. For a year.

Now I don’t have any problem with leaving movies and shopping malls behind. But church? I can’t just not go to church for a year.

I talked with Tirzah Mae’s neonatal nurse practitioner about it and she agreed with my proposed solution. Tirzah Mae would go to church with us in the MOBY. The MOBY holds her close, covers her up and sticks her face in my chest – meaning that no one else can get very close to touch her or cough on her (they’d have to get pretty close to my chest even to just breathe on her.)

We took her to church the Sunday after she came home and she’s been to church with us every week since then (except the week where none of us attended because I had mastitis).

Yes, the MOBY saved my sanity by letting me worship with the body weekly.

One-piece sleepers

When it comes to clothing, babies aren’t picky – which is a very nice thing. They don’t care how stylish clothing is or whether it’s matched or anything like that. What they do care about is getting in and out quickly without too much pulling and tugging. Moms care a little more about matching and cuteness and all that.

I love these one piece sleepers
One-piece sleepers answer both. Mom doesn’t have to worry about matching clothes bleary-eyed after baby has a blow-out at 1 am (after mom has gotten exactly 7 minutes of sleep, none of them consecutive, in the past 24 hours.) Baby doesn’t have to worry about something going over her head. And, if you choose the sleepers that snap all the way up the legs, you can avoid uncovering that little chest during non-blow-out diaper changes (which is a nice plus.)

I put Tirzah Mae in the adorable little onesie, pant, and sock combos often enough – but when things got crazy and I was at the end of my rope, the one-piece sleepers were sanity savers.

Looking back on your kids’ infancies, what baby products did you find absolutely essential? What were your sanity-savers? Pray tell.

Ditching the Shield

Disclaimer: This post contains a frank discussion of some of the difficulties of breastfeeding a preemie. I try not to be vulgar, but I do discuss the mechanics of breastfeeding openly. If you’d rather not read, feel free to skip this post.

After two half-hearted attempts to get my nipple situated in Tirzah Mae’s tiny red mouth, the nurse told me to wait right there.

As if I could do anything else. The swaddled miniature in my arms was hooked to half a dozen monitors, keeping her – and me – tightly bound to our recliner.

I tried again, squeezing breast tissue between thumb and forefinger to make a “nipple sandwich”. But Tirzah Mae was looking away – and my attempt to draw her close caused my sandwich to fall apart.

The nurse returned, deftly separating the cardboard insert from the back of a blister pack.

“Here.” She handed me a clear silicone nipple with small holes on the end. “Your nipples are too big for her to latch onto.”

I thought about protesting. We’d barely tried to latch Tirzah Mae on – and nipple shields, I knew, were not without risks. But they’d drilled home the NICU truth – we couldn’t waste calories doing unnecessary things, even things like latching her on at the breast.

So that was that.

A week later, a different nurse asked me how breastfeeding was going as she weighed Tirzah Mae before a breastfeeding session.

I explained that we were using a shield, but that it was going okay with that.

I heard myself in her voice, urging me to try to latch on without the shield.

I nodded halfheartedly, just like my clients do when I make the same suggestion.

“You don’t understand,” I thought. “I only get to breastfeed once a day and that for only thirty minutes. I can’t waste our precious time trying to get her latched.”

And the frustration at NICU policies caught up to me – scheduled feedings that were spaced too far apart for my infant daughter who was clearly hungry, crying and eating her fists after just two and a half hours, being able to breastfeed only once a day, having breastfeeding timed and with before and after weights constantly measuring our performance. Hot tears rolled down my cheeks and I was thankful for the dimmed lights that hid my anger.

Once we had Tirzah Mae home, Daniel asked me occasionally how it was going – practicing without the shield.

I loved him for internalizing my antipathy towards the shield – and hated him for rushing me.

Practicing wasn’t easy. Tirzah Mae would become angry that milk wasn’t already flowing. I became impatient with her anger. I was tired, drained from long nights with little sleep and days where nothing got done.

It was so much effort to go without the crutch.

I cursed the nurse who gave it to us, who got us hooked on its subtle evil. I blamed her, crying stormily, as I fumbled with the shield with sleep-numbed hands. As it fell off – once, twice, five times.

Tirzah Mae grew angry with the wait and Daniel woke up to her wail. I blamed the nurse when Daniel complained of being unfocused at work the next day.

But we kept practicing, first once a week then more and more frequently.

We’re almost done with it, Tirzah Mae and I.

I never take it when we go out. I never use it when we’re breastfeeding around the house. It stays in the basket beside the bed, only to be used if Tirzah Mae’s too frustrated to latch after a few tries at night.

We’re on our way to losing the shield.

Good riddance, I say.

Tirzah Mae’s Birth Day

I’d already told Daniel I wanted a c-section, but he paid me no mind. I told him that as I cried angry tears, frustrated that I couldn’t stop shaking.

Maybe it was the IV magnesium – they’d said it could give one the shakes – but I hadn’t had a problem with my first dose a week earlier. Maybe it was the cervidil that was attempting to ripen my cervix. Or maybe it was that my condition was rapidly deteriorating – the reason we were inducing at 32 weeks.

Whatever it was, I was weak and out-of-control and I knew that I would need a c-section.

Daniel, knowing how set on a vaginal delivery I’d been, ignored my emotional outbursts.

Then, around midnight, in a rare break from the shaking, I explained myself more rationally.

I was shaking uncontrollably. I couldn’t move my limbs because they were so full of fluid and because I was hooked up to so many monitors and IVs and catheters. I was weak from 8 days of hospitalized bed rest and a week and a half of modified bed rest before that. Between the preeclamptic visual disturbances (poor color vision and dancing lights) and the fluid filling my face, I could barely see. If I was this much of a mess before we’d even gotten my cervix ripened, there was no way I’d make it through Pitocin-induced contractions to deliver vaginally.

Prepping for the c-section

Hearing my calm explanation, Daniel agreed – we would ask for a c-section.

Dr. Tackett came in to check on me – and I told him our decision. He agreed that my request was reasonable. They’d prepare for a c-section.

I had no idea what to expect with a c-section. Until that day, I’d planned for a vaginal delivery. So everything was unfamiliar as they wheeled me into the operating room, made me drink a foul-tasting beverage to neutralize my stomach acid, and had me lie very still on my side while they administered the spinal block.

Ready to vomit

Daniel was there at my head, holding my hand and looking over the curtain along my chest to see the operation.

I felt tugging, I heard a gasp and Daniel asking “Is that the water breaking?”

No, Dr. Jensen replied, he hadn’t even cut into my uterus yet. The water was ascites – excess fluid in the abdominal cavity, indicating that my liver had shut down.

There was more tugging, and the announcement that it was a girl – followed by “And her umbilical cord is wrapped tightly around her neck twice.”

I was overwhelmed with thankfulness – thankful that our baby was born, thankful that we’d chosen a c-section instead of having an emergency one once she’d shown distress.

I don’t remember hearing her cry, but she had to have – I read it in her Apgar scoring when I was reading through her chart later on. I do remember Daniel announcing her name in response to one of the medical staff’s questions – she was Tirzah Mae Eloise.

Pink and crying

Then Dr. Jensen was telling me he was sewing me double tight so I can have that VBAC – and I was again overwhelmed with thankfulness . Thankful that we had a relationship with the doctor who did our c-section. Thankful that he knew our desire to deliver vaginally. Thankful that he believes in VBAC and has helped many women successfully have them.

They brought my daughter close so I could see her and touch her. Still weak and uncoordinated, I flailed my arms in her direction – and stuck my finger in her eye.

Mama's first look

She was so tiny, so red, so clearly not supposed to be out of the womb. But she was alive – my daughter had been born.

“Daughter,” I told her. “I love you, my Tirzah Mae Eloise Garcia.”

They took her off to the NICU and wheeled my bed into the recovery room.

To be continued at a later date…