Success!

Or some semblance of.

Rohan is not a forumla fed baby and as a result my role in the feeding, soothing, putting to sleep cycle is a bit diminished. However, over the last few days, we've introduced the bottle to his repotoire, thus giving me the ability to help with the feedings.

Rohan took to the bottle quickly and within a few minutes of finishing a bottle suceeding in falling into a deep sleep. My small measures of sucess - That his mom was able to get a much needed respite from the baby for a straight 3 hours, that Rohan took to the bottle without much trouble, slept soundly for a while, and that I was able to do a little more than change a dirty diaper!

Lots is written about when to introduce a bottle if you want to manage between breast feeding, bottle feeding, and formula feeding and not "confuse" the baby. For the most part it is "easier" for the baby when it comes to the bottle as they don't have to work as hard. It can also be easier on the parent as they won't have to worry if the baby is getting "enough" milk as it is very easy to measure consumption with a bottle. The added advantage of formula is that it takes longer to digest and as a result, one could get more sleep between feedings. So we waited till Rohan turned 3 weeks old before trying it out on the advice of Rohan's doctor.

Nevertheless, our goal is not to put Rohan on the bottle all the time, just some of the time, and so far...he's doing well.

pre baby advice

One piece of advice a friend of ours gave us before Rohan showed up:

spend as much time as you can as a "couple" since after the baby arrives it will never be the same

...not bad, just different. Advice in heed, L and i went out to eat a ton, saw a bunch of plays, movies, etc. In the three weeks since Rohan arrived, we haven't eaten out once...have barely been able to eat dinner together and have watched TV together maybe once.

But we have spent a lot of time with Rohan.....watching him sleep, eat, carrying him around, staring at him, consoling him, listening to music with him, reading to him, etc. It is hard to quantify or categorize a lot of the time we spend with him, but it is actually a load of fun. A cousin calls the first year, the year of bliss before toddler years, but every time the baby cries, is actually bliss mixed with anxiety.

Luckily with bit torrent, i've been able to download the last 5 episodes of "24" that we missed :-). Hopefully Star Wars will stay in the theaters long enough for us to see it there before it ends up on DVD. Though given Lucas's penchant for milking the golden cow, it will probably be re-released when Rohan turns 5.

sleep, interrupted

The moment friends and family heard that we were having a baby, they consistently ranked sleep as the invaluable commodity they lacked. All recommended that we get as much as possible before Rohan enters the world and suffice it to say, everyone of them was right.

But it is not so much that a new baby prevents a person from sleeping. In fact, newborns can sleep nearly 20 hours a day -- but everyone neglected to mention that newborns tend to sleep in small 1 - 2 hour blocks between feedings. Having been able to sleep and eat whenever they wanted, they don't adapt to our sun cycle very quickly. In addition, their stomachs are so small, they can't hold lots of food at a time.

Since Rohan has been born, neither I nor L have enjoyed a straight 4 hour run of sleep. The longest was around 3.5 hours before we woke Rohan up to make sure he had some food.

The latest rumor, is that by the third month - or earlier, Rohan should be able to sleep through the night. But in a cruel twist of evolution, Rohan should be cutting his first tooth around then, once again throwing us all into the familiar sleep deprivation cycle.

officially insured

Rohan got his insurance card in the mail today and given that he has no income, no assets, no retirement account, and no social security number, one could consider it a major achievement.

Actually all babies are automatically covered by the mother's insurance the day they are born for the next 30 days. But it is then the parent's responsibility to get the appropriate paperwork filled out or the appropriate HR department notified to officially add the new dependant and inflate everyone's premiums.

paper vs. plastic

Before Rohan was born, L and I decided to do what we could for both the environment and Rohan's health by avoiding disposable diapers. We went out and bought some reusable cloth diapers, set up diaper pails to soak the dirty ones in, tried to figure out how it will all work, etc. However, the prospect of using a giant safety pin to secure them had us pretty scared off the subject. So we looked around for alternatives. In our childbirth class they showed a few we thought would work well (with velcro tabs), but they cost around $10 – 20 each…which seemed like a lot given that we might need 15 – 20 of them.

When L's mom came in, she brought a number of cloth diapers from India. With these it’s a bit of a two step process. One is to tie the diaper on, and the other is to wrap the baby's bottom in a plastic sheet so everything else doesn’t end up dirty or wet since the diapers are not a snug fit. For the first few days after Rohan came home – this worked out okay. But the increased volume of laundry grew problematic. Since the cloth diaper was holding virtually nothing in, nearly all of Rohan’s few clothes were in the wash constantly.

The problem lay in the size of the cloth diapers (relative to Rohan) compounded by their meager absorptive properties. The diapers we had bought stateside were actually multiple layers of cloth and Rohan would get lost in all the fabric due to his size. So for the near term we have reverted to disposable. Which, honestly, are proving to be significantly easier to deal with. As Rohan gets a bit bigger, we will give the reusable ones another shot.

In the interim, we have found the Huggies brand of newborn diapers superior to those made by Pampers. Both are good for babies up to 10 lbs, and the hospital gave us a few of each. But now as Rohan starts to put on the pounds, the Huggies continue to fit him much better. To date we have not seen any rashes due to the breathability problems typically associated with disposable diapers. In terms of cost, we’re already rapidly approaching what we might have spent on the “expensive” cloth diapers. Each box of 40 newborn diapers runs around $10 and lasts about 3-4 days. And unfortunately, Costco doesn’t carry newborn diapers.

rohan's rising popularity

As I mentioned in an earlier post, the name Rohan continues to grow in popularity. The Social Security Admininistration just released the rankings for the top 1000 names (per million births) in 2004:

check the diaper

Rohan has found his lungs over the last couple of days and on more than one occasion kept us awake for long stretches at night. We're lucky enough to have a bunch of help around the house to soothe him back to sleep -- but have to be continually reminded (generally by Rohan) that the primary reason for crying is a wet diaper.

I hearby promise to check his diaper whenver the crying commences to both provide for his comfort and our own sanity.

At the same time, I am going to probably check out the CD suggested by Seshu in the previous post.

new parent paranoia

Rohan will turn 2 weeks old tomorrow and so far, he's been to the pediatrician 4 times. Two of those appointments were standard follow-up appointments as a result of Rohan being in the NICU to check on his weight and overall health.

Rohan was 6 lbs 10 oz when born (approx 3 kg) and was down to 6 lbs 2 oz (2.78 kg) when discharged as part of a normal weight loss upon birth. His first appointment -- two days after being dicharged had a modest gain to approximately 6 lbs 6 oz. However, the doctor more concerned about his apparent jaundice and wanted us to give him some time in the sun to bring it down.

By his next appointment he had made some progress in both his weight as well as his jaundice. He was up to 6 lbs 10 oz and the overall yellowness of his skin and eyes was on the downward trend. The doctor was content to have us come in a week later for another weight check.

Two days later however, L and I were concerned about some pus emenating from his bellybutton / umbilical cord stump accompanied by some blood. In talking to the nurse on the phone, she was more concerned about the jaundice levels not going down, so off to to the doctor we went. Surprisingly, Rohan's weight was up to 6 lb 13 oz! A huge improvement over the previous measurement a few days earlier. This time we had a different doctor and she asked that we get a blood test done to be sure about Rohan's bilirubin count the next day at CHOP.

That night brought about our first 4 AM call to the doctor as Rohan was feeding very little and generally proving to be a very fussy baby -- especially in contrast to his earlier few days. Though his temperature was lower than "feverish," the nurse contacted a doctor and advised us to come in first thing in the morning.

Our 4th appointment in one week was no big deal -- Rohan started acting and feeding normally while his weight had only gone up 0.2 oz from the previous afternoon. From the doctor's office we were off to CHOP for the bilirubin test and a CBC (complete blood check).

No matter how many times i saw it in the NICU, watching the little guy get poked for a blood draw is traumatizing! The tests came back normal, so I guess Rohan is doing just fine. We'll know for certain when he goes in for his next weight check on Tuesday.

problems beget problems

Due to Rohan’s admittance to the NICU, he was subjected to a number of sensors and tests. Though his lungs were starting to clear and the first X-ray showed no major concerns, the oxygenation level of his blood started to become a concern. So, onto an oxygen tube he went.

Note to others, when explaining an “oxygen tube” to others, their first thought is usually something like a ventilator as required when the patient can no longer breathe for themselves. This was nothing like that and in fact all it did was blow room air past his nose to help him out a bit. Luckily the tube came off within the first six hours as his O2 levels came back up quickly. It is actually quite painful for a “new” father to watch helplessly as his kid seems to struggle to breathe and not really knowing what’s happening next. Nonetheless, the staff did a pretty good job of letting me know what was going on and what it all meant.

We started down the slippery slope when the first X-ray came back. The primary purpose of the X-ray was to determine if any merconium had entered the baby’s lungs and may be the cause of the grunting. Had any of the doctor’s done their homework (or if I had been paying more attention) they should have realized it to be a near impossibility due to the clear water bag when Rohan delivered.

Nevertheless, the first (of 5 freakin) x-rays showed what could be perceived as air in his body cavity, but outside his lungs – or a pneumo thorax. This sometimes happens if the kid breathes really hard or is given forced air. The latter didn’t happen, so they wanted to keep him in the NICU for further observation and re-take the x-ray since he had moved during the first one. The second x-ray showed a small amount of the pneumo thorax evident besides both lungs, so Rohan was destined to spend his first night alive in the NICU. We wall went back to our rooms and tried our best to sleep. I went back to the NICU around 2 AM to spend some time with the kid in a box.

The next morning a new x-ray was taken to monitor the progression, but the doctors did not see much change. Now that Rohan had been in the NICU for nearly 14 hours, he was getting dehydrated – so time to start him on an IV.

Subsequent x-rays showed that the pneumo thorax was shrinking on its own and no intervention would be required. In the end the crack medical team called it a “spontaneous pneumo thorax.” I wonder how many of these go undetected….should we x-ray all kids to be sure?

intensive care-less

Immediately following Rohan’s birth, the nurse attempted to help the baby to clear his lungs. All babies need to cough out the amniotic fluid upon delivery and start using their lungs for the first time. Rohan decided he liked excitement and would take his time. The nurse helped suction a lot of it out, but he still wasn’t breathing deeply – but rather grunting more than deep breathing.

So an attending pediatrician and two residents quickly descended upon our delivery room to check Rohan out. They decided he wasn’t clearing his lungs fast enough and wanted him ushered to the Nursery Intensive Care Unit (NICU) to see if anything else was the matter and / or contributing to his condition.

Our doula ensured that L got to at least hold the baby before whisking him away and made sure that I would be able to accompany him immediately. We were so swept up with everything that was going on, that these simple actions may never have occurred. I was able to follow him up to the entrance of the NICU where I was asked to wait while they got him “set up.”

That basically just meant putting him in a box with hand holes and hooking him up to a bunch of monitors. Painless enough for him, at least it’s warm, but relatively painful for a parent who has no idea what is going on. Adding to the distress….I had to leave his mom behind and had no way to get a hold of her. Not only is cell phone use prohibited in the NICU, but through a twist of fate, I had her cell phone in my pocket as well.

Looking back on it now, my attitude at the time was excessively worried – but it’s hard to imagine another first time father not feeling the same way. Though I hadn’t carried the baby for 10 lunar cycles, I did still feel attached to him. Watching him through the glass while nurses and doctors poked and discussed various readings did nothing to ease my concern.

The doctors did provide a fairly detailed explanation of what was going on and continued to re-iterate that everything was pretty much okay, but they preferred having him in the NICU where he would be constantly monitored vs. the well nursery. In addition the nurse / baby ratio is significantly higher in the NICU (usually 1 / 3) vs. the well nursery (around 1 / 10+) so he (and us for that matter) would get great care.

STILL…having him in our arms, in our room, would have been a far smoother roller coaster ride.

labor

In the early morning hours of May 2^nd, I was awoken by L who said “I think my contractions have started.” Uh Oh…Not only were they earlier than the due date, but I could name a dozen things we had wanted to get done before labor kicked in. Nevertheless…Time to swing into action.

At the very early stage, the contractions were somewhat far apart. That gave me time to shoot an email to my boss, our doula, family members, and the blog :-). I then threw a few last minute items into my bag and was set to start actually attending to L. Got out the stopwatch and a notebook and went to work recording the length and duration of her contractions, all while trying to offer her some sort of solace, remind her of happy places, etc.

As the contractions increased their pace (now around 9 AM), I thought about going to the hospital. I called the Doula who was on her way over and told her what I was thinking. Her immediate response was, “Why? You can do everything at home that you can do there.” In hindsight that was some of the best advice we had. She talked to L on the phone and guided her breathing through some of the contractions by slowing her breath pace down.

Staying at home with ongoing contractions probably isn’t for everyone. But for someone trying to avoid pain medication and striving for a “natural” birth it made sense. The Doula helped a lot once she got to the house. Instead of me having to monitor L’s breathing, keep her calm, get her water/food, keep the music on, keep the contraction records, etc – the doula took over some of the responsibility.

And, even more importantly, she knew what to do about L’s lower back pain. Since the baby seemed to be in a transverse position, applying pressure to L’s hips reduced the pain during the contractions and invariably helped to ensure the baby got turned around the right way. Over time the Doula recommended L sit in the bathtub for a while to ease to contractions a bit as well. Around 2 PM, she felt that L had progressed enough that it was time to get to the hospital. Her guess was right since when we arrived at the hospital, L was dilated to 8 cm – significantly cutting down the time that she would have to endure “labor” at the hospital and move into “delivery.”

Things to remember before leaving for the hospital:

- DO Bring: A jacket. The temperature may be very different 12 hours from now – it could be cold out at midnight.

- DO Bring: Extra cash. Expenses add up at the hospital. I had $50 when we got there and still ran out due to eating at the hospital cafeteria and parking fees, especially a problem when some backward ass places still don’t take credit cards.

- DO Bring: Food for self. I made some sandwiches to take to the hospital the day of (between L’s contractions) but forgot them at home. By the end of the day, all I was able to eat was my cereal in the morning and a cliff bar around midnight.

- DO NOT Bring: The computer. For some dumb ass reason I thought I might be able to get connected and send some wonderful emails about everything. Not only was there no internet access, but there wasn’t even a phone line in the room to connect too. Not to mention the fact that the last thing on my mind was checking my email.

- DO NOT let the Valet parking take your entire key ring. Have the wherewithal to give them only the car key and not the key to the house. This became a small problem as my mom and mother-in-law were ready to head back to the house, but we had no keys

- Suggestion: Give a trusted friend a set of your house keys. I had left the rent check and a couple of videos sitting in the house when we had to take off. Though neither of the recipients cared about them being late, having someone over to the house before you get there ensures that its cleaned up and ready for baby.

Rohan moves on

Since this blog is supposed to be about me...rohan went out and got his own. Given my current time constraints, i may not be able to get the blogs updated as quickly as everyone would like. Nonetheless....i'm slowly getting there.

Rohan's Blog

Rohan N Shah is born

Coming in at 6 lbs / 10 oz, 20 inches long on Monday, May 2nd at 4:56 PM EST

Rohan N Shah is born

This, of course, is not a picture of him after birth, but rather just before arriving home

much, much more to follow.......

contractions started!

About an hour ago, L got her first contraction....They're coming with a fair degree of regularity now, so junior might even be early.

check it twice

Just about every book, magazine article, website, etc., has a list of things you should bring with you to the hospital. For the most part the lists are all the same, but every so often one will suggest something I hadn't thought of or just plain weird. Of course I can't seem to remember any of those right now.

Nevertheless, we have our bags packed...got the ipod with a 10 hour play list, clothes for me, for baby and L, some foods, cameras and the car seat is around somewhere. I only packed my bag a couple of days ago as i am still tending towards beleiveing the babe will be late.