Cry, cry, cry

The colic-y stuff actually seems to be getting worse.  He’s not so inconsolable now– we can get him to stay quiet as long as we are holding him, walking around, and singing to him. But the duration and frequency are increasing. The start of “cranky time” is creeping earlier and earlier, but it always seems to end between 10 and 11pm.

Cry-it-out is not an option. I mean, I’m morally opposed to it, but I get as tired and wrung out as anyone, and I have had to just put him down and let him scream for a little while a couple of times, to avoid violence. I believe the cry-it-out strategy is born of the unnatural situation that is the modern nuclear family– i.e. not enough women in the household to take care of an infant. This is a curious historical/cultural anomaly.  I think it’s inevitable that women must sometimes leave their babies to cry, because we don’t all have the mental fortitude to hold an inconsolable, screaming, refusing-to-nurse child for three straight hours without hurting it. But I also think it is very, very wrong for “experts” to address this strategy as something good for the child. It’s an inevitable evil.  But there’s no way this is the norm– the best thing– for the human animal. No other animal would do this: the babe would be eaten!

That’s not why we can’t let him cry it out. Obviously, the wolves aren’t going to get him, here. But the couple of times I’ve had to do that, we’ve ended up with the landlady/neighbors at our door. And if you thought having an infant screaming in your ear was bad, try communicating what’s wrong with him to your landlady in an unfamiliar language WHILE he is screaming in your ear. Or trying to understand your neighbors’ suggestions for home remedies, and communicate back that you understand, and that you’ll try it. Or having the screaming occasionally punctuated by an anonymous neighbor lady yelling across the lobby to let me know what a bad mother I am (yeah, my Spanish sucks, but some things come through crystal clear). So it’s good that he’s actually consolable these days. But it’s grueling. It’s getting to be five hours at a time of walking him up and down the lobby, singing anything that comes to mind (lullabies, Patsy Cline, the communion hymn from church…)– because for five hours if he’s not being actively comforted, he’s screaming. At the end of the day I crawl into bed and pass out, praying that the next day will be better… and lately the next day has always been just a little bit worse.

Just to complicate things, my husband has developed severe lower back pain and can’t carry the baby, so only I can do the walking part. He has been filling in by doing the stuff Piglet has been preventing me doing: like cooking dinner and washing the dishes.

The Cusquena ladies’ remedy for colic (it didn’t work for me, but hey, anything’s worth a try!) is to chew a little peppermint leaf, spit it into a little water, and feed the baby a couple of small spoonfuls of the water (not the leaf).

At least he’s sleeping well at night. He wakes up to eat at 3:30 and 6:30 like clockwork. And I’m so tired these days that even our wailing abuela neighbor can’t keep me up.

In the mornings, when Piglet is in a good mood, I’m beginning to see little signs of communication. He seems to actually understand me when I say “are you hungry?”– he goes into his little tongue-out, head-bobbing nursey-face routine. And when he gets all squirmy and grunty and I ask if he wants to go potty, he calms down a little, and his facial expression changes. That didn’t work out well this morning, I admit: he squirmed and grunted, I put him on the potty, and he totally freaked out and yelled. He was hungry, and the potty was not where he wanted to be. But I hadn’t misread him: as soon as I took him off the potty he peed all over me and the changing pad and the bed…

He’s also started imitating us, just a little. Sometimes if you stick your tongue out at him, he sticks his tongue out. And most of the time, if he’s in a good mood, we can make clicky noises at him, and he’ll make clicky noises back to us.

We took him to the botica this morning, and weighed me holding him, and me without him. Not the most accurate way to measure the baby, but after translating out of the metric, the boy weighs roughly sixteen and a half pounds. Most of it in his thighs. The curious thing, though, is that I now weigh less than I did before the pregnancy. I started at 120 (naked), and now weigh about 117: and that’s while wearing shoes, a floor-length denim skirt, and the five meters of jersey cotton that I am using to carry Piglet around in. So it’s entirely possible I’m under 115 now. I’m not sure what to make of that, when my boobs are bigger than ever, my belly is still on the paunchy side, and breastfeeding makes me hungry all the time, so I’ve been eating like a horse. I think a lot of it is muscle atrophy.

In better news, my blood sugars seem to have stabilized. I’m guessing the crazy low glucose numbers are what make so many people give up on a low-carb diet. Those first few days can be really brutal. But I’m very, very glad I stuck it out, because now that my numbers are consistently in the 70s and 80s both before and after meals, I feel so much better. If I were still randomly plummeting into the 40s and 50s, I don’t think I could handle Piglet’s cranky spells at all. It’s a little disappointing to find that my blood sugars don’t appear to be the cause (and therefore the cure) of his ills, but…  stable blood sugars are good for both of us anyway.

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Breastfeeding and hypoglycemia: Will the medically-ignorant please just shut up? (and will the research community please step up?)

I have a blood-sugar control problem. I’m not diabetic. Yet. My fasting levels are normally good: 84-85. But I get a bit high if I eat more than twenty grams of carbohydrate in one go. In high school and college I had all the classic symptoms of hypoglycemia, but was never diagnosed. My aunt once measured my blood glucose at a whopping 33 (anything under 61 is considered hypo). For the first half of pregnancy my fasting sugars dropped into the 70s, and sometimes got down to 60or 61. Second half saw my post-meal sugars creeping upward–  150,160, 165– and I got control of it by lowering carbs and going for a long walk whenever the numbers got north of 130.

Since Piglet was born, though, it’s been a roller coaster. The lows keep getting lower and the highs keep getting higher (three days ago a modest serving of rice and lentils helped me reach a personal record high of 186). Today was scary. I woke up feeling crappy, so I checked my fasting level at 6am. It was 43: lowest reading I’ve gotten since my aunt waylaid me back in high school. It frightened me, so I downed two teaspoons of sugar and three bites of leftover beans from dinner. Forty-five minutes later I checked again: 33. Another spoonful of sugar got me up to 48. My husband went out to buy groceries and cooked me breakfast: I ate half an avocado and a tiny sweet potato. And shot up to 148 at one hour. An hour or so after that I was back down around 50.

All of this sucks. Anything under about 65 and I feel crappy– lightheaded, lethargic, and crabby. Once you get over 150, you’re flirting with incremental, irreversible organ damage. It won’t kill you right away, but it’ll sure make your retirement years hell.

Here’s the problem: there doesn’t appear to be ANY legit medical research on the connection between hypoglycemia and breastfeeding. None. If you search the keywords you come up with tons of stuff on hypoglycemic newborns, but nothing on hypoglycemic mothers. I’m hardly a unique case, though, and further searching turns up a lot of women like me, asking the same questions, i.e. What the heck is going on with my blood sugars? I think breastfeeding is exacerbating my hypoglycemia/making me hypoglycemic– is this possible? What do I do about it? Is this affecting my baby?

In the absence of any real medical input on these questions, a lot of rabid breastfeeding advocates feel the need to jump into the breach and claim there is no connection whatsoever between breastfeeding and hypoglycemia, that breastfeeding is the most natural, wonderful thing on the face of the earth and it is simply not possible for it to have any negative effects on mama or baby.

Which means I can’t find any real, useful, helpful information on the problem.

Rabid breastfeeding advocates: I know you mean well, but you’re full of shit. Back off. I am breastfeeding my child, exclusively. And I want to continue to do so. Denying that the problem even exists is not helpful.

Medical profession: I know there are a lot of medical problems out there. But it’d be nice if you could get to this one. Is my system dumping sugar into my milk supply? Could this be the cause of the colic episodes? Is there something else I should be doing to control it, apart from watching my carb intake and eating protein frequently? How do I keep my sugars from plummeting overnight when I’m not eating?

In the meantime, I guess I’ll lay off the sweet potatoes and rice, keep eating truckloads of protein, and hope for the best.

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13 Days Postpartum

My stitches seem to have dissolved. Swelling is down to just a tiny bit, and the hip pain is nearly gone.  Other than the sleep deprivation, I’m feeling almost human again– which is good, because this week we have to start the bureaucratic go-round to get the baby an official birth certificate and NID, then to the embassy to get a certificate of birth abroad, then his own passports– because he’ll need, as far as I can tell, a local passport to cross the borders here, and a US passport to cross US borders, when/if we go home.

Yesterday the boy seemed constantly hungry, despite his new, improved sucking technique. He kept both breasts completely drained all day.  Which means that despite night feedings, my supply adjusted and I was bursting with milk this morning.  While I fed him from the right side, the left started squirting milk several inches straight out, and soaked his pajamas before I could track down a rag to sop it up with.

I boiled eggs this morning. My blood glucose numbers keep dropping, especially when I’m feeding my hijo. I keep hitting new record lows: 61, 59, 56…     Once, back in high school or college, my aunt pricked my finger and tested me on her glucometer, and I got a reading in the low 30s. “How are you still standing?” she said–then she made me eat a Payday bar. But in my adult life I’ve never seen a reading that low.  56 does not feel good. The thing to do for this problem is to eat small, frequent, protein snacks, which is hard to manage without refrigeration. Boiled eggs seem like a possible solution.

8 Pounds a Month! My New Belt, Blushing

23 Weeks: Third prenatal appointment today:  Perfect blood pressure, gaining weight at a rather alarming rate– 4 kilos/ a little over 8 lbs. in the past month. That actually puts my total weight gain at 15 lbs. for the entire pregnancy, which is just as it should be, but continuing to gain 8 lbs. each month would be awkward. I will start cutting back on the starches– I was planning to do so anyway, but now I have more of a green light to do so. No, not a diet. But I have continued to monitor my blood sugars, and my fasting glucose has returned to pre-pregnancy normal (84), and my post-meal blood glucose levels are getting a bit higher– meaning they actually peak a little over 100 (112 at the highest so far).  These numbers are still very good, but we are no longer flirting with hypoglycemia. And since I don’t expect the awesome blood sugar control to last beyond pregnancy, the sooner I can settle back into my prior low-starch habits, the better. Mostly, I had been eating a lot more rice, oatmeal, and potatoes than I could ever have gotten away with before I got pregnant. In the amounts I’ve been eating those things…  six months ago they would have shot my blood sugars over 160 and it would have taken more than two hours to return to normal. So since I’m no longer waking up in a hypoglycemic fog… I can afford to lose some starch. It was nice while it lasted, but I do have that extreme family history of diabetes to attend to.

Fundal height is still in the upper reaches of normal, but we are no longer concerned about the possibility of twins. The baby was awake, and making my belly jiggle while I was being measured.

I came home with a wide elastic band to go around my middle– I think it will help a lot with the ligament pain. I test-drove it by walking the couple of miles home from the midwife’s office instead of taking the bus, and felt great! The midwife recommended getting one of those big exercise balls to sit on, to help with the sacroiliac soreness. Also, it holds my pants up, which is totally awesome– I have been constantly tugging them up for months.

I’d been wondering where I would ever find cloth diapers in Lima. It turns out the midwife’s office sells them! Yay! The all-natural granola-type approach to childbirth and babies is not that popular in Lima, so cloth diapers are really hard to find– which is how she ended up selling them. Because it was near impossible to find them anywhere else. I have four months, so I may still give making my own a shot. It’d be something tedious to work on in my spare time.

My husband didn’t make it to the last appointment, so it was really nice to have him there this time. I think he really gets a kick out of hearing the baby’s heartbeat, which sounds like a galloping horse. On the other hand, I found myself blushing when the midwife asked about our sex life, and gave instructions on nipple massage to prepare for breastfeeding. Neither of those things would really have been embarrassing if it were just me and the midwife.

Pregnancy-Related Internet Forums: Scary, But Sometimes Useful

The low blood sugars are still bothering me, and the sight of my very-suddenly-protuberant belly is still kind of a shock. But I’ve found help: internet pregnancy forums.  Which is weird, because back when we were not trying to get pregnant, I had surfed through a few of them, and found them terrifying. At that point, fertility awareness charts were a big part of our not-getting-pregnant strategy (a successful part, I should add– it would have been very bad to get knocked up while taking malaria-preventive medication, which saps the folate from your system). I’d carefully read every sentence of Toni Weschler’s Taking Charge of Your Fertility, and Katie Singer’s The Garden of Fertility, but sometimes it helps to get some live advice for the finer points.

There are several busy internet forums dedicated to fertility charting. But one of the quirks of the charting method is that it can be used for both avoiding pregnancy and trying to get pregnant. And in the forums, at least, the trying-to-conceive crowd vastly outnumbers the trying-not-to contingent. Also, the TTC people are completely barking insane. Seriously. If you don’t believe me, do a quick search for fertility awareness forums and shuffle through a few of them. Maybe it’s something about the hormones? Or perhaps it’s the extremely high concentration of women who want nothing more out of life than to BE MOMMIES. Not that there’s anything wrong with that– it’s just not me. And it lends itself, apparently, to abysmal grammar, absurd amounts of abbreviation (WTF is a BFP?), puerile euphemism (BD = “baby dance” = standard term for having sex), and enough pink flashing avatars and signature .gifs to trigger seizures in under three minutes. Two pages into any of them, and I feel exhausted and assaulted. The whole experience made me extremely wary of searching out pregnancy forums, once I did get pregnant.

It took me four months to try it, but I did finally work up enough desperation to dive back in. And it turns out that, despite the hormones, I didn’t have any trouble finding some semi-reasonable pregnancy forums populated by women who were already expecting. I don’t feel the need to post on them, but they have search features, and it’s fairly easy to find some basic reassurance there. Plenty of women, for instance, have posted their “belly pictures” along with how far along in pregnancy they are, so it’s quick and easy to find a wide-ranging collection of pregnant-belly photos of women at the same stage of pregnancy as me. And it turns out that even though I feel rather large all of a sudden… it’s really no big deal. For 18 weeks I’m kind of in the small-to-average range.

Also, once I started searching the forums instead of the medical literature, there were many, many discussions of hypoglycemia in pregnancy. Going by the number of people bringing it up and chiming in on the discussions, it appears to be not uncommon, and the recommendations are the same as for any case of hypoglycemia: eat often, eat small, and stay away from refined carbohydrates. It’s pretty much what I’m doing anyway, so I wouldn’t say it was helpful or informative, but it’s at least reassuring. It doesn’t answer the question of what causes it, or what the mechanism for it is, or why it’s so woefully un-addressed in the medical literature, so I’m still curious– just less perturbed, as (anecdotally) it doesn’t seem to cause problems at the blood sugar ranges I’ve recorded.

I’m still not interested in posting belly pictures and discussing baby names with total strangers (only my husband has that kind of security clearance), but… pregnancy forums: they’re not as scary as I thought–certainly not as scary as charting forums– and they do have their uses. Who’d have guessed it?

Blood Sugar: Where is it all Going? Also… Migraines

I mentioned before that my fasting blood sugar these days is ten points below my normal level, and has been since I got pregnant. I have no idea why, and still have no luck finding any literature on the subject. The web is saturated with info on gestational diabetes, and it seems to crowd out even the possibility of discussing other things that might happen to your blood glucose levels as a result of pregnancy. Irritating!!

My post-meal blood sugars have also been unusually low. I ran a test yesterday with a bowl of oatmeal. Normally a bowl of oatmeal would spike my blood sugar over 130 (possibly over 150, depending on how large a bowl), and my sugars would remain elevated for at least two hours.

8:40– ate oatmeal (with flaxseed meal, butter, and salt– no sweeteners)

9:40– blood glucose 93

10:10– blood glucose 85

10:40– blood glucose 74

11:10– blood glucose 74

So…  never got a measurement over 100, returned to my normal fasting level by 1.5 hours out, and seem to have leveled off at my new pregnancy-fasting-level by 2 hours. You might think I’d be thrilled–after all, my higher-than-healthy blood sugars have suddenly become nowhere-near-too-high. But it’s perplexing to me because I don’t understand WHY that’s happened. It’s not a result of the move, or more exercise, or a change in diet– the numbers dropped as soon as I got pregnant, and BEFORE any of those things happened. I’m not consuming fewer sugars than before, so where is it all going? Did getting pregnant some how make me MORE insulin-sensitive instead of less? Am I suddenly producing truckloads more insulin (which would be bad)? Is the baby somehow taking the hit for me (also bad)?

When I have a good day (i.e. don’t have to go anywhere) I plan to repeat the test over four hours. I’m a little paranoid about reactive hypoglycemia here, given what was happening to me after eating in restaurants. I got a measurement of 60 on my glucometer a couple of days ago, which freaked me out. I immediately tested again– and got 75, so maybe it was a bum test strip. And to be honest, I don’t really feel that great when my blood sugar is at 74. I feel kind of fuzzy-headed and cranky.

And now… migraines.  I’ve suffered migraines since I was 11. Some lucky migraineurs go into complete remission during pregnancy and nursing. Most experience at least a change in the migraine pattern, and often a reduction in the frequency of headaches. This happened to me. I still get migraines, but not as often– the first three months I had only two migraines total, down from an average of 3-5 per month. I’ve had two more in the last two weeks, so it’s not totally reliable, but…  decreased frequency is nice. I’ve also noticed a substantial decrease in severity, which is a great relief since I can’t take any of the effective painkillers while pregnant.

But… even a mild migraine is a bad way to spend a day or two, and I am not just without painkillers– my other top comfort measures — ice packs, and standing under the shower for a long time– are also unavailable to me, thanks to the lack of hot water and a freezer. It’s like being set back to age 11. Then, I had no idea what was going on, or what to do about it, only that I hurt: as a result, I developed, with no prior exposure to the subject (that I know of), breathing exercises and meditation to help me get through it. Now, I know what’s going on, but here I am, back at breathing and meditation. Just like my 11-year-old self, I lie down, imagine my head is an empty eggshell, and think of nothing but the feel of air currents swirling in and out of that eggshell until I fall asleep.  Unfortunately, I discovered painkillers at age 18 or so, and I’m now 10+ years out of practice on the breathing and meditation. I was better at it, when I was 11.

Gestational… Hypoglycemia?

The women in my family are all diabetic, except for me. My mother, my sister, my aunt, my grandmother: all type two diabetics. I watched my favorite great-aunts deteriorate and die from the complications. I know what diabetes is, I know what it looks like, and I am very, very paranoid about it. I would like to avoid getting it. I have a glucometer, and I monitor my blood sugar. Anything that sends my numbers over 150 gets axed from my diet. I never eat a whole banana, but so far I can handle just half of one. I’m careful about things like rice, and sugar is The Enemy.

Or at least, that was the picture until I got pregnant. Very shortly after I confirmed I was pregnant, a weird thing happened to my blood sugars: my fasting numbers dropped from a consistent 83-84 down to 70-74. I assumed this had something to do with the horrific nausea disrupting my eating patterns. I lived for a month on cottage cheese and plain yogurt, unable to keep anything else down. But then, we left the country. Up in the mountains I got even more sick, and my fasting numbers got even more weird, dipping into the upper 60s. I was really, really hoping it was something to do with the altitude, and things would normalize once we were out of the mountains. This was not the case.

In the meantime, the nausea abated some, but we lacked the facilities to cook properly, so we ate at least one meal a day in restaurants, and made up the rest with avocados and yogurt. When we returned to normal altitude, the problem actually seemed to get worse. At the hostal, we didn’t even have the dishes to manage avocado and yogurt, so all meals were in restaurants. My morning blood sugar readings were regularly in the 60s– the lowest I recorded was 61, just at the edge of real, scary hypoglycemia. I started keeping little juice boxes in our room, so I could get back up to normal first thing in the morning– we usually wake up at 6am, but none of the restaurants open for breakfast until 9am. That’s a long time to wait with low blood sugar. I was waking up groggy, confused, and lethargic. And ravenously hungry. 84 is my normal zone, where I feel good. At 65 I am a barely-functioning zombie.

Once we got our apartment, we stopped eating in restaurants. the content of our diet didn’t change all that much: meat, vegetables, rice, etc. But over the course of a week, my blood sugars went back to their pre-mountains level: still low, but back in the 70-74 range so I don’t feel dead when I wake up, but I can still feel out of sorts and a little slow-thinking until after breakfast.

Then one Sunday some friends from church took us out for lunch. The next morning my glucometer read 68. I think it’s something about the restaurants that is really doing me in. An expat friend informs us that “everything here has MSG in it”, so that’s a natural first suspect. I certainly don’t cook with the stuff at home. Whatever it is, there seems to be a pretty strong correlation between me eating in restaurants, and my blood sugar doing a nosedive over the next 24 hours.

But that still doesn’t solve the riddle of why it dropped to begin with, and why it is still consistently lower than my normal pre-pregnancy readings. That part mystifies me. There is a ton of literature on gestational diabetes, and how it’s normal for your body to get a bit insulin-resistant during pregnancy to make sure the baby is getting enough nourishment blah blah blah. But I can’t find any information on why my blood sugars might drop while I’m pregnant. There’s a tiny hint that this might not be unusual, in that the recommendations for morning sickness sometimes include a little blurb about eating as soon as you wake, because low blood sugar may be what’s making you nauseous. But that’s it. Nobody elaborates. Has this actually been studied? Are we talking about ordinary first-thing-in-the-morning fasting blood sugar as though it’s “low” or are we talking about lower-than-normal blood sugar? The literature is extremely unhelpful here.

I know I’m not the only person to have experienced this: I’m not half-Martian, and no single human physiology is THAT unique. But I’m guessing there aren’t that many weirdos out there paranoid enough to be monitoring their blood sugars without being diabetic (yet). Maybe there are a ton of women attributing that new I-feel-like-hell-in-the-morning feeling to the pregnancy alone, and never investigating it further. But I can’t help worrying that the low glucose levels may be having a negative effect on the baby. I wish I could find a good answer for it.