Antenatal expression of colostrum

AKA "Colostrum Harvesting" - fun!

Since 36 weeks I have been attempting to hand express colostrum twice a day for our little girl, to help stabilise her blood sugar should it be low when she's born due to gestational diabetes.

This is not something I had ever heard of and I was thankful that the midwives at the hospital arranged for me to meet with a lactation consultant for a one-on-one session prior to the regular breastfeeding class that the hospital offers. I was given a number of tiny syringes, told how to safely store anything I did express, and shown how to hand express. I was also reminded that because the amount would be so tiny, if anything, that a pump was out of the question.

I was optimistic that I'd at least be able to express something as I have noticed discharge since early in the pregnancy. The first time I tried I thought I had success, a few tiny drops from each side, but not enough to register in the syringe (disclaimer: the pic above is from the web - not mine!). The next few days - nothing.

I was getting distressed and disheartened, after all, this was to help our little one and hopefully keep her out of the SCN. I felt like I was letting her down. I watched as many videos as I could find of actual hand expression, not the fake pillow breasts that are usually used for demonstration, and I read all the info I could find. It reinforced to me what I had been told - ANYTHING I could collect was a bonus and many women, especially first time mothers, have no luck at all.

I kept trying and just after 37 weeks, it started up again. I always have more luck at night after a nice warm shower. It doesn't seem to matter how much I warm or massage in the morning, there's always less success.

I still have very little stored, about 0.2 ml in all, but it feels like something to me and that I haven't given up trying.

I found it hard to find information in one place, so I'll link below the pages I found useful, just in case anyone else is in the same situation!

https://www.breastfeeding.asn.au/bfinfo/antenatal-expression-colostrum

http://www.gestationaldiabetes.co.uk/colostrum-harvesting/

35 weeks

It's still so hard to believe that we only have at most three weeks to go until we meet our little girl. I can so clearly remember a time when I didn't even think we would make it to 8 weeks let alone 38.

I had a vivid reminder of that sheer panic earlier in the week. I wrote previously about how my cousin's announcement that she was expecting her first had sent me into a spiral and that I was sure this meant she would get to keep her baby and we would not. Finding out that her little one arrived this past week brought all those feelings back. I just couldn't shake the feeling that this was it, her baby was here and those wiggles and pokes I was feeling as I read the news would be the last. Hubby said all the right things (he's getting very good at this!) but I still didn't manage to shake the feeling for a couple of days. It still pops up every now and then, but it's not even been a week since I found out, so I guess that's to be expected. We had actually talked about asking not to be notified, but I just never got around to mentioning it to anyone.

Things are going well for us. I stopped progesterone completely last week and I stop aspirin this week. GD seems well under control, I've only had one high in the last week when I had lunch out and even the wholegrain bread was obviously enough to send me over. Our 36 week growth scan was good and I'll take the report to the hospital tomorrow for my group of appointments. I see the psychologist, the midwife, the OB and have CTG for baby. Last time I was there for almost 6 hours.  Hopefully tomorrow will be a little smoother as I have to go back the next day for an endocrinologist appointment.

Bags are packed, car seat is installed, nursery is complete... now we just need our baby to come home with us.

27 Weeks

Some of these vegetable sizes really don't mean anything to me! I know how big a cauliflower is, I also know that my baby is bigger than that!

I hadn't realised that a month had passed since my last post. It has been a tricky month. Four weeks between scans, and I made it to the end without too much panic. We have also gone through a few painful anniversaries and the observance of Pregnancy and Infant Loss Awareness Day and the Wave of Light. All of these events have brought their own painful memories and reminders that there aren't really a lot of people standing with us in our loss.

Well, perhaps that isn't fair. I know everyone has such busy lives and troubles and concerns of their own. I know that I also haven't been the most supportive friend in the last couple of years as I have struggled just to hold myself together, much less be a support to anyone else.  And I haven't directly reached out for help so I suppose I can't expect too much. At the same time, on October 15th, my feed was flooded with images of people lighting candles in honour of their nieces, nephews, grandchildren and children of their friends. I received one message of a lighted candle and it honestly almost made me feel worse, as though the person was ashamed to post it publicly. Probably the ramblings of a grieving yet hormonal pregnant woman!

We are also coming up to the due date of the little one we lost at the beginning of the year. In truth, knowing we were looking at a 38 week arrival at the latest, we would already have that little bundle in our arms. Still can't get my head around the fact that if that baby had survived I wouldn't be carrying the little girl I am so in love with now. I just avoid thinking about it too much, because I don't think it is something that will ever make sense.

Our little girl is doing wonderfully. We had our 28 week scan yesterday and everything was perfect. She's measuring long, but not too big at the moment, which is a blessing considering my gestational diabetes. We even saw her perfect little face on a brief 3D scan, and she gave us a little smile. She's super active and feeling all those little kicks and rolls is such a wondrous feeling.

I am also doing better than I was a few weeks ago. Not working is doing wonders for my back and nerve pain in my leg, as is twice weekly hydrotherapy. Baby seems to love the sensation of being in the pool, she's been extra active the last few visits. I'm also finally able to drop my midday progesterone dose (yay!) as my last reading was over 100, which everyone was thrilled with. Will monitor again in two weeks and go from there.

Hospital follow up to the scan is on Friday, they've asked me to bring in all my scans from my back to make a firm decision about delivery, so I should have a better idea of what to expect by then.

Thanks to those who checked in on me between posts, it is really lovely to know there are people looking our for out little girl x

23 Weeks

Our little mango is the size of a Barbie doll this week according to Ovia. This got me thinking about all of those issues to do with raising girls, gender stereotypes, body image and so on.

More than anything though, this week has seen a huge spike in my anxiety levels. It started with a dream last week that I delivered our girl at 23 weeks, so I guess I have that in the back of my mind. Her movements have also changed this week, which I know is normal at this early stage. She's still kicking just as much, but her quiet times have changed from morning to mid afternoon. I have probably used the doppler more this week than in the last 2 or 3 weeks combined.

I think the main reason though, and this only came out last night while I was talking to hubby about all of this, is that we are so close to the magical 24 week 'viability' goal. I know there is no guarantee after that, but it makes me feel a little better to know that at least they would try to keep her alive. But for these next few days, she's just agonizingly short of that cut off.

I am still not convinced that she's going to be staying with us. It is really hard to plan for a future with her here. I was looking for a photo on my computer the other day when I noticed that none of the videos from our 20 week scan were showing up. Knowing I had deleted them from the USB prior to the last scan, I went into a total meltdown. I was convinced that these few precious videos and photos are the only evidence we will have that our baby girl ever existed and to think that they were gone was too much. Thankfully, it was my fuzzy brain causing the error, not the computer and the files were still there. Still, it shook me how strong those feelings of loss were.

Even as I am in the process of clearing out my office to convert to a nursery, I am still looking at is as decluttering, rather than preparing baby's room. Hubby has convinced me to take the leap and buy a bassinet this week as the one we like is on sale. The only way I am going to manage that is if I buy online, there is no way I can go into a baby store just yet, let alone on my own.

Everything else seems to be going well. My progesterone is still rising, my blood glucose levels are under control and my blood pressure is stable. Here's to making it to 24 weeks!

21 and 22 weeks

Things seem to be speeding up around here! I feel like I am back to appointments almost every other day and while it is so very good to know that everything is progressing well, it is so exhausting.

After my scan last week I had a bit of a break, although also had to go in to school to finalize things. I know there are a few people wondering why I am off so early, but the face that I feel so much more relaxed now is just amazing. And it has made SUCH an improvement to the pain in my leg! 

This week I saw the endochrinologist for a follow up on my GD and they have stopped my metformin. It was a bit of a struggle the first morning, wondering if it was going to hurt baby but she gave me a little kick which I took as a sign of reassurance. They said they needed to do this now as there is some evidence that it can cross the placenta and after 28 weeks this could cause problems for baby. I just have to keep a close eye on my blood glucose as the metformin was also acting to reduce this.

Everything else there is going ok. I am getting better at judging what and when to eat, although I have had a few nights where I just HAD to eat something late, especially when we stay up late to watch the football - it's hard to make it to 2am without something to sustain me!! It does make my morning numbers a bit higher, but still within range so I am not too worried yet.

I then had my hospital appointment which, all things considered, was the best one yet. I still had to wait for ages, but once I was in the doctor was lovely. She had a student who struggled with everything, couldn't take my blood pressure, couldn't measure baby, poked me WAY to hard when feeling for baby and then couldn't find baby's heartbeat with the doppler. I could feel her wiggling, so I knew she was ok, and I even told the student where I usually found the heartbeat at home. No luck!

The doctor found an ancient ultrasound machine, just to locate baby's heart (and bonus I got to see her wiggle again although the image was terrible!) as the machine was too old to even have sound. They still couldn't get the heartbeat, so I just asked if I could have a try - got it immediately and a nice little 152 popped up on the monitor. That's my girl :)

I was given pathology slips for rhesus anitbodies (I'll have an anti-D at 28 weeks all being well) and iron levels. I asked about Vitamin D and was told that they are no longer allowed to request this unless there is proven low Vitamin D (I wonder how they would know this without testing?). I showed her my previous result and she added it to the request right away! 

I also have slips for ultrasounds every 2 weeks, 26, 28 and 30 weeks for now. They said they'll keep on eye on baby and take things week by week. I then asked about delivery and this doctor was sure that my back would be no hurdle to 'natural' birth, even when I told her that when it goes off I can be bedridden for weeks, not ideal with new baby. So she's asked me to bring my xray and scans next time for review.

In the meantime, I have also found out that, given the overall picture, they feel it's best for me to stay at this hospital and not transfer. I guess I understand, I certainly wasn't as upset about it as I thought I might be. Talking about my experiences there the last pregnancy she felt I was showing signs of PTSD which I had thought about but not really acted on. She's referred me to a psych service within the maternity ward. 

Next week is already filling up with physio and follow up scan for baby to hopefully measure those tricky bits of her heart she wouldn't let us see last time. As well as my usual weekly progesterone level blood test. 

Now to tackle the house...

19 weeks

Or the size of a retro gameboy!

My 19th week had been fairly uneventful. Wiggly feelings were starting to turn into definite kicks and we can pick up her beautiful heartbeat almost immediately every night.

Thankfully, our weekly progesterone test showed a huge rebound and we were back up to levels measuring one week ahead. The plan now is to continue on the same dose until 28 weeks, as long as the results keep tracking this way.

The hubby had the weekend off so we ventured out to do a little shopping. Not more than 10 minutes in and I was in all sorts of pain in my leg and terrible pulling feelings in my groin. SO much so that I was in tears in the middle of the shopping centre.

It wasn't just the pain making me cry, it was the thought that here I was, not even 20 weeks and in such pain walking around a store and just about to finish work ealy... when all the #fitpregnancy talk makes me feel like a complete failure because I can't climb a mountain to pose for bump pics!

In addition to that, I have had to start insulin for my GD. My numbers are all pretty much under the limits, but because I am already on metformin (for PCO) and that would be lowering my numbers already and I have to come off that before third trimester... well, they wanted to start me now.

It's not a huge drama, but it is just one more thing to worry about. What to eat, when to eat and being scared of overnight lows when I take my bedtime dose. People much braver than me have to face a lifetime of this, I know I only have a few months ahead of me.

Officially halfway too, as the current plan is still c-section at 37/38 weeks. So hard to believe but oh so amazing.

When It Hurts

Just as pregnancy loss is an isolating experience, I am coming to find that pregnancy after loss can carry much of the same silence and awkwardness.

When I first started telling people about this little one, responses ranged from "How far along are you this time?" to "This time will be different." I also received many subdued "Congratulations" that almost seemed to have an undertone of doubt or even disbelief. I also had a couple of "Again?!" I'm not sure if this was due to the number of previous losses (people were quick to suggest we look at adoption after our last loss), or the short time between our last loss and this baby. I would have liked just one positive "Congratulations!" I knew that people would ask how far, that's one of the reasons we waited till we passed the 8 week point of our last loss before telling even family.

I have also found it hard to talk about my own feelings about this pregnancy. I'm constantly being told off for saying "if" but it is just not possible for me to say '"when" yet. I try to explain that it is not negativity, or even worry and anxiety - it is realism. I have been on the wrong side of the odds too many times to take anything for granted. I also can't talk about the fact that I am still mourning all our lost babies, but also still processing our loss from April and trying to get my head around the fact that if that baby had lived then we wouldn't have our little girl. I just get uncomprehending stares in return. I have people ask me why I am feeling sad, down or withdrawn, after all, I should be happy to be pregnant.

The thing I am finding most difficult at the moment is the feeling that I should be having a happy and painless pregnancy because I am lucky enough to actually be pregnant again. I guess this came to a head after reading a fellow loss mum's comment on an infertility group I was part of. It was basically along the lines of "I wouldn't complain about anything if I was pregnant, don't these women know how lucky they are? I can't stand hearing it!"

I found this really confronting, as while I am thankful beyond belief to be carrying this little one, the pregnancy itself is difficult for me. I truly believe I will do whatever it takes to get her here safely, but should I just have to grin and bear the pain? On top of the daily progesterone and the fatigue this causes (which is nothing more than an inconvenience), and the gestational diabetes, my back injury is starting to play up and the nerve pain in my leg is almost excruciating. At the moment, I can barely walk for 5 minutes before it becomes too much. I am also having troubles with round ligament pain and SPD.

Yes I am getting a support band, yes I have seen the physio, yes I am starting up hydro therapy again this week... but just because I am blessed to be pregnant again does that mean I can't say the words, "My leg is really hurting today."

I never expect everyone to understand what this experience feels like, and I know there are many women who would give anything to fall pregnant, but just as we don't expect them to suffer their losses in silence, why should the experience of pregnancy after loss be somehow immune from this kind of freedom and support?

Pregnancy is tough. Pregnancy after loss is tough.

17 Weeks

Or the size of a playstation controller according to Ovia!

The past week has been a tricky one. My progesterone levels have dropped, a LOT, from 50 to 40. I can't even explain the anxiety this has caused. My specialist says she's not worried yet, and to see what happens this week. Could just be a fluke.

The main thing to worry about here is early labour, so every little twinge or pain is sending me into a panic. I am doing my best to stay calm and our doppler is certainly helping in that regard. Our baby girl's little heart is beating away at a steady 160ish bpm every night when we check before bed.

I had also had a couple of high bgl readings during my first week of testing. I knew that it was due to what I had eaten, really testing myself out to see what I could and couldn't eat (read, too many hot chips, too much rice and pasta!) but I didn't know what the outcome of that would be at my one week check up. Thankfully, they were happy with my reasoning and so I only have to go back in two weeks for a check up with the endocrinologist, rather than an urgent on the day appointment.

So besides waiting for my progesterone test this week, I'm waiting for another test result. One possible cause of the low or dropping progesterone is the MTHFR mutation, which I have never been tested for. Some of the symptoms fit (wheat allergy) but others don't (dairy intolerance). I don't really know what it will mean if the test comes back positive and in this case I have chosen not to google - I'll just wait for the result which can take up to a week.

The main thing scaring me is the progesterone. They've already said the think that is the reason for our previous losses, so the background thoughts of losing our little girl have come right to the front. I've had dreams for the past two nights of waking up bleeding - this usually happens the day before AF arrives so it is genuinely worrying to me to have such dreams now.

This little one is already such a part of us, perhaps even more so than her siblings before her, it is all I can do to keep thoughts of losing her at bay. I just keep reminding myself that she's here now, and doing fine. And at the moment, that's all I can ask for.

16 Weeks

The size of an avocado, but not as green or mushy (thanks Ovia!)

My 16th week started with an appointment at the hospital of horrors. This time I only had to wait 2 and a half hours, I was so glad I told hubby not to bother coming along! I had no idea what to expect but came prepared with all the test results they asked for and was hoping to find out what happens next. Instead, once I was finally called the first question asked was, "Is this your first appointment?" Are you kidding me?! Once that was out of the way the next question was, "Can you tell me about your previous pregnancies?" No, I though, I have been over that, I can see it written on the screen in front of you! Instead, I asked to be told what was happening with THIS pregnancy. Were my tests looking ok, please check my blood pressure, tell me what happens next, do I keep taking the folate, metformin and aspirin. Couldn't get an answer about the folate or metformin, but was told aspirin is fine to continue. All my tests were ok, but my glucose tolerance test came back borderline. All my results were exactly on the cut off.

That was a big enough shock, I had thought the early test was just a precaution, none of my urine tests had shown any issues. I was then told that because of this, I would have to stay at this hospital and not be transferred at 20 weeks as we had been told and been planning all long. I was devastated. There is no way I can have my baby at this hospital and annoyingly (I keep blaming hormones!) I started crying. I was so upset. At this point she chose to take my blood pressure!

Not surprisingly it registered high, from memory 152 over 95. "It must be because you are upset." I was then asked to go and wait back in the waiting room to calm down and she would test it again after the next patient. No way I was waiting out there AGAIN and I knew I wouldn't calm down until I had a chance to talk to hubby about everything that I had just found out. I said I'd get my GP to check next time I saw her.

A call later that afternoon set up my appointment with the Diabetes Educator and Dietician at our preferred hospital for the following Monday. This went really well. Hubby came along so he could find out what I had to do, how often to test and anything he could help with. Ever since he has come in to get me before work so he can help (he writes the number in the log book) with the morning test and does the same after dinner. Sometimes I wonder if this is even the person I married :) Frustratingly, all my tests have been well below the cut off levels making me wonder why I am even doing this, but whatever it takes to get our little girl here safely! I have also since been told that having GD has NOTHING to do with which hospital I birth at and it will all depend on how healthy baby and I are when the time comes.

That afternoon we had our 'before 20 weeks reassurance scan' and everything was wonderful. We had checked our baby girl's heartbeat the night before so knew she was doing ok, but it was so wonderful to see her tiny heart beating away and watch her wriggling around. So much wriggling in fact that we couldn't get a lot of measurements, but what we did get was perfect.

So now it is waiting. Daily blood glucose tests, weekly progesterone and the 20 week scan in just under 4 weeks. Hang in there baby girl!