August 29, 2014 by Evin
This wraps up our week-long series about pregnancy, birth, and new motherhood as an expat in Ireland. Today, I will share information on vaccinations, breast feeding, and general information.
There are expected vaccinations in the hospital, the first is in the first three days then a heel test back at the maternity ward on the fourth or fifth day. Then a regular vaccination schedule continued with the GP. I recommend you download the “Your child’s immunisation – A guide for parents” booklet for more information about the primary childhood programme, covering infants Birth – 13 months of age. CUMH has a booklet too. All the vaccines in the first year were free as part of the Maternity and Infant Care Scheme. As part of this: “The public health nurse will also visit the mother and baby at home during the first six weeks and this service is free of charge.” Which I didn’t realise until I researched the facts for this post because we received one home visit the first week after birth then all future visits were required to be at the HSE office since she said the parking was a challenge where we were located. So be aware of this if you have limited parking options.
So, as I mentioned, within a few days of giving birth if you opted for a three-day hospital stay, you will be visited by an HSE nurse. She will be your case worker for long-term. She checks on things and makes sure baby is cared for. Don’t worry about cleaning up, but if you have boxes of nails and staples sitting on the floor, that is a good thing to put away since her job is making sure your child is in a safe and supportive environment while helping you with the transition into parenthood. There will be other future visits over the next year then one at two years. The GP handles all medical issues, no paediatrician visits unless there is cause for concern. Vaccines are on a schedule with the GP and noted on a card. Keep it someplace safe. No, seriously, those things get lost! This chart from an interesting June 2014 Business Insider article shows the benefits of vaccinations. One quote worth sharing is: “A study of a 2010 whooping-cough epidemic in California, in which ten babies died, found that areas where many people refused to vaccinate their kids were 2.5 times likelier to have high incidences of whooping cough.” Read more: http://www.businessinsider.com/anti-vaccine-campaigners-are-clueless-2014-6#ixzz3Bj3BkBS1
Trust yourself as a parent, even as a newbie. When LB was about four months old or so the HSE nurse was very concerned that his head was too large for his body. He was still a small baby catching up to others his age in size so I was almost waiting for there to be a reason for his being so small. She measured and then demanded I rush to the GP for an appointment so they could tell the paediatrician to see us (he had seen us the week before to no fanfare). I did just that and paid €50 to later find out the HSE nurse was using an American chart for the head and a UK/Ireland chart for the body so the numbers were off. I’m sure she thought she was being clever since I’m American, but my husband and I are of significant Irish ancestry and aren’t we all humans? So, it was all sorted out after I lost a few night’s sleep. I didn’t quite have the same trust in our HSE case worker after that. Of course, neither she nor my GP had concerns that my son wasn’t putting two words together at age 2.5. It is a bit frustrating sometimes, but persistence is key with the Irish healthcare system.
My own post-birth experience was rough. I had bronchitis and stitches were healing. I was tired, as expected. I was fortunate to have my husband and my father present for support, but it was still overwhelming, especially when I failed at breast feeding. I also had a growing liver tumor and anaemia that my GP insisted was normal new mother fatigue (finally this was sorted out after about six months of my insisting it wasn’t normal).
I was expected to feed my child with what is supposed to come from my breasts. I nursed, or tried to, I pumped to encourage them to make milk, I woke every two hours to feed LB because he was so small and needed frequent small meals. Yet, the milk just wasn’t there. Even when it seemed like they were doing good work, I could only coax a half ounce out at most. And that was on the best day. The breast feeding class I was required to take was lovely if you have no issues, but left a lot of troubleshooting out. There was a big leap of faith that if you just keep trying, it will work out.
I wish the Irish breastfeeding classes just told us flat-out what’s what instead of breast propaganda that made me feel inadequate when my efforts were futile. I was later told that milk rarely ‘comes in’ to breasts before day three or four post-birth for first-time mothers. Breast feeding before then was just to teach the baby how to latch and to tell the breast to make the milk? I still feel that makes no sense to me. But I was told the baby can survive those days on the few drips it gets unless baby is born very small or underweight. Like LB. One midwife/nurse advised that I use nipple shields to help LB latch, another said no way I should use them. Their disagreement didn’t help me, it only confused me. Nipple shields are helpful but can agitate the nipples more quickly. The course had me believe using my breasts to express milk every few hours was essential. But it turns out that if you don’t breast feed for a day, you can often just express/pump a few extra times to get the supply back up. If your supply reduces for one day because you need to rest it doesn’t mean you will lose your milk entirely so don’t give up. This was wonderful because after trying to do all the feedings with untreated bronchitis, I just needed sleep.
One approach that worked for us was to rotate the feeds so my husband had time too. I chose not to breast feed round-the-clock since my milk supply was not increasing to meet the demand and we were using formula also. Note: Formula was still needed since the nurse warned LB would be readmitted if he went below 2.5kg. This was medically advised in CUMH. I chose specific meals in the day that worked for my energy level and breast fed at those times. Yet, I still felt guilty for not breast feeding every two hours all day and night. Not that I had the supply, but it was tough to not feel like a bad mother.
One occasion during all this I was invited out by a few girl friends who were sharing a bottle of wine (or two) and wonderful chat. I had to decline, as I had throughout my pregnancy because I was too tired and with my liver I was being extra careful about alcohol ingestion. One commented I could just “pump and dump” as if it was like rinsing and spitting when you get a bad taste in your mouth. But not something that I was trying and failing to create to nourish my child. I really felt very down on myself and wondered how it could be portrayed as so natural and easy when it really wasn’t. Even before giving birth, random strangers would ask if I planned to breast feed. The societal pressure is definitely present in Ireland and I felt like I was a bad mother in the eyes of society for not being a good milk maker. I won’t even get started on the guilt over using disposable diapers! Needless to say, LB was too tiny for premie diapers and by the time he was big enough for the vast collection of cloth diapers we had ready for him, the habits were formed. Which is lucky since our washing machine broke twice in his first year so… well, you know.
So, about the advised to feed him formula thing… I was ‘encouraged’ to formula feed him to keep him out of the NICU and once he gets used to the bottle’s easiness and shape, it was challenging (but not impossible) to get him to latch onto the breast without retraining. I was told that to properly switch him to the breast I would need to stagger bottle and breast feedings. This was possible a couple weeks after birth when his weight was showing promise, but I was home alone then and the primary caregiver. So to stagger feedings when I was told to feed him every two to three hours would have meant breastfeeding him for 45 minutes, waiting 45 minutes, bottle feeding him for 45 minutes, waiting 45 minutes, and so on. Limiting any sleep I would get to be in those 45-minute breaks so long as he settled down and didn’t need a diaper change or bath. How do breastfeeding mothers do it? Do they ever get to cook a meal or wash the dishes? I’m in awe of mothers who do it all.
I took TWO breast feeding classes, my milk came in, and I still couldn’t make it work. I still cry almost every day that I failed in that way. Three years later, I realise that there is one major gap in the “Breast is Best” campaign and that is a reminder that it isn’t just the contents of the breast that are important, but the connection to it. What do I mean? Well, skin-on-skin for one. Even when I was bottle feeding LB formula, I would lift my shirt or lower the neckline so his cheek would be resting on my flesh. If my Dad gave him a bottle, he held him with his hand against a cheek. It is the human connection.
But having said all that, I truly admire my friends who were able to breast feed. It is a magic super power to make the food your child needs. I didn’t make enough, he didn’t latch, and I was sick.
Now, the hardest thing for my body with post-birth is that I am allergic to Aspirin and related pain medicines, which meant I was in constant pain after episiotomy. When they saw I was allergic to their main treatment they didn’t offer an alternative. Therefore, I felt pain for the first six weeks of my baby’s life, making it very uncomfortable to sit for the length of time. On the bright side, I got much better pain management meds after my liver surgery (well, for the first ten days then I went off all the drugs because of complications).
When a friend posted on FB that no one told her about bladder control issues post-birth, I knew I needed to come clean and share this information here. Even if your bladder control was fine during pregnancy it may not be for a couple months after giving birth. If you have a cough or cold during this time, you may consider wearing adult diapers. No, I am not kidding.
Now, I’m sharing the links to some of my favourite books and parenting reads here. Especially the first book.
“Your child’s immunisation – A guide for parents” booklet, covering infants Birth – 13 months of age.
Breastfeeding Your Baby Download PDF
Feeding Your Baby Download PDF file
Breastfeeding and Work Download PDF file
Real Parents Offer You Their Best Advice from Discovery Health
Advice for Brand New Parents? by Lisa Belkin, The New York Times Blog (Sept. 9, 2009)
What if the Secret to Success Is Failure? by Paul Tough, The New York Times (Sept. 14, 2011)
Looking this over, I realise this is a bit controversial and personal compared to my usual posts so please only comment if you have something constructive to say. Don’t bash my choices, just as I would never bash yours. We each do what we must when the choice needs to be made. And mothers need to support one another. Heck, women need to support one another. And trust in each other. So, go ahead and comment with nice things and tell me how you fared with post-birth in Ireland because this is one experience that will be vastly different for everyone.