Thursday, August 1, 2013

Adoptive Breastfeeding

I have decided to share my story in honor of World Breastfeeding Week ( stick with me it will be long)

Adoptive breastfeeding is such a beautiful, bonding, heart healing experience for babies and mama's. It surprises me how many people don't know that its possible and how many people still feel it's taboo or weird. So here is my confession. Scratch that declaration. I am proud and not ashamed I BREASTFEED MY ADOPTED BABY.

It has been a journey that has required patience, love, creativity, and support (seriously without the people who have cheered me on we may not have succeeded).

If this is the first entry you have read on my blog here is a recap for you. My husband and I adopted our daughter from an orphanage in Eastern Europe and got home April of 2013. She was 9 months old and she has Down Syndrome. I knew there was a chance that breastfeeding may not happen for us. being 9 months old and used to formula and used to a bottle with a large hole. Plus having Down syndrome presented some unique what if's. Down Syndrome causes low muscle tone and larger tongues. We didn't know if her tongue would be strong enough so suck efficiently and transfer milk. Also having spent her life thus far in an orphanage and not having much human interaction, we didn't know if she would reject breastfeeding since it is an intimate act of trust and love. Neither of which she had known. My one advantage was that i was and still am breastfeeding my biological babe who is 2 months older than my adopted daughter. That meant i only had to increase my milk supply instead of having to induce lactation. (mama's who induce lactation are my hero's. Such hard work, though so worth it!)

So i started to do my research. There was some literature on adoptive breastfeeding and some very helpful online support groups bit it is unbelievably hard to find literature out there on breastfeeding babies with Down Syndrome. And impossible to find anything about breastfeeding an adopted child with Down Syndrome. I was lucky enough to find a group that is very small and confidential  full of mama's adopting or who had already adopted kids with special needs and breastfeeding. They were a God send. I also found a local IBCLC to help me out. We met before i left to get my daughter. We talked about the lack of info that matched my situation to use as precedent or for guidance and the potential challenges. She was so encouraging though and cheered me on and told me she believed in me and that even if breastfeeding didn't happen for us pumping was a great back up plan. So she helped me with pumping tips to increase my supply and during the months of paperwork i filled 3/4 of my chest freezer with my milk. I was confident in my supply i knew i could make enough to breastfeed my daughter too. the rest would depend on whether or not she could suck and transfer milk efficiently.

In the weeks i spent visiting my daughter at the orphanage bonding became my number one goal. I knew that she would need to feel close to me, safe with me, and loved by me for us to have any hope at breastfeeding. ( i thought it may be months home before she would latch and i was prepared for that but hoping it would happen sooner). During my visits i would give her massages, sing lullabies to her, wear her in my Ergobaby carrier, and repeat mantra's to her ex: kind hands, soft touch, mama loves you, you are safe etc. When i would wear her in my Ergobaby i would wear a tank top that could be pushed down so that her face was against my bare skin so she could get used to the feel, smell, sound etc of me. When they let me feed her her bottle i would hold her in as close to a breastfeeding position as i could. I worked on eye contact and touch. Neither of which she was used to.

When gotcha day arrived i took her back to the apartment we were staying in and thought well here goes might as well try. I started by taking a warm bath with her. I washed her head to toe and cooed at her and sang to her and held her skin to skin. afterward I massaged her with lotion and then brought her to my breast.

To my amazement she latched on! She didn't stay on for more than a few seconds, but she had latched and suckled! We stayed like that for awhile and i let her try a few more times. Even though she didn't stay on long enough to make my milk flow, she had tried. It was a huge moment for us. If you have ever had a baby and can remember that hormone rush , that over the moon in love, mam bear protectiveness you feel when you first put your babe to your breast. Well it was exactly the same the first time my daughter latched on. It was amazing and so encouraging. I knew then that we definitely had a shot at making this work.

I pumped bottles for her and started out by alternating. One feeding of formula next feeding breast milk. She was starving and malnourished and i worried about re-feeding syndrome or making her belly hurt. After three days of that she refused the formula and would only take breast milk. By the 5th day i had her she had finally nursed long enough to make my milk let down and had emptied my breast. I couldn't believe it. she only breastfed the whole way home (36 hours of traveling and flying).

Once we got home it became a different story. She was getting frustrated at the breast and would cry and give up before the milk started to flow. Now that her tummy was filled and she wasn't worried about whether she would get another meal she was wanting instant gratification. So i started to use my freezer stash of pumped milk and bottle feed it to her. This went on for about 2 weeks . She had pretty much stopped nursing. i would try to nurse her but she would usually refuse.It was tough to keep trying and be rejected over and over. But I wasn't ready to give up yet. I called our IBCLC and got some advice from her and some encouragement. We decided to try an SNS (supplemental nursing system) like this . I hoped that i could put an ounce or two in it to give her the instant flow she wanted until my milk let down. Unfortunately she refused to latch on with SNS in place. Some children with Down Syndrome are more likely to have sensory issues or issues with textures in their mouth. My daughter hated the feel of that teeny tiny tube against her tongue. So we continued with bottle feedings.

At this point I decided to try breastfeeding her first thing in the morning when my breasts were over full and I decided getting her to tandem nurse with her brother was a top priority. He could do the work to get milk flowing for her if they nursed together plus while nursing two my milk would let down faster.I had tried to tandem nurse the two of them before and she wouldn't have it, it totally freaked her out. I'm guessing it had to do with trauma from the orphanage. I think she thought she would have to compete with him for food. I started by trying to work on their bond as brother and sister. I let him cuddle her and he would bring her little toys to show her. She had been afraid of the bath so I always bathed with her, now I brought Levi in too. I rigged up pillows and such so I could bottle fed her while nursing Levi so she could see they could eat at the same time and didn't have to compete. The morning nursing session went great. She would nurse when my breasts were over full so we had at least one feeding a day guaranteed to be at the breast.

After a few days she decided that tandem nursing was okay. Victory!! This did not totally solve our dilemma though because Levi also eats solid food and does not Breastfeed as often as she does. But we now had quite a few feedings a day at the breast. Next light bulb idea for me was hey why don't i just use my pump for the other feedings, just to get milk flowing and then latch her on. Genius. I don't know why i hadn't done this earlier. It worked like charm. I would use my double pump at first and latch her once flow had started. then I started pumping one breast while she nursed at the other breast in hopes she would learn that flow took a little time. Eventually she started to breast feed again without the pump and even when not tandem nursing with brother.

We are now almost 4 months home and have been bottle free since June 1st!! Every once in awhile i still have to get out the pump to help her. If she slept longer than usual so is very hungry, or if she has just finished therapy and is tired, or when we are in public she sometimes gets nervous etc She will still need a little help. But i am totally ok with that. And i am so proud that we worked through all that we did together as a team. Our bond is deep and she knew i was mommy very quickly. I feel i can credit a lot of that to our breastfeeding relationship. when we brought Stef home she was malnourished and underweight and had a gray color to her skin along with excema and terrible constipation. She has put on 5 pounds and is is glowing pink. Excema is completely gone. And she no longer has hard painful bowel movements. I know that those are all a credit to my breast milk.

There were moments i was ready to throw in the towel and just bottle feed. There was frustration and tears. But i am so glad we stuck it out and didn't give up. Breastfeeding was the right decision for us and is a special bond we share.

I am taking part in Mothering magazines blog about breastfeeding event. to read stories from other mama's visit here

Gotcha day!!

Finally the 10 day wait was up and all my paperwork was in hand and i could set Stefanya free!

I was nervous because i had asked our facilitator  early on in our process if there was any info to contact Stefanya's birth parents. There was a phone number and a street address.  I had asked her to contact them and she agreed to do it after the 10 day wait was up and Stefanya was legally ours since we had no way of knowing if her birth family would be friendly, or would be upset at being contacted, or if they would end up not liking us and not wanting us to adopt her.

The night before gotcha day she telephoned Stefanya's birth mother. She answered the phone and our facilitator told her " your daughter Stefanya has been adopted by an American family and she leaves the orphanage tomorrow. Her new mother has invited you to come and say goodbye. " Her birth mother said thank you and that she would be there. I was so nervous , i really hoped she would show up but i was also so scared to meet her and was praying all would go well. I knew it was a risk contacting her birth family but since day one i felt God telling me that i needed to do it. I knew that if Stefanya could know them and know where she came from and why she was placed for adoption it would be better than carrying unanswered questions the rest of her life. I also felt strongly that there was a good chance that her birth parents loved her and didn't place her for adoption due to shame or not wanting the hardship of a child with special needs but instead because they were backed into a corner. There isn't access to therapy and help for families who choose to keep their children with special needs in their country. They have no special education. Society does not accept people with special needs. I also knew that their medical system is far behind ours, and getting her the medical care she needed would be difficult if not impossible for them.

We went into the office of the orphanage director and she told me through our facilitator that the birth parents were there and were waiting for me. i was so nervous i think my heart was beating out of my chest and i thought i was going to be sick. The director said don't worry they are very positive and are glad to meet you. that made me feel somewhat better.

They brought in her birth mother and father. Such a surreal moment . They are very close in age to Josh and I. My first thought was oh my goodness Stefanya is the exact image of her birth mother but with her birth father's eyes. When they came in they were speaking in Russian to the director and facilitator. Our facilitator said her mother would like to talk to you. And to my surprise her birth mother (we will call her O to protect her privacy and her birth father D)  O spoke to me in English! she told me how thankful they were that we adopted Stef and she began to cry so i got up and sat next to her and held her hand ( i dunno what came over me i am not usually that brave with strangers) i told her about how much we loved stef already and about our home and all we could offer Stef. I asked if we could use the visiting room to talk for a bit , they said yes. I asked O and D if they would like to see stef. I remember O's eyes lighting up her saying are you sure, can i really? So we had stef brought in and i told O how much she looked like stef and let her hold her.

I felt such an instant closeness to O. I wanted to know more about her and D and Stefanya. I had 3 days left in Kharkiv before we had to head back to Kiev and then home to the states. I told O that i would love to see her again and asked if that would be ok. She said yes she would love to so we made plans to meet in front of the dolphinarium the next morning. I packed Stef up and we said goodbye forever to the orphanage.

Asher and Levi and my mom were all anxiously waiting at our apartment for me to bring Stef home. Well Levi really had no idea what was happening, I think Asher had stopped believing that baby sister was coming home at that point, but my mom couldn't wait to meet her. I came in the door and laid her on the couch for everyone to admire. they all fell in love instantly :)

Wednesday, July 31, 2013

10 Day Wait

In Ukraine there is a 10 day waiting period after court in which anyone who was present at court can contest the outcome. We really weren't worried about it because no one present had any reason to contest it. But none the less it is a long 10 days waiting for your court decree to go into effect so that you can pick your child up from the orphanage and take them home with you.

Stefanya was transferred back to the orphanage so i began visiting her there instead of at the hospital. I didn't get to see much of the orphanage, they don't want you wandering around and don't allow you to see where the children eat, sleep, or play. I was always taken straight to the visiting room where i waited for them to bring Stefanya to me.

I brought her diapers and wipes, formula, and a few medications they had asked if i wanted to purchase for her. (things the orphanage could not afford but that would improve her mystery diagnosis) . Stefanya was always so tired when i visited that she only stayed awake maybe 10 min minutes of every 1 hour visit. i tried to make the most of those 10 minutes with lots of smiles at her and eye contact. I started to bring baby lotion to give her a massage every visit. Everything i did during those visits was done with bonding in the forefront of my mind. i would speak softly to her and tell her about home, about our family, i would tell her mommy is gentle, mommy loves you, mommy will keep you safe, or things like warm hugs, kind hands, soft kisses etc. and just repeat them like a mantra over and over to her even when she slept. I sang lots and lots of lullaby's to the point where I'm pretty sure one of the "nannies" asked me to stop singing lol. I cant be sure though because neither of us spoke each others language.  I also brought an ergo baby carrier with me and an infant insert since i knew she likely wouldn't be able to hold her own head up and i was right. when she began to look like she was going to fall asleep i would put her in the ergo and walk and rock and either sing or repeat my mantra's to her.

I debated talking about this here but i'm going to just do it. Bonding was important for so many reasons. Wanting to avoid attachment disorders since Stef had no one she was bonded to . Everyone was just a caretaker and it didn't seem she had anyone who invested any time in her or was anyone's favorite. Not to mention not wanting her to be scared when i took her with me, and because obviously every mother wants to feel warm and fuzzy about their kids and their kids to feel safe and secure with them. But a huge reason i was so determined to gain her trust quickly and create a bond was that i planned to give breastfeeding her my all. I already have a bio child two months older than her whom i was and still am breastfeeding. ( more about our breastfeeding journey in future posts).

after a few days of visits the nannies asked if i would like to feed her. YES!!! I WOULD LOVE TO!! They brought me her bottle piping hot. It had the hole in the nipple enlarged and had chunky rice cereal mixed in it. They only gave her 2-3 ounces at a time because they felt she was too weak to handle more. (she wasn't) she would choke and splutter and try to gulp it down as quick as possible because if she stopped for a rest the bottle would be taken away. Luckily i was only supervised while feeding her the first 2 times and then they left me alone to feed her.

Stef is a thumb sucker and she gets tired quickly while eating (though now that we have been home almost 4 months a lot has changed) i learned during those visits that it took her a long time to eat because she needed frequent breaks to rest , catch her breathe, and suck her thumb for comfort. I took my time and let her eat at her own pace. She could never finish the last ounce though because the rice was thick and choked her and she couldn't handle it. It was so hard looking at her skinny little body, and knowing she needed more food but that i had no say over anything to do with her until i took her from the orphanage.

And so these visits were much the same day after day while i bid my time until i could take her into my custody. All I could do until then was pray for my baby girl and trust that God would look after her.

(pictures are of the visitors room where i spent my visits with Stef)

Monday, July 15, 2013

friends along the way

Thinking back on our time spent over there i am so thankful for the people we met along the way. Like Nate and his wife Deanna. They are missionaries over there, Nate is from the states and his wife is Ukrainian. they were so nice and so helpful. they took us to the Ukrainian buffet for the first time and told us what everything was.( oh my goodness it is sooo good, and so cheap!) we ended up eating there a lot. And Nate took us to the open air market, which is massive. And he helped us haggle over prices and buy warmer coats and boots. And how can i forget , he introduced us to Mc Donalds fried cherry pies! (delish) It was so nice being able to talk to them in english, when your homesick it really makes a difference! They also invited us to dinner at their home and we got to hear about their hopes for their future work. They are dedicated to building relationships with orphans in their city. They visit them in the hospital, teach them english, teach them about Christ, and love on them. Their dream is to have a home where they can take in orphans who have aged out of the system and raise them up. Teach them to be independent and productive, give them a safe place to stay, and give the emotional support they need. AMAZING people!

And Simon who is the liason in Ukraine for The International Children's Heart Foundation. ICHF performed Stef's heart surgery and did an amazing job.She very likely wouldn't have lived long enough for us to get to her without them performing her surgery. They organize medical missions all over the world and perform life saving heart surgeries free of charge. All of the surgeons and nurses volunteer their time and surgeries are paid for by donations made to ICHF. You can learn more about them here as well as donate. It is an amazing cause. Simon is an Englishman and his wife Luda is Ukrainian. they were so welcoming to us. Simon was so kind as to take us to the hospital where stef had her surgery and give us a tour and Luda helped us with translating.

Like i said when you are homesick and so far away from home for so long it is sanity saving to have kind people like these placed in your path!

Josh's return trip home

When I finally got my "get out of Ukraine" date I can't lie, I was excited.  Its hard being in place where you don't speak the language and don't know your way around.  So first chance I had, I was ready to get back.  Just a little back story.  The days leading into my heading home, Kiev had received the most snow they had had in around 100 years.  Flights were delayed, cars were stuck, the freeway was deadlocked, and people were actually skiing around downtown to get where they needed to go.  So back to present time, my flight was due to leave around 5 am from Kiev, and I was still in Kharkov.  We booked a 7 pm express train which was due to arrive around midnight.  Tack on a 40 minute cab ride and I'd be at the airport with about 4 hours to get checked in and relax before departing for Germany.  All is fine.  I've got my wife's giant suitcase and my own, as well as a carryon backpack (I was trying to lighten the load for my wife and mother-in-law for their return trip).

  I made the 7 pm train no problem.  It was cold outside, like really cold, around 0° F when I got onto the train.  I had my Turkish winter coat on and a beanie, with jeans and tennis shoes.  I was plenty warm inside the nicely heated cab.  Train departed on time and I could taste the end.  Then about an hour in the train slows to a stop.  I'm thinking, no big deal probably just making a quick stop for more passengers, but then I looked out the window and there were no lights, no roads, nothing but snow and dark.  An attendant came on over the PA system, but of course it wasn't in English, so I had no idea what he said.  We sat there for about 45 minutes.  I was in contact with one of the facilitators at this time and she was positive but sounded worried, which didn't sit too well with me.  But then the train started back up.  I checked my watch and thought, oh good, still have a three hour buffer.  Then about 30 minutes later the train goes black.  Now the first time the train stopped everything still worked, the heat, lights, tv's, everything.  This was black, no lights, no sound, no heat, the train just rolled to a stop in the middle of nowhere.  Now the attendants started running back and forth thru the cabs yelling updates as they passed, again, not in English.  Some people started getting off the train, but others stayed.  I started to freak out a bit.  I had no idea what was going on, and without being able to communicate I felt helpless and for the first time, really scared.  I started asking everybody around me if anyone spoke English or if they could help.  But nobody seemed to even acknowledge me.  We sat there for around an hour and with no heat the cab turned into a giant ice box.  I threw on my coat and tried to stay as warm as possible, all the time trying to find anybody who spoke English and would help.  More and more people started to exit the train.  Then finally a younger girl, probably in her early 20's came up to me and said "English?"  I have never been more thankful for somebody.  She told be the train was broken and another was on its way.  We needed to wait outside for the other train and it should be there in 15 minutes.  So I packed up my two giant bags and my backpack and trekked out of the train and into knee deep snow. 

  I managed to get all of my stuff through the snow and onto the train platform where we waited, and waited, and waited.  For anyone who has been to Ukraine you know that things often don't quit work on a timeline.  15 minutes turned into an hour and a half.  The temp dropped and with a wind chill I was told it hit about -15° F.  I have never been so cold in my life.  When the train finally arrived I had to look at my hands to make sure they were grabbing the handles of my luggage, because I couldn't feel anything.  I had to watch my legs walk in the snow because I couldn't feel my feet touching the ground.  But I made it on the new train, found my cab and called our facilitator.  We were now running way late.  She made the calls and had a taxi waiting for me.  When I arrive at the train station in Kiev I had an hour and a half until the plane departed, and a 40 minute taxi ride still to come.  Remember how I said that Kiev had recorded a record amount of snow?  I was expecting Niko and his giant van, which I suppose would be awesome in the snow.  But Niko's van had broken down so I got a front wheel drive Hyundai.  I was stoked we made it out of the parking lot.  First thing I did was check for seatbelts.  There were none.  But I was in the back seat and cramped, so I wasn't too worried about that.  But then about 2 minutes into the ride we go thru a red light.  My eyes must have been about the size of dinner plates because the driver looked back and smiled and said "its alright, its early".  These guys know what they are doing, it is their job after all.  We bombed onto the freeway and I felt like I was in a movie, where drift racing was the main theme.  The massive amounts of snow had been pushed up on either side of the road making the normally three or four lane freeway a two lane freeway with walls of ice on either side.  I was fine until I looked at the km/h and realized our speed, on the ice, with a front wheel drive Hyundai.  I'm not sure I would have wanted to know that speed in a tank.  Then we started passing cars in a new "third" lane that we somehow invented along the way.  As I heard the ice scrapping the side of the car I wondered if this was indeed the end.  Then we pulled up to the airport, safe and sound.  I would have tipped that guy a million if I had it.  I had about 40 minutes to get checked in, through security, and boarded for my flight. 

  I was exhausted as I had been up since the previous morning at around 6 am.  Then I got to the lobby and saw the line.  Easily 150 people in line.  The thing was the flights had been canceled for two days due to the snow and this was the first flight out.  So everybody was there.  I waited in line for about 5 minutes then went to the front and let them know that my flight was leaving in 35 minutes and I needed to get checked in, was there anyway I could get up to the front.  The lady stared at me, then said no.  I said "so what then, this line won't move that fast, should I just re-schedule my flight"?  Her response was, "I don't know, probably".  So I went to the back of the line and waited another 20 minutes.  By this time I was tired, hungry, frustrated, and starting to get a little pissed.  So I did what any Ukrainian would do.  I cut to the front of the business class line.  I then was able to get the attention of the lady in the economy line and told her my flight left in 10 minutes.  She checked her computer and waived me up.  The people behind me started yelling but honestly I didn't care.  I was out of there in ten minutes and I would never see them again.  I booked it thru security and found my gate.  About three minutes later the plane was boarding.  I found my seat and prepared now to be without my family for a minimum of 2-1/2 weeks.  Despite being up for 24+ hours at that point I was wired.  I landed next in Germany, made it to my next flight and arrived in Denver, Colorado.  For whatever reason I could not sleep during any of these flights.  Maybe it was the excitement of the previous days events, maybe it was that I'm 6'3", 200+lbs and was seated between two men my same size.  Whatever it was I was exhausted at Denver and had a 9 hour layover.  I couldn't fall asleep there either, I was terrified I'd sleep through the announcement for my flight.  So I stayed awake until I boarded to Spokane.  That flight I slept, solidly, for an hour.  I arrived at midnight local time, 39 hours after boarding my train to Kiev, and roughly 53 hours after the last full nights sleep.  The trip back was not fun, but it did provide for an awesome story.  And in the end I'd do it a thousand times over, because as a result of our travels we got our little girl, and that was worth it.

Here are some pictures of Kiev during the snowstorm.