Tuesday, April 26, 2011

28 Week Update

Well, I'm gigantic. Or at least I feel like I am. I am measuring 5 weeks ahead, but doctor seems to feel that this is likely due to stretched out muscles from my four previous large babies. I do have an ultrasound scheduled for 30 weeks, to check baby's growth, check my amniotic fluid levels and verify that my placenta, which was low-lying at my 20 week ultrasound, has moved up.

My ligaments and muscles aren't very happy about the size of the baby, and they'll probably only get less happy. I'm feeling pretty feeble but resting and using maternity support have helped. I'm considering making an appointment with the physical therapist at my OB's office, but I'd need to get a referral from my primary care provider and am not sure it would be worth the hassle and the time for the appointments. I am going to try following a stretching and exercise regimen I found online.

Had the gestational diabetes screening today, I'll find out the results in a day or two.

Here's a pic of my hugeness:

Wednesday, April 20, 2011

Breastfeeding, Mental health and Medication

I was perusing science-based parenting blogs this morning, and came across a blog focused on postpartum depression. As someone who has suffered PPD after each of my pregnancies, this was very interesting to me, and I was even more interested to see a couple of recent posts on balancing breastfeeding with the treatment of PPD. The initial one is here, and there is also a follow-up post here.

My psychologist finally figured out this last summer what was at the root of my struggles with depression and anger -- untreated ADD. Taking stimulant medication significantly improved my quality of life and my ability to function as a mom. It was very difficult to adjust to being off the medication during pregnancy, and I have been looking forward to getting a chance to take it again. However, the medication I was taking, an amphetamine derivative, is contraindicated during breastfeeding. It tends to concentrate in breast milk and would result in a nursling, especially a young one, getting far too much of the medication. It might be possible for me to take an alternative methylphenidate based medication, such as Ritalin, since the amount secreted in breast milk is far lower than with the amphetamines, but there is not good information on whether or not this would actually affect a young nursling or not. I do plan to discuss this option with my ARNP, but I am not sure that I am comfortable exposing a nursling to even low doses of stimulants. Finding accurate information to aid in the decision is difficult, as so much of the affects of medication while breastfeeding are unknown. Even experts disagree. Some who are strong advocates of breastfeeding view the benefits as outweighing the risks of nearly any medication, with only a few rare exceptions, while others view the possible risks of many medications as being potentially more significant than the risk of not receiving breastmilk. For many medications, there is little to no good research on milk transfer rates or possible affects on baby.

I could avoid the whole issue by remaining off the medication for a year or so to enable breastfeeding, but that would affect my ability to mother not only the baby but all my children, as well as affecting my adequacy as a homeschooling teacher. Would we all survive? Yes, we've done it before and we're doing it now, but now I know how much different things were when I was on a medication that got to the root of the problems I was having. Providing external structure through meal plans and a pre-planned easy to use curriculum will likely help, but it will likely all be much more of a struggle than I would have it I were taking a medication that I know works.

At this point, I don't even know which way I'm leaning. Still thinking through all my options, and trying to figure out what will be best for the whole family.

Friday, April 15, 2011


Soccer has taken over our lives.

With two boys in soccer (and only two!) we have practices on three evenings a week and games on one weekday evening and Saturday morning. It has meant that all the kids are getting to bed later on a regular basis, especially the girls who beforehand and usually been in bed and asleep by 7:30 or so, and it means that I am constantly thinking about what we have each evening, whether there are clean soccer socks and shorts, etc. I will admit that Roger wore the same pair of socks two evenings in a row this week when I just didn't get the laundry washed. I think we may need to invest in a few more pairs.

I'm naturally a homebody and like to stick to a routine, so this is definitely a stressful time. On the other hand, the boys, especially Pauly, really need to be out moving around. Pauly would be happy spending all his time sitting on his bum reading or playing video games. He will be active if we go to a playground, but it is a struggle to get him outside and moving around at home. It has been very nice to see him at soccer practice and games. He is obviously out of shape and needs to work on endurance, but he has been giving it his best and doesn't stop trying. Roger has been enjoying himself as well. Still, I'm glad that this will only last a few more weeks before the end of the season. I'll enjoy just having evenings at home again!

No pics to share because I am too forgetful to take any. Maybe I'll get some done before the end of the season.