Thursday, 11 February 2010

Nipple pinching, ear-tweaking and chamomile tea By Kate

I never thought I'd have my nipples squeezed and stomach prodded by so many complete strangers, but that's life in a post natal ward, I guess. After Rosie's sudden entrance into the world by emergency cesarean she and I spent four nights in room 11-14 at Hospital La Paz in Madrid, which was quite an experience.

Given the limited nature of my Spanish, my communication with the nurses and orderlies was a bit hit and miss at times, but you couldn't fault the quality of care. We weren't in a large ward, but a room we shared with one other woman and her baby
(plus the inevitable legions of friends and relatives), which had its own en-suite bathroom. Our babies were with us pretty much throughout, just occasionally being taken off for baths, jabs, tests and so on. Most of our immediate needs were provided - an unending supply of nappies, cleaning materials and clean hospital gowns for both of us. And best of all, our partners were allowed to stay the night - although they had to sleep in reclining chairs.

Rosie and I were given a lot of well-meaning attention (although, when it came to establishing breastfeeding, some of it was misguided - but I didn't know that at the
time) and my (and Theo's) learning curve when it came to nappy-changing, baby bathing, cord-cleaning and general care-giving was steep, but satisfying.

While we were in La Paz, we shared our room with three other families - baby Martin with his mother and English-speaking father (very helpful when I needed translations in those first couple of days!!) and their forty or so visitors; Marie, who had just had premature twins by C section, and her twenty or so visitors (but she was with me for less than one day, so I expect the number went up) and baby Arturo plus his Peruvian parents and their thirty or so visitors. What was very touching about the parade of visitors was how much fuss they made of little Rosie as she and I watched the comings and goings with great interest. "Que rica!!" they cried, "Que preciosa!" It was all very gratifying.

Daily entertainment included the doctor's round - a neat, brisk, cheerful man with a nurse acolyte who would waltz into the room and check each patient as follows:
"Have you peed?" (yes)
"Have you pooed?" (yes)
"Breasts okay?" (yes thanks)

"Any pain?" (not much)
"Baby feeding?" (yes)
"Take good care of your babies, Ladies, take care of your babies!"
And that would be it until the next day.

Another part of the hospital routine that made me smile was the relaxing hot drink before bed time. Except usually the inhabitants of the ward had already retired by the
time it turned up. It would be around midnight and the lights would be out, husbands peacefully snoozing in chairs, babies dozing and snuffling in cots or their mother's arms and mothers trying to grab some precious shut-eye before the next feed... Suddenly the tranquility would be rudely interrupted by a blaze of florescent lights and the clanking of a trolley as two nurse orderlies marched in and offered us hot milk or chamomile tea, followed by another with her selection of "calmantes" (pain-killers). I would usually take the chamomile just to calm the sudden rush of adrenalin brought on by the abrupt break in our serenity.

The nurses and orderlies varied in attitude from sweet and smiley (including one who
would try out a few words of English with us) to no-nonsense efficient, to borderline rude. Some were reasonably patient with my limited understanding of Spanish, others considerably less so. Thank god for our bi-lingual visitors, who helped explain a few crucial things.
One standout character was Nurse Bossy (not her real name) - a middle-aged nurse in the no-nonsense efficient bracket who oversaw our care of Rosie. She did many useful things, including show me the best ways to change a nappy, clean an umbilical cord, bath a baby and see off a touch of jaundice. She was frighteningly rough in the way she handled tiny Rosie, but my daughter didn't seem to mind - like most babies, she could sense a person's confidence and was reassured. I resolved to stop treating my baby as if she was made of porcelain.

Nurse B was also determined to get Rosie feeding and putting on weight - Rosie was far more interested in sleeping than eating and consequently lost 6 per cent of her birth weight in the first two days.

I was encouraged to breastfeed - something I was keen to do - but unfortunately, Rosie just wasn't interested. Nurse Bossy tried various techniques to encourage Rosie to sup at my breasts, including different positions, ear-tweaking and foot massage (both stimulate the suction reflex), but at best, Rosie was managing two weak sucks before dropping off to sleep - not very helpful.

Eventually, Nurse B told us to get nipple guards and like magic, Rosie began to suck. It wasn't surprising, really as she'd been given formula from bottles in the time she'd been apart from me after the C Section and hadn't had the chance to use the magic first hour of life to make skin-on-skin contact and find and latch on to the breast. She was, as the breastfeeding experts put it, "nipple confused" - latex teats on bottles were her experience of obtaining food, so my flexible, fleshy things just didn't cut the mustard. Not surprising the nipple guard found favour, it was very similar to a bottle teat. BUT at least it got her taking the colostrum I was producing and then my milk, when it came in on the third day.

We were put on a two and a half hour feeding regime consisting of unlimited breastfeeding and a regular 20ml top-up of formula from the bottle. By day three, Rosie's weight-loss had stopped and soon she was gaining her grams again. Unfortunately, the nipple-guard/bottle regime merely made the nipple confusion worse, so I had my work cut out to get Rosie to take the breast. But that's another story.

On the whole, I have to say Hospital La Paz was extremely good and looked after Rosie and me very well - even the food wasn't TOO bad, especially given Spain's general lack of experience with vegetarianism. The downsides of being in hospital were the heat - even the warm-temperatured Hispanic inmates found the ambience sultry, to say the least - and the lack of opportunity to sleep. Catnapping during the day was almost impossible with the endless comings-and-goings of nurses, cleaners, visitors, doctors, paediatricians, meals etc. etc. and night-time sleep was disturbed by the two babies; their parents (some of whom snored bloody loudly) and of course, the sweltering heat.

All in all, it was a relief to go home. I was lucky and recovered quickly from my C section, sore abdominals soon subsided and my incision seemed to be healing well. I can't help laughing in a hollow way about all that rubbing in of cream to avoid stretchmarks. Well, it worked, I don't have any stretch marks, but there's not much I can do about the 5-inch scar just below my bikini line, or the fleshy ridge of "overhang" above it. As souvenirs of the birth go, I much prefer our gorgeous little Rosie.

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