This is a post about postpartum anxiety and a diagnosis of “failure to thrive.” Which came first, you ask? It’s impossible to know. What I do know is that either of these, on its own, can be overwhelming and debilitating. Dealing with both is even harder. Of course it can be done. I did it, with help from compassionate care providers and with babywearing. Here’s my story.
A determined breech baby
Annika was my fourth baby in under five years. Our last trimester was an emotional rollercoaster. Annika was breech until the day before she was born. At 36 weeks, we had an external cephalic version. My OB and midwife worked together to turn the baby head down. The procedure can be painful and difficult, but it worked! I was thrilled. For a day.
A day later, baby had turned breech again, and I was devastated. I had given birth three times already. After 3 natural vaginal births, I was heartbroken and frightened about the prospect of a Caesarean birth. This was our last baby. I wanted to be fully present when I met her, and I was aware of the risks and impact of Ceasarean birth on baby’s health and our breastfeeding relationship.
In addition, Ceasarean sections are major surgery. How would I care for my 3 older children and a newborn while my body recovered? My husband wasn’t able to take much time off of work. I was scared about recovery from major surgery while caring for four babies under 5 years old by myself, without the daily support from another adult.
At just before 38 weeks, we tried the ECV again. Baby turned head down with ease. This was wonderful! We were offered the option to induce immediately in case baby wanted to turn breech again. We jumped at the chance!
Annika was not on board with our plan. Before the nurse could even begin the intake paper work to start the induction, I felt baby turn again. I went home with tears in my eyes and a date set for a C-section.
A beautiful surprise
Right at 38 weeks, my husband and I took the 3 kids on a fun day trip before our newest addition arrived. We hiked a small mountain, blew bubbles, and enjoyed our last moments as a family of 5. The next day I woke up and baby was head down and engaged! She was ready and I went into labor the next day, able to have the labor and delivery I wanted after all. After such a stressful last trimester, I was looking forward to not being pregnant anymore. I couldn’t wait to hold my daughter in my arms, soaking up the precious newborn moments. In a few hours, I would be nursing her, wearing her, and soaking up the beautiful newborn smell of my last baby.
I distinctly remember the babymoon with my 3rd baby. I was in a state of absolute post-baby bliss. I was just euphoric over her presence. She nursed so well, slept like a champ, and the transition from two kids to three was effortless and enjoyable. I expected that the 4th baby would be similar.
Instead, I was hit hard with postpartum anxiety.
The first time I remember not feeling like myself after Annika’s birth was the first night home from the hospital. She was swaddled in her cradle, safe and asleep right next to my head. I went from sound asleep to wide awake in a second, and I just KNEW she wasn’t breathing. I wasn’t in a panic or anything. It felt very matter of fact. I was going to pick her up and she wouldn’t be breathing.
I leaned over and scooped her out of bed. Of course, she was perfectly fine. Asleep in that peaceful newborn way that covers you in a blanket of calm. I looked at the clock and realized I had only been asleep for 15 minutes.
This whole process continued for days. I would sleep hard for short intervals, then wake, convinced something had happened to Annie. I tried to alleviate this by sleeping with her in my arms or beside me, but it didn’t help at all. Instead, I’d wake and immediately think she had smothered.
Compulsion, obsession, exhaustion
When she was about a week old I started feeling anxious about housework. I’ve never been the neatest person (shout out to all my college roommates, sorry guys), but I would be sitting nursing the baby and suddenly feel CONSUMED with the need to Vacuum. Right. Now.
I would be playing with the kids but unable to stop thinking about the three dishes in the sink, the laundry I had to fold, the bathroom that should be wiped down. On and on it went, the pressure rising until I got up and tended to the tasks, or just broke down. The kids would ask me for a drink and I would just sob, absolute gut-wrenching sobs.
I kept telling my husband I was overwhelmed. Of course you’re overwhelmed, he would say. You just gave birth. You are the mother of four kids under 5. You aren’t sleeping. And I wasn’t sleeping.
But this was different than all that. This was a cocoon of a worry, a cloud of anxiety just seeping into every pore.
Annika wasn’t gaining weight
At Annie’s two week check up, I learned that she hadn’t gained weight since our discharge from the hospital. A few days later, she had lost weight. I was worried, but I felt vindicated. THIS was why I was so stressed out. My mommy intuition had kicked in and told me something was wrong. I would just fatten this baby up, and everything would be better.
Except now I had something else to fixate on. When Annika was asleep, I’d think about how I should be feeding her or pumping breastmilk. When I was nursing her, I’d be thinking about all the other things I should be doing until my skin would crawl and I would jump up to vacuum.
I had a three week postpartum check up with my OB. The nurse went through a standard list of questions: How’s breastfeeding? Are you having any pain? How do you feel emotionally?
Someone finally heard me
I said, “I won’t lie to you. I’m feeling like a hot mess,” and I broke down. I sobbed. And then I talked. I kept repeating, “I just don’t feel like myself.” I think I said it about 6 times in the conversation.
Then, something I needed so badly happened. She validated my feelings. She acknowledged that this was different than the daily overwhelming feelings of motherhood and life. That this wasn’t sleep deprivation. This wasn’t because I could handle three kids, but four of them was just too much. This was chemical, hormonal, physical. She offered a plan to help me feel better, which included medication for the anxiety. It took the edge off, which was wonderful, because our lives were going to get a bit more difficult.
Searching for answers for Annie
When Annika went for her 4-week checkup, she was several ounces under her birth weight. Newborns normally regain their birth weight by 2 weeks old.
I felt defeated. Initally, all the discussion of her slow weight gain revolved around questions like, How often is she nursing? For how long? How many times in 24 hours? I found myself unable to answer. After nursing 3 babies, these questions were so overwhelming. I nurse on demand. Whenever my babies want to. However long they want to. With three other kids all under 5, Annika spent most of her time in a wrap, right near her milk source.
As nature intended, when she rooted, made a noise, or fussed, I nursed her. She was at the breast constantly, sometime nursing actively, sometimes hardly suckling, and always for a different amount of time. The doctors kept suggesting that for some reason she simply wasn’t getting enough milk, so I nursed her as often as I could. However, we began doing weighted feeds, where we weighed the baby before and after nursing to see how much milk she was taking in. Several weighted feeds showed that she seemed to be transferring milk correctly. The only thing that was clear was that something was very wrong. Either with my baby, with my breastmilk, or (I couldn’t help thinking) with me.
My wonderful lactation consultant discussed supplementing with formula, and I was crushed. I am not militant about breast milk by any means. In fact, two of my older kids drank formula at points. I know that “fed is best,” and that meeting the baby’s caloric needs is as important as the many benefits of breastmilk.
But I was doing everything right. I was nursing on demand, following all her hunger cues, practicing skin-to-skin care. I was taking supplements and nearly drowning myself in water to up my supply, and my milk tested at a perfect 21 calories per ounce. To say I was discouraged was an understatement.
Failure to thrive
We began twice weekly weight checks. Every time, I would leave the pediatrician in tears because Annika hadn’t met her weight gain goals. Every time she didn’t meet a weight goal, my feeling of not being “mom enough” was suffocating. Whether it was perpetuated by the anxiety or the anxiety was the cause of this feeling is hard to say.
Our pediatrician suggested some blood work to see if we could get to the bottom of Annika’s struggles. When he handed me the lab order and I read, Diagnosis: Failure to Thrive, all I saw was, FAILURE.
The blood work initially showed that Annie’s liver enzymes were elevated. This only led to more questions: were her enzymes the CAUSE of the slow weight gain or BECAUSE of the slow weight gain. There was no way to tell without preforming a liver biopsy. Thankfully, Annie started gaining weight and her enzymes normalized and a biopsy was never necessary, but it was another fear layered on the other emotions I was feeling.
We were in a whirlwind operation to fatten up my sweet girl. My life became a blur of nursing, pumping, supplementing, waking to feed, counting diapers, and obsessing over the way her clothes fit. This, on top of loving, feeding, and caring for my other three small children and managing postpartum anxiety.
I became obsessive about feeding Annie. And not in a good way. When she was sleeping I’d cry that she hadn’t nursed enough. Every minute she wasn’t nursing, I’d pump like a mad woman, always making sure I had enough to supplement with. When she was nursing, I’d cry about the fact that my bigger kids hadn’t been outside yet today, that the floor hadn’t been vacuumed, that I wasn’t enjoying her newborn days like I should be.
When Annie finally exceeded her birth weight at just about 8 weeks, I let out a sigh of relief only to be brought back down by the news that Annie was still gaining weight at a dangerously slow rate.
I had several friends and family members who had babies right around the same time I had Annika. I watched as their little ones packed on the pounds and grew those delicious pinchable baby rolls, and I felt almost self conscious of Annie’s little chicken legs. I dreaded going out and being asked how old Annie was, because after I answered, the response was always, “Wow! She is so small!”
Every time I would reply, “Yup. She’s a peanut.” But in my head I was screaming, I’M TRYING!
The world couldn’t see that my baby had been diagnosed Failure to Thrive, and I felt like the failure.
We were referred to a gastroenterologist, who like the doctors and nurses and lactation consultants we had seen, asked a host of questions about how and when I nurse Annie. How many wet diapers does she have a day? Any pain while she latches? How much formula does she get? And then she looked at me and said, “You’re doing everything right, mama” and held my hand while I cried.
I needed to hear it. I needed to know that this was not my fault. This is not my failure.
Babywearing helped me survive
Babywearing is literally the only way I survived those first few months. I’m not being hyperbolic. When my anxiety was bad and I felt like crawling out of my skin, wrapping Annie would immediately calm me down. I’ve read that skin-to-skin contact can help produce oxytocin and serotonin, so maybe that’s why. Maybe it was way the wrap swaddled me and her together, like a soft and heavy blanket. Or maybe it was the way babywearing synchronized our heartbeats and our breathing. Whatever it is, it let me keep going when things felt too overwhelming to overcome.
Before I started medication, I couldn’t stop obsessing over all the things I should be doing when I was sitting and nursing Annika. The anxiety made my skin crawl. It seemed inescapable. When that happened, wrapping her allowed me to do these things while still tending to the baby. I could take my older kids outside, clean the house, or fold laundry while being certain I didn’t miss any of Annie’s cues to nurse.
I also noticed that my obsessive thoughts that she would stop breathing while she slept vanished if she slept in the wrap. I could feel her breath against me, and I didn’t spend her nap times checking her chest rising and falling. I was able to breathe myself because I knew she was safe. When she was wrapped onto me, my brain believed she was ok because I could see her every moment.
Wrapping provided the only sense of peace I had the first month after her birth.
She finally outgrew her baby clothes!
Annie’s weight issues had not improved significantly by the time she reached six months. Testing had given us no useful information. In spite of my strong suspicions that she had a tongue and lip tie, the doctors did not believe it was contributing to her poor weight gain.
When Annie was about 6 months, our team of healthcare providers gave us a 30 day ultimatum. If Annie did not begin making significant weight gains, they wanted to hospitalize her and put her on a feeding tube. I fought to see an ENT about her lip tie, and we started solids as soon as she was able to sit up on her own.
One day, while giving her a bath, I noticed a little extra chub around Annika’s chin. I had to snap her cloth diapers one row looser. At 7 months old she finally outgrew her newborn clothes.
Since then, she’s continued to grow. Every roll on her thighs that developed made me soar with pride. We did it, Annika and me. We did not fail. And we are not failing now.
Growing and thriving
Annika is 11 months old now and still pretty petite. It’s hard not to compare where she is now, to where my other 3 kids were at the same age. She’s fitting well in six month clothes, where all my others were wearing 18 months at a year old.
Although we did supplement with formula and bottle feeding for a while, Annie is still nursing. Nursing my third especially was so effortless. I feel like I took it for granted. I was always so worried that a doctor would suggest switching to formula permanently when Annika was struggling to gain weight. I know that a fed baby is best, but nursing is really important to me and I’m thrilled that Annie and I still have a successful and mutually happy nursing relationship.
She crawls like a pro, but I can’t help remembering that my oldest started walking at 10 months.
Maybe it’s the postpartum anxiety, but I get caught in these worried comparisons between my first three children’s milestones and those of my youngest. The doctors cautioned me that her difficult weight gain could lead to gross motor delays, so every milestone she approaches leads to worry about whether she’ll achieve it. Each milestone she reaches brings a sigh of relief. I am working to focus on what is in front of me — how far Annie has come.
Sometimes it’s hard to remember that she has always been more than the frightening label assigned to her. But I remind myself: despite the fact that she was “failure to thrive,” neither of us have ever been a failure.
For more reading
Postpartum anxiety is closely related to postpartum depression. If you’d like to learn more about how babywearing can help, read our article, 13 Ways babywearing helps with postpartum depression.
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