Introducing James

James Christian was born on August 24^th at 4:36AM. Labor and delivery were fairly normal with no complications. He was 8lb 8oz and according to the nurse 18.5 inches but if this is correct he has grown 2.5 inches in under 3 weeks.

I wasn't planning on posting the details of the small complications I experienced during pregnancy because I felt at the time they were not very significant and I wanted to post mainly happy news. However, with the emotions I have been experiencing, I feel like I need to post the bitter with the sweet.

I found out I was pregnant a day or two before Christmas Eve. I was very excited since I had wanted another baby for a while. I waited an extra day to take the test since last time I was pregnant the test result was somewhat ambiguous at first and I only wanted to take one test. When I took it, the positive sign appeared extremely quickly and very bright. I didn't think much of this at the time, but was glad to get the results. I felt more tired this time than last, but thought I probably didn't notice it the time before and brushed it off.

About a week later, just before the New Year, I started bleeding. I bled very heavily and soaked a pad an hour all night long. I just assumed I was miscarrying and felt somewhat sad. We contacted the doctor I had not even had an appointment with yet, and she told us to come in that day for an ultrasound to verify that it was not an ectopic pregnancy. We went to the office and the ultrasound showed two gestational sacs that looked like fraternal twins. I was thrilled it was not ectopic, and a little shocked at the possibility of twins. We were told to go home and come back in two weeks for a follow up ultrasound.

Note: this is not the exact ultrasound, but this is what it looked like.

Those two weeks my emotions rotated through amazement, elation, terror and just an overwhelmed feeling wondering, “how am I going to manage twins at this time?”. I read “Twins, Triplets, and Quads” and bought high nutrient foods. I researched car seats that would fit three across in our Honda Civic. I looked into what slings could carry 2 babies since I would have to climb 3 flights of stairs with 2 newborns and a 2 year old to get to our condo. I walked through our 2 bedroom condo to see where I would fit 2 play pens or cribs and tried to figure out what our options would be when I would have to fit 3 beds in Daniella’s room. These two weeks I was so exhausted I spent much of the time in bed and didn't feel like getting up. I was trying to figure out when to tell the bishopric I needed to be released because I was at risk for delivering early and I couldn't handle two newborns and a 2 year old by myself and still be Primary President. I kept telling myself that as long as both babies are healthy I could make it work. I felt that as long as whatever I ended up with at the end of 9 months was a healthy, or two healthy infants I would be happy. When I went back to the doctors and saw that one gestational sac had not grown enough I felt guilty for feeling so relieved. I new I could handle one child and had it all planned out how to deal with one, but two was overwhelming. I didn't’ realize how overwhelmed I was until my energy returned the next week and I was much more productive.

From this point on, the pregnancy was fairly normal. Trent was able to look at an ultrasound of our baby at 16 weeks and it was pretty obvious he was a boy. I didn't trust it completely until our 18 weeks ultrasound confirmed what we saw. About a month before he was due, I ordered a couple books from Amazon about sleep and soothing since Dani had such trouble with these two issues in the beginning.

At 37 weeks I had a doctor check me and I was progressing quicker than I thought. With my first, I did not progress at all until the day I delivered. So I was a little nervous to hear I had already progressed to 80% effaced and 1-2 cm dilated and my help was not going to be here for another one and a half weeks. At 38 weeks I had only dilated up to 3cm and at my 39 week appointment I dilated up to 4cm. My doctor stripped my membranes at my 39 week appointment. I've been told that she has “magic fingers” because she will often induce labor with just stripping membranes.

Sure enough, that night my contractions started to get stronger and stronger. About 4:30PM they were fairly regular, but I could talk through them easily so I didn't feel the need to rush Trent home from work. I thought I would go in after dinner, but they slowed as soon as we finished dinner even though intensity increased some. Around 10 PM Trent convinced me to go in to be checked since it would be easier to not have to rush to the hospital and it is nice to be able to walk myself to the check in counter and answer questions instead of referring all answers to my husband. The person at the desk asked if I was there to be induced because I did not seem to be in labor. I had not progressed since my appointment that morning, so they said to wait a couple hours to be checked again. We went for a walk around the campus and when my contractions got so painful I didn't feel like walking much, we returned. It was only a half hour later and since I had not progressed further in that half hour, they considered sending me home.

Eventually, they were convinced to let me stay and admitted me. Around 1:30AM I was given an epidural/spinal, had progressed to 5cm (officially active labor) and then my water was broken. Within a couple hours, I could feel the contractions getting more intense. My spinal was wearing off, so I waited a little longer but the contractions got worse and I called my nurse in. She called the doctor to check me and the anesthesiologist to give me a booster for the epidural. I had progressed to 10 cm and was about ready to push. We called my doctor at home (she had given us her number to call her in for delivery) and she rushed in. Shortly afterwards James had arrived.

He was not out for very long when we heard the nurse say he has a cleft lip. After they handed him to me, he looked right at me and smiled. The cleft in his lip allows his smile to be extra wide. Now, I know that newborns are not supposed to be able to smile, that these are considered “gassy smiles” for a while, but it’s still satisfying to receive 5+ wide smiles every day from this little guy. At first we thought it was just his lip and alveolar ridge that were cleft. He was able to suck on my doctor’s little finger and there was some suction. I tried to get him to latch, but he kept falling off. I figured I’d try feeding him more later and perhaps I was doing something wrong and just needed the lactation consultant to come.

He was very swollen from birth and his eyes reminded me of the bubble eyed fish they were so big. I was hit by the worry about what others would think of him. Would be as loved by relatives and friends as his big sister? Would he be able to find friends in school? Was he going to be teased often about his looks or scar? How would this impact his future, and mine? I wondered how to break this to friends, how to approach this in pictures, how do I respond to show him that I love him and am proud of who he is even though I am anxious for surgery to help him look more normal. Despite his facial deformation I looked at him and at times still saw him without the cleft. He was very alert from the beginning. His hands were held open rather than clenched, and he grabbed on to anything he could. When the nurse took him from me to clean him off and weigh him, he tried to grab on to me and hold on.

When the Pediatricians brought him back from their evaluation, I learned that both the soft and hard palate are significantly impacted from his cleft. The lactation consultant came and told me that kids with a cleft soft palate cannot create suction to breastfeed because they require the soft palate to create suction. She brought me a pump and the occupational therapist brought a special bottle to try and feed him with. I was hesitant to use formula, because I so desperately wanted to breastfeed and I felt like I was just giving up on breastfeeding completely by giving him a bottle of formula. After talking to the lactation consultant a little longer, I gave in and was thrilled to at least be able to feed my baby, even if it was not the way I had imagined. By the time he was 8 hours old, he had already taken about an ounce of formula from the Haberman bottle and I was set up on a pump.

When Daniella came to visit us, she didn't notice anything was wrong with baby brother. She was excited to visit and tell us about her day. She talked about how cute he was, and how much she loves him. She was very concerned when she heard him cry and she would run to Daddy to make sure she had not done anything wrong. I’m thrilled that she accepted her baby brother for who he is and loves him just the same.

James’ sweet temperament has been a saving factor in dealing with all of this. His face is so expressive since his lips have much more mobility. The huge smiles I have yet to catch on camera, light up my day. He is a definite cuddle bug and prefers to be held to anything else. He will sleep soundly if he is placed on my chest and sometimes all he needs is his hands to be held to calm down. Other than demanding food on occasion, he is very mild tempered and easy to soothe.

I feel like I’m still riding the emotional roller coaster. There are days when everything goes well, and others when I cry for hours. It just hurts me to realize all he is going to face and knowing that despite being able to “fix” this with surgery, it is not a perfect fix. While he is a baby he seems fairly normal except for the feeding issues and obvious appearance. It takes a lot more time trying to pump and then feed him with his special bottle than it would have if I could nurse him directly. However, pumping is one thing I can do to help him, and in a way it is how I deal with the grief of not being able to breastfeed directly.

He will need years of speech therapy and he may still have difficulty with resonance in his voice. He will need at least 4 surgeries most at a VERY young age to look more normal. The surgery on the palate being done early enough to have less of an impact on speech may somewhat stunt the growth of his maxilla and he may need further therapy to pull his maxilla out so it “grows” to a normal size in relation to everything else. His teeth will not grow in normally even after the palate is repaired so he likely will not have a normal smile until he has major orthodontic surgery. I think this happens during grade school. My heart goes out to what he will have to face at such a young age. I hope that by the time he is facing other kids himself that I am past the tears. I want to show him that I am strong and that there is nothing to be ashamed of in how he looks or sounds. I just hurt for him because I know it won’t be an easy road.