Monthly Archives: January 2017

Two and a half years later

I got a phone call about my daughter this week.

It came out of the blue.  Hardly anyone talks about her to me anymore, and all the medical tests and analysis of her short life are long finished — or so I thought.

The call was from Natera, the company that runs the Panorama screening test that checks for common chromosomal abnormalities in the first trimester by isolating cell-free placental DNA from a vial of the mother’s blood (also known as NIPT or NIPS).  We used the test as our primary first-trimester screening in both my pregnancies.  When they called this week, they wanted some more information about the posthumous testing that was performed on my daughter.  When the autopsy was performed, there was so much autolysis that they were unable to definitively identify her sex based on anatomy alone, so the hospital contacted Natera to confirm the sex they had identified chromosomally.  Apparently the hospital also told Natera that we had decided to opt for a microarray analaysis of our daughter’s tissue to determine whether less common chromosomal abnormalities contributed to her death, but they never followed up with Natera to let them know the results.

So, two and a half years after our daughter’s death, Natera called to follow up, and to make sure that the microarray results agreed with their prenatal screening results (they did).  Apparently this confirmation provides valuable verification data for the company.

The woman I communicated with was lovely, and very sensitive.  She expressed sorrow for our loss, and apologized if the inquiry was in any way upsetting.  I didn’t find it upsetting at all, in fact — I like thinking that the data generated by my daughter’s short life might in some small way be helpful for improving the science of non-invasive fetal testing.  It’s one way in which her life has meaning to people beyond our immediate family.  And I am always interested to learn more about scientific fields other than my own; this gave me some insight into the scientific (and commercial) practice of genetic testing.  Even the corporate flavor of the interaction doesn’t bother me too much, since I believe that the development of non-invasive testing is already providing a great benefit to pregnant women as well as their unborn children (since the false-positive rate and the risk to the fetus are significantly lower than many other screening methods), and I’m basically OK with the fact that someone is making money from providing this service.

I did feel a sense of wistfulness about this conversation.  It’s probably the last time I’ll ever get a phone call about my daughter.  It also made me remember some of the other phone calls I have gotten about my daughter.  Some were very upsetting, like the phone call from my primary care doctor’s office the Monday after I delivered our dead baby in the hospital, congratulating me on my pregnancy (some seriously poor communication happened somewhere… I have since switched doctors, for this and other reasons).  Or the phone call from the campus daycare several months after her death, informing us that a spot had opened up for our daughter.  Those were very difficult calls to receive.  But some calls about our daughter were thoughtful and loving.  There were calls from friends and family — and not just immediately after her death (when I wasn’t always up for a whole lot of talking anyway), but weeks and months later.  These days, it’s hard to imagine that a call about my daughter would be upsetting.  Those wounds have been healing for a while now, and while I still miss her terribly and often wonder who she would be today if she had survived, her memory is not painful to me.  My pregnancy with my daughter was a time of extreme joy, hope, and love.  Her death was the most difficult experience of my life.  But my memories of her now are mostly of the experience of being pregnant with her and our hopes for our lives together with her. I love remembering my daughter, even when it also means remembering the pain of her death.

She lives on in our family.  Our son will grow up knowing that he had a sister.  When he was born, one of the most precious items I packed in my hospital bag was the hand-knitted had that the hospital dressed her in when she was born — the only clothing she ever wore.  Because her life was so short, the few reminders that I have — ultrasound photos, the hat, pictures of her after she was born, her hand and footprints, some certificates from the hospital — are all the more precious.  Even though I was surprised by the call this week, it was nice to talk about her for a little while, and to have an opportunity to remember her presence in our lives.

Nursing on the Tenure Track

Hello, everyone!  It’s been a while, but I’m still here, mostly reading and commenting on all y’all’s blogs, but also thinking about writing once in a while.

First, a quick update: Little S is 10.5 months old.  He has 7 teeth (with tooth #8 about to pop through any day, poor guy), and is right on the brink of walking and talking (he walks with a push toy, and can stand for a couple of seconds before plopping down on his bottom.  I think he’s been trying to say the word “cow” for one of his favorite toys and “dog” when we see dogs out on our walks).  The best parts of the last week have been (1) he learned how to splash in the bathtub (wet, but fun!), and (2) we took him sledding for the first time after Saturday’s snowstorm — he was skeptical, but didn’t cry, so it’s a win, I think!

Our nursing relationship is still going strong.  I didn’t really think much about nursing long-term before he was born — in fact, when our weirdly aggressive breastfeeding instructor demanded to know my nursing goals while I was still pregnant, I stammered out “um, try it and see how it goes?”  Then, my kid was a born sucker (there’s one born every minute, after all), and I was surprised to discover that I really loved our nursing relationship.  It’s not all roses, of course — I seem to be prone to plugged ducts (not mastitis, thankfully), and it quickly became apparent that the downside of nursing is that a small human is still physically dependent on your body months/years after you’ve finally evicted them from the inside, so your freedom is a bit limited.  But on the whole I feel so fortunate that it’s worked for us, and I love the closeness and the special relationship that it’s helped to develop between my son and me.  Nothing beats that snuggle time.

Another thing that I didn’t think much about before my son was born was how moms combine nursing with work, particularly academia.  I mean, I vaguely knew that women pumped while they were at work, and that lactation rooms were supposed to be a good thing.  But man, it’s a whole lot more logistically complicated than I ever imagined.  We had a few challenges that were somewhat particular to my baby: for one, he never took a bottle, which made it complicated for anyone other than me to feed him.  When I went back to work part-time four months after he was born, his dad finally figured out a labor-intensive cup-feeder solution, which the daycare ladies gamely continued until he was 6 months old and learned how to use a sippy cup.  But he would refuse to eat from anyone other than dad or the daycare ladies, and actually these days he generally refuses to take a sippy cup from dad.  When I organized a conference at my university that took place on a Saturday when he was 7 months old, the little guy went on a hunger strike and my husband brought him to me to nurse over the lunch break so that he wouldn’t have to go 12 hours without eating.  Even if he had been one of those normal babies who takes a bottle without a fuss, it’s never easy to leave home as a nursing mom, because for every feeding you miss you have to pump to keep yourself comfortable and keep up your milk supply.

Which brings me to pumping circumstances.  I’m very fortunate to have my own office with a door that closes and locks.  However, all the faculty/staff offices in my building share a single key, and occasionally people will let themselves into my office if they think I’m not there, to leave something on my desk or change a lightbulb or whatever.  So, yeah, after one awkward incident, I made a great big sign for my door as well as a smaller sign that hangs from the doorknob and covers the keyhole when I’m in there.  Also, my window shades are almost as old as my 100-year-old building, and don’t close all the way, and my window is right at eye level on a staircase that students sometimes use to leave the building.  Oh, and the electrical system in our 100-year-old building is flaky, so there have been days when the lights in my office flicker in time with my breast pump, which is a little disconcerting.

I thought that lactation rooms sounded like a great idea, until I had to use one when I went to a conference at a large research center in November.  Don’t get me wrong — I think they’re infinitely better than what most women have, which is nothing more than a bathroom or a broom closet.  But once you’ve been pumping for a while, you realize how critical the timing is.  I found that with my tendency towards plugged ducts, I couldn’t safely go more than about 3 hours between pumping sessions (maybe 3.5 if I stretched it), at least when I was at peak milk production when my son was around 6-8 months old.  If I fed my kid at 8 before we left for the day, then my ideal pumping times were ~10:30, 1, and 3:30, and then I’d nurse him when I got home around 5:30.  The problem with a lactation room is that most of the other women are on the same schedule, so everyone wants to pump at ~10:30, 1, and 3:30, and nobody wants to pump at 9:30 or 4 — so the lactation room is empty most of the day, but crowded when you need it. Surely there must be a better solution!

Speaking of schedule issues, when I was teaching last semester, my class met from 10:20-11:40am, which meant that I had to pump around 9:45am to get to my class in time to set up, hand back papers, and have everything ready to go.  Then after class I’d be swamped with students until at least 11:50, which meant that if I had a lunch meeting or seminar I had <10 minutes to pump, which wasn’t quite enough time, so I either had to arrive late at my lunch meeting or pump after the lunch meeting, which meant stretching the time between pumping sessions to >3hours — and then if I got held up at the lunch meeting, it could easily go to 3.5 hours or beyond.  Two plugged ducts later I decided it wasn’t worth the risk, so for the rest of the semester I was late to all my lunch meetings and seminars on teaching days.  (I was totally ready to play the “breast pump” card, but nobody ever asked — I hope they don’t think I’m flaky now.)

The other thing is, I have no idea how nursing moms manage all the travel in academia.  I have a number of advantages, including a husband who works from home and has a very flexible work schedule, plus my son has three supportive grandparents, two of whom are retired.  For the conference in November, my husband came along.  The conference was three days long, but we compromised so that I went for 1.5 days and then we came home so that my husband only missed two days of work but I still got to go to half the conference and give my invited talk.  In February we are going to a two-week-long workshop in California (I was actually invited to attend for all three months of the workshop, but that was totally unrealistic, so I settled on two weeks instead).  One of the grandparents is tagging along to babysit for the first week, and my husband is coming out for the second week.  I am already dreading this, partly because upending my son’s schedule is going to make him a cranky, whiny, sad little baby, and partly because I suspect he’s going to go on a sippy-cup strike which will stress my mom out while she’s trying to babysit and will mean she’ll probably wind up bringing him to me at the conference at least a couple times a day to nurse.  He’s doing pretty well on solids these days, so the nursing intervals are starting to stretch out, but he still nurses quite a lot.

When people talk about how to support young parents, especially young mothers, in academia, they talk a lot about conference daycare and lactation rooms.  What I could really use to help me continue traveling is money, with the flexibility to use it however I need.  In addition to my normal conference costs, this two-week trip is going to also require us to pay for two extra plane tickets (my mom’s and my husband’s), two weeks of a rental car (which I wouldn’t normally splurge on, but with a baby it seems necessary), all the extra food for my mom and husband, and then there are the hidden costs of my mom and my husband taking vacation time from work.  We are fortunate enough to be able to afford it, but if we weren’t so lucky, it would be a real barrier to my attendance at the conference.  If I were going for only a day or two, it would also be immensely helpful to have funding to pay for a service like Milk Stork — I know people in business careers whose companies have agreed to pay the cost of Milk Stork while they are on work travel, but it’s not exactly the kind of thing I can charge to a research grant (as far as I know).

As a pumping scientist mom, I have had some fairly wacky pumping experiences, including pumping in an old Nike radar station and a transmission electron microscopy lab.  It actually felt weirdly empowering to pump in such super-sciencey places — I am science mom, hear me lactate!  🙂  And as tricky as it’s been to combine pumping with academia, I’m still more than a little bit sad to think that our nursing relationship is already starting to wind down as my baby grows up.  Honestly, part of me loves that nursing gives me a reason to bring my son along to conferences, instead of leaving him for days at a time.  In his whole life, I’ve never been away from him for more than the length of a daycare day, and I’m dreading the first night that I spend away from him (y’know, except for the uninterrupted sleep part).  I’d also really like to continue nursing for as long as he’s interested, but I’m just not sure how realistic that is with all the travel that my job requires.  I’m a little bit worried that I’ll inadvertently wean him (or totally distress him) the first time I have to leave him for several days.  It’s also having an impact on my career: for example I’m probably going to turn down an invitation I received to a conference in Germany in April because I just can’t imagine that a week-long separation is going to work at this point.  That said, if having a baby has taught me anything, it’s that with babies, change is the only constant.  He’s already getting very fidgety at our nursing sessions and nursing for shorter times and less frequently than he used to, so maybe he’ll surprise me one day and just decide he’s done, and I’ll shed a tear and pack up my pump and move on with life.  We’ll see.  I feel fortunate to have made it this far, and I know that I am luckier than many women who don’t have the flexibility to make an extended breastfeeding relationship practical.  And knowing that our breastfeeding relationship is finite makes those snuggles all the more precious while they last.