He just might be a lefty!

Swim and Shop

Sunday night the girls had a swim team party at Rock N' River. Obligatory cuteness:
The party was over at 10:30pm. Vinny was already in bed and we were out anyway. So, why not just run over to HEB and pick up a few necessary items. Okay, really I needed coffee creamer for the morning and the kids thought it would be a good idea to get me some, since they wanted to live. Well, the girls had a ton of sugar at the swim party and our quick trip turned into a gigglefest going up and down every aisle, discovering we needed a lot more than just coffee creamer. Like these awesome $1 sunglasses modeled in the frozen food section :)

Keep That Starz Spirit Up!

Emma's team, The Round Rock Starz, had their Sectional tournament this weekend. They came out strong, winning their first two games on Friday. Then Saturday morning they played a really tough team and lost. They bounced back Saturday night and pulled off another win but by Sunday morning, they had lost focus. They played a team that they had easily beaten twice before and got a little ahead of themselves. They would have qualified for the Regional tournament in Castroville, TX near San Antonio but it wasn't meant to be. The girls were crying and quite disappointed. Despite the outcome, it was so much fun. Emma is just getting better and better and has now decided that she wants to be a pitcher. She will start training with an awesome pitching coach in the fall. Her batting coach (me) worked hard to get her stance and stroke working. She kept her position of batting clean-up throughout the all star season. Even Beto gave me props :)

Frog of the Week!!

So all of that AWESOME swimming in last week's meet paid off for Emma, who was named Frog of the Week for her age group!! They came and placed this sign in our yard so that we could brag all week. This is such a TX thing, the yard signs. Emma was so bummed not to have been able to swim in her meet this week because she had a softball game at the same time. So, she won't be able to swim in the Champs meet at UT this year :( You have to swim in two meets to qualify for Champs. She still wakes up to go to practice every morning, though. We are so, so proud of her dedication.

The Motherlode of Summer Activites

Instead of posting a million little posts, here's a giant one with some highlights of our summer so far. The pressure to do fabulously entertaining things everyday has worn me thin and we are only about 10 days in. However, if I keep up this pace, I should be nice and skinny for our trip to San Diego next month. No time to eat. Emma and Ava both still have swim everyday. We have not gotten to sleep in yet, as Emma has to be at swim at 7:45 every morning. BUT, it has paid off! She finally got to swim in a meet on Saturday since they had a weekend off from softball. Because all of her posted times were from last season, she was seeded in slower heats. It was a great ego booster for her to be able to win all 3 of her heats. Beyond that, though, she improved all of her times by a ton. She improved her breaststroke time by more than 7 seconds even with her goggles falling off!

Ava is doing great as a Tadpole and can swim a short distance...just so long as Coach Caitlin makes it to practice. Because if one of the "boy coaches" even dares to speak to her, the hippopotamus rears it's ugly head and that is not good for anyone. We've spent lots of time at our community pool, at the playground, at Rock N' River, at the sprinkler park and Slip N'Slidin in the backyard. Summer is all about water and popsicles!

BASEBALL!!!

Vinny has become completely obsessed about "Bay-Ball". He wants to play catch all.day.long. When he is unable to find someone to play catch, he walks around swinging an imaginary bat, not unlike a pro working on his swing. The topper was the other day when I sat him down to watch TV while I showered and tried to put on Diego, he screamed for BAYBALL. I had to put on ESPN!! We are in for it. He found a boy at the sprinkler park to play catch with him.

SMORES!!

Ever since Shannon broke down the fat and caloric intake of Smores to me and taught me how to make them in the microwave (duh, why didn't I ever think of that?), we've been having them for dessert...like every night :) We heart Shannon 4ever!

AND, if you are wondering why there are so many pics of the littles and so few of Emma, you obviously don't have a 9 year old. She prefaces every picture I take of her with "Is this for your blog?" LOL...I'm going to have to start lying because this is the look I get when I answer "yes".
The girls and I had a girls afternoon and went to see Up. Emma and I loved it, but it was a little deep for Ava. She still enjoyed it, but I think it mostly went over her head.

Softball Fun

Beyond the awesomeness of watching Emma play and spending hours and hours at the ball fields, we have also had a great time getting to know the families of her teammates. A couple weeks ago we went out for Mexican food with a bunch of the families. We had a great time dancing and drinking beer. One of Emma's teammates has a younger sister Ava's age. They were fast friends.

This one is my favorite photo. Except what you don't see is that right after this shot, Vinny slammed my beer so hard with his sippy that I had to guzzle my beer so as to not spill it. That combined with the Mariachi music spun me into a quick TJ flashback :)

School's Out!

Ava finished up her 2nd year of preschool. She is so excited to move up to "the 4s". One more short year until she starts Kinder. Vinny is old enough to start the 2 year old class but we are going to wait, as he isn't potty trained and still not talking very much. Beyond that, I'm thinking we are going to put him in a secular school. I would have loved to move Ava but she insisted on going to the same school next year. Yay, Jesus!

Emma finished strong for 3rd grade, bringing home straight A's and earning commendation on her math TAKS!! She is an awesome student and can't wait to start 4th grade next year. For the third year in a row, we hit up Hawaiian Ice on the last day of school.
AND...if you are wearing a white skirt and intend to go to the grocery afterward, i don't recommend allowing your children to choose Blue Bubble Gum...my trusty Tide-to-go was defeated :(

Breastfeeding: I am not a NAZI!!

My aunt Peg once said about my blog: "You think everyone is entitled to your opinion". If not here, then where? Up on my high horse I mount...So, as some of you know, the other night at work we were discussing breastfeeding and I (once again?) was defending patients who choose to exclusively breastfeed and decline supplements. Why? Sure my job would be WAY easier to just tell these weepy, sleep deprived parents that "one bottle won't hurt". I mean, the baby would assuredly fall asleep. Mom would "finally" get some sleep and dad could pass (all the way) out. BUT, I can't bring myself to do it. After all of the time I have spent being trained by some of the field's most respected professionals (Shout out to Gini Baker and the esteemed Dr. Nancy Wight), reviewed countless hours of literature as part of my CLE coursework, my RN internship and in preparation for teaching classes on breastfeeding management to my peers, it just feels wrong. I know better. I want to Keep Austin (and the world) Breastfeeding.

I was taught that infant formula's only place in a hospital is as a medication. The risks of feeding formula outweigh the benefits in most cases. Dehydration is the most common ailment that would indicate formula supplementation, and I do recommend formula to babies who are clinically dehydrated, but I don't use weight loss percentage as a defining tool. The whole picture has to be assessed. In my career, I have probably only encountered a handful of infants who were clinically dehydrated. I also fully support a mother's choice NOT to supplement her term jaundiced baby who is receiving phototherapy but breastfeeding well. Why? Because the literature doesn't support blanket formula supplementation. Sure the baby's bili levels would drop quicker (research says about 10 hours faster) but what is the message? "Breastfeeding made your baby sick. Now, it has to be fixed with formula." Our goal should be best practice not quickest treatment and therefore sooner discharge. We know that 99.9% of the time, barring major pathological issues (which, coincidentally aren't going to respond to formula treatment) phototherapy will work and that even without phototherapy most jaundice is self-limiting. So basically 3 days of jaundice vs 12 months of breastfeeding...hmmm? Further, there is a ton of research that indicates that increased bilirubin levels may be beneficial to neonates. The Academy of Breastfeeding Medicine's protocol for supplementing term babies in the hospital can be found here. Click on supplementation.

I chose this profession over all others and, as cheesy and idealistic as it my sound, I want to do right by my patients, every.single.time. I want to help every single baby get the very best nutrition. I want to help meet our nation's Healthy People 2010 Goals for breastfeeding. I practice as if my hospital were Baby Friendly.

But this is not to say that I am a "Breastfeeding Nazi". And really, I resent that term on several levels. My position is this: I believe that women have the right to choose to use their breasts for feeding their babies OR NOT. If one of my patients says "I want to feed my baby with formula" I do not try to talk her into breastfeeding or shame her or tell her the 101 reasons breastfeeding is better. However, when a "breastfeeding only" patient calls me into her room because her baby is crying and wants to eat "all night long", I tell her that her baby is perfect and doing just what babies do on their second night of life AND explain all of the reasons (weight loss, hydration status, bili level) that her baby DOES NOT NEED formula. Of course, if she still wants it, I gladly give it. I am just not going to RECOMMEND formula if it is not indicated. When a patient tells me that she only wants to breastfeed, I support that decision with every fiber of my being. I have and will hold a baby at it's mother's breast for an entire feeding if need be. Remember, I am the mother's AND the baby's nurse. I need to advocate for the baby, too :) I prefer the term "Breastfeeding Advocate". It helps me sleep at night knowing that those babies just might make it to 3 months, 6 months or even a year without drinking formula. I don't judge people for not breastfeeding but I do wish that everyone would at least try. I think that all babies deserve breastmilk but I also understand that there are multiple factors that can impair the establishment of a healthy breastfeeding relationship. I'm just not willing to be one of them.


***And lastly, if my baby can make it out of the NICU after a week without being supplemented because I dragged my freshly cut open body down the hall every 3 hours, you pansy-ass postpartum princesses can suck it up and let your babies cluster feed for one night****

References for the nerds:

Academy of Breastfeeding Medicine ABM Protocol Number 3-Hospital Guidelines for the Use of Supplementary Feedings in the Healthy Term Breastfed Neonate

Berens, P.D. MD (2004) Applied physiology in the peripartum management of lactation Clinical Obstetrics and Gynecology, 47 (3) 643-655

Dewey, K., & Nommse-Rivers, L. (2004) Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation and excess neonatal weight loss Obstetrical and Gynecological Survey 59 (3) 179-181

Gordon, J. MD Bilirubin as an antioxidant

Holcomb, S. (2005) Managing jaundice in full term infants American Journal of Primary Health Care 30(1) 6-12

Johnson, L. MD & Bhutani, V. MD (2002)System based approach to management of neonatal jaundice and preventioin of kernicterus The Journal of Pediatrics 140 (4) 396-403

Neifert, M. MD (2004) Breastmilk transfer: positioning, latch-on and screening for problems in milk transfer Clinical Obstetrics and Gynegology 47 (3) 656-675

Newton, E. MD (2004) The epidemiology of breastfeeding Clinical Obstetrics and Gynecology 47 (3) 613-623

Ostrow, J. & Tiribelli, C. (2003) Bilirubin, a curse and a boon Gut 52 (12) 1667-1670

Shoemaker, M. MD & Ellis, M. MD (2003) Should jaundiced infants be breastfed? The journal of Family Practice 52 (11) 895-896

Tan, K. (1999) Decreased response to phototherapy for neonatal jaundice in breastfed infants Obstetrical and Gynecological Survey 54 (7) 436-437

Willis, S. DrPH & Hannon, P. MD (2002) The impact of maternal experience with a jaundiced newborn on the breastfeeding relationship The Journal of Family Practice 51(5) 465