Archive for the 'nicu' Category

A year of breastfeeding twins

A year ago today we all came home from the hospital together. Sometimes it seems like only seconds, but then I look at them and how far they’ve come and it seems like forever.

Today marks another occasion: it is officially a year that Sarah and Jordan were exclusively nursed (exclusively if you don’t count peas, carrots, bananas, pizza, ice cream… and all the tons of other solids they’ve been having for almost 6 months). But a year with no formula. It isn’t a year from their birthday because they did get some formula in the hospital in addition to breast milk, when they were trying to fatten them up and waiting for my supply to ramp up, and I wasn’t with them 24 hours a day to help with that.

This post has been a long time in the making. The ubiquitous breastfeeding (twins) post. I started months ago. I wanted to tell my “breastfeeding story” from start to present. But I wrote a couple of pages and was still on the NICU experiences and couldn’t bring myself to return to it. And yet, I can’t bring myself to let the occasion pass without some kind of description of my experiences. So here it is, less saga-ish, more freeform.

And here’s the usual disclaimer. Everyone’s experience is different. I am not judging others who did not breastfeed due to choice or biology or circumstance. I’m not saying that if others did what I did it would have worked for them. I’m not trying to give advice, preach for what others should do, or detract from others’ experiences or challenges. I don’t know what it’s like to breastfeed a singleton, nor do I know what it’s like to have true obstacles to nursing or producing milk. I’m simply describing my own experiences.

Breastfeeding twins is by far the most physically and emotionally demanding thing I have ever done. I should say “was” because it’s not the challenge it was early on, though new challenges always present themselves. It’s also one of the most beautiful and rewarding things I’ve ever done. I’m more proud of it than most things in my life, even though it’s something biological that the majority of women around the world do, that has been done for millennia.

I had to work really hard to get things to work, with twin, premature, low birthweight babies. I’m not even sure why it was so important to me to exclusively breastfeed early on, but I do know that I was extremely motivated to do so, fearful of failure, and willing to forgo sleep and sanity to get there. Looking back, I think that some of it was that getting pregnant wasn’t particularly easy for me; staying pregnant toward the end became challenging and scary, and I felt like I failed my babies because they were born early and my body couldn’t keep them safe for as long as it should have. So as much as possible, I tried to get control over breastfeeding, of nurturing my babies now that they were in the world.

Here is a somewhat haphazard list of some of my experiences with breastfeeding:

§ I’ve had sore nipples, cracked nipples, bleeding nipples, engorgement, painful letdown, clogged ducts, mastitis, milk blisters, and hickeys.

§ My breasts have been sucked, bitten, scratched, elbowed, punched, pinched, kicked, licked, tickled, and kissed.

§ I’ve tried football hold, double football hold, cradle hold, double cradle hold, cross cradle hold, side lying, double side lying, baby sitting, and baby standing.

§ I’ve tandem nursed with a tandem nursing pillow, in the big giant nursing chair, on the couch, in my bed, in the guest bed, in my MIL’s bed, in the guest bed at my father’s, in a hotel bed, on the floor, in a doctor’s office, and at mommy group.

§ I’ve single nursed (in addition to all the above) in the NICU, in a public bathroom, in a changing room, in the car, on the car, on a park bench, on the grass, at friends’, at relatives’, at parties, in restaurants, in my office, at daycare, in a museum, at a convention center, at the grange fair, and at the arts festival.

§ I’ve tandem nursed in front of my husband, the nanny, my friends, my mother, my sister, doctors, nurses, and lactation consultants.

§ I’ve single nursed in front of (in addition to the above) my father, my MIL and FIL and BIL and SIL and FSIL, my niece and nephews, lots more friends, lots more family, colleagues, students, daycare caregivers, other kids, other kids’ parents, and a whole lot of strangers.

§ I’ve pumped in front of my husband, the nanny, my mother, my sister, my friends, doctors, nurses, and lactation consultants (and once accidentally, my nephew).

§ I’ve used breast pumps (Lactina, Pump N Style, Symphony), Lansinoh, nipple shields, breast pads, nursing bras, nursing shirts, nursing pajamas, antibiotics, topical steroid cream, milk storage bags, nursing pillows, Boppies, baby scales, microwave cleaning bags, hot compresses, cold compresses, books, websites, and blogs.

§ I’ve pumped, fortified, refrigerated, frozen, defrosted, labeled, thrown out, donated, bottled, served, warmed, tasted, mixed with cereal… breast milk.

§ I have cried over spilled breast milk.

§ I have worried about mastitis, thrush, abscesses, low supply, oversupply, food allergies, biting, latching, overeating, undereating, vomiting, spitting up, nipple confusion, and bottle refusal.

§ I have used nursing to soothe, get over shots, get to sleep, feed, quench thirst, comfort, show love, cuddle, and play.

§ While nursing I have rested, slept, talked, talked on the phone, attended meetings, attended phone meetings, worked, graded, typed, surfed, watched TV, read, drank, eaten, written thank you cards, and bounced, sang to, and held another baby.

§ While pumping I have talked, talked on the phone, attended phone meetings, watched TV, read, bounced a baby, sang to a baby, and held a baby.

§ While nursing I have received sighs, grunts, moans, smiles, giggles, caresses, cuddles, and the finger.

§ None of this would have been possible without the support of an amazing husband who was home most of the time early on to bottle feed and change and hold babies, a 20 hour a week nanny for 6 months, two healthy babies willing to figure it out with me, lactation consultants in the NICU and on phone and e-mail and in my living room, a daycare in the same building as my office, friends and family supportive of breastfeeding, my pump, blogs of other women with multiples showing me it is possible, and the fact that I am the most stubborn person in the world, unwilling to quit or even partially give up in the face of what at times felt like an unachievable task

§ My best estimate is that I have produced 17,130 ounces of breast milk, or 134 gallons. That’s equivalent to 2 ½ gallon cartons of milk every week for a year.

§ I have breastfed twin babies every day, every 2 to 3 hours, averaging 7 to 12 times a day EACH for 365 days

§ I wouldn’t change it for the world.

We were supposed to try milk last weekend but then I got sick and then Sarah got sick so then maybe this weekend. Then Eric was sick and we didn’t get around to it. I was supposed to start dropping the in person 11:30 feeding at daycare (change it to defrosted breast milk and eventually cow’s milk) the first week of classes but we’re about to start the 4th week of classes and I was there every day, 9:30, 11:30, 3:00. For a year during the day, I’ve needed to either nurse the babes or pump every two hours, so I’ve been unable to have long breaks from breastfeeding. Even though I’m looking forward to the increased freedom and flexibility of dropping the working hours nursing sessions, I’m also ambivalent and sad about it. To me that will mark the true end of their babyhood, the true end of my being a mother of twin babies, when I start to work 8 hour days without stopping in to see them every 2 hours. With the birthday a lot of people have been asking me when I’ll stop nursing, and I just don’t know. The American Academy of Pediatrics recommendation is “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.” The World Health Organization recommendation is “infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond.” I will need to cut out working hours breastfeeding, and the plan is to cut back about one (there are currently three) of these per week until they’re all replaced with remaining frozen breast milk and/or cow’s milk. I’d love to cut out night nursing though not simultaneously with working hours nursing. After that, we’ll see what we do with the remaining 3 daytime sessions (first wake up, post-daycare, and pre-bed). Right now it works for the three (four) of us. In a 2002 study, 16% of women (not twin-specific) were still breastfeeding at one year. Can I give myself a small pat on the back?

To me, being a mother and breastfeeding are inseparably tied. I’m sure that once I stop nursing my relationship with Jordan and Sarah will change and evolve, but right now it’s an integral part of our relationship. Although these days sometimes they’re distracted, when the moments are right, they’re perfect. Laying face to face with Jordan in the middle of the night, his head in the crook of my arm, his hand gripping my thumb, listening to him sigh and caressing his baby head. Or nursing him at daycare, forgetting the chaos around us and making him laugh because I tickled his foot with my nose or used his hand to bop myself in the head. Nursing Sarah first thing in the morning when she’s just waking up, with her eyes closed and snuggled in my arms, caressing her stomach and back and legs. Or nursing her when we first get home from daycare, having her try to feed me her bracelet and laugh when I rub her puppy’s ear across her face. Each time I tandem feed in the middle of the night with a double wake up, wondering if this is indeed the last time the three of us will be together like this, with their bodies wrapped around mine, their heads touching, their breath in synch. Babyhood is such a short instant in our lives, and I treasure all of these moments with each of them. I’ll miss it and not miss it and never forget it.

Protected: September 17, I think

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Protected: We are home

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Protected: Going home

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Protected: A quick post before bed

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Rooming in with Mommy & Daddy — a not so brief timeline

We’re back in the hotel and back on the blog — not soon enough for some readers, in particular, a Toronto reader. Here’s what we’ve been up to…

9/13
6:50 AM
Mommy & Daddy wake to alarm
both shower and eat breakfast #1

8:00 AM
J & S still in old room (#11)
change Jordan & Sarah
M (Mommy) bf (breastfeed) Jordan 20 minutes
D (Daddy) feed Sarah EBM-22 (expressed breast milk fortified to 22 calories)
M pumps for 15 minutes, cleans all parts
M & D go to cafe for breakfast #2
Jordan fusses and nurse worries he didn’t eat enough, calls lactation consultant
M & D attend rounds, told that rooming in is on for tonight
M & D hang out, with D comforting fussing J, until…

11:00 AM
change J & S
M bf S, then gives her some EBM-22
D feeds J EBM-22
discuss rooming in with charge nurse, who says rooms have to be cleared, will not happen until much later, maybe 7:00 PM
return to hotel room,
M pumps, cleans all parts
D takes 1/2 hour nap
M eats lunch, e-mails

2:00 PM
M & D show up, nurse asks, “are you packed?” told that someone who needs this room for isolation is currently being delivered, J & S are being moved asap
change diapers
M bf J while lactation consultant watches/advises
J falls asleep on M, consultant says “he’s done, don’t force more”
D sits on stool to quickly feed S EBM-22
J & S are moved to “demo room”
M returns to hotel room, pumps, cleans, packs
D follows J & S to demo room, hangs out for 45 minutes while new monitors are beeping and saying scary things (e.g., no heart rate detected)
M shows up at demo room
D goes to hotel room, packs

**warning, obsessive and boring M details ahead, they made her record everything during rooming in, and you know what M is like even when she isn’t asked by NICU staff to be detail-oriented!

5:00 PM
M bf J 5 min
D fed J 45 ml EBM-22
M bf S 13 min
M fed S 5 ml EBM-22
M changed S’s diaper
M pumped then cleaned

6:00 PM
D leaves to buy groceries (following exchange can be heard: D: “should I stay to help you wash after you finish pumping?” M: “NO, you should get out of here now and get me food” D says M feeds our kiddos, M says D feeds her, who then feeds kiddos, so it’s all a chain of supply

6:15 PM
J starts fussing — okay, wailing
M changes J’s diaper
M holds J, immediately calms down, sit together for 1/2 hour before returning to isolette

7:00 PM
M & D feed themselves a picnic

8:00 PM
D changes J’s diaper
M bf J 13 min
D changes S’s diaper
D fed S 40 ml EBM-22
M fed J 32 ml EBM-22
M pumped
D cleaned parts

9:15 PM
M & D have a conversation (coherent? probably not…)
M falls asleep on D for 1 hour?

11:00 PM
D changes S’s diaper
M bf S 10 min
D changes J’s diaper
D fed J 37 ml EBM-22
M fed S 16 ml EBM-22
D changes second J diaper
M pumped
D cleaned parts
D opened bed and M & D made it

12:45 AM – 1:50 AM (9/14)
M & D sleep

2:00 AM
D changed J’s diaper
M bf J 18 min
D changed S’s diaper
D fed S 34 ml EBM-22
M fed J 22 ml EBM-22
too tired to pump

3:00 AM – 4:50 AM
M & D sleep

5:00 AM
M bf S 5 min
D change J diaper
D fed J 50 ml EBM-22
M fed S 20 ml EBM-22
M changed S’s diaper
M pumped
D cleaned parts

6:30 AM – 7:50 AM
M & D slept

8:00 AM
D change J diaper
M bf J 15 min
D fed S 37 ml EBM-22
M fed J 10 ml EBM-22
D change S diaper
M pump
D cleaned parts

9:15 AM
M & D ate breakfast
M & D folded up bed
D showered

11:00 AM
D changed S diaper
M bf S 7 min
D fed J 50 ml EBM-22
M fed S 13 ml EBM-22
D changed J diaper
M pumped
M cleaned parts

D & M pack up
D brings stuff back to hotel room

1:00 PM
M leaves to go to hotel room
nurse comments, M, you’re having a hard time leaving, aren’t you?

J & S are moved to new home in special care, no longer intensive care. New area (which can’t be photographed for wide view due to privacy) has about 6 slots in the pod. J & S are across from each other diagonally; we can see each other from the other’s location, but can’t really help each other pass things like we could before. At least they’re in the same pod, though!

Okay, that’s more than 24 hours worth of annoying details, since then today has included D at 2:00 PM feeding while M showered, M & D hanging out in hotel room a bit, M & D going to 5:00 PM feeding (same standard routine), D running to store & then M & D eating pizza at hotel, M & D going back for 8:00 PM feeding (same standard routine).

Despite the detail here, it leaves out so many of the major details… every feeding includes all kinds of other things, like mixing fortifier with any pumped milk, multiple burping sessions, and of course, if we want any time that’s not spent on these necessities, that is extra time out of the “box.” But that’s the skeletal description of our most recent day (actually, I guess that’s 2 days, go figure!).

Protected: A few other odds & ends details…

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Mommy and Daddy room in with us at the NICU — a photojournal

1. Here’s the entrance that Mommy & Daddy come in to see us.. they get pretty excited when they are this close, even when they’re very tired!
2. The first entrance to the NICU.
3. The second entrance to the NICU, pre-scrub in.

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NICU tour

1. This is where all the parents scrub in before seeing their kids — it is supposed to be 3 minutes, hands to elbows, using sponges on the right, and then put a gown on. They have never been so clean (and dried skin!).
2. Here’s the badge we need to get in, plus wrist identification on each parent for each kiddo (though they never really check these).
3. The infamous pump room

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NICU tour

Mommy wanted to take photos of our old room, #11, but we got moved before she could, and now she can’t take pictures of the new one. But here are some from the demo room where we all stayed together as a family last night — it’s been called by the nurses the room with the view. And you can even see their hotel from it! And the 2 other photos just show what it was like in our little room for the night with the 2 boxes and a “bed” for mommy and daddy.

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NICU photos



These tell us important things like heart rate (top line) and respiration (bottom line). But they also freak out fragile parents by beeping every time we move, or someone burps us, or we hiccup. Posted by Picasa

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Protected: Rooming out

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Protected: 6 days old

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Protected: A bit of a roller coaster of a day…

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Protected: 5 days old and sleeping well

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Protected: Jordan under the bili lights, 9/8/06

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Protected: Eric feeding Jordan, 9/8/06

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Protected: Eric feeding Sarah with new IV tube in her scalp, 9/8/06

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Protected: Eric’s hand, Sarah’s hand, 9/7/06

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Protected: Dad and Sarah, 9/7/06

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Protected: Jordan, with a splint to protect his IV, 9/7/06

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Protected: Sarah’s new home, 9/6/06

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