Tuesday, June 29, 2010

Wherein I discuss swimming and sleeping

What's been going on here?

Well Nicky has started swimming lessons. We've been wanting to do this since last summer and we finally signed him up. He had his first lesson Monday and loved it! I'm hoping that this gives him some good practice following directions. He's been having trouble focusing and following directions at school. Well, really everywhere.

It's the same issue we've always had, but now that he's four he's expected to be able to focus and follow instructions better. I don't think he's being willfully disobedient, I think he really just gets uber-distracted. It might be ADD as that does seem to run in my family, but I'm reluctant to have him tested and diagnosed this young. I don't think diagnosis would be appropriate yet and a label at this age wouldn't help him anyway. We'll just watch it and see if we can work on it.

Anyway, at swimming lessons Monday he had a good example of why we follow directions...he fell into the pool when he shouldn't have been. Luckily the teacher got to him quickly. His near-drowning didn't seem to make him fear the water which is good, but hopefully it brought home how important it is to be safe near the water and to listen to the teacher.

I'll send the camera with Tom tomorrow so he can take some photos. I wish I could be there too, but taking the girls and I along would be really hard and I'm not feeling up to driving him myself.

In fact, as an example of my sleep deprived state, Monday morning about 6am I finished feeding the girls, changed them and put Gabi in the crib and Lily in the swing. Nana is visiting us, and she was awake so I went into the kitchen to grab a bite and work on my homework. At the next feeding, Gabi woke up first and so I was breastfeeding her. I sent Nana in to get Lily and start waking her up for her turn. Well guess what Nana found? Lily was soaking wet...so was the swing. Odd. Hm, her onesie is un-snapped. And oh look...no diaper!

Yep. Somehow I'd managed to take off the old diaper, wipe her off, and then totally skip that important step of putting on the new diaper. Lovely.

Well that was a hint that maybe I needed to get a little more sleep. So after Tom returned from taking Nicky to swim lessons and school I took a nap. A 5.2 hour nap! It was great. I woke up for dinner. Did my homework. Fed a baby. Put Nicky to bed. And then took another nap! A 3.3 hour nap. That's 8.5 hours of sleep. It was awesome.

So now I just fed the babies their 1:30 feeding and put them down to sleep at 3am. And I was awake enough to post.

Now we'll see if I can grab another hour or so of sleep and maybe I can make it to the postpartum luncheon tomorrow. Tom's got to take Nicky to swim lessons and school, but I'm hoping Nana can take the girls and I to the luncheon. It would be nice to get out. I haven't left the house since the 18th.

Hey, I have a few photos for you:

Cuddles abound. Nicky has Gabi and Tom has Lily:
Cuddles- Nicky has Gabi

Nicky is such a good big brother. Here he's feeding Gabi:
Nicky feeding Gabi

It's hard to tell them apart, but we can finally do it!

The trick seems to be that their ears are slightly different. Each has a little bump on the upper outside of one ear. Nicky and I have this same bump. I actually have it on both ears, but the girls have them on opposite ears. Lily's is on the right, Gabi's is on the left. It seems to be a reliable way to tell them apart right now. But really, other than that...it's a total crapshoot.

Saturday, June 26, 2010

Diaper Rash

The girls weren't due for another pediatric appointment till sometime in July, but they both came down with a bad diaper rash that Desitin wouldn't fix shortly after I started breastfeeding them more. Poor Lily even cried her first real tears during a diaper change about it. We called the pediatrician (of course it was a Friday) and although they gave us ideas I really wanted them seen. I was worried about it being a yeast infection and not typical diaper rash. Or maybe an allergy to the new formula we'd just started the week before. Or maybe something in my breast-milk that they were allergic too... (cue spiral into Bad-Parenting Guilt Vortex of Doom)

So we took them in, after giving them an oatmeal bath:
Sharing an oatmeal bath

and letting them have some naked time on towels:

They enjoyed that. We all enjoyed that. Well, except for the poop in the tub (courtesy of Gabi) and the poop on the towels... and the pee on the towels. Seriously we went through something like 12 towels for this bath!

The pediatrician said it wasn't yeast yet, but gave us some other stuff to use. She said it wasn't anything we did or did not do, and put my mind at ease because I was afraid it was from the breastfeeding that we were doing. She said they're just having more frequent poops because of the breastfeeding, and they are acidic and burn the skin. But that they didn't look at all like a food allergy to the breast-milk or the formula.

She said when diaper rash is this bad then the wipes hurt (because they have soap and alcohol in them, even the sensitive ones we use) and Desitin hurts too. So we started wiping them with soft cloths and water (like we did in the NICU) and using Maalox on their bottoms to neutralize the acid in their poops. We just patted it on with a cloth. (Bonus- it was mint flavored Maalox, so they had minty smelling bottoms for a while.) Then we just put on some Aquaphor . She showed us how to just squirt it on and said not to worry about spreading it around. The diaper and body heat would do it for us. That was good to hear, because that stuff is greasy! She gave us some Aquaphor samples to last us a few changes till Tom could go get some.

And you know what? That diaper rash that we had been fighting for two days started improving within hours. I'd say within 24 hours it was so much better, and within 48 it was totally gone. I still am Maalox-ing and Aquaphor-ing them after poops or if there's any hint of redness, but they're much happier babies. Oh, and I got a great idea from another mom on facebook to use the regular sensitive wipes we have, but to rinse them. This worked great since we were running out of those cloth wipes from the NICU pretty fast.

So diaper rash was conquered, breastfeeding is underway, oh, and my Dad suggested using those chucks pads on top of a towel while giving them naked time. Great idea! And we even have a whole bag of these things from when we were potty training Nicky.

Oh, and one more thing. So this was Friday, June 18th. The girls came home on June 1st. We went ahead while at the pediatrician and weighed the girls. They were in diapers and a little dress, so it's a rough weight, but still their clothes weren't that heavy.

Gabi weighed exactly 8lbs. Lily weighed only 2 ounces less. Awesome!

Happy Bottoms = Happy Babies
Gabi on the left

The Breastfeeding Plan

So about 10 days ago I promised to tell you what the Lactation Consultant (LC) said.

And then I fell into a dark pit and disappeared for a while.

Ok, well actually I just was too tired and too busy to even think about blogging. I had a paper due (which I have another due now) and the babies were/are going through some kind of growth spurt that has me up all night feeding them constantly. And during the day I was awake to work on my paper and feed babies too, so was going with really no sleep other than the small catnaps I'd fall into every once in a while.

But yesterday a call came out over twitter to help answer a question for an expectant mom of twins about breastfeeding. I couldn't just let that go un-heeded since I'm still in the middle of that same issue, so I started answering and realized I had a whole post written.

So here you go.

Let me set the stage for you. I have a four year old who I really wanted to nurse, but had so much trouble with latching and supply that I ended up giving up after 3 weeks of pumping.

So with my second pregnancy I was determined to make breastfeeding work. I was thinking about this way back when we started trying for baby #2 in 2006 even. I was going to make sure to attend LLL meetings BEFORE giving birth. I knew I needed to establish a support network of people who I could ask for help before the babies came. Especially once we found out they were twins. I think this is REALLY important. I didn't even have to join to attend meetings at my local LLL group. They have an email group so I was able to ask questions even while still in the hospital.

I also worked a lot with the LC while the girls were in the NICU. That's a reality I was prepared for this time, while I hadn't expected it with Nicky. Luckily the twins were big, over 6lbs each at 36 weeks gestation, but still they were in the NICU for 12 days. While we were there I pumped like a fiend, and this time I was also able to board in the hospital with the girls to practice nursing. With Nicky I was sent home on day 4. I was able to nurse the twins with help from the LC (and with a nipple shield) but it was still really hard with twins. Not a lot of sleeping going on for me. Mostly they were getting formula as my supply wasn't enough for both of them yet.

Once home I pumped some with my new fancy Medela Pump In Style that I insisted we buy immediately, but between feeding the babies, taking care of Nicky, and trying to sleep and recover from the c-section, pumping was just too much. Getting either baby to latch on took lots of pillows and props and definitely two hands. Tandem nursing was just out of the question for us at this time.

My supply was dwindling away. At the high point I could get one ounce from each side. But now I was only pumping one ounce total from both sides. I could see this going the same way it had with Nicky where I basically just dwindled to nothing in 3 weeks.

So I came up with a plan.

Basically I'm not afraid to give my babies formula. I know for a fact it's good enough. They'd be perfectly healthy on it. To deal with the financial issue of formula feeding twins, I even went ahead and got on WIC which pays for the formula.

However, I DO want them to get the antibodies and good stuff in breast-milk as much as possible. With Nicky in preschool and me working at the university we're exposed to all sorts of germs and the babies need that extra protection. And I also very much want to experience breastfeeding myself. You know me, I'm all about experiencing the most out of pregnancy, birth and mothering because I thought for so long that I'd never have the chance.

But the girls were so small and my boobs so huge (and they would smother if I didn't use two hands due to my anatomy, contrary to all the things you read on breastfeeding) that I just couldn't tandem nurse to save any time right now. My supply also wasn't high enough to exclusively bf even if I did it one at a time, and so often they were both hungry at the same time. Bottle feeding two at a time was hard enough!

So my plan was to keep my supply existent, forget about trying to increase supply with pumping fiendishly. Just keep it in existence until the girls are old enough to have more head and hand control and they can better latch themselves and look out for their own breathing. Then we can try more tandem nursing and I can let them nurse on demand and see if it can increase my supply to meet their wants then. They'll have a stronger suck then too and hopefully be more efficient. If they still have to have formula too, well I'm ok with that. Nursing can be the fun bonding thing and bottles can be the main food source. No problem. We'll let the babies drive that bus.

I ran my plan by the LC during one of the postpartum luncheons they have on Tuesdays. She agreed that it was a great plan. She actually praised me for doing as much as I had already with the twins and said to throw any negative feelings I had out the window. That was so nice to hear! She suggested that I put a time limit on the girls because as it was they would nurse forever if I let them, and then still take a whole bottle, but that would wear them out and use up too many calories for them. So at each feeding, when possible, I latch at least one baby on for only 10 minutes. Both (one at a time) if they'll let me or if I have help to have someone else bottle feed one while I bf the other for 10 minutes. This should keep my supply existent and keep the babies practicing at latching.

So we've been doing this for almost two weeks now. The babies are so much better at latching. I haven't pumped at all and DO NOT feel guilty about it (other than having a really expensive pump we bought that I'm not using). Occasionally if one baby is awake while the other is sleeping I will let them nurse longer, but for the most part it's only 10 minutes. It's not every feeding, especially not at night when I'm trying to snatch every available second to sleep myself (and only getting about 3 non-consecutive hours if that). But it's at least 4x a day I'd say. I think my supply might be increasing too. I might even pump one day soon, just to see if I'm getting any more that way (I was only getting a total of one ounce for both breasts before).

But right now this is working for us. The girls are definitely getting some breast-milk and the pediatrician and the LC both think this plan is very good. They both said that every little bit they get is great. So basically, they're formula fed babies that are supplemented with breast-milk. I think of it as their "medicine" or their "vitamins".

Oh yes, I did run this by the pediatrician too. That visit will be the next post!

Thursday, June 17, 2010

This morning's feeding

This morning the girls fussing woke up Nicky. He came in to see what was going on and wanted to hold a baby. So I finished changing Lily and set him up to feed her while I changed Gabi.

Big Brother feeding Lily

He loves his little sisters so much!

Nicky loves his sisters!

He fed Lily about half her bottle before he got tired and wanted to go watch Diego. Then I took over. It wasn't long before they were both done and knocked out. Tom captured the moment.

Covered up with babies

I tried putting on my mask and catching a few extra zzz's, but couldn't relax enough to sleep. Aw well.

trying to catch a few extra zzz's

So, so tired

Babies are fine. Nicky is fine. Tom and I are fine I suppose, but man, we are so tired.

We've been trying to trade off with him taking days and me taking nights, but while I've been able to stay awake all night fine (trying to do classwork and stuff between feedings) I sometimes don't get to actually sleep much during the day. Sometimes because we have to go somewhere (like the pediatrician, the WIC office and the lactation consultant-more on that in a minute) and sometimes because I still need to be "on" when Tom is taking Nicky to and from school or out to the store. If the babies happen to stay asleep while he's gone, then I can too, but they seem to like to wake up when he's out picking Nicky up and at the store specifically.

And I'm sure it's not easy on Tom either. With me sleeping during the day, that means especially on weekends he's dealing with all three kids at once where I usually only have the twins at night. He does get to sleep from about midnight to 9am usually, but sometimes he'll hear the crying if they are both up at once and hungry, and then he'll come help me.

Don't get me wrong though. I swear we have the least-cryingest babies ever. Very similar to Nicky. Oh they'll fuss, but they're very easy to console. Just pick them up and snuggle them. Give them a binky, a bottle, a change or a cuddle and they'll settle right down. We feel extremely fortunate about this! I think you'd have to drive us all to the funny farm if one or both were colicky.

But we are trying to not get into the habit of having them sleep ON us too much. They usually do a bit though as they fall asleep so much while we're feeding them, but we do try to swaddle them and put them in their crib or pack-n-play for sleep time between feedings. I know at night they'd sleep longer stretches if I just held them, but trying to break them both of that habit later doesn't sound like much fun, and holding one was easier and I think safer than trying to sleep holding two. Maybe if we had a king size bed we could just cosleep, but we definitely can't in our queen bed and they're kind of hard to sleep near. We have an Armsreach co-sleeper in our room at the foot of the bed, but they're NOISY sleepers! We sit there waking up at each grunt, mumble and squeak they make, anticipating them waking and fussing every moment. Not really conducive to a sound sleep.

Oh, and I keep forgetting. I actually am taking two last grad classes this summer to finish up my degree. They're online classes, so I thought I could manage it as long as I get maternity leave from work especially. Well, they meet Tuesday and Wednesday evenings, and I've been having a hard time remembering and attending them! I thought we'd gotten enough into a routine that surely this week I could make it to both classes. Well, I DID make it to Wednesday's, even though that meant I had only 2 hours of sleep during the day. (Tom let me sleep after though from about 9-1am thank goodness!) See, I stayed up to work on homework for that class and so didn't sleep before it. Lovely.

But Tuesday's class? Totally slept right through it. While sleep is awesome, it was so annoying to have missed it again! I just feel like an idiot emailing my instructor again to say I missed class. But I suppose I need to suck it up and just do it. The good thing is I can watch the taped version of the class, but it's not the same as attending. I watched the last 3 weeks that I'd missed, and actually found myself trying to participate at least once. That really doesn't work when you're watching a taped version after the fact though.

Gah, This makes three times during writing this post that Gabi has fussed. She's in her crib with Lily, but fussing and wants her binky. What she really wants is to be held though, so I better get on it. She might also be getting hungry as her last feeding started at 1:10am, but then she did fall asleep and only ate the last part of her bottle at like 3! One feeding just runs into the next at night it seems like.

Well, this time doesn't last forever right?

Oh, and note to self...talk about the lactation consultant luncheon I went to on Tuesday. Next post, Promise.

Saturday, June 12, 2010

Title Shmitle- At least it's a post. Hey, I can't remember everything

We're getting better at this I think. Well, maybe.

It was a rough week though. Last weekend, Saturday, we had to put Sampson down. He was 11 years old and while we'd removed the cancer from his chest, the non-cancerous growth on his leg started growing, and then last week we found a huge new mass on his side. Saturday though was the day we really started seeing him in pain, and Tom took him to the vet. The vet confirmed that his spleen was enlarged. While it is sad to let him go, by far the hardest part was telling Nicky.

Saturday night, Nicky woke up and vomited twice. We thought perhaps it was due to coughing as his asthma had been acting up a bit. But when he projectile vomited all over the backseat as Tom was taking him to the movies on Sunday, well we knew it was something else. Poor thing! His outing to the movie How to Train Your Dragon had to be put off, and he was horribly sick all night Sunday night. Tom stayed in his room with him and I took care of the twins. Monday he was on just fluids, and feeling much better. Tuesday he was back to school and 100%. Hopefully he and Tom can try the movie trip again tomorrow with better results.

We've settled into a workable routine this past week or so. It's not ideal, and not sustainable once one of us returns to work, but for now we're surviving. Basically from Midnight to about 9am I'm on deck with the twins. It works better now to have them sleep in the nursery at this time and I typically feed them in there now during the night. We had them sleeping in our room in a cosleeper for a while and I fed them there, but really neither Tom nor I slept very well with them in there as we wake at every little grunt and squeak. And with two, there is a lot of squeaking going on!

During the night I try to get a shower in at least every other night between feedings some time, and then try to nap between a feeding or two for an hour or two. I usually am not very successful in the napping though. By about 9am I'm ready to keel over and so Tom gets up and takes over. I try to sleep for a good 8 hours then and wake up in time for dinner. Once I'm up, we share the feedings up till about midnight-ish when Tom goes to bed for his 8 hours. So, not the best solution, but it's working for now.

We've had my mom and now Tom's mom here since bringing the girls home, so that gives us some help with the daytime feedings especially. When it's one person feeding it takes a good hour or more, but with two it can be done in 30-45 minutes usually. So that helps. Also, Donna is taking Nicky to and from school this week, and that helps a lot too. We'll see how well this works once it's just us.

Twice this week were particularly rough though. Wednesday we had the girls' first pediatric appointment at 11am, so that meant I didn't really get my full sleep in there. And then we had an 8:30am appointment Friday morning which meant my daytime sleep was off again. But right now we don't really leave the house too often, so this shouldn't happen too much.

Their pediatrician was thrilled with the girls by the way. They've been home since June 1st and in 8 days Lily gained 13oz and Gabi gained 12oz! That puts Lily at 6lb 15oz and Gabi up to 7lb 3oz. We knew they were gaining, and they are up to about 3oz a feeding now, but we were thrilled to see the results on the scale.

The pediatrician was also fine with the toenail painting idea. She said to go ahead and use remover to take it off Lily, and then pick two colors and just do their big toes. So we'll do that soon. She wasn't worried about using any particular kind of polish, so I might just check my stash to see what I have. Or if I do get out of the house maybe I'll pick up a bottle for each of them. We'll see.

Speaking of stores, we found out that the girls were fine to start on regular formula too. We'd been having them on the Neosure stuff, which has extra calories, since the NICU. But with their good gains they can be on the regular stuff now. That works out nicely because our Friday appointment was to get the kids and I on WIC. On the way home we used one of the coupons for formula and that worked out great! It was actually quite easy to do for the formula, although it looks a little more complicated for Nicky and I, so we'll conquer that later. That puts the girls on regular Goodstart formula, although we're still using the liquid, not the powder because of the risk of E. Sakazakii.

At the grocery store the girls were quite the hit. We received many congratulations and complements on them. And everyone kept their distance which was nice. The pediatrician had warned us to keep them as isolated as possible till after their 2 month vaccinations, so it was good to take them during such and off-peak time to the store. Not many people shopping at 11am on a Friday in the summer here. Go figure.

I think that about catches us up to date. I do have a few new photos for you too of course. Ok, I'm going to try to do these chronologically:

All ready to go home from the NICU. (Gabi is in the orange carrier.)
Going Home

At the OB office on discharge day. This is the guy who got us all through this! (Lily is on the left.)
With the OB- We did it!

Nicky has been a wonderful big brother! Here he is with Gabi and I.
Big brother

Once we got them home there were a lot of snuggles going on. (Lily is on the left here.)
Lot of snuggles going on

What Momma does when they're both hungry at once (Lily has the green bottle):
Momma's solution to two hungry at once

Lily's first at-home bath:
Lily's first bath

Gabi's first at-home bath:
Gabi's first bath

Oh and one more thing. I was able to weigh myself finally today with all the swelling finally gone. Last time I weighed was right before having the babies, and then on June 1st after having them. Both weights were the same! What I lost in babies, I gained in water. But now the water is finally gone, and I lost 35.5 lbs of water! Only 23.5lb to go to get back to my pre-pregnancy weight (which recall I'd just lost 40lbs). Not really stressing about following any diet right now, because honestly it's all I can do to remember to eat something most of the time. When I get the babies down after a feeding and my choices are sleep or eat, well, sleep wins most of the time. But once we're all established and have the income coming back in I'll get back on WW and lose it all and more!

Thursday, June 03, 2010

If you're wondering

If you're wondering why I haven't answered your call/voicemail/email...

This is why:

Exhausted but happy

Yeah, that's at about 3 in the afternoon or so yesterday. In the same shirt I'd been wearing two days. I think I did manage a shower and a change of clothes after that though.

So if you're waiting on a return call or email, well hang in there. I'm trying to do the same.

Just a quickie update

I owe you photos I know, but I wanted to let you know we're home. The girls gained really well the night I had them in the room. Lily is up to her birth weight of 6lb 2oz and Gabi is one oz up from her birth weight at 6lb 7oz. They were discharged Tuesday around 12:30 and then we headed up for my follow up OB visit. I think I have a great picture of my OB with the girls, but it's still on the camera. Will get to that when I can.

Oh, and the NICU nurse painted Lily's toenails a pale pink. I wasn't very happy about that I admit. It will make it easier to keep track of who is who, BUT I really wanted to check on that with the pediatrician first. Their little nails are so porous and there are all sorts of chemicals in there. But what can I do now? I certainly don't want to take nail polish remover to them!

So back to the real world I come. Well, sort of. I'm still on maternity leave of course, so don't have to worry about work. But back to my house, my family, my bills (ugh), and grad school.

I've missed two weeks of classes now, but I'm starting to feel like we're getting our legs under us at this point and I should be able to get back in the swing of things for next week.

Of course, my mom has been here though, and she'll be leaving this weekend sometime. We'll see how we handle running this ship on our own for sure then! She's done a great job keeping us fed and running the routine household chores as well as helping watch Nicky and help with the girls too. I'm so grateful for her help!

Well, it's already 1:40am and the next feeding will be between 2:30 and 3:30, so I better try to grab an hour or so while I can. I plan to do this feeding so that Tom can function at getting Nicky to school and stuff tomorrow.

The girls are already 2 weeks old! Time flies.