6 Weeks and 26 Months
That’s how old my kids are (kids!! multiple!! that is so … awesome!). Asher and Boston are six weeks old today and better yet they are both home! Asher came home at 4 weeks 2 days old and Boston and 5 weeks 1 day old. They were in the NICU so much longer than I expected! The progress is soooo excruciatingly slow and then bam! It is like the baby wakes up one day and “gets” it – starts eating, waking up more, looking around with cognition in his eyes. Last friday they had a ped appt. (2nd for Asher and 1st for Boston) and they were 7lbs 7 oz and 7lbs 3oz respectively.
The neonatologists in the NICU are really geared to think the worse (and obviously they do see much sicker babies than my guys) and I left the NICU stressed and freaked out. The one doctor was literally not going to let Asher go home unless I promised to fortify my breastmilk with Neosure and NOT to nurse more than twice a day. Now, I’m going to sound like a bad lactivist here, but they honestly aren’t anti-breastfeeding. This hospital is big on bfing and kangaroo care. They even supplemented the boys with donor milk while my supply got up to par which many local hospitals do not do. Their lactation consultant was excellent! We have issues with Boston’s latch and just general preemie problems and she was helpful and supportive. However, life in the NICU after getting past they “they can’t breathe and might die” phase is all about the “get extra calories in and make sure they all go to growth” phase. What this means is any time spent struggling (to breathe, to nurse, to keep their temperature up) uses up calories that they can’t use to grow. In the womb, where they should still be, they would be able to dedicate all their calories to growth because they don’t have the stresses of the extra-uterine environment.
As a commentor mentioned in my previous post it has been proven that breastfeeding is LESS stressful than bottle feeding for preemies. The doctors also agreed with this. The problem is that the last hurdle to go home from the NICU is to eat orally and while breastfeeding is not more stressful it doesn’t “count” toward total cc’s ingested. So what would happen is this: breastfeed for 15-20 minutes then offer the bottle for 15-20 minutes – a whole feed shouldn’t take longer than 30 minutes because then they are expending too much energy. Just the fact of being awake that long means the preemie tires and needs the rest of their feed through the NG tube. As a mother wishing to breastfeed there are two ways you can go with this:
- Insist on breast only. The babies will probably need to get larger/more mature before they can efficiently take the breast and the bottle and not need the NG tube. Even longer to be totally on the breast. And, your breast has to be in the NICU which means you have to weigh other responsibilities like having a toddler at home.
- Assume that home with mom is the best place to learn breastfeeding and get the babies home ASAP. Play the NICU game and work on the bottle in order to get rid of the NG tube and go home.
I went with #2. I feel very confident that both boys will both be fully on the breast before long but the best place to learn that is at home near me 24/7. So far this has proven to be true as their nursing has been 100 times better since coming home. I’m not saying the way I choose was the right or even the best way but from talking to other women it seems to be a classic conundrum of the NICU nursing mom.
That long story was to get to this point – my neonatologist was convinced (because by then she knew I was a lactivist) that I was going to go home and nurse non-stop at every feed and every time the babies cued (which I have) and not supplement (which I did at first) they would exhaust themselves, lose weight, and be back in the hospital. I said what she needed to hear but it didn’t “feel” right to my mama instincts. That doesn’t mean I wasn’t stressed about it. She also didn’t want me to take the baby anywhere. We brought Asher home first and she didn’t want me to bring him back when I visited Boston because I would be exposing him (Asher) to germs. Once again just not really they way I parent. But, maybe preemies need to be parented differently[1. This is my experience with my preemies. It might be true that another preemie DOES need to be parented differently so please don’t take my circumstances as the gospel. Get a pediatrician you trust and work together on a plan.]?
My appointment with Dr. Lavin[2. I’ve written before about my disagreement with Dr. Lavin regarding vaccines but that he is a wonderful doctor for listening respectfully to parents.] really helped me get a bigger perspective on my preemies. First off, they are huge in preemie
terms. An average singleton born at 32 weeks weighs 3.75lbs[3. Source: http://www.babycenter.com/average-fetal-length-weight-chart] and twins even smaller. My boys were 5lbs each at birth (32 weeks 6 days gestation). Secondly they had only the mildest respiratory distress. Asher needed only CPAP and Boston needed less than 12 hours of mechanical ventilation. Since preemies are compared to other children based on their due dates (called “gestational age correction”) instead of on their birth date (chronological age) my boys are in the normal range for size with 8 days to go till their due date. Dr. Lavin does not feel they are at any increased risk than any other newborn – plus since they received antibiotics for my GBS+ status they actually have a reduced risk for GBS infection (which is one of the main reasons doctors tell you to always to call if a newborn has a fever under 3 months old). They had synagis – the RSV immunoglobulin – but Dr. Lavin didn’t feel they fit the criteria as high risk for that at all. He said to parent however feels instinctual to me (see, told you he was a great doc!) and as long as their weight keeps increasing that I didn’t need to fortify my breastmilk with formula.
Ah, stress release!
They are doing wonderful and eating like champs. I don’t have to wake them for feeds they are awake and cueing! they are mostly getting bottles of expressed breastmilk as they both work on getting better at nursing. Boston is still using a nipple shield but I feel confident they will get it as they mature. I have a little insight into formula feeding and yuck! I mean all the bottle washing and getting up at night! I much more like the “remember to have your boobs on your chest” thing with breastfeeding and can’t wait to get to that point. It is hard enough to pack a diaper bag for 2 infants and a toddler without having to worry about food.
Aellyn is wonderful with the babies. People ask how hard it is to have twins and honestly it isn’t that hard – time consuming because you have to do everything twice but not any harder. What is hard is dealing with a toddler when your hands are full of babies. It really tests your resolve to be a gentle parent. It is frustrating when she pushes boundaries and I’m really using my skills in validating her desires and not falling into a conditional reward/punishment cycle. I swear I almost did a “time out” the other day because I was frustrated and tired. Having a strong philosophical foundation in WHY I want to be a gentle, non-conditional parent and a tool box of ideas for alternatives is going to be invaluable! Lots of fodder for future blog posts!
Speaking of future blog posts – this month has National Infertility Awareness Week in it and several blog carnivals I hope to participate in. I’m excited to get back to blogging for enjoyment instead of rushed updates to my hospital ridden life! I really want to start talking about homeschooling more and expanding on gentle discipline. I’m also hoping to find my way as an IF blogger with kids. Is it possible? Stay tuned!
Oh, and TODAY is also my 5th blogiversary! Five years! What a ride. I really want to revamp my “about me” page and some other new things but I just haven’t got to them yet. Here’s to 5 more years of blogging friends and family.
A Decade Plus 2 – AKA 12 Years
Oh, and on April 1 (yes, April Fool’s Day) I celebrated 12 years of marriage to my best friend. Here’s to the next decade as parents together. I love you Petue13.