More on feeding my boys

(I may just really be tired, but I can't help but read that title as "Moron feeding my boys" which makes me feel like I'm the moron... Oh dear...)

Thanks to everyone for their comments on my last post.  There were so many well thought out, thought provoking responses.  I thought about just replying to each comment, but I know as a commenter, I rarely check back and I thought it might be better to respond in a new post.

And, that way, I'd actually manage a new post, too!  So, hey, bonus!

(Before I get to that, I just thought I'd mention something about my commenting habits lately.  I tend to read and comment on my phone while pumping or holding a baby.  So, my commenting has been minimized quite a bit.  And, I tend to only comment immediately on posts that either can have just a quick response (i.e. "yay for your BFP!" or "wow, your co-worker is a dumbass") or posts that seem to require an immediate response.  If your post resonates with me or if I want to take my time to comment, I tend to mark it as unread to come back to later when I have the time and mental focus.  And, sometimes later never comes!  So, if I'm not commenting on your blog lately, that may mean that I REALLY REALLY want to say something very important and, therefore, am saying nothing at all.  It's a little convoluted but that's my excuse and I'm sorry about it!!!)

Anywho...

First off, thanks to all of you who pointed out how tough it is to exclusively pump and how well I'm doing with it.  I do feel like I'm accomplishing something by doing this and do feel like I'm doing a good job at it.  Right now, it feels like something important I need to do. At some point, when it starts to feel overwhelming and like I'm taking time and energy away from my boys then I know it will be time to stop.

Guinevere  was the first to point out the usefulness of keeping my pump parts in the fridge in between pumping sessions.  A great idea.  And, one that I'd heard someone say before and then TOTALLY forgot about.  And, besides the lessened need to wash so often, do you know how nice refrigerated pump parts feel on sore boobs in the middle of the summer?!  It's like putting your bra in the freezer!

She also discussed the possibility of donated breastmilk.  Not something that we will likely pursue, but an excellent option.  It reminds me of something, though, that I forgot to mention before. Late into our stay at the RMH, I had two tubs of frozen milk in the breastmilk freezer and many of the other mothers put a bottle or two a night in the freezer before taking them into the NICU the next day (it made it pretty evident that we were there for the long haul while most NICU babies were in the hospital for a week or two at most).  Anyway, one day we watched a young mother bring one of the RMH workers over to the freezer and point at the milk and say something.  My DH then ran into the mother who later asked if we'd taken any milk into the hospital with the wrong name.  No, we hadn't.  It seemed like someone had accidentally taken some of her milk.  Or so we thought.  But, it happened again a day or two later.  Someone was stealing her milk.  First off, as the mother, can you imagine?!  How horrible to have a baby in the NICU and know the only thing you're able to do is give her your breastmilk and have it taken.  Second, who in her right mind would take someone else's milk to give to her child when you have NO IDEA the medical status of that woman (for instance, the mother in question was a smoker).  I guess if you knew your own status was likely worse or if you weren't producing enough or (and this is the worst possibility) you didn't feel like pumping but wanted to take advantage of the free food at the hospital for nursing mothers.  I don't know.  Regardless, we quickly moved my "stash" to a friend's mother's freezer after that.

Lastly, Guinevere pointed out that I can't really blame myself for transferring two embryos when costs really inhibit SET with no insurance coverage.  Lack of insurance coverage for IF is one of my big pet peeves, so yeah, I get that.  Especially since, hey, I am definitely evidence that not helping pay for SET IVF will very likely cost you as an insurance company in the long run.  They have paid far more for our NICU stay than they would have for two years worth of monthly transfers.  Of course, in the end, while my employer still may have had to deal with the increased costs due to our NICU stay, we changed insurance companies in between IVF and birth.  So, one got off scott free and one got screwed...

little miss olive also dealt with exclusive pumping with her little girl and says she wishes she had cut herself some slack in the "must always pump" department.  I definitely get that and am trying to...  I really am!!

KC pointed out how jealous she feels of other twin mothers who were able to stay pregnant longer.  Oh, I totally get that!!  Every time someone mentions "my full term twins" or "oh, yeah, I understand, I only went to 36 weeks with my twins" or "oh, I was so big with my twins" I feel the greenest streak of jealousy.  So far every test has said that it is unlikely that my boys will have any major issues from being 8 1/2 weeks premature.  But, lots of things won't show up, yet, and I do fear that there will be secret developmental or behavioral issues lurking down the way.  It's hard to let go.  On the plus side, Missouri has an incredible program called "First Steps" where they work with parents of children under the age of 3 (i.e. before they get into special ed programs in school) who have or are more likely to have developmental issues due to low birthweight, genetic problems, etc.  They send a team of evaluators and occupational and physical therapists to your home to work with you and your child to give them the best start.  It may be as simple as having someone say "nope, your boys are fine" or "they need a little help -- here's what you can do at home."  S automatically qualifies because he was under 1500 grams at birth.  D was 1510 g, though, so he isn't an automatic qualifier.  But, he will likely qualify since he was on oxygen for so long.  You pay on a sliding scale and most people won't have to pay at all.

Dawn talked about tandem feeding being necessary but how sometimes it made her feel guilty because she couldn't hold her boys as much on their own and the double mommy guilt that comes from twins in general. Alex mentioned possibly feeding and pumping all at once to help save time.  First, yeah, mommy guilt is definitely out there!  And, double the babies, double the guilt.  Definitely.  Even feeding them one at a time, I feel guilty not being able to hold them afterward if I have to rush to the other one.

The biggest issue right now, though, is one I didn't mention before -- we can't really feed them simultaneously unless there are two of us around.  There are a few reasons -- the first is that we still have to watch them carefully to make sure that they don't have apnea events during their meals.  They are both MUCH better than before but haven't entirely grown out of their SSB issues.  We have to watch their color carefully and hold them in a side lying position at an angle with our hands on their backs feeling their breaths so we can pace them if we need to.  When they're sleepy or particularly hungry (and sucking really hard) they tend to stall out occasionally.  I'd say there's been a dramatic improvement in the last week or so, but we're still vigilant.  So, for now, we still have to have a one-to-one baby to parent ratio.

The other reason we have to feed them one-on-one is that D is dealing with some pretty severe reflux/gas.  About 3 out of 5 feedings involve him screaming bloody murder about halfway through the meal, arching his back and turning bright red in the face.  Sometimes he absolutely refuses the bottle altogether and won't eat even if he's obviously starving.  Sometimes he projectile vomits half of his meal.  He has to be paced very slowly through the feeding because when he goes quickly he has to burp more and burping brings up acid and makes him scream in pain again.  The gas and acid tend to "attack" again about an hour or two after the meal, too.  He's not a happy baby.  There is very little that will comfort him.  It hurts so much to watch him.  We're working with our doctor on altering my diet, working through some potential homeopathic meds and some anti-reflux anti-gas meds.  The zantac seems to finally be kicking in (I think we had to wait until his esophagus healed a bit after he'd started taking it) and he seems to be doing better.  But, we still have issues getting him through a meal.

Unfortunately, one of the other things that can be exacerbating the gas is caffeine -- they're still both on caffeine and apnea monitors.  The caffeine is weird in that the NICU doctor has them "growing out of" their dose -- rather than reducing the amount we give them, the amount stays the same but the dose per kilogram of body weight gets smaller as they get bigger.  It's taking FOREVER to work their way out of it.

(Side note -- that was true when I started this post about a week ago...  As of today, they're officially off the caffeine!!  Our pediatrician let us reduce the amount slightly and they've been growing quickly so last night was their last dose.  Now we have to keep them on the monitors for two more weeks as it leaves their systems so we can make sure they don't have any episodes.  I cannot wait to get rid of the monitors.  They give a degree of reassurance, but they are the biggest pain in the neck to carry around and have started to give more false alarms as the boys get bigger.)

pex pointed out a new policy in Massachusetts to eliminate free formula packs in all hospitals.  I read that Rhode Island did the same recently, too.  Other hospitals have done so voluntarily.  It's weird, my mind goes in multiple ways with this.  Yes, obviously the formula companies are entirely doing it for marketing.  They aren't really altruistic.  And, maybe there is a correlation between "sticking it out" breastfeeding and not having the free formula.  But, seriously, if your milk isn't coming in or you can't breastfeed for whatever reason (or, if you just don't plan to), let us come up with one more way to make mothers feel guilty, shall we?  As usual, I'm of the "live and let live" camp.  It infuriates me when someone tries to force their beliefs on someone else.  Education is what we need so that people can make their own decisions.  I'm of two minds with the ban -- yes, it does look like the hospital is endorsing the formula -- but I'm also very much against the idea that helping women have an alternative if they need it is SO wrong that we need to march against it!

someday-soon pointed out that I shouldn't obsess over our freezer milk supply to the point where we have tons left after the boys don't want it anymore.  But, what would I do if tiny baby bunnies showed up on my doorstep and needed milk like they did on yours?!  :)  (I seriously just love this story.)

Anonymous had an interesting point -- breastmilk composition changes over time to adapt to your growing babies' needs.  Maybe using our early frozen milk isn't really the best plan.  All the milk we have frozen is from when the boys were near to full term.  Still, not something I'd thought about before (although I knew about composition changes) and something to think about.  I would like to know more about what exactly of the composition changes over time -- is it ratios of fat, protein, etc.?  Is it antibodies?  I think as long as it isn't their entire food supply it's probably fine.  But, something new to obsess about and I always like to have something to obsess about... :)  (On the plus side, I don't think we've had to go into the stash for about two weeks.  Go, boobs, go!)

Finally, thanks to all for saying how cute and big our boys are!  I must say, I'm getting kind of tired of people asking how much they weigh now and then saying "oh, our baby/my nephew/some random kid was bigger than that when they were born!" or "I've never even seen a baby that small" and am very glad they're starting to get bigger than average newborns.  I think people really don't understand the concept of "adjusted age."  Babies who are born prematurely don't just suddenly become "normal sized."  But, people are also often shocked to hear how big they are.  Do they think they'll just stay 3 lbs their whole lives?  Eh, it's a carryover from the "you're so small for carrying twins!" routine.  (Although, I must say I have liked the "OMG, you sure don't look like you have 3 month old twins!!" comments... oak's pumparexia is a real thing.)

Speaking of growing babies:

This is D on May 19 in the NICU, the day after we brought him home (June 13, I think) and about two weeks ago.  He's closing in on 9 pounds!

Here's S as he grows, too.  He's just over 8 pounds, now.  It's really amazing to see how much they are looking like normal babies.

I could keep writing or editing but I'm going to hit publish, now.  Otherwise this will take forever...

Experts agree...

Hey folks! Wow, it's been two and a half weeks, huh? The craziest part about that? It's been more than TWO weeks and I would have SWORN up and down that I just wrote my last post two or three days ago. I have no idea where the time has gone. Everyday I look up and suddenly it's 9 o'clock at night!

First off, to update my last post, every baby meal lately I start singing "Dr. Brown you've got a lovely bottle...lovely bottle!" a la Herman's Hermits. It's possible that I know far too many songs and that my mind responds way too easily to suggestion. Wouldn't it be nice if I could re-designate the memory slots in my brain that are being used for song lyrics and melodies for something more useful?

Things are going well. We're exhausted but happy (my DH is whining about it a bit too much -- what did he expect?). Most of our time right now seems dedicated to feeding the boys or thinking about feeding the boys. They're eating about every 3-4 hours during the day and, on a few glorious nights, every 5 hours at night. Each meal takes about an hour or so to feed them back to back. We occasionally feed them simultaneously but that doesn't usually bode well for nighttime when only one of us is "on" and one baby just HAS to wait his turn.

So, after about an hour of feeding two babies, it's generally time for me to pump. (Unfortunately that means that even when they sleep 5 hours I get about 3 hours of sleep max...but, hey, 3 hours!) I'm pumping for around 30 minutes at a time about 6-8 times a day. Pumping for twins feels like a full time job. I use a hospital grade double pump which works well but can sometimes be painful and my boobs can feel it. I've tried lots of options to make it easier -- changing breastshields, lanolin, speed, suction, amount of time, time in between, etc. -- some help, some don't.

I sometimes feel like I'm pumping to punish myself or to alleviate my guilt. No matter what I tell myself, I can't quite stop feeling guilty that they were so early. If we hadn't transferred two embryos, the remaining twin probably wouldn't have come as early (although the thought of not having either one of them hurts my soul), if I had pushed to be on bed rest earlier, if I had gone to the hospital earlier, if, if, if, if. While I can't say there's any one thing I did that made me go into premature labor, I can say that the combination of being 37, having IVF, having twins, etc. all contributed and those were all things I chose to do. I did everything I could to counteract those issues, but the fact remains that my boys wouldn't have been in the position they were if I hadn't put them there.

I think, also, that I'm determined not to "punish" either one of them for being a twin. I feel like, if there had only been one, then directly breastfeeding would have been more successful -- likely he would have come later and fed immediately and I would be able to focus on him individually and breastfeed whenever he needed it. So, I feel like I want to get as much breastmilk into them as possible.

Right now, I can nearly keep up with them, depending on the day. I generally get about 32-43 ounces out a day. Which is really quite a bit. If I had a singleton, my freezer would be FULL. But, right now they're eating around 42 ounces altogether, so that doesn't really quite cut it... We're supplementing about 4 ounces of formula per baby split up over their nighttime feedings. And, sometimes we go into my dwindling freezer stash from when they were in the NICU. I have a profound sense of failure every time we have to go into the stash. On the days when I have an excess, I feel like I've accomplished something.

(I will say that the special "bonus" of pumping is that it is about 3-4 hours a day where I can't do much of anything but sit still and relax. It's when I check blogs or watch junk TV or read magazines or play games on my iPad. It's my special treat.)

I guess it all has to do with changing the image I had of myself as a mother. I always thought of myself as a babywearing, breastfeeding, cloth diapering, baby food making type of mom. But, preemie twins have changed who I thought I'd be as a mother. I know that I COULD potentially still do all of that but I'm feeling pretty good right now if I manage to interact with each baby individually each day in the middle of all the rest of it. So, I'm doing the best that I can and, if I have to punish my boobs and spend hours a day hooked to a machine, that's what I'll do.

I hate that this sounds so negative. When I'm pumping, I try to think positive thoughts about how I'm continuing to do the best I can for my boys. Please don't think I mean anything negative about formula -- I truly don't. We'll be relying on it more and more as the babies grow. I thank G-d that there's such a thing out there. The most important thing is that our children eat and grow. That is all that matters.

I do find formula companies interesting, though. The breastmilk collection bottles and NICU info packets we used in the NICU were branded by Similac. The breastpumping log books provided in the NICU were branded by Similac. All with "breast is best" information alongside the "oh, and just in case..." And, infant formula must be the only product I can think of (other than, say, cigarettes) that essentially has warning labels telling you that you'd be better off if you didn't use it. The Enfamil newborn formula that we got from the hospital and are using right now has "Experts agree breastfeeding is best" in a box on the side like a tobacco warning! While, yes, that's true, what a bizarre thing to have to put on your product. All the literature that comes with the free formula the companies give out discuss breastfeeding first and then finally slide formula feeding in at the end. You get the feeling that the formula companies realize that the only way people will support their product is if they actively campaign against themselves.

Can you imagine other products labeled this way?

Tropicana orange juice: Warning, experts agree that growing your own oranges and juicing them daily is best. But, if you can't, Tropicana is OK.

It's the "please, use our product but if you feel like a failure every time you open a container we'll understand" method of marketing!

Anyway, this ended up a lot more meandering than I meant it to! I'm impressed I even wrote anything cohesive given the current state of my brain. (Um, that assumes it was cohesive...) I have NO desire to get into a "breast vs bottle" type of debate here. I am FIRMLY of the "do what you need to do to make sure your children are fed and happy and it is no one else's business" camp. I'm just doing what works best for me and my family.

And, hey, my kids are growing big and strong! We have a well baby visit tomorrow (poor kids will be getting shots, I believe), so we don't have "official" weights, yet, but our measurement at home last week has D at 8 pounds and S at nearly 7 1/2 pounds! Yes, to those with full term-ers that may seem small, but it's HUGE to us. They're starting to get little fat rolls and it makes me so incredibly happy to see. We're nearly 12 weeks old and 3 weeks adjusted age and they're doing incredibly well.

See?




That's D in yellow and S in stripes. Love.

Please get these songs out of my head!!

The following songs have been stuck in my head due to baby products for weeks:

"One Week" by Barenaked Ladies -- because we live and die by the "itzbeen" timer. And, every time I say "it's been" (as in "honey, check the itzbeen"), it immediately is followed in my head by "...one week since you looked at me..." etc. The worst part of this is that the damn song was stuck in my head for the month or so prior to the babies' birth for reasons I've yet to figure out. I'd be walking along and "chickity China the Chinese chicken" would just pop into my brain and then the rest would come. I honestly can't even remember the last time I actually heard the song! This wouldn't be so annoying accept for a) when a song gets into my head it tends to fester there in an anxiety-ridden way that often keeps me from sleeping and b) BNL remind me of my ex-boyfriend who was OBSESSED with the band in an "I discovered them before they were cool" and "it's the 90s and I'll cover their songs at 'gigs' at coffee shops and bars while wearing my cool grunge flannel" kind of way. And, that's just annoying.

(As an aside -- the "itzbeen" is a wonderful thing. It has four "count up" timers that you can quickly reset to help you remember who last ate when, whose diaper was changed when, who got meds when, etc. We originally thought we'd want two for the two babies but one has been enough right now. We use one timer for each kid for meals and I use one to keep track of when I last pumped. You can set an alarm to go off when it's been (...one week since you... damnit) too long in between "events." We keep track of everything on paper, too, (because we're obsessive that way and it helps us communicate between us) but this is great especially when you're brain dead at night.)

"Sweet Child O' Mine" by Guns N' Roses -- because we have lots of onesies and washcloths, etc. from Walmart's Carter's "Child of Mine" line. So, any time I change a baby's shirt or hang a washcloth on the line to dry I start hearing "oh, oh, oh, oh sweet child o' mi-i-i-ne" and am forced to start snaking back and forth in place like I'm Axl Rose when, in reality, I look more like Slash with my hair all poofy 'cause I haven't used any "product" in about 9 weeks.

(Another aside -- did you know that "onesie" is actually a trademarked name for Gerber products? Other onesie-like shirts are "bodysuits" or "creepers." Who knew? So, I'm lying in the paragraph above -- I don't have ANY Child of Mine "onesies"...)

"Oh, where do we go now?"

I don't know, check the itzbeen (one week since you...)

Oy.