Breast feeding in All it’s Glory
I imagined myself breastfeeding until my twins were a year old. I daydreamed of them suckling and how nice it would be to bond and have special time with them. I would choose to breastfeed until they were a year old. I would lose all my baby weight and then some because breast feeding trims you down. I would go back to work eventually, but I could still pump. This was going to be wonderful.
I researched nursing bras and decided to get the more expensive ones once my milk came in and I knew what size I would actually be. I purchased some ‘night time nursing’ type bras that were very stretchy with not much support. They would do for a few weeks.
Breast feeding twins was harder than I thought.
In the hospital, with so much help, it was still hard. A lactation consultant came in and worked with me and the babies for 45 minutes straight. A usual consultation would have been 10 minutes. I was happy to have the expertise there. The girls had problems latching on. I was told to pump after every feeding to increase my milk supply. Pump until you’re dry. The first few pumpings were just 1 milliliter or so: precious few drops that add up to a small measurement. I thought over a few days that the measurement would increase.
I nursed then pumped every last little drop of what my mother called “liquid gold” every two hours, round the clock. Surely, it wouldn’t be more than a few more days before my milk came in. Then I wouldn’t have to pump all the time. I could just nurse and that would be the end of it. The pump wasn’t going to be an every day thing: only if we were out and about and it wasn’t convenient to nurse. If I needed to increase my supply after that, I could pump after feeding again.
And forget about modesty and privacy when breastfeeding twins. There are the constant interruptions of nurses and aides checking on you or the babies. There are visitors coming and going. My father-in-law was thankfully no where to be found during each breast feeding attempt. Usually, by the time I had a successful latch for both babies, more than three people besides me had touched, grabbed, or maneuvered my boobs. No wonder I usually fell asleep while the girls were nursing.
Once, two of my best girlfriends from dispatch came by just after I had gotten both girls to latch. I was bare-chested as they knocked and entered. Both were married, but neither had had a baby yet. I think they were a little embarrassed by the situation, but I waved them in anyway and apologized for my nakedness. They visited for a while and just as they were leaving, my grandmother stopped by. She too, attempted to leave after seeing the goings on but was welcomed in.
Another small issue while breastfeeding is that babies fall asleep. My girls needed almost constant stimulation of a head rub or a foot tapping to keep awake and sucking. I was so exhausted that sometimes I didn’t notice that one or both had fallen asleep. One of the grandmas would usually notice the sleeper and initiate a head rub to wake them up. Most people say, “Don’t wake a sleeping baby.” But every twin mom I’ve ever talked to says, “When one wakes up to eat, wake the other one up too.” It kept us on track well for months.
It is hard to measure the amount of nursed breastmilk so I didn’t know how much they were actually getting. I’m glad I supplemented with formula because it made me feel like they were getting the nutrition they needed. By the time we went home, our girls were nursing every 3 hours for 10-30 minutes at a time. After nursing, they each took about 2 ounces of formula.
Once we got home, the babies were still having trouble latching on and they were getting more and more used to plastic nipples. The lactation consultant suggested trying nipple shields and gave me a pair to try. A nipple shield is a thin, plastic, fake nipple that you put on your breast so the baby can suck on plastic while still nursing from you. During the feeding, once the child is sucking well, you take the nipple shield away so they nurse directly from the breast. The idea is to eventually wean off of nipple shields completely. They are supposed to be an aid to get the mom and baby used to the act of nursing. I thought these little devices were genius. I thought they would work. They worked okay, but it was still hard to get the babies positioned while holding the nipple shield on.
Maybe I would only breastfeed until they were six months old. As soon as I get the hang of it and it starts going well, maybe I’ll say a year again. But I want to accomplish a goal. So I’ll make it easier on myself and just say six months.
In the early days, I had the help of new grandmas and aunties to bring me hungry babies and help position bed pillows. All I had to do was sit down and be topless. When family had to resume their normal lives, Ryan and I tried to work it out. But, the struggle of logistics was too great in the end. I tried to do it myself several times. I really did. I read books of how other women set up everything to breastfeed their twins without needing help. Maybe I have short arms. Maybe I wasn’t flexible enough to have one baby attached and reach for the other one. I tried tandem on the bed. I tried tandem on the couch. I tried in the extra wide $600 La-Z-Boy rocker recliner that we purchased for the purpose of tandem breastfeeding of twins. I tried sitting on the floor leaning against the couch. I tried to arrange my own pillows. I tried the EZ2 Nurse Twins pillow – the blow up travel one and the full size foam one. I tried. I really did. But, for me, it just didn’t work to nurse them at the same time. I resigned myself to try to breastfeed the girls separately. And I thought it took forever to breast feed them in tandem and then pump. Nursing them separately and then pumping took so much longer. Was this really worth it?
You hear rumors that the pump doesn’t get as much breast milk out of you as the baby would. Could be true. So, I tried to get the girls to latch on every once in a while. Sometimes I tried the nipple shields just to see if we’d have better success. But they were so used to sucking on the bottle that they actually caused me physical pain. My toes curled. Tears welled up in my eyes. I had to think of happy places with nice beaches and sunshine and sand. I had to take slow deep breaths. This hurt. I mean really, really hurt. I had pains shooting up my boobs like my nipples were being sucked off. I pulled the culprit baby off to check for blood and the continued existence of my nipple: no blood and nipple still attached. I decided that the pump was going to be the way I breastfed my girls. Other moms did it, and I could too.
Well, my milk never came in. I never once felt “let down.” I never had issues with leaking and embarrassment. I was on the phone with the lactation consultant every other day. I tried the herbs to increase supply: pills and teas and maple syrup flavored substances. They didn’t help. I tried the herbs to increase quality, but no matter how small a dose I took, it gave the babies bad gas. I tried “Power Pumping” which is basically a heat pack, massage combo that supposedly helps your body know to produce more milk. I was told to try this once per day. I didn’t notice much change, so I tried three times a day for a few days: a small improvement. So, I tried it with every pumping for a week. Not many more milliliters than I was already getting.
I cried. I cried hard. I was a horrible mother because I couldn’t feed my babies. They weren’t starving to death: I was giving them formula. But breast milk is best. Breast milk is liquid gold. Breast milk fed babies would be senators, doctors and lawyers. Formula fed babies would be bums on the street. Sigh. I knew I was over-reacting but it’s hard to think normally when your post partum hormones are raging and everyone and everything says you’re a bad mother if you don’t breastfeed.
I called the lactation consultant. She was just as upset as I was. I had tried so hard and she knew it. “Run to Reglan,” she said. I knew we were at a last resort to try to breastfeed.
I called my OB to get a prescription for Reglan, a galactagogue, meaning medicine that supposedly increases breast milk supply. It has several other uses, which kind of baffled me. It also helps with heartburn, and slow digestion. But I thought, “It’s gotta work!”
This prescription came with some heavy warnings of side effects, like post partum depression and mood swings. I had been feeling fine. I decided it was worth the risk. I took it exactly as prescribed. The lactation consultant said that if I was going to see an improvement in my supply, I would notice it by the 36 hour mark. On day three, I still was taking the pills and didn’t notice a change. I was upset, but thought it could still work.
I did notice one change on day three of taking the miracle medicine. While making a peanut butter and jam sandwich for myself before I went to pump (again!), I got too much jam on the sandwich. Now, a normal person would scrape the excess off and continue on their merry little way. I cried. Big, crocodile, sobbing tears. Couldn’t keep my chin from quivering and my body from shrugging tears. There’s too much jam! It’s just ruined! A flash of unclouded insight: I was showing severe symptoms. I needed to stop taking the medicine.
I quickly calmed down. At least I knew I was acting crazy instead of having someone have to point it out. Just then, my husband came down the stairs and into the kitchen. I couldn’t let him see how crazy I’d actually become from this stuff. He was so worried about post partum depression anyway. I pulled the glasses off my face (who has time to put contacts in?) and wiped the smudges of salty tears away on my shirt. I don’t think he ever knew. But I did mention that I started feeling some symptoms, so I decided to stop taking the pills. He was glad. Boy, oh boy! He had no idea how glad!
Wait a minute! Aren’t I supposed to be losing weight like crazy? The scale wasn’t telling that tale. Maybe it just took a little longer. I’ll keep pumping.
To get right down to the nitty gritty without drawing it out, I dreaded that pump. It was my enemy. I wasn’t making enough anyway, but I was making some. Some is better than none, so I kept at it. I felt chained to it. Every three hours. It was horrible. Feeding babies with formula in bottles every three hours was enough. Then I couldn’t go to sleep yet because I had to stay awake and pump. Then I had to either put the milk in freezer bags and label it, or I had to put it in the refrigerator for use later. It was a never ending cycle. Pump, label, freeze. Pump, label, freeze. Avalanche of little frozen packets of breast milk falling on my toe said to my tired brain that it was time to take a load of packets down to the deep freezer.
Some moms got up before their twins needed to eat and pumped. Then they didn’t have to warm the milk slowly in warm running water while their babies were screaming. I tried that. But I couldn’t predict when the babies would eat. They weren’t on a stable enough schedule yet.
By about a month old, I was pumping about two ounces of breast milk from each breast every 3 hours. The babies were eating that much. The babies were growing. The babies would soon be eating more than I could produce. Is this worth it? I could keep up the pumping sessions and just feed them the breastmilk I had and supplement with formula. That was initially the whole idea anyway. Formula would be a supplement, not their whole food source. But it was so much easier to just make two bottles on demand instead of waiting patiently for breastmilk to warm.
Many times while Ryan was at work, I would feed the babies formula from bottles, get them settled and sleeping, and then set up to pump. I’d be hooked up, ready to go, just starting to see some squirts of that liquid gold and I’d hear the ear piercing screams of one or the other. At first, I would jump right up and see what was the problem: running to them with my naked boobs jiggling and wet with milk. What a sight I must have been! Nothing was ever wrong. They just knew that I was incapacitated at the moment, I guess. Later, I’d wait for a few minutes to see if they would calm down a little bit. Not a chance! I’d be mad and unhook, wipe the wet off, slowly put the partially filled bottles on the table next to me and go see what the problem was. This got quite annoying and I didn’t like to be annoyed at my precious babies.
Breastfeeding is hard. How can I make it easier on myself? I never became engorged, and the every three hours thing was not helping increase my supply. I would just try every four or so hours. This lasted a week. It was still a stressor. How about every 6 hours? I’ll get a lot more sleep if I only pump every six hours. My supply seemed to be dwindling a little. I was a little sad about it, but figured the less milk I had, the less frequently I’d have to pump, label, and freeze. I’d have more time with the babies. Maybe I could make a quick dinner instead of eating frozen meals all the time. And aren’t I supposed to be losing a bunch of weight? Hmm.
Every six hours was nice. I’ll just pump when I feel the need. I wouldn’t be tethered to that machine so much. That’s only four times a day. Now I feel better. Maybe I’d breastfeed until they were three months old. That’s a good goal. Three months will do the trick. I only have two months left. Two long months.
I had gallbladder surgery when the babies were six weeks old and I loved the ‘pump and dump for 24 hours’ suggested by the surgeon in case the medicine I was given affected the babies. With a smile on my face, I gladly poured the pumped ‘contaminated’ breast milk down the drain. It was then I realized how much I hated pumping. Maybe it was time to stop. I still hadn’t reached my two month goal. I tried for a few more weeks, but my outlook on pumping didn’t improve.
I never lost weight by breastfeeding. Never. I guess if I had tried a better diet or taking the girls out in the stroller. I had concerns about taking premature babies for nature walks in the middle of the heat waves of summer. Oh well.
I decided, after great consideration and several days contemplating, that it was time to stop pumping.
The decision to stop pumping, to stop breastfeeding, was one of the most agonizing and difficult decisions I’ve had to make. The “breast milk is best” idea is lovingly shoved down pregnant women’s throats their entire pregnancy. I wanted to breastfeed. I wanted to give my babies the best. I had the idea that formulas were good, but you just couldn’t beat breast milk. And, honestly, you can’t. It is nature’s perfect food. But formulas are pretty darned great too. You just have to accept that fact.
Common tips for breastfeeding: eat a lot, drink a lot, sleep a lot. Likely causes for my struggle with the task: not eating enough early on, not drinking enough water early on, and not being able to rest. Stress of entertaining the in-laws and no sleep and nosy neighbors and too many visitors I’m sure added to the struggle. I also read that more women who have cesarean section deliveries struggle than women who deliver vaginally. Would I change my mind and have a vaginal birth if I could go back? I think about it sometimes, but I’d rather have control over my bowels and bladder than solely breastfed babies. (Many women complain about southern region control issues after pushing out a baby.)
Sometimes I think I should have tried harder to breastfeed until they were three months, six months, or a year old. I remember all my troubles: the stress of low supply, the exhaustion, the herbs and the medicine. I did try, damn it! I did! And I’m proud that I did.
I don’t want to scare pregnant women away from breastfeeding. Some women really do well. I was a first time mom. Out of twenty of the twin moms I chatted and message boarded with, maybe two never wanted to breastfeed in the first place. That leaves 18 who tried and most of them also had the one year goal. By six months old, maybe three of 18 were still breastfeeding. Again, this information is not meant to scare anyone away. I just want the reality of how hard it is to really hit home. It’s more of an issue for first time mothers, I’ve decided. None of us wanted to give up. All of us had misgivings about quitting. But it just wasn’t working. We all came to the decision that some breast milk was better than none, and our babies needed mommies who were happy. And that was that.
Most Embarrassing Breastfeeding Story
Everyone has one. Thank goodness mine happened in the privacy of my own home.
It was time to pump, but I was tired. I decided to lie down anyway. Maybe I’ll wake up in a few hours when my boobs ache and pump then. Ryan was getting ready for bed. He hopped into bed and I scooted towards him to snuggle. We chatted about this and that, not concerned with time, just happy to have a few kid-free moments.
After several minutes of talking, we both felt a “woosh” near our abdomens. Mid-sentence, he asked, “What was that?” I really didn’t know. We lift up the bed sheets to discover a little pool of my breast milk on his chest and a nice little wet puddle on our bed.
“Eww! Go pump,” he said. So much for a nice moment.
Abra Cadabra. Boobs, be done!
So, I don’t want to breastfeed anymore. I just stop and it goes away, right? Not so fast! I read up on the internet for different ways to stop. Some women just stop nursing and it goes away. Not the case with me. Aching boobs aren’t fun! Days go by. Still the milk flows.
So, I’ll stop milking until I’m dry. I’ll just time my pumpings and only go for five minutes. That will slow me up for sure. I tried that for a few days. The milk fountains, although weaker, are still there.
How about I just pump for relief? Lots of women do that and it works. For me, that was about every ten hours or so. Ever so slowly, I noticed the milk dry up. I would still get what I called “milk knots” that were painful. They felt like little marbles in my breasts. I would push on them and milk would come out. It felt so much better to get some relief.
For maybe another 6 weeks or so after I didn’t have to squeeze for relief, I still noticed little drips of milk at my nipples. It was kind of annoying. I wondered if I had made the right decision. If my boobs had this much trouble drying up, maybe I was supposed to continue breastfeeding.
Who was I kidding? I was done a long, long time ago. I was done mentally. The physical just had to catch up. I made the right decision. And I really don’t regret it. As soon as I made that tough decision, I was a better mom since I had time to be with my babies. As the weeks passed, I realized that I should have quit a long time before I actually did. Everyone noticed a change in my attitude and stress level.
Every woman struggles to make that choice to stop. If you’re struggling as much as I did, you need to stop. You need to stop for the health of your marriage, the health of your body and the health of your mind. You really will feel so much better. You’ll question yourself months down the road. I still do every once in a while. But, then I remember how hard it was. Breastfeeding is hard.
The Boob Sucker Machine
I did all the research. I asked other twin moms. “You want a double electric!” “Don’t waste your time with a single sided pump.” “Definitely don’t waste your time with a foot pedal type pump.” It was unanimous. And what brand is the best? Medela was the unanimous choice. It was also the most expensive one on the market. I didn’t want to, nor did I have the money, to buy a $300 machine for my boobs plus some extra accessories.
I did research some other brands with the double electric feature. I also asked other moms who owned these brands. They seemed satisfied but wished they had better sucking power.
A friend from work sold me her Medela Pump In Style Double Electric for $150. It had just been serviced. I was thrilled that I got the top of the line, even if it was used.
I bought it from my friend when I was maybe 28 weeks pregnant. So, I had plenty of time to take it out of the box and figure out how to use it. I never did.
The first few times I pumped at home, my mom put it together for me. I was too tired, or distracted with other things to see what she had done. I was sure I could figure it out on my own.
So, I used this “fantastic” pump for weeks. I don’t know if it’s the age of the machine, or just the grade of the machine, but I really didn’t like it. Maybe I was pickier than all the other twin moms that loved it. It was considered to be the best pump you can buy on the market at the time.
I tried a hospital grade pump and it was night and day difference. It was so much quicker. It cut my pumping time down from 25-30 minutes to 12-15 minutes. When sleep is at a premium, it’s really hard to make yourself go pump for 30 minutes. Many times, Ryan would come looking for me and I had fallen asleep while still attached and being milked.
I made some calls about renting a hospital grade pump. But by the time I realized I should be using the “Big Mama” of pumps, my mind was done. Maybe, if I had started with the easy pump, it would have been different. Oh well. I couldn’t have tried any harder than I did.
Summation on breastfeeding: even with all the crap I went through, I am still glad I did it.
Bottle Feeding
We started bottle feeding in the hospital. It was meant to be a supplement to breastmilk but turned out a little differently than originally anticipated. The hospital supplied Enfamil Ready-To-Feed bottles and Enfamil disposable nipples: two ounces of room temperature liquid in a plastic container with a separate screw top nipple. Babies didn’t need warmed meals but with the beginnings of little tummy problems, we didn’t want anything too cold which could cause more problems. There were markings on the side in milliliters. We were to track when the start of the meal was and how many milliliters each baby took.
The hospital nurses referred to the formula as “E20.” No one explained the meaning of this moniker. The “E” was for Enfamil. And the “20” was for the number of calories per ounce of formula. Babies born severely premature would receive things like “E24” to boost their weight quicker. Knowing a little more about this formula would come in handy later.
Not knowing much about formula or breastfeeding, I never prepared for the worst and bought formula for home. I would probably only use bottles for breast milk. Ha! In my dreams. So the hospital supplied us with a day’s worth of the ready to feed Enfamil with a few nipples. My mom went to a wholesale store and bought us their brand of infant formula. Surely, they would be fine on off brand powder. Well, they weren’t.
One thing to point out: it is recommended that premature infants not use powder formula or liquid concentrate formula until they reach their 40 week due date, and sometimes beyond. There is a potential for infections because powdered formula is not sterile. Ask your pediatrician. I didn’t know this until I was well under way for using powdered formula. We never had issues with the bacteria side of things, but we did have issues with the switch.
I can whole-heartedly say, once your baby has tried a formula and is used to it, don’t switch. My girls were on Enfamil for the three days in the hospital and we switched to store brand powder when we got home. Now, some pediatricians, including mine, say it’s normal for infants to not poop every day or even every other day. My girls didn’t poop for a whole week once we got home and switched formulas. They acted constipated and uncomfortable along with all the reflux problems. I called the pediatrician. Switch back to the formula they were used to was the advice I got.
I had my sister run to the store and buy some Enfamil “E20” powder. I never paid much attention to the names of formulas as I perused the baby aisles. I figured that there would be a can of Enfamil that said on it somewhere “E20.” My sister returned from the store with a few cans of Enfamil Lipil. She had asked a store clerk for help but the clerk had never heard of “E20.” My advice on this topic: maybe just ask a few more questions and educate yourself a bit more than I did. Chuckle, chuckle.
Switching back to our little friend “E20” helped. It did. But the reflux problems got worse so it seemed to not make a difference.
At our two month appointment, I asked the pediatrician what formula she would recommend. “Nestle Good Start because it breaks down easier.” Okay, then let’s switch. Why didn’t I ask this sooner? Why didn’t I ask her at the hospital what was recommended instead of just using what was shoved at me? I didn’t think I needed to be that picky. I had no idea.
I still don’t know that if I had voiced a formula brand preference at the hospital, if they would have had that brand, or if they would have allowed me to buy it and bring it in myself. Ask plenty of questions. These are just things you don’t think about until it’s too late. Some things aren’t so important. This wouldn’t have been an issue if my kids didn’t suffer from reflux.
A note about nipple flow: the Enfamil nipples that we were given at the hospital were considered slow flow. But with the reflux, NICU nurse Grandma said to try Preemie flow: a slower, slow flow. It seemed much easier on the babies to have a super slow flow. It also made them work harder for the milk which was good for their sucking reflex. With slower flow nipples building their skills, they should suckle better at the breast. Not necessarily.
By age 2 months, we were ready for regular slow flow. We tried it a few times before, but both girls had streams of formula from the sides of their mouths. We knew the flow was too fast, so we bagged the idea for a week or so and tried again later. Feedings started to go a little quicker with the flow a little faster. Then the girls would need another ounce during each feed and the feeding time got longer. We tried the fast flow a few times, but they weren’t ready for that until about six months old.
How do you bottle feed two infants? The one-after-the-other thing didn’t work well for me. Time is short enough to get things done; I don’t need redundancy where I could have things streamlined. So, how do I feed two infants at once? Well, I start with a couch. Not a loveseat, a big 3 cushion couch. Here’s the finished product picture: I sit on the middle cushion, with a baby on each side. Their heads are towards the edge of the couch and feet are touching the back of the couch. (This becomes more difficult to do as they grow longer. I started to lay them on the floor and sit between them with my back leaning on the couch when this set up became too much of a falling off the couch hazard.) So, the babies’ heads are lying on a burp cloth (to save the couch from too much spill or spit and a second purpose is so I can more easily turn their heads one way or another). Bottles are propped to the outside of our little trio, or resting toward the inside of the trio on my thigh. I have a fresh burp cloth for each child, a blanket for each in case it’s chilly, or I need to prop bottles to answer the phone, etc.
One note on bottle propping - Of course, pediatricians and ‘good’ parents alike would never, ever prop bottles. Not many of them have had twins either. My rule was, prop a bottle as long as I’m right there with them. Absolutely no “quick go get this” or “run and grab that” while the bottles are propped. I admit, I did run the diapers to the garbage can in the kitchen a few times, but the babies were still in my sight and I went right back to them. Under no circumstances would I go upstairs to do anything, or think I could just check back on them in ten or fifteen minutes to see if they were done and ready for burping. Leave the dishes. Leave the laundry. The mail will still be in the mailbox. It will all be there waiting when you’re done. Attend to the babies. What’s another twenty minutes of waiting to get your stuff done?
I have at the ready: two burp cloths, two more burp cloths, two blankets, my phone, the tv remote, a drink for me, the bottles, two diapers, the wipes, and the babies. Of course, I change both babies’ on the couch first. Then I turn them to assume the position – one on the left outside cushion, one on the right outside cushion. I put heads toward the edge of the couch and put a burp cloth under each baby’s head. I grab the bottles in my hands and make sure everything is within reach. I sit down on the middle cushion between the babies. I liked the babies pulled in close to my thighs Commence bottle to mouth. When you feel it’s time, start the burping. Pull the bottle from A’s mouth, set it on the couch, have the burp cloth positioned on you and ready to go. Pick up the baby and burp. Then lay the baby back down and continue feeding. Repeat the process with B.
When everyone is fed, burped, and settled, I move each baby back to their own cushion so I can get off the couch without squishing kids, or them rolling into the middle. We can then move to a swing or bouncer chair easily.
The Joys of Acid Reflux
It started in the hospital. My mother in law was burping “Baby A” after a feeding when she started to gag and choke. The baby had a panicked look on her face and she was reaching her thin little arms out as if to say, “Help me!”
The on call pediatrician came in later and we described the event. It was quickly diagnosed as acid reflux. Oh, great. They take after me. Sigh. An oral medication was prescribed. It was Prevacid, an antacid to be taken once a day before a meal.
I was unsure of how to properly give an infant medication so I asked the post partum nurse to show me the first time. Most of the liquid squirted out of the syringe all over her little face. I asked if we could get another dose and just give her most, not all, of that one. Hospital policy prevented that because of the potential for overdosing: no one had any idea how much medicine she had actually ingested. I was mad to say the least. I wasn’t mad at the nurse, just mad that my child wouldn’t get her full dose for the day. I didn’t want any more of those scary choking episodes on my watch! But I had to wait for the next day to dose her again.
The on call pediatrician was advised of the squirting issue and said he’d give us a prescription for dissolvable oral pills called Prevacid SoluTabs. Great! Sounds much easier. The hospital didn’t carry that small of a dose for the tablets so we were back to oral squirting. The second dose went better, but some of the liquid escaped again. I was even madder. We’ll just get home and get her the dose she needs from the tablets.
In the hospital, I was making calls to my human resources department to notify my insurance that the babies were born. I needed to know they were insured. It was reported to me that they were covered. And since we had MedicAid as a secondary “insurance,” I wouldn’t have to pay a cent. Or so I thought.
I sent Ryan to the pharmacy. He came back with wide eyes. Since it was so quick to need a prescription for Baby A, neither insurance company would cover it. The insurance didn’t have the necessary information like date of birth, social security number, etc. Oh my hell, they barely had names. They weren’t even a week old. So just over $70 out of pocket for that first bottle of medicine. Surely, someone would reimburse us. Never happened.
Giving Adelyn the SoluTabs wasn’t as easy as I thought. A preemie baby’s mouth is quite small. Heck, a newborn’s mouth is quite small. Our task was to break a tablet the size of a pencil eraser in half and then hold that teeny, tiny piece in the baby’s mouth until it dissolved. That dang pill never dissolved. I wondered if my kids were born spitless. We called the pediatricians office and were instructed to crush it up, add some water to help it dissolve, and feed it through a dropper.
One half of a teeny pill requires superhuman strength to be crushed between two spoons. Who knew? So much crushed medicine ended up on my fingers, the counter top, stuck to the back of the spoons. I wasn’t sure the baby was getting much more of the dose than at the hospital. The dropper method wasn’t working well either. We had to tilt the liquid back into the rubber end while transporting it over to her. Then we tilted back and saw a nice little trail of small bits of crushed medicine the full length of the dropper. The baby wasn’t getting the right dose.
I called my mom upset. She suggested instead of a dropper, try to put the medicine in a bottle nipple and have the baby suck it out. That was a great idea. We tried that. I still noticed a few granules of medicine in the end of the nipple, but it was much less leftover than the other methods.
A few days after getting home, Chloe started showing symptoms of reflux. Great, just what we needed. We started dosing her as well and would notify the pediatrician at their 1 week old appointment.
At the appointment, we told of our struggles with medicine. An oral suspension was prescribed. Instead of granules, it was a powder in liquid that you shake, draw up the dose, and give in the bottle nipple. Maybe this was the answer we were looking for.
And the suspension worked. But they were still spitty. Really spitty. They ate, then burped. We held the burp cloth under their little mouth and waited for the eruption. Like Old Faithful, it came. Sometimes a few teaspoons, sometimes a few tablespoons. Sometimes they would spit up what seemed like an entire meal. We went through onesie outfits and burp cloths more than diapers.
I called the pediatrician. A second antacid was prescribed called Axid. It was also a suspension medication. It would be easy to give. Great. Finally I would feel like they were keeping it all down. I spoke too soon.
We tried breast milk only, they spit. We tried formula only, they still spit. After spit up came screaming from the burning acid in the esophagus. We tried holding them upright for thirty minutes after meals (except at night when Mommy and Daddy would pass out after they were done burping) and they still spit. I was worried that they weren’t getting any nutrition at all. They were peeing and pooping enough, so they had to be getting enough to eat. If they kept more down, would they not need to eat so frequently? I was exhausted. I was tired of giving my new little babies medicine. It would only get worse.
By ___ weeks old, I had called the pediatrician enough describing symptoms that it was decided to put my little babies on a third medication. It was Reglan. Wait a minute. I was on that and it made me crazy. But it was also prescribed to help speed up digestion. Maybe this would help. The plan was to stay on the morning medicine and stay on the night medicine and add Reglan in during the day: three times a day and thrity minutes before meals.
I didn’t realize it at the time, but “thirty minutes before a meal” meant I had to stay on a strict schedule. I needed to predict when my babies would be hungry. Sigh. This was going to be a lot of work. But it was doable.
There was one major problem with three doses of medicine daily that had to be administered thirty minutes before meals. When anyone else would come to feed babies, they were admiring them. For Ryan and I, feeding time was structured and strict. Feeding time means keeping them awake and sucking. We didn’t “ah” and “ooh” over the girls. There was time for that later. We didn’t take the bottle away when they fell asleep. We wiggled and jiggled until they were sucking again. We had to keep the babies on the same schedule. They had to be given medicine at the same time. I could keep track of something three times a day. I couldn’t keep track of something three times a day at different times and who ate last and who was going to eat at what time and did she get her medicine yet? There was no way.
Reflux Tips
With the bad reflux problems my girls had, we tried to keep them mostly upright for thirty minutes after each feeding during the day. Night time feeds, we just left it up to fate. If one or both spit up a little or a lot, we would rather deal with it, than try to stay up with them for the extra time. Sometimes they spit up even after 30 minutes upright. Sometimes two hours would pass and still a big spit up. We did what we could.
I started out changing diapers after the feeding. At the hospital, we fed them, burped them, and then changed them. When my girls became so spitty after feedings, we decided (at NICU grandma’s prompting) to change diapers before they ate. A good suggestion considering all the leg movement and tummy squishing that occurs when you change a diaper. So we’ve changed diapers, then fed babies ever since. It’s worked out nice. Then we can’t blame the spit up on jostling babies around after feeds.
When spit up continued to be a major problem, I tried some other things. One tested method was putting the crib mattress at an angle. This didn’t work out so well. The angle was fine. I used phone books to achieve the appropriate slant. But I would wake up in the middle of the night and see four chubby little legs poking out of the side of the crib. The babies had wiggled down the slope enough that
The Importance of Schedule
A few visitors weren’t guided in the ways of strict twin feedings and babies inevitably got off schedule. Then I was asked if so and so was due for medicine. “How the hell am I supposed to know” was my curt reply. I couldn’t be sweet and nice, because I didn’t have time. I had structured their feedings according to my needs. The less brain power needed the better. If someone else wanted to take responsibility for keeping track, by all means go ahead. But if everyone was depending on me to remember these things, we had to do it my way.
If it was my husband’s visitors or family that was the culprit, I made him in charge of being the feeding time monitor. If it was my family, I was in charge. Everyone took direction very well, once they understood why. For generations, people believed you shouldn’t wake a sleeping baby. When you have multiples, you must wake a sleeping baby so they stay up with the rest of the bunch. If not, you would be feeding babies all the time.
1 ½ to 2 hrs
Nursing pillows, Boppys, Bed Pillows
Early days with meds – am, 3x 30min before, pm
Spitting up
