About Carolyn - Twintrospectives

Carolyn is the full time working, volunteering, keeping active, Canadian mom of 3 year old twin boys and a 5 year old boy. Carolyn was introduced to the world of parenting in a rush, with the sudden arrival of her 31 weeker firstborn. Two years later, her twin boys thought they’d show up their older brother and showed their little faces at 27 weeks and in just as much of a hurry as their big brother! In just shy of two years Carolyn experienced the NICU twice for three little ones. The biggest lesson she took away from their NICU experiences was a lesson in patience. Carolyn learned to slow down, breathe and focus on the things that mattered; her little boys, her husband, her family. Although her twins experienced many hurdles while working their way through the NICU and she took them to close to two hundred appointments in that first year, Carolyn took time to reach out to the “preemie” community, which spans the globe. The unusual experience of having preemies and multiples has opened up all kinds of unique opportunities Carolyn never knew existed until she started her family. Carolyn has joined organizations promoting premature birth awareness, multiple-births awareness, chairs Multiple Births Canada’s Preterm Birth Support Network, writes a monthly newsletter for the Network, blogs and guest blogs, all in the name of NICU, preterm birth and multiple birth awareness. You can check out her blog at Twintrospectives.

Twinfant Tuesday: Multiple Infants with Multiple Needs

Getting ready for a day of appointments.

The topic of Twinfant Tuesday came up and I wondered to myself and to Sadia, did I have a good experience during the infancy stage and do I have something to contribute? At first thought, I had serious doubts. My memories recall close to four months in a NICU, living away from home, the discharge and then the madness of appointments that awaited us, all the while working hard to balance the needs of my older child. My husband was at work Monday to Friday, working very long days due to unfortunate timing and he and I together were trying to figure out how to navigate as parents of 3, two and under, with particularly special needs.

We made it to some special events.

During the infant stage I was busy running my twin boys to appointments in town and out of town, navigating the hospital parking lots, calculating the best and quickest routes to my destinations, and breastfeeding in empty seminar rooms and in the back row of my minivan. I did whatever it took to keep these little infants well. It felt exhausting and unrelenting. These memories are my initial thoughts when I think about their infancy.

But when I think about these things and the other things that are too many to mention which made up the early week s and months of my twins’ first year, I realize that we had somewhat of a unique experience. An amazing experience actually. The healthcare they required and the follow ups that came with it enabled me to get to know these babies cues, health needs and personalities in a way I can’t explain. It’s as though I developed a sixth sense of proactivity when it came to their unspoken needs. That’s what I’m going to call it. I learned that really and truly, I was their expert. They couldn’t articulate their needs, but I knew how to sense them and articulate for them. I knew them best. Doctors knew about healthcare and the typical needs of babies like them, but I came to realize I know them best and if I had a gut feeling about something it was going to be accurate. Don’t get me wrong; I do appreciate every single thing our doctors and specialists have done for us along the way, but I recognize that we worked as a team and I really was my babies’ voice.

Putting some occupational therapy concepts to work.

So when I look back on my twins’ infant stage, I realize that it really was enjoyable. I did many things with them every day, maybe in atypical ways, but I breastfed them like I wanted to and made some fun and unique memories with them along the way. I look forward to sharing their stories with them one day.

On the road again.

Toddler Thursday: When Your Toddlers Aren’t Toddling Together

We’ve all heard the common question, “How do you do it?” That is how we got our name. Another common phrase I have heard over the years, as many parents of prematurely born twins do is, “They’ll catch up on their own time.” I hate to say it, but sometimes this phrase is like a Band-Aid trying to cover up a bigger “owie” than it can. Sometimes it’s the only thing people can think to say to try to make the mother feel better, when she is wondering if there is a bigger problem to be addressed.

Take my little guys, for example. Growing and progressing a little more slowly than the average baby, but also born much earlier than the average baby. We always take their early arrivals into account. We don’t want to overshoot and stress them out during their development, yet, as a mother I don’t want to undershoot their capabilities by overprotecting or making excuses for them. I believe mothers of premature children may be a little more likely to overprotect their children at times, and that’s okay. Everyone has been through a lot! I also believe there is a balance and it can take a bit of time and self-reflection to understand your parenting style.

My twins are about to turn 4 and when I think back to two years ago, I remember twin b was not yet toddling. Meanwhile his twin had started motoring around on his own. Twin b was able to walk everywhere on his knees, but not his feet. Alarm bells were going off in my head, but I tried to ignore them and give my son more time to figure it out. We shouldn’t compare our twins, as they are individuals and they often do learn things at different times. I kept watching him closely and mentioned it to a few people now and then. I often heard, “he’ll figure it out on his own time.” Hmmm…Are we sure about that?

After lots of watching him in silence, assessing and reassessing; working with him one-to-one to try to get him to walk, I finally trusted my instinct. Something was NOT right. As he approached 24 months corrected/27 months actual we looked at his feet closely. I knew he was able to walk if he had the right support for his feet. I had inspected his feet closely, compared them to his brothers (sometimes comparing twins IS helpful,) watched what he was doing when he tried to toddle and cruise along the couch. I put 2 and 2 together when I realized he could cruise without a worry, but as soon as he tried to stand in the middle of the floor or walk, he’d collapse. His teeny tiny feet just couldn’t keep him standing upright because his feet were very flat and one was practically turning over. We weren’t seeing it because we were trying to promote his walking by keeping him in supportive shoes most of the day, which was supported by his physiotherapist. Once I realized his feet were likely the problem, I contacted our PT and she said my instincts could be correct and he was seen later that week. She yanked off his little shoes, assessed his feet and confirmed that his feet would benefit from the use of orthotics. He was fitted with a custom pair of ankle-foot orthotics (AFOs).

The day we picked up his custom AFOs, the physiotherapist helped him put them on as the orthotist watched. First we had to dig through a box of extra shoes at the centre to fit the larger sized AFOs. Once the AFOs and shoes were on, twin b was set in the middle of the floor…and…HE STOOD…and then…HE WALKED! ALONE. It was amazing to see unfold. One moment he’s a non-walker, the next he’s toddling around the assessment room on his own! I could not hold back my happy tears! They were also likely tears of relief, but I didn’t realize it at the time.

The moral of this story? Trust your instincts and if you feel something isn’t making sense or you’ve said and heard, “he’ll catch up on his own time,” maybe a few too many times, it’s okay to put your foot down (pardon the pun) and ask LOTS of questions to get the answers you need.

Ask the Moms: How to Tandem Nurse

 has written about how to successfully tandem nurse before, but it’s been a few years. In this post, we share the current HDYDI Moms’ experience with tandem breastfeeding. We hope that this can give you some ideas and insight if you are embarking on the adventure of breastfeeding twins!

Skip to: Tandem Nursing Experiences | Pumping and Nursing Experiences | What Helped | What Hindered | Equipment | Support Personnel | Positions | Tandem Nursing in Public | Prematurity | Twin Nursing Ebook

nurseCanva

What is your experience with tandem nursing? How long did you nurse, and why did you stop?

Janna: I successfully tandem nursed my twin boys starting at 3 weeks old. The lactation consultant told me that we were not ready for tandem nursing. Lucky for us, my mom was at the appointment with me and she thought the advice was crazy. My help was going home when the babies were four weeks old, so she defied the woman’s authority and suggested we just try tandem nursing as soon as I got home from that appointment. It was completely successful and with our set up, actually easier than nursing one at a time. From that point on, I nursed the boys at the same time every time.

RebeccaD: I tandem nursed in the hospital (healthy 38 weekers) but hit a glitch when I was re-hospitalized later in the week with a uterine lining infection. One baby stopped latching altogether. I spent a day in bed with him re-learning how to breastfeed. We were back to tandem feeding by about 10 days old. No lactation consultant was as valuable as my mom and mother-in-law constantly cheering me on, telling me I could do it, and supporting me as I figured out how. Their faith in me helped me trust my own instincts. I tandem-fed for most feedings until the boys were 9 months old; by then they were so efficient and so big and wiggly that back-to-back feedings were easier.

Mercedes: As a pregnant twin-mama-to-be, I envisioned myself breastfeeding with the support of a styrofoam-filled “Breast Friend” as I cradled the heads of my peaceful babes while they suckled and intermittently sought out each others hands. It didn’t work out that way. Uncomfortable and pretty much hating life, I soon decided that individually nursing my twins was much more reasonable, although it did take up all of my time. It was my number one (and two) priority, so I made it work. As the twins got older, tandem feeds actually became easier since they required less effort and orchestration on my part. Now that my nurslings are 15 months, it’s pretty much the only way we do it (unless it’s a nighttime feed), because the nursing jealousy is pretty rampant.

Sadia: I tried for 5 months, but was never able to use tandem feeding as my primary mode of breastfeeding. I really wanted to make it work, because I found myself breastfeeding 12+ hours a day while on maternity leave. I needed another adult (my husband) present to hold the first baby while I latched the second on and held her. With both my babies coming home at under 5 lbs and a month before their due date, they didn’t have the neck control to nurse without one adult hand supporting their body and another their head. No number of pillows seemed to raise them up high enough to not need manual support from a parent. When my husband deployed to Iraq, the babies were 5 months kid and there went my extra hands. Also, J went on nursing strike shortly after Daddy deployed, so I had to switch her to expressed breast milk (EBM) from a bottle. I didn’t even try tandem nursing for nighttime feeds; I didn’t trust myself not to doze off, especially since I was working full-time.

Dory: Whenever I have a second set of adult hands (my husband, my mom, or my mother-in-law), I like to tandem nurse. It is so much easier to get them both done at once (no leaking of the other breast or a crying, hungry, waiting baby) and faster (sometimes as quick as 30 minutes, as opposed to at least 1 hour if one-on-one feeding). Because my babies are 2 months old, I can’t speak to stopping tandem nursing, but I imagine that once they get really wiggly (and big), I won’t be able to keep it up anymore.

RachelG: I tandem-nursed until around 8 or 9 months, when my supply wasn’t really enough to satisfy either twin for long. I dealt with supply issues from the very beginning, despite help from lactation consultants, so we tandem-nursed, then supplemented with bottles of formula.

ldskatelyn: I tried tandem nursing in the beginning. I found it was a great thing to do during those nighttime feedings so that I could get back to sleep sooner (aka, get sleep), but I always needed help getting them set up to nurse, which meant waking up my husband. After realizing that my husband was a blessedly sound sleeper and didn’t handle lack of sleep as gracefully as I did (and who also had to work a full time job), I decided I would stick with feeding them one at a time so that I could do let at least one of us get sleep. I also came to love that one-on-one time with each of my girls, where I could just focus on one of them, even if it meant listening to the other cry for 10 minutes.

Tandem nursing dog pile.

Tandem nursing dog pile, featuring Mercedes and her duo.

What were your experiences with pumping and nursing?

Sadia: I tandem nursed one baby on one breast while pumping on the other pretty consistently. This worked great for me because tucking the flange into my bra left me two hands for the nursing baby and pumping gave me EBM for daycare feelings. I returned to work when the babies were 11 weeks old (4 weeks adjusted) and my output fell precipitously. Once J went on nursing strike, “tandem” nursing with the pump and M was my primary means of getting J her breast milk. I could pump so much more with a baby plus the pump than with the pump alone. I tried many, many pumps, and the Medela Pump-in-Style (with extra-wide flanges) was the best fit for me, but babies just fit me better.

Janna: After our morning tandem feed, I would put the boys in bouncy chairs and tell them stories while I used the double breast pump for about ten minutes. I occasionally pumped again after another feeding session if the boys were otherwise occupied and we knew we needed milk for an outing coming up, but mostly I just fed them at the same time in the brown recliner chair every two hours when they were hungry.

RebeccaD: I pumped when I was in the hospital without my boys (when they were 5-8 days old), and when I felt overly full for about the first month. I demand-fed, so there was no predictable schedule, which made direct breastfeeding much easier. What if I had just pumped and then they wanted to eat? It made more sense for me to cut out the middle man. I worried constantly about not having a big freezer stash, and having to be the one to do every single feeding was very taxing. But ultimately, direct feeding worked best for me and my little ones.

Mercedes: I used the pump only very occasionally in the first several months. Sometimes what I would do is start with the pump on both breasts and then get the babies latched on.

Dory: When I was in the hospital with Audrey and David, I needed to get my milk flowing, so I would pump for 5 minutes before nursing. I would then nurse them until they were finished. Then I would try to pump some more and give it to them in a syringe. Once we got home (4 days old), I would continue this pattern, but I wouldn’t let them nurse any longer than 20 minutes. If they nursed any longer, they would use more energy than they would get in calories. I would then supplement afterwards with whatever I had pumped beforehand. Once they passed their birth weight (after their 2 week checkup), I stopped pumping and supplementing. Now, I simply pump whenever I feel like they haven’t emptied me out completely. I have to say that, at 2 months old, they do a pretty good job, and we have our nursing sessions down to 10 minutes latched on! I really only pump every other day in order to build up a supply for when I go away during feedings.

RachelG: I never pumped while nursing. Both babies always ate at the same time, and for much of my nursing life, my pump was set up in a different room from the one I usually nursed in.

ldskatelyn: I never even thought about pumping on one breast while nursing on the other, mostly because my children were always fed back to back. I usually only pumped at night, right before I went to bed, since they were sleeping through the night (12 hours) and I would be engorged and sore by the morning if I didn’t. It also gave me breast milk to supplement their feedings with if they needed it, or to mix with their baby cereal.

What helped the most with tandem success?

Sadia: My husband’s support was key. Knowing that other MoMs, including a triplet mom in the family and a twin mom from my MoM club had done it before me was very inspiring. My husband had observed his triplet cousins breastfeeding when he was a pre-teen and had a surprising amount of breastfeeding experience to offer. I’m so glad that I researched a ton about breastfeeding multiples before giving birth. I was shocked to discover how many people around me just assumed that it couldn’t be done, particularly since I had a career outside the home. Fortunately, my boss was also a breastfeeding mother; her support made it easy to adjust my work environment to allow for pumping time and space.

twnnurs4Janna: My recliner/boppy set up next to an end table made nursing both boys at the same time so easy. I would sit down in the recliner and position the boppy around my stomach with the ends of the boppy situated up on the recliner arms. Then I would lean down and pick up the babies off the floor and put them in the “football hold” laying on the boppy pillow. Once I got them latched, I was hands free and could pick up the food, water, book, remote control, etc… on the end table next to me. I also had my laptop set up on the other side of me, so I could read blogs and email while nursing. My boys ate every two hours for at least thirty minutes, so being hands free and having other things to do really made it easier for me.

RebeccaD: The biggest factors in my success was the support of experienced nursing women in my life — other MoMs, my mother, and mother-in-law – and my husband. The women helped me to develop my nursing relationship with each of my boys, as well as persevere in tandem feeding. My mom stayed with us for 2 weeks after the boys were born, and my mother-in-law for 5 weeks. They would get up at night to help me get everyone in place for feedings. Then they would tell me stories about nursing their babies. It was so lovely. I felt like I was being admitted into a special, ancient circle of wisdom. My MoMs group had several nursing women, and we shared many emails in the wee hours! My husband showed his support by making nursing a priority, by bringing me food and water, and by showing me so much love as I figured it all out.

Mercedes: Time and confidence. Tandem feeds were not for us in the beginning. Over time they just started happening naturally.

Tandem nursing older twins

Tandem nursing older twins.

Dory: For me, I couldn’t have done it without my husband, mom, and mother-in-law. They are my biggest supporters and helpers during nursing. While I get into position in my chair with my pillows and burp cloths, they get the babies ready (taking off sleep sacks or waking them up enough to latch on). Then, while one baby is finishing up, they take the first-to-finish baby off of me to change and re-dress him/her. In addition, I had a very emotional time during the first few weeks in regards to nursing. I wanted to give up every single time I sat in that chair, but they were my cheerleaders (my husband especially), encouraging me to work through it. I’m so glad I did, too! Now, I love my nursing time!

RachelG: I had a fantastic postpartum nurse in the hospital who helped me figure out how to tandem nurse. She showed me how to position the babies on pillows, support their heads properly, and help them relatch when they took a break. I don’t think I could have figured out how to do it on my own without her help early on.

What were the biggest obstacles to tandem nursing?

Sadia: We faced a lot of challenges. For starters, my 33-week preemies spent 16 and 21 days in the NICU. I wasn’t allowed to try to breastfeed J even once the whole time my girls were hospitalized, so I had no opportunity to try it out until after J was home. I had a full time job to which I returned at 11 weeks postpartum, so I couldn’t breastfeed during the day on weekdays. The exhaustion of single parenting twins with a full-time job took its toll on my supply too. I had a very poor supply with the pump, despite taking fenugreek, pumping on a schedule, and having been able to produce enough milk for exclusive breastfeeding during maternity leave. Add to that my husband’s deployment to Iraq and J’s nursing strike, tandem nursing just wasn’t in the cards for us. My huge nipples didn’t help at all. I used standard size pump flanges the first few weeks, and they ripped my breasts to shreds.

Janna: If I hadn’t tandem nursed, I wouldn’t have been able to continue nursing my boys after my help left at four weeks. The nurses and lactation consultant in the hospital and a different lactation consultant we saw at an appointment at three weeks old ALL told us that I couldn’t even attempt tandem nursing until the boys were older, had an expert latch and I was an expert at single nursing. I am so grateful that I didn’t listen to this advice. Everyone should try tandem nursing whenever they want. If it doesn’t work, fine, then go back to single nursing, but if it does work (like it did for me) you can start tandem nursing right away and not have to figure out what to do with that second baby while you’re nursing the first!

RebeccaD: My own physical health was a big obstacle to tandem nursing. The stress of a long (38 week) twin pregnancy, followed by an emergency c-section, subsequent uterine lining infection, and abscess on my tailbone, made it difficult for me to sit up, let alone try to support tiny heads, etc. I did nurse individually side-lying for a while, but I wasn’t able to sleep that way. Tandem nursing turned out to be the best way for me to get rest and feel connected to my babies. Another obstacle was nursing agitation – an intensely uncomfortable feeling that can happen during tandem nursing. I got through it, mainly by distracting myself, and it greatly diminished over time.

Carolyn: I did tandem for a little while once we were home from the NICU. It never felt comfortable, no matter how I set myself up. It was a “me thing” and not an issue with either baby, my nursing pillows, or where I did it. It just wasn’t for me. I had a very easy time nursing, which is maybe why I chose to breastfeed my boys individually, to get it done as fast as possible and move on to the next thing or get back to sleep. (We were feeding every three hours in the early days). I did sacrifice more sleep than I would have liked to, but I got the job done and nursed for about 9ish months. We had EPM bottled, supplemented with higher calorie formula and nursed for the first several weeks in NICU until the babies were stabilized. Tandem feeding was not a negative experience for me, just not my preference.

recliningMercedes: Setting up my “station” and getting into position on my own, at the beginning was very challenging. The only position I found comfortable was a sort of double cradle while reclining position, and this was not sustainable for very long since my hands were not free to do anything else (like scratch a nose, answer the phone, etc.) Now the challenge is that they are so big they can physically overwhelm me at times! The easiest thing to do is just to lie down and let them have at it.

Dory: Early on in nursing (Weeks 1-4 or 5) I really hated feeling “stuck” in that chair. Once I got in, I couldn’t get up without someone getting the babies off of me (especially when I was recovering from giving birth). I wanted to give up every single time I had to sit down to nurse. I didn’t like being a prisoner of the chair and pumping. I felt like I just wasn’t making enough milk (even though in reality I was making more than enough). I felt like I couldn’t do it (emotionally or physically). I was just in a funk. Then, magically around 6 weeks, when my babies were at their fussiest, it was like a light turned on. I was what they wanted and how they stopped crying. Me! Yes, I was feeding much more often than my normal because of their neediness, but I could soothe my babies, and I loved that feeling. No one else could help them like I could. Everyone else could change diapers, hold, and cuddle, but only I could feed them with the nourishment they needed. It took them being at their fussiest for me to love tandem feeding! Now that they are starting to eat fewer times a day, I really truly enjoy our nursing sessions.

RachelG: I found it hard to figure out how to get both babies onto and off of my lap without help. Once I sat down in my chair and got everyone positioned there, we were stuck for hours until I found a way to dis-entangle the babies and get up again.

What equipment was helpful?

Sadia: My breast pump was my saving grace, an alternative to tandem nursing that kept me from going completely insane. I loved my chair with arms. Since my babies were so tiny, a narrow chair actually worked very well for us. Pillows helped relieve the fatigue on my arms, breastfeeding each baby, as I did, for 45 minutes each every 3 hours. I loved my magazine subscriptions. I read those issues of Time, Newsweek and National Geographic from cover to cover.

Janna: A chair with arms and a boppy pillow to support the boys was absolutely helpful. I needed something to do while nursing, so I didn’t go crazy with boredom. A towel tacked over the high window in the living room to cover it so that the workmen fixing the wall outside couldn’t see me nursing.

RebeccaD: The nursing pillow. The Twin Brestfriend wasn’t perfect, but I couldn’t have tandem nursed without it. If I had it to do over again, I would invest in a big recliner to nest in with the nursing pillow. As it was, I had a pretty good set up – armchair, then loveseat, and finally floor. The armchair + nursing pillow held the boys up high when they were really little. I had to have someone hand them to me once I got settled in. When I moved to the loveseat, I could place one baby in the Boppy, put the pillow on over my head, pick up one baby, sit down, then pick up the other baby and latch both on. Once they could crawl, I sat cross-legged on the floor with the nursing pillow, pulled them both on, and when they were done, they just rolled off and crawled away! I would have gone INSANE without distractions – books, iPad, phone. And I always had a little table with water and snacks nearby.

RachelG: I have a big armchair in my living room that I called, “The Chair of Doom,” while I was in the thick of nursing infants. I rarely left it. It was big enough and had enough support that I could juggle everything I needed to there. I had lots of pillows that I used  behind my back, under my nursing pillow, on the sides, etc., just to make everything the right height. I had a small tray table next to me with a bottle of water, remote controls, snacks, etc. Once I was home alone with my kids, I set up a changing table on one side. My changing table came from Ikea, and my mom cut the legs down a little so it was the same height as my chair. I could use it as a staging area for getting kids put onto or taken off of my lap for nursing.

Dory: There are a few pieces of equipment that I couldn’t live without. First, when I am on the couch, in bed, or in a low-armed chair, I have to use my Twin Z nursing pillow. I discussed it during my pregnancy, and it is just as wonderful as I expected. If you have a higher-armed chair, however, it may not work out well. For our armchair in the  nursery (which has very high arms), I use a My Brest Friend (for singletons- the twin version is too large for this chair) with a Boppy Cuddle pillow on top of it. I then place two burp cloths under the babies’ heads, and they latch on using the football hold.

What role did lactation consultants play? Your spouse? Other MoMs? Friends? Family?

Sadia: The NICU nurses were extremely supportive of my pumping and providing expressed milk to the babies, but were strongly against my trying to latch the babies on because of their prematurity. Lactation consultants were useless. Their attitude of amazement that I was even trying made me feel that they’d already decided that I was destined to fail (at breastfeeding, period, forget tandem nursing). The one exception was a consultant at a local breastfeeding supplies store who suggested a nipple shield to counter J’s strike. It didn’t help, but at least she tried to provide advice instead of telling me to give up. Other MoMs and my husband were far more helpful, although their support was more emotional than informational since their experience was with full-term babies. The only preemie mom I knew never had her milk come in, so I was alone in the preemie nursing boat.

Janna: I concur. Lactation consultants were useless. The ones I had just didn’t have any experience with moms successfully nursing twins. Instead it was my mother, mother-in-law and husband who were incredibly supportive, helpful and encouraging. Also, I had two close friends who were currently successfully nursing their singletons. While their advice and support weren’t necessarily specific to twins, they were invaluable with basic nursing questions. For example, NO ONE (not the pediatrician, lactation consultant, no one) had told me about growth spurts so I was almost ready to give up when my boys started crying and acting starving and demanding to eat extra at 6 weeks old. I assumed I wasn’t making enough milk. My friends emailed me back right away and told me it was the (normal, common) 6 week growth spurt and to just keep nursing them all the time & expect to be exhausted, sore and frustrated for a few days and it would all go back to normal… and it did.

RebeccaD: What I needed: confidence, reassurance that I had the basics, and a twin-specific logistical strategy. What I got: two different programs for each baby. Being a twin mom is all about creating a bridge between your babies’ individual needs and your ability, as one person, to meet those needs. Breastfeeding was a serious crash course in this for me. So, my first lactation consultant was basically awful because she treated my babies like two singletons and made me feel horrible for being unable to be two mothers. Luckily I had other support and figured it out. Six months of exclusive breastfeeding later, I started having supply problems, and a different lactation consultant was a wonderful help. I credit her with my ability to continue nursing to 13 months for one and 15 months (and counting!) for the other. But I came into that consultation with a lot more knowledge and confidence. I could tell her, “That won’t work with twins, what else ya got?”

Dory: Our first pre-baby class was a breastfeeding class for couples. It was amazing! I thought it would be silly to take such a class, as I figured I would get all I could at the hospital. I was wrong! There is so much to learn and think about, and it was helpful to have that base understanding. After giving birth, I can’t stress how important it is to talk to the lactation consultants at the hospital, before you come home. We made sure that we got extra time with them to make sure we were getting all of the hints we could. I asked questions over and over, and they were more than happy to help us. They were so sweet and treated us like superstars (get used to it when you are parents of twins!). The were incredible! We also were able to follow up in our pediatrician’s office during the 1 and 2 week appointments. The woman we saw was a lactation specialist. Score for the nursing moms! She was the one that told us not to let them nurse any longer than 20 minutes early on (any longer and they would burn too many calories).

RachelG: As I mentioned earlier, I had a fantastic postpartum nurse who helped me figure out latch, positions, etc. I worked with lactation consultants, but they focused mostly on helping me increase my supply and improving my son’s latch. They weren’t hugely helpful, in that my supply never increased substantially and my son figured out the latch thing on his own eventually, but at least I had the peace of mind that I had tried everything.

ldskatelyn: The hospital lactation specialist was very good about encouraging me to try tandem feedings, and taught me the different positions. My husband and mother-in-law (who was a nurse) were helpful once we got home.

What positions worked or didn’t work for your family?

Tandem nursing positionsSadia: The football hold worked best. My girls hated to be crossed and I felt like I could support them better football style. Our typical setup was as follows:

  1. My husband sat in the chair.
  2. I picked up both babies, one in each arm, cradle hold.
  3. I sat in my husband’s lap.
  4. He held one baby, cradle style across my lap, while I latched on the other in a football hold.
  5. He held the nursing baby while I latched on the second.

Janna:  I had to use a boppy, in a recliner with arms. I put the boppy around me, with the ends of it rested up on the recliner arms. Then I lay the boys down on the boppy in the “football hold” and both my boys were up at the right level, leaving my hands free (for eating, reading books, emailing, etc…). It was ideal at home. I never did try any other position because this one worked so well for us.

bftwins4Rachel: We used the football hold pretty exclusively while tandem nursing.

RebeccaD: Football all the way. They hated crossing, and would kick each other. When they got older, I sometimes pinned their arms under mine or separated their heads with a rolled up blanket so they wouldn’t bother each other.

Dana: I remember getting extremely creative with the positions of the babies in order to tandem nurse. It was something I was actually quite proud of. I didn’t use the boppy too often, but rather lots and lots of pillows.  I encourage any new mom of twins to get real comfortable with having tons of pillows stashed conveniently around the house. (And don’t forget lots of burp cloths stashed in the couch cushions!) Also, don’t be afraid to stack those kids on top of each other! Here is one position I used often:

468051998_e29e4bb03bJenW: I sat in the middle of the couch with the eZ-2-nurse twin pillow, after starting with a boppy but finding it wasn’t enough. I put a baby on each side of me in a boppy so they wouldn’t roll. I maneuvered them both to the pillow first then got them to latch. By about 6 months they were more efficient so it was faster to do one then the other occasionally. Plus, by then they weren’t as interested in staying on the pillow.

ldskatelyn: When I was seriously, regularly, doing tandem feedings, I generally did two football holds, as it gave me the most control over their bodies, keeping them from rolling, allowing me to position their heads correctly. However, kind of just for fun, when I was no longer tandem feeding, but because they were both starving, my husband and I would put our twins into all sorts of different, not-found-in-books, positions. One these was me lying on my side, and feeding them one on top of the other! Another was me lying on my back, and letting them both suckle against gravity.

Dory: When tandem feeding, I only use the football hold. At the hospital, we tried layering them during one feeding, and I was uncomfortable, they looked uncomfortable, and I was on edge the whole time. Once I switched back to the football hold, I felt like I was able to breathe again. One night I was really sick and couldn’t get out of bed. My husband brought me the babies one at a time and I had them against my body and nursing them while we were both on the bed. I haven’t tried that with two babies though.

Did you tandem nurse in public? How?

RebeccaD: Unfortunately… yes. In order of embarrassment: DayOne, a breast-feeding friendly store where my MoMs group had meetings, in the car (with my pillow), on a public park bench (supported by diaper bags and covered by a blanket), on the lawn of a museum with my top almost totally off (they were starving, I was alone, it was a bad day). I usually nursed one right after the other when we were out.

ldskatelyn: I remember feeding both of them at the same time once while staying at my brother’s house. They were both super hungry, so I put my cover on, and fed them that way. It was not the most comfortable (I don’t think I had my Boppy pillow with me) as I was sure I was going to flash his children. Although, it was super funny when one of my nephews commented that his mom only feeds one baby from both sides.

Sadia: Nope. I never figured it out. I easily nursed one — I loved empire opening nursing tops for cradle hold breastfeeding – while bottle feeding the other by about 2 months. If I was walking with our stroller, I’d just push it with my hip while cradling a baby in one arm and holding a bottle for the other baby with the other hand.

Janna: No. When we went out the boppy didn’t really work without my recliner. It wasn’t high up enough, unless I could find a recliner chair with the right size arms. I never did find a convenient way to tandem nurse outside of my home, so I would either stay close to home and only do short outings, or if we had to be out during a feeding, take bottles with expressed breast milk and feed the boys bottles (usually my husband or another family member or friend would help with the feeding) and then I would pump with a homemade, extra large hooter hider giving me privacy.

Mercedes: Nah. I am all for breastfeeding in public and have done it everywhere from cafes to castles to the stands of a Formula 1 race. But it’s always been one baby at a time. Just easier and less conspicuous that way.

Dory: I don’t tandem in public because I don’t have big enough pillows with us. It is easier to feed one at a time and just hold them or prop my arm on a chair. I don’t have the “mom arms” yet to hold both at once and nurse for an extended period of time.

RachelG: No – I really needed my full setup to be able to tandem nurse successfully. In public, I’d either nurse one at a time or feed them a bottle.

Did prematurity play a role in your attempts to tandem feed?

Sadia: Yes, yes, yes. First, there was the matter of the NICU. My babies were tubefed for their first days, so the pump and I got good and intimate. I was only allowed to try breastfeeding once (M only) during my daughters’ hospital stay, so I couldn’t even try tandem nursing until the babes were 3 weeks old. Their sucks were so weak and their muscles so underdeveloped, each nursling needed my full attention during our nursing sessions. Their tiny stomachs and weak sucks meant that they were each at the breast for 45 minutes at a time. I didn’t exactly have a whole lot of wiggle room to try out new positions because I was terrified that they’d drop back below 4 lbs in weight and have to be rehospitalized. Even during maternity leave, our pediatrician had me keep two meals of high-calorie formula enriched with Poly-Vi-Sol in our routine per day just because they had so much weight to gain. J was 3 lbs 6 oz at birth, M 3 lbs 9 oz. Neither baby had achieved 5 lbs when they were released from the NICU. I’d pump during their formula meals.

Janna: No, my boys were born full term, both weighing over 7 pounds. I do think that this is certainly one reason why nursing came so easy for the three of us.

RebeccaD: My boys were also full-term (5 lbs, 15 oz and 6 lbs, 5 oz), which really helped. Baby A was a champion nurser right from the jump. Baby B had a weak latch that never totally resolved, but my let-down was sensitive enough to make it work. I felt terrible when he had to start formula supplements at 6 months, but the lactation consultant pointed out that tandem nursing helped let-down so much that if he wasn’t a twin, he may not have breastfed as successfully as he did, or for as long. That is a tandem nursing success story!

Mercedes: No. My twins were early term, born at 37 weeks and 1 day, although they were small. My daughter, the bigger of the two, was actually the one with more latching difficulty, and the lactation consultant urged me to be patient as the baby learned. She said that 37 weeks is still early and some babies just need more time.

Dory: We were so fortunate that our twins were 36+5 with no NICU time, so we could nurse right away.

RachelG: Not really. My twins were early term (37 weeks), and while my son did struggle a bit with his latch, we never had serious problems nursing as a result of their delivery date.

ldskatelyn: No. My twins were born a day shy of 38 weeks. They weren’t premature. One of my daughters did need help opening up her mouth big enough, but with help of a lactation specialist at WIC, we were able to figure it out, and I was able to stop hurting.

Twin Breastfeeding Ebook

Manibreasto-Cover-3d-WebWould you like more inspiration, support and tools to make breastfeeding twins work? How Do You Do It? author Mercedes has written an ebook on the subject, Twin Manibreasto. She has a special offer for HDYDI readers! Use the code TWIN5 at checkout to pick up your own copy for $5 (code expires Feb. 10).

We hope that this has helped you get some perspectives on tandem breastfeeding. In addition, you can read about how Dory, who is currently breastfeeding, tandem feeds on her blog, Doyle Dispatch.  If you have any follow-up questions or stories of your own, we would love for you to share them in the comments!

The Signs of Premature Labor

Prematurity Awareness Week 2013: How Do You Do It?

World Prematurity Day November 17In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.


The premature births of all my babies (see full stories here and here) — my singleton, born at 31 weeks, and then my twins, born at 27.5 weeks — obviously affected our family very profoundly.

In addition to the many other hats I wear, I chair the Multiple Births Canada’s Preterm Birth Support Network and work in my local multiples group as a peer support worker.  In these roles I have the opportunity to speak with expectant mothers and fathers, and a big part of my message is to educate them on the signs of preterm labour.

The day you find out you’re having multiple-birth babies is a day filled with excitement, wonder, and even concern about how you’re going to do it. While preparing to have multiples you will be focusing on doubles, triples or more of many big ticket items and you will be very focused on the babies who are on the way. It will be equally important to remember to focus on yourself; get enough sleep, listen to your doctors’ instructions and be fully aware of preterm birth labour symptoms.

When it comes to expecting multiples, you should be prepared for the possible early arrival of your little ones, as multiple-birth babies are more likely to born premature than their singleton friends.

It is my experience, though, after speaking to hundreds of expectant mothers, new mothers and well-experienced mothers alike that the majority just don’t know what the preterm labour symptoms are. So here is a list of a few of the common ones, with a link to a longer list to be aware of:

  • Low, mild backache
  • Menstrual-like cramps
  • Pressure (as though the baby is pushing down)

Read the full list HERE and consider posting this on your fridge as a quiet reminder.  Ensure your spouse/partner and family are fully aware of the preterm labour symptoms as well. Sometimes as moms we can think we are strong and know our bodies, but miss some obvious signs, so our family can monitor our behaviour and ensure we get the help we need if symptoms of preterm labour present themselves.

Maintain an open dialogue with your doctor.  No question or concern is too silly.  While preterm labor is not completely preventable, education and awareness are important keys in working towards a healthy delivery.

NICU Graduates: A Picture Round-up

Prematurity Awareness Week 2013: How Do You Do It?

World Prematurity Day November 17In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.


Thank you for joining us this week as we shared our experiences, reflected on our journeys, and celebrated our milestones in the name of prematurity awareness.  Rounding out our series, the HDYDI MoMs are proud to showcase some of our NICU graduates.


Preemies shortly after birth compared to age 7 from hdydi.com

Sadia’s daughters M (top left and on the inside bottom) and J (top right and on the outside bottom) were born at 33 weeks but are now doing more than fine at age 7. They’re dancers, bookworms, pet lovers, Girl Scouts, best friends and the light of Sadia’s life. They read about 3 grades above their age level. M plans to be a restauranteur, astronaut and mother of quadruplets. J intends to be a teacher and dancer.

Preemies grow up strong from hdydi.com

Margie’s boys, Wesley (top row) and Andrew (bottom row) spent two weeks in the NICU after being born via emergency c-section (on their scheduled 38 week scheduled delivery date) due to an undetected blood disorder that caused extreme complications hours before their actual scheduled delivery time. After several blood transfusions each, having a seizure (Andrew) and receiving several rounds of platelets, the boys beat the odds and came home happy and healthy. The photos on the left were taken the day after their birth. After only a quick glimpse in the delivery room, the boys were rush off to receive immediate medical assistance and Margie and her husband were not allowed to see them until the following morning. The entire day seemed surreal, knowing she delivered two babies, not being able to see them and still having a big twin belly. Margie says those first few days were the hardest, scariest and saddest days she’s ever experienced. The photos to the right show the boys in the NICU after most of the wires and tubes had been removed. They are two of Margie’s most treasured photos.

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Wesley and Andrew just celebrated their 4th birthday and love living life at 100mph! Wesley wants to drive an ambulance someday to help sick people, and Andrew dreams of being an astronaut.

Preemies grow up healthy and strong! from hdydi.com

MandyE’s fraternal twin girls were born at 34 weeks and spent 10 days in the NICU. They will celebrate their fifth birthday in January with their very blessed family.

Angela's triplets were born at 27 weeks and 5 days after a month of hospital bed rest. They weighed a little over 2 pounds each. Carter only lived 49 days and Braden & Tenley came home after 4 and 3 months. They fought through L3/4 brain bleeds, shunts, NEC, seizures, sensory issues, feeding issues and GERD, and still have ongoing therapy. In the end though, Angela feels blessed and is very proud of how far her little preemies have come.

Angela’s triplets were born at 27 weeks and 5 days after a month of hospital bed rest. They weighed a little over 2 pounds each. Carter only lived 49 days and Braden & Tenley came home after 4 and 3 months. They fought through L3/4 brain bleeds, shunts, NEC, seizures, sensory issues, feeding issues and GERD, and still have ongoing therapy. In the end though, Angela feels blessed and is very proud of how far her little preemies have come.

 

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Carolyn’s first son was born at 31 weeks, followed two years later by her twin boys, at 27 weeks.  Now five and three years old, they are her superheroes.

The Stories of My Babies Born at 31 Weeks and 27.5 Weeks

Prematurity Awareness Week 2013: How Do You Do It?

World Prematurity Day November 17In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.


I’m Carolyn, the mother of three prematurely born children.

I had a quick introduction to parenting when my 31-weeker arrived very suddenly and with what I thought was little to no warning!

The day my little 4-pounder arrived, I woke up feeling pretty good and headed off to two BBQ celebrations; one at the lunch hour, the other by about 4:00 that afternoon. After BBQ #1 I began to feel a bit of indigestion, sore stomach, a bit of backache. I had eaten a veggie burger, but had a cola pop (a “soft drink” to my American friends), which I had been avoiding during my entire pregnancy. I chalked up the indigestion to having a caffeinated cola, when I probably should have skipped it entirely.

At BBQ #2 I talked about expecting my first baby and we learned of a new mom who had just given birth in a taxi cab a day or two before. We giggled; how could a mother NOT know she was in labour until it was really too late?? The afternoon progressed and so did my “indigestion”.

After several washroom visits that afternoon there were no “results,” if you know what I mean. Around 6:30 PM my husband and I headed back to our city, about a 50 minute drive away, made a quick stop on the way to return several party folding chairs, which I proceeded to carry on my own. I wasn’t in labour, so of course I was still carrying out small tasks and some light lifting. As we drove the rest of the way home I could feel my baby moving quite a bit, but figured, “that makes sense.”

About four hours later I found myself almost delivering my firstborn into a hospital toilet, as we had made our way fairly quickly to the hospital when things were obviously going very wrong.

Do you think by the time I got to the hospital, after having a little bit of spotting, and intense backaches that I thought I was going into preterm labour? Why, no. I had no idea!

Up to that point there had really been no conversation about preterm birth and the symptoms to be aware of. I had heard of it, but I was told I’d likely go to term, maybe even late because I was a healthy woman, with no issues. So when my husband rushed me sprawled across the backseat to the hospital, I thought I was having a bowel obstruction or something completely crazy. Not once did the idea, “I am going to have my baby,” enter my mind. Thankfully our firstborn little boy was very healthy and after not quite 4 weeks in a NICU he was home with us to celebrate our first wedding anniversary.

Fast forward not quite two years later and I was pregnant with twins. I was so excited to be having twins and I tried to remain positive that these little babies would be carried to term. I found that sometimes you can think positive till the cows come home, but you cannot control your body.

Almost two years to the day preemie # 1 arrived, along came preemie #2 and #3; arriving at 27 weeks and 5 days. We were not in a hospital with the type of level of Neonatal Intensive Care Unit anyone would want a preemie born in, let alone two, but that was the hand we were dealt. The hospital we were in didn’t have a NICU at all, just a small area with a couple unwell term babies.

My twins were born in about an hour, after I presented at the hospital and said “I think I may be in labour,” as I wheeled my suitcase into the ward. Within that hour, I went from standing and holding my own, to saying, I am pretty sure I am about to have these babies, to delivering in a high-risk delivery room with no medication or GA. Our twins were born quickly and were stabilized over several hours, while we waited to hear where our tiny 2-pound babies would be transported. Would they go together to the same hospital or would they be separated? We didn’t know. The uncertainty of having preemie babies is one thing, but to have no idea where they will go for the emergency and lifesaving care they need because it depends on bed availability in the province (or state) is traumatizing!

Transport to NICU

Eventually, within 4-6 hours the twins were moved one-by-one to the same hospital. The first one to go was considered the more unwell baby and he took priority. The first twin was followed by my husband and mother to the hospital about an hour away. I stayed to be monitored, was discharged in a little over 3 hours and was able to go behind the second transport ambulance. I was chauffeured of course!

I am very grateful to report that all three of my children — my older son, 5, and my twin boys, 3 — are growing up happy and healthy.  Their premature births have had a profound effect on our family, of course, and I now chair the Multiple Births Canada’s Preterm Birth Support Network and work in my local multiples group as a peer support worker.  I am passionate about sharing my experiences, in the hope that I might educate other families about the signs of premature labour.

Carolyn blogs  at Twintrospectives, reaching both the preemie community and the multiples community.

NICU Terminology

Prematurity Awareness Week 2013: How Do You Do It?

World Prematurity Day November 17In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.


One truly overwhelming aspect of having a child or children in NICU (neonatal intensive care unit) care is the quantity of new terminology thrown around by the medical staff. The Moms put our heads together and came up with a list of NICU terms that many of us had to learn.

Adjusted age: The age that your premature child would have been if he were born full-term. You and your doctor may choose to schedule your preemie‘s vaccinations based on her adjusted age rather than her birth age. It’s often easier to answer strangers’ questions about how old your babies are with their adjusted age rather than going into the details about why they are so small for their birth age. Many preemie parents abandon the adjusted age around age 2, but it depends on how early their children were born and the extent of any delays or disabilities.

Apgar score: A number between 0 to 10 that describes the condition of a newborn (full-term or premature) immediately after birth. The Apgar test is usually given twice, 1 and 5 minutes after birth. Medical professionals score each of 5 criteria from 0 to 2:

  1. breathing
  2. heart rate
  3. skin appearance/color
  4. reflexes
  5. muscle tone

Apnea: Breathing stoppage. Apnea of prematurity is not uncommon, and usually involves a baby not breathing for 15-20 seconds. A gentle touch, often a massaging of the chest, is usually enough to end an apneic episode. Since full-term infants the same gestational age as a preemie don’t need to breathe in utero, premature infants can sometimes “forget” to breathe. It’s scary, but not unusual. The vast majority of preemies outgrow apnea of prematurity by their due date.

NICU terminology from hdydi.com

Aspiration: Sucking of fluid or solids into air passages.

Bililight: Fluorescent light used in phototherapy to treat jaundice.

Brady/bradycardia: Pathologically slow heart rate.

Cares: The three-hourly basic routine of feeding, diaper change, temperature measurement, weighing, and blood sugar analysis. Many NICUs will allow parents to perform all aspects of their babies’ cares once they are stable.

Car seat test: Monitoring your baby’s vital signs for a 60 to 120 minute period in the car seat in hospital to confirm that he or she can manage the drive home.

Catheter: Tube used to deliver medications or fluids or to drain bodily fluids.

Co-bedding: Placing multiples together in a bed, crib, isolette or open warmer.

Corrected age: See “adjusted age.”

Desat/desaturation: Decrease in the oxygen saturation level of the blood, specifically hemoglobin.

Developmental delay: Ongoing delays in reaching milestones.

ECG/EKG/electrocardiogram: Test that checks for problems with the electrical activity in the heart.

Extubate: Removing a breathing tube from the airway.

Failure to thrive/FTT: Inadequate weight gain and physical growth in children. Being small for his/her age does not equate to failure to thrive as long as a child is growing. If a child’s growth follows the growth chart (e.g. stays at 2nd percentile over time), being underweight does not equate to FTT.

Feeder-grower: A baby that is only in the NICU to learn to feed and get her weight up and has no other medical concerns.

Fontanel: One of six soft spots at the juncture of an infant’s skull bones. The skull does not fuse into a single bone until a baby is around age 2.

Gavage: Feeding directly into the stomach by tube.

Gestational age: The age of a baby calculated from a woman’s last normal menstrual period. For full-term infants, gestational age is usually used to describe age in the womb. For preemies, we often use gestational age as a measurement of how close they are to being developmentally equivalent to a 40-week full-term neonate.

Growth chart: Graph that illustrates the distribution of weight and height/length by age in a population of children. The distribution is usually described in terms of percentiles.

Heart murmur: Unusual sound heard during a heartbeat. Many heart murmurs are completely innocent.

Heelstick: Pricking an infant’s heel to retrieve a blood sample for blood sugar monitoring or other diagnostic procedures.

High-calorie formula: Infant nutrition with concentrated caloric content, intended for infants who need to consume extra calories or smaller volumes than other infants.

Hospice care: Palliative care provided when death is imminent.

Incubator: Closed crib that provides a controlled environment (temperature, oxygen and/or light) for infant care and observation.

Intubate: Insert a tube into the (windpipe) to maintain an open airway to enable breathing.

Isolette: An incubator brand, often used to mean generic incubator.

IUGR/intrauterine growth retardation: Poor or slow growth of a baby in his/her mother’s womb during pregnancy.

Jaundice: Yellow skin and eyes caused by extra bilirubin in the blood. Bilirubin is a blood component left after normal breakdown of red blood cells, which are constantly replaced. Common in newborns.

Kangaroo care: Holding an infant skin-to-skin against an adult. The parent or medical provider’s body heat helps regulate the infant’s body temperature, needed since many preemies have inadequate body fat to regulate their own temperature.

Meconium: The product of a neonate‘s first bowel movements, a tarry green substance made up of things the infant has ingested inside the mother’s womb.

Micropreemie: A baby delivered especially early. NICU staff usually reserve the term for babies who weigh less that 1.75 lbs and birth or is born before 26 weeks gestation (14 weeks premature). Colloquially, people use the term to describe babies born at less than 3 lbs or before 29 weeks gestation.

Milestone: Set of functional skills or tasks, including language, cognitive, and motor skills/tasks that most children can do at a certain age.

MRI/magnetic resonance imaging: Procedure to create pictures of organs and structures inside the body.

Nasal cannula: Tube used to deliver oxygen through the nostrils.

Necrotizing enterocolitis/NEC: Infection that destroys all or part of the bowel. It affects 10% of neonates weighing less than 3.3 lbs within the first two weeks after birth.

Neonate: An infant within the first month after birth.

Neonatologist: Pediatrician specializing in treating newborns, especially following complex or high-risk births or early medical challenges.

Newborn: See neonate.

NG/nasogastric tube: Tube that carries food and medicine to the stomach through the nose as in gavage feeding.

NICU/neonatal intensive care unit: Hospital wing containing special equipment and staffed with medical experts to provide care for premature or seriously ill neonates.

Open warmer: An open crib with an overhead heater that adjusts automatically to maintain an infant’s body temperature.

Oscillating vent: A ventilator specifically designed for delicate preemie lungs to minimize  damage by keeping the lungs somewhat inflated.

Palliative care: Medical care focused on relieving of the pain and stress of the symptoms of serious illness rather than just the source of the illness.

PDA/patent ductus arterioles: Abnormal blood flow after birth between two of the major arteries connected to the heart. This blood flow is normal and necessary in utero, but usually stops shortly after birth.

Percentile: The percent of a population that an individual equals or exceeds. A child in the 50th percentile for weight is weighs as much or more than 50% of children the same age.

Phototherapy: Controlled exposure to fluorescent light absorbed by a baby’s skin to break down bilirubin and treat jaundice.

PICU/pediatric intensive care unit: Hospital wing containing special equipment and staffed with medical experts to provide care for children who are hospitalized a significant time after birth.

Preemie: A child born prematurely.

Prematurity: A child born before 37 weeks gestation.

Primary nurse: The nurse responsible for providing continuity in the care of a patient. The NICU parent’s best friend.

Prognosis: Expectations for the future.

Pulse ox/pulse oximeter/oximeter: Machine that measures the oxygen saturation of a person’s blood without requiring a blood sample.

Radiant warmer: See open warmer.

Reflux/Gastroesophageal Reflux/GER: A condition in which stomach contents flow back up into the esophagus. The liquid spit up is mostly made of saliva and stomach acids. Reflux is not uncommon in kids under 2 years old.

Respirator: Non-medical term for ventilator.

Respiratory therapist/RT: Medical professional who help patients who have trouble breathing.

Retinopathy of prematurity/ROP: Eye disease common to NICU babies, especially those who require extra oxygen, in which the blood vessels of the eye grow in a disorganized way. Mild cases usually resolve themselves, but severe cases can result in permanent blindness.

RSV/Respiratory syncytial virus: Highly contagious virus that causes cold-like symptoms in adults but can be extremely serious, even lethal, in premature and other lung-compromised young children.

Seizure: A change in the electrical activity in the brain. Symptoms can be severe or nonexistent.

Sats/oxygen saturation/SpO2: The percentage of potential oxygen-carrying molecules (hemoglobin) in the blood that are carrying oxygen. Normal saturation is 95-100%. This is a good measure of whether an infant is getting enough oxygen.

Suck swallow breathe: Coordination of actions required for a neonate to take nourishment from the breast or bottle. This reflex usually kicks in by 36 weeks gestational age.

Swaddle: Wrapping a baby tightly to give him the comforting feeling of being in the womb.

TTTS/TTS/twin-to-twin transfusion syndrome: A condition that occurs only in (some) identical multiples in the womb who share a placenta. An uneven distribution of blood vessels in the placenta can, in extreme cases, result in IUGR of one twin.

Ventilator: Machine that moves air in and out of the lungs to help infants who are having trouble breathing.

Vitals/vital signs: Measurements that indicate physical/medical wellbeing. These can include temperature, pulse, blood pressure, pulse ox, and breathing rate.

We hope that you never have to encounter NICU terminology and can be content with “swaddle,” “fontanel” and “milestone,” but if you do, please come by to tell us your story or seek our support. We’ve been there. Our littles ones are now doing well. You are not alone.

NICU terms from hdydi.comWhat other terms have you encountered?

HDYDI Prematurity Awareness Week 2013: Kickoff

Prematurity Awareness Week 2013: How Do You Do It?


About Prematurity

Not all multiples are born prematurely, but the issue of premature birth is a cause near and dear to the hearts of most mothers of multiples. Even those MoMs who carried their multiples to term are aware that they’re in the minority. Most multiples are born prematurely, before their bodies are fully prepared for life outside the womb.

According to the latest birth statistics from 2011:

  • In all American births, 11 percent – about 1 in 9 — were born preterm, before 37 weeks gestation.
  • For multiples, that number is much greater. About 60 percent of twins, over 90 percent of triplets, and practically all higher order multiples are born prematurely.
  • 11 percent of twins, more than ⅓ of all triplets, and more than ⅔  of all quadruplets and higher order multiples were delivered very preterm, before 32 weeks of gestation, compared with less than 2 percent of singletons.

According to Multiple Births Canada, among infants born prematurely, nearly 1 in 10 do not survive. Although the majority of premature babies do very well, they are at a somewhat higher risk of a variety of medical and other problems, some of which will be lifelong.

March of Dimes

The March of Dimes leads the campaign against premature birth, working to fund research and support legislation that improves healthcare for mothers and babies.  They seek to focus attention on the issue of premature birth.

World Prematurity Day November 17

What We’re Doing

In honor of Prematurity Awareness Month, we’re sharing our experiences of premature birth with you this week to raise awareness of this issue, and to help other families in similar situations.  Most babies born prematurely spend time in a neonatal intensive care unit (NICU), and you will see that is a major part of many of our stories. We will cover a wide range of topics and perspectives, including:

  • How to navigate the NICU environment
  • The many emotions of prematurity
  • Dealing with special needs
  • Honoring our experiences through reunions, volunteering, and fundraising
  • What expectant mothers should be aware of to try to prevent premature delivery
  • How our premature children have been doing

All week, we’ll be sharing our birth stories as well.  In each one, you’ll find unique circumstances and recurring themes, something that most mothers can relate to.

Wear Purple

We thank you for joining us, and we invite you to “Wear Purple for Preemies” as we wrap up our series on Sunday, November 17, World Prematurity Day.

Prematurity Awareness Month

Grocery Shopping with Twins and More

 

You Can Do This!

Twins in a shopping cart: Grocery Shopping with Multiples from hdydi.com

Yetunde‘s pair are ready to roll!

You can run errands with twins or more, including multiple infants or toddlers. You can do this. Yes, alone. If you must do so alone, or just want to, you should give it a try. We’re going to tell you how The Moms go grocery shopping with kids in tow, from twins to quadruplets, with some singletons thrown in for good measure.

This post assumes that you have access to a car, are walking, or are riding a bike. Taking public transportation with multiples is a topic for another day.

Leaving the House

Plan and Pack

As with most things related to caring for babies, grocery shopping with twins or more starts with good planning. Pick a time that works for you and your kids. Do your babies fall asleep in the car and nap well out and about? Consider going shopping during nap time so that they can sleep through the whole thing. Are they happy and social in the morning? Go shopping then. Make a complete shopping list so that you can minimize followup trips required to pick up things that you forgot during your main shopping haul.

diaper bag and contents from hdydi.com

Photo Credit: dhgatsby

Pack your diaper bag with the things you’ll need. The basics usually include things for diaper changes, something to wipe up spills and messes, changes of clothes in case of mess, something for the babies to eat, and something for them to play with. You’ll also need to have a transportation solution at the ready, whether it’s a stroller-carseat system, baby wrap, wagon, or all of the above.

Twinfant Tuesdays: Errands with Lots of Little Ones from hdydi.com

If your child is old enough to sit in a cart but not big enough to stay propped up, a rolled up blanket can help, as demonstrated by Sadia‘s daughter J at Ikea. M is wearing, or rather worn in, an Evenflo Snuggli. Please see our baby carrier post for our thoughts on wearing twins.

Older kids don’t need all the diaper paraphernalia, but they might need something to keep their hands and minds occupied, like books or toys. A small container of fruit or cereal is a good thing to have on hand for when blood sugar dips and tempers rise. Depending on the ages of your children, you may have traded in your diaper wipes for antibacterial hand gel… although you may find yourself wishing you had wipes, even with school-age kids!

Before you head out the door, make sure that your kids are clean and fed. If they’re just fussy, and you have a constitution that allows you to drive with a fussy child in the car, just move on to loading up. Sometimes you’ll need to drive through the crying to get to your goal.

Don’t forget your shopping bags, cooler or insulated bag, and transportation solution.

If you do make a habit of shopping with your multiples, you’ll need to be prepared to be a minor celebrity. Especially during the first couple of years, when it is obvious that your children are the same age, people will want to stop and talk to you about multiples. Budget extra time for discussion with curious strangers. Arm yourself with standard answers for common questions.

Load Up

3 infants buckled up at home: Grocery Shopping with Multiples from hdydi.com

3 infants in a car: Grocery Shopping with Multiples from hdydi.com Sadia’s daughters and a friend’s son went shopping together regularly. M wasn’t too happy about it.

Put your kids in the car last. That way you’re not distracted by their demands while you pack up. Make sure that they’re somewhere safe, like a crib, swing or playpen, while you pack your car with your stroller (or wagon or baby wraps) and diaper bag and other equipment. Janna kept bouncy chairs in the front room and strapped her boys in on the way in and out of the house.

If you’re using bucket-style infant car seats, it may be easiest to load and strap your babies in in the comfort of your home, then install the seats in your car, complete with babies.

If you’re walking or bicycling, the same general approach holds true. Load the kids last.

Out and About

You’ve loaded up and arrived at your grocery shopping destination with your twins. Now what?

Parking

If you’ve driven to the store, check to see whether they have designated Customer with Child parking spots. If you can score one, it will likely be near the cart return closest to the main entrance to the store. You can maximize your chances of reasonable parking by shopping at off-peak hours such as weekday mornings, but this isn’t feasible for everyone.

Walking and Biking

Janna and RebeccaD walk almost everywhere. RebeccaD purchases only what she can fit in the undercarriage of the stroller. She hits the store with her boys every couple of days. She uses her double stroller for most errands. Janna walks to the pharmacy, grocery store, post office, thrift store. The workout is a bonus!

Once her boys turned a year old, Janna switched to a trailer behind her bike. This isn’t always possible, of course, if your errand is too far away or the weather is too hot or cold, but it works great for her family most of the time.

Implement Your In-Store Strategy

The Moms have a plethora of ideas for containing and transporting kids at the grocery store. Yetunde has actually written about this in the past on her personal blog. If you’re planning to use a store cart, parking near the cart return can make it easier to snap up a cart without having to stray far from your car.

  • A common solution for infants is a double car seat/stroller system, such as the Double Snap-N-Go or Graco DuoGlider. MandyE was once able to run three quick errands within an hour thanks to the ease of baby transfer! Where do the groceries go, we hear you clamor. One option is to use the basket under your stroller as your cart. This severely limits how much you can purchase at a time. Another option is to push your stroller with one hand while pulling a store cart behind you with the other. It looks a little crazy, but it works well.
  • 3-seater cart: Grocery Shopping with Multiples from hdydi.com

    Target has carts that seat 3 kids with ease, demoed here by MandyE’s precious duo.

    More and more stores are offering shopping carts that seat two or more children. In our experience, such stores include Costco, Sam’s Club, Target and many branches of the Texas grocery store HEB. Sadia found it to be worth driving a few extra miles to go to a store that had two-seater carts standard.

    Twin boys crying in a two-seater shopping cart: Grocery Shopping with Multiples from hdydi.blog

    Jen Wood‘s boys don’t seem to appreciate two-seater shopping carts as much as The Moms do.

    Don’t have any stores nearby with carts that accommodate two seated kids? Let your store manager know; the company may simply be unaware of the demand.

    This brings us to another point: “Shop” around and choose stores that work for you. Find places where you can maximize your effort and where you can shop effectively. One-stop shopping is your friend. SarahP typically goes to Costco first, then to Walmart because she can price match there and get all the other odds and ends. Use the grocery store pharmacy. Look for wide aisles. You may find it worthwhile to invest in a cover to keep little fingers off germy cart parts and/or disinfecting wipes to wipe down the cart before transferring your kids.

  • MandyE (in the photo) and Sadia both used the wear one/drive one approach to shopping with twins.

    MandyE used the wear one/drive one approach to shopping with twins. Note that most car seat manufacturers recommend placing car seats inside the car rather than in the seat area. Check your manual!

    You can wear one baby and put the other(s) in the shopping cart. Wiley typically wore her twinfant girls, had her toddler son seated in the cart, and had her school-age son walk. The trick to reaching things on low shelves without spilling a baby is to squat. You’ll have thighs of steel, so that’s a benefit of this approach. Note that many car seat manufacturers advise against placing car seats in cart seats the way MandyE demonstrates and many of The Moms do regularly. Try using the cart strap to secure the seat the way you would with the seatbelt in your car.

  • Twins hiding in the paper towels: Grocery Shopping with Multiples: hdydi.com

    Jen Wood’s guys remind us that our kids are also pretty creative, so be careful when letting them walk in the store.

    Get creative. SaraBeth has seen parents bungee two carts together. Sadia has shopped with her kids in a Radioflyer wagon. SarahP keeps one baby in the car seat in the main area of the cart, puts her 2-year-old in the sitting area of the cart and straps the other baby to herself in a Baby Bjorn. The groceries go under the cart and around the seat. It may look like a circus, but it works! Carolyn – Twintrospectives used her stroller as her cart. When she had too much bagged stuff after paying to fit elegantly back under the stroller, she used a couple of mommy hooks to hang bags off other parts of the stroller. Janna used to hang reusable grocery bags from the double stroller handles.

  • 7-year-olds helping mom push a shopping cart: Grocery Shopping with Multiples from hdydi.com

    Sadia’s daughters can help her steer the cart, although they’re just at the height where they can’t see where they’re going. They now prefer to walk alongside the cart and help calculate the best values and keep mommy within budget.

    Kids don’t have to be contained. If your kids are old enough to walk and trustworthy enough to be free, invite them to help you push the cart or give them carts of their own. Sadia’s kids still, at age 7, walk between her and the shopping cart, embraced within her arms and “helping” her push. If they wish to walk alongside the cart, they are each assigned a spot on the side of the cart to keep a hand on. They are not permitted to let go without explicit permission. SaraBeth determines which twin goes “free range” based on who has been better at listening that day.

  • Twin boys push miniature shopping carts in the store: Grocery Shopping with Multiples from hdydi.com

    Jen Wood’s sons are on a mission. Having his own cart keeps each boy close to mom and focused on shopping.

    Avoid the store altogether. Shop online. Subscribe to a CSA that delivers to your home. Use a drive-through.

There will be days when your kids will be in rare form, screaming bloody murder, and you’ll wonder how essential food really is. We’ve been there. On balance, though, shopping is doable, often even fun. If you treat it like a fun outing, your kids will have fun too. MandyE and Sadia will talk about making grocery shopping fun and educational in a later post.

Ask for and Accept Help

Twins in a double shopping cart seat: Grocery Shopping with Twins from hdydi.com

The Moms love these double seat shopping carts, modeled here by Carolyn – Twintrospectives’ boys. If your store doesn’t have them, see if a manager can order a few. Once they see how popular they are, they’ll get the message!

Don’t be afraid to ask for help. Janna often asked strangers to hold doors for her. Sadia asks store staff to help her lift things down from tall shelves. Carryout services offered by some grocery stores is golden. If you let the staff member load groceries into your car, it frees you up to load up your kids.

Unique Circumstances

Special Needs Children

Marissa‘s son A was very sick as a newborn and was essentially quarantined until he was 6 months old, by order of his doctor. This meant keeping D in too until he had his 3rd DTaP. Marissa’s husband, mother, and grandmother ran almost all of the errands, since A required extensive care when not hospitalized. We know, we said you could do it, but sometimes it’s best that you don’t run errands with your kids, for their sakes.

Grocery cart with infant seat attached: Grocery Shopping with Twins from hdydi.com

Some grocery stores provide shopping carts with infant seat already (and securely!) installed. If you wear one baby, these are great for parents of twins.

Now A is doing much better, but he couldn’t sit in a shopping cart until he was about 14 months old. Marissa wore him most of the time and had D sit in the cart. In addition, A is tube-fed and she does not let that stop them from participating in any activity, even though people are far more likely to stare than when witnessing public breastfeeding. One of Wiley’s daughters needs to drink thickened liquids to prevent aspiration, so they keep individual servings of thickener in their diaper bags now. Due to the aspiration issue, she had to drink pumped milk, so Wiley and her family had to travel with a cooler even though her twin sister could just breastfeed on demand.

Sadia’s daughter’s frontonasal dysplasia does sometimes force her family to contend with awkward comments and questions, but she has a stockpile of canned responses at the ready. She also talked to both her daughters about others’ perceptions and comments, since keeping them out of earshot is not a realistic option.

Higher Order Multiples

Mrslubby‘s husband loves to take her quadruplets and their 4-year-old big sister shopping, if nothing else to prove he can! He loads up two babies in one cart and two babies in another. With their older singleton standing on the end of a cart, he pushes one cart and pulls the other. While Mrslubby cringes at all the looks she gets from strangers with her brood, her husband basks in the acknowledgment of his juggling skills.

Pregnant MoMs

At the moment, Marissa is too pregnant with her third baby to wear her son A facing out in a front-carry. Unfortunately, he doesn’t like back-carry much, so she usually only take one kiddo on errands. Once again, her husband does most of the errands, because that’s what works for her family. As we said earlier, asking for help is an important MoM skill, as is accepting help when it’s offered.

Single (or Functionally Single) Parents

Janna and Sadia were both functionally single parents when their twins were very young, thanks to Janna’s husband’s extended work hours and Sadia’s (now ex-)husband’s repeated deployments. They had no alternative but to run errands with their kids, so it never occurred to them that it should be difficult. On the other hand, RachelG and her husband share equally in family tasks such as grocery shopping, so there is no need for either of them to master solo groceries. Do what works for your family’s needs.

If you’re a working single mother like Sadia, chances are that you have very little flexibility in your schedule and no one to watch your kids without prior planning. Work a weekly shopping trip into your routine so that your little ones know to expect it. Consider having a backup supply of canned and frozen goods to carry you through if you hit a week during which you just can’t make it to the store. Moms do occasionally get sick. Cars break down. Roads flood. Don’t be caught without food and toilet paper.

Unloading at Home

Unloading your groceries with young kids around can also take some planning. Your multiples and other kids may be especially demanding on returning to the safe environment of home. As on the way out of the door, make sure that you have a safe place to keep them while you bring your shopping inside.

Grocery Shopping with Twins and More from hdydi.com

Photo Credit: malloreigh

Consider using a cooler or insulated grocery bag for frozen or refrigerated items. This allows you a bigger window to tend to your kids before you return your attention to the groceries waiting to be put away. If your store has an especially competent bagger, do what you can to get in their checkout line and avoid careless baggers. Alternately, you can oversee the bagging yourself or simply communicate to the checkout staff that you need your things bagged in a particular order. It helps them out if you load groceries in logical groupings while you’re checking out.

Sadia keeps a tote in the trunk of her car to help keep things sorted. Refrigerator items go in the tote, everything else straight into the trunk. When she gets home, she can pick up everything that needs to be put away quickly at once. The rest can wait.

Not Just for Moms

The post has been written about moms going shopping with kids because we’re moms who go shopping with kids. This advice is for everyone else too, though: for the DoMs who do just as much in the way of home and family maintenance as MoMs, for nannies and au pairs who are out and about with the kids, for grandmas and grandpas, whether the grandkids are visiting or are in your permanent care.

Katelyn‘s husband carries one kid on his shoulders. Marissa’s husband wears a Moby like nobody’s business. Just yesterday, Sadia had a lovely conversation with a dad of 9-month-old twins while he wore one baby and had the other lying in the built-in infant seat in the store cart. When she got fussy, dad just scooped her onto his hip. He still had a free hand for the cart. Wiley’s nanny tends to wear one girl, put one in the cart seat, and put her middle boy in the body of the cart while the oldest is at school.

We all find ways to get things done, even if it takes some creativity.

Do you have specific types of errands, family situations, or location-related limitations on which you’d like The Moms’ advice? What grocery store trip tips did we miss?

The Most Challenging Age

The first year in a parent’s life is so challenging that we talk about it nearly every Tuesday here at HDYDI. You’ve heard of the “Terrible Twos“. So, what’s the most difficult age? Where’s the point where you get to tell yourself, “After this, it gets easier!“?

A quick poll of the HDYDI moms finds no agreement. The tales of struggle for those sleepless newborn nights are often just as harrowing as the three-year old tantrums, the four-year old follies, and on and on. The list is actually pretty long!

We’re not saying that life with small children is always a struggle, but rather that different families have different perspectives on what is “the most challenging age”. Kids are different, as are parents, and we shine (or fail to) in different circumstances. While the perspectives differ, the promising news is that it’s just an age–childhood is a series of stages–and these challenges will pass.

Here’s what some of the HDYDI moms have to say about the most challenging stages they’ve encountered.

Preterm Birth to 1 Year Old (Corrected) – Carolyn

If you don’t know me, you don’t know how the experience of preterm birth has moulded much of my life. Those who do know me can attest to the fact that the preterm birth of our twins right up to 15 months (12 months corrected) consumed my life and it was challenging to see and hear about even for those who were outsiders looking in on our rather unusual state of affairs.

Twin A ready for transport to Level III NICU

Twin A ready for transport to Level III NICU

The twins’ first few months were filled with many medical questions, some of which were put on the back burner, while we dealt with a newer, more pressing question to answer during medical disclosure meetings and consultations with the best of the best doctors. I quickly gained my honourary PhD in Neonatology. I was up for the challenge because I knew I was my babies’ main advocate during the long days in the NICU.

Twins' NICU "bedrooms" for 3+ months.

Twins’ NICU “bedrooms” for 3+ months.

Those early days and the activities that evolved became engrained in my brain. I may have been sleep walking the majority of that time during the very early days. Can you say, “routine”? Absolutely!

After our twins came home from their neonatal intensive care unit, we were faced with hundreds of appointments to attend in and outside the home. Somebody forgot to prepare me for the realities a preterm mom and dad should expect when it comes to bringing home tiny 27 weekers. While we were in the NICU talking about all the medical factors surrounding the babies’ lives, they didn’t mention anything about how much time was going to be spent in waiting rooms of doctor’s offices, hospitals, physiotherapists and speech therapists and occupational therapists…and audiologists…in that first year…Oh MY! It practically leaves me breathless just recollecting those long and busy days.

While chauffeuring my mini-men around in the mini-van to appointment after appointment, I was also a mom wanting to breastfeed her twins. When I would find myself in a waiting room at a hospital, with one or maybe two babies getting hungry, I’d talk to a staff member about where I could find a private nursing room, to be told there wasn’t one. Or I’d be stuck in a board room to nurse my babies sitting in an office chair with big clunky armrests! Those were the days. As much as I valued breastfeeding my babies, I was not a mother who wanted to do it in public spaces with random strangers surrounding me. Not my cup of tea. To each her own.

I missed the days many moms get during that first year, getting to establish a routine in their homes, sometimes sitting with their feet up for a few minutes to watch Ellen while they nurse their babies or attend to their needs. My daily routine was more comparable to an army drill, testing my skills and agility with getting twins dressed, big brother dressed, myself dressed, out the door and into the van without forgetting anything. Then there were days when it would snow on my parade.

Bundled up and ready for another run to a follow up appointment.

Bundled up and ready for another run to a follow up appointment.

Those were horrible days, but I didn’t have the choice to go back in and hibernate with my little cubs. We had to be somewhere and we were going to get there for our very important appointment. Come hell or high snow bank.

When I look back on that first year and a bit, which was two years ago now, I remember those days like they were just yesterday. Although that year was my most challenging year to date, I learned so much and truly value the life lessons the experience and my little babies taught me. It taught me so much about what it really means to persevere, to look fear in the face and tell it where to go!

Since then ages 2 and 3 have been a piece of cake. We’ll see what the future holds.

Age 1 – 2 (Toddler-hood) – ldskatelyn

While the first year proved a blur of feedings, naps, changings, sleepless nights, pumpings, doctor visits, and a complete upheaval from my previous life, I enjoyed my super cute girls!  They were innocent little babies incapable of really doing anything wrong and were so completely dependent on me.  I adored them.  They were perfect.

And then they started to walk.  And life was never the same again.

My girls were (relatively) early crawlers and walkers.  They were army crawling around by six months, even before they could sit up by themselves.  By 10.5 months Lisa was walking.  By 11 months her sister Alison was too. I find that the toddler years was the most challenging age.  While the tantrums, the lying, the attitude, and disobedience of my now three year-olds is challenging at times, it’s not all the time, and they are so independent now that it’s easier for me not to feel so stressed out.

But those toddler years, or from about 1 years old to 2.5 years old were rough.

And while my daughters were able to toddle and walk, allowing me not be carrying a child or two everywhere I went, it meant I had TWO little people often going in opposite directions.  I remember trying to walk in a straight line, holding both of their hands, being impossible.  One would walk faster, one would tug to the side, one would spin around in front of me, colliding into the other, leaving both crying on the ground.  Then I would be left pulling them both up to standing positions, which they seemed to no longer be able to do.  They may know how to walk, but it doesn’t mean they will.  And it certainly doesn’t mean they will walk to you when you ask them to.  It often meant the opposite, at least with one of my daughters.

most challenging agePlus, toddlers get into everything.  They don’t know what is safe or unsafe and absolutely everything ends up in their mouths.  They seem to think that if it’s on the ground, it must be picked up and handled, even nasty things like trash and cigarette butts.  They don’t know better.  Toddlers prove to be a source of greater anxiety for their parents.  They hurt themselves all the time, bumping into things. They pull everything off shelves, climb onto chairs and counters, knock over your safety gates, and much more.

My daughter Lisa from about the time she was 13 months old could undo the Velcro on her diaper.  And she was like a ninja with undoing it.  It often seemed no matter what we did, she would find a way to take off her diaper.  This often proved extremely messy.  I would have to clean poop out of sheets and off babies.  Diapers would be wasted.  And Lisa eventually taught her sister some of her diaper shedding ways.  (Stay tuned for a future post with all the fun we had with this).  And this went on for over a year. Most Challenging Age

Teething.  One of my daughters didn’t get her first tooth until she was nine months old.  This left lots of teething over the toddler years.  And every time my girls were teething it meant diarrhea.  And with Alison, it went everywhere.  It was horrible.  Combine that with Lisa’s diaper removing antics and it meant a lot of bathing and laundry.

And then there’s the messy mealtimes.  I wrote all about the joys of that in a past Foodie Fridays post. Finger foods are not really that simple or easy, and really just mean they are easier for little fingers to drop or throw around the room.  Or squish between their fingers, or mash into their hair.

My daughters didn’t say a whole lot of words for what felt like forever (age two).  Most of what I had the pleasure of listening to every day was crying, whining, and grunts, never knowing exactly what they were wanting.  While they began to understand what I was saying to them, I craved for the day we could actually have conversations instead of cavemen communications.

And finally there is nap time.  One nap or two?  In the morning or the afternoon?  One would be awake, the other asleep.  They might play for an hour in their cribs, before passing out, if they did at all.  It could be an hour in length or three.  And when it came time to transition out of cribs to toddler beds it opened up a whole new can of worms.  How do you contain the chaos if you didn’t stay there until they fell asleep?  And when they are napping regularly, it really just means your whole life revolves around their nap schedule.  And when they were taking two naps a day, it means your windows of opportunity are so very short.

I am glad that the toddler stage is past and that my girls talk (even though it’s non-stop), help, no longer require bibs, can walk themselves anywhere, are potty-trained, and we’ve figured out nap and bedtime (most days) in this house.  And they haven’t teethed in over a year. Three year-olds aren’t that terrible…

Age 3 – Sadia

Sure, I was sleep-deprived and frequently in the ER with my twins the first year, but I could hack it. Age One was delightful as I watched my little lumps of snuggle turn into strong, funny little people with a visceral affection for each other. I scoffed at the whole idea of the Terrible Twos; my girls were pure delight. Their observations of the world left me exhausted, but smiling. Nothing gave them greater joy than making Mommy or their teachers happy.

mandjcryingWhen we hit the Terrible Awful Horrible Titanic Tantrum Threes, I was completely unprepared. My sweet little girls turned into irrational demon monsters as they discovered their own wills and the concept of defiance. I didn’t recognize these back-arching, heel-drumming, kicking, hitting, screaming banshees. I became certain that someone was going to need to be institutionalized. I just couldn’t tell if it was going to be me or the children.

In order to prove to myself that it wasn’t just me, I began keeping a record of the causes of each day’s tantrums on my blog, boringly titled the Daily Tantrum Report. Here’s a taste:

October 23, 2009: [M's] pants were too tight. She hated her socks. Her shoes wouldn’t go on fast enough. She wanted chocolate milk. (She actually had chocolate milk, but was too busy flipping out to realize what was in her cup.) She didn’t want today to be J’s turn to lock the door. She didn’t want the sun to be shining yet.

November 10, 2009: I asked [J] to wash her hands. She refused. I gave her a chance to change her mind under threat of revoking her right to wear a dress today. She dug her heels in. I dug my heels in. I tried to dress her. She kicked me in the gut when I knelt to pull her pants on.

A dear friend recently contacted me on Facebook in desperation. She remembered my tears from Age Three and my dire warnings of the horrors to come. Her darling boy turned 4 a few days ago. My friend wants to know when the Terrible Horrible Awful Threes would give way to the Fabulous Fours. I told her to give it a month. Given that our children have been on similar developmental trajectories and we share a parenting approach, I expect to soon hear that her son, like my girls, makes age 4 her favourite age. At 4, my children discovered the beauty of logic, albeit with a slew of strange assumptions that came of a lack of experience in the world. They discovered a degree of self-control and rediscovered patience. Three was behind us. Good riddance.

Age 4 1/2 – MandyE

I’ve always considered our girls to be well-behaved.  They eat well.  They sleep well.  And they’re really pretty predictable.

I actually commented to the pediatrician when they were two that they’d never had a tantrum…I was a little concerned that something wasn’t right developmentally.  The two-year old mark passed with no sign of “terrible”, and my three-year olds continued their exemplary behavior.  Sure, I had fussy babies from time to time, and they would sometimes challenge to see what they could get away with, but the vast majority of the time, the girls were even-keeled.  I credited the 1-2-3 Magic methodology, along with a structured schedule inspired by BabyWise, with my girls’ temperament.

However…shortly before the girls turned 4 ½, I started to experience some of those “terrible” challenges I’d read about.  They were defiant.  “NO!!!” was screamed at me more times that I could count.  They were doing blatantly wrong things, seeming to vie for attention.  While I haven’t (yet?) seen a throw-yourself-on-the-floor tantrum, I have gotten swiped at a few times.

Where did this come from???  I felt like I could hardly recognize my precious babies.

This behavior continued to varying degrees for a couple of months.  It was terrible.  I felt like I was walking on eggshells, wondering when things would flip from joyfully-engaged kiddos to nothing-makes-me-happy.  I hated the feeling on some days, when I’d be counting down the hours to bedtime, praying that the following day would be better.  I missed my sweet girls, whose company I’d always truly enjoyed.

In hindsight, I remember that I started to suspect there was some attention-getting behavior around the time the girls turned four.  I read the book “The Five Love Languages of Children”, hoping to gain some insight.  I did my best to play to what I think my girls’ motivations are – physical touch for A, and words of affirmation for B.  Things were mostly OK until the girls stopped napping over the summer.  Whatever the combination of being more emotionally needy (???) with a bit of missing sleep…it felt near-lethal at times.

Thankfully, the majority of our challenges seem to have passed.  The girls have adjusted to their new schedule, and I have augmented my discipline strategy.  I can’t quite put my finger on it, but there is a difference in common “misbehavior” and sometimes-nasty attention-getting displays.  I continue to rely on the 1-2-3 Magic methodology, but there are times when I pull one kiddo off by herself for a few minutes to help her sort through her emotions and regroup in a more positive manner.

At age four, the girls are still babies in some respects, but they have more complex feelings.  They are able to communicate at a pretty high level, but their logic isn’t always sound.  Ultimately, I’m just grateful to feel like I’m mostly back on course with my girls.  And those challenging times make me even more appreciative of the free-for-all fun and super-sweet snuggles.

What has been the most challenging stage for you?