Twinfant Tuesday: Baby Bottle Care

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Categories Feeding, Formula, Products, Twinfant TuesdayTags 33 Comments

We’ve written quite a bit about our infant feeding experiences here on HDYDI, but I realize that I’ve neglected to discuss my bottle feeding experiences. That realization wasn’t a surprise. As I’ve told you before, much of my identity as a new mother was tied up in breastfeeding. Baby bottles were up there with gavage tubes on the list of things that I’d rather forget.

The fact is that baby bottles are genius.

A baby bottle can allow a father to feed a child. A baby bottle can allow a working mother to provide her child with breastmilk when she can’t be with her baby. A baby bottle can allow the bond of feeding between a mother and child when breastfeeding isn’t an option.

It’s been nearly 8 years since my daughters moved on from bottles, so I’m not the person to tell you about the newest and greatest development in baby bottle technology. What I can tell you is that, like every other aspect of parenting, it’s not just about what you like. You’ll have to take your child’s preferences into account. With twins, that means two sets of children’s preference, and they may like different things.

With M and J, we used Playtex VentAire bottles for formula and Playtex Nursers with Lansinoh storage bags for expressed breastmilk.

Baby bottles are for formula and expressed breast milk alike.

Once I returned to work, J and M went through 6-7 bottles a day, each. Every night, I had 12-14 bottles to wash. During my limited hours home, I had to breastfeed, eat, occasionally shower, complete household chores, and do that thing where you lie down and close your eyes. I’ve heard it rumoured that it’s called “sleep”. That last thing I wanted to spend my time on was scrubbing bottles.

Since all the bottles we used were open at each end, a bottle brush wasn’t a necessity. I didn’t use it much once the babies had outgrown preemie bottles. Instead, I used my dishwasher.

I had three of these handy dishwasher baskets. All the small parts associated with baby bottles and breastpumps fit in the basket for dishwasher cleaning and disinfection. I was a master of placing all the nipples, rings, bottle valves, pump valves, and lids so that each one was fully exposed to water.

This basket holds small bottle parts for dishwasher disinfection.For the first several months, I would take the washed bottles out of the dishwasher and boil them in a pot of water for disinfection, but over time, I grew to trust the High Heat setting on the dishwasher. Before long, the girls’ immune systems had built up to where disinfection was no longer called for. After all, they were getting plenty of immune exercise from their time a group daycare.

For simplicity, I assembled rings, nipples and lips and stored those stacked beside all the bottles. That way, there was no need to spend time unscrewing bottles or pulling through nipples when it was time to feed.

What are your timesaving tricks for life filled with baby bottles?

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Twinfant Tuesday: How to Afford Formula

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Categories Feeding, Finances and Saving, Formula, Twinfant TuesdayTags 2 Comments

7 ideas for saving money on formula, with a particular emphasis on twins, triplets and more... because families of multiples need extra help!Babies are expensive. Next to diapers and daycare, infant formula may be the number one expense. Yes, we all know that “breast is best” but the fact is that exclusive breastfeeding simply isn’t an option for all of us. Many MoMs simply can’t produce enough milk for multiple babies, while for others, the logistics of breastfeeding several babies while providing for their other needs puts nursing beyond reach. Those of us who gave birth prematurely know that preemies and breastfeeding don’t always mix.

Six months worth of formula for just one baby averages out at $860 in the US and ranges from $510 to $3062 in Canada. Now multiply that cost to account for our multiple babies, and I start to feel a little sick.

Unfortunately, I have no magic wand to make this all better, but here are what other MoMs have done to maximize the bang for their formula buck.

  1. Breastfeed/pump. Even a little helps, if you can maintain your sanity while nursing or pumping. Many insurance companies now cover breast pumps and associated supplies, so pumping can be practically free, aside from the additional food you’ll eat to make that milk. Breastfeeding actually requires more calories than pregnancy, I was surprised to learn.
  2. Government assistance. There are two types of US food assistance that may apply to families with infants: WIC (Special Supplemental Nutrition Program for Women, Infants and Children) and SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps).Even if you don’t qualify for SNAP (income is 130% of poverty or less), you may qualify for WIC, so do your research. WIC serves 53 percent of all US-born infants, so your chances are good!While implementation varies by state, WIC generally provides families with vouchers for high-nutrition items, including formula for infants who are not exclusively breastfed.In Canada, social assistance recipients may be additionally eligible for special financial assistance in buying formula, depending on province. Regular, soy-based and lactose-free formulas are all covered, although additional medical documentation may be required for those last two types. This is in addition to the universal child care benefit of $100/month for any child up to the age of 6.All current HDYDI authors live in the US or Canada.

    If you have information about government support for formula-fed infants in your country, please let us know in the comments.

  3. Free samples. Doctors and hospitals are well supplied with formula samples from companies trying to get you committed to their brand, usually in full-size containers. Don’t be too proud to ask for additional free samples when you exhaust the supply that you may have received in the first few days. Keep in touch with the lactation consultants at your hospital. They can hook you up! Yes, they’re professionals committed to breastfeeding success, but they’re all about making sure babies are nourished. Also consider contacting formula manufacturers to request samples. I’ll talk more about making a multiples-specific pitch below in number 6.
  4. Shop around. Here’s a big secret: you don’t have to commit to a formula brand. Formula is like any other food product. The generic stuff is usually comparable to the brand name, at a lower cost. With the more expensive brands, you’re more likely paying for better marketing than improved quality. Find out whether a warehouse club like Sam’s Club or Costco is worth the cost of membership in formula savings. Buy formula in bulk when it’s on sale, being aware of the expiration date, of course. Maybe purchasing formula through Amazon’s Subscribe and Save service may save you cash. Perhaps your local grocery store has good deals on its store brand formula. A lot of store brand formula lines now include soy and lactose-free offerings. Those of us who need high-calorie preemie formula probably still need to go with the brand names.
  5. Coupons. I have a love-hate relationship with coupons. As a user of in-store coupons when I see them, I just wish that stuff would be offered at the lower price point without the hassle of having to scrounge and clip… or at least that coupon savings would be automated at the register. When it comes to formula, though, coupons can save you a whole bunch. Check out formula company websites, and consider following the Baby Formula Coupons Facebook page. Jen Wood mentioned that her Mother of Multiples club had a coupon exchange table at every meeting where parents could drop off their unused coupons for other parents to use. Why not start something similar in your community?
  6. Manufacturers’ multiples programs. A number of the major formula and baby food manufacturers offer programs specific to multiple birth families, usually in the form of free samples or coupons. You need a doctor’s referral to qualify for the Enfamil program, which provides a case of formula per baby. Call 1-800-4-GERBER to sign up for the Gerber Multiple Births program, which includes Gerber Good Start formula. This post at The Krazy Coupon Lady even has a letter composed for you to send to companies that don’t have an official program.
  7. Insurance. Don’t forget to look into your medical insurance options. Especially if you have a child or children with special dietary needs, such as those associated with premature, food intolerances, or allergies, you insurance may cover part of all of your formula expenses.

Do you have a penny-pinching approach that we’ve missed?

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Twinfant Tuesday: How Feeding Multiples Makes the First Year Even Harder

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Categories Breastfeeding, Formula, Household and Family Management, Parenting Twins, Twinfant TuesdayTags , 5 Comments

In my last Twinfant Tuesday post, I talked about the things that make the first year of parenthood challenging: not knowing your kids’ likes and dislikes, not being able to ask babies what they want, the expense, the sleep deprivation. These are things common to all parents, not just parents of multiples.

There are challenges that are unique to us, though, unique to those of us who proudly (or tentatively) wear the badge of the Mother of Multiples club, that exclusive, amazing, inspiring, terrifying club that we find ourselves in. Feeding alone is (warning: pun ahead) all-consuming. Whether you’re exclusively breastfeeding, exclusively bottle-feeding, doing both, or somewhere in between, feeding multiple infants is crazytown.

Touch Saturation

When I recently visited Liggy‘s perfect little ones, we found ourselves talking about how, after nursing for over 12 hours a day, we just don’t want to be touched any more. Even hugs or affection from our pets feel like invasions in those rare moments that our bodies belong to us.

It’s not that we resent the time that our babies are nursing or snuggling. That contact is still beautiful and (once you have the babies’ preferences figured out) peaceful. It’s that nursing contact is the only contact that our senses can handle. It’s as if our bodies are primed to breastfeed and all other physical contact, no matter how otherwise welcome, pushes our sensory capacity over the edge.

Tandem? Sequential? What if We Have More Than Two?

“It’s a good thing you have two breasts,” my daughter M mused the other day.
“True,” I responded. “You know that Aunt D had triplets.”
“I was just thinking that!” M exclaimed. “I guess she had to use three bottles…”
“No, she actually breastfed,” I informed her, proudly.
M was floored. “SHE HAS A SECRET BREAST?”

Sadia is exhausted and disheveled after a marathon nursing session with her pair.
I looked disheveled all the time while I was breastfeeding my pair. I once even managed to go to work with my pants on inside out. Who has time to stop by the mirror?

It’s not just 7-year-olds who assume that breastfeeding more than two babies is downright impossible. While it’s not impossible, it is indescribably difficult. Juggling the babies, consuming enough calories and fluids, getting everyone comfortable, making time for anything else…. People who haven’t experienced life with multiple infants just don’t understand.

Even those who have observed for a few hours can’t possibly imagine what it really means to breastfeed more than one child at a time. You have to get everyone to cooperate. Maybe you’re able to produce enough milk, but if just one of your babies refuses to nurse unless she’s lying across your lap without another baby in the way, there goes tandem nursing.

I like words. I love writing. I just do not have the words to explain how incredibly hard it is to breastfeed two. I know that I don’t have the capacity to comprehend how many harder it is to breastfeed more, and yet mothers do it. Every day. All day.

The Bottles, the Pump Parts, the Washing. Oh My!

Bottles, collars and nipples drying
Photo Credit: if winter ends

When my sister was a baby, we washed her bottles by hand. We also had servants. There was one of her. It was still a lot of work.

I can’t tell you how glad I am to have a dishwasher. We used that thing. A lot.

Word to the wise: if you’re in the dishwasher market and considering having kids ever, buy a model that runs quietly. It was so worth the extra money to have a dishwasher we could run while the babies were sleeping.

Breastpump parts
Photo Credit: aaron_anderer

Now add in all the breast pump parts that need to be washed. There are flanges and adapters and valves. Occasionally the tubing needs to be washed out. Depending on how you store you milk, there may be storage containers to wash.

Even if you use disposable bags for storing your milk, you have to restock those. You have to pull frozen milk out of the freezer to allow it to defrost.

There’s just so much stuff to remember and to do to keep our babies fed.

Shortcuts

There are shortcuts that can make your life easier, things I wished I’d thought of earlier.

If formula is part of your game plan, as it was for us, consider preparing it by the pitcher instead of by the bottle. Just make enough for the day (or the night) and refrigerate it. Alternately, pre-measure you formula into individual containers so you don’t have to think about proportions or deal with scoops all day. Warning: this is another thing to wash!

It took me a while to realize that I could store the nipples assembled in their collars with the lids on. That saved me the assembly. My husband also loved drop-in bag/liners for thawed breastmilk.

If you’re pumping and nursing, you may be able to breastfeed on one side while pumping on the other. I don’t know about you, but I could get about 4 times as much milk from a pump-and-nurse session than from pumping alone. I found that my Medela flanges tucked comfortably into open-front and pull-down nursing bras for a hands-free experience.

I didn’t (and still don’t) remember all that I do in the middle of the night. I had to write down which baby I’d changed and when, who had eaten and when, who’d been fussy and when. Not only did our notebooks serve as a communication solution between my middle of the night zombie self and the awake version, but between me and my husband too. It didn’t hurt to have these notebooks on hand when we went to the pediatrician, either!

We found that one bottle parts dishwasher basket was inadequate, but two was plenty if we washed what we used daily. We ran the dishwasher on the sanitary cycle. We did not skip a night.

Hard? Yes. Impossible? No.

Despite how hard this is, we find a way to feed our kids.

The vast majority of our kids grow into solid foods. They wean off the bottle or breast. Eventually, this becomes a vague memory. What stays with us are just impressions: the smell of the baby on our shoulder, burping while the other continues to suckle; the weight of our children in our arms; the weight of our eyelids; the sight of squishy cheeks; the leap of our hearts when we see our children holding hands; above all, the knowledge that we all survived.

We MoMs did the impossible, rendering it merely improbable.

What is/was hard about infant feeding in your family?

Sadia (rhymes with Nadia) has been coordinating How Do You Do It? since late 2012. She is the divorced mother of 7-year-old monozygotic twins, M and J. She lives with them and their 3 cats in the Austin, TX suburbs and works full time as a business analyst. She retired her personal blog, Double the Fun, when the girls entered elementary school and also blogs at Adoption.com and Multicultural Mothering.

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From the Archives: Infant Feeding

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Categories Breastfeeding, Feeding, Formula, HDYDI Blog, InfantsTags , , , , , 3 Comments

Link Party Button #milkingitI wanted to take this opportunity to highlight the variety of posts here on How Do You Do It? on the subject of infant nutrition, whether breast milk, formula, or some combination. Obviously, there have been several posts over the past several days, but there’s a larger body of wisdom and experience that The HDYDI Moms have gathered here over the years.

Breastfeeding

WBW-Button-150

Expressed Breast Milk (EBM)

Breast Milk and Formula

Formula Feeding

Feeding Tube

We don’t actually have any posts on long-term NG-tube feeding on HDYDI yet, but we have a couple of post-NICU feeding tube mamas in our ranks. If you have questions, please let us know.

Weaning

Infant Feeding in General

Phew. Is anyone else emotionally worn out from the heartfelt intensity of the breastfeeding posts here and elsewhere over the last few days? I cried writing my own post and cried again reading the others. It was cathartic, but it hurt like crazy.

Feeding our infants strikes me as being representative of motherhood in general. We put every part of ourselves into being the best moms we can be, but we never feel that we’re doing quite enough. Or maybe that’s just me.

Do you have other online infant feeding resources to share? Please tell us about them in the comments.

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Quitting Breastfeeding

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Categories Breastfeeding, Emotion, Family, Feeding, Feeling Overwhelmed, Formula, Mommy Issues, World Breastfeeding Week Blog Carnival5 Comments

World Breastfeeding Week 2013 Blog Carnival - NursingFreedom.org and The San Diego Breastfeeding CenterWelcome to the World Breastfeeding 2013 Blog Carnival cohosted by NursingFreedom.org and The San Diego Breastfeeding Center!

This post was written for inclusion in the WBW 2013 Blog Carnival. Our participants will be writing and sharing their stories about community support and normalizing breastfeeding all week long. Find more participating sites in the list at the bottom of this post or at the main carnival page.

***

IMG_0873

The three of us, at 2 weeks, around 5 a.m. after tandem nursing for one of 12 times a day.

Before I was a Mom, my goal was to breastfeed my baby. When I found out there were two babies, I still wanted to breastfeed exclusively. Breastfeeding was tough, much harder physically and emotionally than I could have ever imagined. One of my sons had a terrible latch and it hurt every single time I fed him until the very last time. My twin boys were born at 38 weeks and were nearly 7 lbs each, but by the time my big babies were five days old we were told we had to supplement them with formula, they were not only not gaining weight, but had lost more than 20 percent of their birthweight. Despite sitting topless in my living room in the flotation raft of a twin nursing pillow around the clock for the first few months, they didn’t exceed their birthweight until nearly a month old and struggled to gain an ounce some weeks. We hoped we could get back on track and drop the formula. We never did. By the time I went back to work at 6 months I was nursing and pumping and not coming close to meeting the demands of two growing boys. My breastfeeding journey was long and difficult, but I fed them some breast milk every day until they were almost 9 months old. By that time, I was pumping less than 5 oz a day, which could not feed one bottle to one baby. They were eating foods and finally gaining weight and on the growth chart for the first time in their lives, but it wasn’t from me.

weights

I charted their weights for the first 6 months because it was so challenging.

Quitting was one of the hardest things I had ever done. I felt like a huge failure. I cried and cried. (It has been three years and re-reading this letter I wrote brought back the tears.) I didn’t want to give up but my body did. I talked to the lactation consultant I had been seeing since my boys were born and she suggested I pump to comfort in order to quit. I only had to pump one more time. I was done. I wrote this letter to my boys that day, three years ago. I wanted them to know I did everything I could for them.

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This photo was taken on the day I wrote this letter. It was a setup for a BBQ invitation, but fitting since they were moving on to different culinary pastures.

July 24, 2010

My dear little boys, I love you so much. I want you to know that I quit breastfeeding today. It has been a long time coming I am afraid, but I want you to know that I tried everything to make it work for us. From the moment I found out I was pregnant, I have only wanted the very best for you.

When we found out there were two of you I knew it would be hard at times, and wonderful and amazing. I still wanted the best for you. It would have been easy to forgo breastfeeding entirely, but I know that it is the perfect food for a baby and I wanted you to have it.  I managed to carry you to full term, which gave you a great start. You were both big and healthy and perfect.

Even in the hospital, though, the three of us had difficulties feeding. We struggled with latch problems, some of which were never resolved. Those early weeks were rough. I was in pain, I got an infection, you both lost a lot of weight, I never seemed to produce enough and you were weak and shrinking and it was heartbreaking.

Dad was amazingly supportive and helped with all those feedings, every two hours. For the first two months, we fed you on every even hour – midnight, 2, 4, 6, 8, 10, noon, etc. around the clock. I nursed and pumped and we gave in and gave you formula. Your weight would go up an ounce or two then down, then stay the same, for weeks on end.

You were healthy, though, and doing all the milestone things you were supposed to. I was told time and again that I wasn’t feeding you enough, and it killed me to hear that because I was doing everything I could to feed you as much as you needed.  When one of you developed a milk allergy Joshua, it wasn’t easy to completely eliminate dairy in all its forms. I have missed cheese and ice cream and butter. But knowing it would make you so sick, it was easy to stick to a dairy free existence. And I hope it means you will outgrow it and you’ll be able to enjoy those things too.

The three of us went to the hospital every Wednesday to weigh you and see how you were growing. And those early months the change was gradual. You stayed in your Newborn clothes until you were more than 3 months old. The 0-3 months stuff just started to fit at 3.5 months. Winter was nearly over by the time you got into those 3-6 months clothes at 5 months. I charted your weight gain each week, and the graph was moving up, but very slowly. We would go to your pediatrician appointments and were told you were both 1st percentile in weight, or sometimes not even on the chart. At one point Justin, you were a full pound and a half smaller, even though you were the bigger baby at birth. I was so afraid they were going to think I was a bad mom and take you away or put you in the hospital or something.

At six months you were both finally on the percentile chart. You had doubled your birth weight. You were in the 3rd percentile. And for the first time since birth, Justin was heavier again. For the next two months you took turns, sometimes Joshua was heavier, sometimes Justin. Several weeks you were exactly the same. But once you added solid foods like cereal and veggies you really started to grow and grow. 

Now you are almost 9 months old. You are amazing little boys. You are both so curious and sweet and loving. You are both becoming mobile and are crawling around on your tummies.

I hope I have given you a good start to a long life of health and love. I hope that you know I have done everything I could to make your first months the best I possibly could. I have taken herbal supplements, I have resorted to prescription medication, I have rented a pump, bought a pump, eaten nearly any food any wives tale suggested might increase milk supply. I have only ever managed to make about half of what you have needed.

Now that I have gone back to work, though, it’s just not working out anymore. I no longer produce enough to feed you each one bottle a day. I take extra breaks and drink a ton of water and do all the things that are supposed to help. I pump five times a day and often in a small closet where the door doesn’t shut all the way. I do this because I love you.

But happy, healthy babies need more than just breast milk. They need a Mommy who is happy and healthy too. I know it hasn’t been perfect, and it hasn’t gone how I had hoped, but I truly did the very best I could to give you every drop I could manage. I am sure this is not the only time I will fall short of my hopes for you, I guess being a parent means having the highest hopes and doing the best you can. You are truly wonderful little boys and I am glad to be your mommy. I hope you will always know I will always do what I can for you. This Mommy business is hard, but with two great kids and a wonderful husband, I am the luckiest Mommy ever.

Thank you.

IMG_6041

Jen W. is the mom of two very energetic, and on-the-percentile-chart 3-and-a-half-year-olds who leave me asking at the end of every day, “How DO I do it?” 

***

World Breastfeeding Week 2013 Blog Carnival - NursingFreedom.org and The San Diego Breastfeeding Center Visit NursingFreedom.org and The San Diego Breastfeeding Center for more breastfeeding resources and WBW Carnival details!

Please take time to read the submissions by the other carnival participants. Below are a list of links for today’s participants; you can find a complete list of links (updated throughout the week) at our main carnival page:

(This list will be updated by afternoon August 5 with all the carnival links.)

  • An Unexpected Formula-Fed Attachment — Kyle (of JEDI Momster and) writing at Natural Parents Network, exclusively breastfed three healthy babies. So when she was pregnant with her fourth, she assumed she would have no breastfeeding troubles she could not overcome. Turns out, her fourth baby had his own ideas. Kyle shares her heartfelt thoughts on how she came to terms with the conclusion of her breastfeeding journey.
  • It Take a Village: Cross Nursing — Shannah at Breastfeeding Utah shares how cross-nursing helped her baby in their time of need, and how that experience inspired her to create a community of cross-nursing and milk-sharing women.
  • Random little influences and Large scale support communities lead to knowing better and doing better — amy at random mom shares how her ideas and successes involved with breastfeeding evolved with each of her children, how her first milk sharing experience completely floored her, and how small personal experiences combined with huge communities of online support were responsible for leading and educating her from point A to point D, and hopefully beyond.
  • Mikko’s weaning story — After five years of breastfeeding, Lauren at Hobo Mama shares how the nursing relationship with her firstborn came to a gentle end.
  • My Milk is Your Milk — Lola at What the Beep am I Doing? discusses her use of donor milk and hhow she paid the gift back to other families.
  • World Breastfeeding Week 2013 Blog Carnival – Celebrating Each Mother’s Journey — Jenny at I’m a full-time mummy lists her experiences and journey as a breastfeeding mother.
  • Working Mom Nursing Twins — Sadia at How Do You Do It? breastfed her twin daughters for 7 months. They made it through premature birth and NICU stays, her return to full-time work, her husband’s deployment to Iraq, and Baby J’s nursing strike.
  • So, You Wanna Milkshare? — Milk banks, informed community sharing and friends, oh my! So many ways to share the milky love; That Mama Gretchen is sharing her experience with each.
  • Milk Siblings: One Mama’s Milk Sharing Story (and Resources)Amber, guest posting at Code Name: Mama, shares how her views on milk sharing were influenced by her daughter receiving donor milk from a bank during a NICU stay, and how that inspired her to give her stash to a friend.
  • Humans Feeding Humans — Krystyna at Sweet Pea Births shares ideas on how we can celebrate all the different ways modern mommies feed their babies. While we are comfortable with the breastmilk-formula paradigm, she proposes that we expand our horizons and embrace all the different ways mamas feed their infants.
  • When Breastfeeding Doesn’t Go As Planned — MandyE of Twin Trials and Triumphs shares the challenges she faced in feeding her premature twins. She’s still learning to cope with things not having gone exactly as she’d always hoped.
  • Taking Back My Life By Giving Away My Milk — When Amanda Rose Adams‘s first child was born, he was tube fed, airlifted, ventilated, and nearly died twice. In the chaos of her son’s survival, pumping breast milk was physically and mentally soothing for Amanda. Before long her freezer was literally overflowing with milk – then she started giving it away.
  • The Tortoise and the Hare — Nona’s Nipples at The Touch of Life discusses why we care about breast milk and formula with everything inbetween.
  • Finding My Tribe of Women Through Milk Sharing — Mj, guest posting at San Diego Breastfeeding Center shares her journey breastfeeding with low milk supply and supplementing with donor milk using an at the breast supplemental nursing system. She shares the impact milk sharing has had on her life, her family, and how it saved her breastfeeding relationship. Her article can also be found at her blog:
  • Human Milk for Human Babies — Sam at Nelson’s Nest shares her perspective on milk-sharing after an unexpected premature delivery left her pumping in the hopes of breastfeeding her son one day. Sam’s milk was an amazing gift to the other preemie who received it, but the connection was a blessing in the donor mom’s life too!
  • Sister, I Honor You — A mother feeding her baby is a triumph and should be honored, not criticized. Before you judge or propagate your own cause, go find your sister. A post by Racher: Mama, CSW, at The Touch of Life.
  • Every Breastfeeding Journey Is Different, Every One Is Special — No two stories are alike, evidenced by That Mama Gretchen’s collaboration of a few dear mama’s reflections on their breastfeeding highs, lows and in betweens.
  • Quitting Breastfeeding — Jen W at How Do You Do It? share a letter she wrote to her boys, three years ago exactly, the day she quit breastfeeding after 9 months.
  • A Pumping Mom’s Journey — Shannah at Breastfeeding Utah shares about her journey pumping for her son, who was born at 29 weeks.
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When Breastfeeding Doesn’t Go As Planned

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Categories Attitude, Breastfeeding, Formula, Frustration, Infants, NICU, Parenting Twins, Prematurity, World Breastfeeding Week Blog Carnival6 Comments

World Breastfeeding Week 2013 Blog Carnival - NursingFreedom.org and The San Diego Breastfeeding Center

Welcome to the World Breastfeeding 2013 Blog Carnival cohosted by NursingFreedom.org and The San Diego Breastfeeding Center!

This post was written for inclusion in the WBW 2013 Blog Carnival. Our participants will be writing and sharing their stories about community support and normalizing breastfeeding all week long. Find more participating sites in the list at the bottom of this post or at the main carnival page.

***

I had every intention of breastfeeding.  In all the baby gear I amassed while I was pregnant, I didn’t even have one bottle.  As a SAHM, I wouldn’t need bottles, right?

But then our twin girls were born six weeks early.  By multiples standards, that’s not too bad, really…but there was NICU time, and concerns over weight gain.  Although I pumped just a couple or hours after they were born, they were given several bottles of formula by the time I saw them the following day.

This was not how I’d planned things.

I kept at a rigorous pumping schedule.  To my dismay, I wasn’t getting much milk.  I drank water by the liter.  I ate lots of calories.  I eventually took prescription and herbal supplements.  I never got more than a couple of ounces.

Still, I breastfed the girls with the help of the lactation consultants at the hospital.  Weight checks before and after breastfeeding, though, showed they weren’t transferring any / very much milk.  I was encouraged to pump / breastfeed the girls, but I was told I had to supplement with formula.

Still determined to give my girls the gift of breast milk, I breastfed a baby, then bottle-fed that baby (to make sure she got the calories she needed), and then I pumped (to try to increase my supply)…six to eight times a day.

It was exhausting, of course…but it also felt very demoralizing at times.  Why couldn’t my body respond to the needs of my tiny babies???

After lots and lots of frustrated tears, I finally set a goal of three months.  I would give my girls every ounce I could for three months.  That would carry them through cold and flu season.  By that time, they should be on the growth curve.

After that time, my girls were formula fed.

As I look back, four years later, this is still an incredibly emotional subject for me.

I am not writing this to ask what I could have done differently.  Could I have done something to be more successful in nursing?  To have upheld the “breast is best” ideology I believed to my core?  Maybe.  Or maybe not.  I don’t know.

To be perfectly honest, I still look with some degree of awe and jealousy at the moms I see breastfeeding their babies poolside, or at the coffee shop…my best friend nursing her precious newborn on the couch in my living room.

Four years later, though, I’m getting through the guilt.  I am finally to the point of looking beyond the sustenance our girls got during their infanthood, and that’s a big step for me.

My amazing girls are healthy, vibrant, curious, sometimes mischievous.  I know things won’t always go exactly as I’d like them to, but above all, I want them always to see a mama who loves them heart and soul for exactly who they are.  There’s great value in that “sustenance”, too.

MandyE is mom to 4 1/2-year old fraternal twin girls, A and B.  She blogs about their adventures at Twin Trials and Triumphs.

***

World Breastfeeding Week 2013 Blog Carnival - NursingFreedom.org and The San Diego Breastfeeding Center Visit NursingFreedom.org and The San Diego Breastfeeding Center for more breastfeeding resources and WBW Carnival details!

Please take time to read the submissions by the other carnival participants. Below are a list of links for today’s participants; you can find a complete list of links (updated throughout the week) at our main carnival page:

(This list will be updated by afternoon August 5 with all the carnival links.)

  • An Unexpected Formula-Fed Attachment — Kyle (of JEDI Momster and) writing at Natural Parents Network, exclusively breastfed three healthy babies. So when she was pregnant with her fourth, she assumed she would have no breastfeeding troubles she could not overcome. Turns out, her fourth baby had his own ideas. Kyle shares her heartfelt thoughts on how she came to terms with the conclusion of her breastfeeding journey.
  • It Take a Village: Cross Nursing — Shannah at Breastfeeding Utah shares how cross-nursing helped her baby in their time of need, and how that experience inspired her to create a community of cross-nursing and milk-sharing women.
  • Random little influences and Large scale support communities lead to knowing better and doing better — amy at random mom shares how her ideas and successes involved with breastfeeding evolved with each of her children, how her first milk sharing experience completely floored her, and how small personal experiences combined with huge communities of online support were responsible for leading and educating her from point A to point D, and hopefully beyond.
  • Mikko’s weaning story — After five years of breastfeeding, Lauren at Hobo Mama shares how the nursing relationship with her firstborn came to a gentle end.
  • My Milk is Your Milk — Lola at What the Beep am I Doing? discusses her use of donor milk and hhow she paid the gift back to other families.
  • World Breastfeeding Week 2013 Blog Carnival – Celebrating Each Mother’s Journey — Jenny at I’m a full-time mummy lists her experiences and journey as a breastfeeding mother.
  • Working Mom Nursing Twins — Sadia at How Do You Do It? breastfed her twin daughters for 7 months. They made it through premature birth and NICU stays, her return to full-time work, her husband’s deployment to Iraq, and Baby J’s nursing strike.
  • So, You Wanna Milkshare? — Milk banks, informed community sharing and friends, oh my! So many ways to share the milky love; That Mama Gretchen is sharing her experience with each.
  • Milk Siblings: One Mama’s Milk Sharing Story (and Resources)Amber, guest posting at Code Name: Mama, shares how her views on milk sharing were influenced by her daughter receiving donor milk from a bank during a NICU stay, and how that inspired her to give her stash to a friend.
  • Humans Feeding Humans — Krystyna at Sweet Pea Births shares ideas on how we can celebrate all the different ways modern mommies feed their babies. While we are comfortable with the breastmilk-formula paradigm, she proposes that we expand our horizons and embrace all the different ways mamas feed their infants.
  • When Breastfeeding Doesn’t Go As Planned — MandyE of Twin Trials and Triumphs shares the challenges she faced in feeding her premature twins. She’s still learning to cope with things not having gone exactly as she’d always hoped.
  • Taking Back My Life By Giving Away My Milk — When Amanda Rose Adams‘s first child was born, he was tube fed, airlifted, ventilated, and nearly died twice. In the chaos of her son’s survival, pumping breast milk was physically and mentally soothing for Amanda. Before long her freezer was literally overflowing with milk – then she started giving it away.
  • The Tortoise and the Hare — Nona’s Nipples at The Touch of Life discusses why we care about breast milk and formula with everything inbetween.
  • Finding My Tribe of Women Through Milk Sharing — Mj, guest posting at San Diego Breastfeeding Center shares her journey breastfeeding with low milk supply and supplementing with donor milk using an at the breast supplemental nursing system. She shares the impact milk sharing has had on her life, her family, and how it saved her breastfeeding relationship. Her article can also be found at her blog:
  • Human Milk for Human Babies — Sam at Nelson’s Nest shares her perspective on milk-sharing after an unexpected premature delivery left her pumping in the hopes of breastfeeding her son one day. Sam’s milk was an amazing gift to the other preemie who received it, but the connection was a blessing in the donor mom’s life too!
  • Sister, I Honor You — A mother feeding her baby is a triumph and should be honored, not criticized. Before you judge or propagate your own cause, go find your sister. A post by Racher: Mama, CSW, at The Touch of Life.
  • Every Breastfeeding Journey Is Different, Every One Is Special — No two stories are alike, evidenced by That Mama Gretchen’s collaboration of a few dear mama’s reflections on their breastfeeding highs, lows and in betweens.
  • Quitting Breastfeeding — Jen W at How Do You Do It? share a letter she wrote to her boys, three years ago exactly, the day she quit breastfeeding after 9 months.
  • A Pumping Mom’s Journey — Shannah at Breastfeeding Utah shares about her journey pumping for her son, who was born at 29 weeks.
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Breastmilk, Meet Formula: Part II

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Categories Balance, Breastfeeding, Development, Formula, Infants, Mommy Issues, Overnight, RoutinesTags , , 2 Comments

A while ago, I wrote about starting formula with my until-then exclusively breastfed babies. Three months later, things are evolving again.

Here’s our schedule at nearly 9 months:

7:30-8am – Wake and breastfeed

9am – Breakfast (solids)

10ish-11:30ish – Bottle and Nap

1pm – Sometimes breastfeed, Lunch (solids)

3ish-4ish – Bottle and Nap

5:30pm – Breastfeed

6pm – Dinner (solids)

7:30-8pm – Bottle and Bed

11:30pm, 1:30am, 4:30am, sometimes 6:30am – Breastfeed

It’s pretty great. Except that last bit, where I’m STILL up 3-4x per night. I can’t quite figure it out. M used to sleep 8-12 hours without feeding. R could go at least 6. What happened? Is this a sleep issue (they’ve gotten into the habit of waking and needing a snuggle) or an eating issue (they’re not getting enough during the day and are making it up at night) or a combination of both? It’s not a growth spurt; it’s been going on for weeks. Our pediatrician assures us that they are growing well, staying right on their own curve, and that they certainly could sleep 11-12 hours.

As we approach one year, I know that the boys will gradually drop milk feeds and rely more on solids for nutrition. But which feeds will be dropped? They are already less interested in the mid-day breastfeeding.

I’m faced with what feels like a major decision: Do I prioritize sleep, and make a plan to drop the night feedings? Or do I prioritize breastfeeding?

On the rare night that the boys wake only twice in the night, I feel like a different person. I’m happy, calm, have perspective. On nights I’m up 3, 4, 7 times, I’m thrust back to newborn days all over again – I’m achy and depressed and my mind is in a fog. I’d love to regularly get more sleep, but it means that half the breastfeeds would be cut out. Meanwhile, would my boobs explode in the night? How would it affect my supply? Then there is the whole crying aspect of any kind of sleep modification. Isn’t it easier to just get up and take twenty minutes to soothe rather than to endure seemingly endless minutes of tears?

Then again, it’s not as if breastfeeding isn’t work too. I’m taking domperidone, and despite being assured by a lactation consultant that I would be “overflowing with milk,” I’m not sure it’s making much difference at all. I’m also taking an herbal milk supplement 4x/day. M gets frustrated waiting for let-down, and R has started biting. All the necks of my shirts are stretched out. Sometimes they are too distracted to take a full feeding, which drives me crazy. Other times they are ravenous and I just don’t feel I have enough to satisfy them. I get tired of stripping every time someone is hungry. There are days I want to just stop – go with the order, predictability, and data-friendly formula and close this chapter of mothering. I mean, they have to stop at some point.

Other times, I cling to the connection with my boys, and frankly, the self-righteousness of doing “the best” for them. I love that they are getting the perfect food, and feel horrible guilt that I can’t give them more. It’s such a breeze to be out and be able to feed them without any prep or clean up. I love their cuddles and sweet little milky breath. It isn’t like when they were newborns – I have many other ways to comfort them now – but there is a special peacefulness about it, especially since I’ve stopped tandem feeding and can focus on one little guy at a time.

I could attempt to return to exclusively breastfeeding by one year (over the next three months) by phasing out the formula feedings. Or I could focus on phasing out the night feedings and get some much-needed sleep. Or I could keep doing what we’re doing, take my cues from the boys, and let things evolve naturally. Why does that last one seem so right and yet so hard?!

Anyone successfully transition from formula supplements to exclusively breastfeeding, or vice versa? Do you lean toward guiding their kids through transitions, or are you able to follow their lead?

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Corn Syrup in My Babies’ Formula?

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Categories Anger, Formula, Frustration, Infants, Medical, NICU, PrematurityTags , , , , 1 Comment

I gave birth to my twins, J and M, when they reached 33 weeks gestation. They were 7 weeks shy of being a fully cooked 40 weeks along when they were born, and 2 weeks early even for my minimum goal of 35 weeks. We were incredibly fortunate that they didn’t have any serious complications, but both babies still needed special care in the NICU.

I’ve always been a parent who researches, so I was pretty well-versed on the phases of development the girls were going through at various points in my pregnancy. Still, seeing my preemies brought it home in a visceral way that no research could have done.

A very small newborn, with lots of cords and wires all over her.Both M and J were rather furry when they were born, covered with lanugo, or the in-utero hairs that usually fall off well before babies emerge from the womb. I could only distinguish this fur from their eyebrows with the help of the thin line of hairlessness that separated their foreheads from their brows.

The girls’ skin was loose on their bones. After all, they hadn’t yet reached the milestone of 35 weeks, when their baby fat would make them newborn plump. Without the natural insulation of my body or their own body fat, they had to stay in warming isolettes. They couldn’t maintain their body temperature, so the hospital staff did so artificially. On two priceless occasions, we were allowed to provide kangaroo care, placing our tiny little babies inside our shirts, against the warmth of the skin on our chests, letting them bond to us.

Infants who will be born full-term are still getting their nutrition from the umbilical tube at 33 weeks and nearly 2 months afterward. Oxygen and nutrients cross from mommy’s blood to baby’s in the placenta. Getting energy and the building blocks to grow their bodies doesn’t take any work on their part. They can focus on growing, practicing sucking and kicking and, if they’re lucky enough to share the womb with Sissy or Bro, play with their best bud.

My girls were born at 3 lbs 6 oz and 3 lbs 9 oz. They weren’t to have the easy nutrition the placenta granted them. Instead, they were going to have to gain weight with the help of calories they ingested orally. At 33 weeks, babies are usually well practiced at the art of sucking, but they’re not built to use that skill to take in all their nutrition. To help them out the nurses threaded feeding tubes up our teeny babies’ noses, directing food into their stomachs.

That food came in the form of Enfamil Lipil, a high calorie formula for preemies. M and J needed nutrition to provide not only the basics they would have received from my body, but the extra energy they needed to breathe and otherwise experience life outside the womb. Much as I was committed to breastfeeding, breast milk wouldn’t cut it. It just didn’t have enough calories.

Besides, my body was trying to figure out what was going on. Were there live babies to be fed, or was it time to get out of reproductive mode? I’ve known moms with micro-preemies whose milk never came in, their bodies interpreting the early birth as a miscarriage instead of a live birth. Despite my pumping every 3 hours started a couple of hours after the birth, it took days for my milk to come in. A full-term newborn can afford to live on colostrum for a day or two, since they have plenty of energy saved up in all that squishy baby fat. My babies weren’t squishy.

The nurses at the hospital were (with one exception) fantastic. They took every teeny tiny drop of colostrum or milk I could squeeze out. To retrieve it, they filled the doll-sized bottles I pumped into with formula to retrieve every spray of breastmilk. They split that formula in half and fed it to each of my daughters through their feeding tubes.

Lipil Ingredients. The first ingredient is corn syrup solids.I hadn’t done any research into formula before M and J’s birth, being completely committed to exclusive breastfeeding. It never occurred to me to check the ingredients on our hospital-issued formula. I thought of it as medication, something beyond my area of expertise that I should entrust to medical professionals to prescribe. Imagine my surprise, then, when years later I finally read the ingredients and discovered that my babies’ high calorie formula got its high calories from corn syrup. Corn syrup was actually the first ingredients, meaning that there was more of it in the formula than any other ingredient. The composition of the formula has since been changed, but boy, did I feel silly claiming that my daughters’ first refined sugar was the cake at their first birthday party.

Sugar is sugar, I know, but I prefer to eat and feed my family minimally processed foods. I don’t like the idea of ingesting trace amounts of stuff used in processing. Don’t get me wrong. I buy prepared foods like sliced bread, lunch meats, chocolate (lot of chocolate) and crackers. I try to steer clear of non-sugar sweeteners and high fructose corn syrup. I like ingredients to don’t force me to fight the urge to start drawing out organic molecule structures.

We live and learn. If I were to do it again, I would research everything going into my newborns’ bodies. Perhaps I would decide that that brand of high calorie formula was the way to go. Perhaps not.

I always read the ingredients now.

Sadia is raising her 7 year-old identical twin daughters, M and J, in the Austin, TX area. She is divorced and works in higher ed information technology. She is originally from the UK and Bangladesh, but has lived in the US since college.

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Breastmilk, Meet Formula

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Categories Breastfeeding, Formula, Infants, Mommy Issues6 Comments

I am fortunate that I have been able to exclusively breastfeed my twin boys for the first six months of their lives. Well, they had a little formula in the first week of life when I was re-hospitalized for a uterine lining infection after an emergency c-section. On the plus side, I never had to rent that hospital-grade pump, because I was in the hospital! Seriously, that was what I kept repeating to myself as I desperately sought a plus side to being separated from my 4-day-old infants. I was so committed to getting my boys that breastmilk.

And I did. I managed to successfully navigate soreness, scheduling, supply-building, growth spurts, cluster feeding, and nursing tandem. Breastfeeding has been a huge source of both pain and pride.

However, at the boys’ recent 6-month check up we learned that they are not gaining weight adequately, despite growing in length and hitting developmental milestones (ahead of schedule, cough cough brag brag). I sort of suspected something was up because over the past couple of weeks, they have increased to 10 feedings per day and are starting to fuss around feedings. I hoped it was the 6-month growth spurt, or maybe due to a recent round of colds we’ve been sharing, but the scale doesn’t lie. They weren’t getting enough.

This was devastating news because somewhere along the way, I let breastfeeding get pretty wrapped up in my worth as a mom. Maybe even as a woman. In that light, I was a huge failure. I mean, with twins you do basically have someone on the boob 800,000 times per day. It’s easy to feel like it’s all you do, even though it really isn’t.

We decided to start with one bottle of formula per day. We picked the most stressful feeding, the one right before bed. Usually, I’m tired and frazzled, they’re tired and want all my attention, dad stands there helplessly. Awesome way to make bedtime as stressful as possible! That night we each took a baby and a bottle and snuggled in. I’ll admit to some silent tears (I’d never fed my babies a bottle before) and then a different kind of sadness when I realized how damned big my ego had gotten over this breastfeeding thing. It was so peaceful cuddling one baby while dad cradled the other, knowing they could get all the attention and food they needed. For the first time since they were born, there was no pressure to be everything to everyone.

The next day I was able to celebrate the benefits of supplementing, as well as give myself a hearty congratulations for making it to 6 months. I also scaled back the hyperbole and reminded myself it’s literally one bottle per day, Miss Perfectionistpants. But I also mourned a little. My role as a mom was shifting slightly. Would I still be special to my sons?

How I underestimated myself and those little fellows.

Breastfeeding can get completely tied up into our sense of motherhood. If you find yourself having to introduce formula, give yourself some grace. It doesn't have to be all or nothing. Great insights from a mom of twins.

The next day, both babies were under the weather – vaccinations plus a lingering virus had them pretty run down. At bed time, M downed a 7 ounce bottle. R took only a couple ounces, but he’d been snacking all day because I let him stay attached during naps (this stopped being cute like 2 months ago but I can’t seem to break the habit for good). Knowing they were good and fed, we sang a little song and put them in bed like always. But my sick little guys started fussing right away. Couldn’t possibly be hunger! Meds were already administered. Rocking, patting, nothing was helping.

Finally I nursed R while dad rocked M. I couldn’t think of anything else to do. He quieted immediately. I have no idea how much food R actually got, but I’m convinced it wasn’t calories that he needed. It was being wrapped up in mommyness. He needed me, plain and simple. When I laid him down, he fell right to sleep. Then I took M and did the same. The kid just had 7 oz and his brother had surely drained whatever was in my breast, but he nuzzled in just the same and became calm and peaceful. After a few moments I was able to lay him down too.

Thank God for formula. If the boys hadn’t had a bottle, all of that comfort-needing would have been totally mixed up with hunger and they would have gotten hysterical. I would have had to juggle them both at once, tandem feed, and try to comfort simultaneously. I wouldn’t have been able to indulge in that peaceful, individual time with each baby, no rushing, no concern about “saving” some milk for the other. They each would have gotten only 50% of me.

Isn’t this the toughest part about being a twin mom? When they both just need you and you have to figure out how they are going to share?

Being a mom is so much more awesome than being food. However we comfort our little ones, in our own special way, satisfies them deeply. By letting go of being the only food source, I realized I can be even more abundantly a comfort source.

My current goal is to make it to a year mostly breastfeeding. And my second goal is to appreciate the space formula allows me to exercise other dimensions of being a mom – including more flexible comfort logistics.

Are twins just cosmically given to control freaks to teach us a life lesson? Any other Type-As out there trying to accept that you can’t do it all?

Read more in Part II.

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Reunited

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Categories Birth Stories, Breastfeeding, Development, Formula, Infants, NICU, PrematurityTags , , , , , , 11 Comments

I got the best news in a long time today. A college friend’s twin boys were reunited at 2 months old. Her second NICU baby got to come home from the hospital, 7 weeks after his brother.

In the middle of the joy I felt for my friend, though, I felt an upwelling of the sadness, anger and helplessness that tainted the joy of my own babies’ release from the hospital, over 5 years ago. Homecoming is one of the ways that the NICU experience can differ for parents of premature multiples in comparison to preemie singletons. Many twins and triplets are released from the hospital simultaneously, but many are not.

Our daughters were born 7 weeks early, but had few problems apart from their small size. J had a hole in her heart, which eventually resolved itself, and M had a facial cleft that turned out not even to require surgery. Neither of these conditions required hospitalization, so they were textbook “feeder growers,” newborns who were hospitalized until they had fattened up enough to maintain their own body temperature and had the strength to suck enough nutrition to keep them healthy.

Our girls didn’t need any assistance breathing; they’ve been verbal and long-winded since the start. They were keep in warm isolettes, and fed a mixture of high calorie formula and my breast milk through feeding tubes inserted through their noses and threaded into their stomachs. Every three hours came a diaper change, weighing, blood sugar measurement, temperature measurement and feeding. We watched every number as they rose and fell, and I promised myself I would take notes when they got home so as not to double feed one baby and starve the other. J and M were cared for by the same nurse, so their schedules were offset by 15 minutes. One benefit to having NICU babies was that they were on a clockwork schedule by the time they came home.

There were 3 criteria to be met, we were told, before the girls could come home. They had to weigh 5 lbs (2.25 kg), be able to maintain their own body temperature, and take 8 meals in a row by mouth, drinking at least 31 mls of formula/breast milk each time. Every now and then, when J asks for her “warmed up milk, please,” at breakfast or dinner, I wonder at the way she guzzles 8 oz of milk down and think back to the days I tried to get her drink 1 oz by force of will alone.

We wanted all the girls’ energy to go to growing at first. Somewhere in the first week, I think, they were introduced to doll-sized bottles. It took a few tries to get them to suck, first 1 ml, then 3, more and more each meal. They finally made it up to 31 mls at a time, but couldn’t keep it up two meals in a row. It was just too much work.

M couldn’t finish her bottle at every feeding, but she made an effort. Once, I was even allowed to let her suckle at my breast, although the nurses took her away before she exhausted herself. J was less predictable. She’d suck like a champ and then suddenly get distracted, seemingly more interested in playing with the bottle than drinking from it. Two weeks in, she broke our hearts by refusing two meals in a row and being put back on her feeding tube. It was the only time I saw my husband so upset that he couldn’t stay in the NICU to monitor every last detail of our babies’ care. A friend took him out for a beer.

When our girls were 2 weeks old, the hospital staff pronounced them to be the healthiest babies in the NICU. They could afford to be downgraded to a less fancy-schmancy NICU within the same hospital network. We talked it through and agreed to free up their beds. However, when the paperwork arrived, we were asked to sign a waiver releasing both the hospitals and the ambulance service of responsibility for the babies during their transport. There was no way we were signing that, so the girls stayed put.

Two days later, M was ready to come home. She hadn’t quite made the weight cutoff, but they couldn’t see any reason she wouldn’t be just fine at home. She passed the carseat test, and home we went.

mcominghomealone

J was still on her feeding tube. I felt more torn as a mother of twins in that moment than I ever did before or since. I was celebrating the health of one of my daughters, but leaving the other alone at the hospital, without even her sister with her. My husband was away for an army training exercise, and I was still recovering from my C-section. Fortunately, my father-in-law was able to stay for 3 weeks, and drove us the 30 miles to the hospital every day so that I could deliver breast milk and steal a few moments with J. I couldn’t stay too long, though, since M was in her carseat in the hospital parking garage with Grampy.

After 5 long, agonizing days, J was ready to come home. It finally felt like my life as a parent could start. My friend just ended 48 days of that waiting, and I hope that her heart can finally begin to heal.

Did you get to bring your babies home at the same time?

Sadia’s daughters, M and J, are still short for their nearly 6 years, but Sadia is short for her nearly 33, so it works out nicely. They guzzle milk, grow, and keep each other busy in El Paso, TX.

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