Minor Illness: Better Unconsolidated

“Mommy! It’s weird enough staying home on a Monday school day, but staying home without M is even weirder!” my daughter J told me while munching on dry rice cereal this morning.

We didn’t have the weekend we’d hoped for. I went to the gym Saturday morning, as planned. We spent part of the morning cleaning the house, then stopped by a store for a birthday present before getting on the road to a friend’s birthday party. About a mile from the house, I heard a sound from the back seat. I looked in the rearview mirror, and poor little M was vomiting. When she could finally catch her breath, she began to cry. “I wanna go home. Mommy, take me home.”

I was stuck at a red light in a turn lane, helpless to comfort her. As soon as I could, I turned the car around and headed home. I talked to her the entire very long mile home and she just took turns throwing up and crying. I opened J’s window for her when she began to gag. Thankfully, her breakfast stayed down.

As we pulled into our driveway, I told J that I needed her to fend for herself while I tended to her sister. I unlocked the door and let J in, then returned to the car to lift my sobbing, retching, vomit-covered M straight into the bathtub. By this time she was apologizing for the mess in the car, which I told her not to worry about. I got the shower set to a comfortable temperature, helped take off M’s clothes, then left her in the warm water to throw the soiled clothing in the washing machine. I washed the puke out of her hair and helped her wash her skin, which had her feeling much better. She asked to wear her pajamas, pathetically telling me she really didn’t want to go out again that day.

While she dressed herself, I pulled the nasty car seat out of the car. As I was pulling the cover off, I heard a wail from the girls’ room. M had thrown up again, this time on the carpet. I comforted her, dressed her, and tucked her under covers on the couch with a big bowl in her lap in case she felt nauseated again. The car seat cover went in the washing machine too, and I started it on the sanitary cycle. Then I took my carpet cleaner to the spot on the carpet.

M wanted me to hold her, which I did for a while, feeling her grow steadily warmer in my arms as she took breaks to throw up. I took her temperature, which was a miserable 102°F. Fortunately, she was able to keep a dose of ibuprofen down. By this time, J insisted that she was bored. I gave her a number of ideas for activities, but she wanted me to play with her. When M felt better, I hosed off the car seat and cleaned the car upholstery and carpet and then played a few rounds of Funglish with the girls.

(The things we moms do… comfort babies, clean up vomit, provide security and medical care. I would have never guessed this would become second nature and feel completely manageable. This stuff is easy after twinfancy!)

The next morning, M had her appetite back and was ready for cereal. The fever didn’t return, and by evening she was her normal goofy dancing self… but not before her sister began to complain of a headache, completely lose her appetite, and run her own fever.

Fortunately, J never threw up, but I elected to keep her home from school today. Daycare rules have been drilled into me for all time. No kids in school until they’ve been fever-free for 24 hours.

M tried to convince me to let her stay home, but was more than happy to go to school when she realized she wouldn’t have to go to after-school care. And that brings me back to the beginning of this post.

“Mom,” J told me, pondering the clock, “In a few minutes, M will be starting science.” An hour later, I got an update. “Now, M will be writing in her journal.”

I found it intriguing that J didn’t seem particularly concerned with what she was missing or what the class was doing. Her focus was on M’s activities. One of those twin things, I suppose.

When illnesses are minor like this, it’s so much easier to have one child be sick at a time.

When Mommy Is Sick

When Mommy Is Sick, from hdydi.com. Sadia reflects on how different it is to be a sick single parent with big kids than infants.Remember how my little M came home from her Christmas vacation feverish and pathetic? I caught her virus and became equally feverish and pathetic.

It started with a cough and quickly blossomed into what I suspect is this year’s flu. When I realized I might be contagious, I elected to work from home rather than bringing my germs into the office. That afternoon, my cough worsened and I was certain I was about to be very ill. I begged off work to stock up on easy foods and medication.

Let me tell you that it’s far easier to be a sick single mother of 7-year-olds than of infants.

When Mommy Is Sick with Infants

The last time I was this sick, my daughters were babies. I had a blog, but wasn’t blogging with any regularity and I certainly wasn’t recording how hard those first few months were. I have vague memories of those days of fever and pain.

On the worst day, my fever around 103°F, I remember thinking there was no way I could carry the babies and their car seats to the car to take them to daycare, so I kept them home with me. I was so weak that I remember crawling into the nursery and feeding my babies, one at a time, holding the bottles through the slats of the cribs as I lay on the floor. I changed their diapers through the slats, too. I was too weak to lift them out of their cribs. They stayed in there all day.

My husband was in Iraq and I was too proud/worried to ask the neighbours for help. The only close friends I had nearby had babies younger than mine–we had 5 little ones born on the block within a 12 month period–or were elderly. I wasn’t going to risk passing on what I had to them. Our families were thousands of miles away.

I was well enough to take the babies back to daycare the next day. One of the teachers didn’t live too far from me. She told me to call her if I were ever in the same situation again. She would be happy to bring the babies into school for me. It hadn’t occurred to me to reach out to my daycare community. I’ve never made that mistake again. I also make sure that my friends and my daughters’ friends’ parents know that I’ll be there for them in a crisis.

When Mommy Is Sick with 7-Year-Olds

When I was at the store last week, I focused on picking up food that my kids could prepare themselves: a fresh gallon of milk for cereal, hummus and pita chips, pre-sliced apples and baby cut carrots, sandwich fixings. For myself, I picked up generic multi-symptom flu meds, bananas, chamomile tea, and the few frozen meals available with sane quantities of salt.

That night, I took my acetaminophen-laced meds before driving out to get my girls from after school care. I explained to them that mommy was very sick and that I needed them to be very grown up. It turned out that M had eaten dinner at the Y, but J had skipped it. I showed them their self-service options and told the girls to clean up after themselves.

I didn’t feel like my temperature was falling even an hour later. I came out from my room and asked the girls to prepare for bed, telling them I didn’t feel good. J asked if she could take my temperature. I asked her to open the box of thermometer probe covers, applied one to our thermometer–we still use the two the NICU sent home with us 7.5 years ago–and popped it in my mouth.

102°F. Great.

M and J had changed into their pajamas and brushed their teeth. I reminded them to put their dirty clothes in the laundry and sent them off to bed after J brought me a wet washcloth to try to cool my neck and forehead. I kissed them on the top of their heads instead of nose and cheek as I usually do.

J asked me how to set the alarm clock because she was going to check on me every two hours. I told her that I appreciated the thought, but needed her to get plenty of rest to maximize her chances of staying healthy. She wasn’t pleased.

I posted my fever on Facebook and asked for advice. Several friends recommended taking ibuprofen, but I discovered that the only bottle I had had expired. I figured I’d try to push through.

I dozed feverishly until 9:00. On the hour, my two sweet girls scuffed into my room, each in a bathrobe and slippers and holding her nightlight. They wanted to see how I was. Since they were up anyway, I asked them to load up in the car so Mommy could pick up medicine. They were unable to help me at the 24-hour drive through at CVS Pharmacy, so we had to all go inside to pick up a bottle of ibuprofen.

I ordered pizza delivered a couple of times during the week I was most unwell. The girls’ Girl Scout leader took them to their scout meeting and their teacher dropped them home. I loaded and ran the dishwasher as my daughters made their way through plates and cups, and I disinfected around the house as best I could to keep my virus to myself. I also cleaned the cat litter and took out the trash.

Otherwise, though, my daughters have been pretty self-sufficient. I’ve reserved my energy to spend with my girls, talking to them about their days, talking about the things they find interesting, picking up after them, especially dirty dishes, dirty clothes, and dirty floors. They’ve helped out by making their own meals, putting away clean dishes and clothes, and taking care of their own basic physical needs. I’ve dropped them at school and picked them up, run their baths, and checked their homework.

Poor M felt terribly guilty for having passed on her virus to me, so she needed extra affection to help her understand that I had chosen to risk getting sick because I loved her … just as she was doing in caring for me. J tired of working to get along with her sister and needed me to intervene a few times.

There’s been a lot more TV at our house than I’d usually allow, but given that eating a meal wore me out so much that I slept for two blocks of 8 hours the following day, I feel like we’ve been doing really well.

Ever wonder if it gets easier? It does!

How do you manage care for your children when you’re sick?

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.

Stuck to Mommy

My daughters returned home to me in Texas on Friday after a glorious 3 weeks enjoying the holidays with extended family in Washington and Oregon. Poor M caught the virus her father and grandmother suffered before her and came home with a fever. Things were looking a little worrying for twin sister J, but she’s managed to avoid the coughing, runny nose, fever and exhaustion.

Both girls insisted that they absolutely had to have Mommy snuggles all night Friday. Mommy could not sleep in her own bed. With M still feverish, I didn’t protest and took advantage of the opportunity to monitor her throughout the night. I just need to give up on keeping the girls in their room. If I’m giving in on their request that I sleep with them, I might as well do it a non-lofted bigger-than-twin bed. We are getting seriously squished as these girls of mine grow!

Saturday came and went, all the while M refusing to leave my side. If I sat, she sat next to me, thigh to thigh, arm to ribs, head to breast. If I stood, she hooked her hand in my pants waist and came with me. J wanted to be in the same room as me but she, usually the snugglier of my pair, wanted a typical amount of physical contact: the occasional hug, the odd moment tracing the lines on my palms, asking me to brush her hair a couple of times.

I thought that M might be needy because she didn’t feel well, or just because she’d missed me. After she let me release her for the period of her bath time, it occurred to me that at 7, she might know why she was so acting so needy.

“What’s up, M? Why such a snuggle bug?”
“I didn’t get enough snuggles while I was gone.”
“Oh? You know, you can always ask for snuggles. Grammy and Grampy and Daddy and Auntie love you as much as I do.”
“I know. I had four grownups for snuggles, but I snuggle you every day and them, it was more like every other day. And then I got sick and didn’t want to share my germs.”

I imagined my 7-year-old trying to emulate her grandmother and father in self-imposed isolation, protecting those around her from her germs, sacrificing the comfort of hugs to behave like a grownup. I was proud of her and yet it made it that much harder to know that my little girl had been sick without me there to care for her. A sick little girl needs her Mommy or at the very least her custodial parent. However you categorize it, M needed me.

As she fell asleep that Saturday night, one arm under me and one arm over me, breathing in my face and occasionally coughing, I was glad to know that my mature little girl thought me immune to her germs, able to give her all those missing snuggles while she still felt poorly. Usually, she gives a sleepytime squeeze before seeking personal space.

Sunday, and Monday too, she remained glued to me. By Monday, she allowed her sister in my lap, but only as long as I kept a hand on her head and a leg where she could rest hers. I had made a halfhearted effort to find childcare for the day, since school wouldn’t open until Tuesday, but the YMCA has been inconsistent in their full day care, M begged to stay home, and I wasn’t convinced J wasn’t still incubating the virus. I elected to work from home. Thank goodness that I have that option!
Snuggle bunnies from hdydi.com

This photo was taken with my iPad resting on my stomach. M is the farther child, but her legs are hooked over mine. She insisted that I type one-handed, allowing her sister next to me only as long as I kept a hand on her head.

How do your children seek comfort when they don’t feel well? Do they seek out one parent over the other?
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.

(We Will Never Be) Full-Term

My boys are almost two, and I’m 32 weeks pregnant with our third son. Over the weekend, I spent some time in L&D. Everything is fine, but to say I had flashbacks to NICU is an understatement. In order to lighten the mood in my own mind, I re-wrote the lyrics to “Royals” (originally by Lourde). So without further ado, here is:

(We Will Never Be) Full-Term

I’ve got fine hair upon my flesh
I cut my teeth on breathing tubes and a blue Soothie
And I’m not proud of my address
In the NICU wing, no nursery envy

And every nurse is like:
De-sat
Jaundice
That was a bad brady
Art line
PICC line
Puttin’ in an NG

Kangaroo care, we’re being snuggled in our dreams

But everybody’s like:
PDA
Caffeine
Bathing in pink basins
Surgeons
Breast pump
Unplanned extubation

We don’t care, medical terms are your affair

And we’ll never be full-term (full-term)
It don’t run in our blood
Mom’s uterus just ain’t for us, now the machines all beep and buzz
Let me be your ruler (ruler)
You can call me preemie
And someday I’ll breathe, I’ll breathe, I’ll breathe, I’ll breathe
Let me live that reality

My twin and I aren’t gonna code
You watch our hearts on the machine when we’re sleeping
And everyone who knows us knows
That we’ll be home soon, give the hospital your money

But every nurse is like:
De-sat
Jaundice
That was a bad brady
Art line
PICC line
Puttin’ in an NG

Kangaroo care, we’re being snuggled in our dreams
But everybody’s like:
PDA
Caffeine
Bathing in pink basins
Surgeons
Breast pump
Unplanned extubation

We don’t care, medical terms are your affair

And we’ll never be full-term (full-term)
It don’t run in our blood
Mom’s uterus just ain’t for us, now the machines all beep and buzz
Let me be your ruler (ruler)
You can call me preemie
And someday I’ll breathe, I’ll breathe, I’ll breathe, I’ll breathe
Let me live that reality

ooh ooh oh ooh
We’re smaller than you ever dreamed
And I’m in love with clothes sized “P”

ooh ooh oh ooh
Life is great in Intensive Care
We’re your full-time love affair

And we’ll never be full-term (full-term)
It don’t run in our blood
Mom’s uterus just ain’t for us, now the machines all beep and buzz
Let me be your ruler (ruler)
You can call me preemie
And someday I’ll breathe, I’ll breathe, I’ll breathe, I’ll breathe
Let me live that reality.

The Search for a New Pediatrician

A few weeks ago, I went through a semi-traumatic experience at my pediatrician’s office, one that prompted me to start searching for a new pediatrician. (Please read this letter first to get the full back story.)

I was actually very torn whether to even bring it up with the doctor, much less take the drastic step of actually switching to a different one. I don’t know why exactly, because I’m usually a very proactive and assertive person, especially when it comes to anything dealing with my kids.

I may have felt some guilt for having put my daughter in that situation in the first place. What if I had stayed with her the entire time instead of going back out to the lobby to check on my son? What if I had my husband meet me at the doctor’s earlier so he was there for the temp/weight checks? These thoughts went back and forth in my head, resulting in me sort of blaming myself for letting it happen. Yet, I couldn’t shake the upset feeling, and therefore I wrote the letter.

It was a source of anxiety for many weeks. Some fear of confrontation perhaps, or maybe just a fear of the unknown. What if I did switch doctors and it wasn’t any better at the new place, or even, it was worse?!? This is where HYDYI helped me. From the comments I got on my post, I garnered enough moral support to feel justified in what I was thinking. (Thank you!)

I rewrote the end of the letter, to strongly emphasize that I feel the conduct of his staff has become unacceptable. I demanded that I would be willing to work only with the single competent nurse/medical assistant on future visits. Then I mailed it and waited in anticipation of what would happen next.

Well, a few days later my doctor called and left me a voicemail. In it he thanked me for writing the letter and bringing the issues to his attention. He wanted to call and speak with me the next day. I was trepidatious because though the reply was prompt and the message was polite and sincere, there was no apology in his voicemail. I just had a bad feeling that a conversation with him would not turn out well.

It did not turn out well, indeed. He called at lunchtime the next day, and the conversation began nicely… but I was getting the vibe that he didn’t even have a clue who I was until almost the end of the conversation when he remembered that I was the parent with the side by side double stroller that didn’t fit in his exam room doors. He explained that his twin patients usually ride in tandem strollers, and they’re accompanied by many relatives, which I felt was his way of faulting me for the horrible visit that I had. I was getting more and more upset as the conversation continued, and he was having some trouble keeping his cool as well it seemed.

But the last straw was when he absolutely refused to ever see my twins in a joint appointment. For the first time I’ve ever heard this in the almost-year of my twins’ lives, he explained that his policy is that separate patients have separate appointments. He will not see them back to back, nor can shots be given to one after the other. Appointments are made together, but in actuality, they’re not at the same time. His rationale is that he never wants to make a mistake with a twin and give the wrong vaccinations, so wants to take his time as well as give his staff time to make sure no mistakes take place.

I could kind of understand if the patients were identical and very difficult to tell apart, but my twins are not, and his policy really applies to all sibling appointments, which makes absolutely no sense to me. Plus, really, what parent would let one child get a double dose of vaccines while the other got none? And couldn’t you easily tell which baby got shots by which one is crying hysterically and has little band-aids on the legs already anyway?

So that was it. His insinuation that I should bring a cadre of people to my kids’ appointments to help out, and that I need to buy a new stroller to accommodate his facilities, brought me to the conclusion that I never want to see him or his staff again.

On Veterans’ Day when my preschooler and I had the day off, I made an appointment with a new pediatricians’ office to meet their patient liaison. I knew the second I walked into the office that the vibe was different there. We liked it so much that I changed them to my provider that very same day. Fingers crossed that our first actual doctor’s visit will be everything I’m expecting it to be.

The Straight Tuck Talk

Worth it 

Almost 7 years ago I gave birth to two beautiful, identical twin boys. It was not an easy pregnancy. I had gotten so big, so fast, that I developed horrible sciatic pain that lasted almost 8 months. My cute little chunkers continued to grow at such a rapid pace that at around 7 months they cracked apart the front of my rib cage when I sneezed…like a wishbone. If that wasn’t enough, the docs threw me on bed-rest for the last 6 weeks, much of it in the hospital. Of course, because the boys were growing so hearty and healthy,I continued to tell myself (and many people reminded me) that all the pain and suffering was worth it.

At 36 weeks they took me off bed-rest and told me to walk around. Unfortunately, because the twins were putting so much weight on my pelvis floor, it was almost impossible to move my legs without someone giving me a slight nudge from behind. I’m not kidding when I say that people would literally point and shout obscenities my direction when I walked by. (Like I couldn’t hear them!) The last measurement of my waistline before my delivery was 65 inches…the height of an adult person.

This picture was taken the night before the twins were born.

When they were born they were both healthy and almost 6 lbs each. It was truly the proudest achievement of my entire life. Immediately, the boys took to breastfeeding like champs; I quickly lost all my pregnancy weight, and then some. However, what they left me were two lifetime badges of honor – one called Twin Skin, and the other Diastasis Recti.

The Truth Set Me Free 

TWIN SKIN is the term commonly used for the (twin) postpartum skin that has been stretched passed its ability to re-conform to its original, pre-stretched elasticity. It has lost all its collagen, resulting in saggy, wrinkly, loose-feeling skin usually surrounding the belly button. Think of a balloon. Now blow up that balloon as big as you can without popping it. Let it all out quickly and take a look at what you’ve got. That’s the general idea of what I have been left with for the last 7 years. What’s worse, the more weight I lost the more skin I gained! Often it was so uncomfortable, that when I sat down, folds of skin were literally in my lap.

DIASTASIS RECTI is a vertical separation between the two abdominal muscles that cover the front surface of the belly. Think again of a balloon, but this time it’s one of those long children’s party balloons. Now imagine it is blown up, nestled between the bottom of your breastbone and your belly button. For many, the more you try to “work it” off in the gym, additional damage is done; strain on the muscle causes the size of the “balloon” to increase as well. And yes, I even tried following the Tupler Technique to a “t”, but found it to be useless. After 2-3 years of trying everything, I finally had to admit what several PT’s had been telling me all along: there is no non-surgical correction for muscle laxity this severe.

Nope, not pregnant.  This was me a few weeks ago.

I know that this is hard to hear, especially if you’re struggling with this condition. People get focused on their boot camp routine, and are hopeful that reaching their fitness goals will alleviate the problem. For some, the issue may not be as severe as my own. But for me, in order to feel truly good about myself, I needed to accept that surgery was my only option. And to be honest, this acceptance set me free. For several years, I felt strong,healthy, fit and able to keep up with my kids, as well as reach my personal fitness goals. I wasn’t fixated on changing anything about my stomach. Basically, I just ignored it’s existence; deep down I knew that one day it would be gone.

The Double Standard

Over the years, I tried to open up to other moms about how disconnected I felt from my battle scars. I’ve talked about how, over time, they have left me feeling less feminine, less like myself, and sometimes even less human (trust me, s**t got weird). Unfortunately, some folks felt the need to compare my feelings of distress I have about my twin pregnancy, and the travesty it has made of my body, to the amount of love I have for my children.

“But, you wouldn’t trade anything in the world for those kids, right?”

“The more you love your kids, every day, the more you will accept this as just a part of being a mom.”

F**k that. I’m sick of feeling ashamed of wanting to look human again. Or feel that, for some reason, I need to be a martyr for my children and wear some sort of “badge of honor” in the shape of flabby skin on an inflated tummy. Of course I accept that this is one prospect that can happen to some moms. That said, I don’t have to love it, and I certainly don’t have to feel like a bad mom for wanting to change it. Sure, my kids are worth every worry-line and sleepless night, every ruined blouse and scratched coffee table, every ache and pain and scream of every second of birthing my darlings. But I AM WORTH SOMETHING as well.

So screw the paradoxical notion that makes moms believe they have to trade being a proud mama for wanting to reconnect with their body. Once I started to listen to my heart without criticism, without judgement, and without fear, I allowed myself to be hopeful of the possibility of change. Thinking about the prospect of ‘wiping the slate clean’ gave me hope, and made me feel happy.

Also, this may blow your mind, but I’m not someone with low self-esteem. I feel good about who I am and even what I look like. I feel even better about what my body has been able to accomplish! I celebrate it! But in all honestly, I also felt I owed it the rehab/repair it deserved, from all the hardship it’s endured.

7 Years Later.

So what was I waiting for?? When the twins were 5, heading off to kindergarten, my husband and I finally decided to have another baby. The pregnancy had minimal complications…wretched back pain, an over-due delivery… but WAY easier than the twins. It did, however, make the diastasis recti worse. The twin skin? Oh, I was tucking it into my tube socks by then! (A slight exaggeration of course, but check out the size of me with only ONE baby in there!)

my singleton pregnancy, after twins

With our family complete, and once I was done breastfeeding my little dude around 14 months, it was definitely time to do something about this mess.

The first step, finding the right doc, was a piece of cake. My neighbor had experienced the same procedure earlier in the year and she loved her surgeon. At my first consult, I was also pleasantly surprised. I was expecting a car-salesman type white man, with slicked-back hair and big, super bright teeth. Instead, I was greeted by a tall, middle-aged woman with a gentle smile and very nurturing demeanor. She answered all my questions thoroughly (I had a list of THIRTY TWO), and I soon felt confident that I had easily found the best plastic surgeon in town. I was so excited! Then, two days later, her gal sent me my estimated total cost. WOWZA! Are you sure I can’t just do more sit ups??

So let me again remind you that this is only MY STORY. Abdominoplasty might not be for everyone, and I will be the first to admit that its f’n expensive. No, your insurance company won’t pay for it. Trust me, I tried everything. We wrung our hands for quite some time trying to figure out how to obtain the loans possible to pay for the procedure. In the end, I am so happy that we did. Even with my most recent bouts of recovery-induced pain, I have no buyer’s remorse.

I Did It! 

This was major surgery, and of course when the time came, I was terrified. I listened to meditations every night leading up to the big day. I tried to stay off the internet, where I was bound to find endless stories of botched jobs and regret. My husband continued to remind me of my courage and the strength in my family’s support of me. I continued to remind myself that I was finally at the end of a long journey that began 7 years ago.

I am now on day 5 of recovery from a 2-part procedure that fixed both problems: abdominal plication (the muscle repair) and abnominoplasty (the tummy tuck). Seeing as I’m not a doctor, and chances are neither are you, we’ll keep the explanation short and simple. 1) She cut my abdomen open, from hip to hip. 2) Pulled and stitched my muscles back together vertically, down the middle of my belly. 3) Cut off all the unsightly loose skin. 4) Pulled the skin tight. 5) Lastly, stitched me back up, from hip to hip.

STILL Worth It? 

So, while I’m currently in the “thick of” recovery, now might be a good time to ask… Would I do it again? Absolutely. That said, it’s not for the faint of heart. It is taxing on your wallet, your body, and also your relationships. Over the next several weeks I will be more dependent on others that I am usually comfortable with (as is the case for most mothers, I’m sure).

Recovery is difficult. These past 5 days have not been easy, but every day is 100% better than the one before. While my husband holds down the fort with all three boys at home, I’ve had the luxury of camping out on my mother’s recliner … a poor-(wo)man’s medi-spa if you will. I’ve been told I’ll be on pain meds for at least 2 weeks, and possibly up walking around slowly in the next day or two. The real kicker is the amount of time I will need to resist picking up anything heavier than 10 lbs… 8-10 WEEKS. That means my needy, fussy toddler and I will have to come up with an arrangement that works for the both of us. But I’m confident we’ll get through it.

I knew I wasn’t alone (check out the comments on this photo for example) yet I still think many women feel that they are. Because of this, I thought it was best to go public with my experience and possibly help another mama gain some perspective and a bit of hope. Whatever you decide to do with your torn up tummy, don’t forget to love YOU. Allow yourself the grace to feel good about whatever decisions you make that will ultimately help you become your best self.

My brood.  Worth it.

Sad/Happy

I am 36 weeks pregnant. I have had a very healthy pregnancy, despite the concerns over us having twins. I see my OB and a high-risk doctor, and I have fantastic care with both offices. I have beaten the odds. My babies are doing great. I should be happy 100% of the time. I should be. When I think about my babies, I am. When I think about the struggles that so many others are going through, I just can’t be 100% happy.

Last Monday, we went in for our 35 week scan. The nurses looked at us in amazement as they looked at the ultrasounds. Heartbeats are perfect. Amniotic fluid is perfect. Both babies are practicing breathing. Then they hook me up to the monitors for 20 minutes to check their heartbeats further (to make sure they are raising and lowering as the babies move). The babies pass the NST (non-stress test) within minutes, although they keep me hooked up for the full 20 minutes anyway. The nurses can’t believe how successful a pregnancy I am having. Seriously, they stare at us because here we are at the HIGH RISK DOCTOR and we are showing signs that we are passing with flying colors. Last week, our doctor used the terms “gorgeous babies” and “hitting it out of the ballpark.” We are thrilled. They are sad that I am not delivering at their hospital, because they all want to come visit us. They are happy with our fairy-tale pregnancy, as I’m sure they don’t see many being a high-risk office.

I know that others are hurting, and it pulls me out of this dream land that I’m in. I really struggle with this mix of happiness and devastation.

My grandfather passed away last summer, and his twin brother passed away 6 months later, in February. To say that I was sad is an understatement. I had to learn how to function again without my grandfather. At least I had his twin brother as my surrogate. Losing him hurt in an entirely new way. The very next month, however, I got pregnant with our twins. Our family was in the depths of grief, yet my pregnancy and the idea of new life gave a bit of light, hope, help to recover out of the dark times.

positiveIt seems like life has a funny way of doing this. We are faced with horrific situations. Then something wonderful happens. Maybe not to us, but maybe to someone around us. It provides just a bit of light. It allows us to feel like maybe there is something positive that can happen in our lives too.

Maybe we are in such a dark place that we just can’t see it. We don’t want to see it. We aren’t ready to see it. That’s okay too. We will see the light when we are ready to. Until then, it’s okay.

Does that mean that those of us that have been privy to the light shouldn’t revel in it? I don’t know. I struggle with this daily. I want to be thrilled. And when I think of my babies, I really am thrilled. I can’t think of anything happier. But I do think of the sadness that others are feeling, and I do forget about my babies and my happiness. I do grieve. I do cry. I do want to be in that dark place too. But right now, I can’t. Right now, I have to be a mother and give these babies the best chance they can get. And that is by providing them a happy, light-filled surrounding for them to be born into.

Did I pay attention to the election this year? No, because I didn’t want to be brought down by the negative campaigns.

Do I watch the news about the devastation from the typhoon? No, as I can’t bear to hear about the loss of life as I am about to bring in two lives myself.

Can I bear to even watch Grey’s Anatomy? Barely, as I just can’t allow myself to witness that tear-jerker (even though I know they are only actors on a fictional TV show).

It doesn’t mean I don’t know they are happening. I know they are. I’m not completely shut off from the world. I know there is suffering. I know that so many friends and loved ones are suffering. So what do I do? Do I let myself be sad right now? Do I let myself be happy? Can I be both? I try to do both, and I struggle. I really do struggle. I wish I could just be 100% happy right now. I want to be for my two babies.

Life has both awful and glorious moments. If it were all terrible, we wouldn’t have a reason to face another day. If it were all incredible, we wouldn’t understand how magnificent those special moments are. Right now, my “job” is to provide a light-filled moment. I hide my achy back and sore hips. I take a shower every morning, straighten my hair, and sometimes even put on some makeup. I put on a big smile and am grateful for the gift of these babies that I have been given. I will provide the brightness for those around me, if they want it. It doesn’t mean that I am not struggling inside. I doesn’t mean that I am not hurting for them. I just know that I have allowed myself into that dark spot other times in my life. Now is my turn to help give relief to those that need it.

*You can read more about Dory on her family blog, “Doyle Dispatch.” To read more posts about Dory’s pregnancy and nursery decorating on her blog, you can see the list here.*

Seeking Supplemental Prenatal Care

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.

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, and how we’ve dealt with these complex issues.


When we found out that I was carrying twins, my husband and I were both thrilled and terrified. I imagine this is a common response among expectant parents of multiples. On one hand, I was excited to be able to complete our family in one fell swoop, but on the other hand, I was keenly aware of the potential complications of a multiple pregnancy. In my own circle of friends, I know one mom who lost her twins prior to viability and I’m good friends with Sadia, whose girls arrived at 33 weeks and had to spend some time in the NICU. Meanwhile, I wasn’t aware of many moms of twins who had managed to carry their babies to term.

Between having suffered a prior pregnancy loss and the stress I felt over the possibility of serious pregnancy complications, I dealt with a lot of anxiety throughout my pregnancy, but especially in the early months. My worry led me to do a lot of research on twin pregnancy and to seek out supplemental care in addition to my normal prenatal care.

It is important to note that while my outcome was a healthy pregnancy and two full-term babies, the supplemental care I received did not directly lead to those great results. I happen to have been one of the fortunate ones whose bodies handle a twin pregnancy relatively well. There was nothing I could do to guarantee a healthy pregnancy for myself and for my babies. My goal in seeking out more care was to try to detect and adjust for any major complications as soon as possible. As it turned out, my complications were all pretty minor, but some of the supplemental care I pursued could come in handy to other moms of multiples.

I faced a conundrum when I was choosing an OB practice to visit during my pregnancy. On one hand, I wanted the best care for multiples that I could get. On the other hand, I was committed to giving birth to my twins in a well-equipped medical setting but with as few interventions as possible. To that end, I chose a practice that prides itself on a low rate of caesarian sections, but that has plenty of experience with twin births, as well.  The standard of care is for each patient to visit with all the health care providers in the practice over the course of her pregnancy, and while my twins would ultimately be delivered by a doctor, much of my care early in the pregnancy was handled by certified nurse midwives.

I was generally confident in the care I was receiving from my midwives, but it was important for my elevated anxiety levels to have medical twin experts keeping a closer eye on my pregnancy, as well. To that end, I did a great deal of research on twin pregnancies and discovered that the Texas Children’s Hospital in Houston, TX, has a dedicated Program for Multiples. For the cost of an insurance copay and a tank of gas, I was able to receive a personalized assessment including a comprehensive ultrasound, genetic counseling, and, most important to me, individualized nutritional advice.

As it turns out, my assessment indicated a clean bill of health for my fraternal twins and me at around 13 weeks of pregnancy. Had I been carrying identical twins showing signs of Twin-to-Twin Transfusion Syndrome, the ultrasound could have detected it early, and I would have been referred for further treatment and, hopefully, a successful outcome.

My pregnancy was otherwise fairly unremarkable until my blood pressure began to creep higher around 26 or 28 weeks. At that time, I was referred to a MFM doctor in town, who provided more supplemental sonogram to monitor the growth and development of my babies. Each ultrasound indicated that growth was steady and my babies were stable, but by 32 weeks, it became increasingly clear that they were locked in a breech position and didn’t have much room to rotate head-down.  Knowing that my chances of getting them to turn were small, and that my doctor could not deliver them vaginally if they were breech, I had time to mentally prepare myself for the possibility that I would need a c-section after all.

At 36 weeks 6 days, an ultrasound indicated that growth had stalled, and my MFM and OB conferred and decided that my twins would be delivered the next day. My c-section was scheduled, and I was left with about 18 hours to wrap up my preparations and finish up the work I had planned to do before going on leave.  The next day, my twins arrived, weighing 6 lbs 15 oz and 7 lbs 1 oz. They required no time in the NICU.

twins2-sm

James and Rebekah, 6 days old.

Ultimately, beyond listening to our doctors’ advice and taking care of our bodies during a twin pregnancy, we can do very little to control the outcome. According to the March of Dimes, 60% of twins are born prematurely. I was one of the fortunate 40% who managed to carry my pregnancy to term. But I feel it’s important to share my story during Prematurity Awareness Week to let those expecting twins know that a successful pregnancy is possible, and that seeking out supplemental care early on could help you identify warning signs for complications and improve your chances of a healthy pregnancy.

Prenatal Care for Twins

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 will start out by saying that I have never been pregnant before now. This is my first pregnancy and I have been thrown in head first with this new world of twins. So my experience is different. I didn’t know what to expect when going into it all. I had other friends that had been pregnant with singletons, and so I wasn’t completely naive, but I also really learned as I went. So, here is my experience with various aspects of prenatal care for our twins.

Prenatal Vitamins

I had wanted to be pregnant for a while, so I started taking prenatal vitamins very early on (well over a year before actually getting pregnant). I knew that the benefits were only going to help me, so I had no problem taking them long before we actually started trying for our baby. I have quite the sweet tooth, so I took the gummy prenatals with extra folic acid- two before bed- and it was quite the delicious pre-bed treat. Because I am also lactose intolerant, I also took a calcium supplement (gummy version) and a multivitamin (also gummy). After about a month of 6 gummies all right before bed, I started spacing them out a bit more and went with 1 of each vitamin at lunch and 1 of each before bed.

It ended up being a very good thing that I started this so early, because once I got pregnant, I had major trouble stomaching any vitamin supplements at all. I literally couldn’t do it. I felt so guilty to be denying my babies these added nutrients, and I talked to my doctors and nurses quite often about this. Thankfully, they said that I had done the right thing by starting so early, because my body had a built-up supply of the nutrients, and my babies would still benefit, even if I couldn’t take them every day.

Once the 2nd trimester hit and I started to get over the morning all-day sickness, I got some Flintstone vitamins, upon the suggestion of my doctors. I actually could take these just fine (2 at night before bed), and I felt like I could do something again for my babies. This didn’t last, however, and once I got to about 28 weeks, I had trouble with the nausea again, and I had to stop taking them. Thankfully, my pregnancy diet (and cravings) included lots of fruits and veggies and protein, so I knew that I was doing what I could. Plus, the babies were growing really well and the doctors were happy.

Moral of the story: start taking your prenatals EARLY, but listen to your body. It doesn’t help you to get sick after every vitamin, when it may be better to rely on those better vitamin-rich foods instead. And no matter what, talk to your doctor. I felt guilty each time they asked about prenatal vitamins, and I had to say that I wasn’t taking them. Then, they would respond that it was ok. I was doing well, and I shouldn’t worry. Oh, I love getting support like that from a doctor!

The First Appointment

Thankfully, I knew what to expect at my first appointment, so this wasn’t a surprise, but I can understand that some may have been taken aback if they weren’t prepared.

Because we had been seeing a doctor for a short time leading up to getting pregnant, my appointments were on the fast track. Please don’t worry if you don’t have all of these appointments right away.

I took a pregnancy test on April 5, when I was only 3 weeks 5 days pregnant. When it came back positive, I called my doctor immediately and he scheduled me to get a blood test done that day (a Friday). We went in the moment they opened the doors and I happily gave them my arm to draw the vial (and I hate getting blood drawn). They told me that they would fax the doctor the results in about an hour.

An hour passed, and we didn’t hear anything. Because it was a Friday, I knew our doctor would be closing early (a half day), so I didn’t want to have to wait to find out if we were going to be parents. I called and spoke to the secretary (whom I had become really close with due to our visits), and she was able to tell us the great news: it was positive! I asked about the HCG levels, and they were a good steady number. We set up an ultrasound date for 3 weeks later, and I dreaded having to wait that long for the final confirmation and heartbeat.

Finally, the big day arrived (6 weeks 3 days), and my husband and I nervously went in to the office. I got undressed (waist down) as I knew that they would be needing to do an internal ultrasound. This is because the baby/babies are too small at this point to be seen using the stomach ultrasound. They need to get closer, which is why they have to make it internal. If you aren’t prepared for this, I can understand how this would be scary and uncomfortable. Prepare yourself, though, because it really isn’t painful if you are ready for it. They insert a stick-like wand “up there” right against your cervix. There may be moments of being uncomfortable, but they really try to make it as pain-free and quick as possible. I promise that, once you actually see your baby/babies heartbeat(s), you will totally forget about anything else except this miracle that is happening to you.

People have asked us if we were surprised it was twins. In a short answer, yes. Although my doctor wasn’t. When we went in, I was joking with him in order to cover up my nerves. I was convinced that something had happened in the past 3 weeks and I had lost the baby. I didn’t have any proof to confirm this, but I just was worried. 3 weeks felt like a long time to wait in between the blood test and the ultrasound! So as we were joking, I told him that I hoped I was still pregnant. He told me that he knew I was, and it was just a question of how many. I asked him if he would buy us dinner if it was just one. He happily agreed (knowing through the HCG numbers that it would be two). Well, he was right, and we didn’t get a dinner from him. Oh well!

When he was looking at the ultrasound, he quickly (within seconds of any image on the screen) said, “Yes, there they are.” We were shocked. My jaw hit the floor. Thank goodness I was already sitting/laying down. The nurse turned to my husband a few times to ask if he needed to sit down, but he was frozen to his place. Two heartbeats. Two strong heartbeats. Twins.

At our office, we got lots of pictures and even a flash drive with all of the pictures and a video of the heartbeats. We went home to share the news with our parents via Skype (they already knew we were expecting, but they had no idea about the next doubly exciting chapter to this story).

Perinatal (“High Risk”) Appointments

When you are expecting multiples, you are categorized as a “high risk” pregnancy. Many people, upon hearing this, get scared or confused. To someone not facing these appointments themselves, they may wonder why it is “high risk.” After all, there are so many more twins born now. So is it really “high risk?” Yes, it is. Now, this is not to say that you will definitely have problems with your pregnancy. I didn’t have any complications after the first trimester.

Those of us blessed to carry multiple babies at once are considered high risk because bodies simply weren’t made to carry more than one baby at once. We can do it and be successful at it, but we do need to be carefully monitored.

Be prepared to see a perinatal specialist, a “high risk doctor.” They will focus on your babies’ needs throughout the pregnancy. For us, once we got in the groove of appointments, these were our ultrasound visits. We started by going once a month (plus a couple of additional appointments due to scheduling issues). They did a full tummy ultrasound (no more internal ultrasounds unless they had trouble seeing your cervix), where they would focus on measuring the size of the babies, the amniotic fluid amount, the length of my cervix, the cord and placenta placement/size, and check the vitals of the babies.

Then, once we hit the third trimester, we went in for a couple of appointments every 2 weeks. They still only did the measurements once a month, but they just wanted to check and see the babies a bit more often. They also wanted to make sure I wasn’t going into pre-term labor.

At 32 weeks, we started our weekly perinatal appointments. They scheduled the measurement ultrasound for every 4 weeks still (32 and 36 weeks), but I would be getting additional ultrasounds each week as well. During these, they would check the amount of amniotic fluid (to make sure it wasn’t leaking out). They would check the stomach cavity and diaphragm. They would also look at and measure the heartbeat and heart chambers. Finally, they would look to see that the babies were practicing breathing. Now, they don’t actually breathe when inside the womb, but they do pretend to do this. After 3 weeks of this, I realized that Baby Girl A would pass this part of the test with flying colors, as she would always show this. Baby Boy B, however, would get jostled a bit to wake up and show us something. I asked our doctor about this- should I prepare myself for issues after they are born with his breathing? She told us not to worry. They give themselves a window of 45 minutes per baby to watch for signs of breathing practice. If the baby hasn’t shown it in that 45 minute time, then we would worry. Baby Boy always took longer than his sister, but never more than 5-7 minutes, so there is nothing to fear. In addition, there are many other aspects that they look for during these ultrasounds, not just breathing. All of the results as a whole are much more important than just any one part.

Finally, in these weekly visits, they do the Non-Stress Test (NST). After the ultrasound (and they’ve figured out where the babies are), they hook you up to these monitor belts. They will put some jelly on these discs and place them on your stomach where each heart would be located. Once they find the heartbeat and can hear it clearly, they will attach the disc to an elastic belt, wrapped around your waist. Then, they find your second baby and do the same thing with another disc and belt. Finally, they will put an additional disc on the top of your uterus to measure contractions. You will be hooked up to this for 20 minutes.

During the NST, they are looking for changes in your babies’ heartbeats. They want to see them rise and fall, as the babies move around. If they don’t see much variation, they may do a few different things to get a reaction. First thing is they will ask you to drink some cold water. Cold liquids and foods often get those babies jumping. Jumping babies = rise in heartbeats. I also tried eating some apples that I brought with me, as that often got them moving and shaking. When that didn’t work, they brought in the buzzer. It is a mini airhorn of sorts that they put against your stomach. It vibrates and emits a buzzing sound. When they did it, both babies jumped and started kicking like crazy (and I started laughing because it was so funny to witness. Well, for me, they jumped but Baby Girl didn’t show a change in her heart rate. That’s when Daddy stepped in to the rescue. He came over to me and put his hand over Baby Girl. As she always does, she jumped to life at his touch. Then he started talking to her and coaxing her into getting excited. It finally worked, and both babies passed this test.

Regular OB Appointments

In addition to your perinatal appointments, you will still see your OB, who will actually do the delivery. If they are in the same practice, you may schedule these on the same day. For us, however, we didn’t have this luxury, so we had extra appointments. We made the decision that we would both go to all of the high-risk appointments, because that was when we could see our babies. My husband didn’t want to miss that! For the OB appointments, they focused on my care, and he really didn’t need to be there for them. He came to a few early on to meet our OB and discuss her thoughts on twins and twin deliveries. As I started going more often (and more quickly) to these visits, I gave him permission to save up his doctor time for the other appointments.

During the OB visits, they will take your weight (to make sure you are growing at a good rate) and blood pressure. They will also have you pee in a cup to check your protein levels (to check for signs of preeclampsia). Then you will go back and meet with your OB. She will ask about how you are doing. Sometimes you will get a cervix check (be prepared for this to be a little uncomfortable, as your lady parts are a bit more delicate when you are pregnant). She will also order blood tests and your gestational diabetes test.

Gestational Diabetes Test

I documented my experience (and nerves) about this test here. It really wasn’t bad, but I worked myself up to a bundle of nerves.

Dealing With It All

It all has to do with attitude. I loved going to the doctor so often, because it meant that they were really thorough in making sure that we were all okay. Because I had stopped working after the first trimester (I was a teacher and I finished the school year and didn’t return for the upcoming year), I could be flexible with my appointment times. I also didn’t mind if they took a while. Having this laid-back attitude definitely made a difference in what could have been a very stressful situation. I looked at my appointments as adventures. After all, I got to see and talk about my babies. I got to express fears or concerns and get to know what was going on in my body. I took advantage of the Do-you-have-any-questions? section of my visits. I stayed positive. I listened to their advice and did what they said to the best of my ability. I kept a smile on my face. It really helped.

We had one ultrasound tech that we kept getting that would rush through our ultrasounds. This meant that we got poor pictures and felt like we couldn’t appreciate the experience during those weeks. After the first time this happened, I left the office in tears. I just wanted to see my babies, and I hated that I had to wait another month to get the chance. Well, after a few times of this with her, I realized this was just her style. So, one day I went in and told her, “We aren’t in ANY rush today! I’m feeling great (a lie). It’s beautiful outside, and we don’t have anywhere to be! We are at 34 weeks, and who knows how many more of these appointments we will have left. So, feel free to take your time during this ultrasound!” It did the trick. She commented that she couldn’t take forever because they had a very hectic schedule during the rest of the day. BUT I noticed that she took a little longer on their faces, even though it wasn’t medically necessary. AND we finally got two more pictures of our beautiful babies (which we hadn’t gotten for a few weeks). We didn’t have to be rude or spiteful or call her out on her previous rudeness. Just a upbeat, passive comment was all it took to win her over and get what we wanted in return.

*Dory is currently pregnant with boy/girl twins. She blogs on her personal blog Doyle Dispatch. To read more posts about Dory’s pregnancy and nursery decorating on her blog, you can see the list here.*

Foodie Friday: Suck-Swallow-Breathe

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.


Almost all preemies have difficulty with feeding, and my boys were certainly no exception. In order to eat, a baby has to be able to suck (at the breast or bottle), swallow, and breathe. But not at the same time, of course, and trying to coordinate that is very difficult.

Mr. D was born with the ability to do all three. He never required oxygen support, could generally swallow what was in his mouth (although he did need “reminding” from time to time), and could hold onto a pacifier, bottle, or my nipple like a pro. What he couldn’t do was figure out how to do all three in such a manner to ingest enough milk to live…especially when he’d rather be sleeping.

D’s challenges were fairly typical for preemies. Eating is hard work. So hard, in fact, that a twenty-minute rule is placed on both breast- and bottle-feeding in most (all?) NICUs: the baby gets 20 minutes to eat all he can, and then is weighed (if breastfeeding) or the amount remaining in the bottle is examined, and the rest of the required meal is poured down the feeding tube. I wanted to breastfeed, but was told we could only attempt it twice a day, as it’s even more work to extract milk from a breast than it is from a bottle.

The first time I breastfed Mr. D, he took me by surprise. He did really great! The lactation consultant warned me that many babies take one or two good feeds from the breast, and then begin to struggle. That was the case for him: he could extract a few drops of colostrum, especially when I pretty much hand-expressed it into his mouth, but once my milk came in, it was beyond him. He would latch on, and then fall asleep.

Suck-swallow-breatheHe didn’t fare much better with the bottle. I was taught how to hold him, how to stroke his cheek or under his chin to “remind” him to swallow, how to burp him, how to tickle his feet when he was nodding off…and he would still only swallow a few milliliters. He would sometimes become fearful of the liquid in his mouth, and hold his breath until I sat him up and helped him to dribble it all out. But mainly he would just look up at me, with an expression of what felt like disdain on his face, and then close his eyes. He held onto the nipple (mine or the bottle’s), but that was it. That was all he wanted to do.

The nurses told me it often happens like a switch—nothing, nothing, nothing, BOOM: eating! That wasn’t the case for Mr. D. Instead, he’d take a few more milliliters each day, most days. What was exceedingly frustrating to me was that, as his weight (from his oral plus tube-feedings) increased and his IV-nutrition was tapered off (to end abruptly when he yanked out his second scalp IV and they couldn’t find better access), his required intake went up, too. He was supposed to eat 23 mls, and would manage 19, and I’d go home to pump in triumph, only to return to discover they’d raised his goal to 26.

But he did improve. He kept getting so close. I felt like we were nearly there. Feeding was the only thing keeping him in the NICU, and I wanted him home.

He developed reflux. My pediatrician tells me “100% of babies have reflux”, and I don’t doubt her. Mr. D’s was worse than some, which again is common with preemies. That muscle at the top of their stomach (cardiac or esophageal sphincter) is as weak as their other muscles, and is forced into doing its job way too soon. One of his day nurses asked me if there was a history of milk intolerance in my family. Yes, there is: I was allergic to milk protein for my first few years of life. She suggested eliminating dairy from my diet, in case Mr. D had the same problem. I did. We also began fortifying his breast milk with soy formula rather than the special preemie formula. (Breast milk has about 20 calories, and it is very common to add formula to it to boost that to 22, 24, or even 27 calories for premature babies, as their tiny stomachs can’t hold enough volume to give them their necessary caloric intake.) I don’t know that it made much difference, but I was willing to try anything.

On his tenth day of life, he pulled out his NG-tube for his tenth (estimated) and final time. He wasn’t meeting his goals, but they decided not to replace it. He did well, getting closer and closer. On his thirteenth day, we were told we could take him home the following day: Valentine’s Day.

At 6 am on V-Day, I got a call from the neonatologist. She was just coming on shift having been gone a few days, and she didn’t think we should take Mr. D home. “He simply won’t grow on this,” she said, referring to his intake and reflux. I asked her if she was planning on re-inserting his feeding tube. No, she was not. Then why? What could they do for him that we couldn’t do at home? “He simply won’t grow,” she insisted. We reached an agreement: if Mr. D could eat all 55mls of each of his day feedings that day, and I agreed to take him to his pediatrician in two days instead of three, I could take him home. She strongly implied that she disagreed with this, but not enough to rule it out.

Challenge accepted, I thought. For each meal, I stripped an irate baby down to just his diaper. There was no way I was letting him get warm and comfy. I did not alert the nurses to his small spit-ups during burping. I twice emptied the remaining 2-3 mls of milk into the burp cloth at the end of his 20 minutes. And he got to come home with us that evening.


Mr. A could neither suck nor swallow nor breathe at the start. He did take early breaths on his own, but with much effort. The NICU staff quickly determined that he could not maintain his breathing, and gave him surfactant and intubated him. Once extubated, no one was surprised that he could not suck. He actually had the reflex, and would happily gnaw on a Soothie if it was held in his mouth. His cleft soft palate, however, left him with the inability to form negative pressure in his mouth. As such, he could not draw liquid from a nipple, nor could he hold his own pacifier in his mouth by sucking merrily to sleep. In order to assess his ability to swallow, the neonatologists had the nurses perform what I have since learned is a very outdated “test”—they poured sterile water into his mouth. They assured me that, if inhaled, it would not cause any problems, as it was sterile and a very small amount. The first time they “tested” him, the liquid slowly dribbled out of his mouth. He could not swallow. They repeated the “test” two days later, and he “passed”—the water went down somewhere, and they assumed it went down his esophagus. He was cleared to begin oral feeds.

I was introduced to a variety of bottles and nipples, all specially designed for babies with clefts. I was a bit dismayed to realize most of the nurses had no more familiarity with these “feeding systems” than I did. Essentially, they all worked the same way: a nipple was placed into A’s mouth and he chewed on it and the nipple released milk due to compression. Some of the bottles were squeeze bottles, so that I could force extra fluid into his mouth.

It was a disaster. I was too naïve to realize how large of a disaster it truly was. Only once did Mr. A take in over 10 mls (two teaspoons). Feeding him generally went like this: hold him in a specific way (hands angling his jaw upwards, entire body elevated to at least 45 degrees, while trying to support his head and body but not of course cradled in my arms), introduce nipple, watch him struggle, watch him desaturate (often followed by heart rate decelerations), fearfully yank the nipple out of his grey-blue lips, let him recover, repeat. At the end, measure remaining milk and discover only a handful of milliliters to be missing, and then pour the remainder down his feeding tube while snuggling him to sleep.

After a few days, I told the nurses I no longer wished to feed him by mouth. I was terrified. I could feel, somehow, that his desaturation and bradycardia events were different than Mr. D’s episodes of breath-holding. I hated feeding him, he hated eating, I feared I would kill him. The nurses told me I didn’t have to do anything I wasn’t comfortable doing, meaning they would continue to do his feedings for me. That wasn’t entirely what I meant, but I was too insecure to argue. And so he struggled along for a few more days, with me or my husband holding him while the nurses fed him. I came to accept his “behavior”—after all, he was gaining weight and showed no ill signs. So I resumed the feedings.

When he was transferred to the children’s hospital, he was evaluated by their feeding and development expert. I wasn’t there (we were not forewarned of it, or I would have been!), and came to his crib an hour later to be informed by the nurse that he was no longer to eat by mouth. Ever. He would need a surgically placed tube going directly into his stomach. I was irate. He had been, I thought, showing signs of improvement. And here some lady looked at him once, did not even give him a chance to truly try, and ruled out eating for the rest of his life? I made the staff aware of my displeasure, and they promised me she would speak to me. She didn’t, not for some time.

Mr. A was eventually given a swallow study: he sat in a car-seat-like chair, being fed radioactive barium mixed with breast milk to various consistencies: pudding, nectar, thin. X-ray-like machines videotaped the entire event. And there it was in black and white: Atticus was drowning. The milk went up his cleft palate and into his nasal cavity, and from there it entered his trachea and lungs. What remained into his mouth also largely ended up in his lungs. He was unable to cough to protect himself. My baby boy had silent aspiration.

I felt awful. Guilty, guilty, guilty. If I’d held my ground at the first hospital, if I’d truly listened to my instincts, we would have stopped feeding him by mouth weeks ago. He must hate me. He must fear me. My job was to keep him safe, and here I was, endangering him every three hours on the dot. And my pride, my pride at what I thought was improvement and my wrath at the feeding therapist, who had told me what I had been unable to believe, as if my wishing could make those drops of milk enter his stomach safely. “He was took 13 ccs!!” I had argued, over and over, his record amount so strong in my memory. Almost half an ounce, I was forced to admit, almost half an ounce of my milk flooding into his lungs.

It did not occur to me until almost a year later that who I should have been mad at, instead of myself, were the doctors and nurses at his birth hospital. I was in over my head, but so ignorant I had no idea. They should have known. They should have recognized what I felt in my heart and what led me to ask to stop: this was not normal preemie behavior. None of this was typical. And they didn’t. True, the most challenging preemies are probably passed off to the children’s hospital sooner than my Mr. A was, but watching for signs of aspiration is not a difficult art, and it’s one that should be taught to and remembered by everyone working with sick babies.

Mr. A got his G-tube placed when he was negative-one-week, adjusted. His feeding plan was changed to reflect that, while he was not to eat by mouth, certain exercises could be done to help stimulate his oral-motor skills. Feeding has continued to be one of his biggest challenges, but I am happy to end this by saying that we are now very close to replacing one of his 5 daily tube-feedings with an entire meal eaten by mouth. And as for Mr. D, he is an avid eater, and above the 90th percentile in both height and weight. The suck-swallow-breathe struggles are behind us all.