Category Archives: NICU

Quad Momma +1 Intro

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Hello everyone!

I thought I would take a moment to introduce myself!   My name is Paige, and I live just outside of Parry Sound, Ontario, Canada.

I am happily married to my husband Greg, and we just celebrated our 7th wedding anniversary.  We have a beautiful 4 year old girl, and recently welcomed home GGBB quadruplets, who are now 20weeks old, 11 weeks corrected.

I have been blogging throughout our journey at www.lubbelinkhof.ca if you’d like to check us out from the start.

Here are a few things you should know about me:

#1 – I am a Christian, and while I don’t typically blog about this it may come up.

#2 – I have PCOS.  I do not ovulate.

#3 – We took medications to get pregnant.

#4 – I breastfeed 90% and supplement 10%.  Yes it can be done! :)

#5 – I tell it like it is. I am not super mom. I do not pretend to be.

#6 – Our oldest daughter is Madelyn Grace.  She was born a healthy 7 pounds 11 ounces at 38 weeks.  Next up our babies were born at 31 weeks 1 day, and the first is Jessa Joy, followed by Alyssa Faith, Brett Paul, and Colton Gregory. We spent 1 week in the Level 3 NICU in Toronto, then 5 weeks in the Level 2 NICU in Orillia.

#7 – All of our kiddos are healthy, however we do receive support from PT for Alyssa & Colton. Alyssa also receives OT for her “over active” vestibular system, and Infant Development follows all of our kids.

#8 – I love answering questions so fire away! The only way to find out is to ask. Its much easier for me to answer them then to come up with random blogs on my own, so if there’s something specific you’d like to see, let me know!

#9 – Because of the current craziness of life my posts are likely to be sporadic, but I want to attempt my best to post here as often as I can!  Please feel free to reach me at paigelubbelinkhof@gmail.com or comment here.

Until next time,

Mrslubby.

A preterm MoM intro

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With the new year upon us I thought I’d take on a new blogging opportunity. Let me introduce myself. My name is Carolyn and I am a mom to fraternal b/b twins, living, parenting and working in Ontario, Canada.

My twins are 2.5 years old and are spunky little men, with great personalities of their own. My guys are little for their age due to arriving at 27 weeks and challenging their parents from day one! They are amazing fighters and have come so far!

Canada offers mothers maternity and parental leave if they’ve been working enough hours leading up to the arrival of their child (ren.) I was lucky to be one of those people. I actually took 16 months off to be with my babies. The times were tough, but we made it through. There was definitely a lot of frustration and tears for everyone involved, but these little men taught us much about perseverance and developed our ability to kick adversity in the b-u-t-t time and time again.

I have been writing a personal blog coming up on 2 years about the ups and downs of my family. You can find my blog at http://twintrospectives.blogspot.ca. We also have an older boy, born at 31 weeks, who the twins love and learn so much from. These 3 boys have been our family’s inspiration.

I usually blog on the topic of prematurity and what might come afterward for others and what has evolved for my family in particular. The experience of preterm birth has given me a positive outlook on life, which might sound weird, given the fact preterm birth is the scariest thing most who go through it will ever experience. I figure if I can get through such an uncertain time, along with my family members, then there isn’t really anything else we can’t figure out. This is what I hope to be able to teach my children as I mother them and watch them grow during their childhood.

Aside from helping my own children along the way, my greatest passion is assisting new families going through the preterm birth experience, one step at a time. I have found my way into my local Multiple Births Canada (MBC) chapter, now working as a peer health worker (outreach worker,) as well as I’ve  just taken on a co-chair role in the development of MBC’s Preterm Birth Support Network.

In 4 short years my amazing little preemie men have taught me so much about life and I hope to be able to share some of what they have been teaching me with the How Do You Do It community.

Reunited

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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.

It takes a lot of blankets to secure a baby of less than 5 lbs in a carseat.

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.

Prematurity Is Never Easy

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M and J were born 7 weeks premature. When we found out we were having twins, my ob/gyn told us, right off the bat, that we could expect them to arrive early. She offered to help us find a new doctor who had privileges at a hospital with a neonatal intensive care unit. My husband and I agreed that we wanted her to care for us during the pregnancy, even if she wouldn’t be the one to perform the delivery if it was early.

We didn’t know the first thing about prematurity. When the doctor said, “privileges at a hospital with a NICU,” we were so naïve that we just looked at her blankly. She had to spell out that a NICU was a neonatal intensive care unit and we should prepare ourselves for an extended hospital stay. This pregnancy was high risk, all the more so because I was 5’0 and weighed 112 lbs. There wasn’t exactly a lot of room for expansion, at least up and down. The prospect of gaining the ideal 60 lbs over 9 months seemed challenging, and turned out not to be a goal I could accomplish.

Still, the pregnancy was so relatively easy on me – not so my husband; my temper was terrible! – that I was sure I could carry the girls to at least 35 weeks. I had no morning sickness, and I was floating on air during the second trimester. Thirty-five weeks was our goal, because twins tend to gestate about two weeks faster than singletons, and therefore 35 weeks for them was as good as 37 weeks for a singleton.

We went through the motions to prepare for preemies. An aunt got the girls preemie-sized outfits at the baby shower the family threw for us, even though I couldn’t attend. (My doctor highly recommended that I not fly to Oregon.) We took our Lamaze class with a group of couples 2 to 3 months farther along in their pregnancies than I was. Despite these steps, we hadn’t prepared emotionally, and I was still deeply attached to the idea of a natural birth. I had made a list for my hospital bag, but hadn’t actually packed, when my water broke at 33 weeks, 1 day.

The actual birth was a haze. J weighed 3 lbs 6 oz, M 3 lbs 9 oz. J had a patent ductus arteriosus (PDA), or a hole in her heart. It’s a common condition in infants, and resolved itself within a couple of months. Neither M nor J needed any help breathing. They didn’t need oxygen treatments. Unlike some of the other preemies in the NICU, they didn’t have any issues with apnea of prematurity, which is essentially what happens when a preemie forgets to breathe.

They were really small, though. They couldn’t regulate their own body temperatures because their baby fat hadn’t come in yet. They had to stay in their warmed isolettes, although they were strong enough that we were allowed to hold them for several hours each day, and keep them warm with our own body heat. When they finally downed 31 mLs (1 oz) of formula and breastmilk in one shot, I cried for joy, because that was one of the criteria the NICU had set up for release from the hospital. Days earlier, my husband had fought for my right to breastfeed, fighting formula and the feeding tube while I was being moved out of the operating room, until a doctor kindly, but firmly, told him that our babies were really, really sick, and all our plans were going to have to wait.

We had the healthiest preemies in the NICU, but still, they were tiny.

In the picture above, J and M (in the matching white onesies) are a day shy of a month old. D, a dear friend’s son, is two weeks old. That’s half their age. He was born on his due date at 40 weeks gestation, compared to M and J’s 33 weeks. His legs are twice the size of theirs. His arms are twice the size of theirs. Each of his hands could almost contain one of theirs. M or J would disappear inside the newborn-sized onesie D is wearing. What you can’t see is how baggy their preemie-sized onesies are on them.

Remember, M and J are twice as old as he is, if you count from their birth age.

I actually learned not to measure their age from their birthday. When I did use their birth age during their first year, I felt like I had to keep explaining why the girls were so small, or why they weren’t holding up their heads better at their age. Not only that, but my poor friend kept having to defend little D when we were together in public. “He’s not fat! He’s not huge! The twins are just really really tiny!”

Once we reached their due date, the day they would have been born full-term, I began to use their corrected age, that is, how old they would have been if they hadn’t spent the last two months of the gestational period outside the womb. It was so much simpler to tell strangers at the grocery store that the girls were a month old, rather than, “They’re three months old, but they were born two months early, and please don’t look at me like that because I’ve never done a drug in my life and maybe if I’d been on bed rest the pregnancy would have lasted longer, but I did the best I could, and I’m really trying to be a good mother.”

Yes, I was extremely touchy about the fact that the girls were born early. I felt like my first act of motherhood had been to betray them by evicting them from my body half-cooked.

Our pediatrician was fantastic. The entire practice has a lot of experience with preemies. In fact, all the twins I knew in our old town went to one of two pediatricians. (Not all twins are premature. My husband’s now 16-year-old triplet cousins were born full term. However, the rate of prematurity is high for twins, over 50 percent.) The doctor focused always on how M and J were doing compared to where they started, rather than looking at averages. When he tracked their growth on the growth chart, he used their corrected age. When it came to timing immunizations and the introduction of solid foods, we followed the guidelines of the American Academy of Pediatrics, again using their corrected age.

M and J are healthy. They only long-term effect of prematurity appears to be the state of their teeth, although we faced some challenges in the early years with their lung development. We’re the lucky ones, though. Others aren’t as fortunate.

Here’s what I would tell my pregnant self if I could:

Don’t be irritated with he doctor when she tells you that you need to quit working. Listen to her when she says that you’re having too many Braxton Hicks contractions, too early. Working part time and telecommuting was a great alternative to working full-time, but you could have afforded to stare at the ceiling for a few weeks to give those precious girls a better start. It might have made a difference. It might not have. You’ll never know.

I will never know what I could have done differently to give J and M another day or two in utero, but I will always wonder.

Sadia’s daughters, J and M, are now thriving in first grade. They’re a head and half shorter than their classmates, thanks to inheriting Sadia’s (lack of) height. A previous version of this post was published on Sadia’ personal blog, Double the Fun, on honour of the Bloggers Unite Prematurity Awareness event 2009 .