answers and photos

thanks for the emails & comments on that last post!! they all mean so much to me. here's an attempt at responding to some:

CNH - hi Chantel! I've been watching your blog w/rapt interest!! I can't believe your LOs are scooting around already. That prayer is excerpted from a prayer here... I'm sure quoting it is fine - I forgot to source it when I posted. I'd love to read your take on it, given the differences in our situations. Thanks to Jennie for posting the link.

MKW emailed me w/ this empathetic thought: As for full-time nursing and cloth diapers... I hope you not setting the bar too high that failure, of some sort, is immanent. And you're left feeling depressed, and frazzled to the bone and defeated. I fully believe in nursing and did both boys for about 7 mos., but I also knew I was a better mom for being able to bottle/formula supplement and leave them and regroup with time out with J or friends and come back to them anew. Full-time nursing is a draining anchor. And yes, it's great for the babies, but you need to watch yourself along the way and protect your sanity, because THAT'S what will be best for the babies and you. You will be close and loved by them because of who you are, how much you wanted them in your life and how much you love them everyday, they'll never measure your love by whether or not you used disposable diapers, bottles, or breastfed them every meal. Choose your battles... and in this case how much you're weighing down an already very demanding daily job of love.

I wanted to share this with you all because this is something I think and talk about often. And I agree with what you wrote, M.

I am using cloth diapers part time - mostly during the day. I think w/ the next size of diapers, I'll be able to use them at night, too, but really, I don't push myself on this subject. Right now, K is doing virtually all of our laundry, and I just don't know how it will be when I'm doing it myself. I plan to do it as I can and won't worry about it when I can't. I'll be using prefolds during the day only, and fuzzybuns as much as possible, for those who are interested in knowing. ;o)

As far as breastfeeding goes, I persevere because I can, and because I simply want to. I want that relationship with them both. I want that nutrition and all those benefits for them... but don't think that I am going to play hardball w/this either. Anyone who knows me will know that I'm just not an all-or-nothing person, sometimes to a fault. In this case it just means that I'm going to continue to perservere and see how close to exclusive I can get in nursing. I'd like to know that my supply is sufficient to feed them both, but given the demands of twins, I'm pretty sure that I'll always be ok with offering the occasional bottle. And if I get to a point where I feel like my supply is good enough without being 100%, I'm ok with that too. I just feel like, for now, I'm on the path, and I'm ok with this being a process.

A while ago, Megan asked me in comments about the amount of supplement I am giving the boys. I responded there, but I wonder if she checked in. I just wanted to make sure that you know your question wasn't ignored. This week, I think I'm down to about 22oz a day, combined. Still a long way to go.

Finally, thx to Maylily for the email & all you others who send love & encouragement... Your words make this easier.

Here, some new pix - all by Amy - & a video of Shoghi finally having some happy time:

amboobdextrous, or the next nursing update

Moving right along... the biggest change since my last nursing update is that Maxwell has taken off! He's latching so much better, and at our last visit to the lactation consultant, he actually managed to get more milk than Shoghi! I'm still not giving him lact-aids, but I hope to start trying that this week.

One "bad" thing that's happened is that I'm running out of the domperidone I was given by a friend, and my doctor won't prescribe it since it's off-label. I can't take the other common medication that they will prescribe because it can cause depression, to which I am already predisposed. I really can't risk that right now, on top of everything else. I have recently learned that 4 months postpardum is a common time to start having PPD, and the boys just hit 16 weeks yesterday. So, I'm not sure what I'm going to do about that. I have another 3 weeks of the dom, so I have to come up with a strategy right away if I'm going to wean off of it.

Speaking of weaning off of things, what's your take on caffeine while nursing? I know you're not supposed to drink coffee, but seriously, how could I possibly endure life without it right now? Do any of you readers have experience with caffiene affecting your supply?

As far as supplement goes, Shoghi is, as of today, down to one ounce, about five times a day! That means he's probably getting more than 20 ounces from nursing - wow! When Max gets to have a really good nursing session, I drop his supplement down to 1.5 ounces for that feeding. Granted, this doesn't happen as much as I'd like, but how could it, really - I end up having both of them in my arms at the same time so much, there's just no way I can do it right now. I can best manage to feed Max with a bottle while having him sit in my lap, and with the other arm, hold Shoghi while he nurses. This is the position we often use at night. On a good day, I manage to get them both nursing at the same time once or twice (hence the title of this post). I can say this much - it's getting much, much easier to have them tandem nurse as they get bigger. It was such a huge frustration when they were so little that I completely tabled even trying until pretty recently.

I couldn't talk about nursing without talking about sleeping. On quiet days at home, we are now falling into a clear pattern, with a rough morning and late afternoon nap, and settling down for nighttime napping/sleep at about 7pm. The coolest thing is that lately, the boys are getting into some really long sleep periods at night, and I have begun to be able to offer nursing only to get us through from midnight until about 7 or 8 in the morning. I don't really have an expectation of them developing fast and clear habits this early, so I just love it for when it happens.

I sleep with the boys in my bed, with Shoghi next to me and Max on the other side of him. I've begun experimenting with sleeping between them, and rolling back and forth as they want to nurse, but so far, that's been more exhausting, and it makes me uneasy to have my back to one. It's easier to simply move to the other side of the bed to nurse Max when he wakes. I love sleeping with the boys - I really can't see how I would get any sleep at all if they were not in bed with me.

Finally, this week was our first Thanksgiving, and it was also my 36th birthday (on Thanksgiving). It probably goes without saying that this year I had more to be thankful for than ever, and thinking about all that is going to happen in terms of the boys' development in the next year just astonishes me. I certainly missed being with both my East Coast family and Jennie's family with whom I have celebrated in recent years. It was a joyful day here, though, and we all got just a little teary, noting the election of the embodiment of hope, Barak Obama, and all the tremendous gifts our children, family and friends are bringing to our lives.

untitled

alright, alright. what can i say? after my flurry of posts earlier this month, i've fallen silent. i'm rather overwhelmed, truth be told. i had the thought to tell you about sleep, more about our adventures in nursing, and even a day-in-the-life post.... i just don't think it's going to happen any time soon.

don't get me wrong - the boys are fabulous. healthy, beautiful, perfect little babies - ptew, ptew, knock wood, and all that. but damn if it isn't a lot of freaking work to care for them. my days go in increments of 15 minutes, pretty much. one 15 minute set will be easy, and the very next might have me broken out into a sweat or ready to cry. even with years of childcare behind me, i admit it - i was not prepared for life with two infants.

these days, i often think of this prayer, and how much it applies to every breath, every action, every word of my current experience. maybe the constant act of raising children is meant to teach us deeper aspects of servitude, to carve out places of selflessness in our spirits.

Oh, God, make me a hollow reed, from which the pith of self hath been blown so that I may become as a clear channel through which Thy Love may flow to others. I have left behind me impatience and discontent.... The task of the day suffices for me, and all the future is Thine. Thou changest weakness to strength, doubt to faith, perplexity to understanding.... With eagerness and patience, with hope and gratitude, I bend to the task of the hour, lest when Thy call comes I be found unready.

all heaviness aside, there are lots of moments to enjoy. i have a lot of help, and the boys are becoming more alert, more interactive. max is on the verge of laughter. i love them with a depth i cannot even describe.

here are some photos of recent times:

max has started sucking his thumb,
which might just be one of the cutest things ever

ah, the elusive shoghi smile

oh, precious sleep

leave it to the pros

yesterday amy came over to finish up our photo shoot of newborn shots. i've posted some of the earlier shots before, but i couldn't wait to share with you these four that she got yesterday, including shoghi's very first smile... for now, these are the first in her photostream.

happy awake time

at 6 weeks adjusted age, we're finally getting some consistent happy awake time. here's max, cooing away a couple days ago.

progress in nursing

On Tuesday afternoon, we all packed into the car with our new doula E and went over to Beyond Birth for our latest lactation consultation. I'm feeling a lot more confident... here's why:

Shoghi

3 weeks ago, Shoghi was getting almost 3 oz of supplement, 8 times a day, and now we're down to giving him just 1.5 oz 6 times! His weight gain is still at the top of the desired range, so he's clearly tolerating the drops well. His second cold is finally receding; what a relief!

Max

We are in a learning-to-nurse process with Maxwell. He's latching on much better since his second frenulum clip for a posterior tongue tie, so as much as I can, I offer nursing to him. Many times it ends up being nursing to sleep, but increasingly, I'm able to nurse him before he takes his supplement. The new plan is to give him 1/2 ounce formula or donor breastmilk when we have it, then offer to nurse, then give the rest of the bottle. I'm not using the lact-aid with him yet - I just don't think he's ready for it. We were given 3 exercises to do with him to strengthen his tongue and improve his latch. In addition to the above, this time we learned more about infant paced feeding.

We've been learning about this and bottle position for a while - it really seems like it's one more way to really engage the baby's instincts about hunger and eating. The more I learn about it, the more I eonder if there could be a connection between typical bottle feeding (baby lying down/milk pouring into mouth) and later eating disorders/ obesity. Here's a snippet about bottle position:

To avoid undermining breastfeeding, it is important to help baby maintain breastfeeding behaviors while he feeds from the bottle. One way to do this is to approach baby with the bottle in a way that makes bottle-feeding similar to breastfeeding. This means that the bottle nipple is not poked into his mouth, when it is barely open. Instead, point the nipple up toward the ceiling and lay the side of it across the baby's lips, stroking downward, so he has to open widely to accept it. This helps preserve the wide open gape he needs for a good latch at the breast. It may take a minute or two for him to do this, but by consistently waiting for him to open his mouth wide before giving him the bottle, you will teach him what he needs to do in order to be fed. Once he opens his mouth very wide, place the lower part of the nipple on his lower lip with the nipple pointing straight up and then roll it into his mouth so that it goes in deeply.

And here's a bit about paced feeding:

Many mothers also find that babies feed better when the bottle feedings are paced so that they are more like breastfeeding. Bottle feedings are paced by stopping and gently withdrawing the nipple after four or five sucks or whenever the baby expresses tension through facial expressions. The nipple stays in contact with baby’s lower lip, allowing the baby to draw the nipple into his mouth again when he is ready. This helps the baby retain control of the feeding, reminding him to stop when he is full.... Holding the baby so that he is more upright allows him better flow control. There is no need to keep the nipple full of milk; he will fill it when he sucks.

~from LowMilkSupply.org

Seems like the more these basic instincts are suppressed, the more likely it would be that later in life a child might be out of touch with his sense of hunger/ fullness. At any rate, it's surprised me how much there is to know just about giving a bottle, and I really wish I'd known this from the beginning.

Building Supply

This week, we focused mostly on Max's learning, but there are other overall changes, too. I've switched all my herbs to blends from Mother Love Herbs. That makes my life a lot easier: instead of taking 9 capsules 3 times a day, I just have to take 5 now. I've also increased the amount of domperidone I'm taking - I'm almost at the maximum dose.

Last week, after a particularly hard day, I also decided that succeeding at getting the boys to exclusively breastfeed is only going to be possible with more help. I bit the bullet and hired a doula, who is now coming in 3 days a week for 5 hours each time. Combined with my sister's help on Mondays, that means I have 4 days a week of helpers. Of course, Korin helps me every day, but I don't want to have her continue to have to focus on us when her daughter needs her attnetion. It just makes for a (more) tiring day for her! Anyway, the addition of the doula really means that I can pump on those days I have extra help, something I really can't do when I'm alone.

So, there you have it. Steps closer to the goal! I meet with the lactation team again a week from Friday, so I'll update again after that appointment.

笑一个... SMILE!

Monday, November 10th was the big day - Maxwell was the first to grace us with a whole morning of delightful smiles. Here he is today - we finally got it on camera!

despite

We had a really hard night last night. What had been a fine day dissolved in a matter of seconds into one of those parenting moments you wonder how you're going to get through. Without giving a boring play-by-play of the succession of crying/feeding/crying/diapering/hysterical screaming/red-faced wailing, suffice to say that I barely survived a good hour of watching my babies work themselves into a frenzy. It was completely unendurable. I talked, sang, bounced, snuggled, tried tandem nursing, shushed, shouted to be heard, used a cool wash cloth on their hot faces, grabbed bottles, bouncy chairs and boppies before it was all said and done. When I say I barely survived, believe me: I found myself shaking, nauseous and tearful after it was all said and done.

After somehow managing to get us all through it uninjured (you try holding two hysterical babies without dropping them!), I lay the boys down in our bed and covered myself in my grandma's quilt to stare blankly at the wall and recover my wits. Maxwell was next to me, looking at me all the while with his big inky blue eyes. It took me a minute to feel his tiny hand brushing my arm beneath my blanket, and a minute more for me to realize it was deliberate: my little baby was seeking out my touch, or giving me his. This contact broke my heart and I began to weep as I held his hand in mine.

Despite it all, we are in this together, and despite it all, in that moment, I felt loved.

Three Months

Dear Shoghi and Maxwell,

Today you are three months old. I suppose for the rest of our lives, I will be saying "I can't believe you are __ old," but really, how is it possible that you were born so long ago already? How could you have gone from those two fragile, tiny bodies to these two robust, vibrant beings?

Shoghi, right after birth

touching Shoghi for the first time

Maxwell, right after his birth

touching Maxwell for the first time

To say that I love you doesn't begin to capture this experience. Your presence has awed and humbled me. Many times a day, I will have you in my arms and wonder at the fact that you are my sons. Your joy and your pain twist my heart and in those moments of sensing your experience in this world, I know I will forever be a servant to your needs - it is a command stamped into the very fiber of my being. You are the essence of beauty; you are the bringers of delight.

Shoghi, from the moment you were born, you have captured our hearts. Many of the people who love you observe that you have a wisdom to you, a kind of seriousnessthat radiates from your face and hands. You are so expressive with your hands, your Popi wonders if you will be a piano player, while the rest of us simply sit entranced by the gentle dances you perform with your long, delicate fingers. You have the look of an older child - since you were tiny, I could look at you and see the boy you will grow into, gentle and mischevious and sweet. For now, though, you are my baby, with your indominable, insistent way that makes us all snap to attention.

Shoghi.
photo by Amy Schmeets

Maxwell, you are the ultimate love. You have many nicknames, but the one I think of right now is one we don't use often: Maxwise... you have the essence of a faithful companion and often we compare you to Frodo's loyal Samwise. Your spirit seems to be infused with a tender earnestness and patience that make you both vulnerable and a joy to be around. Physically, you are the embodiment of BABY - your chubby, rosy cheeks and your perfect rosebud lips fill me with delight. Your clear, bright eyes have engaged and mesmerised us all from the day you were born. You coo and gaze at the world and any day now your beautiful face is going to burst into a huge grin, a moment I am waiting for with every fiber of my being. Many have said that you exude a spirit of love, and I have to agree. As you grow older, your charm will propel you outward, but I fear you will also have to learn to protect yourself - your tender loving, eager heart may make you susceptible to being put aside in favor if those more demanding. Whatever the case, I'll be here to guide and protect you, to help you find the powers you need to let your gorgeous spirit emerge and shine.

Maxwell.
photo by Amy Schmeets

Over the last month, you have both woken up to the world. You spend more and more time looking around and meeting our gazes with your eyes. You watch shadows and movement, and you now make your sweet baby sounds that cause my heart to soar. As your bodies grow bigger and stronger, you have also been able to endure delays in eating and sleep more graciously, which makes life easier and happier for us all.


To say I look forward to watching you discover the world is as inadequate a statement as any ever made - I think it will be pure magic. I love you each for who you are, and together for the family we have become.

love,
your mama

catching up, part 2

The Nursing Update

Where to start? I don't think I've ever really posted fully about our adventures in nursing, but I want to record this for myself, and maybe there's something here that could be helpful to someone else in a similar situation. So, if you're one of my uncles, or you're my dad, and you would rather not read about this part of twin parenting, then just hang in there - I'll have another post up in a few days, I hope!


I'm very committed to nursing the boys. Despite the fact that they're already almost 3 months old and neither is yet nursing completely, I am striving to get there. I'm not really a person for politics or making big social stands, so for me, the decision to try so hard to nurse is mostly because I feel strongly that it's the best course for us, regardless of how hard it might be for me now. I've only got an uncertain amount of time alone with my sons before I'm going to have to start working again, and that makes me even more determined - I want that nursing relationship with each of them, and I hope that intimacy can continue even after I go back to work. Pursuing nursing has become my primary occupation after taking care of their other needs. It takes a lot of time, patience, outside loving support and, believe it or not, money, to succeed at nursing when you have the challenges I've encountered... and yet I persist...

Instincts

So, here's what I think - if you ever find yourself the first-time parent of a baby in the NICU and you want to nurse, find your gut feeling and go with it. Then, find the best lactation consultant you can outside the hospital system, and get them to come to the hospital and help you and your baby, immediately.

I got pretty bad advice at the NICU. I should have been coached to begin pumping as soon as I got back to my room after being in Recovery. I should have been pumping every 2 hours, in my room at the hospital and at the bedside. I didn't start pumping at bedside until probably 5 days had passed! I did try on Day 1 to get both babies to breast, but I really knew nothing about preemies and nursing, so I focused more on the care I could provide them, like kangaroo care, changing diapers and giving bottles. They call babies sucking a bottle "nippling" in the hospital and actual nursing "practice nursing" - so strange... it's just one of the many ways that the natural process gets screwed up.

The other thing they do in the hospital is feed in 3-hour intervals. Now, if you've had a newborn baby at home and nursed, you will no doubt know that nurslings do not nurse every 3 hours... they nurse much at closer intervals! So, after a month of scheduled feedings, the boys' internal mechanisms for hunger were set on this schedule. Getting them to have smaller, more frequent feedings has been all but a failure.

Along the same lines, I have found it really, really hard to get away from knowing exactly how much they are eating. Whereas moms who exclusively nurse become tuned in to their baby's hunger cues and nursing habits, all i had was a schedule and a number of millileters. Those numbers were so important in the hospital, they impacted when the boys could come home. I never pumped as much as they ate in any feeding, so I was left with fear that they would starve! Still, even after having been home for almost 2 months, it makes me uneasy to not know how much they've gotten from a nursing session, which makes me want to reach for formula supplement if they're acting fussy.

All-in-all, I think my experience was one which led the 3 of us to suppress our instincts about nursing and hunger.

Galactogogues

No, I'm not talking about some Sci-Fi creation; galactogogues are substances that help increase breat milk supply.

When the boys were born at 32 weeks, I had many factors against me in the breastmilk supply department:

At 35, I'm in that "advanced maternal age" category;

• c-section;
• premature delivery;
• polycystic ovarian syndrome (also the cause of my infertility);
• chronic hypertension.

I am taking a ton of herbs (fenugreek, blessed thistle, goat's rue, juice plus, prenatal = 9 capsules 3x a day) and a prescription for domperidone.

Again, because I'm not solely pumping, I haven't got a strong sense of how much I'm producing... right now, it's not enough to feed one exclusively. I'm gratefully receiving some donated breastmilk from a local friend, which always goes to Max, since he's not at the breast much.

So that's where we've been.

Where We Stand

Shoghi is, and has been from the beginning, the stronger nurser. I'm currently nursing him on demand, and six times a day, I also give him supplemental formula with a lact-aid. By now, he's an old pro at latching on. Several weeks ago, I took him to an ENT and had his frenulum (tongue tie) clipped, and this helped to free up his tongue and improve his latch. He can nurse in several positions, and he sleeps next to me so he can side-lie nurse throughout the night. How easy it would be to just nurse one baby! How much sleep mamas of singletons must get!!!

The plan with Shoghi is to drop his supplement amount slowly over the coming weeks until my supply catches up with his needs.

Maxwell is pretty much starting at the beginning of learning to nurse. It has taken having his posterior tongue tie clipped twice, the last time being last Friday, to free up his tongue mobility and allow him to latch well. He gets all his calories from formula, given to him by bottle. Now he is finally able to "pratice" nurse, so whenever I can. I start his feeding with 1oz of formula, offer him the breast for as long as he wants, then finish up with the rest of the bottle.

A note about frenulum clips - everyone told me it wouldn't hurt the baby. In my experience, that proved to be false. Seems a little like the old supposition that circumcision didn't hurt. I'd recommend giving babies homeopathic aconite for both the pain and fear, and have some baby pain reliever or arnica on hand for afterward.

I'll be meeting with the lactation consultant again next week, and I'll let you know our progress then. It'll definitely be easier to post about this next time, since I won't have to start at the beginning.

for C, S and B; Seth and Kevin!

here's a little post for my favorite blog readers!

some recent photos

a video of shoghi, rolling over!