Tuesday, July 31, 2012

Getting Ready to Breastfeed Twins

With all the benefits of breastfeeding, many moms strive to nurse their babies at least for a few weeks, and some for much longer. While breastfeeding one baby has a steep learning curve and struggles, breastfeeding two or more can bring a whole new variety of challenges and complications. The most common challenges to breastfeeding twins relates to the fact that many twins are at least slightly premature.  Even a birth date at 35 weeks – which is only 1 week shy of what is considered ‘full term’ for twins - can affect a baby’s ability to nurse efficiently. And even breastfeeding healthy full-term twins brings a set of challenges that most moms and lactation consultants have never encountered.

Honestly, I want to warn you that the greatest challenges of breastfeeding for me were not logistic, nor physical. They were mental – either self-imposed, or imposed under the pressure of a well-meaning but short-sighted lactation consultant or nurse.
If you want to breastfeed your twins - exclusively or not -and make the whole experience a lot easier on yourself, I recommend you invest some time researching and learning now before the babies arrive…finding time to read and comprehend a book while playing ‘Hot Potato’ with 2 crying newborns is simply not enjoyable or effective! Read (ok, at least skim) a good comprehensive book on breastfeeding like this one...

Find a breastfeeding 101 course from le leche league, your hospital, birth center or birth and parenting education center. Nothing beats the getting the 411 in person from someone who knows what they are talking about!
Get a phone number of a lactation consultant or counselor. Try to get a referral from a friend or acquaintance who had a good experience. Also, find out how she charges - if by visit, or for calls or both. (Some may charge two fees for twins, even if they only have one visit with you. You really should not have to pay for twice when they truly only have one visit, unless they are doing extensive coaching/examination of each baby and spending twice the time doing it). Also, you should also call your insurance company to find out if L.C. is covered. - Note sometimes it is covered better or only during your postpartum hospital stay, but not thereafter. If you do have questions or problems breastfeeding when the babies arrive and sleep is in short order, the hardest part is already done –finding an expert to call, and all that’s left for you to do is pick up the phone!

Create a ‘nursing nest’. You will be spending a LOT of time with your little nurslings. You might as well do it as comfortably as possible! If you have a rocking chair, glider or other comfy chair you plan to use, create a ‘nursing nest’ with it. (If you don't have a special chair, pick a spot on the couch or other chair with space to keep supplies nearby) This means choosing place that makes the most sense for your lifestyle and schedule. Yes, instinctively you may want to place it in the babies’ room, but that may not be the best option depending on your family and preferences. For instance, since I had 2 older 3 year olds, I put my nursing nest in the living room so I could watch and interact with my other kids and make sure they weren’t getting into trouble! Next to my chair, I put a TV tray that could hold my laptop computer or a book or magazine. On the window sill of the other side of the chair, I put a small basket in which I could store all sorts of essentials – nipple cream, TV remote, an extra burp cloth, tissues, my breastfeeding reference book and my big kid’s favorite finger puppets. I also kept the boppy leaning right next to the chair as well as my breast pump.

Here are some other recommendations just based on my personal experience...

Nursing Bras
Buy just one or two nursing bra in advance, buy different styles so you can decide which you like best after you are nursing. Get one that fits even while you are pregnant, but err on the large side as your bosoms will soon have superhuman elastic capabilities. It was much easier to know what fit well AFTER I was actually nursing. Then you can stock up on your favorite bras. I also highly recommend nursing bras with one-handed access – NOT SNAPS! Sometimes you just don’t have 2 hands available when you have 2 babies!

Comfort measures
I recommend getting the gel pad ‘soothies’ and a good nipple cream. I like the cocoa butter oil-based version that is not sticky like the lanolin and it goes on nicely even if you’re a bit chaffed.

Breast Pump
You don't usually need to buy this ahead of time because first, it is hard to know what you will need, and also they usually have them available a the hospital. Though, if you are pretty sure that you want a pump, you can buy ahead of time and shop for the best deal. If you will be going back to work at some point, you will probably want to plan on buying a good pump. Some moms who stay home hardly, if ever, use one. If you aren’t going to buy your own breast pump, try to rent or borrow one. It will really help you build supply for the first several weeks and when your babies have growth spurts. If you do borrow one, you should probably buy all new parts for it at a baby superstore near you, or order online.

Find other M.O.M.s who know
Get connected with a good twins club/ moms club in your area. You will no doubt have questions or need input that is best found from other mothers of twins who have recently been in your shoes. If you can’t find a local club, join an online forum like are available at babycenter.com  that has mothers of multiples groups (like this one).  They are usually free of charge and full of compassionate women who have wisdom and experience they are eager to share.

Saturday, July 28, 2012

Gentle, Patient and Kind...sibling (and parent) readiness!

Well, just a quick post to say...I'm late! I've never been on known for being on time, so it is fitting. My due date was 2 days ago. I had a checkup yesterday and everything looks great, so we are just waiting and this point. People ask me if I'm antsy, but really, no. I can wait for this baby to be ready. I have plenty to do in the meanwhile...like clean, work on some blog posts, heck, I even have some 'work' to finish up and a church website that I am helping put together. I am almost hoping for an extra week or 2 actually! But even if I didn't have that, I still would have my other kids to play with and spend extra time with. Which I am trying to do now.

When my older ones were 3, and we were expecting the second set of twins, I really didn't do too much 'prep' that way. I simply tried to keep them involved in the pregnancy, looking at my belly and feeling the babies kick. Asking them what they wanted to name them (Ellie and Jo were the answers! Not bad for 3 year olds I guess!) Talking about what the babies would look like when they are born. Dispelling myths about how they would not be able to play with the babies much until they were older. And how little babies put things in their mouths and can choke so it will be important to keep the little toys upstairs in their room (really, you don't have to worry about this until the babies are about six months old!). We talked about how the babies would drink milk from my breasts, and how they might cry alot and how mom will need lots of help getting diapers, blankets or towels. 

After the babies did arrive, I also made sure to spend some extra fun time with my big girls on a special outing every week or 2 for that first month or so after the babies arrived. The grandma's were glad to help babysit the little ones so I could take the big ones to the zoo for a few hours, or even just to the mall or the grocery store.

And in fact, when the little sisters arrived, I don't remember having any problems of jealousy or indifference or anger. Both the big sisters were nearly four years old at the time, and were really quite proud and interested in this phenomenon of each having a baby sister (they basically claimed who belonged to who! But the concept quickly faded over time!). Not that we didn't have problems! Just not those ones...

But what's been on my mind now, is how crazy life in our house is already, and how much crazier it  is going to be very soon. How to manage 5 different kids with various attention spans, anxiety problems, emotional regulation difficulties and cognitive ability to understand why a baby needs my attention more than they do for the moment.I've been paying extra attention to the things that are going to be hard - like teaching my kids to be patient when they need something from me. Right now, I am usually available quite immediately. But with a tiny baby, I've explained to them that I might be feeding her, or getting her to sleep, and that they may have to help themselves or manage to wait PATIENTLY for a few minutes. In fact, most times that there is fighting or crying in our house (remember, the twins are ages 3 and 7!) it is almost always because someone is not being either gentle, patient, or kind. I guess it's my new version of how to prepare your older kids when you are having a baby, or babies...

I've focused on three character qualities. "Gentle, patient and kind" has become a mantra in our house. Every time someone teases their sister, fights over something or simply has a meltdown waiting for a turn or waiting for me, I start asking them, "Is that the way you should behave?", "You need to be gentle, patient and kind...which one are you having trouble with right now?". If it is a fight between the two older ones, or an older and younger one, I will ask the older one "What just happened?" and "What should have been done differently" and while they are quick to point out the faults of the other involved, I also point out how their own kindness, gentleness or patience was lacking, and then usually tell them to practice saying or doing what they should have.

Is this working? I don't know. So far, perhaps for one of the older ones...a little. We'll probably have to keep it up a long time I guess. I figure, it certainly can't hurt! Meanwhile, I am practicing those traits myself! The best way to learn is by example, and it is really hard to expect your kids to not yell at one another, if you yell at them. Or to wait patiently for things, when you are not patient when you want them to get their shoes on and get in the car, or to be gentle and kind and when your voice gets strained when you tell them for the sixth time to do something or push them away abruptly when they are teasing their sibling. I found the bible verse to be very true - before you remove the spec from your brother's eye, you must remove the plank from your own eye! After all, could I really blame my kids for saying 'shut up' to each other, when they heard it from me first? I could say similar things about my husband's habits. It is really an exercise for all of us I guess. Here's hoping that it lends to a more peaceful atmosphere in our house...

Tuesday, July 10, 2012

Packing for the Hospital When You're Expecting Twins

So, I hung out with a friend tonight who was asking 'How many weeks are you now?'. I just hit 37. "Any Day now!" she said. I've been telling people that if I were the 'betting type' I wouldn't put any money down until August! (My due date is July 26). I told her that I didn't even have my bags packed yet, nor the crib up...she said I was crazy. No. I'm just busy, and after carrying 2 sets of twins full term only to be induced at 38 and 39 weeks, I figure my chances of having a singleton before her due date just aren't very good. Though, I suppose something flukey could always happen, but I'm not anticipating it! Anyway, on the way home, I decided tonight would be a good night to pack my bags. Correction, tonight would be a good night to sit here and type what my husband is packing as I dictate it to him :)

If you are expecting twins, you should DEFINITELY pack your bag before 37 weeks, as the average twin mom has had her babies by then! I think it was just after 30 weeks that I packed my bags when I was having twins.

1. My Nightgown. 
I didn't get through either of my first two labors in the hospital gown - too hot and uncomfortable. The first time I ended up nude (long story - I had been in the shower for a while and never got dressed afterward) the second time I shed the hospital gown after a few hours in favor of my strapless, much lighter, cooler nightgown - which we had to cut the strap and re-tie in order to get it on over the IV drip machine.

2. Microwaveable Heat-pack
Though the hospital staff frowned upon us using this (I'm sure we could sue them if my husband heated it up too hot and burned me or something asinine). I consider it an absolute necessity. It is great both during labor to help relax muscles and definitely afterward when the cramps kick in and the ibuprofen wears off. Of course the hospital has heat packs, but they are the chemical kind that are about the size of your hand and get about as warm as your armpit on a summer's day. You can make your own simply by buying a large tightly-knit tube and filling it with rice or flax seed or corn and knotting the opening. Simply heat until desired temperature in the microwave at 30-second intervals.

3. Slippers
For sliding on and getting around the hospital and not having to mess with tying shoes. Dad might want to bring his too. This is especially useful if you are there for a longer stay if you have a C-section.

4. My 'Away Bag'
This is just my toiletry travel bag which I always keep fully loaded and ready-to-go in under my bathroom sink. It has all the necessities like shampoo, deodorant, toothbrush/toothpaste, lotion, hairbrush, etc. It also has all my husband's similar necessities so we don't have to lug two bags everywhere we go.

5. Some labor necessities
This is mostly things that are already in your 'away bag' but that I wanted  to point them out individually, because to be without them can be torture. a) chapstick (need I say more?) b) hair bands or ties. I had some brand new ones during my first birth and I didn't realize that they were too stretchy and wouldn't keep them pigtails in my hair! c) your preferred nipple cream...I think most hospitals provide lanolin, but I am not sure! d) glasses AND contacts if you wear both (you may find one or the other hard to manage during labor...especially if you get hot or in the tub/shower and your glasses fog up! It was SO annoying to have then constantly falling out and in every picture you can hardly see my face because it is usually covered by my hair! If there is anything else you personally want that would be helpful during labor, like a photo to focus on, or a squishy stress ball to squeeze, or massage oil or scented oils, or music, or WHATEVER...jot it down, or put it in your bag now.

6. For Dad
Change of clothes, including sweatshirt! (can you tell I am a freeze-baby!), slippers, glasses &/or contacts, snacks, pillow, toothbrush and toothpaste, comb, razer, shampoo, etc. I think many of these things are mentioned elsewhere, but I wanted to put a summary here!

7. A Book, movie, or some knitting, just in case
Not that you expect to go have a baby in the hospital and have a lot of time to kill in the meanwhile. BUT let's just say, you never know. I was admitted with my second set of twins being told I was to be induced straight away. After a night of Cervadil, my care got transferred to a different doctor who sent me home to take some medication before being induced again a few days later. But not after spending about 18 hours in the hospital just sitting around waiting to consult with various doctors and specialists and for discharge papers and such! I was so glad I had brought a book and some tinkering projects. I thought they were maybe trying to squeeze another night's billing out of me...

This is a broad category. It could be snacks you prefer for during labor, if you are lucky enough to have a care provider who will let you eat (or plan to anyway). Snacks for after delivery when the hospital meal just doesn't quite cut it. And don't forget dad...after all, the hospital doesn't bring him a lukewarm plate of slop every 4 hours, so if the cafeteria isn't open, he's on his own looking for a Taco Bell all-night drive thru or grabbing a granola bar! It's also a good idea to make sure you have some small bills and change for vending machines.

9. Cell Phone & Charger
After all, you might like to make some phone calls about your new arrival! And even if you can't use your mobile phone in the hospital, you'll probably need the phone numbers from it, so make sure they are all in there!

10. Your favorite pillow
Make sure it is in a notable pillow case so it doesn't get mixed up with the hospital pillows. It will be handy when you need 100 pillows to tandem nurse, should you get that ambitious while you are there! AND if your hubby stays overnight with you, he will really appreciate it too!

11. Nursing Bras
This will be nice to make you feel like a 'real person' again under that hospital gown or pajamas you brought!

12. Some nice granny undies
The hospital will provide you with these lovely, massive, disposable grandma underwear things. They are ok. If you would rather wear your own actual cotton massive granny undies, be sure to bring them with - and be sure they are big enough to house a sanitary pad with built-in cold pack that is the size of a phone book!

13. Clothes to wear home
Just don't get too optimistic about getting into your favorite jeans again...definitely bring something with an elastic waste-band or better yet, a maternity dress.

14. Camera/Video Camera/Charger/ Batteries!
Don't forget, you'll want to have a few pics or videos to remember your babies' special day! It is also good to bring some disposable cameras, as nurses and friends are more inclined to pick those up and snap some memorable shots than they are your big breakable, confusing DSLR. If you are delivering in an operating room (standard procedure often times even for vaginal twin births), make sure film exposure for the throw-away camera is for outdoor use  because the lights in there are BRIGHT and if you get a camera for indoor use that has better film exposure, your pics will all be washed out like ours were. :(

15. Your birth preferences or birth plan
If you have one...this is a handy way to communicate to nurses and staff what your preferences are for labor and delivery, without having to state them 100 times - which is kind of tuff when you are having a contraction anyway!

What to pack for your babies...

16. Special baby blankets, if you have them
Here, it is COLD in hospitals, in winter, it's cold because it's winter. In summer, it's cold because the air conditioning is set to keep it winter inside. The hospital blankets are simply cotton, so you may want a little heavier one for your little bundles. If you have a special blanket you made or were given for them, it will be precious to have in photos, and if the blankets are a little different, it will help you tell whose bassinet is whose as just a glance without having to read the 'fine print' on the bassinet tag. We actually made simple little name tags for in our bassinets cut out in the shape of a heart with some little stickers.

17. Special baby hats, if you have them
Your babies will each get a little hat when they are born to help them maintain their body temperature. If you have special baby hats that someone gave you or you purchased, now is a perfect time to use them! And again, if they are slightly different, it is handy to help you tell them apart without looking at their wrist bands, in case they happen to look alot alike!

18. 1-2 simple outfits to wear at the hospital
As I said before, where i am from, hospitals are cold. Here they provide a tiny wrap around shirt for your baby to wear, but that doesn't do much if their toes are cold! We brought a simple snap or zip up sleeper jamma for them to wear. Some hospitals also have volunteers or services that will take your babies' photos so you may want to bring a special outfit for that.

19. Special going home outfits
Again, you may want this to be weather appropriate. As much as I may have loved to have cute dresses for them with matching bonnets and pinafores, it just wasn't going to work with Minnesota February when the temperature ranges from minus 20 to about plus 20. Our special 'coming home' outfits were a cute pair of soft fleece polka dot pajamas!

20. Car seats
Where I am from, you can't leave the hospital with your baby without one...need I say more?