Two Month Check-Up

We went to the twins' check up today. I was kind of disappointed that I had my appointment with the same doctor as last week's visit. I really thought it was going to be a different doctor. I am trying to find one that isn't pompous and patronizing.

Their overall visit went well. The main concerns at this point are Henry's weight gain, his acid reflux and his skull growth. Mary Catherine checks out well with no issues. The doctor wants me to try to have Henry drink 4 oz at each feeding, which means I will have to continue to measure them each feeding, so the scale rental will continue. Henry easily gets 3 oz, but usually is done after that and is happy until the next feeding, but we'll keep nursing and try to get him to get 4 oz.

He wants me to give the zantac one more week and then 'touch base' whatever that means. It probably means, "Can I have your $25 so I can tell you there's nothing we can do?"

He said he wants to keep an eye on Henry's weight gain and that I am to come in if it drops to less than 1/2 ounce per day. I assured him that I was more concerned about Henry's weight gain than he was so didn't have to remind me. He wanted me to come in next week for a weight check but I told him that I wasn't going to do that because I have a scale (which I had already mentioned at least twice) and I weighed him enough at home.

The main crux of the appointment was our discussion on yeast. He was the same doctor I saw last week that would not give the babies anything because he didn't see anything. Well, this week when I came back I told him that I am still suffering with the yeast issue myself and that I had read and spoken with many women who had dealt with this and they say over and over that both the mother and child need to be treated, even if there are no symptoms. I mean, how can I have yeast for the last six weeks in my milk ducts and they not be affected??

I ever so calmly said to him, "If it felt like shards of glass were coming out of one of your body parts and someone sucked on that body part for 40 mins eight times a day I bet you would be singing a different tune about prescribing something when you don't see anything. "

So, he would not give them what I wanted him to give them, but he gave me the prescription that works 40% of the time. Good Gravy. He said that maybe I don't have yeast, maybe it's something else. I said, "What could it be?" He said, "I don't know, I'm not an adult doctor."

Umm...that is lame. There is such a disconnect between pediatricians and ob-gyns. We are talking about an issue that is critical in nursing and he seems clueless. Shouldn't a pediatrician know a thing or two about nursing?

It's as if his attitude, (and the other dr.) is breastfeeding is best until there is any hiccup at all and then we are completely ignorant so here is some formula because we aren't adult doctors.

On a more positive note, the twins are developing perfectly. They are right on track mentally and socially for a two month old. The dr. said that they were technically full term for twins at 37 weeks. However, out of the other side of his mouth, he said we had to make allowances for their growth because they were so small. He said they would catch up eventually. I don't know what that means. Jason is a twin and he (and Karl) was the smallest kid in his class until ninth grade. Let's hope they catch up before then...

Henry's stats:

8 lbs 15 oz (3%)

23 1/8 in. (50%)

Mary Catherine

8 lbs 5 1/2 oz (10%)

21 3/4 in. (25%)

Hungry Babies

This is what it looks like every time before I feed them.

Weight

I weighed the twins tonight in a dry diaper before I bathed them.

Mary Catherine~ 7 lbs 6 oz

Henry~ 8 lbs 1 oz

We have had good feedings all day long today! Yay! It takes about 45 mins to nurse them, but I am not complaining. We have to switch back and forth a few times to make sure that Henry gets enough. This last feeding at 7 pm, MC got almost her whole feeding done in less than 15 mins. I just keep her going so that she's not crying.

I need to ask the LC, but maybe someone else knows so I will ask it here too. Mary Catherine's poop is sometimes green and grainy instead of mustard yellow and grainy. I've read that sometimes that means that she's getting too much foremilk and not enough hind milk. I know that she is getting hind milk because of how much she's drinking, but maybe I'm wrong.

I pray it continues to go well tonight at 10 pm and for the next 10 months! Hee-Hee.

Praise!

I just had to write that this last feeding at 10 am went perfectly.

Both babies got over 3 oz. I ended up having to switch Henry over to Mary Catherine's side at the end because that side makes more, but that's okay. I switched her over to his side just to keep her busy even though she didn't need any more.

I don't realize how much stress this causes me every three hours until something like this happens and I feel so relieved. So much of my day is consumed with their feedings and weight gain. I wouldn't trade it, but it is stressful. I cannot imagine having to deal with a more serious issue with them. I really feel for families that have that in their lives.

Update on Progress

For the last three or four days I have been nursing the twins without the SNS tubing. I am not sure at this point if it was the right decision. I just felt like based on my documentation that the twins were getting lazy with nursing with the tubing. Instead of making progress of drinking less out of the SNS bottle and more from me, they were reversing that trend. They would suck and suck and then let the tubing kind of drizzle in their mouths. And with nursing, you get the best results when they suck continuously.

Yesterday I spoke with the Lactation Consultant about how things were going. We talked through a short term plan that includes the following.

• I will stop pumping except when I give the twins a bottle instead of nursing, like in the middle of the night. We are hoping it will make it so that I'm more full at the beginning of the feeding. The body is supposed to be supply and demand but two hours may have not been enough time to replenish the supply. We're going to try it for a couple of days and see if my supply stay up.

• I will continue to weigh the twins before and after each feeding.

• I will also weigh the twins (in just a dry diaper) each day at the same time to check their weight gain.

If the twins do not get what they usually do when they nurse, I will give them a bottle (of expressed milk) after the feeding to make up the difference. The lactation consultant was not thrilled about this idea and said that 'by the book' they encourage the SNS tubing to avoid the nipple preference issue, but she said that you cannot ignore what the mother observes about her children.

So, basically if I think they are being lazy with the SNS based on my documentation of their intake then we have to work through this another way. Also, I told her that the babies will be getting bottles regardless, so it is not as if I was going to eliminate them all together. They get a bottle in the middle of the night (of expressed milk) and on Sundays at church.

When we use a bottle in the middle of the night it is so much faster because I don't have to weigh them before and after and they drink it faster. Instead of being up for over an hour, we can be back in bed in less than 30 mins. We also know how much they get and don't have to wonder if they are a little fussy if it's because they are still hungry. We can let them fuss their way to sleep without concern of hunger. Thankfully Jason still is willing to help me with their feedings so that I don't lose so much sleep.

I'm not used to having to nurse for 30-45 mins. My other three children were very efficient nursers and were done within 10-15 minutes so I never used bottles. Of course, they weren't sharing a milk supply either.

I'll let you know how it goes over the next few days. Already this morning Henry had to have an ounce in a bottle after nursing for almost an hour. He drank 2 oz, but is usually content with 3 oz, so I gave him the extra oz in a bottle. He subsequently spit up most of the extra ounce, so I don't know if it was worth it. Mary Catherine drank 2 1/2 oz within 30 minutes.

Whoever is on the 'good' side usually has no trouble getting their fill because the milk comes faster. Since Henry's suck is better I put him on the slow side. I figure he can work for it. Eventually he'll get it.

Please continue to pray for us. We are thankful for your prayers. We give the Lord the glory for any improvement we have with the twins.

Six Weeks

Mary Catherine weighs 7 lbs 1 oz & Henry weighs 7 lbs 13 oz at six weeks old

I am still dealing with nursing issues. I need to touch base with the LC to discuss where they are at this point and get more advice, encouragement, guidance, etc...

The frustration at this point is that they nurse with the SNS tubing and get 2 oz from that, and about one more from me. After they eat, I pump and get at least 2 oz, so I have plenty of milk, it's just that they are not accessing it from some reason.

I could be off base, but I feel like the SNS is kind of making them lazy a little, now they their suck is getting better. They are both latching on okay. Their suck could be better, but I feel like it would get stronger if they had to work a little harder to get the milk. The tubing isn't difficult and it practically falls into their mouth. Sometimes it actually comes out too fast and they choke.

So tonight I decided they were going to nurse with nothing attached. I pumped afterwards and got about an ounce or a little more from each side. Mary Catherine did well and got her fill pretty quickly b/c I put her on the 'good' side. Everyone who has ever nursed knows you have a good side that produces more than the other side. My good side produces about half to one ounce more.

I kept switching Henry from side to side to get him his fill. I think he ended up with about 3 oz, but he spits up so much that he might have wanted more but by then he had nursed for over 30 mins and he was tuckered out.

I weigh them before they eat and after so that I can see exactly how many mL they get for my peace of mind.

Wish me luck. (really prayers, b/c I don't believe in luck.)

One Step Forward, Three Steps Back...

Well, I finally got the scale from the LC.

Once again, not good news. Henry's suck is not as good as I thought and he is not drinking enough from me.

This is quite disappointing. I had already gone back to feeding them at the same time and was enjoying the fact it goes a bit faster that way.

Now I am attempting to continue to feed them at the same time, but now they both have the SNS tubing to deal with as well. It does not go easily all the time because I don't have a free hand, so if they pull off then I have try to direct their heads to latch back on while also making sure the tiny tubing lines up into their mouths as well. While at the same time making sure the other twin doesn't pop off.

I would have to say that I am discouraged. I pray that as they grow bigger this improves. It certainly helps to have the scale because we can see how milk they drink from the SNS and how much they drink from me. It just adds one more thing to this circus I call life.

I think the thing that is so frustrating is that I know I have plenty of milk, but they can't seem to access it. I do think the balance between feeding them and pumping is tricky. I am not sure that my body is having enough time to refill to a level that they want. However, I can't stop pumping until they are nursing exclusively or I won't have anything to put in the SNS bottle. Also, I can't risk lowering my milk supply. I'm up to 2-4 oz per side depending on how well they eat. According to the scale they only take in about one ounce so if I were to stop pumping then my supply will adjust to only making one ounce every 3 hours and that would definitely not work.

It makes my head hurt.

I have not spoken with the consultant again since I learned that Henry's intake was less than we thought. However, when I spoke with her the other day she was so encouraging and said that no matter how this ends up that I was such a trooper. She said that she was going to use me as the 'example' when other moms were whining about nursing one baby that was issue free. (her words, not mine) She thinks they will eventually get it because of my perseverance. I can be quite stubborn I suppose. This is one of those instances that parents of stubborn children are thankful for because don't we all say, "She so stubborn, but hopefully that trait will help her when she grows up in some way."

It really helps me to know that people are praying for the twins and their growth. I pray that I keep my cool and think about the big picture. They nurse for a year, so a couple of months of headache is worth it.

Henry's Praise

Yesterday afternoon I forgot to pump after a feeding, so by the next feeding I was quite full and for the first time, Henry nursed without any assistance from the SNS tubing.

YAY!

So, I decided to try it again at the 7ish/8ish feeding. He nursed and didn't fuss, but would not take a good nap after that feeding. I'm not sure if it's because he didn't get enough or if it was just a bad nap.

At the 10:30/11 pm feeding I gave him a bottle of expressed milk because by that time I'm practically a zombie and I don't have the energy to deal with nursing. I also gave him at bottle at the 3 am feeding.

After each of those feedings, I pumped, like normal.

So, this morning at 6:30 am, it had been 3 hours since I pumped, so I decided to try to nurse him again unassisted. He did well and slept well. I thought that at the 9:30 am feeding that I might be low b/c I pumped after the last feeding, but I had enough that he ate and was content afterwards. He even spit up a bunch, so hopefully that's a good sign.

My nursing experience with these twins is totally different. With my other children when I would nurse I would have to wear nursing pads because I would leak and I would get engorged in between feedings, but it's not that way with the twins. I never ever leak. I don't know if it's because I'm completely draining myself with the pumping or what.

Well, after Henry's first unassisted nursing, I called the LC because I wanted to ask her about pumping and nursing. The problem that I face is that by the time I'm done nursing both of the babies it has been an hour and half because I nurse them separately at this point. So then I pump, only to start over again in another hour and a half to two hours, depending on when they wake up. They wake themselves, I usually do not wake them. I would wake them every 3-4 anyway because the LC said it is very important with twins to keep my milk up and consistent.

So, I feel like my body is not having enough time to refill. I know that I always have some milk, but I need enough that Henry is not frustrated. However, if I stop pumping and find out he's not getting enough then I will mess up the supply that I've worked so hard to maintain.

The plan at this point is to meet with the LC sometime this week and rent a digital scale from her. I will weigh Henry before each nursing and after to see if he's getting enough. If he is getting enough, then I will stop pumping on his side and only pump on Mary Catherine's side.

I'm very encouraged by Henry's progress. He's 5 weeks today. I am thankful for your prayers. I can totally see the Lord's hand in all of this. Please pray for his continued progress and for Mary Catherine's. I don't think she really nurses at all yet. She basically drinks her milk via the SNS tubing while 'nursing'. We're praying for her suck to improve!

Some Praises...

Some praises to share~

My milk is doing better. I actually have a little bit in the refrigerator, so I'm ahead a feeding or two.

Henry seems to be doing better. There's no way to know for sure, without a digital scale to weigh him before and after feedings. However, the LC told me that when I saw that he was leaving some milk in the SNS bottle it probably meant that he was pulling more milk from me. So, the last couple of times Henry has left half of the SNS bottle. So, either he is eating less or he's getting better with his latch and suck.

Mary Catherine is the same. Her suck is terrible and she drains the entire SNS bottle so I know she's not pulling from me at all.

Please continue to pray that both of the babies would nurse exclusively~no gadgets, no pumps, no bottles necessary.

I thank you for the prayers. Things are improving!

La Leche League

I went to the local La Leche League meeting today.

I was hoping that someone there had experience with what we're going through, but no such luck.

It was a good meeting and there were lots of moms there, but I doubt I'll go back.

I'm just not the type of mother that is cut out for that kind of breastfeeding.

You know, the kind that advocates walking around the house shirtless while holding your naked nursing baby so you can have skin to skin contact while you do the dishes.

Also, I'm not for nursing much past the age of one. I believe if your child can tie his own shoes, he should no longer be nursing.

I know that might make some of you mad, and I'm okay with that, because we're all different.

And yes, both of those examples were witnessed today at my meeting...

Milk is Up

I've been taking Fenugreek for the last few days. The LC said to take 3 pills 3x a day. I am happy to say that my milk production is up a bit. It's about 1/2 oz to 1 oz more. It doesn't sound like much, but they only drink 2-3 oz per feeding, so that makes a difference.

Praise the Lord.

Thank you for praying. I know you are praying and I'm thankful.

My Appointment Results...

So, $140 later... (I should become a lactation consultant in my later years...)

Okay this is what I know, or was confirmed for me.

Mary Catherine has a terrible suck. She now will use a nipple shield and the SNS until she improves. I will then have to wean her off of two things. We're hoping that her suck will improve. The LC was hopeful, but concerned.

Henry's suck is okay, but his frustration level makes it so he will not latch correctly without the SNS to give him constant milk. I will work on weaning him off the SNS by closing the valve off and on while he is nursing to encourage him to draw from me.

So, the plan is to continue to nurse one baby, with all contraptions necessary, while someone else feeds the other baby. For a few more weeks, it will take a circus to get this accomplished. Thank the Lord in Heaven for my girls and Jason, as well as good friends and family who have been recruited to help off and on.

I mourn for the ease of nursing my babies without all this pomp and circumstance.

The LC did recommend the Podee bottle because it is harder to suck the milk, which will strengthen their muscles. My sister is going to drive and get that for me at Babies R Us, which is 45 mins from us. This bottle should be better for everyone because the girls won't have to hold the babies completely upright when they feed them.

As far as my milk supply, I am now taking Fenugreek Seed three times a day and I will start Reglan. The LC said that each baby should be getting 2 oz of milk every three hours. She said they may drink more because it's in a bottle and flowing faster, but they don't 'need' more at this point. So, if I don't have more than 2 oz of breast milk and they are still starving, I will give them some formula.

Right now, I'm still ahead a little bit on milk. I know it's the Lord supplying my needs. He wants me right there, not too cocky, not too prideful...just right there leaning on Him for my every need.

Another Lactation Consultant

I'm meeting with another lactation consultant today.

Pray that she can help the twins and I figure this out. I'm down to the wire. I only have two feedings of frozen milk left, so if I don't pump enough at the end of each feeding for the next feeding we'll have to use formula.

Milk...

So, things here have been crazy. Jason and the kids left for Charlotte on Thursday, which left me alone with the babies. If the babies were tandem nursing that would not be such a big deal. However, it still takes two people to feed the babies every three hours.

Thankfully, my sister spent the night Thurs, worked from here on Friday, and came back at dinner time on Saturday to spend the night again. In between those times, my friend/neighbor Sharon came over and helped me feed them. I am very blessed by wonderful family and friends.

What I usually do is nurse one twin with the SNS and someone else bottle feeds the other twin. I have been trying to put the twins on to nurse at the same time initially and then have someone take one twin to bottle feed after a few minutes so they don't forget what it's like to nurse. The problem is that they still have fairly weak sucks so they get on, but my milk will not come down. I tried pumping today right before I put them on, but it still did not help.

I have started to feel like Henry is really enjoying the bottle too much and has very little patience for nursing, even with the SNS. So the last few feedings I have done only SNS with him and no bottle at all. The SNS is basically an upside down bottle with a very thin tube that goes into the baby's mouth. So, I can see that he gets 2 oz, but he gets it while 'nursing'. At first Henry protested quite a bit, but the last two feedings he has done better and finished his 2 oz bottle via SNS.

Mary Catherine is much more patience and will try to latch over and over, but even when she does it to no avail because her suck is so weak. It's like a tickle. Hopefully it will not backfire that I'm concentrating on Henry so much.

My pumping is not going to well. I'm barely producing enough to make it to the next feeding. I only have four feedings worth frozen. I feel like the woman in the Bible who only had enough oil for one more loaf of bread. The Lord kept providing b/c of her faith, but I'm sure she was a little nervous at first.

Please pray that my milk production will increase and that the twins will begin to nurse well. I know once they nurse it will help my milk, but it's such an arduous task to teach them.

I'm going to a La Leche meeting on Th. If I don't feel like I get any help there, then I will make an appointment with another lacation consultant. I want to make sure we are doing things correctly.

Weight Check

We took the twins for their weight check.

Henry weighed 6 lbs 3 oz, which means he gained 9 oz in 4 days. They wanted him to gain 1/2 oz to 1 oz a day, so he blew that out of the water. He gained half of what he lost. Another 9 oz and he'll be back to birth weight.

Mary Catherine weighed 5 lbs 9.5 oz, which means she gained 5.5 oz. Her birth weight was 5 lbs 12 oz, so she is very close to that now.

Henry got 2 oz of formula on that Friday, but since then they both have had breast milk via bottles and SNS tubing. I'm so glad that I had the courage to follow my gut and ignore the pathetically rude pediatrician.

I'm not saying formula is bad, and who knows how all of this will end up, but at this point it is important to me to give them breast milk and try my hardest to get them to nurse well.

Thank you all for the prayers.

Please pray that they will learn to nurse so that I can feed them at the same time and I don't need so much help from everyone. Jason has lost quite a bit of sleep helping me every night with the bottle feedings. He does it so willingly, but I just don't see the need for both of us to be tired, if we can help it. He has to go to work to support this family. I get to be at home where it doesn't matter if I'm incoherent or smelly or sleep deprived.

Sun Night/Mon Morning

I have just a few minutes before I have to start the feedings again.

They drank bottles around 2:45 am. I was back in bed at 4 am after feeding MC, pumping, cleaning the bottles, the pump, refilling the bottles with the newly pumped milk for the next feeding.

They woke up next at 6:30 am. I was going to try to nurse Henry and then wake MC, but she couldn't wait so I took her in to Jason. (He finished his night sleeping in the living room b/c he finished with Henry and had him back in bed before I was finished with all my stuff.)

Henry would not latch on, so after 10 mins of screaming, I fed him a bottle.

They were back in bed around 7:30-7:45 am.

At 9:30 am, I woke MC and nursed her for about 10-15 mins. She drank about 10-15 ml from the SNS tubing. She then drank her bottle. At 10:30 am, I was finished with her and woke Henry and did the same with him for the next hour. I was glad they both attached and drank, even if it's not coming out from me very well. They got some practice.

After that I pumped, cleaned the pump and bottles, and refilled bottles for the next feeding. Then I warmed my lunch and sat here to write this.

It's already time to wake MC again and start this all over again. I'm thinking that I will just give her a bottle of milk and then pump. Or maybe I'll see if she will sleep as long as Henry and try to attach both of them with SNS tubing. I just cannot bear another two hours right now.

I need a shower.

Last Night...

I have a small break in between the chaos, so I thought I would update.

Last night for both of the middle of the night feedings, we bottle fed the twins. The LC recommended that so that we are not up too long. It was a good recommendation because the twins are so terrible at their suck that it takes them at least 30 mins to drink 2 oz.

After they eat then I pump.

Jason fed and changed Henry and I had Mary Catherine. I am so thankful for his help. It's not easy to lose sleep and Jay loves sleep more than food. :) He happily and lovingly helped me both feedings. Let's hope that sweet demeanor stays for the next couple of weeks.

This morning (8:30 am) MC slept longer, so I had time for Henry to nurse with the SNS tube. He did well and drank 20 ml from the tube while staying attached. He still doesn't attach perfectly, but we're working on it. it took about a dozen attempts to get him to stay on. Afterwards, I had Kerrigan feed Henry a bottle while I had MC nurse with the SNS tubing. She also stayed attached and drank 20 ml via the SNS.

I still don't think that they are getting much from me b/c when I pump I get the same amount, but they are learning at least. So, they 'nurse' for 15 mins and might get close to an ounce, including what they get from the SNS. A lot of work for a little reward.

All of this is so new for me. I'm not used to needing help, but at this point it's absolutely necessary.

(As I sit and write this, my friend and neighbor, Sharon, just called and offered to come help feed a baby while my family is at church. God is so good to work through people.)

Wake Med Today...

So, the lactation consultant called me back from Wake Med. I decided to go over there since it was today versus Monday.

It took awhile and we learned a bit and now we have a 'plan'.

In short, basically the twins are not good nursers. Most likely due to being born early and being small with little mouths. So, because they are not good nursers, they do not nurse correctly, so my let down doesn't come down.

We weighed the babies and then I 'nursed' and then she weighed them again. MC is a better nurser, but even she was pitiful. After almost 15-20 mins of nursing, she only gained 5 ml. In case you don't know how much that is, 30 ml is an ounce. 5 ml is about the amount you put in a medicine dropper. So, obviously there is a nursing issue. It's honestly a wonder how they were not worse off than they are at this point.

Our plan is to continue to nurse and work with each twin on his/her technique, while having an S-n-S tube going down into his/her mouth near the nipple so that she/he is getting breastmilk via the tubing to encourage a continuous latch on. They are off and on so much that we don't have any rhythm and so no let down, which causes frustration, etc...

Now, while I'm doing that with one twin, the other twin will get expressed milk via a bottle. Hopefully being fed by one of my girls or Jason. Already the fun of bottle feeding the twins is wearing thin. We have to feed the baby sitting up so that he/she doesn't get lazy by having the milk pour down his/her throat. It's not easy for the kids to do that, but they try. If the twins don't wake at the same time, then I will probably do it all myself. However, I've spent the last two weeks waking them at the same time, so usually they are up at the same time.

After 'nursing' that twin will also get a 2 oz-3 oz bottle of milk.

After that bottle, I will pump. I'm going to get a hospital grade pump on Monday.

Hopefully within the next couple of weeks, the twins will figure out how to nurse better and we can go back to tandem nursing. Until then, I will be spending A LOT of time doing all of the above and preparing for the next feeding. I have no idea how anything else will ever get done.

The other kids don't need to eat do they?

Appt.

I have an appt. on Monday with a lactation consultant about 1 hr. from here. Apparently there are not very many of these people. Maybe I should look into this for my next career...

Continue to pray for us.

She told me to feed my saved milk instead of formula, which is what I wanted to do, but I just needed someone to back me up.

I have no solutions about this yet, but she made me feel better during our conversation. She gave me hope.

Worst Ever

Last night and this morning were horrible.

Henry will no longer attach at all. One day of supplementing with bottles and he's already done. So, he screams hysterically while I try to feed MC.

Then I supplement them with bottles.

Then I pump.

It took over 2 hours-twice. The girls helped me a little this morning but they don't really like feeding them b/c they spit up.

I am so spent.

If you know of a lactation consultant in my area, please email me with her name. painterse@hotmail.com or you can send it to me on FB or in the comments section here.