Tummy time

Even before the boys were born, we were lectured on the necessity of letting the babies spend time on their tummies. We were warned that they would not develop strong neck muscles and that they would likely have flat heads from lying on their backs all the time. So, after a week or two, we started putting them on their tummies so that they would be strong and be able to sit up and roll over at the appropriate time.

Trouble was, both babies hated being on their tummies! They STILL hate being on their tummies at three months of age. They struggle and cry and suck their hands and cry some more, and I feel like Mommy Dearest for putting them through it.

I've had lots of advice, mostly obvious:

• Make sure they are not too full


• Make sure they are not hungry


• Don't put them down when they are cranky


• Make sure they aren't too tired


• Lie down with them


• Distract them with toys


• Put them down on something interesting to look at

Problem is, with twins, catching that period of not too full, not too hungry, not cranky and not too tired is HARD, because when one baby is miraculously in the perfect tummy time zone I am usually feeding the other one, and although I can manage to flip the baby onto his stomach he lasts for only a minute, two at the most, and then I have a crying, struggling baby to contend with while still feeding the other. I put them face down on my chest while reclining, and they will tolerate that for a while, and I can lie on my back, bring up my legs and put them face down on my shins and move my legs up and down, and they seem to like that the best, but that nearly kills me!

I don't know what to do about this, but I'm trying not to worry about it too much. The boys are gaining head control, although they are not yet too comfortable in their Bumbo chairs. I can put them in my Moby wrap in positions for three- to four-month-old babies and they do all right with not too much head bobbing, but there is definitely room for improvement. They are well-supported in the Mei Tai, so not an issue. I'm curious though: is tummy time a construct of Western society? Do other, baby-wearing, bed-sharing, hands-on cultures place the same value on tummy time, or is it more prevalent in societies that sleep babies in separate rooms and place less emphasis on carrying them around all the time?

She should have her own reality show

When Duckling and Pin were five days old, we went back to the hospital for an appointment with a lactation consultant. Breastfeeding is really hard, and breastfeeding twins is even harder, especially when you have no idea what you are doing. I had been home for two days, and was breastfeeding the boys on demand.

Duckling had been diagnosed with jaundice a couple of days after birth, but was deemed well enough to go home. I had been advised to supplement with formula to help with the jaundice, but was determined to breastfeed as much as possible. Pin had raised bilirubin levels, but not as high as Duckling, and was never officially diagnosed with jaundice.

The night before the appointment with the lactation consultant, Duckling refused a feed, and in fact did not really wake up properly. I put him in my nightgown for some kangaroo care, and he took the next feed so I wasn't too worried.

When we got to the appointment, I described Duckling's behaviour and they were immediately concerned. They checked his diaper and saw dark orange urine, and did a test to check his bilirubin, which was even more elevated. He hadn't gained any weight since discharge, and all in all looked like a sick baby. I was shocked. I had no idea he was not doing well, and in fact thought I was doing so well by breastfeeding him. I didn't know that he was sucking but not really eating, and didn't know how to tell the difference.

Enter the nurse practitioner from the NICU. She crackled with energy, took a history, and tried immediately to create a rapport with me by telling me that she too had fertility issues. She then told me that he was dehydrated because I wasn't feeding him properly. She made me feel like a terrible mother, that I had made him sick by not taking appropriate care of him, which sent me over the edge into hysteria. She called for blood tests, she called for bili-lights, she did everything except yell 'stat' at the nurses. She got things accomplished, but with the end result of further overwhelming an already overwhelmed, post-surgery, new mom of twins. I didn't stop crying for hours. Duckling was admitted for jaundice, which meant Pin and I stayed too. We had a private room and the isolette for Duckling, and a cot for Pin. S had to go home and get my things, and there we were, back in the hospital two days after leaving.

I guess I had been instructed on what to look for to let me know if the babies were not doing well, but I have no recollection of this. I didn't know to check, or even how to check, that they were swallowing and not just sucking, and I didn't know that they weren't latched on properly. I knew to check for wet diapers, but didn't know the difference between 'kind of wet' and 'soaked'. I truly thought I was doing a fabulous job. The whole experience left me doubting my abilities to feed my boys myself, and I have never had the confidence to stop supplementing with formula, with the end result that I was never able to produce enough milk for both babies. I'm still breastfeeding them both, but I follow it immediately with bottles of formula. I have so much guilt about this, I can't even describe it. I resent using formula, and I detest all the washing, sterilizing and filling of bottles. I don't like anybody else (except S) to give bottles to the boys, because I still believe it is my job to feed them.

I know that nurse practitioner was doing a great job at ensuring my baby got the care he needed, but I wish I could tell her just how terrible she made me feel.

Another trip to the ER

S was changing Pin a couple of days ago and noticed a huge lump just above and to the left of his penis. He immediately called me to have a look, and I took one look and was on the phone to the paediatrician within minutes. She was unavailable, but her fabulous assistant was able to contact her on her cell and run the problem by her. She made a preliminary diagnosis of hernia and advised us to go to the emergency department at our local children's hospital to have it checked out.

Unlike the last time, we didn't panic. We fed both the boys, packed their diaper bag with more food and diapers, and calmly proceeded to the children's hospital and parked in the lot. We proceeded to triage, lined up at the appropriate computer without being prompted, and this time were registered immediately. We were seen by triage within 5 minutes and told to wait in the waiting room for assessment. We saw the intake nurse about 10 minutes after that, and after the usual questions, weight, temperature and preliminary examination were issued with a hospital bracelet and told to wait for our turn. And wait we did. I know Pin was low on the triage scale, not being in any pain, or bleeding, or showing any sign of discomfort at all, but we had to wait 7 hours to see a doctor. SEVEN HOURS.

We ran out of food. We ran out of diapers. We definitely ran out of patience. I started haunting the triage nurse, asking her how many people were ahead of us, and could she get us some formula. I breastfed them as much as possible, but not having the greatest milk supply this was not a solution to two hungry crying babies. S went out to try and buy some more formula, but apparently downtown Toronto is not the baby-friendly mecca you would imagine it to be, and there was no formula to be found.

Just as I was once again bugging the nurse to find us some formula, we were called in to see the doctor. They took one look, diagnosed a hernia (uh huh) and referred us to the general surgery clinic because an inguinal (groin) hernia can become 'stuck' and needs to be surgically repaired as soon as possible. By 'as soon as possible' I mean that the general surgery clinic will call us within 2 weeks with an initial consult appointment, and schedule us for surgery after that.

In the meantime, every time we change his diaper we have to push the hernia back into his stomach, to make sure it isn't stuck. It makes a little popping sensation when it goes back in, and sometimes we can feel liquid moving through the intestine as we push on it. It gives both of us the willies to do it but we do it faithfully because we are so scared of it getting stuck. If it's stuck, part of his bowel will not get oxygen and will start to decay, causing Pin to become ill and have pain and to need emergency surgery. I feel so sick that he has to have surgery; the thought of my sweet little boy having general anaesthetic and postsurgical pain and possible complications is nauseating. At the same time, I want him to have the surgery as soon as possible so that it doesn't get trapped and start to decay.

Cutting the Cords

Guest post by my husband, S

The first 2 months with the twins, and perhaps a week prior to their arrival, has been a whirlwind. I feel like Tony Shaloub's character, Fred Kwan, in Galaxy Quest on traveling through space in a pod — "That was a hell of a thing." And yet somewhere inside me, Sam Rockwell's Guy Fleegman character also comes bubbling up: "AAAAARRRRRGGGAAAAGGGGHHHAHHHHH".

It's hard to keep a clear memory of what happened in those exciting, hyper-stimulated days and nights in February and beyond. I recall the wonderful experience my wife and I had during labour, an experience that forever changed my life. I greatly love, admire and respect S, and this bond grew deep and inward in ways I cannot describe during the 16 hours of labour.

The caesarean delivery that lay at the end of this experience was as shocking as the labour had been affirming. Nothing can prepare you for the war zone chaos of an OR during a caesarean delivery of twins. Two teams of doctors, nurses, anaesthetists, and interns are required; one team for each baby. I cannot imagine the melee of birthing triplets or more.

I held up pretty well, at least at the beginning. The crowd was getting to me, and the mask was making me feel claustrophobic, but I was doing ok. The experience immediately struck me as a surreal one. I guess I was expecting it to be surreal, but until it happened, it was hard to quantify it. This was Dali surrealism: melting clocks and human faces morphing into spaniels.

And then a couple of high pitched squeaks.

Duckling emerged from behind a doctor as he carried him to an attending nurse. He did not look real at all. I was expecting him to be a slimy and reddish, but I was surprised by his large size and his purple/whitish silver colour. He was quickly wiped down and weighed, then thrust under a heat lamp like a burger and fries, ready to be picked up by the waitress. As Pin caught my peripheral vision, I recall a nurse asking me if I wanted to cut the cord for Duckling. I leapt at the chance, compelled out of a sense that this act gave me a bona fide reason to contribute to the OR staff chaos.

The umbilical cord was tough, like cutting through thick, wet leather. The memory of it stays with me, but at the time it did not feel like this magical, bonding moment that I had hoped it would be. Yet, somehow, I know that this moment will indeed endure.

Milestones

Being a parent of twins, I find that I am so busy all the time that I let a lot of things slide. I don't keep a baby book, I haven't started memory boxes for them, I haven't had any of the numerous photos printed and put into frames. I usually write this blog one-handed, while nursing one of the babies, often in the wee hours of the morning.

I know I will regret this later, especially when telling the boys stories of their babyhood. Thank goodness S is great at saving the photos to the hard drive with descriptive labels, otherwise we would be completely lost.

Today Pin actually saw the rattle I was shaking at him, saw it and smiled and cooed and tracked it with his eyes. I put it in his hand and he gripped it and shook it for a while. I'm pretty sure he had no idea he was doing it, but he certainly liked the noise it was making. I ran around the house looking for the video camera but it's buried in a pile of something, somewhere. I'm sure he'll do it again, but the first time is always so magical and surprising. I tried it with Duckling a while later, and he also smiled and tracked it with his eyes.

At nine weeks of age, the boys can:

• Coo
• Smile
• Follow us with their eyes
• See bright colours and follow them with their eyes
• React to rattle noises
  
• Drool (mostly Duckling, who is nicknamed Bubbles)
• Sleep 3 to 5 hours at a time, sometimes (well, once) more
• Sort of hold their heads up
• Throw their feet straight up in the air and fart, even when asleep
• Make sucky noises and breathe excitedly when they see my breast or a bottle
• Poo only once or twice a day, instead of 6 or 7 times a day, although these poos are now so voluminous that they fill the diaper, leak, and sometimes go halfway up the back
  
• React when the other is crying, even though they ignore each other completely for the most part
• Cry vociferously and with intent (Pin's nickname is Loudy for this reason)
  
• Put themselves all the way to sleep if I lay them down half asleep
• Put themselves back to sleep if they wake up at night and aren't hungry and are swaddled

Who said babies are boring.

Sleep

Why is everybody so focused on getting babies to sleep through the night? Sleep doulas, books, DVDs...all designed at getting babies to sleep longer than is natural or healthy. It's practically a competition among some parents. Bottom line, although I love sleep as much as anybody, I believe that babies are designed to wake up when they are hungry, and should be fed. Why train them to sleep through a natural urge, something that is necessary for survival?

Two nights ago Duckling and Pin slept for 7 hours straight, something they have never done before. I woke up at 8 and was momentarily terrified that something horrible had happened, but no, they just slept longer than usual. Probably a reaction to their first vaccinations. I felt GREAT the next day! Of course I was excited to see if it happened the following night, but we were back on the 4 hour schedule of wake eat sleep. By four hour schedule, I mean Pin wakes up at midnight, feeds and cuddles and has a change and is soothed back to sleep (or not) and then Duckling wakes up at 1 (if I'm lucky, otherwise he hollers until I am finished with Pin by 12:45 or so), feeds and cuddles and has a change and is soothed back to sleep. I fall asleep about 2 am, then Pin wakes up about 4 or 5 and the whole process starts again.

I GET the idea behind sleep training, I really do. I just think that they need to eat when they need to eat. They have little tiny tummies, and are fed breast milk and formula, which digests in the blink of an eye and leaves them hungry a few hours later. That is how they are designed, that is how it is.