Breastfeeding and Pumping, Pumping, Pumping, Pumping, Pumping....

My mum coaching me through my first sucessful latch with Phoebe at 1 week old.

I have unresolved emotions about my breastfeeding experience and I think a lot of mothers do.  It’s not like I think about it all the time (I have moved on with my life!) but when I reflect on the first 3 months of their lives and my battle to breastfeed two premature babies I do get emotional.  

I had some obstacles to successful breastfeeding.  This is my list of “premature baby” breastfeeding issues:

• My babies were unable to suck until they were 3 days old
• They did not successfully latch until they were 7 days old
• My babies needed help latching for the several weeks (you have to kinda do it yourself, often several times!)
• My milk did not come in until they were 8 days old because I had to bring it in with an electric breast pump
• I only ever had enough milk to feed one baby even though I tried natural medicines, drugs, extra pumping, etc.
• I only had half an hour per child to change their nappy, breastfeed, burp, bottle top up, burp and resettle to sleep while they were in Special Care.
• I was only allowed to gradually increase breastfeeding from 1 feed a day to 5 feeds a day between 1 week and 3 weeks old.  Premature babies find breastfeeding absolutely exhausting and are really not up for breastfeeding around the clock.
• The first time they ever received all their feeds at the breast was at 3 weeks old and even then I could only offer the breast then top up with formula in a bottle because I didn’t have a good supply.

This is my list of “reflux baby” breastfeeding issues that presented at 7 weeks:

• Baby would scream and arch back mid feed
• Baby would quickly pull off (taking half my nipple with them!)
• I would cry every feed because it hurt me so much and it absolutely killed me to hear them scream in pain.

As I’ve mentioned in a previous post - my nipples were so badly damaged and I was so emotionally and physically drained that I gave up breastfeeding at 8 weeks.  I will always feel guilty that the day they developed reflux was the day I missed a pumping session (our first outing with our babies!) and they were given more formula than breast milk.  I know reflux can develop in breastfed babies but I also know reflux is more prevalent in formula feed babies.  I wonder if I had enough milk for both would they have gone through all that pain?

I then gave up pumping at 11 weeks because they developed RSV and were admitted back to hospital for a week.  This was extremely stressful for me and I had a baby lying on my chest 24/7 in an upright position so she could breathe.  I have written about this in a previous post about sick babies. I know what some of you are thinking..."why didn't she start pumping again when she got home?".  The thought did occur to me but honestly - they were very, very, very demanding babies and I was barely coping with the hours of crying as it was.  Maybe I could have tried to bring in my supply again at around 5 months?? Maybe??  But I tried to pop them on the boob and they'd already forgotten how to breastfeed and so I would've been pumping every 2-3 hours again and I did not enjoy that the first time!

I guess the point of this post is to let people know that breastfeeding twins is more than just trying to latch two babies at one time.  There are many obstacles to overcome that many people would be absolutely clueless about.

Overstimulation and Self Settling – 4 months

I could write sooooo much about our sleep journey so I will keep this post to what was happening in the girls’ life at 4 months old when we asked a “baby whisperer” to help us.  The girls had the following symptoms.

• A lot of crying (3-4 hours a day)
• Difficult to feed (bottle refusal and crying)
• Hard to settle to sleep (not even mummy rocking, patting, shushing, car, pram, music, etc.etc. would work!!!  They would just scream for hours and then pass out from exhaustion)

Here was the baby whisperer’s diagnosis:

• Overstimulated.
• Overtired.

Recommended routine for when they are awake:

• Baby wakes and then nappy change. 
• Put baby in bouncer and leave them alone.  Don’t be stimulating.
• Wait for baby to tell you they’re hungry.  It’s important to learn your baby’s hunger signs....most babies grizzle and try to eat their fists.
• Offer food.  Don’t beat yourself up if they don’t take much.  You can’t make a baby drink!
•  Burp lots
• Put them back in the bouncer and leave them alone.  Don’t be stimulating.
• Wait for them to tell you they are tired.   Tired signs are very important and shouldn’t be ignored.  Tired signs may include grizzling, jerky limb movements and yawning. 
• Offer food again.  This was to make sure they were full before putting them back to bed.  This was important with my girls who would often refuse to feed at all during an awake period.
• Put baby to bed.  

Controlled comforting:

• Put baby to bed and give them a sleep cue such as “sleep time”, “shhh” or a song – whatever you are willing to do over and over (you’ll see why soon...!).  Put your hand on their back (mine were tummy sleepers) and give them a reassuring soft pat/jiggle to calm them down a bit while giving the sleep cue.  At this point they may be protesting but hopefully not screaming.
• Leave the room and listen.

-          Now you want to listen and let the baby protest but not let them get hysterical.  This is a hard judgement to make, especially by mums who are particularly sensitive to their baby’s cries!  This is where having a baby whisperer there to hold you back from running in is helpful!  The idea is not to help them to sleep by going in as soon as they start crying....the idea is to let them cry but intervene before they get so upset it is really hard to calm them down.

• Give the sleep cue and calm baby down without picking them up.  You want to hang around long enough to calm them down but not aid them to sleep. 
•  Leave the room and listen.
• Repeat until baby is asleep.

We had a rule that we would let baby have their dummy the third time we went in.  Often they would settle at that point.  It was strange that they wouldn’t settle if we put them in the cot with the dummy straight away but letting them cry a bit before the dummy worked well. 

I am not a Robin fan either – Twins with Reflux

So here is my post about reflux.  At about 8 weeks my girls started to get more and more difficult to keep happy.  They would take longer and longer to settle to sleep.  Then they would cry a lot after feeds.  Then they would cry a lot during feeds.  In a week they had gone from fairly contented babies to babies who seemed to cry in pain at most feeds.  When I say cry I don’t mean a bit of “boo hoo, I’m hungry”  I’m talking “AHHHHHHHHHHHHHHHHHHHHHH I’m in a HUGE amount of pain!!!!!!!!!!!!!!!!!!!!!!!!!!!!!” high pitched squeal that got the attention of our neighbours and made me cry, stress and lose my sanity. 

I, of course, consulted a baby book that had a large section of baby crying – “Baby Love” by Robin Barker. 
From this book I got the general gist that:

• Babies cry and sometimes they cry for hours so just deal with it,
• colic is a myth and reflux is over diagnosed – your baby couldn’t possibly have either of these, and
• bothering your GP with “my baby is crying” makes you look stupid and wastes their time.\

Of course she didn’t actually say those things but that was the general impression I got in my crazed sleep deprived, thereissomethingwrongwithmybaby and I’mabadmother kind of state.

It frustrates me that no one told me about silent reflux.  It is very common with preemie babies and is really obvious when you know that crying during and after feeding is NOT normal. To cut a long story short it turned out that the girls needed hypoallergenic formula and reflux medication.  However, it took three weeks for us to work this out and get the dose right.  There is really nothing quite as soul destroying as babies crying in intense pain and feeling completely helpless.  Reflux pretty much pushed me close to depression.  If it wasn’t for my faith in God I believe I would’ve developed post natal depression.  I was so close so many times but my faith and my unbelievable husband, family and friends kept me from........ who knows what.

I believe the girls developed an aversion to milk and this is why they didn’t drink a full bottle of milk until they were 12 months old.  I also blame reflux for their poor sleep quality for several months.  It is also the reason why I had to stop breastfeeding and eventually, pumping.  Imagine trying to feed a screaming child that once latched on quickly pulls off (taking half your nipple with them!), arches her back and screams in even more pain.  My nipples were so badly damaged and I was so emotionally and physically drained that I gave up breastfeeding at 8 weeks and pumping at 11 weeks.

I will always feel guilty that the day they developed reflux was the day I missed a pumping session and they were given more formula than breast milk.  I know reflux can develop in breastfed babies but I wonder if I had enough milk for both would they have gone through all that pain?

I'm not a Tizzie or Gina Fan

The general message we got from baby books like "Save our Sleep" and "The Contented Baby" was:

• If you ever help your child to sleep they will never learn to fall asleep by themselves and your lives will be ruined forever and ever,
• You can put a baby in bed and they will fall asleep after they cry for a bit - even at 2 weeks old,
• You can manipulate babies into feeding and sleeping when you decide they should, and
• If your child is not sleeping through the night by 6 months you have FAILED!

 

Why the baby book routines never EVER worked for my babies:

• They never ever woke up hungry. All of the routines assume that a baby will take a full feed upon waking if their last feed was around 3-4 hours earlier. This just simply was not the case for my girls.
• They got tired well before the scheduled nap time.
• They would wake well before the scheduled nap ending time.
• They never took a full feed once they got reflux at 8 weeks. We were lucky to get them to drink 50ml in one go.
• They were always sick and sick babies don’t eat or sleep very well. 

Trying to put my babies on a routine resulted in many, many hours of crying....and the babies cried a lot too.  We had this idea that having twins meant we had to have a strict routine but by trying to implement a routine we were making things worse.  When we started to do what they wanted to do things drastically improved.  We would offer food when they showed hunger signs and put them to bed when they showed tired signs.  We also stopped waking them from their naps to try to feed them.  I don't know why we didn't try the common sense method to begin with!!!  ahhhhh....hindsight.

Casear Fun! Warning - surgery photos!

Me in my sexy surgery get up.  Too bad you can't see the attractive pressure stockings.

So I had a scheduled Casear.  This means I didn't actually go into labour at all.  I don't know what a contraction feels like...I didn't even experience those Braxton Hicks fake thingies!  So roughly a casear can be broken up into these phases:

Epidural/Spinal Block:

So they stick a big ass needle in your back that hurts like hell.  Yes, I cried, yes it's painful but seriously - it probably isn't as painful as pushing out a baby!

Numbing:

Everything from my chest down went numb.  I could feel the OB pushing and prodding but I couldn't feel hot/cold or pain. Yes, I could tell when he was cutting and I knew when he was pulling out a baby.  It's this bizarre sensation of rumaging around in your insides that's hard to explain. 

 

Baby A comes out:

So the OB yanks out the first bub and she screams - woo hoo!  Because of the curtain I couldn't see my tummy but I could see bub come out all covered in goop and blood.  So bub A gets whisked off to the assessment area.

Baby B comes out:

Because Baby B was a bit higher up the OB had to really tug her out with some force that literally took my breath away and made me feel a bit off colour!  She also let out a cry.  The OB tells me she had an umbilical cord (no idea whose) wrapped around her leg but she's ok.  Baby B gets whisked off to the other assessment station.

Nausea, uncontrollable shaking and feeling whoosy:

Unfortunate side effects of the anesthetic...the anethetist pops in an anti-nausea to my drip which helps a bit but I'm still shaking a lot.  Not that best thing when you are about to hold a baby (or two!).

Hold babies:

I held Sophia (baby A) for awhile very akwardly on my chest.  I'm long sighted so trying to look at her when she's basically on top of my chin was tricky and made my eyes hurt.  They brought over Phoebe for me to cuddle but I was already concerned about dropping Sophia so told them to hand her to Simon. This was a truly beautiful moment staring into Sophia's eyes (yes she opened them!).

Immediate recovery:

About 15 minutes after birth the girls were put in humidity cribs and I was left to lie in the recovery area.  I wasn't feeling the best from the anesthetic so happy to just do nothing and smile to myself.  I can't remember how long I was there...maybe 45 minutes - 1 hour?

Special Care Visit:  

I then got wheeled into special care so I could pat their head for a few minutes.

Recovery in maternity ward:

The anesthetic wore off a few hours after surgery and boy was my tummy in pain!  There was the internal pain and then the casear stitches pain - ow!  I couldn't move...not even roll over.  I had a catheta and they had to check the blood loss....I won't go into details!  Let's just say it's just as well I was pretty out of it otherwise I would've been much more self concious!  I vomited quite a bit 6 hours after surgery.  I'm sure you can appreciate how painful this was considering how many tummy muscles are required to vomit.  I was only allowed to visit my girls in special care once I was off the catheta and the catheta stays in for about 24 hours.  During that time Simon was showing me video and photos of the girls - this was just awesome!  As soon as that was out I forced myself into a wheelchair and went for a thrilling ride through the ward to see my bubs.  I didn't walk on my own to special care until about two and a half days after surgery and when I did start walking I felt pretty whoosy and I was in quite a bit of pain.  By the time I checked out of hospital the whoosy feeling had gone and I only had the casear site pain, pelvic pain and muscle weakening to deal with (refer to pregnancy info post re. pelvis pain and muscle loss).

Recovery at home:

I wasn't lifting a baby and when I did it was a very very light baby so I think my recovery from the casear was pretty quick.  The casear site pain had completely gone about 2.5 weeks after surgery.

What is it like to be pregnant with twins?

I thought I might answer some of the common questions I get asked.....and I thought I would start at the very beginning.  I've already written about the emotional side of being preggers with my twinnies but failed to mention what it felt like physically (other than the panic attacks during scans!).

Morning Sickness:
I had really bad morning sickness from 5-15weeks.  Have you ever had gastro?  Well, that's exactly what it felt like except you add an intense feeling of starvation.  It's a vicious cycle of:  I'm sick, I'm starving, I eat, I feel better, now I'm sick and need to throw up, now I've thrown up I'm starving and feel sick, I eat.....etc. 

Pelvic Pain:
I had Symphysis Pubis Dysfunction from 9 weeks gestation till the girls were about 3 months old.  Basically my pelvis moved around too much. It was excruciating!!!  My pelvic area felt like two bones were grating on each other and not playing happy families.  I did physio and couldn't walk very far let alone exercise.

Muscle Weakening:
I was basically sedentary due to the pelvic pain so after I gave birth I had lost a lot of muscle in my legs.  I couldn't get up off the floor for months and a walk around the block felt like a marathon.

Stretch Marks:
I got a lot of them.....everywhere.....

Multi-baby kicking:
It really did feel like a party was going on in there.  Most of the time it was good fun but sometimes it was extremely uncomfortable and made it difficult to sleep.

Weight gain:
I put on 20kg and I have slowly lost the weight over the past 18 months.  I still have 1.5kg to go though.


Wow - it really sounds horrible doesn't it?  There are a lot of people out there with much worse experiences and there are a lot out there that would give anything to be pregnant so I can't complain!  I just thought I would be honest and tell it as it is.

12-18 Months

The last 6 months have been filled with lots of adventure. The girls have started to go to playgrounds and play with kangaroos! It is such a joy to watch them get excited over something like a puppy dog or even a train set. I think my favourite moments have been them learning to talk. I was thrilled to hear their first word (other than mum, dad, nanna) which was "bird". This was around 13 months. They say about 50 words now. They have started to talk to wach other as well. Their first word to each other was "boo" as in peekaboo then "share" quickly followed by "no" and "hello". They also hug and kiss each other...awwww. I am yet to capture this on camera though.

I must admit not everything has been smooth sailing. They still got sick once a month and there was a trip to the emergency room with dehydration. They still don't sleep through the night either. They have been able to self settle for over a year. Unfortunately they still aren't very good at staying asleep. They go to sleep fine at 7pm but will wake once or twice in the night and will be up for 1-3hours. I think our problem is that when they are sick we help them to go back to sleep (rocking, cosleeping, milk feed) and then they get used to this and demand it all the time. We have tried over and over to sleep train them (cut back the milk and cosleeping) and eventually they will get a bit better but by the time we've done that they are sick again and we are back at square one. There is just no way they will fall asleep by themselves when they are sick. They can't suck their thumb with a blocked nose which is the main issue....they really like their thumb! They are sick every month which drives us nuts but we've been told there's nothing we can do about that.

Top 10 clues you are a sleep deprived parent with toddler/s

10. Even though the babysitter is happy to stay up until midnight you return from date night at 8.30pm so that you can catch some shut eye before the kids start to wake.

9. You have become proficient at sleeping while your child cries - much to the annoyance of your spouse.
8. There is a space on your bookshelf where all the parenting books used to be. These books were destroyed several months ago in a cathartic bonfire.

7. When you wake to a screaming child you don't need to look at the clock to know what time it is....you can just tell it isn't 7am.

6. There's a sweet little night light in your house you bought to help you see things while feeding and changing your newborn baby/ies. This light has been on for 18 months.

5. You know what Phenergan is.

4. The pharmacist knows you by name because you have purchased colic relief, phenergen, nasal spray, panadol, nurofen, vapouriser, baby vicks, real vicks, cough syrup, losec, antibiotics, teething gel, hypoallergenic formula, various thermometers........and most importantly - a LOT of birth control!!!!

3. You have a pillow and blanket set up on the playmat so that you can lie on it while your child/ children can play around you first thing in the morning.

2. You cannot remember the last time you set an alarm or even bothered to close the curtains to keep sun out.

1. You are writing a post about sleep deprivation.

Happy Birthday Phoebe and Sophia!

On Phoebe and Sophia's birthday 11.01.11 our suburb was flooded and we had to evacuate. We didn't have power for a week and the beautiful park we planned to have their party at was covered in muddy water! Thankfully our property was not flooded and we were able to celebrate the girls' birthday a couple of weeks later at our home.

Our gorgeous girls were all grown up! They walked, talked and giggled just like all the other toddlers. I was actually getting the Huggies moments I had been dreaming of for so long. They drank a full bottle for the first time in their lives and they both slept through for 5 nights in a row (this record is yet to be broken!). Most importantly they were HAPPY! And happy babies make for a happy mummy.

8-11 Months

At around 8 months my life seemed to gain some kind of normality. I wasn't housebound and I could actually get a few things done (e.g. the washing up!) while the girls were awake. My house was starting to look more livable, I was having regular showers and on the odd occasion I had the opportunity to style my hair. I stopped walking the girls in the pram for 2 hours in the afternoon to keep them happy and went to the shopping centre or a friends place instead. This didn't help my weight loss efforts! Instead of burning off calories by walking the girls and starving in the afternoon (never had time to pack a snack for myself) I was downing iced coffees and biscuity snacks.

It was around this time I joined a gym. I left the girls in the care of complete strangers (the creche workers) for the first time. They settled pretty well at the creche and I was able to have some baby free time. The best thing about going to the gym was being able to shower and get dressed without fear of waking a child or having to listen to them protest at my unavailability!

Being able to crawl around was fantastic for the girls because they could finally get up to some mischief! They loved to do things like ....fossick through the kitchen cupboard, smash open a packet of chocolate buttons and nibble on them.

4-7 Months

My little munchins look all sweet and innocent in this photo (Phoebe is on the left). However, they were a HUGE challenge. Let's see....
* they didn't sleep through the night (still don't!)
* it took ages (and a lot of screaming!) to get them to settle to sleep
*cat napped during the day
*never drank a full bottle....in fact never drank anywhere near the recommended amount and often did not put on any weight
*were sick ALL the time (reflux, colic, cold, flu, teething pain, immunisation reactions...etc.)

The one thing the really really upset me was the inconsolable screaming. Those tiny babies were depending on me to keep them happy and I failed.....miserably....every...single...day. I was very close to depression several times. I had lots of help from family (especially my loving husband) but the fact I couldn't seem to do a good job even with all this help made me feel even worse. Even with all the help there were days when I had 2 hours of sleep and no shower.

We were given lots of (conflicting) advice but the only advice that seemed to make a big difference came from a Baby Whisperer we paid to come out to our house and work out what was going on. She told us that they were severely over stimulated and overtired. She showed us how to do a form of controlled crying. After a couple of weeks of putting her advice in place we had babies that put themselves asleep. They started to feed a little better and scream a little less too. They still were quite difficult and it wasn't until 7 months that I took them out of the house by myself - a HUGE achievement!