Wednesday, September 3, 2008

First Pediatrician Visit; Changing Schedule

On Tuesday we went to see the pediatrician. Both seem fine and she is fine with next visit being in a month. Ned weighs 5 lbs, 2 ounces with a 32 inch head and Penny weighs 5 lb, 10 ounces with a 33 inch head. Here are some photos of them in their car seats at the doctor's. Penny is so much bigger than Ned - check out her double chin! She eats like a champ - he is much fussier. I won't go into details but he skipped one of his feedings entirely - I couldn't get him to latch at all and eventually he went back to bed and slept until his next feeding.

The three hour feedings during the day have been really tough on me and our Baby Nurse recommends trying for 4 hours and getting them more interested in eating and spending time awake so we are going to try that starting today (but feed them if they wake up early). I've been frustrated because it is so easy to feed them the bottle and so hard to get them to be eager (and not fall asleep) when I feed them. I know I am making enough milk for 2 so I really want to "tandem" nurse but they are not ready for that - I can't hold their heads and my breast for both at once unless I had 4 hands. I'll have to look into that. They've seemed a little more awake after feedings so we'll have to do some play time - maybe I'll delay my pumping about 20 mins after each feeding so we can have play time.

I readily admit that it has been hard to take advice from our Baby Nurse. She is wonderful and Husband is 100% behind her but as a stubborn woman I have my own ideas. I need to remember she has 30 years experience and is only here for 6 weeks so I should learn what she has to teach, make sure I keep up on the breastfeeding and the rest will figure itself out. I do appreciate her helping out during the day (changing, swaddling, burping) and doing the 1 night feeding. I think I am way more rested than most women in my position. I have been getting up to pump to stay on top of milk supply for the bottle-fed baby. If anyone has a suggestion as to when I can add another pumping (assuming a 2 am feeding, 6 am feeding, 10 am feeding, 1/2 pm feeding, 5 pm feeding and 9 pm feeding) that would be great. I pump right now after each feeding, and get up at 2 am to pump while Baby Nurse feeds the kids formula.

Here are a few more cute ones - waking Ned up to eat this morning and them in their pack n' plays sleeping after morning feeding.


LauraC said...

So many scenarios are running through my head. Does your nurse have a lot of experience with *slightly* preemie babies? Because you really need to give them that sleepy time in the beginning to catch up on many things, so trying to force more awake time may make them a little grumpy.

Also they are still so little and their stomachs are so little, that it would be hard to go 4 hours between feeds.

Scenario 1: Since you're already pumping at each feeding, why not alternate feeds once a day? Feed one baby at breast then pump while baby nurse feeds the other a pumped bottle. Try this once a day with each baby to get you little more of a break. This may help the 3 hour schedule feel less stressful because you'd only be dealing with one kid and the pump.

Scenario 2: Have one feeding each day (the one that is most stressful) be the bottle feed for both babies. You don't have to wake babies quite as much to get them to bottle feed as you do to get them to breastfeed.

Not sure how to fit more pumping sessions in there. I tracked my total daily output and adjusted variables (length of time pumping, time between pumps, etc). I found I produced the same whether I pumped 8 times a day for 20 minutes or 6 times a day for 30 minutes. I chose to pump less frequently but made the periods longer.

Good luck. It is all confusing at the beginning but you will eventually figure out what works for your family. And remember - YOU are in charge, not the baby nurse. You are paying her to HELP you. She may have experience in babies but you know what YOU need.

Mommy, Esq. said...

I already do scenario 1 - it takes 1.5 hours just to feed 1 baby at the breast since part of that time involves "waking them up" to eat (and the last 20 mins are pumping). The other baby gets a bottle of pumped milk. If they wake up earlier than the 4 hours no problem on my end (or hers) to feed them more often. Both have already slept since the 9 am feeding for 3.5 hours so looks like they may need more sleep than we were giving them by waking them up every 3 hours.

Husband said...

Just my perspective on why we hired the baby nurse: I want her to tell us EXACTLY what to do. Wife and I both work in jobs where we get brought in to be experts on some topic. Why wouldn't we do the same for the most important change ever to happen in our personal lives?

Here's how I put it to Wife yesterday. If one of her clients wanted to run a closing in a way that she knew was wrong, how would she react? Of course she wouldn't let them do it, and she'd be pissed if they kept fighting her.

Same thing, except now we're the clients. She may be working for us, but we're paying her so we get the benefit of her expertise.

Liz Jimenez said...

They're so adorable!!

I will say, if you're not feeling right about your baby nurse, STAND UP FOR YOURSELF. I'm sure it's really helpful in a lot of ways, but if it goes against what you believe, don't do it.

The four-hour schedule would be lovely. But I will only say that I do not think it is compatible with the goal of successful breastfeeding. Is the baby nurse a lactation consultant? I only ask because a lot of the advice she seems to be giving is (in my unprofessional opinion) counterproductive if the goal is to EBF. Janice at the Winchester Hospital lactation center (she runs a breastfeeding group on Wednesdays and does individual consults, it's near the Stop & Shop in Woburn) is a great person with twin experience.

If your goal is to EBF, then more pumping and more bottles is not the way to go, nor is extending the time between feedings.

I hesitated to comment, because I know you're getting more than enough advice at the moment, and I didn't want to just make things worse. But as someone who was in very similar shoes to yours a year ago, this was the single biggest piece of advice I wish I had understood at that time: the only way to up your supply and get the kids nursing is to nurse them a LOT.

Sorry if that's out of line. And EBF isn't the be all end all. Your kids will be healthy and loved and nutured either way. Just thought I'd throw it out there. I, too, am wary of some of the advice the baby nurse is giving you.

Liz Jimenez said...

One last thing, then I'm off my soapbox. Husband makes an entirely valid point, that you hired this person to tell you what to do.


Just because she has a lot of experience and you're paying her and she's an expert, doesn't mean she has the only right answer. She has a particular philosophy. A perfectly valid one. But if it doesn't mesh with your own, then that's worth examining. They're your kids, not hers. If you feel like you want to follow her plan, rock on. If it doesn't feel right to you, then don't do it.

A. said...

Adorable babies!

Just to chime in against my better judgement, you hired the baby nurse to help you get the babies on a schedule. This is her #1 goal, and it's the reason she gets so many "rave" reviews from previous clients. Yes, also, to show you how to "do" things, but once you've changed a meconium diaper and learned proper swaddling, bathing and burping techniques, you're pretty good to go on the whole "how do I take care of these kids" front. She could probably go home right now and you'd be all set on that front. What you're working on now is the schedule aspect of things, and getting 1-week-old babies on a schedule is not possible if you truly want to breastfeed them. 3- and 4-hour feeding schedules are designed for formula-fed babies. You just need to evaluate what is most important to you - having the kiddos on a schedule by the time your support (husband and baby nurse) leaves, or breastfeeding them. I'm not saying either is right or wrong - there are benefits to both feeding approaches. But you definitely need to evaluate your goals here, and know that Marlene's approach will not mesh with a goal of exclusive or near-exclusive breastfeeding.

I know that it is difficult and time consuming to feed two babies that don't want to stay awake right now. It will get better as the babies wake up a bit more, but in the meantime you may want to try to get some help, maybe from a lactation consultant or a fellow twin mom, on tandem nursing. If you can feed them both directly each time you can cut out a lot of the pumping sessions (not to mention bottle prep and cleaning) and save yourself a lot of time.

Sorry, I am so not a lactivist, and I truly do think that formula feeding has it's place in this world. I am supportive of any choice that is made as long as it results in happy and healthy babies and mommies. Just wanted to put my 2 cents in about Marlene's techniques since you are trying to go the breastfeeding route.

A. said...

I should have just read Goddess's comments first, because I guess I basically echo her. I agree with everything she said, nicely put! And she definitely managed to say it in a non-offensive way.

What A Card said...

Ditto, ditto to the two comments before. Your night nurse isn't WRONG, it just sounds like she's not totally committed to a goal of exclusive breastfeeding. Which is fine, if it's not your goal either. The first month or so of breastfeeding is complete chaos. You survive it, you enjoy it, but you can't really schedule it, if that makes any sense.

Many good wishes to you, I know what a whirlwind this time is, both hormonally and just questioning if you're doing anything right. You are :), so hang in there!

Krissy said...

I had a thought drifting through my head when I read this post and decided to jot it down before it disappeared with the million other thoughts I had today...

Mommy Esq and Husband, you guys seem to be doing a fabulous job with your new little ones! Congrats on being coherent enough to even type!

I could be totally off my rocker here (it wouldn't be the first time), but I remembering the first few months with our husband and I felt so "watched." Like everyone was watching us to see how we would manage two screaming infants, two car seats, breastfeeding two, etc. We felt such pressure to instantly be the best parents ever!

I have written about some of our new parent disaster moments (Faith rolling off of the couch onto the hard wood floor; Jonathan choking and having to do the hymlich; struggling to maneuver our double stroller; grocery shopping (need I say more?!) etc.

Our schedule wasn't perfect, our nights still aren't always restful, I am not a perfect mom, and my husband isn't a perfect dad. But gosh darnit, the PRESSURE to look as though we had it all together!!!

Anyway, the point is, if you feel like you need to take the kids in for a weight check with your pediatrician, great! Doesn't matter that your ped is fine with not seeing them for a month. I think the same goes for your baby nurse...don't let her undermine your confidence.

You two are now the experts on your children. Pre-kids, I worked in the field of aging. We always told family members that they, not us, and not doctors, were the experts in regard to their loved one.

Hang in there, one feeding, one nap, one chore, one more day at a time! Pretty soon you two will be advising other new parents on the rigors or raising infant twins.

LauraC said...

Oh I hope what I said didn't come across in a negative way! I'm really sorry if it did. I think others interpreted what I meant correctly. I think the cliche "it takes a village" rings true because I've found that parenting has required getting information from a wide range of sources. And I've also found I learned some of my best lessons through mistakes.

You are guys are totally rocking to be blogging this much and be this lucid!

Rebecca said...

Oh, your babies are so cute!!! Look at their itty-bitty faces.

I want to echo what the previous posters have said---I really don't think that exclusively BFing and strict schedules are compatible. Three to four hours works ok for a formula fed baby, but I think more like every 2-3 is what most BFing moms do.

I agree with Goddess--Janice is fantastic and has lots of twin experience. She's simply wonderful and not a lactivist at all. Her group is also a great resource---you learn so much.

As for pumping, can you BF one baby while pumping the other breast? That way, you wouldn't have to spend the extra 20 minutes pumping after a feeding, and it would be more like tandem feeding (I've heard tandem feeding increases your milk supply better).

Best of luck figuring this all out. Feel free to send me an email if you'd like.

PS Hope this doesn't come out negative---the double crying in the background is a bit distracting here!

CityMarketSally said...

I have been lurking, but wanted to come out of hiding and say thank you for so openly sharing what you're going through. Your children are precious and I admire how hard you're working to "get it right." We're expecting b/g twins sometime around Thanksgiving/early December and its like you're giving me a crash course and answerng all of the questions I keep asking myself. First the career questions (I am self employed, but very professional) and now how to get home, get on a schedule, EBF, etc. You may be frustrated, but from my perspective your priorities are so admirable and you're willingness to share is just golden. Best of luck.

Anonymous said...

From the Dark Ages (or back-when-it-was-dark-all-day), and someone who does not have twins, but had 4 singles -- I completely agree with all the comments about schedules and breastfeeding -- they are totally incompatible! Go for one or the other and things will work just fine for you. I also am in awe of your continuing to blog so prolifically with 2 newborns in the home!!! (Nancy's Mom)

Anonymous said...

Wow, I have to strongly, strongly disagree with the 4 hour schedule for such little munchkins.

I actually started typing a lot more, but I decided to back away from my soapbox because I don't think that is what you need. Suffice to say I agree with what A, and goddess, and Krissy all had to say.

If you disagree with Marlene, or something she does goes against your gut, then do it your way. Seriously. Krissy said it best in her post:
"You two are now the experts on your children." You're great parents, and those babies are gorgeous!

Anonymous said...

Hi! I have absolutely no advice for you whatsoever, but wanted to say congratulations on your two beautiful bundles of joy - they are seriously adorable! And in true Jenkins style, you are excelling in your early days of parenting - trying to get it perfect, of course! Best of luck Mommyesq. and Husband - I'm sure you'll be wonderful parents. But, go a little easier on yourselves! Easier said than done, I know...

Anonymous said...

Ned and Penny look so healthy. You are doing a wonderful job. My turn for the soapbox. Please take my comments with a grain of salt since every baby is different and you should do whatever works for your family.

When the babies are as small as Penny's and Ned's they have to eat frequently b/c their tummies are so small. Until Neve was about 5 weeks old, she was eating every 2-3 hours (on average probably 2.25-2.5 hours) -- I was feeding "on demand" in that sense and focused on getting full feedings so that she wouldn't want to snack. Then we were able to stretch it to 3 hours on average, sometimes less, sometimes more -- still "on demand" in that sense. If you are going to exclusively breastfeed stretching to 4 hours consistently for each feeding this early sounds a little uncommon (though my sister-in-law did that for the first of her 3 exclusively breastfed babies -- but she did tell me that people thought that was uncommon). In addition to their tummies being so small, the breastmilk goes right through them, much quicker than formula and that's why the feedings are closer together than formula feedings.

I know it's really hard right now b/c I'm you're exhausted and all you do is feed or pump (do you feel like a cow in that sense? I did!), but they will grow so quickly, their necks will get stronger and their stomachs will grow too! Before you know it, you'll be able to tandum feed, the feedings will naturally be 3ish hours apart and the feedings will will take less time -- you'll no longer feel like just a milk dispenser -- I PROMISE. Keep telling yourself that the phase you're experiencing now is TEMPORARY.


Nancy said...

Hey! My mom reads your blog. heh :) two KICK BUTT. Mommy - you have to, have to, HAVE to do what feels right to you because only YOU know that feeling. Husband has great points, but I'm sure there are people who would close differently than you - are they wrong? nope, just different. I'm sure your nurse would let you know if you are dead WRONG, but if you're doing what feels right, I'm betting that it's not dead wrong.

And my GOODNESS those two are so cute!