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My sister gave birth to twins earlier this week. They are ~seven weeks premature. All things considered, the babies are doing quite well but are expected to be in the ICU for about 3 weeks. The girl is 4 pounds and the boy is 5 pounds. They are breathing on their own and the little girl has been eating.
Unfortunately, I don't think my sister is doing as well as the babies right now. She is understandably really scared, overwhelmed, recovering from a C-section and perhaps experiencing post partum depression.
I'd like some suggestion on what I might do to help her. She lives two states away so there are limits to what I can do. Those of you who've had premies or twins, what things helped?
[ March 10, 2007, 07:42 PM: Message edited by: The Rabbit ]
Posts: 12591 | Registered: Jan 2000
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I didn't have premies or twins (my one baby weighted more than her two together), but I DID have Post Partum depression, rather badly, and I was dealing with a new born and a very handicapped toddler at the same time.
It sounds like her babies are big enough that once the hospital clears them to go home, they should be just about the size of normal babies, but there will still be TWO of them. Encourage her to talk to her doctor about the depression, and even consider medication. I know it's hard if she was planning on breast feeding, but sometimes it's worth trading to formula so that you can be a better mom in other ways. I fought it for almost four months before I finally agreed to take my anxiety medicine and switch my son to formula, and it was VERY worth it. Instead of being constantly stressed and crying at almost anything, I was able to enjoy things with the kids again.
I know one of the biggest worries with premies is lung development, and illness. She's lucky that it's not really "winter" anymore, but I'm not sure spring is much better. She should be careful to watch how they're doing, and about making sure people who have coughs and colds don't come in contact with the babies. I know this can be hard because everyone wants to see them, but things that adults think is nothing can hospitalize an infant.
Also, the biggest thing to stress is that there's no such thing as being a hypochonriac mother for a newborn (espescially premies). She should take them into the doctor whenever she is at all concerned. A good pediatrician won't mind, if hers does, that's a sign that she needs to switch doctors. When my son was only a few weeks old he contracted a cough. Family members told me not to bother taking him in at first, because the doctors couldn't do anything for babies that young. We finally did take him in, and the doctor DID give him a decongestant because he was so bad. However, it wasn't enough, we thought he was getting better but really it got worse. He almost died in the doctors office when we took him in for his follow up because his brochial tubes were infected and he had fluid in the lungs.
I'm not trying to scare you or her, this won't happen to most kids. However babies, particularly premies are susceptible to coughs, and even a very dangerous kind called RSV. Most likely her babies will be fine, but if she's at all worried about how they're doing, make sure she knows that it's OK to take them in. Peace of mind on there health will be important for her, because with two, she doesn't need any extra stress. She doesn't need to feel silly or like she's "overreacting" to things, if she's worried, they do what it takes to make herself feel better... that's my best advice. You can never be TOO careful.
Posts: 1321 | Registered: Jun 2006
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My sister is a P.A. and her husband is a surgeon so I'm not concerned about them getting adequate medical care for the babies.
Its too early too say whether or how badly she's suffering from post partum depression. It has only been 2 days since she had a C-section and she has two wee ones in the neo-natal ICU. At this point I think its pretty normal for her to feel overwhelmed and scared.
In her practice she treats a lot of people for depression and has always been quick to get help for herself. I'm confident that if post-partum becomes a big problem for her she will get the help she needs.
What I'd really like to know is if there is anything I can do to help her now. What kind of things are likely to give her comfort and support.
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Rabbit, I've got nothing useful to offer except my prayers - it's a situation I've not faced before. I hope you find something.
Just a thought - is there anything you can do that would make it easier for them to stay at the hospital? It sounds like that won't be an issue for them from the hospital side, but is there anything you can send/arrange to help with handling the house and the mundane chores of life? That stuff can seem overwhelming when facing this kind of crisis.
Posts: 26071 | Registered: Oct 2003
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quote:Is there anything you can send/arrange to help with handling the house and the mundane chores of life?
My mother? Well technically I can't say I'm sending her, but she is flying out on Sunday and plans to stay as long as she is needed.
Unfortunately, her husband (the Dad) has a cold so he can't even come to the hospital to see them right now.
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Honestly -- a phone call, a card, or a small gift sound great. It sounds like she has the support she needs, and I'm sure she knows she can count on you too (if not, you can remind her in the card/call). I is perfectly normal to feel this way after a baby -- and she's got it double. The first few weeks of a baby's life are just going to be hard no matter what.
Congrats on the new additions to your family.
Posts: 2392 | Registered: Sep 2005
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Here are some things that you can buy for your sister and the babies:
1. Receiving blankets. Your sister can use them to do a "blanket exchange." She wears the blankets on her person, next to her skin (I used to tuck them into my bra strap). The blankets absorb her scent and she can give them to the nurses to put in the babies' isolettes. They can learn her scent and it will eventually comfort them. When it's time for a new blanket, the nurses give them back and your sister can smell the babies' scent. I always found it very comforting. Before using them, the blankets much be washed in Dreft only and only dye-free, perfume-free fabric softeners can be used. The blankets must be dried in the drier (the heat kills any remaining germs).
Also, fleece blankets for kangaroo care.
2. Beanie Babies. After being washed (again, in Dreft w/ dye-free, perfume-free fabric softeners), these are the perfect size for isolettes. The nurses used to use Aerin's to hold leads and tubes in place.
3. Wubba Nubs. These are just the greatest invention ever for preemies.
4. Extra Breast Pump Kit. Obviously, this only applies if your sister is pumping. If so, it makes things much easier to keep one at home and one at the hospital. That's what I did.
Preemie Magazine has a great marketplace page. You might want to browse and see if there is anything else your sister might like.
I "decorated" Aerin's station and it helped me a lot. I put up pictures of friends and family and the 121st Psalm, along with a couple of trinkets that have been like good luck charms to me. I thought of the NICU as Aerin's first home and I wanted it to be as nice as it could be for her.
Kangaroo care is the best thing for both the mother and the babies. It is really the only thing that can truly and completely comfort a NICU parent. I would advise your sister to start it as soon as they will let her.
It sounds to me like the babies are doing extremely well. They're VERY big for 33-week twins and they're both breathing room air, which is great. From what I can tell, their only issue seems to be feeding. They're old enough that I'm assuming that their PDAs are closed. I'm glad to hear that they boy is bigger than the girl as boys are almost always weaker (black girls do the best and white boys the worst). Your sister might want to look out for reflux, which almost all preemies have to some degree. This is usually treated with Reglan, Zantac, or Pepcid and by keeping the babies on an incline.
Mazel tov on the new additions to your family. If you or you sister want to speak to me directly, I'd be happy to do so. Just email me and I'll email you my number. Please keep us updated on the babies' progress. Y'all will be in my prayers.
Posts: 3037 | Registered: Jan 2002
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I will add too, my willingness to talk to you, Rabbit, directly or your sister about advice handling twins. Granted, my twins were not preemies, but they were fairly small (right around six pounds - which was small to me since both my other children were well around eight pounds) and I do know what it's like having to handle feeding two infants and caring for them.
I might be a better resource for when she gets home, Mrs. M will have a good handle on the hospital stuff. Posts: 14428 | Registered: Aug 2001
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Thanks so much Mrs. M, You've given me some good ideas.
I do think that they are doing extremely well, all things considered. The little boy is having trouble regulating his blood pressure and is on medication for that. The only issue with the little girl so far is feeding.
Right now I'm more worried about the Mom and Dad than the babies. It is alot easier for me in my removed position to look at the situation objectively and feel confident that they babies will be OK. But when my sister sees her tiny little ones with all the tubes and monitors, she just falls a part. She will be going home from the hospital today without them which is breaking her heart.
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Rabbit, my wife and I have twin boys who were born 4lbs and 5lbs respectively (although they were not premies). While we were very lucky to take our boys home with us when my wife was discharged, I must say we could have used a few good nights of sleep before we took them home. We didn't sleep at the hospital much, and with 2 infants, we got absolutely no sleep at home.
So perhaps try to encourage your sister to catch up on some rest while she can. She and her husband are going to have double trouble soon enough.
I can only imagine how difficult and challenging a time this is for your sister. I don't know how one comforts parents with newborns in NICU. Fortunately, it sounds like the babies are doing considerably well under the circumstances - their size, in particular, is encouraging. While these days with the babies in the NICU are difficult and scary, they will soon be in the past, and your sister and her husband will have many wonderful years to look forward to. Twins are amazing.
Posts: 195 | Registered: Nov 2005
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Neat article about a baby surviving birth at 21 weeks & 6 days of gestation -- the youngest known so far. As Mrs. M might suspect, she's identified as a Black female.
Posts: 14017 | Registered: May 2000
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I will go ahead and throw out my best pieces of advice for parents of twins.
The babies need to be on the same schedule. It was the only way I survived. That means, if one baby wakes at 3:00 am because he's hungry, his sister gets awakened then fed too. That was how it went, consistently, the first month or so. Daniel would waken, but Abigail would still be sleeping. Didn't matter, I woke her and fed her at the same time. Otherwise, I'd finish feeding Daniel and then she'd wake up 20 minutes later. I couldn't survive like that. I needed sleep!
I don't know if she's nursing or bottle feeding - but if bottle feeding, mix all the formula for the day in a pitcher and keep it in the fridge. Then, pour off the bottles as needed. To warm them, keep a crock pot full of water, and turned on low. The just pop the bottles in the warm water, turn it up if you need to, then put it back on low when you're done.
I don't know how much of a neat freak your sister is, but if she can stand this - it's a life saver: I never bothered putting baby clothes away. I was going through too many little sleepers and outfits a day. I kept two laundry baskets in the room. One would be right by the changing table full of clean clothes. I'd pull out what I needed, put it on the baby and go. The other basket would be there to receive dirty clothes. That one would get washed when full and it would then become my "clean" basket. This applies, of course, to the everyday sleepers, onesies, and playsuits. Nicer clothes that we wore to church or somewhere out I would keep folded and/or hung in the closet. But for everyday stuff, no sense wasting time folding it and putting it away. Time is a precious commodity for parents of newborn twins.
For as long as possible, let the babies sleep in the same crib. This helps them sleep, number one, because they have company, and two it helps cut down the number of times you're washing sheets and changing bedding. I kept both cribs made up and ready, and if a diaper leaked or a baby spit up in the middle of the night, I could just transfer them over to the other bed, and not worry about changing the sheet until the morning.
If I think of more stuff, I'll post. Best of luck to the whole family!
Posts: 14428 | Registered: Aug 2001
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Belle -- I did something like that with the laundry with just one baby. I put the clothes in drawers, but I just shoved them in there and didn't bother to fold. There wasn't any point.
I've often noticed that the rules that govern raising multiples are similar to the ones for singles -- just that much more important to observe so you don't go crazy.
BTW, if she hasn't already bought a bassinet, I recommend the Arm's Reach co-sleeper. I have the mini for one, but they have a bigger one that can fit twins. Talk about a life saver -- for the first few months having the baby in the room with me and right next the bed was the only way I slept. This is particularly helpful if she chooses to nurse. Reach over, grab a baby, lie on your side and fall back asleep while they do their thing. Posts: 2392 | Registered: Sep 2005
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I have to disagree with some of the above advice. While it is great for term babies, it can't be done with preemies.
quote:The babies need to be on the same schedule. It was the only way I survived. That means, if one baby wakes at 3:00 am because he's hungry, his sister gets awakened then fed too.
I'm sorry to say that this isn't something that should be done with preemies. Good sleep is critical to their health and development, much more so than with term babies. I even let Aerin sleep through one feeding if she wanted to, though you can't let them sleep through more than that. It will be a nightmare for your sister, but it's best for the babies.
quote: Reach over, grab a baby, lie on your side and fall back asleep while they do their thing.
Preemie feeding is very different from feeding a term baby. You CANNOT do the above with preemies. You cannot co-sleep in any way with preemies and they will almost certainly need to be either upright, semi-upright, or on a flat surface to nurse or bottle-feed. Preemie feedings tend to take much longer than term baby feedings. Aerin's used to take up to 2 hours at a time. If they go home on apnea monitors, feedings will take even longer.
Honestly, your sister is in for a rough time when the babies come home. In addition to the feeding issues, she will need to chart all feeding and elimination for both babies for at least a month. I had a nurse for the first 2 weeks Aerin was home and she was a lifesaver. I highly recommend that your sister skip one feeding per day (she can pump if she's nursing). She can take a shower or a nap, both of which are huge morale boosters. Also, the NICU will have them on a schedule already, so she can either keep it the same or tweak it to fit her needs.
I thought of a couple more things yesterday. The babies cannot have a mobile or anything like that for at least 3 months. It is much too overstimulating. However, they do love vibration when it's safe for them (I'll look up when it was okay for Aerin - I think it was pretty early). If they don't go home on apnea monitors, your sister might want to get Angelcare Monitors for her peace of mine. And if she is nursing, My Brest Friend pillows are the best. My nursing stool helped me a lot, too. The NICU should have a lactation nurse and a speech pathologist to help with any nursing and feeding issues.
Hope they're doing well. I'll post more as I think of it.
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I am not experienced with premies so I have to assume you are right about how to feed them but I still think that having babies in the same room as you for the first few months is very helpful. That long walk down the hall can feel like miles at 2 a.m. especially if you were just up at one.
But I'm sure her doctors are telling her what she needs to be doing for the health of these babies. It really sounds like she has a good support system -- which is really the best thing she could have anyway.
Posts: 2392 | Registered: Sep 2005
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Thanks for all the advice and warm fuzzies. The babies are making good progress. The little boy is off the blood pressure meds. My sister says the little girl is a tiger. She gulped down her milk the very first time they fed her. They have both lost some weight but no more than was expected.
posted
Awww...they still look so fragile. I think it's the wires. There are some cute shots of the two of them together, though. I'm glad everyone is doing well. I hope your sister is feeling better about her new mommy role.
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Those kids are huge! They don't even look like preemies to me.
Seeing those pictures really took me back. The excess body hair does fall out, but it's so gradual that you don't even notice until it's long gone. I think it's adorable.
They seem like they're doing wonderfully well. I couldn't be happier for y'all!
BTW, I didn't mean to say that preemies can't sleep in the same room as their mother. They just can't sleep in the bed with her. Though preemies are very noisy sleepers. They grunt in their sleep, which is hilarious but makes sleep difficult at best. There's no real medical reason for them to grunt, they just all do. We had Aerin in with us for the first 2 nights after our nurse left (she stayed downstairs with the baby nights until then) and I got literally no sleep.
Posts: 3037 | Registered: Jan 2002
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quote:Originally posted by Mrs.M: Though preemies are very noisy sleepers. They grunt in their sleep, which is hilarious but makes sleep difficult at best. There's no real medical reason for them to grunt, they just all do.
As a side note, just for the record -- grunting in a baby should raise the concern of respiratory distress. Infants will often auto-PEEP by grunting, doing a small Valsalva manuever when the small airways of the lung are collapsing in order to stent them open.
Mind you, I don't think that the babies Mrs. M are talking about were in respiratory distress [and as she notes, preemies are a different group, in whom routine grunting seems to be more of a norm -- whether it's immaturity of the nervous system or what have you]. I just don't want someone who has a baby that doesn't grunt normally not to take it as a worrying sign if such a baby were suddenly to start to grunt, especially with a cold or cough.
---
Edited to add: Cute babies! Posts: 14017 | Registered: May 2000
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Great links, CT! I bookmarked them. You have really good medical links. You should be a doctor or something. Posts: 6246 | Registered: Aug 2004
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Mrs.M- a question on the Wubbanubs. To lessen risk of SIDS they say no stuffed animals in the baby's bed. Does a wubbanub count as stuffed animals? My baby was full term and healthy and happy, now 8 weeks old. I got her a wubbanub and now her grandmother is claiming I am going to suffocate the baby.
Posts: 1001 | Registered: Mar 2006
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scholar, you can take it away when she falls asleep.
Of course, I make all my SIDS based sleep decisions on an individual basis. My second daughter could not sleep on her back. After observing her, my mom (a registered nurse who works with babies) pointed out that she was starting to fall into a deep sleep state, and then waking-- and the probable cause was that she wasn't breathing right because her tongue seemed to be falling back (she had a tiny chin, it caused eating problems, too) and obstructing her airway. She suggested we flip her over and see what happened. We did, and lo and behold, she started breathing normally and sleeping well. Because she was a full-term baby, with no family history of SIDS, no smokers in the house, etc., etc. on the "no other risk factors", we made a decision that this was okay for our baby. She has slept on her tummy ever since, and we got a lot of rest that other parents weren't getting those first few months. It is every parent's right to do the same, and thoughtfully consider whether or not you should follow a specific piece of standard advice for your baby.
Posts: 21182 | Registered: Sep 2004
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Good News, The babies both came home thursday evening and a doing great. There due date wasn't until April 9, so they came home nearly 5 weeks before there due date. The little boy is now up to 5 lbs, 10 oz (quite the fatty), his sister is still only at 4 1/2 lbs but she is doing better than him in every other respect. They came home with apnia monitors and wearing the hats I knitted for them (well not all the hats I nitted for them, I kind of got carried away and knitted 8 hats).
Annie, Their last name is Armenian. Armen immigrated to the US when he was about 12. The name is pronounced the same as the composer Katchaturian and is spelled the same in the cyrillic alphabet but got transliterated to our alphabet differently.
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quote:Good News, The babies both came home thursday evening and a doing great. There due date wasn't until April 9, so they came home nearly 5 weeks before there due date. The little boy is now up to 5 lbs, 10 oz (quite the fatty), his sister is still only at 4 1/2 lbs but she is doing better than him in every other respect.
quote:(well not all the hats I nitted for them, I kind of got carried away and knitted 8 hats).
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