Pump It Up

So, the twins are almost four weeks old. Does that seem just insane to you? It does to me. I swear it was just yesterday we were buckling them into their car seats to bring them home from the hospital, grateful that they both passed the car seat check and that they actually fit in their seats. And now?

Well, the days seem endless, but the weeks are flying by -- if that makes any sense.

Before I explain, though, please let me take care of some bloggy business here. On April 18, likely as I was delivering the twins, Sanders over at Just a Dash of Sanders gave me a blog award. She is the mom of twin girls from near our old Penn State stomping grounds. Her gorgeous girls are a wee bit older than mine, so I'll be keeping an eye on her blog so that I can learn what's yet to come...

Also, while editing blog comments, it came to my attention that I was getting some substantial traffic from another blog, Multiples and More. I had joined the site several months ago and check it frequently because there are so many "been there, done that" multiple parents there it has some really great advice. Well, lo and behold, they had my blog featured on their front page under the "Expectant Parents" category. So here's my shout out and thanks for the highlight!

Back to the twin updates: Life is consumed by feeding them, whether it be actually feeding them, preparing to feed them, cleaning up from feeding them, planning feeding them, or pumping to feed them. They eat 7-8 times a day and it is currently taking an hour to prepare, feed, clean up, and pump. It is a full-time job.

I had hoped to nurse the twins as I was very successful nursing Violet (hello, the child weaned at 29 months!). But, according to the lactation consultants, they are true 37-weekers. Which means that they were just young enough that at first, nursing was such an effort that they tuckered out quickly. When coupled with high bili levels (especially Juliet's) and higher-than-preferred weight loss (Willa), we decided that they needed a bit of supplementation until my milk came in reliably. So, under the guidance of a lactation consultant, we started a tube-at-breast (TAB) feeding protocol on the day after they were born (Tuesday).

We were discharged on Wednesday from the hospital with borderline bili levels and borderline weight loss, both were to be checked on Thursday by the home visit nurse. We were still TAB feeding and learned that it was likely that we would need to supplement that way until the girls hit their due date. On Thursday, Juliet's weight loss had stabilized, but Willa's had not. On the other hand, Willa's bili levels were out of the range of concern, but Juliet's were not. In fact, the doctor prescribed a night on the bili bed, which was delivered to our house within the hour.

On Friday, after Juliet's night on the bili bed, we were back to the hospital for another bili level check for her and another weight check for both. Saturday was another weight check for both. Sunday was a doctor's appointment with bili levels (all OK) and a weight check (both girls gaining, finally).

At our Saturday weight check, I told the lactation consultant that I was pretty sure that both girls were sucking on the TAB and not nursing. This was confirmed when the LC did a weight before and after a feeding and the only thing in the baby was the supplement. Sigh... So we changed our game plan again and are offering the breast for as long as baby wants, then bottle feeding pumped milk or formula.

We've been sticking to that since then and both girls have surpassed their birth weights and are doing well. Juliet will attempt to nurse 80% of the time, with one or two feedings where she nurses for 6-8 minutes. Willa will nurse for 1-3 minutes at 1 or 2 feedings a day.

I am frustrated that I haven't been able to get them back to just my breast -- not frustrated with the babies or myself, but at the circumstances that got them off my breast in the first place. Willa's weight loss was rounding 11.5%, which is the starting-to-get-scary point. And Juliet spent one night on the bili bed, but if her levels hadn't improved, she likely would have been admitted to the hospital for more intensive therapy. I get that they both needed to eat and that they weren't quite equipped to nurse like champs from the beginning. But I'm still pretty sad about it because I really, really loved the bond that nursing created between me and Violet. I'm not sure that I'll be able to get either of them back to the breast full-time... sigh...

And then there's the pumping. I don't know how women who only pump can do it. By the time we get both babies fed, it's a 40 minute commitment. Then I pump for about 20 minutes. If I were producing enough to sustain both babies, I wouldn't begrudge a minute of that time. But right now, I'm only pumping enough to feed one baby. I'm trying everything I can think of to increase my supply: power pumps (ten minutes on, fifteen off three times in an hour), staying hydrated, drinking Mother's Milk tea (gives me diarrhea), and extra pumping sessions. And it is not reflecting at all in my pumping totals. In fact, the only thing it is doing is making my nipples crazy sore.

As much as I wish the feeding thing was different, I'll go on this way until I'm so tired I can't function. Or until I fall asleep and suck my nipples right off with the pump. I am feeling a little helpless about this situation, but really am doing my best.