Newborn diaper log

You probably need to log the babies' "output," at least for a little while. This is something they do in the hospital for all babies to make sure they're getting what they need.

We called it the diaper log; pictured is the one we used.  Across the top it says that the doctor wants eight or more wet diapers daily; the number of BMs (bowel movements) varies. Once again, we had to report this to the pediatrician daily until the babies were gaining well enough.

The columns are:  Day/Date; Approximate Time; Which Child?; Wet?; BM?; Color.

This is all probably particularly gross to people who haven't had newborns before.  Apologies.

Keep in mind that their expected output will change as they grow older. You won't always go through diapers this fast.  I recall averaging 15 diapers a day total in these newborn days.  By about three months we were averaging 11 diapers a day total.

Each baby would be changed before feeding; the information would be logged.  After feeding, we'd check the diaper and change and log if necessary.  You might be able to save time/diapers by just changing after, but then you aren't really getting an accurate number of wets and BMs. Once we weren't really worried about their output anymore, we switched to changing them when they seemed to need it.

Finally, most people know that boys can "spray."  Be forewarned -- girls can, too.  Beyond that, my singleton sprayed BMs.  Once that happened, I changed his diaper only when I had a receiving blanket covering my shirt.

Thus concludes one of the grossest blog entries I'll have.

Newborn nursing log

When you get home, you might want to log your babies' feedings. When you're feeding twins, it's tough to remember who you fed and how well they did. We had to report this information to the pediatrician daily for a while; we found it helpful and continued with it.  I was nursing; if you're feeding with formula you'd have different column headings.

Pictured is my log. Across the top is the goal as given to me by the pediatrician -- "Feedings -- Want 8 - 12 each day each child."  Yikes.

The columns are: Day/Date; Approximate Time (of day); Which Child?; Which Side?; # Minutes; Comments.

For the record, ideally you want to nurse both babies at the same time. I didn't have a lot of luck initially with this, so my feedings were one after the other.

Later I was able to nurse the babies together, which of course was wonderful and a great time-saver. I also learned after the fact some things about how I might/could have tandem nursed earlier. I'll share this in another blog entry.

Our babies were having some trouble with gaining weight (a visiting nurse came in every few days to weigh them), so we were told to supplement with formula. Toward the bottom third of my log, you may see (in my scratchy little writing) things like "1/4 oz." or "1/2 oz." That was when we started supplementing, and how much the baby took. It wasn't long before my log said "+1/8 oz. supp., not too thrilled w/it." They figured out pretty quickly what was yummy and what was...not so yummy, and they were growing fine.

We learned at the hospital that babies can drink from little cups, like the kinds that come with medicine bottles. Cradle the baby in one arm, tuck a cloth under his/her chin, hold the little cup to his/her mouth, and upend the cup slowly. The advantage to this is you don't have to worry about nipple confusion at all. This is how the babies got their supplemental feedings. I didn't do them; my husband or someone else would, often my dad. Nursing the babies had to be my job, and it was a big one; I wasn't going to voluntarily take on supplemental feedings.

By the way, in case you're looking at the log and getting nervous, this all gets easier. Babies nurse faster, they learn to latch and suck better, you can learn to tandem nurse, and they need less feedings after a while. You can do this.

Help!

People will ask "what can I do to help?"  Hopefully, you know who will provide quality help and who won't.

The ones who will expect to be entertained or catered to -- frankly, you don't need them around.  If you have to let them come see the babies, be very clear beforehand that everyone in the house will be busy taking care of babies; tell them a short time frame and do whatever you need to do to enforce that, even if it means being rude.  You don't have time to entertain someone; you'll be very busy and very tired, and keeping those babies fed, clean, and safe is the priority.

The ones who have can be helpful if they're told what to do -- tell them what to do.  Don't be shy.  Here's a short list of things people can do.

• Laundry, especially folding baby stuff.  They can put it away, too, especially if you've labeled the drawers with what goes in them. 
  
• Diaper a baby and bring him/her to mom to be fed.  Take baby from mom to be changed.
• Hold a fussy baby.
  
• If babies are being bottle-fed, feed a baby
• Load/unload the dishwasher.  Loading is easier because you don't have to know where everything is, but like the baby clothes, you could label your cupboards if you wanted to, and/or give a "where things go" lesson.
• Hold fussy babies.
• Bring you food and/or a drink when you're nursing.
  

The people who will just pitch in and help when needed -- those of us who have this sort of person around are fortunate.  Even these people can benefit from a list or knowing the routine, but if you have this sort of person, you're all set.  With those people, add "make dinner" to the list.

Remember, too, that these are your babies.  You and your husband have the last word about how they're handled, when and how they're fed, etc. If someone's trying to railroad you into something, you need to be the parents and do the right things for your babies.  So if your mom says, "don't pick up that baby, you'll spoil it!" you pick that baby up and tell her that doctors now say it's not possible to "spoil" a child that young.  If someone is around who's making you second-guess everything you do, they're not helping and they need to correct their behavior or go.

Even before the babies are born, people can help.  They can bring food for the freezer, preferably something with protein and vegetables together, and something easy to cook.  We're talking "throw it in the microwave" easy.

So what kind of help did I have?  For the first week, my husband was home.  That was lovely!

For the first couple of weeks, at least, my parents came over every day.  I'm very fortunate that my parents are nearby and are quality helpers.  After that, my Dad came every weekday for about four months.  He'd help with diapering and holding and bringing them to me.  He'd bring me food or water while I was nursing...he was awesome.  I could get through any morning, no matter how rough, knowing that Dad would be over at 11 or 12, carrying a decaf frappacino or an Auntie Anne's pretzel...

My friend C- came over most mornings for the first couple of weeks after my husband went to work.  She helped me take the babies to a doctor's appointment.  She said she'd clean the clothes that ended up with poop on them as long as I gave her gloves...so I gave her gloves.  She helped me get my son to latch on by  grabbing my breast and stuffing it into his mouth.  Yep.  She had nursed all of her kids, and she knew exactly what to do.  She was invaluable.

My sister provided us with a bunch of meals for the freezer.  At the moment, I can't remember whether she brought them when the babies were a month or sometime before they were born.  In any case, it was a lot of wonderful, wonderful meals, complete meals with meat and a starch, and veggies, all in one container.  Heaven.

Other than that, we had some visitors who mostly came to see the babies but left in a reasonable time frame.  It was nice to see them and they held babies.

We lucked out in the help department.

Coming home from the hospital

I don't have great "home from the hospital" advice.  I'm sure if I could do it over, knowing what I know now, I'd do better, but it didn't go that well at the time.

We thought we wouldn't want anyone at home with us for the first week or so.  My husband would be off work, there were two of us and two of them, how hard could it be, right?  For us -- wrong.

It took us a long time to be ready to leave the hospital.  Nurse the babies, get them dressed, oh, this one is hungry again...  Finally we got going; my parents followed us home in their car, but stopped on the way to get pain medication for me.  Then they came over to help us get a little bit settled, and left way sooner than I wanted them to.

Somehow, inexplicably, we didn't get those babies into their (shared) crib until 11 PM.  Maybe we were in the mode of feed, change diaper, "oh they're fussy let's try nursing" when instead we should have tried to get them to sleep when they were fussing.  I don't know.

I guess my advice is to try to pay attention to how things go in the hospital and try to stay on a similar routine at first.

In the hospital

I don't have much to say about the hospital that's specific to twins, but I'll put it here as well as overall hospital advice. 

Breech babies have more room than you think:  My Baby B had been breech for quite some time, but my doctor would try for a vaginal delivery as long as Baby B wasn't significantly bigger than Baby A, which he wasn't.  Still, I was a bit concerned.  However, one night just three days before the twins were born, we discovered via ultrasound that Baby B was no longer breech.  At 35+ weeks he had room to flip without me realizing it. So there's hope for those crazy breech babies.

A rude awakening: My daughter (baby A) had been born, and she was lovely, and my beautiful new baby, and how gorgeous, and I was trying to see her as she was being cleaned up, oh how lovely, I was trying to see..."PAY ATTENTION TO ME!" says the doctor at the end of the bed, wanting me to work on delivering the other baby.  And so began a lifetime of having to split my attention.

Do what works for you:  I had read about how important it was to have the baby(/ies) in the hospital room with you.  That may be true, but it wasn't something I could manage.  I had the twins around 5 AM on a Wednesday.  My daughter was in the NICU the first day and night. I was able to go see her once that day to nurse; she did fine.

My husband and I were taking care of our son.  I was nursing him and we had him in the room with us Wednesday night. It was exhausting.  I hadn't slept much Tuesday night, being in labor.  I hadn't slept much Monday night because I was nervous about going in to be induced.  I was exhausted to begin with and nursing was tough...eventually I think I sent him to the nursery and had a little nap.

My daughter came out of the NICU on Thursday at 11 AM; she nursed like a champ.  My son was still having trouble throughout the day.  So Thursday night, I had them both stay in the nursery.  I told the nurses to feed her formula when she needed it, and bring him to me to be nursed when he needed it.  I figured she was doing well nursing even though she'd had bottles in the NICU, so she'd be okay with a night of bottles.  He was the one I had to concentrate on.

I was sort of brokenhearted to have to make that decision; in the best of all worlds, each baby would get nursed and cuddled and stay in the room with mom, and it would be glorious and all earth-mothery.  But when you have twins, you have to figure out what will work for you.  Remember they'll never know any different; sharing mom's attention and maybe having to wait a bit will be normal for them.

Other hospital advice:

• If you have a vaginal delivery, start taking stool softeners immediately.  I didn't do that, so -- TMI!  (too much information) -- the first bowel movement after delivery was extremely painful.  I'd much rather have pushed out a third baby.  I'm not kidding; take the stool softeners until you have that first B.M.
• At our hospital, if you had a private room your husband could stay with you; there's a chair that pulls out to sleep on.  If you're able to do this, it's so helpful.  Not only does he get to be in on everything, but babies need a lot of taking care of.  The nurses do some and you do some.  Dads for some reason seem to be really great at swaddling, too.  I was bad at swaddling.
  
• I wouldn't worry about having a nightgown or anything.  Wear a hospital gown on the front and one on the back for good coverage.  Also, the hospital will provide you with this weird mesh underwear and lots of pads for bleeding.  Just use that stuff, and use their socks, too.  The only clothes you need is what you're going to wear home, and make sure they're not your pre-pregnancy clothes; they won't fit yet.  Maybe bring a pair of maternity pants that you wore early on, so you know they snap up smaller than you've been lately. 
• Bring snacks for the hospital.  I don't know if it was the nursing or the fact I'd pushed a couple babies out of myself, but I was ravenous in the middle of the night.  Also, order extra food when you're filling out your menu card, food that you can eat later, like a banana or an apple.  If you don't want it in the middle of the night, your husband might.
• Er...sometimes a receiving blanket or two and some of those hospital socks jump into your bag.  I don't know how that happens; it just does.  As it turns out, you can never have enough of those receiving blankets, and the hospital ones are really good.
• In the hospital, they'll have charts to keep track of all the babies' feedings as well as "output" (pees and poops) and whatever other things they keep track of.  When you change and feed the baby, they'll have you write it down.  You may need to continue that at home; I'll talk about that in another post.
  

You're pregnant with twins...

I'm too late with most of this advice for my friend, but hopefully it will help someone.


Support: Seek out a local twins club affiliated with the National Organization of Mothers of Twins Clubs, Inc. (NOMOTC)  Why?  Because you have questions and concerns, and it helps to meet people in the same boat (or already successfully ashore). Why before I've even had the babies? Because then you'll make the effort to go afterward; you'll already know how helpful it will be.  Honestly, going to a MOT meeting when I was expecting the twins was one of the best decisions I made.  There's no membership fee until your twins are three months old, and then you can choose to join or not.

Due Date: There was a study done at one point (I saw it written about in Twins magazine) which determined that 40 weeks is not term for twins.  I don’t remember exactly, but I think term for twins was 37 weeks – after that, the outcome started to decline in terms of babies’ health.  So if, for example, your doctor says “we really want to get to 40 weeks,” think about getting a new doc.

Hospital: If you have a choice of hospitals, go for the one with the higher-level NICU.  Choose your doctor based on the hospital.  Why?  If one or both of your babies needs more than your hospital can give them, the baby(/ies) will be taken to a different hospital. It has happened that mom is at one hospital and one or both babies are elsewhere.  This doesn't make nursing or bonding impossible, but it sure doesn't help, and it has to be stressful.

Car Seats: When thinking about car seats and strollers for those first few months, do get some kind of a "system," meaning, make sure it's the kind of car seat you can take out of the car and fit right into your double stroller without disturbing the babies.  They didn't have double strollers that would fit car seats when I had my twins, so we had to carry those baby seats or transfer the babies into the stroller.  Thank your lucky stars they keep improving twin products.

Mobility: It's tough to get around when you're pregnant with twins.  I asked for a temporary sticker to park in the disabled spots of the closer visitor parking when parking wherever I could find parking became a problem.

People say the darndest things:  When people find out you’re expecting twins, they may say some stupid things, like “better you than me” (with that attitude, I guess so!) and “if I were you, I’d kill myself!”  No lie, I got that one once.  People will also ask whether it was fertility drugs (“why ever would you ask that?”) and whether twins run in your family (“they do now!”)  Just be prepared and realize it's not just you -- we all get that. 


A C-Section is not inevitable:  I remember people just assuming I'd have to have a c-section.  It's not true.  Sure, you're probably more likely to need one with twins than with a singleton, but it's only if there's some reason -- it's not automatic.  Ask your doctor the conditions which would cause you to have a c-section; don't assume or listen to people who are assuming.

Ditto: The same goes with "Oh, your baby will need the NICU!" and "Your babies will be premature!" and "You'll never be able to nurse!"

For the record: induced vaginal delivery at 36 weeks, babies 5 lbs, 11 oz and 5 lbs, 15 oz., one baby under NICU observation for 30 hours, nursed for two years (a teeny bit of supplementing and formula, more details on that later).

And finally:  Better you than me.  If I were you I'd kill myself.  Did you have fertility drugs?  Do twins run in your family?  You know you're going to need a C-section, the babies will be premature and need the NICU, and you'll never be able to nurse, don't you? :(

But seriously, finally:  You're pregnant with twins.  Congratulations.  It's an awesome experience (literally, an experience that inspires awe) and I wouldn't change it for the world.

And so it begins...

I've always thought about writing down my twin advice, but I never quite got around to it.  I guess no one ever seemed to need it that much.  Even when my sister-in-law was pregnant with triplets, well -- she already had four children, so she wasn't quite so freaked out about the whole thing as most of us are.  (She did great, by the way -- the triplets are starting kindergarten soon.)

So why am I finally doing this?  Well, I have an online friend who's much the same as I was eleven years ago -- an older first time expectant mom of twins.  She announced this a while back and I said something like "I'll give you all my twin tips!"  Then a few months later "I'm still planning to give you those twin tips!"  Then very recently she posted how she's eight months pregnant...so yeah, I'd better get to this.

I'm a first time blogger.  I'll do my best to make this organized and readable.  We'll see.