Breastfeeding Twins

2013-03-30 14.21.36We’re about to get real up in here and talk about something I think is so important to talk about publicly. So, if me talking about nursing my babies ain’t your thing feel free to exit now…otherwise, prepare yourself to get a tiny bit little personal.

(P.S. Mind On Medicine could be abbreviated to M.O.M. Can we all take a moment to relish how ridiculously fitting that is?)

I knew when I was pregnant that I wanted to give breastfeeding a good ole college try. I would give it a go, see how it went, and hope for the best. When I found out we were having twins I became even more okay with supplementing formula or completely formula feeding if nursing didn’t work out. My number one goal was happy babies and happy mommy, however that happened was fine. However, I did know I wanted to give it my best shot, since breastfeeding is the best thing for babies and has some awesome benefits for mom as well (lower rates of some cancers, weight management, lower risk of post-partum depression, etc.).

Somewhat out of character for me, I didn’t read a bunch of books or investigate a bunch of websites. I read up a little and went to Twitter for tips and tricks and hoped the lactation consultants (LC) in the hospital could guide me through the early days. What I didn’t expect was to be sick before and after delivery, to be recovering from a major abdominal surgery, or to have two slightly premature babies with immature lungs in the NICU on respiratory support. But, we rolled with the punches and moved forward.

After my c-section I was started on Magnesium for pre-eclampsia (my blood pressure was really high – 180/110 when they put me in the hospital – and I was losing protein in my urine) and had to stay in bed for monitoring, so I wasn’t allowed to go to the NICU and see my babies until they were over 12 hours old. All the Twitter peeps had told me to put the babies to the breast early and often so I could establish good feeding habits, but clearly that wasn’t an option for us. So, now what?

When the (amazing) L&D nurses finally wheeled me to the NICU the (equally amazing) neonatology team was rounding and asked if it was okay if we started feeding the babies. I can’t remember hardly anything about the first 24 hours after my surgery, Magnesium does weird things to your brain, but I do remember asking if we had any options other than formula. They told me we could use donor breast milk (um, freakin’ awesome that moms choose to donate their extra…THANK YOU) and we all agreed that our number one goal was getting some weight on these babies so I could take them home, so donor milk  it was.

At some point in that first day a LC came by and hooked me up to a breast pump. Holy weirdness, people. Those things are strange. She explained it to me and told me not to expect more than a few mL in the first days, especially with the babies away from me in NICU. She wanted me to pump every 2.5 hours around the clock for 20-30 minutes at a time in order to establish a good supply. Welcome to mommy-hood!

So, I diligently followed orders with the overwhelming love, support, and encouragement of my husband. I’m so thankful he was so helpful when I was sore, exhausted, and sad in those first few days.

They mixed what I pumped with the girls’ bottles of donated milk and 6 days later we were leaving the NICU…with no decent amount of milk in sight from me. I was sure I had a milk-dud situation on my hands.

The NICU gave us feeding guidelines and loaded us up with bottles of Neosure, so that when we got home they’d have something to eat.

Almost instantly as we got home my milk came in. Something about having the girls with me kicked my production into high gear and I was able to start pumping enough for them.

It was a rough road and I won’t discuss it all here, because it would be the longest post ever, but it involved  a month of exclusive pumping, a slow transition to nursing with a shield, a long process of weaning off shields, and finally mastering exclusive nursing in time for me to put away the pump a couple weeks before going back to work.

I’m now back at the hospital with 180+oz of milk in my freezer (oh, did I mention the massive oversupply once my milk finally came in?), pumping enough for them to eat while I’m away, and incredibly proud of my decision to breastfeed despite our obstacles.

Another thing I’ve gotten out of all of this – a very clear understanding of why exactly people choose not to nurse their babies. It’s freaking hard, people.

If you’re pregnant or have a new baby and have questions, shoot me an email. I’ve picked up some tips and tricks along the way and I feel like since I’ve made about 60 gallons of milk (yes, seriously) in the past 18 weeks I am somewhat of an emerging moo-cow extraordinaire.

Questions People Ask Twin Moms

From the moment you find out you’re having a baby people have questions – is it a boy or a girl, what are you naming it, how are you feeling? When they find out you’re having multiples, the questions increase exponentially by the number of babies gestating in your uterus. And, when those babies finally arrive and you take them out and about, people have even more questions!

As A Twin Mom, Always Be Prepared To Answer The Following Questions:

  • Are they twins?
    No, they’re triplets…oh my gosh, have you seen their brother?!
  • Are they identical?
  • They look the same. Are you sure they aren’t identical?
  • How do you know they aren’t identical?
    They have different blood types. And hair colors. And eye colors.
  • Are they “natural?”
    No, actually we made them from MSG and Red Dye #40 in our garage.
  • You had a c-section, right?
    Yes, because they tried their hardest to come out feet first…not because they are twins.
  • Are you getting any sleep?
    They’ve slept 10 hrs straight every night since the day we brought them home. Why? Do you think I look tired?
  • Are they your first?
    And second.
  • Will you have any more?
    I’m due in 8 months!
  • How do you tell them apart?
    I can’t really, each morning I just pick one to be Amelia and one to be Reese…surely it will balance out eventually.
  • Do twins run in your family? 
    They can’t even walk yet…but they’ll probably run some day.

In all honesty I don’t mind the questions – I’m so proud of these two that it makes me really happy other people are interested in them! Sometimes it does get old being able to predict every conversation I’ll have while I’m waiting in line at Baby Gap, but I’m so grateful to have healthy babies I could answer these simple questions all day long.

Speaking of Baby Gap, though – that place is the holy grail of adorable baby clothes. I wish I could get them to sponsor this blog – surely one of you has the connections to make that happen. MAKE THAT HAPPEN!

Any other twin moms out there get asked the same questions over and over? 

Medicine, Marriage, Family

I remember when I was considering applying to medical school being terrified that becoming a doctor meant I’d never be able to have a family. Every Google search led to horror stories about divorce, blogs berating physicians that chose to have children, and forums full of miserable doctors. I almost chose a different career path purely out of fear.

As I’ve mentioned before I strive to make this blog a balance of medicine and other things – particularly family. I want my blog to serve as a place for pre-meds and medical students with these worries to find a positive story.

I love blogging about medical training and education, but the goal of Mind On Medicine has always been to create a place to write what we might sit down and talk about over a cup of coffee…and I can guarantee right now there would be lots of talk about mothering multiples, being a working mom, breastfeeding twins, returning to work, sleeping in 2 hour chunks, etc.

So, in order to continue in my endeavor to have work-life balance on this blog, I’m going to be starting what we will oh-so-creatively refer to as “Twin Tuesday.” On Tuesdays I’ll share anecdotes about adorable babies (obviously), but I also hope to delve into some of the challenges and excitements of being a mother in medicine.

I hope if you stumbled on this blog and you’re worried about medicine and family life and marriage that you will stick around! It’s not easy, but it is possible…it’s an adventure that I’m so glad I have chosen to embark on. And, while I still have a ways to go, knowing what I know now I’d still choose to do it this way!

Also, if you’re considering throwing your dreams of medicine out the window because you think you have to choose one or the other, I hope you’ll email me first so we can chat. I’ve been in your shoes!

Introducing…The Elves

One month ago today I was 35 weeks pregnant and headed to the hospital for a non-stress test and ultrasound to check on “Baby A” due to concerns about restricted growth. At my appointment I was swollen like a balloon and had a blood pressure of 180/110 and “3+ protein” in my urine (in other words, I would have made a super easy USMLE question on classic presentation of pre-eclampsia).  I was sent straight to Labor & Delivery – no time to even go home and pack a bag (which my husband may or may not have so kindly asked me to do the weekend before)! My abdomen was somewhere along the lines of ginormous when I snapped my last “belly picture”…

We got all ready to welcome The Elves, who would arrive late in the evening of December 3, 2012 (by c-section because Baby A was trying her hardest to enter into this world feet first).

If you follow the blog you know we had opted out of knowing the babies’ sexes before the birth, so the delivery was all sorts of exciting!

SURPRISE! It’s a girl!

Baby A 

DOUBLE SURPRISE! It’s another girl!!

Baby B

They were 5 weeks early and having some trouble breathing, so they headed off to NICU after kisses and hugs from their dad and I. The next time I saw them, 12 hours after they were born (because I was busy enjoying the lovely side effects of magnesium sulfate – every horrible thing your patients say about that drug is true), they were hooked up to all kinds of wires and breathing with CPAP assistance.

They were rockstars, though and did awesome in NICU! After a few days they were able to reunited for the first time since birth.

And just 5 days later we were able to go home as a family of four (+ 3 crazy canines!). The girls each weighed about 4.5 lbs when we left the hospital – if putting a four and a half pound baby in a carseat isn’t terrifying, I don’t know what is!

Happy one month birthday, Elves – you bring an unexplainable joy to our life.