Category Archives: 1st Month

Big Discovery

Day: 32

Its a busy day! We took out the boys to see Nicole & John, Courtney and Matt, and Stephen L. & Steve R., who drove all the way to clear the barn in Norlina! We also made an appointment with Cindi Freeman, a lactation consultant for a home visit on Tuesday. We had a great time seeing the friends and family.

Big discovery with the breastfeeding today after I read the following post on KellyMom.com:

http://kellymom.com/babyconcerns/fussy-evening.html

After all, I may have enough milk for the boys! Usually when they get fussy, especially just before going to bed, right after a full nursing session, we would try to soothe them but break down to offer a bottle, when they guzzle down 4 or 5 oz, I thought I didn’t have enough milk for them. Well, from reading the article, this could be all wrong! The boys fit perfectly with the cluster feeding, their most fussy time is in the evening, and after that they go for a long period of time of sleep. So when a bottle is inserted into their mouth, they had no choice but to swallow (that explains why initially they always  have mouth full of milk), but that triggers the sucking reflex. So they become more fussy with a full stomach.

After reading about this, we decided not to give them bottles at all (other than the 2 oz my own expressed milk with the probiotic) today, and we did it without supplement! Later on, Dr. Gil called and said we could stop using the probiotic since its been a month and bottle feeding can diminish the milk supply. The evening feeding was tough, they would have the typical cluster feeding symptoms – after being on the breasts for an hour, they were happy for less than half an hour then they were rooting again, so the last feeding before bed lasted from 9:30 to almost midnight – longest ever and it was not very fun sitting for almost 3 hours, eating dinner, surfing, napping! However, they woke up around 4am, so we made it 🙂

This is really a change that brought a sense of accomplishment, the boys were much happier yesterday, especially we put them in the carrier or moby wrap during the day and that makes everyone’s life much easier. So I thought I would write down the important things we learned:

  • Knowledge is power, confidence is the key. I find Kellymom.com (recommended by Bonny) is extremely helpful as a site for anything related to breastfeeding). Understanding the problems boosts the confidence and makes the breastfeeding goals attainable.
  • Offer breasts on demand. Really the key is to offer breasts, rather than bottles whenever the kids want them so the milk production is encouraged and the body can adjust the volume according their demand. Easier said than done, I feel that’s what I do all day long, but I find having a feeding schedule is not a good idea, even if it’s 2 hours apart since during certain time of the day, the body may have to produce constantly and other times, it can have a break for 3 or 4 hours.
  • Use carriers and spend a lot of time with the baby. We find skin-to-skin, and motion really help with calming them down, the only time this doesn’t work is when they are hungry. And yes its true, when I think of the babies, or when they cry, my nipples start uncontrollably leaking.
  • Burp them really well and put them in upright position as much as possible. At first we didn’t know why they looked uncomfortable, but now we know – they need to get the bubbles out of them and it takes time. We do massage them and they are much happier after passing the stool.

I thought a clip of the baby being fussy will be fun to share, since most of the time it’s the perfect happy baby pictures and videos, just for a change 🙂

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Address the Milk Supply Issue

Day 30

The boys are a month old!!! And I am still working on building up the milk supply. Even though having enough milk seems almost impossible, the thought of giving up never crossed our mind. So far we tried brewer’s yeast, mother’s milk tea with Dr. Gil’s lactation formula, nursing every two hours, pumping between the feedings or after the feeding to empty the breasts. I am getting close I think but the boys seem not to get enough, and I would like to see more milk coming out!

Since we do have a deadline of August 22nd, we don’t have the luxury to continue to use donor’s milk (and it’s probably not a good idea since it may be the cause of the lack of the milk) in China, we will give it another week before we go with medication. Since I won’t need to pump too often, I purchased a Lansinoh manual pump (trigger-operated style) for just under $30, and surprisingly I like it better than the Ameda (hospital grade electric pump). This morning at 1:30, I tried it for the first time and got more than 5 oz out of it. It’s less painful and it’s mobile. It also can be used while nursing one baby, to save up the milk and probably extract more because of the easier let-down. So today no supplement yet (and it’s almost 7:30pm)!

Our paediatrician Dr. Young recommended using Domperidone, instead of Reglan because there’s a 50% chance of post-partum depression for using Reglan. However, Domperidone is not approved by FDA, we did some research online, it’s used to treat vomiting and it’s the side effect that increases milk supply by increasing the prolactin. The FDA opinion failed to indicate though, the potential risk of heart attack only happened when Domperidone is used via IV. However, for some women, milk still diminishes if stop using the medication. For others, a 7 to 10 day use of Domperidone will do the trick. Also there’s trace amount of medication goes into the infants, however, there’s no shown negative effects.

We decided before we try out the Domperidone on our next appointment on August 9th, we need to rule out any potential problem. Even though the possibility of retained placenta is very low, we decided to have an ultrasound just to rule out that possibility (thanks Sara for the suggestion). We called Dr. Deigan’s office, even though there’s no referral required according to the insurance company, they still need one. So we called in Triangle for a referral, Dr. V said he would see us right away, we went in yesterday and asked him for the referral, he refused it and said it would be an insurance fraud(???), he wanted to do a vag exam instead so Michael and I walked out of his office w/o having anything done – we are done with him at this point. The doctors treat you nice ONLY if you go along with what they want to do. Before our deliver, we asked for the fluid check, they refused it, during labor, we asked for the catheter because they forced me on IV fluids, they refused it, post-partum uterus scan (which is a covered service) again refused.

So Audrey wrote us a referral for a scan next Monday, we are hoping there’s no retained placenta since I don’t have time for a D&C at this point. But just in case, it needs to be taken care of for sure. So we will have a lactation consultant (since Li has tongue-tie and he seems to be more hungry after the feeding and drinks more from the bottle than his brother does) come early next week, then the ultrasound, if these potential causes are ruled out and I still don’t have abundant supply, we will try out Domperidone.

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Tough Night, New Strategy and Goodbye to Bonnie

Day 29

The night before last was tough, it was the first night that Lin wouldn’t go back to sleep after the 3am feeding, he cried and cried, and Michael ended up taking him to the living room, because Li was awake after hearing his brother scream. I vaguely remembered that I was laying on my side and breastfeeding Li then Lin early in the morning, when the sun came out,  we were both exhausted.

I seem to move around to find the best feeding nest – from my bed to mom’s bed, to couch, and finally the lay-z-boy seems to work the best. I love tandem feeding, for some reason, feeding the boys separately doesn’t work as well as feeding them in the same time, not just because it’s more time consuming, they are just more satisfied and content after some breast time. They sing together, making rhythmical noise, and they are both sweaty and tired after some good suckling work. It is the cutest thing when they gaze into each other’s eyes while drinking the milk.

So in the morning, we were trying to figure out what causes the recent fussy mornings, Lin’s been the harder one, and he spits up almost after each feeding (you have to understand for someone like me who doesn’t have enough milk it’s hard to watch him spit up the milk). Michael and Mom tried burping them more often, half way through the feeding, and it seemed to help greatly. By now, both boys have been put in the room for “time out” and we let them scream and cry since we just didn’t know what was wrong with them. However, now we realized it’s probably the discomfort from drinking all the milk and taking in the air in the same time that bothered them. After burping them frequently, they seem to be both soothed today and the house is much more quiet. It is probably true that babies all cry for a reason, the challenge is how we read their crying code.

Lin’s cord stump felt out yesterday, and apparently he has an “outie”, we are surprised it took that long for it to fall out. Audrey thinks the purple dye makes the process longer, it usually takes about 3~5 days for the cord to fall out for a home birthed baby. Also there’s research showing that using alcohol also delays the fall out – so we didn’t use any. I guess Li’s will be coming off soon as well.

Last night, Elissa came over and picked up Bonnie, the babies were crying for food (and I was leaking like crazy) so I went and fed the babies, when I came out, Bonnie was already gone! I will miss her dearly, she’s such a great cat, and she pretty much left the babies alone. However, giving her to Elissa is the best thing for her since she can play outside at her beautiful home and have 2 cats and a dog for companionship, and lovely owners who adore her. So I am glad that it worked out, and we are very grateful that Elissa offered to take her.

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Making Progress

Day 26

Thanks everyone for posting the comments on the previous blog – it has been so helpful to get advice and encouragement from the experienced moms – even moms with twins like Sarah and Callie (my tmott buddy)!

Well, I am happy to report that after trying Dr. Young’s advice – putting the babies on the breasts as much as possible, we are surprised that the babies actually seemed satisfied most of the time, yesterday we didn’t give them donor’s milk until 10:30am, Lin drank 4 oz and Li drank about 2 oz after the 10am feeding from the breasts. I stopped the bottle feeding when I noticed Li had a mouth full of milk coming out and then Lin spit up all over, and their belly felt so big and tight, they looked like they are having a hard time processing it. So we started to wonder if they just don’t know when to stop, even though they are full. I noticed in the middle of the night, Lin would still suck during the sleep, so yesterday we decided to try the pacifier for the first time to stop them from crying, knowing that they can’t be hungry and they have clean diaper. Li took it pretty well, Lin spit it out – he’s the fussy one, during the day, he would only sleep in Michael’s arm. Twice already, we had to leave him in the room, and let him scream and cry for 5 minutes to learn to soothe himself after we tried everything we could. Last night he did it again, once I picked him up, he’s quiet, so I think he just wants to be held all the time, so maybe you can spoil an infant – does that make sense?

I guess parenting is a learning process – each child is unique I can see the different personalities of the twins already. Surprisingly, the challenge we are facing is how to tell if they are full and how much they need to eat. Glad that we are making progress for sure – I feel the fullness of my breasts, and sometimes they leak like faucets, these are all good signs, today we will record how much wet  and dirty diaper they have to make sure they are getting enough milk from me. I have to agree that using the pump to determine my milk production may not be accurate at all, since it’s not the best way to get the milk out (I can still express good amount of milk after a dry pumping). And most importantly, instead of looking at breastfeeding as a chore, I start to feel comfortable with it (most of the time we tandem feed them, in the afternoon, I lay down and rest while feeding one at a time), after all, breast milk is  the best gift a mother can give to her child(ren). Another good thing is the 3am feeding only took 30 minutes instead of one hour – what a sense of accomplishment (and that is why I am still up writing the blog)!!! I am also taking my daily breastfeeding recipe – a mix of flax seed oil, PaleoMeal protein powder, chia seeds and 2 tablespoons of brewer’s yeast – add it to soups and stews throughout the day, maybe that helped as well.

We are still planning on hiring a lactation consultant for a home visit. We called the insurance company, for medical reason, it may be covered. Insurance also covers a pump up to $3,500 if it is medically necessary. However, Dr. Young said it really needs to be a life and death situation, she has never been successful getting her patient a pump that’s paid by the insurance company, anyway, it was too good to be true, we thought for the insurance company to do that.

The boys do have a routine now, they go to bed between 10:30 to 11pm, wake up for feeding between 2:30 to 3am, then wake up again between 5:30 to 6am, after breakfast, we take them out for a 15-minute walk in the Ergo carrier (they totally love the walk, and are always quiet being in a fetal position and in motion even though they are so sweaty when we take them out, see Li being so comfortable after the walk in the picture), then the morning is when they are most active and want to be fed non-stop, in the afternoon, they quiet down a bit, and sleep some (Lin has been up in the past few days all day though), then become more sleepy when the evening comes.

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Breastfeeding, Breastfeeding, Breastfeeding

As committed as we are, breastfeeding is so much harder than I expected. My milk didn’t come in until day seven, and it was the transitional milk (colostrum mixed with some milk), the color of the milk has changed over the past three weeks, it’s still not completely white but I am making progress everyday, this morning I pumped 5 oz at 5:30, the most ever! However, with the growing appetite the boys have, it just seems impossible to catch up. They are consuming between 16 and 24oz a day for donor’s milk, and we are learning and trying different strategies to see what works the best.

We called Dr. Young, our paediatrician today to get her advice on how to increase the milk supply, her opinion was pumping isn’t as efficient as letting the boys suckle for the purpose of building up milk supply. So we will put them at the breast more. Lin was actually satisfied this afternoon after staying on for about an hour – yes an hour, that’s why it’s so tough, because there’s no break in between the feedings. They are definitely more content and soothed breastfed rather than getting the milk from the bottles. They also have their rhythm of suckling, swallowing, and breathing, I noticed they make some interesting sound as well during the feeding, sometimes they even hold their hands, most of the time, they present mirror images with their fists right next to their faces – so adorable!

So I am eating a lot of oatmeal, drinking plenty of water, and we will try out the brewer’s yeast, and six packs of Mother’s Milk tea with Dr. Gil’s lactation formula. Some day, maybe I will have plenty of milk and I will have to freeze it 🙂

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Lin and Li’s heart beat

A few days before labor started, to make sure that we can closely monitor the status of the babies due to the water leaking problem, we borrowed the heart rate monitor from Nicole and John, and Michael was able to record the heart beat, thought that’s pretty cool, these audio files were recorded at 5:30pm, June 29th, 3 days before they left their home of the womb.

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The First Three Weeks

The twins are three weeks old! And it’s so hard to believe!!! It’s been a very stressful three weeks, many challenges to deal with, many tiring hours, but the boys are approaching 9 lbs and are making amazing changes everyday. Just as I am writing this blog, Michael is bouncing Li on the birth ball, and Li made his first laugh (not just smiling, both of them started smiling at the end of the first week), and he was laughing out so loud, very cute indeed!

Michael and I were talking about how much we had prepared for the pregnancy and labor/delivery, and how little we educated ourselves on what to expect after their arrival. The main challenge we are facing is milk production. My milk didn’t come in until the end of the first week, and by now, it looks like it just went over the transitional stage, the color starts to turn white just a few days ago. The SNS system was so frustrating, and we tried everything to increase the milk, drinking Mother’s Milk tea with Dr. Gil’s lactation formula, eating a lot of oatmeal, nursing them frequently.

No one has told us that breastfeeding is a 24/7 around the clock job!!! And sure it’s not easy to actually breastfeed, even though most people just seem to be able to pick up their baby and they latch on. One difficulty for us, is to tell how much they need to eat. The first night home was a nightmare, we thought they only take about 15ml, so in the middle of the night, they were screaming on top of their lungs (and it was so stressfu), then their appetite increased drastically till now they drink about 50 oz or more, looks like I have enough for one baby since we are cutting down the donor’s milk to 16 oz now, but its such a strggule though, especially when I put them on the breasts, they would stay for an hour, then half an hour later, they get hungry again! Michael and I plan on hiring a lactation consultant to make a home visit, we think the babies may not be extracting milk efficiently, especially Li, with the tongue-tie.

Despite the challenge, babies are doing great. We are lucky that they are more fussy during the day than at night, they can sleep between 3~4 hours at night, so we usually get up between 2-3am, then 5:30-6am. We think the tight swaddling and rope wrapping worked, also the red light bulb with less stimulation might have helped also.  They are pooping and peeing all the time, and surprisingly their poop doesn’t smell that bad! By the end of the 3rd week, their faces definitely look much fuller than before. We co-sleep with them, and it’s good that they don’t wake each other up. However, as time goes, they are more needy, especially when they are hungry, they want the milk right away! We are still learning and trying to figure out why they cry – even though sometimes they seem to cry for no reason, we know they need something.

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