Sleep, Smiles, and Food!!

four to six months

4th month!!
Sleeping is getting soooo  much better. Neely is sleeping about 6 to sometimes 10hours! However, Avery bug is sleeping about 6 to 8hours. Big accomplishment this month we are sleeping in cribs! Sharing crib right now and getting a little wiggly, not sure how much longer we can share one crib. We started cereal and stage one veggies! Some days we really like the cereal and food, while other days we are over it and would just rather take a bottle. I am making the girls baby food which consists of zucchini, squash, sweet potato's, green beans, pears, apples, and bananas. I started making baby food for several reasons, 1) cost, although its not really expensive it does add up with two mouths, 2) nutrition, I am not normally "one of those" that buys only organic and bakes/cooks from scratch. But, a friend challenged me to look at the ingredients in some brands and I was a little mystified about some of the sneaky additions. Also, I could never make myself even try store bought food, to smell it was enough. When you make it yourself, you know exactly what is in it and don't mind trying it. 3) Its SOOO easy. I know it sounds like such a chore and now back at work, I still have time. I can make a weeks worth of food during one nap time. Just boil, blend, and freeze ( I found some silicone one ounce square freezer trays that worked perfectly).  Girls are now taking 4 to 6 ounces of breast milk. We are up to size 1 diapers and wearing 3 months clothes! Neely is weighing 11lbs, 2 oz and Avery is up to 10lbs 6oz.

 

4th month

5th Month
 We now have a "bedtime!" Girls are going to bed around 8pm and sleeping until 5 or 6am. It feels nice to have schedule! We are still Breastfeeding about once to twice a day and bottle feeding about 6ounces. Due to the significant decrease in my supply we are mixing half milk and half formula. We are using soy formula due to Avery's Milk protein intolerance. At first the girls were very resistant to the formula, but now they are starting to tolerate it better.  We are eating more and more fruits and vegetables and love baby Mum-mums. Neely is helping mom by holding her own bottle! It makes for much easier feeding time. Neely has followed Avery and is now rolling from back to front and her brace is off!! Yay! Girls are now sleeping in separate cribs because they are so very wiggly. They are never in the same place they are when we put them done at. We still have to get up every once or twice in a while and re-pacify the girls, but its getting less and less frequent.  Girls are laughing and smiling and its so fun to watch and play with all the new developments!  Neely is up to 6 months clothes and Avery is wearing 3 month. Both girls are wearing size 1 diapers, although they are getting a little snug! Neely is up to 12lbs 14.5oz,  Avery 11lbs 9oz

5th month

6th month!! We've made it half of a year!!
Sleeping from 8pm to about 6am on most days. They love all fruits and veggies that we give them, so far we do not have picky babies.  Both girls are taking 4 to 6 ounces of formula and breast milk. We have started to switch from soy formula to regular and Avery is tolerating it well.  Girls are up to size two diapers. Neely is in 6 month clothing and Avery is wearing 3-6 month. They are starting to take two distinctive naps. Rolling around from back to tummy and tummy to back. They are sitting up with the help of boppy pillows and love sitting and playing in bumbo seats! Starting to love the jumper and figuring out how to roll the rattle and play with all the pieces.  I feel like all of a sudden I can breathe and I feel like we can do this!Girls are interacting with us and each other and we are starting to get a routine down. Feeding is getting easier we are all sleeping better, things are looking up! Weights::  Neely 14lb 11oz,  Avery 12lbs, 10oz

 

These are our amazing 6 month pictures taken by JDuarte!!!

 

Sleepless, Spit-up, and Swings

Every month brings new challenges, joy, and new developments in our lives. Here is our month-to-month, sleeping, eating, and doings.


1st month
Girls eating every 2-3 hours, taking about 1 to 2 ounces of breast milk. Neely is our good eater and usually finishes first. Avery we have to work with. We have 30 min to feed the girls and it seems like toward the end of the evening it takes longer and longer to feed. After a couple of sleepless nights with the girls in one of the cribs in our room we have re located them to the pack and play in the living room. I got so much more sleep not waking up to their every little peep. Having issues with spit up which we are told is normal for our late preterm girls! Girls are wearing preemie clothes and starting to fit into newborn size. Still need preemie diapers. They are not big fans of tummy time and are starting to focus on objects and gaining more head control. One month weights: Avery 5lbs 5oz, Neely  5lbs 12oz

Tummy Time

 

Happy Valentines Day

  

 

2nd month
 We have made it to feeds every 4 and sometimes when we are really lucky 6 hours!! Girls are starting to breastfeed better and taking about 3oz when bottle feeding!Still seems like we have enless nights, but we still have them on the same schedule and feeding is getting easier, both girls are able to drink bottles faster, making it possible for us to get a little more sleep! Because reflux is so bad Neely and Avery are both on meds and sleeping better upright in their bouncers. Girls are both loving the swing (best invention ever!) and allowing mom to take a couple naps here and there. They are both fitting into newborn clothes and newborn diapers! They are starting to smile and follow objects with their eyes! It is amazing how fast they grow and change.    Two month weights: Avery 7lbs, 5.5oz, Neely 7lbs 12oz


Avery in her Moby Wrap (another great invention)
 Only way to get anything done with a sleepy baby that wont sleep.

 

2nd month

 

                            

Easter Pictures!!

3rd month
Girls are sleeping anywhere from 4 to 8 hours! Neely sleeps much longer than Avery and during the first two months if one woke up than we would get the other one up to keep them on the same schedule. I took a chance one night and didn't wake Neely up to see how long she would sleep. It turns out she slept through the entire feed and onto the next... 8hours!! Glorious! The next night lil sister Avery got the hint and slept through the night too! At this point I was just waking up once during the night to feed/pump! We still are breastfeeding and getting a little better at it, but not quite exclusively. Girls are up to 3 to 4 oz when bottle feeding!  They are still sleeping in swings and bouncers and needing medication for reflux. However we are starting to take naps during the day in their cribs! Avery started turning over from her stomach to back! Since Neely is in her brace it makes it extra hard to roll with that stinky thing. Girls have started watching Baby Einstein and love it!! Avery weighs 9lbs 3oz and Neely is up to 10lbs

3rd month

 

The perils of breastfeeding twins...

As a nurse who is well educated in helping patients breastfeed and understands the benefits of breastfeeding, you would think that I would have had it down pat. However, that was not the case. I felt like I knew nothing. During our hospital stay I had two wonderful lacation consultants (LC) to assist me in all the wonderful things that accompany breastfeeding. The latches, nursing pads, bras, pumping equipment, pumping rules, nursing pillow... and the list goes on and on.

 Because the girls were small and not very vigorous at breastfeeding I would let them nurse for as long as they could and then pump and give them a  bottle. When we got home this continued, however, after about a week they were still having problems latching. I was still pumping around the clock and producing more than enough and already had some saved in the freezer. I called our LC and they were able to get me an appointment to work with us. Thank goodness our insurance paid for it! Of course when we got there both girls latched right on and breastfed perfectly. Well, we got home and just like before the girls were having problems latching. I called the LC again and this time spoke with another LC who told be to come back so that we could use nipple Shields. The shield is small and flexible and fits over your nipple to extend to reach the top portion of the babies hard palate (roof of your mouth). This helps to stimulate the baby to suck. At the end of the shield are holes to allow milk to pass into the babies mouth. They are very easy to use and really helped the girls to breastfeed.

 We used these for about a month and the girls did pretty descent with them. They still needed additional feeding through a bottle, so I was still pumping a good amount of time. In the morning Jake would be up doing treatments before work and would do a feeding for me so I could get a little sleep. I would wake up and pump and get anything from 10oz to 16oz. However, throughout the day and by the end of the evening it would taper off to about 4 to 6oz (which is completely normal, I freaked out at first thinking that my milk was drying up, but it was not, this is why its good to pump after the morning feed, b/c you have more milk). After about of month of using the nipple shield I started to take it off because Neely was starting the leak all the breast milk underneath the shield and was pulling it off. At this time I was breastfeeding them about 3 times a day and bottle feeding/pumping the other times. Although we had made leaps and bounds with breastfeeding, it still was not enough and we would use what I had pumped to give them a little more ( SIDE NOTE: there is a lot of people that said by just putting them on the breast for as long as they want as often as they want would fix this problem, but for our circumstance it was not possible. I tried this one day and literally continuously breastfed them for 4 hours straight, started with both on, then Avery was done after 25 min, Neely was still on and hungry, switched her sides and then after about another 20 min Avery was rooting around, so then I put her on, in which time Neely was done... this went on back and forth, on and off for 4 hours. At this point I was physically exhausted, had no time to eat drink, go to the bathroom or nap at all. I gave them both a little bottle and they were finally satisfied.)

One bad thing about the nipple shields is that the awful sore nipples come back after not using the shield. So I would alternate to alleviate some of the pain and finally breastfeed them with no shield. At about 3 months I was still getting a significant amount of milk and able to store bag full. However, that all changed when I went back to work (the girls were 3 months). There was not enough time some days to pump as much as I needed to and slowly by 5-6 months I was getting little to nothing out and the girls were exclusively bottle feeding what I had stored up.  Thank goodness I had a lot in the freezer and were able to spread it out until the girls were 8 months old.



** I used the breastfriend, twin pillow and loved it. It allowed you to strap the pillow around you and place both babies in the football hold a the same time. At first the girls were so small that we would have to use little blankets to roll up and place under their heads to get them closer to me, but as they grew it got easier. I also used the ameda pump, I chose this one over the medela because it was a lot smaller and I could control the speed and suction at the times that I wanted it. It was small enough to put in the diaper bag or my work bag (so I did not have to carry two bags).




Daddy using the twin pillow for snuggle time in the NICU

Girls snuggling on the pillow after feeding.

Avery & ASD

 In a follow up weight check for Avery, Dr. Wallace listened to her and heard a murmur consistent with a septal defect. This meant that there was a hole somewhere between the cambers of the heart. The chambers keep oxygenated blood and deoxygenated blood separate, if they are mixing than the baby does not get enough oxygen to organs and tissue.

We had just been through Neely's hip issue and now this. Geez. She did a pre Ducatal and post Ducatal oxygen saturation check to make sure it was not causing her respiratory distress. Her saturation was normal and she wanted us to follow up with a cardiologist as soon as possible. They were able to fit us in the next day. We we scheduled to do a EKG to look a the electrical conduction of the heart to make sure there was no arrhythmia's and an echo cardiogram to look at the structure and blood flow of the heart. Thank God, we were scheduled with the perfect doctor for us. Dr Case attends all the echo cardiograms to explain what they are seeing as they conduct the study.

Avery getting her EKG done

The Lord was showing us his grace that day because even though Avery did have a moderate sized hole between the atria of her heart (called ASD, atrial septal defect), Dr Case explained to us that although an abnormal finding, this was not going to cause her any problems in the future and would hopefully close on its own. We went back for a follow up at six months and it had not closed. But Dr. Case did not think any intervention was necessary. We will go back when Avery is 18 months old to see if it has corrected itself.

Sacral Dimple

 Also during our NICU stay we learned that Neely (poor little bear!) had a sacral dimple that would need a ultrasound to confirm that the dimple was closed and the spinal cord was not teathered.  A dimple, which is located below the tailbone, could indicated that the spinal cord never formed correctly and is tethered.

 No one ever said the word "spinal bifita" and it never occurred to me at the time that this  was what they were worried about. On our last day the nurse practioner looked at it and thought that it was closed and didn't think that an ultrasound was needed. However, when our pedi looked at it she could not say for sure that it was closed and wanted us to get an ultrasound just to make sure. A week later, after what seemed like 3 million appointments, we took  Neely to Cooks for a spinal ultrasound. The ultra sound was quick, easy and over in 5 min ( took me longer to get the the girls in the building). We waited anxiously for the results the following day. Our sweet pedi knew how worried we were and called us at 6:30pm on a Friday night to report that the sono showed no thering. Woohoo! Another crisis averted.

Pavlik= :(

Neely, formally baby A, was breech upon arrival.  I was told when we were in the nicu that due to her presentation that we would need a hip ultrasound to check for congenital hip dysphasia. Apparently this is found in infants who are breech, because they are unable to tuck themselves into head down position, not allowing the hips to flex and the head of the femer fit in snugly with the hip socket. Without the head fitting snugly the socket it does not form the way it needs to be. This creates a shallow socket where the hip can dislocate easily. Below is a picture of this.

  We got the sonos done and since I never heard back front the clinic I thought we were in the all clear. Wrong. When I went for the girls 2month appointment I asked our pedi about them. When the results were send over it showed that her right hip was shallow and could potentially cause her hip to dislocate from her joint when she got old enough to walk. We were sent to an orthopedic doctor how looked at the scan and then decided that she needed to wear a brace to correct the problem. Enter pavloc brace. The contraption looked simple enough, but after putting it on her and explaining that we had to leave it on 24hours a day for 3 months I started crying. I had never heard of this or see a baby in this and the thought of my poor child being stuck in this contraption for three months made my heart break.

After about a week we got used to it. However Neely didn't seem to mind it all. You could tell at first that she would get frustrated because she could stretch out her legs, but that only lasted a day. Mom and Dad finally adjusted too! Diaper changing and bathing got much much easier. We learned to bathe her with a wash rag around the brace. Thank goodness it was summer so that we could dress her in onezies, rompers, and dresses they all worked really well over the brace. We also got her some stinking cute leg warmers!

After the first month we went back to make adjustments and we were told that she could have it off one whole hour a day!! We were elated! Neels got to take good baths (which she loved!) and we were able to wash that stinky brace, finally! The bad part about this was, now everyone could see the brace so we got lots of "whats wrong with her?" and "what's that?" You would think that with all the inconsiderate comments that I got throughout my pregnancy that I would be used to this type of questioning, but I was not! Fortunately for the Neel Bear she was none the wiser!

Three weeks later we went back and another sono which revealed that her socket was improving, but not completely formed. We were able to take it off for about 4-6 hours a day.

She loved her brace-free time! She loved rubbing her feet together, since she was unable to in the brace. While out of her brace we worked with her on rolling over, since sister had already accomplished this. After a couple of weeks she caught up to sister and loved rolling around on the floor. 

July 10th, at 6 months our Bear had an X ray to see if there was any improvement (could not do sonos anymore due to her age).  Dr. Messer came back with great news! NO MORE BRACE!! YAY! Right hip was no longer shallow! Woo hoo!

Update: Had our one year appointment with Dr. Messer last week and repeated XRAY. Everything looked great! No more ortho appointments!












http://www.hipdysplasia.org/developmental-dysplasia-of-the-hip/child-treatment-methods/pavlik-harness/

Late preterm

Late preterm. Ugh. Lets start  with that.  U.g.h. At 34.5 we found ourselves in this special category of preterm. We were not necessarily micro premie (24 to 33 weeks), however, we were far from term. As a labor and delivery nurse when I have previously delivered infants at this gestation I always thought they would stay in the nicu a couple of days/weeks and go home "normal. " I was sorely mistaken. Late preterm infants, our special category, come with a wide assortments of problems. Although closeish to the magical 40 week mark we still fell short. 

This special category came with lots of appointments, follow ups, and protection from germs with quarantine proportions. The girls had bi weekly weight checks not only because they were so small, but they needed to make sure they were not working too hard, burning off calories, while they ate. We had strict instructions to only allow them to eat for 30 mins. If they took longer to eat, than they were burning off more than they were taking in. This meant that we had special "techniques" to get them to eat and burp and pray that they had taken enough and would not spit it all back up.  That hurdle did not compare to the poor breastfeeding and GI problems . We had several phone calls and visits to the lactation consultant. Hours and hours and hours and hours (you get the picture) of pumping. Trips to a pulmonolgist for synergis shots because the girls were at risk for rsv because it could be life threatening since they had immature immune systems.  Some of the appointment I had help. Others I did not. Loading, unloading, carrier#1, carrier # 2, stupid huge stroller and praying  I remembered everything x2.  Finally about 3 months of age it starting turning around.