Wednesday, October 12, 2011

Twin Logistics

Okay, here's what you've all been dying to know: what does a typical day with newborn twins look like? What do you have to do with them all day? How is it different than having one baby?

Well, to answer the last question first, it is not all that different than having one baby. It is more work, and sometimes there are logistical difficulties, but mostly, it's just feeding two babies instead of one. It gets really difficult when Sammy is around - especially if there is only one adult in the house. I try to avoid that situation as much as possible. Two days a week, I am alone with Leo and Zoe and Sam in the morning. If the babies wake up at different times and Sam is helpful about getting ready for school on her own, everything is fine. But when both babies wake up and want to eat at the same time, it gets dicey. That happened this morning. Luckily, Sammy has really stepped up to the plate, getting herself dressed quickly and not throwing any fits. More about how I handle that later.

Zoe and Leo are still on a three-hour feeding cycle, which is how they came home from the NICU. The doctors have told us to keep this schedule until they are at least two months old (they are seven weeks now), except at night, when they say we can allow them to go four or five hours between feedings. The doctors want the babies fed aggressively until they catch up to their peers - meaning when they make it on to the growth chart. Preemies do gain weight faster than full-term babies, and they do catch up, but it takes a while. I used to set my alarm at night and we'd wake them up if they slept too long, but I've stopped doing that. According to the doctors, both Zoe and Leo are eating well and gaining weight extremely well, so I don't see why we shouldn't allow them to sleep if that's what they need. We need it, too. Most of the time, they go four or five hours between feedings at night anyway, but Leo has gone as long as six and a half. And sometimes they only go three, just like during the day. Those are the tough nights. But that's no different than any single newborn, really, except that we can't take turns - both of us are involved in every feeding.

Generally, we've tried to keep both babies on the same schedule, meaning that if they don't both wake up at the same time, we'll wake up the sleeper so we can feed them both at once. Every mother of twins I've spoken to (except one) and every book I've read and every web site I've browsed has told me to do it this way. In fact, keeping both babies on the same schedule was the number one piece of advice. I'm not sure why. It works for us most of the time, but mostly because we are feeding them both breastmilk and formula. Because they are preemies, the doctors told us that they both must have at least two bottles of high-calorie formula per day, so exclusive breastfeeding is out. (I wouldn't have been able to do that anyway.) So, when there are two adults in the house, I nurse one baby and the other baby gets a bottle from the other adult. At the next feeding, we switch. If both babies are on the same schedule, this works out very nicely. If they are staggered it gets confusing because I might have to nurse one and then nurse the other almost immediately, which doesn't work. So I'll skip nursing that one and then go too long without nursing and my milk supply suffers.

But when only one person is home, you want them staggered so you don't have to try to feed both at once. I suppose some parents find ways to feed two babies at once on a regular basis and enjoy the time-savings, but to me, it's more trouble than it is worth. I haven't even tried to nurse two at once, and I don't intend to. The way that Leo squirms, it would be impossible anyway.

But sometimes I have to deal with both at once. Sometimes they both wake up to eat at the same time and I'm the only one home. I've tried a number of things to deal with this. Sometimes, I just let one cry until the other one is finished. That has to mean that Zoe is first to eat though, since Leo needs to be held upright for a long time after he eats and she'd be crying for an hour if she were second. So if Leo is screaming louder and I don't want to make him wait, I'll try to feed them both at once. I've done this by setting one up in a car seat on a coffee table in front of me, or on a chair next to me, and holding the other. I'll nurse the one I'm holding and bottle-feed the one in the car seat. This works, but they never get quite a full feed, and I don't like not being able to quickly burp the one in the car seat. I wouldn't do this on a regular basis, not matter how efficient it is. I did it this morning, nursing Zoe and giving Leo a bottle. While I was doing it, the babysitter arrived to take Sammy to school and I gave her my keys and instructions for the day and said goodbye to Sammy and made sure she took her lunch and her umbrella. I felt like twin-supermommy!

I'm not sure how much longer the breastfeeding will last. My supply isn't that great so a lot of time I'm nursing and giving a bottle to "top them off." Then I have all the downsides of nursing, plus all the extra dirty bottles to clean. Leo has become a pain to breastfeed because he keeps popping off and squirming. He does the same thing with a bottle, but at least he's not scratching and biting me in sensitive places that way. But I'll probably continue, at least with Zoe, mostly because it's still easier to nurse in the middle of the night, and because it does save money. The bonding was great, but I think I'm over that. I've bonded with both of them now, and they are starting to interact with us a bit more in other ways, so it's not as big of a deal. Once they are both bottle-feeding and more mature, one person might be able to feed them both at the same time more easily, especially when they can hold their own bottles.

Another thing we do is keep a log of all of their feeds and diapers. This is standard fare for twins also. I thought it would be a pain and maybe not worth the hassle, but it is so necessary. I can't tell you how many conversations we've had like this:
Adam: Did you do Leo or Zoe last time?
Amy: I can't remember. Don't you remember?
Adam: Well, I know Leo pooped earlier and I changed it, but was that the last feed?
Amy: I don't know. I think I fed Zoe last time. Right?
Adam: I don't know. Oh, wait, I remember - I fed Zoe last time because I remember giving her her vitamins.
Amy: Oh yeah, that's right. And I gave Leo his Zantac. But wait. Oh no, that's right.
Adam: So that means that I feed Leo now, right?
Amy: Wait, now I'm confused. Who did you say you fed last time?
Adam: I don't remember what I just said.
Amy: Me either.
Adam: Let's go look at the log.

I'm not exaggerating. We have witnesses.

Having a video monitor has been super-helpful. We still can't always recognize which one is crying. And it does matter. We ignore Leo's crying much more than we ignore Zoe's. Much of the time, there is nothing we can do to help Leo, but if Zoe is crying before feeding time, it probably means her diaper is leaking or she is lying in a pool of spit up or she has a poopy diaper. Those are things we can fix.

Another challenge with twins is keeping up with the supplies. We go through diapers and wipes at an insane rate. And then, preemies grow so fast! We were short on preemie sized diapers so I ordered another case from Amazon, but then a few days later, they had grown out of that size and we ended up with hundreds of unused tiny diapers. (We'll donate them to the NICU.) Both Leo and Zoe grew quickly out of their preemies-sized clothing, too, and are now growing out of the newborn stuff and moving on to "0-3 month" size. For a while, I was rearranging their drawers every week. We used less than one case of newborn sized diapers as well - they were only in that size for a couple of weeks. Thank goodness for Amazon. I can get anything within two days without leaving my home.

It can also be difficult to keep track of whose stuff is whose. Pacifiers, clothing, half-used burp cloths, bulb syringes, syringes for medications, etc. We have to have a system for everything. Luckily, I enjoy system-building! I've got the whole house set up pretty well right now.

I was really worried about bathing twins because I had it in my head that I'd have to bathe both at once. Of course you don't bathe both at once - at least not when they are newborns! The NICU gave us a little tub that we used a few times, but they grew out of it and then I tried using a little chair in the sink. But that doesn't submerge them in the water and they hate it, so I use it to soap them up, then throw in on the floor and dunk them in the sink to rinse them. They love that. I hate using the kitchen sink, though. I never feel like it is really clean. I just bought an inflatable tub that goes in the regular tub to see how that works. I probably bathe each one about once or twice a week.

Of course, we have to trim their fingernails. No difference there between twins and a single baby - just double the work. Neither one has enough hair to brush, but Zoe has developed a bad case of baby acne and we have to wipe her face after each feed.

Laundry is pretty crazy. I didn't do any laundry until recently because Adam and my parents and our babysitter did it all. Only now am I starting to take over that task. I'd guess we're doing about a dozen loads a week. It's not just the baby clothes and blankets and burp cloths - it's also the 2-3 shirts a day that Adam and I each go through because of the spit up, and the extra outfit Sam wears each day since she has to change her clothes when she comes home from school (germs, you know, since they are preemies and we have to be super-careful about them not getting sick). It helps that we have lots and lots of swaddle blankets and wash cloths (which we use as burp cloths). It's worth the investment to ensure that you can go three days without running out. I'd guess that we have about 50 burp cloths to cover that, and about a dozen blankets.

Speaking of swaddling, we're not doing that this time around, whereas it was a mission-critical skill with Sammy. Leo sleeps in his car seat because of his reflux so can't be swaddled, and Zoe doesn't need to be swaddled to be happy. We keep Leo's car seat in the crib to keep it off the floor, and we only have the one crib, so Zoe sleeps next to a giant car seat, and they can't even see each other. That bums me out, but it's the best method we've found so far. I just discovered that Leo loves to be rocked in the car seat so I'm going to buy a swing and see if he can sleep in that. But our dream of having them sleep together as babies probably isn't going to happen.

Another key with twins: have a place to safely stow a baby in every room of the house. (I call these devices, "baby jails," since they are basically ways to keep the baby from getting out.) You never know when you'll need to put one down and deal with the other. We have a couple of bouncy seats but the babies are really still too small to enjoy them. But we do have a super Ikea changing table in the living room which is like a hammock and can be used for naps. And the extra car seat is usually available. We have the Pack 'n Play set up in our bedroom. They're still little enough to safely leave on our bed or on the floor on a blanket without supervision. This will get more challenging later, so we'll need more baby jails like swings and exersaucers and such.

So what is a typical day like for me? After a night of about 5-6 hours sleep (broken up into two chunks), I'll wake up, feed two babies, and get Sam ready for school. Then I'll have about an hour before the next feeding so I'll try to feed myself and drink as much coffee as possible. (I've stopped worrying about caffeine in the breastmilk. They'll live.) Then I feed two babies again and shower in my time off. There might be time for a quick nap here, or possibly some work on my computer like paying bills or writing a blog post. If I'm on top of things, I'll unload the dishwasher and reload it with the previous night's bottles and maybe start a load of laundry. Then I feed two babies again and then eat "lunch." By around 2pm, I'm usually dressed and fed and ready to go out somewhere if necessary. (I've made a point of showering and getting dressed most days and even though it takes until the afternoon, it's worth it.) Adam gets home from teaching somewhere in here on the days that he teaches. (When he doesn't teach, he usually tries to work from home but will feed the second baby and help with laundry and dishes and everything else.) Someone picks up Sam from school. Sometimes that is me. Some days the babysitter comes around this time and entertains Sam and helps with the late-afternoon feeding. Babysitter or not, if any errands need to be run, someone tries to dart out between feedings. Some days I take Sammy with me to the pharmacy or the post office and call it quality time with her. (And really, we do enjoy that.) If I'm totally exhausted, I might take a nap in here. Otherwise, I'm shopping online or opening Amazon boxes or Putting Stuff Away. I can't tell you how much time I spend Putting Stuff Away. If I go one day without Putting Stuff Away, the house becomes completely disorganized and that's when I start to lose my mind. That brings us to around 6pm. Because we've had so much help with meals, I haven't yet gotten into a rhythm of making dinner, so there might be a scramble here for food, or I might prepare something. But we almost always still sit down at the table - Sammy, Adam, and I - and eat together. Then we have to immediately try to figure out how bedtime for Sam will work, because a feeding inevitably overlaps with that long process. (We really need to get Sam's bedtime down to a reasonable time instead of the hour-long process that it is now.) I wish I were more organized at the end of the day, but we don't keep the twins on a rigid schedule, so we never know exactly how the timing will go. The free time after this feeding is usually reserved for dishes, making Sammy's lunch, more Putting Stuff Away, other chores, and maybe a little bit of TV. Then there is another feed around 11pm which ends around midnight, and the adults go to sleep. Usually, we only have one true middle of the night feeding to deal with after that.

That makes seven feedings a day. Each one takes about an hour per baby, if you include changing their diapers, burping them, bathing them, soothing them, and doing whatever else needs to be done with them. That makes 14 hours per day of hands-on baby duties. (They sleep the rest of the time.) Most days, I only do a little more than half that. Maybe nine or ten hours, tops - sometimes only seven. The rest is handled by Adam or the babysitter. There really isn't that much other work related directly to the babies (laundry and dishes and opening Amazon boxes, mainly), and Adam has been helping so much that it's not overwhelming. (My parents also did a lot of that work while they were here.) And since I've been using Amazon for supplies, Peapod for groceries, and using every short-cut I can think of for meals (frozen food, pre-prepared food from the grocery store, pizza deliveries, ready-to-heat meal services, take-out, and mostly, lots of help from friends and neighbors), I've had enough time to do things like write blog posts, take Sammy to her gym, take Sammy to her dance lessons, attend a picnic, take Sammy to the playground, etc. On top of that, because of technology, I've spent most of the time while feeding babies reading books on my Kindle or checking Facebook or e-mail on my Droid. That time is relaxing and enjoyable. I don't feel harried or overworked most of the time. The worst part is just the repetitiveness of it all - and the feeling that there is no way out of this routine for many, many months to come. And that is no different than it was with one baby. Oh, I take it back - that is the second-worst thing. The worst thing is listening to your baby cry and not being able to do anything about it. Thank goodness Zoe is so mellow and happy so it's only Leo who is crying. If both were crying as much as he is, I'd probably be a wreck.

The biggest difference between my first experience with an infant and this one is not that I have two babies. It is that I have perspective. I know that this time will end. Of course, I knew that last time, but it wasn't real to me. I had no idea how much easier it would get, and how different things would be in a year. I feared that I had given up all my other values forever, for my sweet baby Sam. And that was scary. This time, I know that this period is an investment. And since it doesn't feel permanent, I'm able to enjoy my two new sweet babies, Leo and Zoe, so much more. Some days are torture, and some are just filled with drudgery, but most of the time, I'm enjoying myself. No one is more surprised about that than I am!

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