Preemies - Adjusted Age - SUCKS!

[Smurfette2]

Attention Moms: Do not follow my advice on formula/breastmilk cocktails for your preemies.

So I switched pediatrician's and had our first appt yesterday. Disasterous. The last doc kept trending my twin preemies as full termers and put them in the 5 percentiile. Agh. The new doc was even worst. :( She says a birth at 36w 4d is NOT full term - three days DOES make a difference and gave them an adjusted age of like 13 days old or something. *cries*

My girls were born 3/13 - their EDD is now 4/6 which makes them basically 2 weeks old. The only positive thing she said was that they appear to be catching up much faster than expected which means adjusted age shouldn't go beyond their first year. Then she moved on to their weight. They've lost between 7-9 oz since their last "4 wk" doc appt. She said to STOP feeding them formula and solely BF. She said the pacifier is killing their appetite. She said they should NOT be sleeping 6 hours at night and to wake them up every 90 minutes to 2 hours for feedings! Head and neck control is on target for chron. age, same with reaching for things like grabbing the bottle when daddy feeds or grabbing sis' shirt and rolling from side to side. She said the rolling was unusual for 2 week old babies *cries* and for me to watch to make sure they aren't actually hyper-extending (arching their backs - a sign of special needs). I definitely know the difference between hyper-extension and rolling over. I have quite a bit of work experience with special needs children but the whole feeding thing is an eye opener. She also said they need a quiet environment to grow in so no more roadtrips until they are 3 months (adjusted age)!! New doc totally ragged on my old doc and says the girls should've spent AT MINIMUM 3 weeks in the Nic until they put on at least a pound. She says independent feeding and breathing isn't the only criteria required for home release and going home three days after birth is child abuse. WTF?

New doc wants to see them back in a week to see if I've followed her instructions and says they should put on at least 4 oz in that time. She says moms of multiples with a background in medicine tend to be the most stubborn of parents because we think we know everything. BOO!!

So my bubble was popped and last night I dragged my deflated ego to their crib to wake them up for a feeding(s). I know it's for the best. I want them to be healthy. I can sleep later. Next year. Whatever.

Sorry for the 2nd thread - I felt expectant moms should pay close attention in case they deliver before 37 weeks.

[Smurfette2]

I swaddled Sophia all day and it seemed to help her settle down a bit. She used to hate being swaddled. I tell ya... there are no easy answers to this newborn thing.

[ShanaV]

Oh Mama, sounds stressful! 

I would probably take both dr's opinions with a grain of salt. Neither of them spend 24 hours a day with your babies like you do. No one knows your babies better than you. Just follow your instincts and meet your girls' needs and they will do fine. 

IME, if they sleep, let them sleep. I mean, you can try waking them up to feed them, but I don't know if it's necessary. I tried a few times to wake the second one up to feed him after the first one woke to feed (the typical advice to feed both at the same time to keep them on the same schedule), but if he was sleepy, he just wouldn't eat. I couldn't force it. So oh well, if one or both slept, I let them.

And the no trips / quiet environment thing sounds pretty anal to me. I mean, maybe no wild late night parties, but seriously, your babies can go outdoors. Again, you know what your babies can handle. If they're not happy, take them home, if they're happy, let them be out. What's the big deal?

The NICU advice is whack. We spent a long time in the NICU and the standard from all docs and nurses is they can go home when they can breathe, maintain heart rate and temperature, and eat on their own. That's it. Some NICU's will require a 5 lb minimum, but not all. Three weeks in the nicu for a 36 week baby is just silly. 

Keep up the swaddling. It really helps. :D

[nwatt]

My boys were born at 34 weeks 5 days on 3/2.  They did spend some time in the NICU and nursery, a total of 8 days, but had not gained a pound and not reached their birth weight before they were released.  The docs only wanted them to show a trend toward gaining weight while maintaining their temperatures. 

[~Adorkable~]

just because the new doc ragged on the old doc does not make the new one right, they may be but please dont get in the habit of believing it "just because" my twins were 36w0d and came home after 4 days and no nicu time, they were released as soon as we had feeding down and they were responding to that (one had just started gaining weight, the other had just stopped losing weight). 

ever baby is going to be different. 

depending on your twins weight and considering that they have lost weight again i would personally wake them to feed, but maybe only once, so like every 3 hours, 6 hours does seem like a long time for such little babies to go without food, but i would also respect that they really need sleep as well.

i think the new ped's use of term like child abuse and shock value terms like that are not helpful and show a personality that i would not tend to trust easily, she seems to see things pretty ridgedly and thing everyone else is wrong, not a very productive mindset. i would get that "grain of salt" out and use it regularly

[Smurfette2]

*sigh*

I just want them to gain weight and thrive. That's all. I rented a

baby scale from my medical supplier to keep better track of

their progress.

I agree that they're sleeping because they're tired so last night

I let them sleep 4 hours before waking them. They weren't too

interested in nursing so we just held them until it was time for

the next feeding.

Still kinda hung up on the adjusted age even though they make

efforts to reach and smile and coo. It's hard to ignore a ped with

years of experience and go with Mom's intuition.

Edited by Smurfette2 - 4/22/11 at 12:07pm

[ShanaV]

36 w 4 d is really, really good! Believe me, you are fortunate to have had them inside for so long!  I mean, they may only be a couple of weeks (at most) behind in "normal" development.  Compared to my experience, I wish I could have had those six weeks of my life back -- mine came out at 30 w 5 d and came home at 37 w.

Don't stress. Keep up the good work! ((hugs))

[OGirlieMama]

I am sorry your confidence has been so shaken. Please remember that no pediatrician has all the answers. You really have to feel it all out to realize what advice you're going to take and what you're going to let go. What most concerns me is her claim that releasing your babies from the NICU was abusive. Not just wrong, but *abuse*? That's some pretty harsh commentary for someone who was not present at their birth, did not see them in the NICU, and (I assume) is not trained in neonatalogy. If your babies were able to go home, that's the safest place for them, given the risk of infection every day in the NICU.

Go easy on yourself and on everything you have done. Your babies are here and doing well, and you are doing right by them. 

[Smurfette2]

Well Sophia and Grace both managed to gain 1/2 a pound a piece over the past week. My new doc wasn't even there today! She transferred to another medical group. Supposedly no one in the office knew. I don't care anymore. The doc we saw today is happy with their growth so I noted it on the chart and I'm over it. My girls are going to be fine.

These are totally the fun days. I played with them today and they smiled and laughed! OMG. I LOVE IT! We went to look at new cars because my 328i just isn't cutting it anymore. Thankfully it's a lease and the dealer says I can do a trade with no money down but I didn't see anything I liked. Our family needs more room, better gas mileage and possibly a lower car payment. End of story. Anyway they cooed and wiggled while the wind blew their mobiles around.

Being out in the sun I noticed subtle differences in my girls. Grace's hair used to be thick and straight. Her hair is thinner now and curly. Sophia has lost most of her peach fuzz and her hair is lighter than her sisters. I still have this nagging feeling that we re-named them incorrectly. I get this strong urge to call Sophia "Graciela." And when looking at Grace, I sometimes say "Sophia Mia" (my nickname for Sophia).

So typical of me to get my own kids mixed up. LOL.

[mylilmonkeys]

Good job on the weight gain!  Feels so good, doesn't it?  

My girls look nothing alike and I still call them by each other's names.  Course, I also have been calling my 2yo by her 11yo sister's name, too.  I think it's exhaustion and too much on my mind.

[ABO Mama]

My guys were born at 36w0d, and spent 12 days in the NICU (silly critters were slow eaters).  They also had very slow weight gain, and had a mix of bottles and breast (almost 100% bottle and formula in the NICU to almost 100% breast by 3mo).  Waking babies at night is something that is easy for a Dr to say, but not so easy for the peson who has to do the waking up!  I also found a lactation consultant who was helpful, and very supportive of breast feeding.

Now that my "babies" are 7yo, the 4 week age adjustment is a very distant memory :)

[Smurfette2]

^^^ Exactly. Docs don't realize adding another baby to the mix makes all the difference.

We've gotten into a pretty solid routine though. DH wakes up on cue and he'll bring the girls to me while I set up shop. He does the football hold scoop with both of them which is remarkable to me. I tried to scoop them and failed miserably. I wish I could say I'm a good mom with great stamina but no. Sometimes I fall asleep while the babies are nursing and I'll wake up and they're both asleep too. We try to return them to their beds - doesn't always happen. Mostly they sleep in their bassinets in our room. I ditched the co-sleeper because twisting and turning just wasn't working out. The Moses baskets are SO AWESOME, Sofigra (their combined nickname) loves being in them and it's the best when I'm working on the computer because they can lie at my feet and stare at me all day.

The time is flying by. I can't believe they're already going on 2 months. Hey how did you twin mommies go shopping with the kids? Did you take a stroller or use the infant carriers in the shopping cart? I need a better system. Right now I'm using their pram to shop and I just load the groceries in the pram basket but the take down is like a 10 minute process. I'd hate to do it in the rain or in an emergency.

Have a good day ladies! :)

[Llyra]

I don't put the infant carriers on the shopping carts. The carts can tip over-- a baby in the next town over fell, like that, when the mother was literally a foot away from the cart, reaching for something. Anyway, the poor babe was badly injured, and it put some mega fear in me about the carts. We always shopped with a double stroller-- I'd let DD1 walk alongside, and the twins rode in the stroller, and I'd bring along a front carrier in case DD1 needed to ride, or somebody was fussy. I could only buy what would fit in the cargo space under the stroller, and that was a PITA, but if I needed something big or to buy a lot, I'd send DH after work, or go myself when he was home.

[Smurfette2]

Originally Posted by Llyra 

I don't put the infant carriers on the shopping carts. The carts can tip over-- a baby in the next town over fell, like that, when the mother was literally a foot away from the cart, reaching for something. Anyway, the poor babe was badly injured, and it put some mega fear in me about the carts. We always shopped with a double stroller-- I'd let DD1 walk alongside, and the twins rode in the stroller, and I'd bring along a front carrier in case DD1 needed to ride, or somebody was fussy. I could only buy what would fit in the cargo space under the stroller, and that was a PITA, but if I needed something big or to buy a lot, I'd send DH after work, or go myself when he was home.

Girl, I have never, ever heard of a shopping cart tipping over with an infant seat on top of it. How big was the baby? And what kind of shopping cart? One of those dinky Trader Joe's baskets? That's scary.

Like I said, we're doing the stroller thing and I have to put our goods underneath which I'm sure has the security cameras all zooming in on me. But at the market, I've been offered help. I just wish I could zip in and out.  I really don't mind taking Sofigra in and out of their carseats. I'm pretty sure they get sick of sitting - I would. Our stroller is mostly a pram with individual carrycots so they can lie down at a slight angle and take in all the sights. I'm really enjoying my twins. I know it sounds silly because duh, of course right? But it's been 15 yrs since I last had a baby and I never expected to marry again, let alone have more children. I'd given up. So I'm pretty stoked.

Goodnight. :)

[hergrace]

Originally Posted by Smurfette2 

The time is flying by. I can't believe they're already going on 2 months. Hey how did you twin mommies go shopping with the kids? Did you take a stroller or use the infant carriers in the shopping cart? I need a better system. Right now I'm using their pram to shop and I just load the groceries in the pram basket but the take down is like a 10 minute process. I'd hate to do it in the rain or in an emergency.

I had two techniques for shopping with the kids in the early days.

1) Wearing the kids: one on my back and two in front.
2) Pushing the stroller and pulling the grocery cart.

[kjoy2]

Originally Posted by hergrace 

I had two techniques for shopping with the kids in the early days.

1) Wearing the kids: one on my back and two in front.
 

You are my hero.  Photo needed. Stat.  

I also wore my babes... but I only had two. 

[hergrace]

Originally Posted by kjoy2 

You are my hero.  Photo needed. Stat.  

I also wore my babes... but I only had two. 

Since I only ever wore all three of them when I was by myself, there are no pictures.

As soon as they were sitting by themselves, I moved to one in the cart and wearing two, which was much easier.

[kjoy2]

But, Kate, there had to be mirrors!  AHHHH!  :lol

[Smurfette2]

Hergrace - you have triplets?

[Rani]

Wow things have changed or Im not remembering the math.  My dd was born 4 weeks early. She is almost, gasp, 13 now. We knew her exact conception date because it took us most of 9 months to conceive.  No one ever said she was preemie or that she needed an adjusted due date....maybe Im confused...?