Quadruplets!

[anjsmama]

Not me! Woo, I'm drowning with just my 35 mo and 6 mo...

A close family member to me has been struggling to conceive over the last three years, and her dh is 40 so they've been praying for sooner than later... They were ecstatic to find out they were pregnant and doc said twins! But a week later he heard a third heartbeat, and saw a fourth sac, and now at 8 weeks they have seen and heard heartbeats for quadruplets. And now, panic among the family is widespread.

Experienced multiple mamas, what would be your biggest advice for pregnancy and making it through the early months? I want to offer help to them in any form I can but yikes! 4 little ones scares even me... Any advice for our whole family ( books, gear, personnel, techniques, anything!) would be greatly appreciated!

[~Adorkable~]

right now i think she just needs to focus on her health and that of her babies and understand she has a lot of hard choices to make in the next handful of months. Not the least of which is that the subject of a selective reduction, for the sake of the remaining fetuses is sure to come up. And if she chooses to go forward with all four that nature may choose otherwise. So i would say just be there for her and let her know its ok to be scared and happy at the same time, its ok to be torn and flip flop your emotions and thoughts.

hopefully she will find her path smoothly and have great care to guide her, the more educated she is the better she can make sure that her doctors really do have her best interests in mind. she is going to need a very smart and very confident team of  MFM (maternal fetal medicine?) specialists

one day at a time

[lesliesara63]

Everything that Adorkable said. She is probably overwhelmed right now so your positivity would be a great gift. She will hear lots of comments about how hard it will be, so if you can be encouraging that will be helpful. Her nutrition is key right now. High protein meals. Maybe if the family could start bringing meals even three times a week, it would help her to take care of all those babies. I had triplets and worked until 20w and could barely do any cooking or cleaning. It took a ton of effort just to eat well and pay attention to my other two children. I needed more sleep than in any other pregnancy. I could not have gotten through it without the help of my family and a few close friends. There are lots of us triplet MOMS out there and on each forum you can find one or two quad MOMS also. She can do this and it will be hard work, but it will also be wonderful. I look at my daughters everyday and wonder how did this happen and how could we imagine life without all three babies.

[anjsmama]

Thanks for the responses ladies! I know it has been awhile. A very happy update here.... She is technically "due" March 6 but the babies are coming tomorrow! She will be 33 weeks exactly. The doctors are really pleased with this length of pregnancy for quadruplets and all 4 babies are looking healthy as far as the U/S can tell and the smallest is more than 3 lbs. The biggest is almost 4 lbs (again according to U/S measurements, we will know for sure tomorrow)! 

I must say the family has stepped up and if ever parents and a family SEEMED prepared to welcome 4 babies, they do. 

Now - what can we do to help them during NICU parenting? Her doctors have mentioned it is typical for preemies to stay until the approximate time of their due date, so that will be several weeks for them.

Also adorkable, your kiddos are Jan '11 babies like my DD so I know you successfully breastfeed your twins , has anyone ever done it with triplets or more? This is her intention at this point, and I am a huge breastfeeding advocate and plan to support her as far as she wants to go,  but the back of my mind IS concerned about her ability to feed/pump/feed/pump/feed/pump 4 babies all day everyday! 

[Just1More]

Are you still nursing your your youngest?  How do you (and she) feel about you helping out by pumping, too?

When some friends in our neighborhood had twins (just after their first turned a year old), a bunch of us pitched in and got them a deep freezer, and quite a few people took over meals to fill it.  Not just whole meals, but stuff like premade muffins, cookie balls, etc.  Maybe doing that, and keeping it filled, will save her a lot of time (and a lot of visiting, etc).  I know that with just one newborn, it's a lot to keep things at the point of presentable enough to have people stopping by with food and wanting to chat, see the baby, etc.  Having a Saturday drop off, or whatever, keeps her from having to accept things daily.

Originally Posted by anjsmama 

 This is her intention at this point, and I am a huge breastfeeding advocate and plan to support her as far as she wants to go,  but the back of my mind IS concerned about her ability to feed/pump/feed/pump/feed/pump 4 babies all day everyday! 

[~Adorkable~]

i know of folks who feed there triplets 100% breast milk, from both bottle and breast combo, so who knows, I'm sure someone has better know how than me. what i will say is that even if it takes a long time to have every baby learn it happen many month is, i did not mine 100 on the breast till 6 months in! until that point i pumped a lot.

i would make sure she had a very good pump from day one, a hospital grade one was smoother on my nipples by far than my consumer grade from the very same company. and i would make sure that it is somebody else's full time job to clean and prep her pumping tools for her, it is a hassle and she is doing enough by hooking her self up to that stuff every day! for me having to wash everything was insult to injury, when my DH took over that duty, it really felt good.

there is nothing wrong with having to supplement if it comes to that, but i would make sure she has a realllllly supportive quality trained lactation consultant working with her that she likes and that all babies get regular exposer to as much of her milk as they can if for nothing else but helping them not get sick. (I'm so proud to say my twins have not gotten sick yet and 12 1/2 month and heading thru there 2nd winter, despite me having 3 colds including one now, they have never had anything but one single night of sniffles, antibodies rock!)

maybe look in to donated milk to help out too

and above and beyond the need for nourishment, i would encourage nursing just for love and comfort, she has a lot of babies to bond with, a few minutes each day to spend one on one cooing over each baby, noticing the lovely differences and little personalities will be cherished time for all of them, hopefully she will have the support team that will give her this time with each of them and the other ones taken away even for a few monuments, loved by other folks.

the LLLi book Mothering Multiples has great info in it for breastfeeding multiples, if she does not have it buy it ASAP, the more folks around her that read that the better

[~Adorkable~]

there is a NICU/Premmie parenting forum her on mothering.com, i would go to it and check in and get advice from those brave mommies

[anjsmama]

Such  a good point. I honestly don't know why I hadn't thought of that before. Sure would be easier to get milk from me than a random donor! 

This is a good point too, since I know people are dying to help, but sometimes "visit" style help can be overwhelming.

Originally Posted by Just1More 

Are you still nursing your your youngest?  How do you (and she) feel about you helping out by pumping, too?

When some friends in our neighborhood had twins (just after their first turned a year old), a bunch of us pitched in and got them a deep freezer, and quite a few people took over meals to fill it.  Not just whole meals, but stuff like premade muffins, cookie balls, etc.  Maybe doing that, and keeping it filled, will save her a lot of time (and a lot of visiting, etc).  I know that with just one newborn, it's a lot to keep things at the point of presentable enough to have people stopping by with food and wanting to chat, see the baby, etc.  Having a Saturday drop off, or whatever, keeps her from having to accept things daily.

[anjsmama]

Just an update, all is well! 

One boy, the biggest, 4 lb 10 oz and 3 little girls, the smallest 3 lb 2 oz. Docs estimating they were actually closer to 32 weeks than 33, but doing well and no complications thus far. 

[mylilmonkeys]

Congratulations to the family!  What a wild world it will be for them. :D

[Emaya]

I second Adorkable's suggestion of the LLL book, Mothering Multiples.

The the midwives at my hospital were amazed at how quickly I built up quantity after my c-section and I think the massage technique shown in this link was the key: http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

I've chosen to do about 50/50 breastmilk and formula, but I don't doubt that I could have built up supply to exclusively breastfeed. I don't know for four, though.

Sounds like your family member has a wonderful support in you! Good luck to her, multiples are wonderful.

[Spring Lily]

Wow, what great news! Glad to hear they're so healthy. Mine were preemies and about the same size. The NICU forum here helped.

Has your friend joined the local multiples group? There are twins groups that usually have some triplets and quads in them, and there are high order multiples groups, like MOST (Moms of Supertwins) for triplets+. http://www.mostonline.org/ Those kinds of groups are going to be the most help for them. I know my local club arranges meals to be delivered to a new MOM's house, matches you up with other people who have had preemies, and has a big loaner library of gear. She doesn't necessarily have to buy lots of gear, through a club she could use it for free as long as she needs! They also usually have yearly sales where you can get good deals on clothes etc. Anyway, I'd highly recommend looking into that, and if she doesn't have time, maybe you could do the research for her and present her with the options available in the area.

I also want to 2nd the idea of a hospital grade pump. Maybe (hopefully) her insurance will pay for it, but if not you can rent them privately. Also, if she doesn't respond well to the pump, she can swap it for another. I tried several and finally realized that the Medela Symphony was the best pump out there (for me). I had to rent it privately because my insurance co didn't offer that one, but it was worth every penny. It took us a couple of months to go from pumping only (supplementing with formula) to exclusive BFing, so if she knows that even a rough start doesn't mean the end of BFing, that will help. It's nice to have hope that things will get better. The LLL multiples book will help her, too.

I can say that one of the worst things about having preemies in the NICU was having to find time to come home and eat and sleep and pump. Anything you or friends could do to help her get easy meals for a few weeks so she can maximize her rest until the babies come home would be appreciated, I'm sure. Also, after a c-section they told me I couldn't drive for 2 weeks. DH went back to work so he could take his FMLA time when the babies were home, so I was often stranded at home, unable to visit the babies. Maybe talk to her about the logistics when she's ready, to see if she might need someone to drive her. Make sure she brings snacks and her pumping parts to the hospital so she can pump while she's visiting. When they first come home, if they have no health issues, they will likely be sleepy preemies for several weeks, so that is a good time for her to restock the meals in the freezer. I wish I'd taken more advantage of that time, but I was so overwhelmed. Having a plan will help!


ps Almost forgot--laundry!! That stuff piled up like no one's business. Is she cloth diapering? She may need 2 washing machines. With twin babies + a toddler I know we were averaging 2 loads per day. (We had a diaper service so we didn't have to wash our own cloth, thank goodness we were saved some loads each week!) Friends could help by either coming over to do laundry or stopping by to pick up laundry and then return it folded, and put it away. Folding and putting it away is always the hard part.

[anjsmama]

Wow thank you all, excellent suggestions!

She does have an excellent hospital grade pump... which I know, because my mom & I bought it for her. 

I'm definitely going to get Mothering Multiples and get a copy for her ... geze, is she going to have time to read, ever? 

The bit about driving her back and forth is a great point, I really should ask her. They are estimating 6 weeks for the two bigger babes and 7 weeks for the two smaller ones in the NICU, so I think her DH is also going to return to work so he can take the time off once they come home. 

She does have two washing machines, but I think she's probably going to need someone to run them! Especially since they're in the basement and I think stairs are supposed to be limited for awhile after c-section?

Adorkable, I love what you said about nursing for comfort and bonding. I think that message may really take some of the pressure off of her in a good way... even if she doesn't end up providing 100% breast milk, any breast milk makes a huge difference and any time spent nursing means a lot for the relationship between baby and mama. 

I was really amazed that none of the babies are twins. Actually, I'm really just amazed by all of it. I can't believe how big they are. My first DC was 4 lb 11 oz, and one of her quadruplets is that big! They are doing really great so far. As of today, only one of them is on oxygen. 

...She is most worried about: how they will sleep. As in - you can't really sleep with 4 babies in a bed (can you?) - They do have cribs for each of them in their room. She is thinking maybe 2 of them should be sleeping together for awhile? Also - what if they all sleep at seperate times? Does she need to hire outside help for a period of time... I am afraid that she will not get any sleep. I know how limited my sleep was when my kids were newborns and there was just one at a time! I'm sure there's probably some info on this in that Mothering Multiples book.. yes, must get it!

[Spring Lily]

Originally Posted by anjsmama 


...She is most worried about: how they will sleep. As in - you can't really sleep with 4 babies in a bed (can you?) - They do have cribs for each of them in their room. She is thinking maybe 2 of them should be sleeping together for awhile? Also - what if they all sleep at seperate times? Does she need to hire outside help for a period of time... I am afraid that she will not get any sleep. I know how limited my sleep was when my kids were newborns and there was just one at a time! I'm sure there's probably some info on this in that Mothering Multiples book.. yes, must get it!

You can fit 2 babies in a cosleeper, so one option is getting 2 of those and putting one on each side of the bed. Another option is taking one of the cribs and sidecarring it to the bed. She could lay them in a row in there, because they won't be too long to fit that way for awhile. Cobedding multiples really does make a difference. It made a huge difference in the NICU to mine when they were big enough to put in an isolette together. Amazing how much better they each did right from that first day of being allowed to snuggle together! Not only could that be good when they come home, but she can even begin a dialogue with the neonatologist about the possibilities of cobedding them in the isolettes (2 and 2). Our NICU also had full size cribs just for cobedding multiples, when they were able to move to room air. (They have to be big enough to maintain their temperature to be taken out of the isolette).

For me, my milk production and general ability to function all required that I sleep through 1 feeding per night. I pumped every 2-3hrs the rest of the time. If they can afford a night nurse to come in and give bottles for that feeding, they should do it. The night nurse could also get them all changed and everything prepared for your friend and THEN wake her up, so she maximizes her sleep time and is only awake long enough to feed them & pump. The night nurse could even burp them and put them back to bed. That would be huge and probably save your friend a couple hours of sleep at night.

Does she have a housekeeper? That's the only other outside help that immediately comes to mind. It's so hard to keep on top of the necessities (diapers, feeding, meals, laundry, sleep) --in fact some days all of that is bordering impossible--that having someone come in every week or two to, say, clean the bathroom and kitchen, change the sheets, etc.

[charis4]

Wow, those are GREAT weights for quads, congrats to the family on getting them that far!! I bf'd my triplets (while parenting my other 3 kids, two of whom were under 5yo) for 6.5m exclusively and then weaning completely at 11 m. Unfortunately, two of my babies could never latch correctly (one had severe reflux that effected his tongue and the other has a deformed tongue) so I had to almost exclusively pump. Not trying to say how great I am, just that its doable! If she can get them on the breast, she'll be doing well. Its so much easier than pumping/cleaning pump parts/feeding. Karen Gromada's book Mothering Multiples is fabulous!!

Please pass on the congrats and encouragement from the mamas on here!!