Setting up for Twins Part 1 - Sleeping

Setting up for twins can be a very costly experience and I know that there are ways and means to do it all on the cheap. Unfortunately, I wasn't in the mindset at the time of purchasing second hand items and although I shopped for specials, bought middle of the range and didn't double up on everything, we did end up spending alot of money to set up for our twins.

If I had to do it all again there are a few things I would do differently to save our cash and I'll list them as we go so maybe you'll benefit from the lessons of my mistakes.

If you've been looking around the web you've probably found a host of nursery checklists already and many of them, I believe, are over the top. Do the babies REALLY need ALL of those things?

The first piece of advice I will give here is to WAIT! Set up a few essentials that you know you will need early on, but for all the other bibs and bobs, just wait. Chances are you are not going to be totally alone for the first week or so and you will have someone who can duck out to the shops for a few items that you really do need (assuming that you have access to shops close by). I know, it's so easy to get carried away with all the cute little outfits and toys and such that are on the shelves (and this is exactly what the shops are hoping for), but I found that alot of the things I bought early on still to this day have never been used.

Basically there are just a few questions to ask yourself the first of which is...

Where will baby sleep? Be sure to check out all the information about SIDS when considering your babies' sleeping arrangements. (See SIDS & KIDS)

We went straight out and bought the two cots and made all the nursery look pretty, but the reality is they slept in seperate bassinets (which we hired - a big saving!) for the first 8 weeks...

Then we put them in just the one cot until they learnt to roll over, so we really didnt need two cots for quite some time!

Next you need to think about linens. You'll need 3 sets of bassinet sheets and 3 sets of cot sheets each. If you intend to use the bassinets only at first for sleeping then you won't need the cot sheets up front. I bought about 6 sets of cot sheets EACH! Why, I'll never know? We've never used that many. To begin with 3 sets was enough since they shared the same cot. Later we have needed the 3 sets each (especially when we've had times of illness).

As for blankets, once again I purchased WAY too many and then went out and bought baby sleeping bags anyway since they are safer for baby to sleep in. Depending on when your babies are due and the season (keeping in mind the possibility of premature birth with multiples) just buy a couple of blankets to start off with. Avoid fleece as small amounts can be pulled off and ingested by little ones. Cotton blankets are best, teamed with baby sleeping bags or swaddling for adequate warmth.

I've never used bumpers or any other padding around the cot and was actually quite paranoid and took the mobile down every night just in case it fell into their cot while I was asleep. :) Having premature babies put me on high alert for the risk of SIDS so I wasnt taking ANY chances!

We also purchased TWO baby movement and sound monitors. For whatever reason, we never used the movement plate of the monitors and so we only ever used ONE of the monitors for sound only. The twins slept in our room until around 6 months old so I just felt we didn't need the monitors on. When they were in their own room (and still even now) we use one monitor just for sounds. This is completely a personal choice and will depend on what you feel secure with in yourself.

On the subject of saving dollars... secondhand cots can be found quite easily (try ebay or your local classifieds) and often in very good condition. Just be sure to check that the cots meet the current Australian standards as many of the older models can be quite dangerous as the slats are too wide and baby can get their head stuck or they may have paint which can chip off and be swallowed or the paint used may actually be quite toxic.

Next post I'll talk about purchasing clothing for your twins...

Bringing our Twins home from Hospital

By the end of the six weeks our twins spent in NICU & Special Care, I was so used to the routine of two to three visits to the hospital a day and pumping breastmilk around the clock that I was actually surprised the day we were told that it was time to have a night "rooming in".

"Rooming In" meant that we could spend one night in the hospital with the babies to see how we all coped and, pending no difficulties, we could be discharged the next day.

It was scary, and I didnt sleep a wink. (That's my husband sleeping happily in the bed) All the monitors were gone! How would I know the rate of their heartbeats?

One of the nurses reminded us that they were not sick little babies any more and we should treat them like any other "normal" full term baby! (Except for the fact they there were still only around 2000 grams!) But she was right, we had to make that transition from parents of sick premmies to parents of healthy twin babies and it was time to go home.

Standing outside the doors of the maternity unit was a HUGE step. They really were 100% our responsibility now. They were OUR babies!

Later I thought about this photo. We didnt have any flowers or gifts to be taking home like all the other parents we had seen come and go from the hospital with babies over the six weeks - all our flowers had wilted long ago and the gifts were unwrapped, washed and packed away in the nursery. In a way it took away the celebration feeling of this moment but we were still excited!

Getting everyone into their car seats was the next challenge. We had asked one of the midwives if our convertible car seats would be okay for the girls to travel in and her response was that if it was designed for "From Birth" and no weight limits, than it would be fine. When we saw how big those seats were compared to our tiny little babies, I was concerned. I padded them up with blankets and they still seemed to disappear down into the seat. Needless to say, this was our one and only trip in the car with the girls until they seemed big enough to fit their car seats properly. In hind sight, I would recommend that ALL premature babies ride in a capsule until they are bigger.Yes, we are at home in this photo! We hired some baby hospital bassinets for home. I figured that it might ease the transition and help the babies to settle in better if something was familiar. As it turned out, they were a God send! The positives were numerous. Not only were the babies VERY content to be in these, but the large wheels made for easy and smooth transport for the girls all throughout the house. They were especially good a couple of weeks later when I was feeling like a complete sleep-deprived zombie and practically walking myself into walls! They were also easy to rock backwards and forwards to settle the babies to sleep.

It was great to have family there to help out at home for that first week. (Actually my parents were with us for alot longer than that!) Not having to worry what's for dinner and help with all the laundry makes a huge difference to coping in those early days.

Twin-to-twin Transfusion Syndrome

Hello again! Well this is my second blog post and it's a bit of a heavy one as I'm going to do my best to explain Twin-to-twin transfusion syndrome and our experiences with this disease.

First, the factual info: (borrowed from the TTTS foundation website) http://www.tttsfoundation.org/

"Twin to Twin Transfusion Syndrome is a disease of the placenta that affects identical twin pregnancies. TTTS effects identical twins (or higher multiple gestations) who share a common monochorionic placenta. The shared placenta contains abnormal blood vessels which connect the umbilical cord and circulations of the twins."

Our experience...

We were told very early on in our pregnancy that there was a risk of the babies developing TTTS. It was obvious that they shared one placenta and had only a thin membrane seperating them. I guess our doctors and sonographers didn't want to alarm us or instill fear as the disease was very much played-down. Most of our questions were answered with the standard response of "well, we will worry about that IF or when the time comes". I did some research online, but as soon as I encountered the many listings of memorials, I soon developed the same attitude.

My pregnancy showed NO SIGNS of TTTS until I was 31 weeks pregnant. This was a blessing for us as many pregnancies develop the disease much earlier.

NOTE: If you are currently pregnant with identical twins and have learned there is a risk of TTTS for your babies, I would like to suggest the following as things which I believe helped us in our situation - they may work for you, they may not....

1. DO NOT torture yourself reading or watching memorials. This disease is VERY random and there are no two pregnancies alike, therefore you will not find another story similar enough to make a prediction on your pregnancy!

2. REST! I have read frequently that doctors have prescribed bed rest for women whose pregnancy has developed TTTS. During my pregnancy, my body seemed to know this and gave me no choice but to rest. I just didn't have the energy and when I did exert myself I ended up in severe pain. (I have to add here a little side note that just days before I was diagnosed with the TTTS I went on a long shopping spree which I found most difficult but was determined to finish getting the nursery organised! It's an interesting coincidence that my pregnancy was fine just days before hand and this was the week the TTTS started. My increased activity was the only unusual thing I had done.) It's not confirmed evidence, obviously, but as I said, an "interesting coincidence"!

3. TRUST YOUR INSTINCTS! Take special note of ANY changes in your body. I was told to watch for sudden swelling in the abdomen (faster than the usual pregnancy growth) and a feeling of tightness or fullness. I was not aware how quickly TTTS can develop. I had an ultrasound when I was leaving hospital after being treated for an infection at 30 weeks gestation and the babies were perfect - almost identical amounts of amniotic fluid in each sac. (A sign they check for to diagnose TTTS). That was Thursday. Monday morning I said to my family "If I didn't know better, I'd say I had TTTS!" as I had woken feeling that exact full belly feeling (though not tight) and just put it down to the babies' growth! On the Tuesday is when the next ultrasound revealed that we indeed did have a TTTS problem! A problem so great that the babies ended up being delivered 4 days later!

4. Keep a POSITIVE attitude and PRAY. Never give up Hope for your babies! There ARE success stories and we're one of them!

Pregnant with Twins

There is good and bad to tell here. It will probably sound like alot of bad (and it was) but the end result was SO worth it and I would do it all again!

I do not look back with fond memories of my pregnancy. It was my first experience of being pregnant. The early days were filled with excitement and joy when those early detection pregnancy kits (plural, of course! Snaps for anyone with a strong enough will to resist testing more than once!) displayed "Positive". Even more excitement when we discovered at an early ultrasound at 7 weeks that there were TWO heartbeats and that the TWINS were identical!

By week 8 I had terrible morning sickness (actually Hyperemesis - that's a whole other post in itself). Everyone had advice on how best to deal with it. "Have you tried Ginger?" seemed to be the favourite with most people. I recall a trip to the grocery store with an iron determination that I was going to beat this niggly little nausea with all the tried and true home remedies suggested. Crackers first thing in the morning; Lemonade; Peppermints; Vegemite toast; Ginger biscuits, Ginger lollies, Ginger Beer, Ginger sushi slithers, Ginger tablets, Ginger, Ginger, Ginger!! Even just looking at that list is enough to make you feel sick! My "niggly nausea" soon turned into an all day and all night spree. I was sick so frequently and so violently that I actually tore muscles under my rib cage. The pain was excrutiating and it wasn't until a trip to the hospital late one afternoon for an IV of fluids to treat my dehydration, that my doctor started to take my complaints seriously and put me on Zofran! Still only ONE tablet a day so eating was next to impossible but at least I could hold some fluids down.

There were some nice times throughout such as seeing those two little people bobbling about on the screen at each ultrasound and hearing all the good reports of their growth and development. It baffles me how they managed to get any nutrients from the tiny amount of food I was able to eat. I guess my lack of activity helped to conserve all energy for the babies' growth.

At 22 weeks into the pregnancy, the vomitting stopped. I was finally wanting (and able) to eat but only small portions at a time thanks to bloating and heartburn. Ligament stretching became my new issue as the twins grew rapidly during this time. I'd spent so long in bed and with very little nutrition that I now was anaemic, stiff and sore so walking around was very difficult. Even a short walk on the beach landed me in a hospital bed again the next morning with pain and frequent braxton hicks.

At 30 weeks I was again admitted to hospital with a severe urinary tract infection. High fevers and heart palpitations were threatening the babies' health and I was being prepared for the possibility of having to deliver the babies this early. I was proded and probed with tests, medicines and antibiotics trying to fight the infection and keep me from going into premature labour. Thankfully, the infection was gone within a week and I was able to go home. The ultrasound ordered prior to my leaving confirmed no dilation and babies all happy and healthy - settled in for another few weeks. Six, I hoped. Eight would be great, but that was not to be.

My routine (monthly) ultrasound was the following Tuesday. I was 31 weeks and 3 days pregnant. The usually chatty Sonographer was serious and quiet on this occasion. When she went for a second opinion, we knew there must be a big problem.

We were already aware of the risks related with my type of pregnancy. The twins shared the one placenta, putting them into a high risk category for developing Twin-to-Twin Transfusion Syndrome (TTTS). More on TTTS next post. A basic explanation is that one baby could begin to donate blood to the other baby through the placenta resulting in oversupply of blood in one baby and severe anaemia in the other. It is a highly life-threatening complication and rarely a good result when left untreated. The treatment in itself is invasive, dangerous and not always successful.

When the second sonographer confirmed the detection of TTTS in our twins, we knew it was not good. It was decided that we should book in for a Caesarian sometime during the next week. Although we knew all about the condition, we had purposely avoided learning about the statistics and so in the week that followed I was not overly concerned. The sonographer was quite relaxed that the babies had an excellent chance for survival being 32 weeks gestation by then and so I was satisfied. He scheduled in another ultrasound for the Friday to check what was happening.

Friday 13th - I had the first of two steroid shots early that morning with the second to be 12 hours later. This would help to develop the babies' lungs in preparation for premature birth. I was the last patient of the day for the ultrasound. Our regular sonographer was "Dr Comedy" (as we nicknamed him) - his dry sense of humour and tactless bedside manner were far from funny but the brutal, matter-of-fact honesty was somehow laughable and surprisingly appreciated in our situation. After the repeat ultrasound, he sat down on his swivel chair, dialled a number he knew by heart and leaned back putting his feet up on the desk infront of us. He hadn't explained anything to us, but we overheard "Yep, they've gotta come out or one's gonna cark-it!" and "I'll be sh*tting myself if it's not done this weekend!".

Right! Enough said... let's go! - That was my first reaction and off I went. Straight into hospital without stopping at home first (bags were dropped off later by my parents). Straight into a bed, second steroids shot, and hooked up to monitors. That's where I stayed all night with round the clock, tireless checking by the nursing staff. No time for sleep. These bubs were coming out by 9am if not by emergency sooner.

Wow, that's been a long post. I will try to keep them shorter in future. Next post I'll talk about the Twin-to-Twin Transfusion Syndrome...