Thanks Karen, for all the great references.  Just wanted to add that I also
gave this mother my copy of your book!  So now I'll need to get a new one
for my office library.
I'm glad you made the point of assessing these babies as if they were
singletons.  Since I have very limited experience with twins, it is helpful
to me to just focus on each one separately as if they aren't related.  This
mom really prefers to nurse them separately, and at present they are mostly
waking at different times anyway, so she plans to continue separately for
now.  Her other babies were nice sized term babies, so these little guys are
a lot for her to learn to handle.
I practice in a small town, so am so glad to have Lactnet.  If I had someone
more experienced with multiples to refer her too, that would be any kind of
reasonable driving distance I would.  As it is, I'm trying to educate myself
fast enough to stay a day or two ahead of them!
As for delivering all twins early, I have to agree with you.  These guys did
seem to have an indication for delivery, being so discordant and mom having
escalating blood pressure, but I can't help but think it would be a lot
easier to teach 2 39 weekers what to do than 2 36 weekers.  Also, OB
insisted on an epidural (which mom had not had before) and delivering in OR
(complete with the mad dash there at the last minute with Baby A at plus 2
station and mom panting.)  The actual delivery was very smooth, though, and
mom felt pretty good about it, although she felt she had more to recover
from than with her other deliveries.  I agree about the mag effect on higher
thinking, too.  Mom reported feeling like she was in the twilight zone for
the first day or so.  Fortunately dad was there to rotate babies on and off
breast and change diapers!
Jennifer Tieman
Family Physician
Mom to 3, and new baby #4 expected 5/31/03

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