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From:
cillakat <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 30 Jul 2002 21:09:51 -0400
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Hey all,

About six weeks ago, I posted about a mom who had just found out that
she was pregnant with monoamniotic twins.  It was a big shock (I suppose
it always is) b/c she was only getting a quick u/s before switching to a
homebirth practice.

Once she realized that it would not only not be a homebirth, but would
also definitely be an early csec with less than a great chance of two
live babies, she began interviewing NICU's around Atlanta.  She'd also
considered Boston since all of the extended supportive family is there.
In the end, she stayed here in Atlanta.  Went into the hospital at 27
weeks, monitoring 3x per day.  Every time, babies sounded perfect,
placentas were fused but babies were always w/in (projected) a few
ounces of each other.

Based on some new reasearch, they were considering going to 36 weeks if
both babies looked good.  32w6d mom went into labor.  ctx (mild) through
the night.  In the am mom called nurse to monitor.  Nurse came in...ctx
were regular but not strong.  Shot of terbutaline didn't change
anything,  mom asked to be checked: 5 cm.  Within minutes, mom was
whisked back for a csec and two baby girls were born, cords completely
entangled with a "huge boyscout knot"  that looked to be "two or three
true knots" in one.  No one could believe that both babies made it.
Everyone was feeling very relieved that 36 weeks wasn't mean to
be.....the outcome might not have been so good.

Babies gained well in NICU.  Mom had lots of issues with staff about
breastfeeding issues including the LC who told her that "in 20 y of
practice, I've never seen a case of nipple confusion".  Hospital
wouldn't "let" her cup feed "because the risk of aspiration is too
high".  Mom's a speech path with a hospital background and a LLL so she
cup fed when she could, but babies got bottles when she wasn't there.
Also, b/c she had such an 'extreme' position on breastfeeding and
artificial nipples (she's actually very very diplomatic and is *so*
non-offensive in her manner), the neonatologist suggested not
breastfeeding at all for several days b/c she didn't seem to be coping
well.  "The girls are doing fine but we're worried aobut you".  It was
*so* frustrating.

One baby is exclusively back to the breast for feedings, just
occasionally (less than 1x per day), needs a little finger feeding to
organize and latch on.  The other baby is significantly  nipple confused.

Last year there was some discussion about preemies, nipple shields and
milk transfer (improved with nipple shield).  I'm thinking that if baby
is *already* nipple confused, that a nipple shield would be fine and
dandy b/c at least mom could (theoretically) ditch the bottles and
pumping (which is *extremely* time consuming) and have baby at least at
the breast (while of course simultaneously getting baby off the nipple
shield).

Fwiw, babies were 3#13 and 4#04 and are gaining well.  The smaller one
(nipple confused) is gaining a little less than an ounce per day and the
larger is gaining slightly more than an ounce per day.

Thanks for all of your help and well wishes when I initially posted this
bit...

:)
katherine in atl

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