Help: Questions about premi babies. I'm a little worried

[Shellbelle]

Hi! OK, will attempt to answer some questions for you!! I am a neonatal nurse so hopefully can help a little!!

Length of stay in hosp can vary greatly. Esp with twins. Basically when they are having all suck feeds bf or bottle, and gaining wt they can go home! With single births we normally tell parents that hopefully if there are no other probs, they can expect to be home by their due date.

Humidicribs are used for small babies or those that cannot maintain their own body temp. If your babies are over about 2kg, and managing to keep their own temps they can go straight into a normal cot. In saying that, most premmie babes will need phototherapy for jaundice, and will need to be in an isolette (humidicrib) for this.

Side effects vary from baby to baby and every circumstance is difference. Go have a tour of the NICU where your babies will be born and ask the staff any questions!

Most babies do not obtain a sufficient suck/swallow reflex till about 35wks gestation. Berofre this it is recommened to let babies nuzzle to help with your milk. BUT, the most important thing is to express, express, express!!!! Every 3 hrs day and night to get your supply! Also your bubs (if they have no respiratory probs) will have naso gastric tubes to put your milk down for them!

You will most likely not be able to stay, just go in every day. When they get close to coming home you can usually board in with them to see how you go with all BF's and cares your self!!

Hope that helps!!

[The[cookie]Doctor]

Mine's not first hand experience, but I will tell you what I know.

You CAN give birth naturally. Even to Premature twins. Why is your OB saying that you will have to have a C-Sec (unless it is your choice of course, I'm not sure!)?? My sisters were born at 33 weeks gestation (in December), both VAGINALLY. Mum went from here to Melbourne to do it, but she did. If you want to birth them naturally, stick to your guns. That and if you show any signs of labour, why would they give you an immediate C-Sec? If your water breaks you may still hold them in for longer than that. If you lose your plug it may still take weeks (Twins were 10 days after lost mucus plug).

If your OB is being so precautionary about them going to be prem, has he given you steroid shots? Is he going to? If you go into labour prematurely, this is something that he should consider, and at least hold you off for 24hrs (if possible). Not be getting them out straight away.

As for measurement... are you talking tape measure from your pubic bone? Because these are HIGHLY inaccurate with twins. It's recommended not to even listen to fundal height with singletons. Besides all twins grow differently! Just like all babies grow differently. Don't know how tall/big you are but little girls can birth big babies and go to full term, and so can you. Mum is about 5'3" and well, generally 45kg and she held on until 33. Be positive!

Now, the medical stuff.
At 33 weeks the girls were in until they were about five weeks old. The were at the Royal Womens until they were 2 weeks and then transferred to local hospital.

As said they were both born vaginally. The other thing is, their cord should stay attached as long as possible, even if they need to be worked on. Because while the placenta is still pumping and that cord is still attached - they have a life source. Stevi (twin 1) was born 1600gms and Charli (twin 2) was 1670gms.

C went to NICU as she was having issues breathing and was on assisted breathing with a CPAP machine for a few days. She also had to have caffeine shots every now and then to help with some apneas. She caught an infection (SCN & NICU are notorius for them) but it wasn't serious and was moved to SCN after maybe five days.
S went straight to SCN in an isolette.

They wear little eyemasks for jaundice phototherapy. From what I saw they are very repsonsive to their mothers touch. Mum's get to do their nappy changes and report stats when they're in there etc.
Yes, you CAN most certainly breastfeed. Get as much help as you can in the beginning (as it will be hard) to establish a good supply. You'll find that if they are in NICU or SCN you will need to be expressing every three hours, no matter how little you get. And when you get your first skin to skin cuddle, express after. All those hormones should stimulate a nice flow for you.

The girld were'nt able to breastfeed until about 4 1/2 weeks. Until then they were tube fed and the mids and mum would use a dummy at the same time so that they associated sucking with food. They are still breastfed now at 5 months. Though they are comp fed due to low supply - so it is important you work hard on supply from the beginning.

So far no specific side effects can be seen. Generally premmies CAN be slower in development, but this is not for every baby. They will stay small for a while. The girls still weigh more than 1kg less than Alexander and he is 3months and they are 5months. They will catch up eventually!

I'm not sure where you're situated but after your discharge you're best to stay as close as possible to the hospital. The RW in Melb has accomodation across the road and mum spent two weeks there until the twins were transferred.

Any more questions and I'll see what I can do. HTH and good luck!

There is a thread about twins, born at full term vaginally, i'll see if i can find it so you can have a look. Might give you some hope/inspiration. You're doing fine

ETA: I can't find the thread. But this is the link to the video. YouTube - Natural Childbirth of Twins and Triplets!
Mods i know this has already had permission for the thread it was started in but i couldn't find it, hope this is ok.

[Inanna]

Kristy big hugs my love . It is a scary thought isn't it? But knowledge is power and you are doing the right thing asking questions.
I think Shel answered most of your questions.

Ususally if labour looks pending a dose of steroids will be given to you to help the babies lungs handle breathing (if before 35weeks) My baby was born at 28 weeks and weighed 815grams, at this size they require help breathing - your babies may need help to but that will depend on their gestation and size. Most babies are trialled on cpap first - this is "continuous positive airway pressure" and basically reduces the work your baby has to do for itself (to breathe).

Like Shel said parents are routinely told that babies go home at about their due date. Of course some are a little longer and some are a little shorter. But that gives you an indicator.

As Shel said your baby won't have a suck swallow reflex until about 35-37 weeks. Until then a tube will be put through your babies nose (if it is not ventilated) or through it's mouth into it's stomach.

Breast milk is liquid gold to all babies but especially premature babies. One of the things that happens for Mamas of premmies is that we often in those first early days feel helpless. A feeling that this baby doesn't belong to us but to the hospital. It can be really tough. As much skin to skin contact and kangaroo cuddles as is possible is important. Expressing is the gift you give in those first weeks. The NICU will have a lactation consultant who will speak to you and you will make friends with the breast pump!

Wishing you luck and please keep us updated.