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

Hi all, I guess this is the right spot to ask.

I am 31 weeks pregnant with twin boys. at my OB app today im measuring at 38 weeks. im told my uterus will probably only go to measuring 41weeks max. surposidly if my torso was an inch longer i could go more. but anyway this also means that he expects thati will go into labour within the next 3-4 weeks. he also that if i have any sign of pain or labout i should go strait to hospital as i will have to have a c/section. how scary (not the c/sect just that it could get so serious)

I'm aware of most stetistics saying after 28weeks we have a 98% servival chance. im just not too sure about a few things, Like:
-how long would the babies be in hospital?
-what about going into a humidicrib?
-side affects of premi birth etc?
-can you breast feed still?
-Do I stay with bub in hospital after my discharge or just go in every day?

Please help with your stories and advice.

Kristy, this is not an area I know much about. What I do know is that my friend's 24 weeker (born at 24w+2) was released from hossy in the same week he was originally due, and is now a healthy 2yo. Also that over 30 weeks the babies have a really, really good chance. I believe the two criteria which impact the outcome the most are gestation and weight.

You can certainly bf, but depending on the gestation the babies may not be able to suck, so you might need to express in the beginning. You would go home after discharge and go in to feed/spend time with bub, as you wish. Most parents spend a lot of time in the hossy, you might like to ask friends to make you some meals if your babies are born early so you don't have to cook as well.

Best of luck, I hope your babies hang in there for a while for you.

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!!

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! :hug:

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 :hug:

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.

Hi Kristy
My DD was born @ 31+3 weighing 1512 grams. I had had 4 steroid shots as we knew she was coming early and she was able to breath on her own from birth with only 1 desat. There is a trial in most hospitals where a baby can be in an open cot if they are more tham 1.6kgs. But I'm not sure of the ins and outs of it. Even when DD was in the isolette I was able to touch and comfort(more for myself than her) and kangaroo cuddles are just magic, I wore a loose fitting top always so she could just snuggle in under there.

My DD was in hospital for a total of just under 5 weeks and came home may 10 she was due 2nd June. She was 2.4kgs when she was discharged feeding by bottle. BF was not an option with us but it is certainly encouraged. We started nuzzling when she was just a few days old.

DD was born @RBWH and I was able to stay @ Ronald's House. I didnt have to pay as I was a transfered patient from another hossy. When we were transfered back to our original hossy a week later I was able to stay in their old cardio wing which had been converted to accom for people in my situation who live more than 50 kms away from the hospital. I could see(if I strained lol) DD's isolette at night from my window. The SCN she was in was great. The nurses were very understanding especially at 2 am when I couldnt sleep and would go over. The other mums would be in early in the morning and would come and go during the day but I was the only one who would stay all day.

DD has no "side effects " as such. She is small for her age and will be petite more than likely for the rest of her life. Her development is a little delayed but only by a month or so.

HTH and best of luck xoxoxoxo

ETA DD was born VB

Kristy big hugs my love :hug:. 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.

Hi Kristy,

I've just been through this experience. Aidan was born at 35w1d (totally unexpected!) on May 18 and we just took him home on Tuesday May 27 at which time he was 36w3d gestation.

Everyone has given you great info. At my hosp they said that they expect babies to go home somewhere between 36w and 38w. Once their body temp and breathing is under control then its all about the feeding. We were REALLY lucky. Aidan loves boobie and was a fantastic feeder from when we first tried him - the day after he was born. He was increased to all suck feeds last weekend (which he coped with really well). On Monday we "roomed in" at the hosp - I checked back in to hosp and DH and I had him in the room with us overnight to see how things went. It was all good so on Tues he came home with us.

I only stayed in hosp for 4 days after Aidan was born so after that it was back and forth for expressed milk deliveries and feeds.

It totally depends on your bubs as to when they will come home. Hopefully you'll keep them in for at least a few more weeks to give that sucking reflex a chance to develop.

Good luck

Hi Kristy,

Don't stress too much (i know its hard). These days the hospitals are so good.

Caitlin was born at 34wks 3d and weighed 1880g. She was in the isolet crib for a week and a half and was tube fed for a week and then they slowly introduced bottle feeds. In all she was in hospital for 4 weeks mostly because she needed fattening up. I ended up having to express milk for feeding as her mouth was too small to bf and in the end I kept up expressing and bottle feeding when she got bigger as I was never comfortable with bf'ing. Have just in the last 2 weeks gone onto formula. I was in the hospital for 4 nights and then travelled in with EBM twice a day and stayed at the hospital for 2 feeds each trip. It is exhausting but in the long run it ends up being just a small blip on the radar 3 months down the track. So far Caitlin has no ill effects from being born prem apart from being small and off the charts! She was weighed this week on her 4 month birthday and she was 4.9kg's. The hospital will tell you not to expect to take bubs home before the due date but in most cases you do get to take them home earlier.

Take it easy, I hope it all goes well and as I said try not to stress about it.

hey guys thanks.

your advice has made me feel a lot better about it all.
im packing my bags tonight but also decided I'll pack an emergency premi bag with my brest pump, dr brown premi bottles and a few other little things. if you can think of extra things i may need that would be appreciated too

ashleajayne- yeh no chance of a natural birth i had an emergency c/sect with DS. i'm glad for a c/sect this time. labour is crap. lol.

fingers crossed it might be still a few weeks.

I had a photo of siblings me and DH. I had lots of positive affirmations, and my kids did pictures. All of these were on the isolette. They made ME feel like I was doing something and that we were alwys there even when we were not physically.

Princepessa - So wonderful that you are now home and doing well.

Hi Kristy J,
My DS was born at 34 weeks and was in respiratory distress so needed to go in a humidicrib as he needed oxygen therapy. He weighed 2.3kg so was a reasonably healthy weight but his lungs were still immature. I started breastfeeding him at 4 days old and he had no problems with the feeding it was just his weak lungs causing the problems and he also caught an infection which made things worse for him. We were able to take him home when he was 2 weeks old and he has had his fair share of ups and downs mostly just recurrent problems with his lungs but other than that he is a happy and healthy 22 month old little boy. I was lucky that i was able to board at the hospital we were at and so i was able to spend a lot of time in the SCN but it will just depend on your hospital whether or not you will be able to do this. It would be a good idea to take a tour around the NICU and SCN at your hospital as this way you will be more prepared if your boys need to spend time in there.
BTW while i was in hospital with my DS a woman gave birth to twin boys at 33 weeks and they only spent just over 3 weeks in hospital with no ongoing complications so i hope this helps with the positive thinking :)
Good luck and i hope that your baby boys hang in there a few more weeks as it will give them a bit more time to grow stronger and hopefully not need to spend much time in hospital. :)