Cassie Shepherd

February 3, 2014

Closing 2013: Life With Twins

I wrote most of this post in December. It's now February. 
I never used to be late. Life with twins makes me late for everything.

Four months have passed since our little ones arrived. 
The days have been long, but short; stressful, but blissful…

Month One - September
Coming Home
After the girls were delivered, I slept three hours (in one hour increments) over a 61 hour time period. I've never experienced such exhaustion. Ever. I still haven't slept longer than six consecutive hours.

The babies were the culprit of my exhaustion, both physically and emotionally. However, all I wanted to do was be near them. Hold them. Cuddle them. They were my happy place. They still are.

Three hours after I delivered the girls, a nurse asked my goals for the day. Confidently and without hesitation I announced I wanted to tandem breastfeed before I left the hospital. It was an ambitious goal. 

I know Emily briefly latched at the hospital. I can't remember if Addie did. However, despite countless tries, neither were ready to breastfeed. And, tandem feeding was out of the question! I assume most of their difficulties were because they were four weeks early. They had trouble latching and if they ever did, they would lose control and break the latch a few seconds later. And, it didn't help I had no idea what I was doing. I met with three lactation consultants and remained hopeful we'd get there. Overall, I had a great experience at the hospital. Everyone was supportive of what I wanted. I know not everyone is as lucky as I was.

I delivered on Wednesday morning and discharged Thursday evening. By Sunday somehow I managed to come home, do newborn pictures, let one too many people visit, and then completely lose it. Sunday night, I cried in the shower for over an hour. Although, I was grateful for support, saying I was overwhelmed would be an understatement. While people over flowed into our house, settling into a routine was nearly impossible. Mitch was returning to work Monday morning and I could hardly handle the thought of him leaving us. If I were to do it again, I'd insist he take more time off. Fortunately, my parents came to stay with us so I wasn't completely alone with two newborn babies. I don't know what I would've done...

We syringe fed the first couple of days. Ideally, I wanted to do this until they could exclusively breastfeed. Once Mitch went back to work, other people started coming in to help and I quickly realized expecting others to syringe feed was unrealistic. I recognized I desperately needed help so accommodating to what others could do was absolutely necessary for my sanity. So, we started using bottles within the first few days. In hindsight, I think this turned out to be a blessing.

During our first week home, I sent this picture to Mitch while he was at work.
I asked him to tell me who was who. He guessed wrong.
For the record, Addie is on the left.
Since the minute we came home, literally, I set my alarm clock in three hour blocks to make sure the girls were on the same feeding schedule. If we woke them at 1:00 AM, we would change diapers, feed, maybe change diapers again or even an outfit, swaddle, I'd pump, and then we were usually back in bed an hour later. At 4:00 AM we would begin the routine again. This meant sleeping two hours at a time. Assuming nothing happened in between.

By the second week, I didn't need an alarm clock. The girls moved like clock-work. Night and day. Every three hours they would eat. If only one would wake up, we'd wake the other. Mitch woke every night with me. My parents came every day. It became monotonous and our world revolved around when they would eat next. 

I pumped every 2-3 hours. I knew it was crucial to establish a high milk supply. I hated it. In fact, I hated it so badly I got nauseous every time I'd sit down - before I'd even turn the machine on. The doctor told me it was stress induced. Despite everything, I pumped around the clock, determined to build my supply and patiently wait while the babies figured out how to nurse. During this time, I think this was one of the only other times I cried -- I spilled a whopping two or three ounces of pumped breastmilk...I cried for forty five minutes.  Of course I look back and laugh now, but it was a HUGE deal then.

Exactly two weeks after delivery, I went to a Mother's Night Out for Mothers of Multiples. My local support group is uh-mazing! One of the girls (in fact, her name is Cassie) told me about nipple shields. Why no one told me about these brilliant inventions before - is a mystery? The next day, I used them with the girls. And, snap! Just like that, they were nursing. I was even able to accomplish my first tandem feed.

By the end of the month, I felt things were going well. The girls had gained back to their birth weight, plus some. I had fully recovered without any complications. I'd lost a good 30 lbs. And, aside from lack of sleep, I felt I could finally handle things on my own. Up until this point my parents had come to help every day. Shepherds often came over in the evenings to let Mitch and I go out and get a quick bite to eat or just take a little break. And, visitors had finally started to settle down. The babies still slept a lot so I decided it was time to return to work. Four weeks had felt long enough. 

Month Two - October

Fish Lake
Then the honeymoon period ended. Maybe I rushed back into "life" too soon. In hindsight, it is easier to say I wasn't doing as well as I thought I was by the end of September. Even though, between two jobs, I wasn't working more than 15-20 hours a week, I probably shouldn't have added the stress of going back to work so soon because life really took a turn for the worse.

It was LDS General Conference weekend. On Saturday, we drove to Fish Lake for the day. It was our first long outing. While we were there I suddenly felt feverish. I had a strong instinct to nurse the girls…I was engorged and in a lot of pain. So, I just went for it. It was the first time without the
nipple shields and the girls did just fine. I took some tylenol and napped it off. We returned home and I was fine. I never took my temperature, so I didn't know for sure if I had a fever. I thought it was just a fluke.

By late Sunday night my fever had returned. And, the pain had continued to get worse. I called the on-call nurse and told her my symptoms. By then it was clear I had developed mastitis, a breast infection. 70% of first time mothers develop mastitis. It is common and it clears right up with antibiotics. For most of us anyway.

I went through my first seven day dosage of antibiotics. When I was done, I knew immediately my infection hadn't cleared. I visited the doctor, upon which they gave me another five day dosage.

Up until this point, I might go as far as to brag my babies were amazing. They were sweet and hardly cried. Really. They were just starting to smile...Now, don't get me wrong, it was definitely stressful, but I think we were pretty darn blessed with happy babies. I don't know, maybe all babies are like that.

When I started the second dosage of antibiotics, it was like a switch was flipped. The poor girls started having screaming fits. It was clear they were in pain and I couldn't figure it out. During this time my milk supply was starting to be extremely effected from the mastitis. It was quickly dwindling. I didn't have enough to feed them despite pumping every two hours. I went from producing almost double of what they needed to half of what they were consuming. It was extremely frustrating to see my supply diminish after all the hard work to build it up. When I think back, I still have a hard time with it. 

We started supplementing with formula. By all means, I've never been against this, but it was my goal to exclusively offer breast milk for at least the first six months. I felt deflated. But, lets just say, I completely 100% understand why everyone says, before you deliver, "You know, it is okay if you chose not to breastfeed. Remember that." I get it. It is really really hard work. The whole nursing thing has by far been my greatest trial in this journey. To those to whom it has come easy...count your blessings.

We weren't sure if it was the formula or the antibiotics causing the babies tummies to hurt. Once I made the connection that it could be the antibiotics I started to pump and dump (what little bit I was producing) and turned to my freezer stash. I knew my freezer supply wouldn't last more than a few weeks so we had to start weening in more formula. The babies continued to struggle with feedings and inconsolable crying...

Round two of antibiotics failed. By day four I was feverish again. I'd seen the doctor once, but returned when it was obvious the medication was failing. Upon my second examination, I was urgently referred for a breast ultrasound. I was sure they'd find something wrong because nursing couldn't possibly be this complicated for everyone. And, sure enough, the doctor found an infected abscess. He promptly stuck a long needle in the side of my breast and drained the infected lump. It was actually a cool procedure. I watched everything on the ultrasound machine.

Then I began round three of antibiotics. A 10 day dosage. This meant a long 10 days of pumping and dumping my precious breast milk. Fortunately, we knew these antibiotics would work because some scientists tested it against whatever scientists do in fancy labs.  The last day of my dosage, just as I was starting to feel better, we visited the pediatrician. The girls got their two month immunizations and she told us to stick with formula for at least two weeks before we explored other alternatives as to why they were struggling with their feedings. 

On the same day, I got a flu shot. It was a Friday. Saturday I came down with an awful fever probably because of the flu shot. And, within a few hours the girls were also feverish - despite giving them tylenol every three hours. The next day, Sunday, we were planning to have them blessed in church. I look back and think I was absolutely nuts to be trying to do so much. My immune system was pretty much shot, obviously. If it weren't for my parents and the support of my in-laws, I don't think I would've survived.

Near the end of October, I had to find something to look forward to. So, I talked Mitch into letting us do a DNA test on the girls. Up until this point we believed they were fraternal because they were in two separate amniotic sacs and placentas in utero. But, everyone, including Mitch and I, had such a hard time telling them apart. We continually questioned if there was that small .003% chance they could be identical. We conducted the test by rubbing cotton swabs on the inside of their cheeks and then sent it into some other scientists with fancy labs. We did the test on Halloween night, which was a Thursday. I wanted the test to go out ASAP so I packed up the girls and drove to the post office all by myself early Friday morning. It was a big deal. A once ten minute errand took me over an hour.

Month Three - November

The first two weeks of November were better. I was finally able to nurse again. (The girls had been refusing to nurse...probably because of low supply and blockage.) Addie returned to her happy normal self, but Emily was still hurting. I called the pediatrician once a week and we started the process of elimination. I started feeding her on-demand and offering the bottle whenever I could. A lot of the time she wouldn't eat even after 3-4 hours. I don't quite know how she pulled it off, but when I took her in for weight checks...she was fine. Always 3 oz behind Addie. Nothing to be concerned about. We just had to bare through it.

On November 8th, we received the DNA results. I quickly skimmed it -- skipping paragraphs at a time searching for the results. Near the end of the page I saw the word 'monozygotic' and my heart started racing. I knew it meant identical, but I had to read it at least five times to make sure I understood it right...

"We are pleased to report to you the results of the twin zygosity test that you requested. Analysis of the DNA indicates that Adalynn Elizabeth Shepherd and Emily Kate Shepherd are monozygotic, or more commonly referred to as identical twins."

I called Mitch and then spread the news to our families. It was really exciting. Everyone told me that finding out if they were identical or not wouldn't change anything. Of course it didn't change my feelings toward the girls, but it has made answering questions a lot easier. And I think it is really neat that it is so rare. It was some great news during a difficult time.

The girls started laughing mid-November. Every developmental milestone is bitter/sweet - I cried putting away newborn clothes...but the joy of seeing them laugh, swat at their toys, hold their heads up, suck on their fingers, and discover the world around them is indescribable. But, by far, the best milestone was seeing them discover each other. And, I still am mesmerized by their bond - cooing back and is so precious and one of the many things I love about having twins. 

About a week before Thanksgiving, I got sick - again! I was extremely afraid my mastitis was returning. But, turned out to just be the 24-hr flu. We sanitized the whole house and by some miracle the girls didn't get it. My milk supply seemed to be getting better, but when I got the flu I took another major dip in milk. It was during all these times I have been thankful for formula and the fact that I could still feed my babies. And, thankful they took to bottles so early. I can't tell you how many times I've wondered what would've happened if they were born before formula was invented! (And, again, thankful for an amazing family who stepped into help.)

Even though I wasn't sick long, it still took me about a week to recover. I had my second major breakdown during recovery. I knew it was again related to exhaustion...not being able to get the proper rest my body needed to recover from everything and knowing it wasn't going to get better. I couldn't "hold-out" for a few more was going to be like this...waking up in the middle of the night, taking care of two babies...forever!

I guess the girls knew I needed a break -- or it was a tender mercy from angels watching over us, but, right about this time, the babies dropped one of their night feedings. And, this has made all the difference in my world. All of the sudden they were going to bed at 8 and not waking up until 3. Sometimes I'd wait around until 10-11 then 1-2  thinking I was going to be up any minute with them...and then they never did. It really was perfect timing.

Over the next week I experimented with how I wanted their new schedule to go. I tried pushing their feedings back in hopes they would sleep from like 12-7, but that didn't work at all. They did not like being woken up. So, finally, I just settled on the schedule their bodies adapted to. Sometimes they'd wake up around 1, like they were ready to feed again, but I would just put the pacifier back in and they were just fine going until about 3. They'd nurse and then fall right back to sleep...until 6-7.

Thanksgiving weekend we decided to move the girls downstairs into their nursery. With their new schedule and obviously quickly outgrowing the pack-n-play they absolutely needed more space. I also noticed Emily was starting to move more in her sleep. Within days of putting her in her crib I'd find her all over the place. She has always always always been a wiggle worm. Even in utero. 

Month Four - December

Ever since they started sleeping longer -- I haven't been sick. By the end of December I had gone five weeks without being sick! Wow! I'd regained a lot of my energy and most days I didn't feel like I was going to fall asleep while standing up. But, don't get me wrong, I still have those nights, but things are MUCH better than they were.

Sometime mid-December, Emily turned a major corner as far as her screaming fits. And now, she is a much happier baby with lots more smiles. I gave up drinking milk and still avoid most dairy items. I don't drink caffeine anymore either.

The girls settled into a good enough night routine. They'd fall asleep around 8 and wake at 4 to nurse. One would always wake up first, usually Emily. She'd nurse for 10 minutes and go right back to sleep. I'd burp, re-swaddle, and she'd sleep until 7. I'd wake Addie and do the same routine. At this time, I actually think Addie could just about sleep through the night. Maybe not quite til 7, but probably between 6-7. But, the anticipation of when she'd wake up would kill me. I'd have a hard time going back to sleep...thinking she'll be up again soon. So, I'd always wake one up after the other.

During the day it was easy to feed them every three hours -- sometimes a little earlier; sometimes later. Unfortunately the girls self-weened from breastfeeding way to fast for me. I swear they finally learned how and then it was over. Seriously - within weeks. And, obviously I am sure this has to do with the fact that they had the bottles so regularly for so long and then they started to get social. And frankly they both were just more interested in staring at me and smiling than in eating. They'd feed for a few minutes, break the latch, laugh, smily, and be irresistibly cute. Maybe I could've done more to get them to nurse, but I just thought they were so darn cute I'd laugh and give up. I didn't want to spend the time trying to get them to nurse. But, they continued (and still do) nurse fine in the middle of the night (when they can't see me and are too tired to care). This means I pumped (and still do) every four hours during the day. Ugh. Not my favorite.

Christmas Morning
Building a routine has been a lot of hard work. Consistency is key and there were definitely times I threw my hands up in the air and could have possibly run out of the house screaming that nothing works! However, when I step back, the routine and the consistency have naturally fallen into place. This is what I know and love. I didn't study child development for six years to turn around and give up on so many of the methods I learned and wanted to practice. At the end of the day, I definitely think my education has greatly contributed to my sanity though. I guess that is why I chose to major in family studies. I don't know how people just wing it! Not that one way is better or not - "winging it" is just so not me.

By the end of December both girls were easily reaching for and grasping toys. They continued to laugh more and respond to smiling. We started baby sign language and who knows if they'll catch on, but I think it is fun. They could both roll from tummy to back and during the last days of December all of the sudden Emily was rolling from back to tummy. I was really surprised. Even though I shouldn't be. She just doesn't stay still. Ever. I'd leave the room for a few minutes and come back and she'd be half way across the floor...or rolled over on top of Addie.

One of my very favorite things during this time is waking up to their smiles. I am not a morning person AT ALL, but hearing them start to coo as they wake up from a long night's rest is the absolute best way to wake up. In the morning, and even for naps, they never ever wake up crying. Just little baby sounds coming from their cribs -- talking back and forth to one another -- and I am instantly drawn to them. When I peek inside one crib I am greeted with shoulders shrugging and a huge smile. And, then, I get to walk over to another crib and see it happen all over again. It is priceless and makes it all worth it.

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