Thursday, December 15, 2011

Wherein I Disregard the Advice of My Pediatrician

Before we left the hospital with Ezra and Elliott, our pediatrician recommended that half of their feedings consist of a high calorie formula. She also instructed us to add Enfamil to any breast milk for an additional caloric boost. Nathan and I listened to her concerns about breast milk "not being enough" for premature babies and decided we would use the high calorie formula if there was not a sufficient supply of breast milk.

The first night at home, the babies both refused the formula. I finally was producing enough for both of them, so after a full day of solely breast milk, they did not care for the taste of Similac. Because of this, Nathan and I opted to feed them only breast milk (without the Enfamil) until their first appointment. If they had not gained a sufficient amount of weight in four days, we would begin supplementing. At last week's appointment, they had eached gained weight and the doctor we saw was pleased with their progress (the town's only pediatrician was away on vacation, so we saw a general practice doctor). The doctor encouraged us to continue breastfeeding and did not mention formula whatsoever.

Yesterday, we had a two week appointment with Ezra and Elliott's actual doctor. The babies were weighed, with Ezra coming in at 5 pounds 9 ounces and Elliott at 6 pounds 6 ounces; that means each baby gained 1 pound 1 ounce from their birth weight! The pediatrician was impressed and said most premature babies hopefully maintain their birth weight by two weeks; a 20- 25% weight gain was amazing in her opinion.

I let her know we tracked all of the babies' feedings and totaled the number of mililiters consumed daily. Taking the previous days feeding totals, the doctor quickly did some math to make sure Ezra and Elliott were getting enough milk. She looked up from her calculator and gasped. Her mouth was left hanging open as she stared at us and then the babies in disbelief; apparently, they are eating a ton.

For premature babies, the pediatrician recommends that for each kiligram (2.2 pounds) the baby weighs, they should eat 160 mililiters a day. Per kiligram, Elliott is eating 190 mililiters a day and Ezra is eating a staggering 220 mililiters. Obviously, they are well fed.

I could tell the pediatrician was impressed, so imagine my surprise when she again encouraged us to use the formula and add Enfamil to my breast milk. She asked why I had not been using the formula, and I had no real answer other than, "I didn't feel like I should" and "The lactation specialist and nurses told me I didn't have to." She gave me a disappointed look, and I felt like I had done something wrong when in reality, I have been doing an awesome job keeping these babies fed (yes, I will brag about myself here because it has been hard work!).

She said Ezra and Elliott may be drinking too much because the breast milk isn't dense enough to satisfy them. She also said that they could be using too much of their energy to process all of the milk they are receiving. None of it really made sense to Nathan and me. We came home and relayed the information to our mothers and neither one of them understood the logic.

I think I'll continue to disregard the formula advice. If I need to use it, I will and I won't feel guilty about it. However, I'm not going to deny my babies perfectly good breast milk.

And lastly, the doctor recommended that the babies not sleep together. Hmmm... I don't see that happening anytime soon.
Has anyone ever heard of separating twins while sleeping? It just seems so unnatural.

22 comments:

  1. Celia! I feel like you're in my head! The same exact thing happened to me when I had my twins. I ignored the dr. too and I solely breastfed them for a year. I also was told to seperate them while they slept and I didn't until they were for months old. You know them better than anyone and you love them more than anyone. You are doing an amazing job. Keep up the good work!

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  2. Sounds to me like they got their info from an Enfamil rep. I totally agree with Marissa. YOU know them best and clearly you are doing all the right things.

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  3. WHAT?! Ummm, I'm pretty sure that breastmilk has been proven to provide better nutrients and keeps babies happier and healthier than formula. Obviously this is the case here. I so wish you could change pediatricians because it's pretty apparent that you don't have the same views. That lady's talkin' crazy. It would seem silly to me to start them on breastmilk, when they didn't have a positive reaction to it initially. They probably wouldn't end up taking it. And seperating them?! Yeah, I don't think so. Haha. I'm such a nut. I think you're doing great and you're right to just keep doing what you're doing. It will be interesting to see what she says at the next appointment when she sees that they are still doing amazing due to momma's milk.

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  4. Haha. I meant start them on formula, when they didn't have a positive reaction to it initially. Wow. Proofread Jenny, proofread.

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  5. You go girl!!! I'm super impressed. Pumping for twins is SO much work, and I commend you for that. Seriously, I bow down to you because I've been there and it's H.A.R.D. Keep following what you know is best.

    And yes, separating twins is crazy. We didn't do it until the girls were almost 7 months and I had a really hard time with it. It's just SO adorable to see them snuggle up together. I miss it so.

    Seriously, you win at motherhood. You are amazing.

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  6. Yep, totally bogus. Breast milk has more calories per ounce on average than formula, and while fortifying is recommended if babies aren't gaining, breast milk is perfectly suited to your babies' needs. And that is insane weight gain. I would start just nursing and quit the pumping and tracking and get them reweighed in a few weeks to see how they are doing. If not pumping is easier for you.... If its easier than do it!

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  7. Sometimes doctors are so annoying.

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  8. My son was a preemie - born 8 weeks early and has only had 10ml of formula in his life. He's 8 months old and doing great. Some doctor's dont get it! you're doing so great!!! keep it up!!

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  9. You're amazing!! You're doing a fantastic job! They made us track Noah's eating schedule, and pees and poos for a while when we came home from the hospital and it was so much work and so annoying and after awhile we just stopped when we felt like he was okay, even though it was probably irresponsible. It just got to be too much with all of my health problems as well. You know what is best and you are doing a fantastic job!! I'm not sure about the sleeping together thing, because I'm not a twin expert. We were very paranoid about sleeping stuff, though, because we'd read all kinds of things about preventing suffocation by keeping cribs safe and maybe that's what they're worried about? The babies getting in each other's way? Or one of them tossing a blanket or an arm on the other one when they get big enough to do that? I don't know why they would say to separate them...Don't most twins sleep together? But everybody feels differently about that because plenty of people co-sleep and stay safe, so whatever works for you guys is fine!!

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  10. Wow Celia I think the scale shows definitely that your breastmilk is MORE than doing the job! You are so awesome! i cannot fathom pumping for both! I would definitely consider just nursing Elliott for sure. Hayden was only 6'12" when he was born and i never had to pump or anything... it totally might even work for Ezra too (BUT as caitlin said, ONLY if that is easier). You are really doing so great. Don't listen to the ped. She's crazy!!!

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  11. I always feel SO guilty when I disregard pediatrician recommendations but, honestly? I know my kids. You know your kids. Do what you feel is best (and I second Caitlin- maybe time to just nurse them. They're obviously thriving). I've gotten really good at the nonchalant shrug and the, "I disagreed with your advice" before changing the subject.

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  12. My mom did not separate my twin brothers while they slept until they were two big for one crib. At which point she divided them, and they refused to sleep, from then on they slept on a mattress on the floor until they were 4. They just could not bear to be separated. As for the breastmilk thing, my pediatrician thought that breastmilk alone was by far the best way for babies to gain weight. So I guess they are all different. Good job doing what you felt was best.

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  13. they tried to get me to feed beckett and aiden formula too!! along with these vitamens that were so nasty. i honestly felt that they were getting everything they needed from my breast milk without the added supplements and look at them - they are huge now! also mine slept in the same crib until they were too big, which was around 4 months. they were adorable laying side by side and it melted my heart to see them together. also helped keep them on the same schedule in the beginning which helped a bunch. anyway you are really doing a great job with your boys! they are so lucky to have you as their momma!

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  14. Worst things about small towns. You don't get a lot of choice in who your doctor is! We had that issue in NM. I HATED our ped their but really did not have another choice.
    do what you feel is best its obvious that they are doing great on your milk! Keep up the amazing work your an amazing mother.
    and how could you separate those adorable little boys! Seriously they have been together for a while :)

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  15. Mine slept together til they got too big to share the crib. I have always believed in keeping them close to each other. And great job on the breastfeeding. Mother's know what is best for their children no matter what doctors say.

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  16. Ok, I have been lost for like an hour reading every post since your birth story!! I am so glad that everything is going well for you!! (As well as can be, right?) Your little boys are adorable!

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  17. Seriously, sometimes I think drs are crazy. Ours told us that the boys were burning more calories with the effort of eating than they were taking in, which sounds like what your dr is trying to say, but if that's the case, then why are they gaining so much?! Rock on, girl. You are kicking butt. Twin moms are awesome and you are some more proof.

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  18. If they are gaining weight, just keep doing what you feel is best. Your breast milk is made for them. And of course they want to sleep together.

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  19. I let my twins sleep together until 5 months when they started rolling. They wouldn't even consider sleeping unless the other baby was there with them. They love the comfort of their sibling and it gives us mom's a little more rest during the night. Keep up the good work and go with your gut!

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  20. Kudos to you mama! Breastmilk all the way. My son gained tons of weight, I don't think he lost any weight after birth.

    It's a shame that so many doctors don't believe in the power of breastmilk. We were created with breasts for a reason, long before formula ever existed.

    Keep doing what you're doing, you're doing great! They are precious by the way :)

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  21. For me, as long as you think your decision of ignoring the pediatrician’s advice will not harm your baby’s health, that would fine. Maybe the pediatrician has a good reason why she insisted you to use the formula. It all still depends on the decision of the mother. But that doesn’t mean that your pediatrician is giving you the wrong advice.

    >Chalice Lindgren

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  22. Breastfeeding is ideal because it provides the ideal nutrition for infants, and lowers risk of breast and ovarian cancer for mommies. However, if your pediatrician believes that it’s best to put your baby under a particular formula for awhile, maybe you should consider it too. If the doctor says it’s nothing serious, then, you may continue with breastfeeding.

    Malachi Cates

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