Seeking Advice on Preemie Twins Staying in Hospital & Preparing for Home Arrival

Updated on February 04, 2008
A.P. asks from Bogota, NJ
21 answers

Hi, this is my first time for a request but not for myself. I have read many of your requests and responses and figured I would send this one out. A friend of mine in the DC area will have her twin boys delivered via c-section this afternoon due to complications and pre-eclampsia. The twins are apparently in great health so the Drs. determined it be better for them to be delivered at 20-something weeks than to risk damage inside the belly. My question really is how can my friend prepare herself and husband mentally and physically when her twins have to stay six or more weeks and she can go home in four days? Have any of you pumped milk and fed it to your babies? Have any of you requested donated breast milk instead of formula? I had two c-sections and was able to advise on that recovery but my kids were full term and was able to take them home four days later. Any advice will help. I will give my friend this site once she comes home from the hospital. Thank you all in advance. :-)

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So What Happened?

Hi Ladies, Thank you so much for your generous support and comments! I am forwarding all of your wise words to my friend and her husband. So the boys were delivered yesterday around 5 PM and cried on their own at delivery!! Doctors said it could not
have gone any better and they are in great health. One was 2lbs 10 oz and the other 2lb and 8 oz. Their parents will announce their names soon. I will keep you posted and thank you so much again for all of your kind words and support. A.

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A.S.

answers from Rochester on

DEFINITELY go ahead and pump milk - it will help the babies' immune system and help them grow. Have her talk with the hospital's lactation consultant and USE her...

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K.H.

answers from New York on

It is the hardest thing that your friend will ever go through. I had a son born at 28 weeks via c-section not only was my son in the hospital for over 2 months but he had to be taken from the hospital that he was born in an hour after birth to go to a NICU that could handle a baby of his size. I was unable to see him for the first 4 days. There is no way to prepare for such a birth and for the following days spent in the NICU but I found the greatest way to deal with the abundance of information you hear along with dealing with my own emotions was the NICU Diary that I bought from preemie.com here is the link:
http://www.preemie.com/NICU-Diary_p_0-62.html
This diary was great - so many parents, nurses and doctors asked about it and were so impressed by the contents. It was a way for me and my husband to deal with everything that was going on. It is also amazing to look back at everything that went on during those days.
Breastfeeding and a preemie: I pumped starting after the c-section. Pumping made me feel like at least I could do something for my baby. The NICU's and intermediate Nurseries have private pumping rooms so you can pump and be at the hospital visiting. Preemies, depending on when they are born may not have the sucking reflex yet so it will be a long time before they can really breastfeed. Mine was able to start a week before he came home from the hospital but it really tired him out so I would breastfeed, pump and give a bottle at each feeding. It is a lot of work. I did this for 5 1/2 months before unfortunately switching to formula which I was originally really upset about but in retrospect realize that going that long with our unique situation was a lot. My son was never able to just breastfeed despite working with a lactation consultant.

If your friend wants to find additional information on preemies I highly recommend the book Preemies: The Essential Guide for Parents of Premature Babies by Dana Wechsler Linden. This book was helpful but tell your friend to just look up things the doctor discusses with her do not read the book in full because some of the statistics in the book are discouraging and could be more harmful than helpful to your friends emotions.

Your friend is set for a ride on the roller coaster - the NICU is full of ups and downs.

My son is now 14 months old and doing great - at birth he was 2 lbs 15 oz and went down to 2 lbs 6 oz and did not even fit in preemie clothes. At 14 months old he is now 26 lbs and has just started wearing 24 month clothes. What a difference a year makes.

Best of luck to your friend - most importantly, just be there to listen to her!

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A.R.

answers from New York on

my twins were not ready to come home when I was, they needed incubators and light treatment etc and came home about a week later. I hung around the hospital a lot and nursed them during the day. the staff fed them at night, when I went home to sleep and to be with my other children. this was not a six-week marathon but it was do-able in the short term.

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V.H.

answers from New York on

Hi A., I don't think that you can actually prepare your self mentally when you have to leave your babies in the hospital( you actually don't get use to it but you can accept it).It is very difficult no matter what anyone says to you. My daughter was seven weeks premature and was hospitalized for two weeks, she was 4.8 llbs and she was tiny. I went to the hospital everyday from 11am- midnight. I pumped breast milk at the hospital and ensure that there was enough to feed her because I didn't want her on formula( by the way, a hospital grade pump is a great rental investment). I held her when I was allowed to and I read and sang to her.One of the things that must be kept in mind, there are two babies and they are 20+ weeks. What you can do for your friend is to be supportive: meaning, if she does not return your call or does not call you, be understanding. you can volunteer to drive or pick her up from the hospital. you can also cook her and her husband a meal. The greater issues will arise when the babies come home as you well know... as for donated breast milk, I have to mentally get used to that. I would also have to know the individual. I saw BM that was brown in color, and I almost puked. The nurse told me it came from what the mother ate. So it made me realise that diet was very important because your child is ingesting what you eat.

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S.G.

answers from New York on

I had my son at 30 weeks - emergency C-section. My son was taken to another hospital 20 minutes away and i remained at my local hospital. That was the hardest since for 3 days all I got were pictures of my son. I pumped the whole time I was in the hospital and my husband took it to the NICU where our son was. They did not give exclusively the breast milk but supplemented with a special formula designed to help "fatten" up babies. Your friend should talk with the nurses at the hospital about pumping and I'm sure they will help her with the issues that can arrise. The whole time our little one was in the NICU I pumped and took it with me everytime I went to visit so they always had a supply. The babies won't be drinking from a bottle for a while and once they can the nurses should start your friend trying to breastfeed. There is no way to mentally prepare for a preemie especially when you throw post-partum hormones and emotions into the mix. There are alot of great books out there and some fabulous support groups that can be a huge help. Wish her much luck for me.

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J.F.

answers from New York on

Unfortunaly there is nothing you can do to prepare for leaving your babies behind when you go home. My second daughter had to go into the NICU after she was born and was there for a week. She had an infection and had to be on IV and was also jaundice and had to be in an incubator. The hardest thing is walking out of there because you feel like you are abandoning your babies. The best thing you can do is be a support for your friend. The words I hated to hear was "I know how you feel." This was coming from people that never had a baby in the NICU. No one that has never had the experience really knows. After I found out that my daughter was going to the NICU I asked to go home even though I had just delivered her that morning. I just couldn't stand being in the room with another mother that had her baby with her. I just wanted to be home with my family. They did let me go home and the rest I got before my daughter came home helped so I wasn't so stressed when she came home. Your life just starts revolving around visiting hours which are usually all day long and feeding times. I was there for every feeding and bath. I know how hard it can be if she needs someone to talk to just send me a message and I will send you my email.
Good luck to her
Jenn

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L.M.

answers from Syracuse on

My daughter was 6 weeks early and spent 4 weeks in a hospital 45mins from home. It was difficult, but you just have to keep telling yourself that they will come home. I drove up every day to even just spend an hour or two with her. She was my first baby and as much as I wanted her home, it was almost like a grace period of getting used to the whole thing and taking care of her, but at the same time getting myself physically and mentally prepared to devote myself to her when she did come home. Plus, my mantra those 4 weeks was that God only gives you what he knows you can handle. It may sound corny, but it helped. Tell your friend to hang in there and take things a day at a time, lots of support at home helps too.

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L.H.

answers from New York on

i am a mother of a 16 month old my baby was born 1 month early and had to stay in the hospital it was hard i came home the same day only because i hater hospitals i gave birth at 8:05 pm and was home by 11 that night i had to take 2 buses and walk to visit my baby it is hard but you get used to it it is better theyt are in the hospital where they can get all they need tell her day by day it gets easy but you do get tired

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R.S.

answers from New York on

Hello A.,

First I will tell you how thoughtful it is of you to do this for your friend. It's an unsettling and exhausting time for her and she'll need friends like you. I delivered twin girls (C-Section) 2 months early who were in the same amniotic sac. Similarly the drs. were more concerned about the dangers of them being on the inside than on the outside. One stayed in the hospital for 3 weeks and the other for 4 weeks. If your friend is able, the best advice I can give is for her to spend as much time with them in the NICU as possible while still getting the rest she needs to recover. Holding them kangaroo style (skin on skin) when she can and as often as possible will help her and the babies to bond with each other. As many of the other women have suggested, pumping will help her feel connected with them and will assure her she is giving them the very best nutrition possible. It's very easy to pump and freeze - ask the NICU nurses for assistance. Have dad be the milk man when she needs some rest and/or wants to spend time with one baby who may be home from the hospital earlier. Also, please tell her not to get too stressed about the d-SATS and Bradys and the 5 consecutive days of being free of these before they can go home - she'll miss the reassurance those monitors bring once they're home and not hooked up to anything :) Tell her to be as involved as the nurses will allow - changing diapers, taking their temperature, giving bottles, etc. This will help her feel close to them and give her emotional strength. Be assured that when she leaves them they are in the best of hands. Breast feeding: I was able to breast feed (supplementing about 1 feeding a day with formula) for 12 months. It's possible, even if they're bottle fed early on. All the best of luck to her!

R.

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R.N.

answers from New York on

Hello A.,

First of all, how nice of you to post this message! There is no "Molly Manners" book on what to do or say when someone has a preemie. My husband and I were thrown into it head first when I delivered my son at 27w5d (and he was born with a great deal of additional complications) and I still shake my head thinking about what people said to me during that time! I know they meant well, but sometimes it would drive me insane.

Second of all, there is no way for them to mentally prepare themselves. They will find themselves thrown into an entire new world that will become "normal". I don't know anything else aside from being in a NICU with my son Sean -- and we were there for 116 days.

I would definitely tell them the following:
a. learn as much as you can. Those monitors and machines are so scary and loud those first weeks. You get to the point you don't hear them anymore, but they are overwhelming in the beginning
b. be your child's advocate. If something doesn't seem right, you have something the doctor's don't: mother's instinct. Voice any concerns you have and ask as many questions as you want
c. stay in the NICU as much as you want. You have to be comfortable at all times. Your babies will be able to read your moods, fears, etc. I am a notorious crier but made sure not to cry at Sean's bedside. I was a mom that needed to be there as much as possible; my husband could only tolerate it for 15 minute increments, once or twice a day. There is no "right answer", just what makes you feel comfortable.

I pumped for a little over a year. Sean and I never did get the hang of breastfeeding, but I wanted to give him my milk. I knew of one mom whose milk dried up and received donated milk, but no one else did it. They really had to scramble to find it (I don't think this was a normal practice in our hospital).

The hardest time for me was the nights ... I cried every single night as I walked out of our hospital. The receptionist used to leave a box of tissues for me. It was a very difficult time, but please let her know that by the time I left, I cried to leave the nurses and the doctors (I saw them more than I saw my husband and family!) and I walked out of there knowing full well I could take care of Sean (with a colostomy bag and g-tube nonetheless.) She will get "training" on EVERYTHING there, so she will know her babies better than anyone else does leaving the hospital.

Please -- if she needs someone to talk to, she can absolutely email me. Just send me an email message privately and I'll give you my email address.

Take care,
R.

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A.B.

answers from Syracuse on

if they are so early they might ask her to formula feed not breast. but she could always pump when her milk comes in and store it. breastmilk can be frozen. have her speak to her doc about what to do....
my 2nd child was born 4 weeks early and stayed 6 days only after birth. i was given the option to board at the hospital with her. i had my own room and free roam of the hospital(gowns and bedding as well) but i had to bring in my own food. i got no food service from the hospital. it was very convenient but if they arent coming home for several weeks they might opt to take turns staying there with them or jsut be there all the time. its hard with work schedules and such and you feel like you are neglecting your kids but they are so tiny they really wont hold it against the parents ;o)
good luck to your friend
A.

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J.B.

answers from New York on

Hi A., I have twins (now 8) my twins were also in the hospital after i came home but not for too long at all. It will be very hard for her especially if she is a new mom. I remember always wanting to be at the hospital and my mom helped me get everything ready at home. I remember waking my husband up at all hours of the night just to go take a ride to the hospital and see, hold and feed them. Try to make sure she gets all her rest now this way she will be strong when the babies come home (with twins you dont sleep alot, lol) Maybe try to grab her to get out a bit either for a massage or manicure something to relax her or even a bite to eat in between hospital trips...once she brings her babies home it will be exhausting! Unfortunately this is nothing you can prepare for. Just try to be there for her, support her and keep telling her that her babies are doing great and will be home soon. She should take advantage of this especially after a c-section also let her take advantage of the nurses helping her and guiding her, if she is a first time mom she might be a bit nervous especially if they are so small. Remember those nurses have the most experience. Tell her to read a certain story (my twins still love the story i read them in the hosp) sing to them and talk to them. Coddle them! You are a great friend and she is lucky she has your support. Best wishes and good luck!!!

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J.B.

answers from New York on

I have twin boys who are 5 months old now. The hospital I had the boys at allow moms to stay in the hospital in a room (just no food service, nurses, etc) sort of like you are in a hotel so I could be there to nurse them every 2-3 hours. They were only in the NICU for 10 days but I couldn't have done it any other way. Tell your friend to check with the hospital. Also, tell her to take advantage of the rest she will get while at home alone. I know it is so hard to be without them, but when they come home .....it's all over. I am so exhausted and when I was pregnant really hated hearing "rest while you can" well I wish I did!!!

Good Luck to your friend.
J.

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D.A.

answers from New York on

Hi. I can totally empathize with your friend's situation. I was pregnant with twins when my water broke at 31 weeks. They also were born via C-Section but, since it was an emergency situation, we delivered at a city hospital (RWJMC), not our intended one. I can't speak more highly of the care they received. It was exceptional and the nurses (in every unit) were very understanding and supportive. My babies, thankfully, were of good size (4 lbs. and 3.8 lbs.) and in good health.

They both were immediately taken to the NICU and placed in individual incubators to help regulate their temperatures. They both had jaundice- which, tell your friend is common--they are placed under lights, wear special glasses- and while the lights are on- you can't hold them. (This went on for almost a week). They do take blood from them everyday- from their heels. They have a heart monitor and an oxygen monitor attached to them, plus any IV's. They will also have a tube coming from their mouths- that's where they'll feed them until they're old enough to learn from a bottle. At first, it's scary b/c you are overwhelmed with giving birth early, having the babies apart, seeing them look small and then be hooked up to machines. But the nurses are very comforting and will explain everything to you. Just don't be afraid to ask, anything-- they are happy to answer questions, let you hold them- if possible- teach you how to change, feed, bathe them- whatever they can do for you- they will. My son needed extra oxygen for one day- called a CPAP-- this is a large mask placed on their faces to help push oxygen into their lungs-- it just looks scary b/c they are so small. Honestly, it's amazing to see these babies- some very small and ill- be such fighters.

I was in the hospital for 5 days. When I was released, my husband would drop me off on his way to work and I would stay the day. He would visit after work and then we'd go home. I rented the hospital pump and started right away. I didn't get much at first, but they didn't eat much and the nurses ALWAYS said, "whatever you get, we will give-- it's liquid gold." My babies were in the NICU- then moved to SICU (a step down unit where we were allowed to dress them, feed them, hold them as much as we wanted and assume most of the care). They both were released on their 31st day of life.

As for your questions, I pumped every 2 hours around the clock to try to get as much milk as I could to come in. I rented the hospital pump. They gave me special tubes/ stickers to put the milk in. So, while they were in the hospital- they got my milk, but, if they ran out- they gave them special preemie formula. I met with the lactation specialist numerous times-- The difficulty was that while they were in the NICU- they liked the pumped milk so they could accurately record how much they were eating. I should have asked about having them "practice" breast feeding-- but I didn't. So, my guys never took to breast feeding. What I did do every day was kangaroo them-- your friend needs shirts she can unbutton so she can place the babies against her skin. Once they are moved to SICU, she can practice breast feeding everyday but they will still have them learn to drink from a bottle. I still pumped throughout the day, but I brought their baby books with me so I had something to do while they slept. Once my husband and I went home for the day, I did a final nighttime call to check on them and their weight, etc. Then the next day, I would start all over again. I packed lunch/drinks but the hospital gave free lunches to Moms so I used that option sometimes. I was glad that both babies were released the same day. I didn't want to leave one to visit the other. But some Moms have said having only one home helped them establish a routine, then the 2nd baby joined when they came home.

I just lived every day for that day. Try to focus on the babies and their small gains, even if they have setbacks- try to stay positive. The best thing, if possible, is just to be there- to talk to them, touch their hands, hold them (if possible). They will feel your love and strength.

Another thing that was helpful was joining a twin Mom group. Many people have been in her exact situation and can listen, share and offer support. It's also nice when they come home and are big enough to be around people, to meet up with Moms who have twins and share / swap ideas and stories.

My b/g twins are now 9 mo. old and weigh 20 lbs. and 18 lbs. It's an amazing, wonderful- double blessing.

Best of luck to your friend and her two precious gifts.

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K.W.

answers from New York on

I'm with Jennifer B. ask about staying with the babies.
My son had a UTI at five weeks and was hospitalized for five days. I stayed in the room with him to breastfeed. I changed his diapers etc...My hospital allowed meals for me because I was in turn nourishing the patient.

be strong and pray.

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J.E.

answers from New York on

My twins were delivered at 32 1/2 weeks via C-section due to my severe preeclampsia. It was very scary and overwhelming but they are now 16 months old and perfect!!! I pumped while my babies were in the NICU (my daugher was there a little over a month, and my son 3 1/2 weeks) so she should be prepared that one twin may stay longer, which is normal and quite common. What helped is that I transitioned one coming home, and then the other- which eased me into caring for 2!!! Since I was so stressed, my milk took a lot longer to come in- I was so frustrated and almost gave up breast feeding, but stuck with it and pumped for both of them for 7 months!!! The best advice I can give you as a friend is to be there for support- I felt like a failure and an incompetent mom that I caused this, and my friends were wonderful and supportive and were always there for listening and encouragement. It does get so much better and it's all worth it in the end! Good luck

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M.G.

answers from New York on

You are a great friend to inquire on this for her. I am a mother of two premature babies - one born at 23 weeks and the second at 24 weeks. I can assure you that nothing is harder in the world than to leave your babies behind when you return home. I'll be honest, she will cry each time she leaves, she will cry when she goes to bed and she will cry when she wakes up, and every time she pumps into a machine vs. feeding her own babies by breast. But because i have gone through this twice, I can honestly say that to look back, although hard, I used the time to help in preparing me for when they did come home. she has no choice but to leave them, but there are many things she can do to help them even though they are not with her at home. Pumping is huge - it is one thing she can do for her babies that no one else can and they will need it - a lot of it once they start feeds. she can also get as much rest and take care of herself now - sleep as much as she can, heal and prepare herself mentally for when they come home. As once they do come home - she'll miss those nights of full sleep, trust me!! I also recomend journaling. It will be a long road with many ups and downs before they come home, and journaling is something that will help her both with her emotions as well as to share with her little angels once they are older and can understand what they went through as early arrivals. The road is long - mine almost four months for each of my children - but so worth it in the end. The nurses and doctors will become like family - ask them lots of questions and call them often when you are home. And most especially, hold and talk to your babies as much as possible, they will hear you! Best of luck to you!

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T.N.

answers from New York on

Hello! My daughter was born at 29 weeks and stayed in the hospital until her due date, 2.5 months later. This was a very emotionally challenging time for my husband and I, but I think the best advice I can give is to encourage your friend to settle in to this new and unexpected routine with enthusiasm. It helped us to visit our little one every day, bringing pumped milk for her.
As far as the pumping goes, a lactation specialist at the hospital got me pumping right away and while I felt helpless about so much of what was going on, THIS I could do. Pumping is not fun and will not give her that wonderful bonding experience, but the fact that I could provide such good nutrition for my daughter gave me a real sense of purpose. Something to warn your friend about is that preemies who have been bottle fed often end up not nursing well or nursing at all. I struggled with this with my daughter and it was very frustrating. If the twins are healthy enough at their birth, your friend may be able to nurse right away, which would help. If not, she can work with a nursing specialist when the twins are ready and hopefully they will take to the breast. Otherwise, she may be doing many months of pumping and that will have to be what she has to work with!
Overall, it's best just to accept the situation as it is and while the babies are in the hospital, be vigilant about their care. She should make friends with the nurses and other staff, because she will see them EVERY day. Bring gifts and treats - working with sick or small babies is a tough and demanding job with little thanks!
By the time the babies come home, your friend and her partner will be SO ready and well-trained by the hospital staff that caring for the little ones will be much less challenging than expected, so that's something positive!
My best to your friend, her partner and her little ones!
Trae

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C.D.

answers from New York on

My daughter was one month premature. Because of complications she was transferred to a different hospital that had a NICU and watching as they put her isolate onto the stretcher & then into the ambulance and take her was the most horrible moment of my life. I asked to be discharged the following day even though I was not recovered from my c-section. She stayed in the NICU for 2 weeks. It was really difficult traveling back & forth to the hospital every day, and extremely emotional, but it gave me time to heal and be prepared for when she came home. She was my first so I was clueless about what to do. The nurses in the hospital taught us how to hold her, she was so tiny, and how to feed her, she had a NG tube. They also had a special room for moms to pump. They gave us bottles & labels and took care of it for us. My best advice would be to touch / hold them as much as possible and talk or sing to them. My daughter still calms down whenever I sing her the NICU song that I made up....it is amazing. Tell her to enjoy the quiet and free time before they get home. Take care of herself and heal so that she can be there for them:-)

If you have any other questions please feel free to email me.

Your friend is lucky to have such a supportive friend like you! Friends & family are the most important thing!!!

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J.H.

answers from Utica on

Hi. My son was a preemie, and had to stay in the NICU, but thankfully it was only 2 weeks.
It's so hard, emotionally.
Ask your friend to check for a Ronald McDonald house by the hospital that the babies will be in. There was one right next door to our hospital that was available for the parents to stay in (if the hospital is far away from home--for us it was an hour away).
The big thing for her to remember (as hard as it is), is that you know they are being taken care of and watched over every minute of the day. And if something were to happen, thats the best place for them to be.
The NICU our son was in allowed you to visit any time, day or night (with the exception of a half hour shift change), which helped alot, just knowing you can go in and at least see/talk to them.
Just reassure her that it's going to seem like a very long 6 weeks, but they are going to get the best care and in the end she'll have two healthy little ones to bring home.
Feel free to email me if you want any other details of our NICU experience ([email protected]____.com).
Oh, something she should look into...before the babies can leave the NICU, they'll have to be "tested" in their carseats, to make sure they can breath ok in the seat. Tell her to go online and find inserts for her carseat (that are specifically for preemies). And www.preemies.org is a good website to check out.

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T.G.

answers from New York on

My oldest was born at 31 weeks, almost 13 years ago, also from pre-eclampsia. He was in the hospital for 33 days.
There really isn't anything you can do to prepare for having to leave them at the hospital & go home without them. But I can share that on the positive side, it gave me a chance to recoup & be rested when he was able to come home. Something that seems awful to say when you are just heartbroken to leave them there but grateful for when they come home.
I did pump, freeze & bring my milk with me. Make she she specifies that she wants them solely on breast milk. Sometimes the nurses are very busy & forget or just grab the formula because it's easier for them (my experience)
If she has any questions, I wouldn't mind helping her thru what I can. I'm praying for her & the babies

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