17 weeks – a positive week

This week has been much more relaxed and positive than last. I haven’t had any contact with any health professionals and it’s been great just getting on with normal life.

17 weeks

I still don’t have loads of energy and the nausea gets worse if I try and do too much, so I’m resting as much as possible to keep the vomiting at bay. I still go to bed just after Tom gets in, but I have been able to stay awake a little longer and do some reading. I have also been able to take Joel to a couple of toddler groups like we used to before the hyperemesis hit, and small amounts of work have been possible and enjoyable for me whilst he’s at nursery. Getting out of the house and doing some sewing have really lifted my mood.

I should also mention that I have of course been monitoring my own blood pressure, and it’s been fine, on the low side. I still feel faint quite often, but I’ve learned a few ways to cope with this, such as not taking my morning tablet until school run time, so that by the time it has an effect on me I’m back home.  I decided this after I almost fainted on the way back from school one day having taken the tablet at 7.15am – stopping, crouching down and sticking my head between my knees multiple times by the side of the road is not an experience I want to repeat!

Another reason I’ve been feeling more positive is that we’ve bought a few bits for the babies. Aldi have a baby event on, so Tom bought a few small size clothes – we’d checked our stock of clothes from the boys’ baby days and we hardly have any newborn or 0-3m, probably because we didn’t need many with them being born average weight, long and lean. It’s highly likely that the twins will be born smaller and earlier.

I’ve also been browsing preloved woven wrap (sling) groups on Facebook for a while, waiting until my kind of thing in the right size(s) comes up. One such wrap caught my eye this week, at a good price because it had a few pulls that I’m willing and able to fix myself (handy part of my job 😉 ). So I took the plunge and bought our first wrap of the twins’ stash – a Firespiral twilight anemone tourbillion in a size (short) 6. The colours are very me, it’s the right size for single carries as a newborn and tandem carries when they’re a bit older, it’s a staple wrap being 100% cotton and gorgeously soft, and it’s made by a fabulous small British business which weaves and finishes its wraps in this county. I’ve had a quick go with a weighted teddy but I’m looking forward to using it with real babies!

I’m still keeping my eye out for a longer wrap (size 7 or 8), probably a slightly thinner one and a linen blend, which will be nice and cool for the summer when tandem wrapping newborns. This is one useful thing to be doing online whilst I’m resting. I’m not planning on getting a double pram/buggy suitable from birth – we will start with wraps and if I feel a single pram/buggy would be handy to have the option of one in each, we will sort that out once they are born.

anemone wrap

I hope next week will be as good as this one was 🙂

 

16 weeks – different opinions

This pregnancy has been a rollercoaster since the start, so by now I shouldn’t be surprised when I encounter a fall again after a high point. I expect this will continue.

16 weeks

Last week when I went to the twins clinic, as a follow up from a week’s worth of almost daily blood pressure checks at the day assessment unit (DAU), I saw a lovely doctor. He listened to me, as well as looked through all my results, both in and out of hospital, on their machine and mine. His conclusion was that they’d stressed me out with repeated hospital trips for BP monitoring, and that while we can’t completely ignore high results, he was happy that my mean readings at home with the hospital 24-hour monitor were fine and that I just have white coat hypertension – BP that shoots up in a clinical setting. He trusted that I was happy and capable of monitoring myself, and would say if I spotted a change. I also have no risk factors apart from twins, an excellent gestational history, my blood and urine tests for BP complications have always come back normal, and the echocardiogram I had whilst in hospital on a drip for dehydration showed that my heart was working well. All good.

Since then I’ve been feeling very positive. Dare I say it, for the first time I saw a glimmer of enjoyment in this pregnancy. My vomiting has got less frequent, and although the nausea is still there all the time, it’s much more bearable without so much vomiting. I finally felt like I could start getting involved in twin-related groups on Facebook, and I even started looking at sling options. Again, all good. The only thing that concerned me slightly was that I was experiencing some dizziness even on the lowest dose of the drug to lower my BP, and my home monitor was showing very low (for me) numbers at these times. It wasn’t good having to do the school run and look after Joel whilst feeling light headed.

On Wednesday night though, I couldn’t sleep very well. I knew the next day I had to go back for another appointment, this time a kidney scan – they wanted to check that my acute high BP wasn’t affecting my kidneys, an extra test on top of all the blood tests I’ve had that show kidney function to be normal. I thought that the DAU had also booked me for a babies scan, but actually it turned out they hadn’t (as usual, less than optimal communication between departments and to the patient). It doesn’t feel like I’ll ever get over the anxiety of a scan since the one where they found no heartbeat. So I felt this was what was causing my tossing and turning.

After dropping Joel at nursery on Thursday lunchtime, I headed to the hospital and arrived 5 minutes before my kidney scan time. An hour later I was still sitting in the waiting room. The act of sitting around waiting in a hospital is something in itself that causes me stress. I can physically feel it – I get hot and sweaty, red in the face, I can feel my heart beating faster and harder. After the hour I asked the receptionist when I would be seen, as I had to go and pick up my son from school soon. She said 5 minutes. 10 minutes later I went in for the kidney scan. Unsurprisingly all was fine, with no signs of any damage or malfunction. Eventually I got my notes back with this written in them.

By this time I thought I wouldn’t be able to stay for the other scan and as it was I was already going to be late for Andrew. Thankfully Tom was able to drop what he was doing at work and run (literally!) to school, albeit not on time. The university can hand the bill for his absence to the NHS. So I went to the antenatal clinic as planned. However, as I said, when I got there I found there was no scan booked, but the receptionist said that I should see a doctor anyway being as I was there. Cue another wait in the waiting room, though not as long.

The twins midwife whom I saw before called me in for a BP and urine check. Unsurprisingly BP was high, though actually it’s been higher and given how long I’d been there already and how stressed I was about Andrew wondering where we were, I didn’t think the numbers were too bad. Everything is relative!  Also I really wish the staff wouldn’t talk to me during the BP test, even if they think it’ll help calm me down, as it doesn’t help and talking can increase the readings. I’ve taken to ignoring them or smiling, they probably think I’m rude. At least my urine was fine, as it always has been.

After another short wait I got called in by a doctor, and the midwife followed us in to the room too. The doctor looked at all my high BP results in the notes and asked how much of the drug I was taking to try and lower my “consistently high” BP. I explained all about my hospital anxiety, the results of the 24 hour monitor being normal, the fact that I’d been feeling dizzy at home even on the lowest dose of the drug and that my home monitor was showing very low (for me) BP at the dizzy times. I was hoping that they’d say to stop taking it because it was bringing my BP too low.

But even with all the info I tried to give her, she came to a conclusion that was totally contradictory to the opinion of the doctor I saw last week. She said that she didn’t think it was just white coat hypertension, that there was something else going on, and that the lowest dose of drug wasn’t controlling my “consistently high” BP. She wanted me to go back to taking a slightly higher dose per day. I expressed my concern over already feeling dizzy, and she basically said that’s tough, deal with it, she doesn’t think it’s low enough to cause growth issues with the babies, even though it feels very low for my normal BP. She thinks the risk to me of untreated hypertension is greater than my discomfort in looking after children whilst feeling dizzy. And she pointed out a few times that it’s twins so higher risk – yes I had actually got the news thanks, but it’s not like this automatically condemns me to every complication going.

The midwife also chipped in with her opinion, which was basically the same as the doctor, though she did express it in nicer words. I said I didn’t understand how they had completely the opposite opinion from the last doctor I saw. There wasn’t really an answer for that. The midwife then suggested that my community midwife could come and do some BP checks at home for me, in the hope that they will be lower than my hospital ones. I agreed to this. As I found before, they won’t accept my home monitor readings, even though it’s clinically validated, brand new, a respected brand, and reads about the same as the 24 hour monitor I had from the hospital. Just another brick wall to bang my head against.

I couldn’t see myself getting anywhere, the conversation was going round in circles, so I gave in and just said I’d take the higher dose of drug and put up with the low BP. Thankfully they don’t want to see me again until 20 weeks (as long as my community midwife doesn’t refer me back), so at least I can just try to forget the negativity and not stress about it. The doctor said I can always go back if I have concerns – no thanks, I’m staying away for as long as I can, you’ve all put me off! (I said this in my head of course!) Obviously I will continue to monitor myself, as I have been, and if I see evidence of it rising, I will go back, I understand the potential risks, I’m not stupid. Nor am I against medicalisation if it’s necessary, I just don’t understand how it is in this case at the moment.

Finally I got home after a long afternoon at the hospital, and tried to relax. I kept going over what had been said, wondering if I could have explained things better. Again I didn’t sleep so well. Surely this kind of stress isn’t helping anything. The next day I got a call from one of the community midwife team (I hadn’t met her before). She said she’d been asked to take my BP today and could she come round in about 45 minutes. I wasn’t expecting that so soon, so it did throw me as I was trying to rest from my sleep-disturbed nights. I didn’t feel at ease, particularly after waiting longer for her to come and stressing about probably being late for Andrew, again! It was quite high, though not as high as in hospital, but higher than my usual home readings. She was nice though, and chatted with me briefly (I had to dash out to school) about my anxiety. She wasn’t overly concerned and was satisfied that I understand my BP monitoring and signs of preeclampsia to look for, so I would say if I saw a change.

She also suggested learning some breathing and relaxation techniques. I did a pregnancy yoga class when I was pregnant with the boys, and learned some techniques there that I used in labour. So this gave me the idea to order a pregnancy yoga DVD, as I can’t face going out to an evening class at the moment, to refresh my memory from over 4 years ago. I also posted in a gentle parenting multiples Facebook group asking if anyone had had this anxiety out of the blue in a twin pregnancy – plenty of ladies replied that they had, and gave me some great tips on how I could try to minimise it, as well as recounting similarly frustrating experiences of doctors and clinics. Just feeling not alone in this has really lifted my mood.

I feel like this week was a slight knock back for me, but I’m determined to get back on track and feel more positive. Deep down I totally know my body can do this, I’m not afraid of birthing twins, it’s just a case of trying to overcome this physical fight-or-flight response that occurs when I feel under stress from others.

15 weeks – blood pressure

This week has mainly been about blood pressure! When I last blogged, I was waiting to speak to a doctor about why they wanted to start me on a drug to lower my BP, when my readings at home were within the normal range.

15-weeks

On Monday I went back to the day assessment unit (DAU) where I had last seen the doctor who prescribed the drug on Friday. Once again my BP was high in hospital. I explained my situation to the nurse who called me in from reception. She understood my concerns and said I didn’t have to take a drug if I didn’t want to, and that she would get a doctor to speak to me. The doctor came pretty quickly and was much more open to chatting to me about it than the one I’d seen before, which was great. However, after listening to my concerns that my BP at home is fine, and therefore the drug would bring it too low, she explained that she would still like me to try the drug for a few reasons.

First, I’m only in the second trimester, when BP should be on the lower side of normal, so that it has room to increase naturally in the third trimester as the babies grow. Second, even if it’s just spiking in hospital, that’s not good for me, and they need to do something about it. She wouldn’t let me go home with such high readings that day, I would have to take the drug and it have a measurable effect there, or they’d keep me in (that would be totally counterproductive, but there we go!) Third, a couple of my readings at home were in the mild hypertension range (which the NICE guidelines say don’t treat with drugs), and even if it’s just one reading a day that high, I should try the drug. Fourth, it’s twins, so I’m at an increased risk of preeclampsia, which can show at any stage of pregnancy. I should add here that I’ve had several blood tests and urine tests at every stage of being in hospital with high BP and none of them have shown any signs of preeclampsia. I could kind of see the logic in some of her points, and agreed to take the drug there, mainly so I could get out of the place again! Thankfully it worked and my BP came down to the high end of normal so they let me go.

They gave me another 24 hour cuff to take home, and I had to go back in the next day to return it. The results showed that my BP was really quite low in the afternoon and overnight. Then the next morning they seemed to go up again to high end of normal / mildly hypertensive. However, I had seen this on the hospital 24 monitor at the time it measured, and decided to compare with my home one – mine was reading a lot lower when done at the same time! The day before my machine was reading similarly to theirs. So I’m not convinced that this wasn’t a fault. Also, the dose they gave me in hospital was twice that of what I’d been prescribed to take at home, so the large effect after the first dose was probably then in contrast to a smaller effect after the doses I took at home. Confusing!

A midwife looked at the 24 hour results and agreed that they looked very low and then much higher. She asked a doctor and the doctor said I should start taking the double dose that I did in hospital at home. I was reluctant, because it had gone so low at home after that dose in hospital, but by that point I figured I might as well do it, to get them off my back! If I fainted, that would be good evidence to show them I don’t need it.

The next day, I didn’t actually faint, but I did feel light headed when getting up, walking around or standing for a while. This wasn’t a good feeling when I had to do the school run and look after Joel on my own. I tested with my own BP monitor, and the numbers were coming out really quite low, especially when I tested immediately as I stood up. They went up a little towards the end of the effect of morning dose, before I then took the evening dose.

I had to go back in the next day for a BP check (slightly pointless being in hospital for it, but hey ho). I explained my light headedness and low numbers to the nurse, but my BP was still high in hospital. As it was Thursday, she said the twins clinic doctors wanted to see me to discuss everything that had been happening with BP that week. I’m so glad they did!

I got called in by an obstetrics registrar whom I hadn’t seen last time at twins clinic. He was lovely. He talked through my gestational history (which he said is excellent), my general health history (I’m young, fit and healthy), my experiences of miscarriage and hyperemesis (which I don’t think help my anxiety in this particular hospital where I’ve been treated for both), and the results of various BP tests in hospital and at home this week, including my home monitor readings and my light headedness. After all this he said that in his opinion, I’m fine! I’m not chronically hypertensive, and I don’t need to be on the drug at this point. I do have huge spikes in BP due to “white coat” hypertension when I’m in hospital, but he said my mean 24 hour readings before the drug were great, and he looks at the mean, not one-off results that could be explained by external factors (like anxiety). He said the DAU doctors tend to see the word twins, then panic and over medicalise it, thinking of all the things that could go wrong. He reassured me that it was nothing to worry about, and to trust that my body can do this. Of course they will monitor me, but he said all the hospital visits this week had stressed me out and they should leave me alone for a while, so I should go home and relax. I have a scan booked for next week anyway, so I’ll be back then. He admitted that the feeling of being light headed was not good, and if my BP was too low it could be more harmful to the babies if they don’t get enough blood from me, so told me to take the lower dose of drug for now (it’s dangerous to suddenly stop taking it all together as it could cause high BP!) He said he trusted that I’m a sensible person who clearly understands BP and would tell them if I had concerns that things had changed.

I came away from that appointment on cloud 9! It was so refreshing to speak to a doctor who really understood my concerns and who agrees that twins in itself is not something to over medicalise. I have no risk factors in this pregnancy other than twins, so it’s really nothing to get in a flap about. I feel so much better at the end of this week, and even my sickness has been a bit better since then, so I’ve managed to eat and drink more. I’m hoping this continues next week too!

14 weeks – first appointment at twins antenatal clinic

week-14I can’t promise that I will have enough time to blog every week of pregnancy like I did in my second pregnancy, but I wanted to keep a record for myself of how things progress and thought it might be useful for others to read about a twin pregnancy too. It’s clear just from this week that this pregnancy will be very different from my previous pregnancies – this one will involve much more monitoring because it has the potential for more complications. I’ve already spent more time in hospital in 14 weeks this time than I did in the entire 40 weeks of the others! This is partly due to the sickness, but also because my care is now managed by doctors at the twins (or multiples) clinic rather than by midwives in the community.

On Thursday, Tom and I spent the afternoon at the twins clinic. I wasn’t sure exactly what this would entail as the midwife I saw for my first scan didn’t know what goes on there to tell me. First it involved a 45 minute wait doing nothing in the waiting room. From previous experience at the hyperemesis day unit, I know I don’t cope well with sitting around waiting, especially when I’m feeling sick, and I can feel I’m running on adrenaline trying to keep alert and not vomit, so that I’m ready to talk to whoever sees me.

So of course when the first thing the nurse called me for was to take some obs including blood pressure, it was inevitably raised, as it always seems to be in hospital. I explained that I had a home BP monitor and that it had been within the normal range when I’d been testing myself. They took a couple more readings, and by the final one it had come down to the higher end of normal. Whilst this was happening, a lovely midwife came and introduced herself as the twins specialist midwife, who I would be seeing a lot of in clinic and maybe even delivery. She was very talkative, reassuring and welcoming in a place that seemed daunting to a newcomer. She was also very sympathetic and knowledgable about the hyperemesis (I guess she’s used to twin pregnancies!) when I explained that I’d been in the hospital a couple of times on a drip already. Then she explained that they could give me a 24 hour BP monitor from the hospital to take home with me as they do that quite a lot for ladies who struggle with BP testing in the hospital, so I most certainly wasn’t abnormal!

The next step was to see a doctor, and he introduced himself as one of the obstetrics registrars. It turns out that the administrator at the community scan clinic where I’d had my first scan should have booked another scan for me to have at the twins clinic that day, but fortunately one of the obstetrics consultants who specialises in multiple pregnancies happened to be free just then so he quickly did another scan, to confirm that there are two amniotic sacs and two placentas. In medical terminology this is a “DCDA” twin pregnancy – dichorionic (two placentas) diamniotic (two sacs). This is good news – it’s the least risky of the possible placenta-sac combinations, and it means the least amount of foetal monitoring for the twins and I don’t automatically have to have a c-section. So this was reassuring.

We then went back with the registrar to chat through a twin pregnancy and what care I will receive. First he went through all the things that we’re at an increased risk of – such as gestational diabetes, raised blood pressure, pre-term birth, restricted foetal growth. He also outlined that if they were to be born very early and needed neonatal intensive care, it is often the case that two beds are not available at the same time in Birmingham, and they would possibly have to transfer them to another hospital, perhaps even as far away as Liverpool. But he emphasised that this was the worst case scenario that they have to prepare us for, and hopefully it wouldn’t come to that. Even if twins are born only a couple of weeks prematurely or at 37-38 weeks (which is classed as term for any baby), they often require some special care after birth, but he said that this would be available at the Birmingham Women’s Hospital.

He then talked through birth options. I have no choice but to give birth in the main delivery suite at the BWH, though later when I rang the homebirth midwife, whom I’d been in contact with before I knew it was twins, to tell her I no longer needed to see her, she got annoyed at this “lack of choice” mentality from doctors. She said they wouldn’t advise me to have twins at home, but there’s no legal reason why I have to go to hospital. I explained that the main reason I was preparing for a homebirth with my third labour was that my second labour was incredibly fast (about an hour from waters breaking to delivery) and I literally only just made it to the birth centre. So if we get to term with the twins, and if I labour as quickly as or more quickly than the twice before, there is a possibility that at least one of them could be born at home by accident. She reassured me that her midwifery team would gladly come out to help us in such a situation and organise an ambulance if necessary.

Back to the doctor’s view…. due to the DCDA nature of the pregnancy, they would be happy for me to attempt a vaginal birth, as long as the first twin’s head is facing down (so he/she is not breech or transverse), and as long as there are no signs of foetal distress. I know that my body can give birth, I’ve done it twice before with no pain relief and not struggled – and this time each baby will be smaller than their older brothers were. So I am keen to do this. He also explained that even if the first one comes out fine, it isn’t uncommon for the second one to be in an awkward position for a vaginal delivery and that they end up going down the c-section route pretty quickly if that’s the case, so they would constantly monitor us for signs of foetal distress.

There was a lot of info to take in, and I felt quite overwhelmed by it all, but the doctors and midwife that I saw were all very friendly at least. The last couple of things I had to do were go down to the day assessment unit (DAU) to get the 24 hour BP cuff fitted, and then finally go back to the clinic to have a blood test. Nearly 3 hours after we arrived, we were on our way home (to my parents’ house where we are staying for New Year). That night I didn’t sleep very well at all, mainly because I was woken up by the BP cuff inflating every two hours overnight, and partly because I was processing in my head all the things we’d talked about at clinic. The cuff continued to take a reading every hour in the daytime, and we had to go back to the DAU in the afternoon, 24 hours after it was fitted, to get the results.

After another wait, the nurse who had fitted the cuff the day before came and took it off, then plugged it into a computer to print off the results. When she came back with them it was good news – the first and last readings (taken at the hospital) were in stark contrast to the readings at home, with the hospital ones being definitely in the moderate-severe hypertension (high BP) bracket, and the home ones being mostly within the normal range, except 2 (out of 19) which were in the mild hypertension range. I didn’t think that was bad considering I was still feeling stressed from lack of sleep and the all the info to get my head around. She said she’d just need the doctor to sign it off, but that I should be able to go home soon because it all looked fine.

However, when the doctor came to see me, she said she was going to start me on a low dose of a drug for high BP. She didn’t show me the results, and in hindsight I wished I’d asked to look at them there and then, but I was feeling too sick and just wanted to get out of there, in my usual fashion when it comes to hospital visits! She was clearly in a rush and rambled off that she’d get a prescription sorted and I’d need another blood test now (to check my organs are OK, which they were 2 weeks ago when I had the same tests done at the HDU), then I’d need to come back in 3 days to check that my BP wasn’t too low after taking the drug. So the nurse took some more blood, and thankfully I had the thought to ask her if the BP results were in my notes – they weren’t, but she happily went and got me a copy to take home. That evening I was more sick than I had been for a while, so I didn’t take the tablet, it probably wouldn’t have stayed down.

My parents, who are pharmacists, looked at the results and looked at the NICE guideline for treating hypertension in pregnancy. According to the guideline, drug treatment isn’t needed in the mild hypertension range, which only 2 of my results were, and the higher ones were clearly a temporary effect of being in hospital. The guideline also states 10 risk factors to consider when deciding whether to treat gestational hypertension, such as being overweight, being over 40, a history or family history of hypertension or pre-eclampsia – the only one that applies to me from these 10 is that it’s a multiple pregnancy. The worry that I and my parents have is that the drug would bring my BP down too low, and this would cause me to faint, which isn’t good whilst being in charge of two children. So I have decided to go back on Monday and try to have a more detailed conversation with a doctor as to exactly why they want me to take the drug. In the mean time I have continued to test my own BP at home with the monitor I have had since being in hospital for fluids – unsurprisingly it has remained in the normal range and never gone even into the mild hypertension range. If I need to take the drug that’s fine, but at the moment I can’t understand from my results why it is necessary, and it could entail more risk than benefit.

So that brings us to the end of week 14. It’s been an interesting one, with lots to learn and digest. I don’t have another appointment at the clinic until my 20 week scan, so I’m hoping for a stress-free time away from hospital until then, at least once we’ve figured out the BP thing!

A trimester of hyperemesis gravidarum (HG)

They say be careful what you wish for. When I first wrote about being pregnant after my miscarriage in the summer I said I was hoping that I would be more sick. At the time (about 5 weeks) I still only had nausea as opposed to vomiting too, and my pregnancy that ended in miscarriage never had developed sickness to the extent that my pregnancies with the boys did – so for me the sickness would be a reassurance.

Well by 6 weeks the vomiting had started, and for a couple of weeks I was able to cope with this. I was definitely reassured that I was vomiting several times a day, and although obviously not nice, somehow I could see past this and concentrate on why this was happening and what we would get out of it. I basically spent my days on the sofa, doing as little as possible. Friends from church and my mum very kindly stocked our freezer with meals cooked for the boys, so I didn’t have to cook and smell the food, and Tom took over doing all the housework that I would normally do. Every day I went to bed as soon as Tom got in from work, earlier at weekends, and napped whenever I could.

But by week 9, I was starting to feel completely exhausted from all the sickness – I was getting more and more dehydrated and malnourished. It also didn’t help that the boys were sick from a tummy bug that week, and I probably caught that too, though it was hard to tell when I was already so sick anyway. My mental strength was starting to crumble, and I found myself no longer able to focus on the good. I was also battling with the memory of only getting to 10 weeks in the previous pregnancy, and the anxiety surrounding this did not help. Finally in week 10, I decided enough was enough and I would go to my GP to get a referral to the hyperemesis day unit (HDU) at the Birmingham Women’s Hospital. My midwife had said a couple of times that if my sickness got really severe to the point of dehydration then I could be referred to the HDU and they could give my IV fluids.

Unfortunately the GP that I saw that day was not informed about severe pregnancy sickness. I explained how I was being sick up to 10 times a day, more if you include retching and spitting up stomach acid, how I was only weeing a couple of times a day and even then it was a dark-coloured trickle, how I had a headache, and how little I was eating and drinking. Her first suggestions were to try ginger, acupressure wrist bands, and eating more. Whilst these may have an effect for mild nausea, they really don’t help when the sickness has got this severe. I told her the only thing ginger did for me was burn my oesophagus on the way back up, and yes I had tried the bands earlier but found they made no difference, and believe me I would love to be able to eat more, but I can’t help that it just comes back up again, that is if I actually manage to chew it without retching. She did do a urine test, and in the tiny sample that I could produce, my ketone level was at 2+, which is a sign of dehydration, but she told me that the hospital would only admit me with a level of 3+ or more. I tried to explain that the hospital has a day unit and they wouldn’t necessarily admit me, but she laughed as I don’t think she liked that I was telling her information that she clearly didn’t know of. She then prescribed some medication, cyclizine, which I knew of as the first line of anti-emetic drugs that can be taken in pregnancy. I tried to tell her that this had done nothing for me previously when I had labyrinthitis (inner ear infection that gives you vertigo and nausea), and that I was concerned about taking medications in pregnancy. She simply brushed off my concerns like I was stupid and made no attempt to have a conversation with me about these. Plus she told me that they would just put really strong anti-emetics in a drip with fluids in hospital anyway, so I might as well try the oral ones first. This is downright false. I ended up in tears because I felt so awful but was getting nowhere in this appointment – she didn’t exactly have the bedside manner to deal with the crying either. So I left and went back home.

After the weekend I managed to get hold of my midwife, who said that she wasn’t aware that the ketones had to be at a specific level to be referred to the HDU. She was sorry that she couldn’t do a referral herself, but did suggest that I might get further by going to the walk-in centre that afternoon rather than my own surgery. So I tried this, and did end up getting referred to the hospital. Not that the GP there was any more clued up on severe pregnancy sickness, but he noticed that my heart rate was quite high, so phoned the hospital where he was told by an obstetrics registrar that ketone level wasn’t a good indication of dehydration, and that my heart rate clearly was. After a bit of a wait at the HDU, the doctor there decided that I was indeed dehydrated and prescribed a couple of bags of IV fluids. I had these in the evening and felt soooo much better, it was amazing! The thing I noticed most after a bag of fluids was that I actually had an urge to go for a wee – I hadn’t had that for a while, it had just been trickling out if I happened to try when I was in the bathroom being sick. After a nice long chat with an obs and gynae doctor, who clearly had a clue about severe pregnancy sickness and who actually listened to my concerns and entered into conversation about them, I agreed that I would try some cyclizine. They didn’t want to admit me, so I went back home and had a good night’s sleep when the drip was finished.

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For a few days following this my sickness was much better, but then it started to get worse, and once again I became concerned about dehydration. I wanted to get this checked out before we were due to go away for Christmas at the weekend. My 12 week scan was booked in for the Friday at 9.30am, so on that morning I rang the hospital (who didn’t need a referral after I’d been in once) and they said to come in after the scan. Well as I said in my last blog post, the scan showed that I am expecting twins! Whilst this doesn’t make the sickness easier to bear, it does make it easier to understand – multiple pregnancies are associated with a higher level of hCG, an important pregnancy hormone, which is also thought to be linked to the cause of pregnancy sickness (though this is still not known for sure).

I was assessed at the HDU, and initially they said my dehydration wasn’t severe enough for IV fluids, but the doctor was slightly concerned about my high blood pressure and heart rate. I wasn’t too surprised by this myself, because I had been really anxious before the scan (due to my previous experience of not finding a heartbeat), then felt like I had been hit with a whole load of other emotions at the news of twins, and I always feel like adrenaline pumps through me when I’m out of the house at medical appointments, as I’m trying not to be sick and I build myself up to speaking to other people, plus I’d had to wait in the waiting room for quite some time before seeing the doctor as it was a busy day. She decided to do a full set of blood tests, to check for anything underlying that wasn’t obvious. That meant another 2 hour wait in the waiting room with sick bowls. In the end she decided that she wanted a cardiologist to give me a check up, because she didn’t think it was anything pregnancy related that was causing this, and that was the limit of her expertise as an obs and gynae doctor – my blood test had come back completely normal, except they were still waiting on the thyroid function one, which would come back in a few days. So I got admitted to the ward, to await a cardiologist.

He arrived more quickly than had been expected, and sat down to ask me questions and do an examination. His conclusion was that there wasn’t anything major wrong, as I didn’t have any symptoms other than the fast heart rate and raised blood pressure. He thought that it was simply the result of dehydration, sickness, the stress of waiting around in hospital all day, and the shock of twins – enough to send anyone’s heart a bit funny! He suggested that the ward did another urine test for dehydration, and it turned out that this one showed I would benefit from some IV fluids, so they put me on a slow overnight drip, whilst I tried to get some sleep on a ward with ladies who had recently had operations and were clearly struggling with pain and calling the nurses all the time! Thankfully my blood pressure and heart rate had come down to within normal parameters by the morning, and I felt much better for the fluids. The cardiologist had also said that he thought it would be a good idea to have a look at my heart more closely with an ultrasound scan, just as a precaution, though he didn’t expect it to show anything. So I had to wait for that to be done before they were happy to discharge me. As expected, the scan showed my heart was in good working order, and by mid afternoon I was on my way home, feeling much more relaxed than the day before.

That takes us up to the start of this week, and since then I have been relaxing at Tom’s parents’ house. We are staying for the week until Boxing Day, and the boys are thoroughly enjoying spending time with their grandparents, while Tom gets a good rest too, which I feel he definitely deserves after holding the fort at home for so long. I am able to rest all the time here, even more so than at home, and the difference it makes to my sickness is really noticeable. I am hoping that this week here, and then another week of Tom being off work and spending time with my side of the family up to the New Year will help me get back on track and stay out of hospital in January. I find the vomiting is a vicious circle – the more sick I am, the more sick I get, until I break the cycle with the IV fluids that give me a boost because I no longer feel the negative effects of dehydration for a while. By resting enough to not be sick so many times, it helps me stay out of this downward spiral. I also heard back about the thyroid function result from my blood test this week, and it is slightly over active, which is common in pregnancies with higher hCG such as multiples, and it can cause a fast heart rate. So we will discuss whether anything needs to be done at my twins clinic appointment next week, but as it’s not that bad it may be fine to leave it alone.

So here I am just at the beginning of the second trimester, incredibly thankful that I and the babies survived the first 13 weeks despite the horrendous daily life that I’ve lived in that time. Hyperemesis (= over sickness) gravidarum (= of pregnancy) or HG is NOT normal “morning sickness”, it is a potentially life-threatening condition that used to be the biggest killer of pregnant women in this country until IV fluids were introduced some decades ago. I feel nauseous in every waking moment, day and night, and my vomiting is worse in the afternoon and evening – something that people often tell me they find strange when they’ve only experienced (first or second hand) “morning sickness”. There isn’t actually a standard accepted definition of when pregnancy sickness becomes severe enough to be called HG, but it usually includes a loss of more than 5% of pre-pregnancy weight, inability to keep down food and drink, and the need for hospital treatment. I suffered with pretty severe nausea and vomiting in pregnancy (NVP) with the boys, but this time it has definitely been worse, further along the mild to severe continuum, and the term HG is appropriate. Not that it matters if it has a fancy name or not – any amount of nausea and vomiting that debilitates a woman in daily life should be taken seriously.

Unfortunately though, understanding of HG amongst health professionals isn’t as good as it should be. I was lucky that my midwife was on the ball and that Birmingham Women’s Hospital is one of the leading centres for HG treatment in the UK, with consultants who have a specialist interest in it. The same can’t be said about the GPs whom I saw. Many women experience much less satisfactory care than I have, and I see this on a daily basis when I connect with other sufferers on the Pregnancy Sickness Support (PSS) forum. This forum has been invaluable in keeping my spirits up when house bound for so long – I feel like I have made some new friends, all of whom know exactly what it’s like to go through this. I’ve also had great online support from a couple of friends outside of the forum who have suffered the same and who have been checking up on how I am. One day, when I’m feeling better, I hope to be able to give something back to PSS as a charity and help others who will go through this in future.

For now I am concentrating on getting and staying well, and preparing for two little ones to arrive with us in May/June!

Don’t mention ginger! It doesn’t help severe pregnancy sickness or #hyperemesis

I’m sure you’ve all noticed the big announcement in the news this week – little Prince George is going to be a big brother. Obviously that’s very happy news, but like when the Duke and Duchess of Cambridge announced their first pregnancy, this announcement has had to come earlier than the usual 12 week milestone when many people share their news because Kate is suffering again with Hyperemesis Gravidarum or HG – severe pregnancy sickness.

When the news broke last time, I felt the urge to write a blog post on it because of the way this severe form of pregnancy sickness was being talked about in the media. I kept reading about the fact that she was suffering from ‘morning sickness’, albeit an ‘acute’ or ‘severe’ case. This annoyed me then, and it still annoys me this time around, because there still seems to be a lack of understanding about what the poor mum is living with. Although the sickness I suffered in both pregnancies wasn’t quite as severe as hers, I do know what it’s like to have more than a spot of morning sickness.

Probably my biggest issue with the term ‘morning sickness’ and how it is used in reference to someone suffering with severe pregnancy sickness is the ‘morning’ bit of it. At the beginning of my pregnancies, I was sick any hour of the day and night, multiple times. In fact I’d say apart from the dash to the toilet as soon as I got up, I was sick more often towards the end of the day and into the evening, because the sickness was worse the more tired I was. In my second pregnancy, I can still distinctly remember feeling nauseous while in labour in the evening. HG is not confined to the morning, it takes over daily life, morning, afternoon, evening, night. I had a week off work when the sickness first hit in my first pregnancy, and I don’t take sick days lightly. In my second pregnancy I went to (paid) work for a rest as it was easier than looking after a toddler (not that I was very productive in that time).

This week I watched a TV programme in which a friend of mine, Amanda (who blogs at the Family Patch and has coauthored a book on HG) and TV doctor Dr Hilary were being interviewed about HG. It was great that they had invited someone in who has experienced HG and has researched a lot on the topic. Shame they also invited a (male) doctor who didn’t have a clue. One part of the interview that really annoyed me was when the doctor mentioned ginger. This natural substance has been found to relieve nausea, so is often suggested as something mums suffering from morning sickness can try. While this may well help those feeling a bit icky of a morning, in my experience it doesn’t do a thing for repeated vomiting and constant all-day nausea. If I had a pound for every time someone asked if I’d tried ginger when I was pregnant, at least I’d have made a fair financial profit from pregnancy. In all honesty, once I’d been asked for the umpteenth time, it was difficult not to slap the person asking! Apparently I’m not the only one who feels this way about the mention of ginger in talk of pregnancy sickness – there were plenty of us shouting at the screen when the TV doctor mentioned it on this interview.

Another aspect of pregnancy sickness that I find misunderstood is the length of time that it can go on for. Everyone says that you’ll feel better at the end of the first trimester, to just hang on in there until 12 weeks then it’ll all be fine. I was disappointed that this wasn’t the case for me. In my first pregnancy, I continued being and feeling sick well into the second trimester. In my second pregnancy, I was still being sick until about half way (20 weeks) and the nausea didn’t go until I gave birth. Imagine having one of those 24 stomach bugs, the kind that means you throw everything up for about half a day and then feel nauseous and wiped out for the other half of the day. Now imagine that on a 9 month time scale. NOT NICE.

I, like many other mums, found that my sickness got worse (lasted longer) in my second pregnancy. I often get asked if we’d like a third child (mostly in reference to whether we’d like a girl – but that’s another blog post entirely) and my answer always goes something like this… No way at the moment! Some days and in some ways I’d quite like a third child, but the main thing that puts me off is doing pregnancy while looking after 2 active boys – I’d worry that my sickness would be even worse a third time round, and I’m not sure how I’d cope. I think having a newborn as well as the boys would still be hard work, but I think I could cope more with that than the 9 months before it. I know that some mums who’ve had severe pregnancy sickness decide to stick with an only child because they can’t face it again. This sickness is a serious matter if it puts you off having another child.

This royal baby is a second pregnancy, so the chances are, the Duchess is feeling even worse than last time and it might go on for longer. It’s encouraging, though, that she is being treated at home rather than hospital this time, particularly because she has another child to look after (though I’m sure she has plenty of help with that). As much as I wouldn’t wish HG on anyone, I do hope that the fact that someone so present in the media spotlight is suffering with it will ultimately help others – with blog posts like this and all the opportunities for previous sufferers to tell their stories to others while it is so prominent in the media coverage, I hope that awareness will be raised of exactly what it is like, how it’s not just about feeling a bit icky in the morning, and how ginger will not help, so don’t even suggest it!

Breastfeeding toddlers & beyond: not as weird as you might think – #KBBF2014

The theme for today in the Keep Britain Breastfeeding Scavenger Hunt is “Breastfeeding Beyond a Year”. I still remember the feeling when Andrew, my eldest son, got to his first birthday and was still breastfeeding. At the time I wrote a blog post on it called the not-so-crazy world of toddler breastfeeding. After all the struggles we’d had in the early weeks and months (as I explained in my last KBBF post, I have IGT – insufficient glandular tissue – so can’t exclusively breastfeed a baby), I could hardly believe that we’d got to 12 weeks let alone 12 months. But he was still keen to feed, or nurse would be a better term as it really wasn’t about the food anymore but about the comfort and routine. And I always said that I wanted him to decide when to wean and it wouldn’t be me who would initiate the weaning process. So we carried on beyond the time that most mums I knew were breastfeeding.

Apart from his lack of interest in weaning, there are other good reasons to have carried on nursing a toddler (and now preschooler). I think that it’s helped in the fact that he’s still hardly ever been ill. Nursing has been fundamental in his daily bedtime routine for a long time, along with a bath and reading books. He likes to have that routine and I think it has helped him know that it’s bedtime before he could understand properly what was going on. Nursing has also helped when he’s been upset or tired over the years, to calm him down, though these days he only really has some milk before bed.

 

When Andrew was around 13 months old, I found I was pregnant again. This brought with it all sorts of thoughts and feelings about breastfeeding, for example: I had bad vomiting and nausea throughout the pregnancy and wondered if I had the energy to carry on and how I should initiative weaning in that case; I wondered if Andrew would self-wean anyway, as many do during the pregnancy of a sibling; I wondered if/how it would work out with tandem nursing if he did want to carry on. I wrote about these thoughts at various times in my weekly pregnancy diary blog posts, such as this one.

Well we both made it with the breastfeeding through pregnancy thing, and when Joel was born, we became a tandem nursing family. I had lots of support from my local LLL group, and one leader in particular had gone out of her way to help put me in contact with another LLL leader from elsewhere in the country who had tandem nursed with IGT. She made the good point that the toddler is an excellent breast pump substitute in terms of giving the breasts extra stimulation after the newborn feeds (of course you can’t get the milk back from the toddler though, like you can from a bottle of pumped milk, and give it to the baby, but I never got much from a pump anyway.)

As Andrew was basically down to just having one feed before bedtime, I made sure that Joel had had good feeds himself up to that point, and then he had time with Daddy whilst Andrew and I had milk time. He probably was getting very little actual milk by that point in the day, but as he’d nursed through pregnancy, when milk supply drops naturally even in mums without IGT, he was used to that. He just liked the time with me, and I think the tandem nursing helped him accept Joel into the family, although he was young enough to not really care that much anyway. Sometimes Andrew would ask for milk while I was sitting feeding Joel in the day – an increased interest in nursing can happen with older siblings, even if already weaned, so he wasn’t unusual in this, and would usually be happy with a few sucks from the other side, just to mark his ground more than anything I think. There weren’t many times that I would actually have one feeding from each side at the same time – tandem nursing refers to breastfeeding 2 (or more) children in the same time period, not necessarily precisely simultaneously.

Joel seemed to get more breast milk than Andrew did at the same age – I could tell partly from the fact that he needed less formula supplementation and partly because his poos looked so much more breastfed than Andrew’s ever did pre-solids! Many mums, with and without IGT, report increased milk supply with subsequent children. So even if Andrew was taking a little of the shared supply when Joel was a baby, I was happy that over the span of their nursing years, they were getting their own fair share.

Before I knew it, we somehow managed to get to a whole year of tandem nursing; it dawned on me that I was tandem nursing 2 toddlers, and nowadays a toddler and a preschooler.  Neither of them nurse for very long these days, but both of them still enjoy Mummy milk before bed. I think Andrew is slowly on the stopping straight because he doesn’t ask for it every day now, but I’ve heard that this is how self-weaning at this age can happen – a slow process that you look back on and can’t pin point an exact time that they stopped, the breastfeeds just go down from once a day to once a week to once a month etc. We often joke that at this rate, Joel will stop before Andrew, because he’s probably less interested in it than Andrew was at this age, but who knows! (Only they know.)

I look back now and can’t quite believe that I’m sitting here writing this, given our shaky start in the world of breastfeeding. But I’m glad that we persevered through the hard times to get to this point. When I think about how much breast milk that my boys have had over their nursing lives, it’s probably similar to how much some babies had who were exclusively breastfed for the 6 months that is seen as the ‘standard’ amount of time to breastfeed for. Some people may think that breastfeeding or nursing toddlers is weird, and pre-schoolers even weirder, but it works for us and I’m happy to carry on for as long as they require, which may turn out to be not much longer.

Others who are writing about breastfeeding beyond a year today include….. (please go and visit their blogs too).

Sorry about the mess

Circus Queen

Hex Mum

My thoughts on things

Baking Betsy

And another WAHM like myself taking part in the hunt is

Cherub Chews

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Why I Chose to Breastfeed – #KBBF2014

The theme for today in the Keep Britain Breastfeeding scavenger hunt is ‘Why I chose to breastfeed’, which I thought was a great title to write to. The so-called ‘benefits’ of breastfeeding are often talked about when people are trying to explain what’s so good about breastfeeding, and indeed there are many reasons why breastfeeding is a good thing. But I think each individual mum who chooses to breastfeed has particular ones among these many reasons that mean something to her personally. So why one mum chooses to breastfeed (or not) is not necessarily the same as the next mum’s reasons, and that’s why a title that acknowledges a personal story is, I feel, very important when it comes to the ‘benefits’ of breastfeeding.

And for me, this is a very good question – why did I choose to breastfeed? Well, if you’d have asked me this before my eldest son Andrew was born, when I was pregnant with him, I would have said something along the lines of “I’d like to breastfeed because I know it’s the natural way of feeding a baby, but if I hit problems and it’s too hard, then nevermind, I’ll just bottle feed instead.” Only after he was born and I hit major problems breastfeeding did the determination to carry on arise from somewhere inside me (hormones? natural instinct? back of my brain?).

I’ve told our story in full in previous posts, so I won’t go into too much detail here. The best post to read about how our breastfeeding story started in the first months of Andrew’s life is this one. It turned out that I have IGT (insufficient glandular (breast) tissue) or hypoplasia, and would never produce enough breast milk to exclusively breastfeed a baby. It’s estimated that only a tiny percentage of women have IGT, and therefore pro-breastfeeding literature is keen to point out that it is ‘rare’ to be unable to physically produce enough milk to breastfeed. And I think it’s important to point that out, of course, because there are many other reasons why mums might have (or perceive they have) a low milk supply – for example feeding to a schedule (rather than on demand), giving some bottles & skipping some breast feeds, baby isn’t growing the way the charts say they should, breasts don’t leak or feel full once feeding is established etc. etc., when actually things could be done about all of these and the mum could produce enough milk. But for me, it feels disappointing to be among the unlucky few who can’t produce enough milk, even if we try really really hard at doing things to increase our supply (though there is something special about being a ‘rare’ case).

 

However, just because I can’t exclusively breastfeed a baby, doesn’t mean I can’t breastfeed, and between us, Andrew and I figured out how to use a supplemental nursing system (SNS) to allow him to breastfeed as much as possible, whilst getting top ups of formula milk at my breasts. I’ve written more about this ingenious device here. It wasn’t always easy, and combination feeding like this is a bit of a minefield in terms of working out how much supplement to give and managing demand-led feeding alongside scheduled top ups in the early weeks. Many times I wondered why I was bothering to do this, when it would be easier to just give him bottles and give up trying to breastfeed.

So why did I choose to carry on breastfeeding, despite all the struggles? First, sheer determination is something that I’m well known for – once I get my mind set on doing something, I like to see it through, and I didn’t realise just how much I wanted to breastfeed until I started, and then stopping wasn’t something I was going to do without a fight. This is my personality, and I know not everyone is the same, for me it was a very personal choice to continue in this sense. Second, I learned through breastfeeding that it is not simply about getting calories into a baby to nourish them physically, despite how the medical professionals saw it like this whenever we saw them. Breastfeeding is part of my mothering, and I realised that I enjoyed it: I enjoyed being that close to my baby, calming him down when upset, soothing him off to sleep, letting him know that I was there whenever he needed me, and he seemed to like it at my breasts too, even if he wasn’t immediately hungry and just needed the comfort. I wouldn’t have had this amazing mothering tool if I had given up and turned to bottles.

KBB Scav Blue 14

That small baby continued to breast feed, even when he showed interest in solid foods and then took to them very well. In fact, when he got more calories from the solid stuff, the formula top ups went down and eventually he just breast fed alongside solids and water/other drinks. That little baby whom I struggled to establish a breastfeeding relationship with at the start, is now a lively 3.5 year old who still to this day likes some Mummy milk before bedtime, even if just a minute’s worth of sucks. Clearly he doesn’t need the calories in the milk (his appetite for food and drink is healthy!), but clearly he feels the need for the routine and the comfort (and probably the effect of stalling bedtime for another minute or two, he’s a clever chap!), and I’m happy to fulfil that need for as long as he requires it, it’s part of how I parent. I’ve also done the same for his little brother, who is now 19 months old and enjoying breastfeeding before bedtime still, plus the occasional other feed if he’s upset or in the early morning.

As well as the major reasons in my choice that I’ve outlined above, there are several other reasons that I was glad I was breastfeeding, like the antibodies in my milk (both of my boys have hardly been ill at all) and the need to buy less formula which is so expensive and produced by unethical companies. I wish I didn’t have the faff of sterilising the SNS and having to think about how much top up milk (if any) I needed to take out just in case we stayed out longer than I was planning – these are other reasons why I would have loved to exclusively breastfeed, but I didn’t have that choice.

So this is why I chose to carry on breastfeeding, I’m so glad I did – looking back now at how far we’ve come makes all the early struggles worthwhile. I’ll write more about breastfeeding beyond a year, including tandem nursing 2 children, in my next hunt post, so stay tuned 🙂

There are lots of other bloggers taking part in the hunt, so please head over and read some of their posts too. And don’t forget to enter the rafflecopter below to be in with the chance of winning some fab prizes!

Diddle Diddle Dumpling

Keep up with the Jones Family

My baby boy and me

Being Mum

My thoughts on things

 

a Rafflecopter giveaway

Keep Britain Breastfeeding scavenger hunt 2014

I can’t believe another year has passed and it’s nearly time for the annual Keep Britain Breastfeeding scavenger hunt again. I enjoyed the past two years that I’ve taken part in it, and as breastfeeding still seems to be going strong in our household, I’m glad to be back taking part again this year. You can read my posts from previous years here…

2012

What’s so good about breastfeeding?

Mum-to-mum sharing: at breast supplementation

Breastfeeding support

Small steps add up to a long breastfeeding journey

2013

What I love about breastfeeding

Where to turn when breastfeeding gets tough

When will I stop breastfeeding?

Not only am I blogging about our experience this year, but I’m also taking part as a prize donor – this Sewn Down Purple Lane wet bag that could be used to store cloth breast pads or CSP (or anything else!) is up for grabs as part of the hunt’s prizes. The design woven into the fabric is a chemical diagram of an oxytocin molecule, a very important hormone for breastfeeding and new mums in general.

Oxytocin wet nag for kbbf

I’ll be writing two blog posts over the week of the hunt (Friday 20th to Thursday 26th June) – one on why I chose to breastfeed, and one on my experiences of breastfeeding beyond a year (x2 children). The aim of the hunt is to raise awareness of breastfeeding throughout National Breastfeeding week (the week that the hunt is running). It is NOT about making anyone feel guilty about not breastfeeding – whether a mum chooses to breastfeed or not is her own choice, and one that others shouldn’t judge, everyone has different circumstances, but I believe that this choice should be an informed choice, based on access to correct information on how breastfeeding works and where to turn to find useful and knowledgeable help if things don’t go smoothly. And that is what this hunt is about – lots of mums sharing their own experiences with the view to informing other mums who read them. Mum-to-mum support or peer support is such a big part of many mums’  successful breastfeeding stories.

I’m looking forward to reading lots of other great posts on breastfeeding and hearing all about others’ stories, as well as sharing our own experiences. If you’re interested in breastfeeding, I hope you will join in too.

 

3 year breastfeeding anniversary

It’s been a loooong time since I last wrote a post on breastfeeding. I’ve been meaning to for a while, but other posts and other things in life have pushed it down my priority list. When Andrew turned 3 a few weeks ago, his birthday marked our 3 year breastfeeding anniversary, and that, I thought, deserved a write up of my thoughts.

Breastfeeding has become so much part of our daily family life that I often don’t think about it, it’s just something we do day in, day out. Not that I want to belittle it, actually it means a lot to me, but it’s certainly not something I stress about like I did in the early weeks, and therefore it doesn’t take up much of my brain space day to day. It’s only when I deliberately reflect on how far we’ve come that I realise just what an achievement it is to be sitting here writing this.

If you haven’t read how our story started, you can find it here. At less than a week old, I was having to supplement Andrew with formula, and in my new-parent-world-just-been-turned-upside-down-with-a-newborn state I had no idea how long we’d be able to carry on breastfeeding. Just getting to 3 weeks seemed like an impossible task, let alone 3 years. But we were blessed with good info from knowledgeable people – Cambridge is a great place to have a baby in terms of volunteer support networks in the early weeks – and a supportive family, and week by week we survived and Andrew began to thrive.

I was particularly grateful to have been shown an SNS (supplemental nursing system) by a specialist midwife in the hospital, and to have been given a new one when we ruined the original in the microwave steriliser – it was a local La Leche League (LLL) leader who rallied around at the weekend to find an ex demo one with a retired midwife colleague of hers. Without this, especially in those crucial first weeks of trying to maximise my milk supply, I know we wouldn’t have carried on anywhere near this long.

Once the hardest struggles were over, by around 6 months into his life, I decided to let him wean when he wanted to, and to my surprise, he was keen to continue even when he was well and truly eating solid foods in the later half of his first year. By his first birthday he was usually breastfeeding twice a day – once first thing in the morning and once just before bed.

Just after Andrew turned 1, and we were celebrating a whole year of breastfeeding, I found out I was pregnant again. As my milk supply had never been great, I was convinced that he would self-wean with the inevitable dwindling of milk production in pregnancy. But again he surprised me, and wanted to still feed up until and beyond Joel’s birth.

Breastfeeding was generally much easier the second time around, because I knew what I was expecting and was fully prepared. Or so I thought, until Joel had jaundice and was a very sleepy baby who needed much more encouragement to feed in the early weeks. But at least I knew who to turn to straight away for useful info and help from personal experience. He soon grew out of the sleepiness and has continued to breastfeed until now, over 1 year into his life. Like Andrew at this age, he usually feeds once first thing and once just before bed each day.

So here I am, still breastfeeding a 3 year old and a 15 month old. Andrew now only has about a minute’s worth of sucking before bed, and to be honest I think it’s just another one of his bedtime stalling tactics, knowing he can get an extra few minutes up with me and out of his room. But I said he could self-wean, and that’s what he will do one day, whatever his reasons currently are for continuing to breastfeed. We have joked that Andrew will probably outrun Joel in his breastfeeding stint, mainly because Joel is going through a biting phase (something that Andrew never did), no doubt linked to teething, and some days I wonder if my yelps will put him off for good. Who knows how long the biting or the breastfeeding will go on, but it’s up to him, with some gentle teaching from me that biting really isn’t on.

BM keepsake

As we were approaching Andrew’s third birthday, I did something that I’ve been contemplating for a while: I bought a Breast Milk Keepsake. Claire, fellow mummy blogger with twin boys just a little younger than Andrew, has figured out a way to take pure breast milk and shape it into beads in various shapes then set them in resin to make pendants and other jewellery. All I had to do was provide 30ml of my milk and choose which design I wanted – I went for 2 stars to represent my boys, on a purple background in a 25mm silver pendant. This is the perfect way to represent the achievement that our breastfeeding journey has been, and I am so pleased with the result. I now have something tangible to remember our years of breastfeeding once they eventually wean, and a pretty piece of jewellery to wear that is also meaningful.

The keepsake arrived on the date that was exactly 3 years since we had to go back into hospital with Andrew and our future of breastfeeding looked bleak. As I held it in my hand and looked back to that day 3 years ago, I couldn’t quite believe how far we’d come and if you’d have said to me then that in 3 years time I’d be holding one of these, I would never have believed you.

Disclaimer: I received no incentive to write about Breast Milk Keepsakes, all opinions expressed are entirely my own and honest