A Forum for Parents of Multiples in Singapore

Nora

Aug 4, 05 - 2:20 PM

Pregnant with Twins but one is too small...

Hi! I needed some advise and hope that there is somebody who had gone through the same experience as me....
I'm pregnant with twins (now 32wks). However one is smaller than the other; weighing just 840gm while the brother is 1.4kg at last visit to gynae.
Doc has prescribed bedrest along with some medications but otherwise said ther's nothing else but to wait. Possibility is to have an early birth if babies are still not growing well.
Anybody out there can give me any suggestion as to what I can do to help mty babies put on weight? Does massage help?

*sasha*

Aug 5th, 2005 - 4:13 AM

Re: Pregnant with Twins but one is too small...

Hi Nora,
I hope that you are following your doctors advice and taking the bedrest seriously. Can I ask if your babies are identical? Meaning they are monochrionic, in one or separate sac, sharing a placenta.
Studies hv shown that there tend to be a greater discrepancy in birth weights between identical twins than in non-identical twins because in the womb they share a blood supply unequally. They might also be affected by the twin-to-twin transfusion (TTTS). Did the doctor mention anything?
If one of the babies is growing less well in the womb for no apparent reason, it is a good idea to deliver both babies to give the small one a better chance, this of course depends on the stage of pregnancy. It is often said that the womb is the best incubator but the womb can sometimes be a hostile place for some babies, and early delivery can sometimes be better.
Nora, I am not sure what really you can do to help your baby gain weight except that you take a lot of rest.
My babies were born at 29weeks weighing an average of 1.3kg and they are doing really well now. I am sure yours will do juz as great. You will be in our prayers and thoughts. Be strong and patient :)
Beep us if you need anything else.
Take care
Sasha

Nora

Aug 6th, 2005 - 12:22 AM

Re: Re: Pregnant with Twins but one is too small...

Hi Shasha!
Thanks for sharing and your encouragement! I really needed that!

My twins are actually fraternal and they should have their "own supply of food" right? I really hope they will do just as fine as yours.

Can I ask if yours have to stay in hospital after birth and for how long? Did you have a normal delivery or cesarian? I am also not sure if I should opt for cesarian birth or try for a normal delivery
should I be able to carry them till full term.
I had two cesarian before this due to their breech position.

Thanks again Shasha!

*sasha*

Aug 9th, 2005 - 1:31 AM

Re: Re: Re: Pregnant with Twins but one is too small...

Hi Nora,
My boys were in the NICU for abt 5wks then another 3wks in SCN. They were discharged only when they were abt 2.5kg and were able to have their milk frm the bottle.
I had my elder twin by normal delivery, the second one was in breech so was able to keep him in until they discovered an infection so had me wheeled in for emergency c-section. If I cld do it over again, I hv no doubts abt having a normal delivery!
Just have plenty of rest. I am sure you will get thru this and all will be ok.

Mrs.Mani

Aug 7th, 2005 - 8:51 PM

Re: Pregnant with Twins but one is too small...

Hello Nora,

I can understand your situation, as I went thro the same.

My twins are 3mths old and are fine now. At about the same time as yours, we found out that the girl was not growing well. they suspected placental problem, any way the problems that Sasha mentioned are ruled out for you since yours is fraternal.

As your doc says, there isn't much we can do. I didn't take any spl medicines and don't know what you are taking. But never undermine the advice abt bedrest, it dragged me upto 36 weeks.

Your gynae may want you to have frequent scans, so that they can monitor her growth. After 36 weeks my gynae didn't want to wait any further, since the situation didn't improve much, though she managed to gain a bit more. I had induced delivery and it was 'Normal'. You can very well hope for normal delivery, coz the high levels of hormones in twin pregnancies help to have normal delivery. From the very beginning my gynae use to tell that I can have normal delivery. But the position matters, atleast the leading twin should be head down. They are not bothered about the other twin's position, either head down or breech. Mine was exactly the same. My boy was leading and head down, whereas my girl breech.

What you can do now, is to have bedrest and eat well. Avoid junk/fatty food and try to have nutritious food like cereals, milk, fruits and veges. Try to have real fruit juices and make sure to have adequate protein. Protein is much emphasised for weight gain.

Still you have the possibility that your girl picks up and put on weight normally.(That's what I had been told) Let's pray and hope for the best. There's nothing that prayers cannot do.

Good luck and best wishes.
Regards,
Mrs.Mani.

stephanie chiang

Aug 15th, 2005 - 8:40 AM

Re: Pregnant with Twins but one is too small...

Hi Nora,

I have the same situation like you before. One of them stop growing for about 5 weeks (was at 1.3 kg). Indeed it was very worrying and my gynae told me to bed rest when I was 32 weeks. He did blood flow scan every week to ensure that the flow to both babies are okie. Thank God, I managed to carry the pregnacy to 37 weeks. Miraculously, the baby who stop growing for a while managed to grow for the next five weeks. Their birthrate was 2.2 kg and 2.4 kg.
I think resting is very important. Just rest well and try not to worry too much.

Take care,

Steph

NORA

Aug 28th, 2005 - 2:42 AM

Re: Re: Pregnant with Twins but one is too small...

Hi everybody!
Its me again. Just an update..My twin 1 is still growing slowing now 1.2kg while the other is steady at 1.8kg. I am now 35wks into my pregnancy. Will be seeing my gynae again end of this week. Thank you so much to Shasha, Ms Marni, Linda and Stephanie for being very encouraging and sharing your experience with me! It really help to know that I am not "alone".

Possibility of my smaller twin to be warded in the NICU is quite high (gynae predict about 3-5wks stay) but hopefully the brother would be healthy enough to be discharge. How do you cope with one at home and the other at the hospital? Is it possible to fully breastfeed both of them? What should I do to prepare myself? Should I be getting any special clothes/diapers for my smaller twin or should I wait till I have given birth? I imagine that the usual baby clothes sold outside would be too big right?
Thanks again. Hope to hear from someone soon!

NORA

*sasha*

Aug 28th, 2005 - 8:18 AM

Re: Re: Re: Pregnant with Twins but one is too small...

Hi Nora,
Glad to hear frm you again. Was gonna send you an email to see how you are doing. You still hv some time for twin 1 to catch up on his weight. But other than that, are his vitals all alright?

Where will you be delivering at? My sincere advice is for you to visit the hospital NICU if you think twin 1 will be warded there. This will help you prepare yourself mentally and emotionally for your visits there.

When I had my sons, I did not get to see them until 3 days after since I had C-sect for twin 2. All I saw was photos and videos my husband took. But when I visited them for the first time at NICU, I was so overwhelmed wt sadness to see them wt tubes all over their body. They were so small and fragile. I was afraid to touch them as I didnt want to disturb the wires etc.

Nora, you will find that life will be much easier wt one twin at home first. It allows you to get into routine then when the 2nd one comes home you can easily try to fit him in. It is definitely possible to breastfeed them both. For this, you might want to contact our other member Cecile as she has lots of experience in breastfeeding of twins.

It will be a be of a challenge to look after 1 twin at home and also having to shuttle to hospital to visit the other. You need a lot of support frm your husband and family and wld be great if you also hv help.

There is no need to spend money on special clothes. My boys fitted tops of 0-3mths and uses normal S-size nappies. Remember that they will grow out of it really fast.

If you need someone to talk to, juz beep me or email me. I am praying for your babies. Be strong...my boys are living proof :)

Ratna

Jan 13th, 2007 - 7:57 PM

Re: Pregnant with Twins but one is too small...

Dear All,

I would like to re-live this thread as I am having the same situation here. I am now in week 30 and my baby is 1.7 kg and 1.1kg. My gynae find this quite alarming and told us to be prepared for early delivery, can be as early as next week. We are in quite a shock as we are hoping to carry the babies until at least 36weeks. We are still hoping for that, as I read some of you managed to carry them a bit longer. I have been resting and not working since I found out that I am pregnant and have been eating quite a lot to make sure that the babies are getting enough, but there seems to be some problem with the blood flow/placenta. We are first time parents and are hoping to find out more about hospitals and neo-natal ICUs in Singapore, and also how to care for premies should I really need to deliver earlier than expected. Really appreciate if you can share with us your experience. Thank you.

*sasha*

Jan 13th, 2007 - 10:46 PM

Re: Pregnant with Twins but one is too small...

Hi Ratna,

As mentioned above, I had my twins at 29wks & their average weight at birth is 1.3kg each & our gynaes actually told us that that was a gd weight for twin preemies.

You did not mention if you are carrying identical or fraternal twins. With identical twins, it is possible for a blood vessel in the placenta to connect the babies' circulatory systems thus causing one baby to receive too much blood & the other too little. This wld also explain the discrepancy in weight btw both twins.

I wld strongly recommend plenty of bed rest & fluids to prevent preterm labour. Alternatively, you can also get your gynae to prescibe some medications. However, if this cannot be stopped & your gynae strongly stands by his opinion that your babies will hv to go thru preterm birth, then I hope that he has started to give you steroid jabs to speed your babies' lung development.

If you can carry them through 33-34 wks, I reckon that is an achievement itself :)

Wt regards to hospital, I delivered my babies at KKH. They hv one of the most well-equipped NICU in the island. Their staff (nurses & neonatolgists) are well-trained & knowledgeable. They also provide classes & support groups for parents of preemies.

I guess you may already hv a hospital of your choice. But, I believe KKH being a childrens’ hospital, caters better to the needs of preemies. I hv heard & seen of cases where babies had to be sent to KKH after birth as the hospital the mother delivered in does not hv the equipment necessary to monitor the baby’s condition. KKH, however, does not necessarily hv to accept such cases as they give priority to their patients which is why most times, their NICU is fully booked. You will also then be charged at private rates.

Speaking of which, you also need to think of financial issues shd your twins be born prematurely as they wld then hv to spend quite a long time in NICU & SCN. I hope that you are aware your babies will be billed according to the class ward you choose. Therefore, it can be quite costly if you were to stay in A-class ward & your babies are born early.

Also, I strongly advise you to visit the NICU BEFORE you deliver to better prepare yourself. I had a shocking experience the 1st time I saw my babies in the NICU. It was horrible & just made me feel so terrible for delivering them early. I believe that if I had visited the NICU earlier, then I cld hv prepared myself better, mentally & emotionally.

Shd you deliver preterm (which I pray you do not), there will be a lot of complications involved in your babies: low birth weight, breathing & digestive difficulties, underdeveloped organs, developmental probs & learning disabilities. They may also be more cranky & unsettled & hv probs wt feeding but all these will be resolved wt either medication, time or both.

Touch & speech is the best way to care for your babies when they are in the NICU. Even the smallest preemies will fight to survive when they come in contact wt both daily. Breastmilk also helps so try to express as soon as you can, to start & maintain your supply. The hospital will gladly store your EBM & feed your babies (most likely they will be tube-fed after birth if they are preemies).

Caring for preemies after their discharge is a very delicate job. You hv to maintain a high level of hygiene as they are more prone to infections so always wash your hands before you hold them., sterilize bottles daily, keep air clean etc. Also, try to avoid visitors coming & touching them or bringing them out too much in the first 3mths or so after discharge.

It is difficult in the beginning but you will get the hang of it after a while. Multiples hv the same needs as other newborns. You may however need more rest & support than you imagined. Take time to enjoy your babies & always ask friends, loved ones & others for help when necessary.

Hope that helps. Pls do not hesitate to email or contact me if you have other worries.

Ratna

Jan 14th, 2007 - 9:05 AM

Re: Pregnant with Twins but one is too small...

Dear Sasha,

Thank you so much for your helpful advise and encouragement. Really appreciate it as we are now quite worried and confused. And it is indeed very encouraging to know that your twins are doing well now despite them being delivered at 29 weeks. You must have done very well taking care of them.

I remembered early in my pregnancy gynae told me that the twins are fraternal. As it progressed further he always noticed that one is progressing in a slower pace than the other, but he was still OK with that. But the discrepancy is getting more alarming and he asked us to do some scanning in TMC to monitor the blood flow, placenta, etc. The result shows that there are no problem with that, but then he threw in the news that we could need to deliver as early as next week if the smaller sister is not growing well. We have been praying that the twins would progress well and on next visit to gynae (which is next Tuesday), there will be more encouraging progress. I have seen the pictures of preemies in the ICU ward from magazine and it really breaks my heart if i were to see my twins in there. And considering that the smaller twin is only about 1.1 kg, I am also worried about her survival...

With regards to hospital. We are now considering KKH as gynae says that the twins could spend 4-5 weeks in NICU, especially the smaller sister. And your advise make us more confident choosing KKH as it has the best NICU in Sg. My husband and I are PRs, do you know whether we are considered as private patients bcos of this, even though we take B2 or C class? This is something which we would like to ask the hospital on Monday as the dept is closed now on weekend. Also if there is a need to feed them EBM, I guess it is about time to invest on a good quality pump, any suggestions on this? Thank's a lot...

*sasha*

Jan 26th, 2007 - 8:47 AM

Re: Pregnant with Twins but one is too small...

Hi Ratna,

Sorry if I had taken a while. I now understand your gynae's worry because first & foremost, your twins are fraternal which then rules out TTTS as a culprit for their weight discrepancy. Sometimes, if one of the babies is growing less well in the womb for no apparent reason, it is a good idea to deliver both babies to give the smaller one a better chance. But this depends on the stage of pregnancy(I wld reckon anytime after 32 wks is gd for twins). It is often said that the womb is the best incubator but it can also be a hostile place for some babies & an early delivery can sometimes be better.

I believed you wld have already gone for your doctor's appt & I hope to hear gd news frm your end. Who is your gynae in KKH then? Wt regards to hospital charges, I believe it is the class you choose. Also depends if you were refered to the hospital or you made the appt on your own & chose your own gynae. For the latter, you will be charged subsidised rates whereas for the former, you will then be charged as a private patient. I may be wrong though so I hope you have also spoken to the hospital regarding this.

There is definitely a need to BF your babies. It is the best souce of nutrition for them. You may have some setbacks wt it in the beginning (I did!) but things will only improve so dont give up on it so easily. KKH also has a great lactation consultant who can help.

Wt regads to breastpump, it depends on your lifestyle. For me, it was sufficient wt a single but definitely electric one. A double one may save you time esp if you are working. I recommend the Medela brand. You may also rent this frm the hospital as an alternative.

Let me know how things are & hope to hear frm you soon.

Ratna

Feb 5th, 2007 - 5:09 PM

Re: Pregnant with Twins but one is too small...

Hi All,

Just to share great news, I just delivered my twins last week. One of my girl birth weight is 1.925 kg, and she spent 1 night in NICU. She is still in the nursery and will be sent home tomorrow morning, and she's doing very well, Thank's God. My other girl 's birth weight is 1.27 kg, and now is dropping some more weight as expected by doctors. But I was told she is coping well and they have increased her formula feed. Couldn't help not to worry about her though.. She looks so small and it breaks my heart to leave her in the NICU. I delivered at 33 wks finally, as 3 gynaes already said that I can't hold on anymore. I am trying to increase my breast milk flow now, and am having some difficult times. One day I can only pump not more than 20 ml but I am still trying hard. Anyone can advise me on this? And I am a bit anxious too as one of my girl will be discharged tomorrow. I am hoping I can cope, taking care of her, pumping breast milk for my smaller girl and other house work...

I really thank you for all the encouragement and advise I got from Nora, Sasha and other folks in this forum. My advise for other forumers with the same problem, please not to worry too much. I was so worried during last few weeks of my pregnancy and it worsened the whole situation. Find a good gynae who are experienced with high risk pregnancy, believe in the powers of prayer, bed rest and relax... Pregnancy should be an enjoyable experience and don't let the situation rob that from us:) My prayers goes to all mothers with preemies... Hoping that our babies will be healty and happy as they are meant to be...

*sasha*

Feb 5th, 2007 - 11:35 PM

Re: Pregnant with Twins but one is too small...

Hi Ratna,

First of all, CONGRATS! I had a feeling you had delivered your twins. Pls do not worry abt your 2nd twin in NICU wt regards to losing weight. It is normal for babies to drop their weight in the first 1-2wks & thereafter, they will put on weight steadily. I experienced the same for my twins.

Wt regards to increasing breast milk flow, you can get your gynae to prescribe fenugreek which helps or talk to the lactation nurse in the hospital who will be more than happy to help & share tips. Are you in KKH?

Frm my experience, it is best to be consistent in expressing. True that the first 2 wks, you may not get much but if you keep up in expressing every 3hrs(even in the early mornings), you will soon get a steady supply of breast milk for your twins.

Like yours, my twins were also discharged separately, abt 7-10days. I do not hv help & on top of that, also had a 2yr old toddler. having one twin home wont actually be that bad. I worked myself around a routine & by the time twin 2 got home, I simply fit him in the routine.

Having a routine will help wt time-management & this will help you wt balancing your chores & looking after your babies as well as have some time off for yourself!

I hope you will have a great motherhood journey wt your newborn & if you do hv any queries or doubts, pls feel free to contact me. My number or direct email is available on the website.

Will we also be seeing you anytime soon during the gatherings? :)

Ratna

Feb 9th, 2007 - 12:01 PM

Re: Pregnant with Twins but one is too small...

Hi Sasha,

Thank you your advice. I have been busy with my girl these past few days and also for feeling very exhausted, though I think all I did is pumping breastmilk and feeding my baby... I didn't know how you manage to cope with the twin plus one toddler:):) I guess when the needs arise we would have the means...

One of my girl is still in NICU, she is in TMC right now. I was keen to go to KKH as we were thinking about the bills but at the end we don't have the time to look for gynae in KKH, it was a really sudden decision to deliver the baby early as I expected to hold on to at least 34-35 wks. After delivery gynae found out that they are sharing placenta, this could be the cause for the discrepancies between the two babies. Right now at day 8 my baby is still below her birth weight and we are a bit worried. But as you said, it is common for the 1-2 weeks, so I guess we just have to wait and pray... Btw BM flow is increasing now, thank's again for your advice:):) Would definitely go for the gatherings, once the twins are already more settled and looking forward to see you and other mummies in person:):)

Justin & Joanne

Feb 9th, 2007 - 5:12 PM

Re: Pregnant with Twins but one is too small...

Hi, Joanne & I has a similar issue with our b/g twins, the upper (girl)twin was not growing as fast as the brother. Our OB mentioned the difference in size early on at 20 weeks however, we adopted a wait and see attitude and took bed rest and proper nutrition advice seriously and the smaller twin manage to grow sufficently that there was no longer a cause for concern up till the 29 week. On that visit our OB told us that the smaller twin seems to be "falling off the chart" and that the plan was to deliver the twins at 34 weeks so that the twins can be taken care of outside the womb. We spoke to other mothers who has "small" babies and since we knew we were going to deliver soon decided to follow their "advice" eat Crabs and Durians (not everyday)from week 32 onwards, The twins did put on some weight fast however it was most likely that it was in line with the gestational growth spurt. We followed the OB's advice and prepared for a elected C-section on 25 Jan 2007 at 34 weeks. The babies were delivered via emergency C-section on 23 Jan at 3pm. They came out kicking screaming and despide beeing tiny they needed minimal support. They are both doing well in NICU and I'll be taking my boy (bigger twin) home tomorrow 10 Feb and the girl (smaller twin) should be out before March. Your OB knows best and bed rest, bed rest , bed rest. Good Luck!

Author	Comment
Nora Aug 4, 05 - 2:20 PM	Pregnant with Twins but one is too small... Hi! I needed some advise and hope that there is somebody who had gone through the same experience as me.... I'm pregnant with twins (now 32wks). However one is smaller than the other; weighing just 840gm while the brother is 1.4kg at last visit to gynae. Doc has prescribed bedrest along with some medications but otherwise said ther's nothing else but to wait. Possibility is to have an early birth if babies are still not growing well. Anybody out there can give me any suggestion as to what I can do to help mty babies put on weight? Does massage help? Email: rafzanur@singnet1500
*sasha* Aug 5th, 2005 - 4:13 AM	Re: Pregnant with Twins but one is too small... Hi Nora, I hope that you are following your doctors advice and taking the bedrest seriously. Can I ask if your babies are identical? Meaning they are monochrionic, in one or separate sac, sharing a placenta. Studies hv shown that there tend to be a greater discrepancy in birth weights between identical twins than in non-identical twins because in the womb they share a blood supply unequally. They might also be affected by the twin-to-twin transfusion (TTTS). Did the doctor mention anything? If one of the babies is growing less well in the womb for no apparent reason, it is a good idea to deliver both babies to give the small one a better chance, this of course depends on the stage of pregnancy. It is often said that the womb is the best incubator but the womb can sometimes be a hostile place for some babies, and early delivery can sometimes be better. Nora, I am not sure what really you can do to help your baby gain weight except that you take a lot of rest. My babies were born at 29weeks weighing an average of 1.3kg and they are doing really well now. I am sure yours will do juz as great. You will be in our prayers and thoughts. Be strong and patient :) Beep us if you need anything else. Take care Sasha Email: sasha@twinsplussing.com Website: http://www.twinsplussing.com
Nora Aug 6th, 2005 - 12:22 AM	Re: Re: Pregnant with Twins but one is too small... Hi Shasha! Thanks for sharing and your encouragement! I really needed that! My twins are actually fraternal and they should have their "own supply of food" right? I really hope they will do just as fine as yours. Can I ask if yours have to stay in hospital after birth and for how long? Did you have a normal delivery or cesarian? I am also not sure if I should opt for cesarian birth or try for a normal delivery should I be able to carry them till full term. I had two cesarian before this due to their breech position. Thanks again Shasha! Email: rafzanur@singnet.com.sg
*sasha* Aug 9th, 2005 - 1:31 AM	Re: Re: Re: Pregnant with Twins but one is too small... Hi Nora, My boys were in the NICU for abt 5wks then another 3wks in SCN. They were discharged only when they were abt 2.5kg and were able to have their milk frm the bottle. I had my elder twin by normal delivery, the second one was in breech so was able to keep him in until they discovered an infection so had me wheeled in for emergency c-section. If I cld do it over again, I hv no doubts abt having a normal delivery! Just have plenty of rest. I am sure you will get thru this and all will be ok. Email: sasha@twinsplussing.com Website: http://www.twinsplussing.com
Mrs.Mani Aug 7th, 2005 - 8:51 PM	Re: Pregnant with Twins but one is too small... Hello Nora, I can understand your situation, as I went thro the same. My twins are 3mths old and are fine now. At about the same time as yours, we found out that the girl was not growing well. they suspected placental problem, any way the problems that Sasha mentioned are ruled out for you since yours is fraternal. As your doc says, there isn't much we can do. I didn't take any spl medicines and don't know what you are taking. But never undermine the advice abt bedrest, it dragged me upto 36 weeks. Your gynae may want you to have frequent scans, so that they can monitor her growth. After 36 weeks my gynae didn't want to wait any further, since the situation didn't improve much, though she managed to gain a bit more. I had induced delivery and it was 'Normal'. You can very well hope for normal delivery, coz the high levels of hormones in twin pregnancies help to have normal delivery. From the very beginning my gynae use to tell that I can have normal delivery. But the position matters, atleast the leading twin should be head down. They are not bothered about the other twin's position, either head down or breech. Mine was exactly the same. My boy was leading and head down, whereas my girl breech. What you can do now, is to have bedrest and eat well. Avoid junk/fatty food and try to have nutritious food like cereals, milk, fruits and veges. Try to have real fruit juices and make sure to have adequate protein. Protein is much emphasised for weight gain. Still you have the possibility that your girl picks up and put on weight normally.(That's what I had been told) Let's pray and hope for the best. There's nothing that prayers cannot do. Good luck and best wishes. Regards, Mrs.Mani. Email: ncmani_sg@yahoo.com.sg
stephanie chiang Aug 15th, 2005 - 8:40 AM	Re: Pregnant with Twins but one is too small... Hi Nora, I have the same situation like you before. One of them stop growing for about 5 weeks (was at 1.3 kg). Indeed it was very worrying and my gynae told me to bed rest when I was 32 weeks. He did blood flow scan every week to ensure that the flow to both babies are okie. Thank God, I managed to carry the pregnacy to 37 weeks. Miraculously, the baby who stop growing for a while managed to grow for the next five weeks. Their birthrate was 2.2 kg and 2.4 kg. I think resting is very important. Just rest well and try not to worry too much. Take care, Steph Email: mwsc13@singnet.com.sg
NORA Aug 28th, 2005 - 2:42 AM	Re: Re: Pregnant with Twins but one is too small... Hi everybody! Its me again. Just an update..My twin 1 is still growing slowing now 1.2kg while the other is steady at 1.8kg. I am now 35wks into my pregnancy. Will be seeing my gynae again end of this week. Thank you so much to Shasha, Ms Marni, Linda and Stephanie for being very encouraging and sharing your experience with me! It really help to know that I am not "alone". Possibility of my smaller twin to be warded in the NICU is quite high (gynae predict about 3-5wks stay) but hopefully the brother would be healthy enough to be discharge. How do you cope with one at home and the other at the hospital? Is it possible to fully breastfeed both of them? What should I do to prepare myself? Should I be getting any special clothes/diapers for my smaller twin or should I wait till I have given birth? I imagine that the usual baby clothes sold outside would be too big right? Thanks again. Hope to hear from someone soon! NORA Email: rafzanur@singnet.com.sg
*sasha* Aug 28th, 2005 - 8:18 AM	Re: Re: Re: Pregnant with Twins but one is too small... Hi Nora, Glad to hear frm you again. Was gonna send you an email to see how you are doing. You still hv some time for twin 1 to catch up on his weight. But other than that, are his vitals all alright? Where will you be delivering at? My sincere advice is for you to visit the hospital NICU if you think twin 1 will be warded there. This will help you prepare yourself mentally and emotionally for your visits there. When I had my sons, I did not get to see them until 3 days after since I had C-sect for twin 2. All I saw was photos and videos my husband took. But when I visited them for the first time at NICU, I was so overwhelmed wt sadness to see them wt tubes all over their body. They were so small and fragile. I was afraid to touch them as I didnt want to disturb the wires etc. Nora, you will find that life will be much easier wt one twin at home first. It allows you to get into routine then when the 2nd one comes home you can easily try to fit him in. It is definitely possible to breastfeed them both. For this, you might want to contact our other member Cecile as she has lots of experience in breastfeeding of twins. It will be a be of a challenge to look after 1 twin at home and also having to shuttle to hospital to visit the other. You need a lot of support frm your husband and family and wld be great if you also hv help. There is no need to spend money on special clothes. My boys fitted tops of 0-3mths and uses normal S-size nappies. Remember that they will grow out of it really fast. If you need someone to talk to, juz beep me or email me. I am praying for your babies. Be strong...my boys are living proof :) Email: sasha@twinsplussing.com Website: http://www.twinsplussing.com
Ratna Jan 13th, 2007 - 7:57 PM	Re: Pregnant with Twins but one is too small... Dear All, I would like to re-live this thread as I am having the same situation here. I am now in week 30 and my baby is 1.7 kg and 1.1kg. My gynae find this quite alarming and told us to be prepared for early delivery, can be as early as next week. We are in quite a shock as we are hoping to carry the babies until at least 36weeks. We are still hoping for that, as I read some of you managed to carry them a bit longer. I have been resting and not working since I found out that I am pregnant and have been eating quite a lot to make sure that the babies are getting enough, but there seems to be some problem with the blood flow/placenta. We are first time parents and are hoping to find out more about hospitals and neo-natal ICUs in Singapore, and also how to care for premies should I really need to deliver earlier than expected. Really appreciate if you can share with us your experience. Thank you. Email: josephine_rdkn@yahoo.com.sg
*sasha* Jan 13th, 2007 - 10:46 PM	Re: Pregnant with Twins but one is too small... Hi Ratna, As mentioned above, I had my twins at 29wks & their average weight at birth is 1.3kg each & our gynaes actually told us that that was a gd weight for twin preemies. You did not mention if you are carrying identical or fraternal twins. With identical twins, it is possible for a blood vessel in the placenta to connect the babies' circulatory systems thus causing one baby to receive too much blood & the other too little. This wld also explain the discrepancy in weight btw both twins. I wld strongly recommend plenty of bed rest & fluids to prevent preterm labour. Alternatively, you can also get your gynae to prescibe some medications. However, if this cannot be stopped & your gynae strongly stands by his opinion that your babies will hv to go thru preterm birth, then I hope that he has started to give you steroid jabs to speed your babies' lung development. If you can carry them through 33-34 wks, I reckon that is an achievement itself :) Wt regards to hospital, I delivered my babies at KKH. They hv one of the most well-equipped NICU in the island. Their staff (nurses & neonatolgists) are well-trained & knowledgeable. They also provide classes & support groups for parents of preemies. I guess you may already hv a hospital of your choice. But, I believe KKH being a childrens’ hospital, caters better to the needs of preemies. I hv heard & seen of cases where babies had to be sent to KKH after birth as the hospital the mother delivered in does not hv the equipment necessary to monitor the baby’s condition. KKH, however, does not necessarily hv to accept such cases as they give priority to their patients which is why most times, their NICU is fully booked. You will also then be charged at private rates. Speaking of which, you also need to think of financial issues shd your twins be born prematurely as they wld then hv to spend quite a long time in NICU & SCN. I hope that you are aware your babies will be billed according to the class ward you choose. Therefore, it can be quite costly if you were to stay in A-class ward & your babies are born early. Also, I strongly advise you to visit the NICU BEFORE you deliver to better prepare yourself. I had a shocking experience the 1st time I saw my babies in the NICU. It was horrible & just made me feel so terrible for delivering them early. I believe that if I had visited the NICU earlier, then I cld hv prepared myself better, mentally & emotionally. Shd you deliver preterm (which I pray you do not), there will be a lot of complications involved in your babies: low birth weight, breathing & digestive difficulties, underdeveloped organs, developmental probs & learning disabilities. They may also be more cranky & unsettled & hv probs wt feeding but all these will be resolved wt either medication, time or both. Touch & speech is the best way to care for your babies when they are in the NICU. Even the smallest preemies will fight to survive when they come in contact wt both daily. Breastmilk also helps so try to express as soon as you can, to start & maintain your supply. The hospital will gladly store your EBM & feed your babies (most likely they will be tube-fed after birth if they are preemies). Caring for preemies after their discharge is a very delicate job. You hv to maintain a high level of hygiene as they are more prone to infections so always wash your hands before you hold them., sterilize bottles daily, keep air clean etc. Also, try to avoid visitors coming & touching them or bringing them out too much in the first 3mths or so after discharge. It is difficult in the beginning but you will get the hang of it after a while. Multiples hv the same needs as other newborns. You may however need more rest & support than you imagined. Take time to enjoy your babies & always ask friends, loved ones & others for help when necessary. Hope that helps. Pls do not hesitate to email or contact me if you have other worries. Email: sasha@twinsplussing.com Website: http://www.twinsplussing.com
Ratna Jan 14th, 2007 - 9:05 AM	Re: Pregnant with Twins but one is too small... Dear Sasha, Thank you so much for your helpful advise and encouragement. Really appreciate it as we are now quite worried and confused. And it is indeed very encouraging to know that your twins are doing well now despite them being delivered at 29 weeks. You must have done very well taking care of them. I remembered early in my pregnancy gynae told me that the twins are fraternal. As it progressed further he always noticed that one is progressing in a slower pace than the other, but he was still OK with that. But the discrepancy is getting more alarming and he asked us to do some scanning in TMC to monitor the blood flow, placenta, etc. The result shows that there are no problem with that, but then he threw in the news that we could need to deliver as early as next week if the smaller sister is not growing well. We have been praying that the twins would progress well and on next visit to gynae (which is next Tuesday), there will be more encouraging progress. I have seen the pictures of preemies in the ICU ward from magazine and it really breaks my heart if i were to see my twins in there. And considering that the smaller twin is only about 1.1 kg, I am also worried about her survival... With regards to hospital. We are now considering KKH as gynae says that the twins could spend 4-5 weeks in NICU, especially the smaller sister. And your advise make us more confident choosing KKH as it has the best NICU in Sg. My husband and I are PRs, do you know whether we are considered as private patients bcos of this, even though we take B2 or C class? This is something which we would like to ask the hospital on Monday as the dept is closed now on weekend. Also if there is a need to feed them EBM, I guess it is about time to invest on a good quality pump, any suggestions on this? Thank's a lot... Email: Josephine_rdkn@yahoo.com.sg
*sasha* Jan 26th, 2007 - 8:47 AM	Re: Pregnant with Twins but one is too small... Hi Ratna, Sorry if I had taken a while. I now understand your gynae's worry because first & foremost, your twins are fraternal which then rules out TTTS as a culprit for their weight discrepancy. Sometimes, if one of the babies is growing less well in the womb for no apparent reason, it is a good idea to deliver both babies to give the smaller one a better chance. But this depends on the stage of pregnancy(I wld reckon anytime after 32 wks is gd for twins). It is often said that the womb is the best incubator but it can also be a hostile place for some babies & an early delivery can sometimes be better. I believed you wld have already gone for your doctor's appt & I hope to hear gd news frm your end. Who is your gynae in KKH then? Wt regards to hospital charges, I believe it is the class you choose. Also depends if you were refered to the hospital or you made the appt on your own & chose your own gynae. For the latter, you will be charged subsidised rates whereas for the former, you will then be charged as a private patient. I may be wrong though so I hope you have also spoken to the hospital regarding this. There is definitely a need to BF your babies. It is the best souce of nutrition for them. You may have some setbacks wt it in the beginning (I did!) but things will only improve so dont give up on it so easily. KKH also has a great lactation consultant who can help. Wt regads to breastpump, it depends on your lifestyle. For me, it was sufficient wt a single but definitely electric one. A double one may save you time esp if you are working. I recommend the Medela brand. You may also rent this frm the hospital as an alternative. Let me know how things are & hope to hear frm you soon. Email: sasha@twinsplussing.com Website: http://www.twinsplussing.com
Ratna Feb 5th, 2007 - 5:09 PM	Re: Pregnant with Twins but one is too small... Hi All, Just to share great news, I just delivered my twins last week. One of my girl birth weight is 1.925 kg, and she spent 1 night in NICU. She is still in the nursery and will be sent home tomorrow morning, and she's doing very well, Thank's God. My other girl 's birth weight is 1.27 kg, and now is dropping some more weight as expected by doctors. But I was told she is coping well and they have increased her formula feed. Couldn't help not to worry about her though.. She looks so small and it breaks my heart to leave her in the NICU. I delivered at 33 wks finally, as 3 gynaes already said that I can't hold on anymore. I am trying to increase my breast milk flow now, and am having some difficult times. One day I can only pump not more than 20 ml but I am still trying hard. Anyone can advise me on this? And I am a bit anxious too as one of my girl will be discharged tomorrow. I am hoping I can cope, taking care of her, pumping breast milk for my smaller girl and other house work... I really thank you for all the encouragement and advise I got from Nora, Sasha and other folks in this forum. My advise for other forumers with the same problem, please not to worry too much. I was so worried during last few weeks of my pregnancy and it worsened the whole situation. Find a good gynae who are experienced with high risk pregnancy, believe in the powers of prayer, bed rest and relax... Pregnancy should be an enjoyable experience and don't let the situation rob that from us:) My prayers goes to all mothers with preemies... Hoping that our babies will be healty and happy as they are meant to be... Email: Josephine_rdkn@yahoo.com.sg
*sasha* Feb 5th, 2007 - 11:35 PM	Re: Pregnant with Twins but one is too small... Hi Ratna, First of all, CONGRATS! I had a feeling you had delivered your twins. Pls do not worry abt your 2nd twin in NICU wt regards to losing weight. It is normal for babies to drop their weight in the first 1-2wks & thereafter, they will put on weight steadily. I experienced the same for my twins. Wt regards to increasing breast milk flow, you can get your gynae to prescribe fenugreek which helps or talk to the lactation nurse in the hospital who will be more than happy to help & share tips. Are you in KKH? Frm my experience, it is best to be consistent in expressing. True that the first 2 wks, you may not get much but if you keep up in expressing every 3hrs(even in the early mornings), you will soon get a steady supply of breast milk for your twins. Like yours, my twins were also discharged separately, abt 7-10days. I do not hv help & on top of that, also had a 2yr old toddler. having one twin home wont actually be that bad. I worked myself around a routine & by the time twin 2 got home, I simply fit him in the routine. Having a routine will help wt time-management & this will help you wt balancing your chores & looking after your babies as well as have some time off for yourself! I hope you will have a great motherhood journey wt your newborn & if you do hv any queries or doubts, pls feel free to contact me. My number or direct email is available on the website. Will we also be seeing you anytime soon during the gatherings? :) Email: sasha@twinsplussing.com Website: http://www.twinsplussing.com
Ratna Feb 9th, 2007 - 12:01 PM	Re: Pregnant with Twins but one is too small... Hi Sasha, Thank you your advice. I have been busy with my girl these past few days and also for feeling very exhausted, though I think all I did is pumping breastmilk and feeding my baby... I didn't know how you manage to cope with the twin plus one toddler:):) I guess when the needs arise we would have the means... One of my girl is still in NICU, she is in TMC right now. I was keen to go to KKH as we were thinking about the bills but at the end we don't have the time to look for gynae in KKH, it was a really sudden decision to deliver the baby early as I expected to hold on to at least 34-35 wks. After delivery gynae found out that they are sharing placenta, this could be the cause for the discrepancies between the two babies. Right now at day 8 my baby is still below her birth weight and we are a bit worried. But as you said, it is common for the 1-2 weeks, so I guess we just have to wait and pray... Btw BM flow is increasing now, thank's again for your advice:):) Would definitely go for the gatherings, once the twins are already more settled and looking forward to see you and other mummies in person:):) Email: Josephine_rdkn@yahoo.com.sg
Justin & Joanne Feb 9th, 2007 - 5:12 PM	Re: Pregnant with Twins but one is too small... Hi, Joanne & I has a similar issue with our b/g twins, the upper (girl)twin was not growing as fast as the brother. Our OB mentioned the difference in size early on at 20 weeks however, we adopted a wait and see attitude and took bed rest and proper nutrition advice seriously and the smaller twin manage to grow sufficently that there was no longer a cause for concern up till the 29 week. On that visit our OB told us that the smaller twin seems to be "falling off the chart" and that the plan was to deliver the twins at 34 weeks so that the twins can be taken care of outside the womb. We spoke to other mothers who has "small" babies and since we knew we were going to deliver soon decided to follow their "advice" eat Crabs and Durians (not everyday)from week 32 onwards, The twins did put on some weight fast however it was most likely that it was in line with the gestational growth spurt. We followed the OB's advice and prepared for a elected C-section on 25 Jan 2007 at 34 weeks. The babies were delivered via emergency C-section on 23 Jan at 3pm. They came out kicking screaming and despide beeing tiny they needed minimal support. They are both doing well in NICU and I'll be taking my boy (bigger twin) home tomorrow 10 Feb and the girl (smaller twin) should be out before March. Your OB knows best and bed rest, bed rest , bed rest. Good Luck! Email: jusper@starhub.net.sg

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