While I was pregnant with my boy/girl twins I knew there was a good chance they would spend at least some amount of time in the Neonatal Intensive Care Unit (NICU). What I didn’t know was that when my twins made their debut via emergency C-section at 31 weeks we would be spending the next 4 ½ months there.  Here are a few tidbits I learned during our 133 days in the NICU:

1. Even before your multiples are born, research your local NICUs. 

If you have multiple options for where to deliver your twins take the NICU into consideration.  To avoid having your children transferred to a different hospital than you it is important to know your NICU Levels, especially if you know your child(ren) may have congenital conditions. Does your local NICU have private rooms or multi-patient pods? Are you allowed to stay with your children 24/7 or only during certain hours? What is important to you? You may also be able to get a tour of the facility so you know what to expect. Like the good ol’ saying goes, hope for the best but prepare for the worst. 

2. The NICU can be traumatic, but it can also be amazing. 

I was completely naive about my twins being in the NICU.  It wasn’t until I saw how fragile and sick my preemies were that everything came into perspective.  Seeing all the monitors and hearing the alarms going off constantly was completely overwhelming.  I didn’t understand most of what the doctors and nurses were telling me, but I quickly learned a new vocabulary. Just search the internet for “NICU glossary” and you’ll find countless helpful articles.

Seeing your children struggle to breath will stay with you forever, and nothing will make you feel more guilty than leaving them behind and going home without them. You’ll probably feel horribly alone but you aren’t. I promise every parent there is feeling a thousand different emotions, just like you.

Some days might feel like one step forward, ten steps back but keep in mind your children are still in their third trimester and you get to watch them develop and grow! How cool is that?  And the day they no longer need breathing support or a gavage tube will teach you the meaning of celebration.

3. Trust the doctors but also trust your gut.

NICU physicians are awesome.  They are special people that have made it their career to keep tiny babies alive.  That being said, they don’t know everything.  They can go off their knowledge and experience of what “normally” happens in certain scenarios, but every child is different.  Educate yourself and trust your gut.  If you don’t feel comfortable with a procedure or method of care talk to the doctors and ask lots of questions.  Get the opinions of other available doctors. Especially for first time moms like I was, I felt I had to ask for permission to care for my own child. They are yours, you have a say.  However, please also keep in mind that as much as you may not want a certain procedure or medical device for your child, they may truly need it.

4. Spoil your nurses.

Or at least be super duper extra nice to them.  Nurses do not get the recognition they deserve! You will quickly learn that the people ultimately caring for your babies are the nurses. You may only speak with a doctor once a day for a medical update, but the nurses are the ones doing the grunt work for you, because they genuinely LOVE your child.  I considered our nurses my twins’ mothers while I couldn’t be.  The first few days we brought our nurses gallons of Starbucks coffee and giant cake-pops. By those little acts of kindness they knew who we were, they were happy to see us, and I believe subconsciously they took better care of our babies because of it.

5. Donor breastmilk is legit – take it if offered. 

I didn’t know about donor breastmilk when my twins were born.  I was in my room recovering from my c-section and one of the NICU doctors came to ask for my consent to give my children donor breastmilk.  I think I probably looked at him like he was crazy because the thought of giving my children another woman’s breastmilk sounded disgusting and dangerous.  At the time I wasn’t producing enough for both of my babies so they needed to supplement them with donor milk or formula.  He reassured me that the milk is screened and pasteurized; the benefits outweighed any potential risks.  That being said, FORMULA IS NOT POISON! Unless you are a milk producing goddess we all hope to be, you will likely be giving your twins formula as well. It’s a lifesaver, literally.

6. If you are suffering, seek help! 

Three weeks after my twins were born I was diagnosed with Postpartum Depression and Posttraumatic Stress Disorder.  Imagine every negative emotion coursing through you all at the same time constantly for over 20 days straight. Sadness, fear, anxiety, worry, exhaustion, disappointment, regret, loss, inadequacy. And I don’t mean like I was bummed out or feeling blue. My chest ached with deep terrifying sadness and fear. I felt completely useless to my children.  I regretted having them at all.  I showed up to the NICU multiple times a day but I didn’t want to be there.  When at home I pumped nonstop for them but I hated myself when 30 minutes later I only had an ounce or two to take to them.  When doctors would talk to me I could only nod and fight back the tears, I couldn’t contribute to the conversation or to the care of my children. Every time the monitors would go off my heart would race and I would go into fight or flight mode. And one day I snapped.  Both of my children’s monitors kept going off, back and forth, loud piercing beeps in the quiet of the NICU. I wanted to get up and run out of there but instead I grabbed my phone and penned a desperate email to my doctor.  The next day I was started on an antidepressant.

I am not ashamed to admit that I am medicated.  It is the best thing I have ever done for my kids and marriage.  Once the medication took effect I could control my emotions.  I could hold a productive conversation with the doctors and discuss my children’s care without crying.  I could think reasonably and logically.  And best of all I began to see the positive sides of everything; I saw everything as blessings in disguise.  Every time my husband and I had received bad news, we made “positive positive positive” our mantra, and now I could really live it.  I wasn’t manic by any means, I still felt sadness and anxiety but at a manageable level.

Your babies need a strong tiger mom! Be it medication or meditation, exercise or support groups: do whatever you need to do in order to be an effective advocate for your children.

7. Have a sense of humor!

I know there is nothing funny about watching your babies fight for their lives. But it’s also hilarious when your husband changes his first diaper and gets poop shot up his arm.  Or when your child refluxes but farts at the same time.  It’s OK to laugh and smile even when you’re surrounded by sick babies. Laughter is the best medicine!

8. These kids are so much stronger than they look.

If your multiples are born prematurely they may be the tiniest little nuggets you’ve ever seen. Seeing them covered in tubes and wires just adds to their fragile appearance, but do not underestimate them! Babies are amazingly resilient and will quickly become your tiny heroes.

9. Breastmilk and pumping may be your ultimate nemesis (but you’ll miss it later).

Pumping, pumping, pumping, and more pumping.  While your babes are in the NICU it may feel like all you do is pump. The 8-12 times a day recommendation is a killer schedule.  I would dread when my pump alarm would go off every 2-3 hours. Before my twins were born I dreamed of breastfeeding both for at least a year, that was my goal. Pumping at first is amazing because you can actually watch your colostrum and milk coming in.  It quickly turned into a chore that had to be planned around.  No matter how often I pumped it was never enough, leaving me feeling inadequate.  I had to keep reminding myself that some was better than none.

In retrospect I don’t know how I kept it up for 11 months.  When the time came to wean it was bittersweet; it felt like the end of an era in a way. I’m sure breastfeeding mothers feel the same way.

10. If your preemies need to come home with any special equipment YOU CAN HANDLE IT!

Chances are you won’t need to worry about it, but sometimes premature babies need special equipment in order to go home safely. If the thought of lugging around oxygen tanks or monitors sounds overwhelming, you aren’t alone.  Just remember if this applies to you that it’s totally manageable! Yes, it can be a pain in the ass but you’ve made two or more humans with your body at the same time – you can do anything!

11.  And this is an important one! You may find yourself hugely, painfully, wrathfully, envious of mothers with full term babies. 

ESPECIALLY full term multiples. That bitch is SUPERWOMAN!