Archive for the 'Guilt' Category

The day we gave the bottles away

Published
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twinutero
on April 6, 2008
in Fair & green, Feeding, Guilt and Sleep
. 0 Comments

It was overdue, long overdue.

Last weekend we finally rid the house of all baby bottles. Alex and Jon are over two, after all, and Thomas is three and a half. It was embarrassing to have them ask for a bottle in public or have visitors pass a load of empty bottles in the kitchen sink.

Mostly, we were tired of the dependency. Whenever the kids were sleepy, or upset or awake in the night, they would ask for a bottle of milk. They didn’t always get one, but they were rewarded often enough to keep asking.

Why did we wait so long? Because there never seemed a good time to take away something so obviously comforting. Had Thomas been an only child, or more than fifteen months older than his brothers, we would have weaned him long ago. But I don’t think he sees himself as older at all (well, except when it’s convenient) so it was hard to say yes to the twins and no to Thomas. We decided to wait until they were all ready to leave the bottles behind.

That, of course, could have been long ago. All three kids started drinking from sippy cups before they were one and from real cups before they were two. They didn’t need a bottle to have a drink. They sometimes needed a bottle to settle down, however. It was a habit, and with all the changes of the past six months (i.e., moving to a different hemisphere) we were reluctant to break the habit and further rock their world.

Last weekend, however, after a string of wakeful nights, we said enough. In the morning, we told the kids that today was a special day. We were going to pack up all the bottles and give them to some babies who need them more than we do. Everyone helped, Jon most enthusiastically. The bottles went into a bag; the bag went to “the babies”. In fact, the bottles went to the basement until we were sure we could handle life without the bottle crutch. Yesterday, they did go to less-fortunate children in a nearby township.

The transition was surprisingly easy. We always have an answer to “I want a bottle.” Jon usually pipes up with, “Some babies.” They have seen the bottles go into the bag and they know that babies, not boys, have milk in a bottle.

We’ve replaced nightly bottles with Klean Kanteen sippy cups. Klean Kanteen products are stainless steel, free of bisphenol-A, odorless and dripless. We bought them in Ottawa before we left (at Arbour). They are pricey however and the kids objected to the chill of holding a steel cup. So we found bottle insulators and now have the most expensive sippy cups on the planet.

But… we have no bottles.

Is blogging about your kids exploitation?

Published
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twinutero
on March 15, 2008
in Blogging & writing and Guilt
. 0 Comments

This question has been on my mind since I started reading mommy-blogs – more so since I started my own.

What is the difference between showing cute photos of your children to relatives, friends, or even acquaintances met on airplanes, and posting those same photos to a blog? In my mind, a big difference.

Sharing pictures and guess-what-my-kid-did-today stories with relatives deepens a personal and hopefully enduring connection. Same for friends. Sharing with strangers and acquaintances strengthens your connection with that person, but does little for your kids.

In all of those circumstances, though, you have control over who sees the photos and hears the stories, and more often than not you get direct feedback, so you know whether you want to continue sharing with this person.

Not so with a blog, of course. That photo of your baby breastfeeding, your toddler in diapers or your preschooler sleeping are out there for anyone with an internet connection to see.

Call me paranoid, Luddite, introverted (I may indeed be all of those) but I have a problem with posting intimate moments of my child’s life to the world. It is, after all, their life.

“Your children are not your children,” as Kahil Gibran famously wrote and Sweet Honey in the Rock beautifully sang.

That photo, now cataloged on the internet, is a fragment of a life that will expand in a million directions to form a complex adult with a very real and personal past. We’d think twice about posting a candid bedroom shot of our spouse or an entertaining faux pas of a sibling. I don’t think children are different.

Informed consent and benefit-sharing are two basic ethical principles drilled into every student of moral philosophy. It’s generally acknowledged that receiving informed consent from a young child is impossible. As for sharing benefits? Well, why do we blog? To share our “lessons learned” with a community of peers; to see our writing and photography published; to be heard; to gain a following; to earn money….

Few of these benefits go directly (if at all) to the main subjects of the blog, our children. Yet they carry a fair share of the risks, mainly loss of privacy although one could imagine worse.

So where do you draw the line? Have I already crossed it, despite attempts to respect my family’s privacy? Are all memoirs – and blogs are memoirs of a kind – exploitative? As with most ethical issues, debate is open and sometimes the best criterion is “I know it when I see it.”

I’ve seen plenty of insightful, respectful mommy- and daddy-blogs. I’ve also seen many where my sole thought is, “Are those kids going to be pissed….”

Prenatal testing with twins

Published
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twinutero
on November 9, 2007
in Coping, Guilt and Pregnancy
. 0 Comments

I underwent prenatal genetic testing during my pregnancy with Thomas (when I was 38) and with Alex and Jon (when I was 39). Both times, my husband and I agonized over the decision. We received genetic counseling before consenting to amniocentesis with Thomas. This is standard practice in Ontario, probably elsewhere as well. However, counseling is required only once and therefore we were not sent for (nor did we seek out) the standard counseling classes when I was pregnant with the twins.

But prenatal testing is different for multiple gestations. We gradually learned of these differences through our own research and through umpteen phone calls to the wonderful team of counselors at CHEO (our regional children’s hospital).

There are many academic and technical papers on the web describing the procedures, risks, and benefits of prenatal testing. Some of these talk about multiples. However, I have never found a website, written in plain language, that lays out the differences between testing in a single versus a multiple pregnancy.

So, with the hope that it will help other parents making this profoundly emotional decision, here is what I have learned. (And here’s my disclaimer: I am not a doctor. This is my understanding of the facts but best to check them with your doctor!)

1. If you have fraternal twins, the chances that you will give birth to a child with a genetic abnormality are much greater. The chance that any one of the babies is affected remains the same as for a singleton, since fraternal twins are the result two separate conceptions (two eggs; two sperm). However, because you’re having two babies at the same time, the total risk for that birth is doubled.

2. Prenatal screening in a singleton pregnancy usually involves testing the mother’s blood in the first and second trimester to measure levels of fetal proteins (called maternal serum screen), and an ultrasound in the first trimester to measure a fluid-filled sac at the back of the fetus’ neck (called nuchal translucency). In a multiple pregnancy, however, the blood tests are not an accurate screen for Down syndrome or trisomy 18. Therefore, screening for these conditions is done using nuchal translucency only.

3. The maternal serum screen is not accurate for two reasons. First, there is not enough information on normal levels of fetal proteins in a multiple pregnancy. It’s therefore difficult to know what is abnormal. Second, normal versus abnormal gets completely messed up when more than one fetus contributes proteins to the mother’s blood. For example, higher levels from one baby may be masked by lower levels from its sibling.

4. Because the blood tests cannot be used, the screen is much less reliable. In a singleton pregnancy, when blood tests are used, the boundary between a positive and negative screen is usually set at one in 250. In other words, if the screen shows that the risk of Down syndrome or trisomy 18 is greater than one in 250, the screen is positive; if it is less than one in 250, the screen is negative. However, in a multiple pregnancy, this all-important boundary is set at one in 375. This means that many more results will be positive, and this is simply because the test is not very accurate.

5. Amniocentesis increases the risk of miscarriage. There is about a one in 200 chance of fetal loss following the test. This risk is higher for twins that are in separate amniotic sacs. This is because two needles are required sample fluid from the two sacs. The rate of miscarriage may be increased for up to five weeks following the test. (I haven’t read about amniocentesis for higher order multiples. I’m not sure if it’s done.)

6. Amniocentesis with twins can be tricky not only because the babies may be in two amniotic sacs, but also because they may be on top of each other or positioned in another way that makes it difficult to reach. If this happens (as it did with us), the test may be delayed for a week or so until the babies shift. Furthermore, it is recommended that no more that two needles are inserted during one test. If the doctor cannot successfully draw two samples after using two needles, the test must be delayed at least 24 hours.

I can’t go on, I’ll go on (Part 2)

Published
by
twinutero
on August 20, 2007
in Coping and Guilt
. 2 Comments

It wasn’t that I denied postpartum depression. After my discouraging attempts to contact the helpline and clinic, I simply dropped the idea that I might be ill and began to believe that I was just having a difficult time.

But there were other warnings that, in retrospect, I might have heeded. A traumatic postpartum period was one. Crushing sleep deprivation was another. I’ve already written about our sleep trials which, I’m sorry to report, continue to this day. The first couple of months after the twins were born however, were bordering on torturous.

I remember getting up with the kids one morning and slumping into the armchair in the living room. I immediately fell asleep. Only for a second; just long enough for Thomas, then about seventeen months old, to climb to standing on a dining room chair. I woke to see him grinning at me, then I fell back to sleep – again just for a second. That was the only time I drifted off while “on duty”. Most of the time I just felt nauseous for lack of sleep, and occasionally, while doing errands, it wondered if I was truly fit to drive.

I have since learned that depression and sleep deprivation are co-conspirators. It’s very hard to get the better of depression without sleep, yet it’s very hard to sleep with two new babies and an active toddler.

And then there was my behavior. Throwing my dinner across the living room was the most impetuous outburst. There were many other anomalies, however, most of which can be summarized as “losing myself”. My parents and husband often urged me to get out of the house. Alex and Jon were born in early December. That month seemed particularly dark and slushy, and was followed by a frigid January. We hadn’t yet bought our double stroller so getting outside with the kids seemed a monumental undertaking. Strangely, getting out alone was equally monumental. I simply didn’t know where to go, or what to do.

One afternoon my parents successfully coaxed me out the door. I wasn’t on a mission; there was no agenda other than to spend time away from the babies and on my own. I can now think of a dozen places I would go, given that opportunity. Then, however, I felt completely dissociated from life outside the house, outside my kids. There was nothing there that engaged me or even involved me. I drove aimlessly around the city for an hour and came home.

None of this struck me as particularly odd – at least not until it culminated in the now infamous flying-dinner. The morning after the chicken was scrapped from the wall, I called my doctor. She saw me immediately. Without hesitation she recommended medication, and without hesitation I accepted. Perhaps under other circumstances I would have insisted on therapy rather than pharmaceuticals. But I was scared. I had three little boys at home depending on me.

So I started on Zoloft. It’s one of the older SSRIs and the one most often prescribed for breastfeeding mothers. It takes several weeks to kick in and the effects, at least for me, are gradual and subtle. I knew I had reached a turning point when (it seems so trivial now) I walked a few blocks to stationery shop, browsed for a while, and bought a new journal. Not that wandering and consumerism are signs of mental health, it was that I did this purely for enjoyment. I walked because it felt good, and I bought the journal because I liked the flowers on the front cover. I did something for me. At the time, it was liberating, even bold.

Looking back on that day, I realize that the world – the world with my kids – has since opened again. There are still challenging times (Thomas didn’t learn the words Jesus Christ at Sunday school) but the flat gray has lifted and life is now shockingly vivid.

To be continued….

I can’t go on, I’ll go on. (Part 1)

Published
by
twinutero
on August 2, 2007
in Coping and Guilt
. 3 Comments

I’m not a big Samuel Beckett fan, but he did have a way of capturing resignation – and resolve. Many times, especially during the six months after the twins were born, I have thought: I simply can’t go on. Then, after napping or crying or walking or slamming a few doors, I have always resolved to go on.

It sounds dramatic, but it’s accurate. I was diagnosed with postpartum depression when Alex and Jon were four months old. I haven’t yet written about it because the memories are painful, embarrassing and confusing. Also, I’m not over it; I’m medicated. That too is difficult for me to admit and talk about. But here goes….

Thanks in part to Brooke Shields and many bloggers, it has become somewhat fashionable to write about postpartum depression. So much the better because I am sure many more women suffer from it than are diagnosed. There are now graphic posters in maternity wards, doctor’s offices and even on the side of city buses. I was well aware of PPD before Thomas was born, and anticipating the added strain of two more babies, I was on alert when the twins were born. Still, it took four months for me to realise that I wasn’t myself and needed help.

That realisation hit me one evening as a full plate of pineapple chicken hit the living room wall. I had hurled it from across the room. The kids were in bed, thankfully. How could I explain to them why Mommy was throwing her food? I couldn’t explain it to anyone. But it was good to have something – even a plate of pineapple chicken – fully under my control because everything else seemed beyond me. I felt gnawed at, picked apart by the formidable responsibility of caring for three children under two years old, nurturing a marriage that was also under two years old, accepting the ailing health of my mother, appreciating the superhuman help of my father - and holding onto something of myself. Everyone needed part of me and no one, myself included, was happy with the part they got.

It was not a permanent state. There were days when feelings of competence and self-confidence edged out those of absolute inadequacy. Well, there were parts of days. I never doubted my fortune and never lost the exquisite love for my family. I never got that low. But I can see, now, that it is possible and even that small glimpse is truly terrifying.

It shouldn’t have taken me so long to recognize PPD. In retrospect, the triggers and symptoms were obvious.

Trauma during or after birth has been linked to postpartum depression and giving birth to the twins was not straight-forward, as is often the case for multiple births. I was induced at almost thirty-nine weeks. Jon was delivered with amazing ease. Alex however, dug in his heels. He was breech and the doctors used all their might and ingenuity to turn him. After an hour, he was delivered by Cesarean while Jon, who I had barely seen, was in the NICU.

They were both healthy. I was worse off. The birth wasn’t easy, but it wasn’t traumatic. The pain that followed, the hospital stays, the failure of doctors to diagnose a problem, the nights without my babies, the tests and drugs – that was traumatic. By the time I was ready to leave the hospital for good, I had, at the urging of several nurses, seen a social worker and a psychiatrist. They asked if I was depressed. They asked my husband if I was depressed. We both said no – and believed it – and went home.

Over the next few weeks, my confidence in this self-diagnosis foundered. I took steps. I called a helpline. They said, basically, if you aren’t thinking of killing yourself or someone else, you’ve called the wrong number. Okay…. A few days later I called a clinic at the hospital where I had given birth. This number and option was given to me by the social worker. I left my name and number – and they never called back. A depressive asking for help is almost oxymoronic. It takes a major power surge, strong and fleeting, to reach out. Acknowledgement is vital.

So I let it go.