Friday, October 23, 2009

The Quest for Five-Pound Preemies

The Quest for Five-Pound Preemies

But first, something cute that Chiara said: Sometimes she pretends to be a baby (most of the time she’s a mama or a grandma).  The other day she told me, “Hold me, I’m a baby.  But be careful [sic] my umbilicord.”

Back to the Peas: there’s a lot of shocking things we’ve heard so far, but I won’t do the recap.  At our third prenatal appointment, our first with the high risk perinatologist, we heard another doozy:

 “You know, there’s a lot we can do with 3 pound babies.”

A lot we can do with 3 pound babies????  He made it sound like that was our goal weight.  Are you serious?  Can’t we aim a little bit higher?  I have textbooks that weigh more than three pounds.  In fact, I think my first cell phone weighed more than three pounds.  I don’t care what you can do with three pound babies.  I don’t want no three pound babies!  I want babies that weigh at least as much as my laptop.  So how do I grow huge, healthy preemies?

The thing is, if all goes well, these babies will only be preemies because the risk of cord entanglement is so great, and the doctors think it’ll be safer to take them early than to let them cook a little longer.  So in theory, these should be the healthiest preemies ever because they weren’t delivered early as a reaction to an early labor, as the case in most situations.

Back to the FAQS:

There are several different ranks of preemies, based on gestational age.  Obviously, the earlier the gestational age, the higher the risks for complications, both acute and chronic and the longer the babies will have to stay in the neonatal intensive care unit (the “NICU”).

23 – 24 weeks is considered to be the edge of viability.

23 – 28 are the “micro preemies.”  These are the twins that Ang had.  (See first post).  Her twins are healthy now, but a lot of that’s because Ang and her husband work hard to keep them that way.  (Mr. Ang has a special relationship with his Purell bottle and in fact, wears one on his belt like a modern day germ-killing gunslinger). Because of their delicate immune systems, micro preemies can’t travel on planes or be in daycare for two flu seasons.  I have told the Peas that this is not an option for us.  We have a very important family reunion Labor Day weekend and the Peas MUST be there to meet the other three new cousins that are coming into this world between February and April, 2010.

28 – 32 weeks is considered early preterm.  If we had stayed at our hospital in the city (instead of transferring care to an Oakland hospital), 28 weeks is when I’d check in and 32 weeks (best case scenario) is when the twins would come out.  If the delivery isn’t an emergency (and hopefully ours won’t be), the mother is given steroid shots a few days before her C-section.  This helps the babies’ lungs develop more quickly.  Babies born at 32 weeks can still have complications, but they can be out and home in as early as 3 weeks. These are the 3 pounders that the doctor was talking about.  They can’t breastfeed right away because they haven’t developed their sucking reflex yet, but many moms of early preterms are able to pump so their milk still gets fed to the babes. 

32 – 34 weeks is considered late preterm for twins (for “singletons”—a term Matt thinks sounds a little condescending—late term is 34 – 36 weeks).  At 34 weeks, if the babies weigh enough, there’s a good chance that they can come home either with the mother or just a few days later.

37 weeks is considered term for any baby, but for twins, 37 weeks is pretty much as cooked as they need to be.  Twins often come early, and for some bizarre reason that baffles scientists, twins progress faster neurologically in weeks 33 – 35 than do the lonely singletons, and therefore are ready to be born earlier, too. 

Preterms are also determined by weight but the charts make my eyes cross because everything’s measured in grams.  1000 is the cut-off between micro preemies and early preemies in this currency.  2500 is the goal weight to go home.

Now, my only experience with the metric system was the time I spent in Italy and my only experience with grams was the time I spent at the shop of the macellaio.  That’s my only point of reference.  So for me, 1000 grams is about five days’ worth of prosciutto for four people, even if everybody has seconds.  And 2500 is enough for a party, but only if it’s right after payday.  Otherwise, it’s mortadella for the group.

Start the Party!

So how do we get this party started?  How do we get the fattest preemies possible?

Kara’s suggestion (you remember Kara from Post #1, right?) was to see if I could eat 4000 calories a day.  Four THOUSAND calories a day.  The only time I ever counted calories was early in my ballet career and if memory serves, 4000 calories is like, a week’s worth of food.  So I’m going to have to eat a week’s worth of food everyday in hopes that I can get two babies that are the prosciutto equivalent of two Opening Night receptions.  Apparently my goal is 20 pounds by 20 weeks and 40 – 56 pounds before it’s all said and done.  Gaining weight early on is important for twin mommies in order to have enough fat stores & nutrients “thereby providing a nutritional reserve for the second half of pregnancy, when diet alone can’t keep pace with the nutritional demands of the fetuses.” (from the book Kara recommended: When You’re Expecting Twins, Triplets or Quads)

If my progress with Chiara is any indication, I will pass the 20/20 mark no problem.  But it’s not just what I get to eat that matters, it’s what the Peas get to eat.  So I gotta beef up that placenta, since there’s only one for two of them.  And how do I do that?

Stay tuned!
© 2010 Janine Kovac 

1 comment:

  1. I just LOVE when people take my advice!! I am on a huge ego trip right now (all for the good of the peas, of course)...