Trips with kids

Both me and my husband love to travel. But being underweight and supposedly vulnerable, our little fellows were not allowed a lot of outing in the initial months. The first outing they had was the trip from NICU to our house, through most of which they slept. After reaching home we followed doc's instructions and kept them inside till they gained some weight. Their first longest trip was at six months for their choroonu. Now ten months old, they have had a few road trips and one train journey. When three babies travel, if the journey has to be comfortable, there has to be four adults to accompany them, to take care of their needs.

Loooong journey, by our standards :)

The short road trips are okay, but for longer journeys we prepare the day before itself, packing all the necessary items like diapers, wipes, diaper disposal bags, change of clothes, towels, sheets, hand wash, toys, books etc. Morning we pack water, formula and snacks (nuts,fruits,cookies,cheddar cheese, peanut butter- preferably dry foods to keep the hands and car clean). Car seats are extremely useful for long trips. We have a hatchback now, so we bought only one car seat. Until a few weeks back, one baby used to sit on it, the other two used to sit on our laps. They prefer to sit on the baby car seat or the actual car seat itself. Mostly they do not sleep during the trips. They enjoy the trips, but once they are back home, they would be tired, and sometimes cry quite a lot. We let them sleep until they are well rested and then they wake up with bright eyes, all happy and looking forward to the next trip.

Want to know how we manage shopping with triplets? See http://tripletshouse.blogspot.in/2016/01/shopping-with-kids-in-kerala.html

Update: April 21, 2013
Today we-me and husband- took the trio to Durbar Hall Ground in Ernakulam- a public open area with a large lawn of buffalo grass. We waited this long to take all three together because we felt a bit unsafe and unsure if just the two of us can manage ourselves- we were unsure what we would do if all three started crying together, or if one of them ran towards the busy road or so. Whenever we went out for short journeys- even for routine hospital check ups and injections, we took them only one at a time, a luxury we could afford because my parents were there at home to look after the other two. 

                             

We were nervous, and excited. Before the pregnancy, both of us have always dreamed about taking our baby for outings, adventures, and showing him the exciting new world. When we knew we were to have triplets, we talked about the adventures we would have once they grow up. But once the babies came out, and we saw what it really is to be parenting triplets- well, we shelved our dreams about adventures for the time being.

Anyway, on this April evening, finally, both of us took them out to the large lawn of D.H. Ground. We thought they would be scared, they wouldn't move, they might cry. But the moment they set foot on the grass- Kutty laughed so heartily, like never before, and started running! Raman followed, and both of them were soon absorbed in their play and excitement and sheer pleasure. Balu was a little afraid at first, then he also joined them, but he was careful never to move away from us. However, they were soon joined by other children playing in the lawn and theyquite enjoyed the attention and company.

Update: 31-12-2015

Now that we have had quite a few trips, I feel equipped to give a few 

Tips to travel with twins and triplets in Kerala:

1. Make sure your babies is well slept the night before the journey.
2. No need for a head bath before the trip, unless you are visiting a temple. Even so just use a wet towel to wipe the babies' heads and then dry with another towel. Do not risk a cold after the trip.
3. Do not forget the change of cloths, diapers etc- the list I mentioned before. And the snacks and toys. A chocolate, a picture book, a surprise new toy- all these help to comfort if the babies become restless. Otherwise during a long journey, you will become exhausted when two or three energy balls move around on your laps, and arms and around you- oh yes, they do that.
4. Do not forget to find a way to block the sun as your car windows cannot have sun films. The magnetic shades are not very effective- try to use a black cloth instead.
5. Take a pillow so that one or two of the kids can take a nap comfortably in the back seat. But make sure they do not fall. If only the parents are there, better to have a car seat in front passenger seat, with one baby sitting on that, and the non-driving parent can sit at the back with the other baby/babies.

How was your first outing with your baby? What other tips can you think of?

 

Baby's first solid meal- 'Choroonu' ceremony in Kerala

For Hindus in Kerala, 'choroonu' ceremony marks the first solid meal for babies. Choroonu ceremony (Annaprashan) marks the introduction of first solid food to a baby. This is held in a temple usually. We can book it (like weddings and other functions in temples) earlier itself, especially in the more famous temples like Guruvayoor, and all the necessary food items are prepared by the temple authorities. We do not need to bring any of the food items if it is performed in a temple. (As this also marks the baby's first entry in a temple, we have to remember to urinate the baby before the function outside the temple. Nowadays since people use diapers it is not a serious issue, but otherwise it is not good if the baby pees inside the temple- the parents are sometimes asked to pay for conducting a cleansing puja). The baby is given a bit of rice, sugar, salt, ghee, daal, fruit and sometimes a little vegetables all served in a piece of banana leaf. The baby is dressed in a kasavu mundu (and they look irresistibly cute!) and the father and mother and any close relative feed the baby with tiny bits of the food. It is a beautiful ceremony and a landmark in the baby's life. 'Choroonu' in Kerala is usually performed when the baby is 140-168 days old, that is between his/her 5th and 6th month, calculated according to the Malayalam calendar. However this can be done later than this also, like in our case, when the baby is born premature, or due to some other reason. It is best to consult an astrologer to decide the date and muhurtham.

Our triplets had their 'choroonu' in October 2012. We planned to have it in Ambalapuzha Sreekrishnaswamy Temple where I used to go quite a lot as a child, and where Lord Krishna is the deity- in a child's playful form. He loves food, especially butter, milk, ghee and payasam, and all of us in our family are in love with this little, naughty, cowherd God. We also wanted a choroonu ceremony in Pazhaveedu Devi Temple at Alappuzha, as well as one along with the Vallasadya at Aranmula Parthasarathy Temple. (We can have as many choroonu ceremonies as we want! Many families do it in a number of temples.)
Raman ran a high fever the night before choroonu at Ambalapuzha. The whole night he was awake, crying, and temperature did not subside even after the prescribed dosage of Paracetamol (which usually was quite sufficient for their fever). We kept wet cloth on his forehead and Ramesh rocked him on his lap for hours, but he kept waking up and crying. We got really worried. I was worried sick seeing his small face red with fever. Then I had this feeling that Krishna Himself did not like it that we were going all the way to Ambalapuzha without first going to Poornathrayeesa Temple in Tripunithura, which was much closer to our house, where also Krishna is in child form. May be it is my blind faith, totally illogical, but I prayed that let Raman be all right for tomorrow's function, and we would have another choroonu in Tripunithura as well. In half an hour his fever subsided, and he slept well. Next day morning we went to Ambalapuzha, gave them rice and daal, salt and ghee in a small piece of banana leaf. Had the same ceremony in Pazhaveedu and Tripunithura. There was also a Tulabhaaram with rice for the babies (weighing the babies by scale and offering the deity something equal to the weight of the baby- rice, sugar, jaggery, banana etc., sometimes gold too!) . Then after a few days there was Vallasadya. Everything went well. Giving the pictures below.

(In this blogpost there is information about choroonu in Guruvayoor - http://simplyknow.blogspot.in/2010/09/anna-prasam-or-choroonu-in-guruvayur.html )
Post on Vidyarambham-Ezhuthiniruthal
Post on Feeding in the first few months

Post on Naming ceremony
Post on Diaper use
Post on Guilty feeling about formula feeding my babies
Post on the benefits of oil massaging babies and how to do it

Ambalapuzha Sree Krishna Swamy Temple

Raman being dressed up in Kasavu mundu

Aryakkutty being fed by mother

Daddy feeding Balu

Raman tasting his rice

Happy Kutty

Raman's Tulabhaaram

Triplets choroonu at Poornathrayeesa temple

NEXT...Trips with kids

'Perital' chadangu (Namakaranam) - Baby naming ceremony in Kerala

'Perital' chadangu (Namakaranam) or Baby Naming of babies in Kerala is done when they are 28 days old, or 56 days. A black thread or chain -an aranjanam is tied around the baby's waist on the 28th day. So this is also called 'Noolukettu' chadangu. Gold ornaments are not worn below the hip. The black thread around the hip of the baby which would also carry rings made of five different metals is supposed to protect the baby from bad demons. In Southern parts of Kerala, naming is performed on the 27th day if it is a baby girl. Baby is bathed and adorned with ornaments. The child's eyes are lined with mayye or kanmashi (Kohl) (Applying kohl or kaajal was not a habit for us, the main reason being the suspicion about purity of the kohl. Whenever we applied it, we made sure to make it at home, from the 'nilavilakku'). A black spot is placed on one cheek or asymmetrically on the forehead, to ward off the evil eyes. The father whispers the name in the child's right ear three times while the left ear is covered with a betel leaf. This is then repeated with the left ear. Blessings are bestowed as Aashirwad and also gifts are showered with the tradition of bringing good luck to the child. A mixture of ghee (melted and clarified butter) and honey is given to the infant as a base for its various foods in the future. Sometimes honey and vayambu (sweet flag) with a tiny bit of gold that is scraped on a stone is given (It is called oramarunnu- supposed to make one's words sweet to the listeners' ears. Hence the song 'Thenum vayambum naavil thookum vanambady'- The nightingale which sings with honey and sweet flag in its sound). But since our babies were a little premature and DrAG instructed us not to let them have too much outside contact for the first couple of months for fear of infections, we scheduled the naming ceremony in their 6th month only (Sept 2, 2012). It was done according to Tulu customs, with a puja, and finally calling their names in their ears. 

We had planned to name our babies linking the names of both our parents. However when my mother went to pray at Ernakulam Siva Temple after our triplets were born, she saw Lord Ganesh idol in the child form in the temple, and with a surge of emotions and bhakthi, she felt that her youngest grandson baby resembled Bal Ganesh idol. She wished to give him the name Balavinayakan, which all of us loved.  And we named our eldest baby Suryanarayanan (Jayasuryan's and Lakshmi Narayanan's grandson) and our little baby girl Devasaraswathy (Devaki Amma's and Sarasamma's granddaughter). We called them Ramu (Raman), Malu (Arya, Kutty) and Balu. Here are the pictures of the naming ceremony according to Tulu customs.

NEXT.. Babies' First Rice Meal

My Post Graduation under QIP complications

Updated on 7th February 2014
Many times I thought about this page- whether to mention this or not. At last I decide that I should tell that story too, due to two reasons- 1. It is an integral part of the story of my triplets. Will never be forgotten. 2. It might in some way help someone in similar situation. If I had some kind of a guidance, this page would not have been there. I am going to write the post in a very unemotional way, just as things happened without mentioning the great emotional stress, anxiety, fear and worries that I had to undergo during my pregnancy which was complicated enough in the first place, without any of these. 

I am a teacher in a Government institution, and we have this opportunity to do our higher studies under quality improvement program. We get our full salaries during the period of our P.G or Ph. D course, only thing is that we have to execute a bond saying that we will serve the government for a specific period of time (4-6 years) after successful completion of the course, without resigning, or without taking long leaves of any sort. The application and bond has to be approved by the Director's office, and also by the Higher Education Department of the Government. A very good and convenient system, for which all of us junior teachers who join the job without a P.G. are thankful. Thus I too executed a bond, and joined my P. G. in Chennai.

The first two semesters went exceptionally well, I enjoyed the new place, new college, new-found thirst for knowledge, new friendships, new energy. My colleague and senior during my undergraduate course was also there, and she stayed in the same paying guest accommodation as me. In November 2011 my father had a severe cardiac arrest, and I came back and stayed at the hospital for a few days. We decided that we should continue the treatment- at least that much we should do for our parents, who are really desperate for a grandchild.

So we did our first IVF during my vacation (semester break of month after first two semesters). This was due to two reasons- 1. we were not getting any younger, and everyone advised that continuing the treatment and having a family is more important than any studies or career advancement. 2. we hoped that if I indeed got pregnant, I would still be able to continue the course until a week before delivery or so, and then can complete the course right after delivery and in another year life would be so much better.

How very wrong we turned out to be!

During the terrifying weeks of OHSS when I knew I was pregnant, I still hoped that I would be able to continue the third semester when college opened in July. But when the scan revealed triplets, travelling to Chennai became out of the question, as described in this post. 

The first thing I wanted to know was if I could go back to Chennai. DrTC said, yes, I could, but then if there was some mild problem, or if there was a spotting, then I might have to visit a hospital there, and as soon as they found out about the multiples, they’d make me stay in the hospital. Unknown hospital, unknown people, unknown city. And if there was any serious problem, then every single person in the family would blame me for going. So, really it was up to me to decide, and yet I had no options. I said I had a comfortable room to stay, good helping friends around. Doctor laughed at this and said I was saying all these because I had no idea how complicated and difficult life could become during pregnancy. Ramesh offered that he could come and stay with me, and again Dr said, the problem was that things were unpredictable. If something happened then all the effort, all the sufferings, all the money, all the prayers and hope everything would be wasted. And so, finally I had to face that tough moment of actually realizing that I was not going anywhere for the next year. I could not believe it.

As I had to undergo bed rest Ramesh and LR ma'am (cousin, friend and boss, she was always very supportive) went to Chennai, and my teachers were 

quite happy to learn the good news. After a very easy procedure of giving an application with medical certificate, I got my study period extended to another year. I was asked to join back in July 2012, when third semester started for our junior batch, and I would complete the course along with that batch. I would miss my friends I knew, still I could not ask for anything more! Then Ramesh went to my own institution, where again my colleagues were happy, and a leave was sanctioned for three months, which I could extend after three months.

Still, the ease with which the leave was sanctioned made me feel a bit uneasy. So I asked my husband to go to the Director's office, six hours away from my hospital, and inform the office about the developments. There he was informed that the procedure was not correct, I should have informed about my leave earlier itself, and even if I had informed, it would not have been any use because as I was discontinuing the course, even for a year, I was supposed to repay the salaries I received in the previous year, with interest. Also they were skeptical about the genuineness of my case. The medical certificate was from a private hospital, and thus unacceptable.  

None of what happened was anybody's fault. The rules simply did not take into account cases like mine. After my husband returned I searched all possible clauses and service rules and previous government orders in similar cases. The rule said that in a QIP course, the study leave is given for two years together without any break, and if someone needed extension (due to, say, an extended semester), then an application for extension can be given at the end of the two years, and the extended period will be considered as leave without salaries or other benefits. But there was no mention of course breaks due to medical reasons. And no mention of maternity leave. I could not complain because, may be I was not supposed to get pregnant during a post graduate course under QIP. So I sent my husband back again with a request for extension of the course and also asking to take my case under humanitarian considerations. They took the application and request, and later forwarded it the Higher Education Department of the Government with a note saying that my case could not be considered genuine as there is no solid proof, and as there is no rule for extension. Thankfully, before this forwarding note reached the Government we got to know about it. Then through one of my husband's friend's friend, who knew the Director personally, we were able to convince the Director that we were not lying, and that I was indeed undergoing bed rest due to multiple pregnancy. This eased matters considerably and the Director informed the Government that I could be given an extension. They were all doing their duties, and their skepticism came from the fact some people do take advantage of the system, especially when they have political connections. Now that they understood that I was telling the truth all along, they became quite helpful. 

Meanwhile Ramesh also took a request to the local Member of Assembly, who forwarded it the honorable Minister of Education. A copy of that also was sent to the Higher Education Department. So due to all these finally an approval for extension was granted, after six months of running around behind various people of power, and losing quite a number of working days for my husband. 

07-02-2012

Got the QIP extension order today. Ramesh went to the Director's office to get a copy of it. It just says I have to reapply for extension in August.

The government grants a maternity leave of six months with salary, which is quite a blessing to the employees. I was looking forward to taking this leave from October to March, as well as two months' vacation in April- May and four months of leave without salary, so I could spend time with my newborns without a lot of financial loss. But as per the order I would be receiving salary till August 2012, and then a year without salary to complete the course. I also lost a consideable amount in taxes as because of the uncertainty about the leave I was late in filing the tax returns and thus I was unable to take the 'savings and deductions from income' into consideration. Also there was a fine for late filing.

Anyway, at least I did not lose my job. Nor did I have to repay a year's salary with interest, so I suppose I should be thankful.

I rejoined the course in July 2012. Initially we were planning to shift to Chennai- all of us. But there were many problems in that. Health problems of babies due to relocation and climate change, unpredictability of how convenient a new house would be, the expenses of shifting and renting a new house, loss of income for Ramesh if we relocate and so on. So I left alone, leaving my five months old triplets under the care of my husband and my parents. I tried to come home for every holiday, every weekend. At times it was very difficult. There simply were no tickets available in trains. And then there was a lot of work to be done during the weekends. Especially there was a highly demanding teacher, who used to consider his students' personal lives irrelevant. There were many nights when I traveled with a waiting list ticket, sitting when a kindly co-passenger permitted me to sit at the edge of her berth, or standing near the toilet when they were not so kind (most of the time I got to sit, passengers of second class sleeper compartments in India are exceptionally kind and graceful. In spite of all the difficulties in getting tickets, I still love to travel sleeper class). 

It was a pleasure to see my little ones grow. One weekend I would come and see them turning over onto their stomach and back! Another weekend, they would start crawling on belly! Then during a long holiday I saw them starting to move around on all fours! Then a tiny tooth came out! Then little sounds with meanings-words! Thankfully I did not miss any major milestones of their development. They were always happy to see me early on Saturday mornings. Then I would feed them cereals, rice, mashed potato, cooked carrots, boiled bananas, cookies, cheese.. Their development stages varied, their eating habits varied, sleeping patterns varied. These development stages I will describe in another post.

I completed the course in June 2013. Good marks. Rejoined my job right afterwards. I got my QIP extension sanctioning order later. I lost a year's seniority, but that did not matter. We shifted to my place of work, with my husband travelling everyday. Life fell into a pattern. All the dust settled in the professional front with uncertainties and challenges continuing and new ones coming up in personal life. But then, such is life.

 NEXT...Babies' Naming Ceremony

Oil massaging and bathing babies

Oil massaging babies is a very healthy,enjoyable and exciting activity. We asked our pediatrician if we should start bathing them right away, and he suggested giving them an oil massage only, for the first couple of weeks. He suggested extra virgin olive oil for the massage. So at 10 am every day, about an hour after their morning milk, me or my husband gave them the massage. We used to spread a towel on the table, place the baby on the towel, keep a small bowl of olive oil close by and start talking to the baby. The babies thoroughly enjoyed it, and so did we. We used to take the oil in our palm, and spread and massage it on the baby, over the tiny hands, legs, little body and face.  After the thorough massage (most of the oil gets absorbed by the body), we used to wipe them very gently before placing them back in the crib. After sleeping deeply for another hour the babies wake up all fresh and have their milk before going to sleep again. This massage ensured absorption of nutrition, good and uniform skin color and moisture, glowing skin, good sleep, good intake of milk and growth.  Our body has many tiny circulation channels in it, for blood and other fluids, air etc. A nice, good massage opens up and straightens the channels. Also when parents' finger tips touch babies' body parts and nerves, the nerves get stimulated which is good for the babies' growth both physically and mentally. The touch itself is very healthy. 'You should keep touching, massaging and pampering your babies with your fingers, and hug them a lot'- our physiotherapist used to say. The bare skin in contact with the loving parents' touch can do wonders to the babies' emotional development. So the oil massaging was one of the highlights of the day for both us and our babies. 

The right kind of massaging is very important for their development, as both the traditional prasavaraksha experts and the modern physiotherapists would tell you. Start by applying oil in the naval, push it inside with a finger- apply a little pressure. The naval of young babies tend to be out for the first few months, we can help it go inside by this gentle procedure.(Later after the baby starts crawling on the stomach, it will go inside). Then push the nipples inside in case of boys. Apply oil on hands from shoulder till finger tips, apply on thighs and massage inwards, apply on knees and feet. Apply on the back and massage. Massage in round motion on the buttocks. Exercise the body by moving hands, legs and whole body. Cross the hands, move them up and down, do the same with the legs. See the video below. And finally apply oil on the face, push forehead in, pull nose out, pull cheeks out, straighten the ears, apply on head, kiss the baby, and you are done!

After two weeks or so, we started bathing our babies. after the olive oil massage. We applied baby hair oil on the head. Then after a few months we replaced olive oil with virgin coconut oil, because being in Kerala, pure coconut oil is available in plenty. We follow the same massaging and bathing procedure now also, with pure coconut oil. And I highly recommend this.

Another tip I wanted to give is about a tree called Danthappala (Wrightia Tinctoria, also called Ayyappala and Vettuppala- Sweet indrajao). It is seen in many places in Kerala, a tree with small white flowers. The leaves have high medicinal value when it comes to skin problems, infection, discoloration, even psoriasis. According to http://kerala-junction-news.blogspot.in/2010/12/re-wwwkeralitesnet-treatment-for_10.html, the preparation of the oil with Danthappala is as follows- collect a half kg danthapala leaves. Take half a litre of pure coconut oil in vessel and dip the leaves. Allow the oil to heat in sun light for 3- 4 days.  Collect the remaining oil.  Smear the oil every day before bath and allowed the skin to receive some sun light. I tried this because the tree is available in my workplace, and it definitely is very good for the skin and hair.

NEXT...My Post graduation and Complications

Diaper use and disposal issues

In Kerala use of disposable diapers was not very common at least until a couple of years back. As expecting parents, we never planned to use them for our babies. But the first time I went to see my babies at NICU, they had diapers on. Later when our first baby was brought to the private NICU room, and the nurse fed him milk through the nasal tube, he pooped. I didn't know it, but the nurse said he did, and she said she'd show me how to change the nappy. The neonatologist, Dr.Abraham George was very particular that babies should not lie on their back, but should always lie on their stomach. Initially we had a lot of reservations about this, but nevertheless we trusted our doctor immensely and rightly, and hence did as was instructed. (There is a lot of debate on the issue of whether babies should be put on their backs or tummy to sleep, but for us it proved to be a good method to let them sleep on their tummy. It reduced gas formation, and made it easier for them to sleep. They always sleep on their tummy although at times they turn around in sleep and lie on their sides or back.) Hence during the first month, on Doc's strict instruction, we fastened the nappy on their backs. This made it possible for us to change nappies in their sleep, without turning them around. But after a month or so we found it unsuitable and started fastening it in the front itself. 

So unlike we planned, or rather not planned, our babies always had disposable diapers on during their first year. Initially we were apprehensive about heat build up in the covered area, but later we found that the babies were quite comfortable with nappies on. It is difficult to clean up three babies as soon as they poop or pee because as I clean up one, the others tend to make a mess. While diapers are on we get time to clean them one by one. So even though we bought some reusable diapers and briefs, we never used them in the first year. And somehow disposable nappies seemed much cleaner too. However, they had rashes whenever we used a different brand other than Godrej's Snuggy, which has a soft, cotton feel. So we stuck to Snuggy. (It is just my babies' case- my friends do use Pampers and other brands without any issue). 

It is good to reserve a table for diaper changing, preferably in a space near bathrooms. Absorbent sheets are very useful while changing nappies, and also when the babies are taking short nappy-free naps :) Also diaper rash creams are to be kept handy, and wet wipes are good to clean up. We do not use those regularly, but during travels, they are quite useful.

Now we were face to face with a major problem-disposal of the disposable diapers. Being environment- conscious and wanting to be green, we found this unsuitable to our principles, made us feel guilty. But we really had to use disposable diapers in our situation, and so tried to dispose them in as safely as we could. In the first few months, each baby used an average of 12 nappies per day, that is, we were left with 36 nappies at the end of the day! We tried burning them with all sorts of fuel, but only wood dust seemed useful- for complete burning. But getting so much wood dust was a problem, it took hours for it to burn and caused pollution. Diesel was the second choice, but that was too expensive and it caused too much pollution. Thus we finally made an arrangement with a neighboring hospital's garbage disposal group, and every second week we took the tightly sealed sacks with nappies to the hospital, where the garbage disposal team took our sacks along with the hospital wastes for treatment and disposal. This was the safest and greenest option available for us. It became a chore every night to unload the waste bin to the big sack, fasten the sack and keep it outside in a small shaded area in our tiny backyard. Once we had a problem when a stray dog jumped into our compound in the middle of the night and tore up the sack. Early morning we found soiled and torn nappies scattered around. Such nightmare! Then we started tightening the sack and also spraying the outside with Dettol, so the smell would keep the dog away. It worked. 

Update March 2013

After the first few months, the diaper use reduced to 6-7 per baby per day. Since one diaper costed Rs.10/-, the daily expense for it reduced from Rs.360/- to Rs.200/-. We weren't very successful in potty training them, so the nappy use continued. Probably it was a good idea to potty train them sooner, but when we tried we found that it increased their stress. So we left it at that, and left them to develop bowel control on their own. It took time, but it worked. They started to tell us when they wanted to poop or pee, they developed a routine according to their own biology, and the stress was much less for them and for us. Now at two and a half, they still use nappies when they sleep, that is 2 nappies per baby per day. Some times I think about Dr.Sigmund Freud's anal stage and wonder if it would affect their psychosexual development, but it seems very unlikely from the way they are progressing..It would all have been wild and messy and crazy moments every time, everyday, when they'd suddenly pee and poop and try to touch it or smear it or what not! So we chose to be safe, and we are still continuing the slow transition to diaper-free days :)

Oil massage for babies

Update on December 2013

I am so glad to say that now they are totally out of diapers, and potty-trained. Finally saying good bye to diaper days :D

Feeding triplets

Feeding triplets in the  first six months

Today (15-06-2012) my triplets started on cereals! :)

Feeding the babies is taking up the major part of the day everyday. We have kept a diary in which we write down each feeding's time and quantity each one consumed, each one's pooping time, colour and consistency of poo (Raman's is dark green, always. Chattu's is loose and Arya's is like tiny balls), if there is any throwing up then details of that, sleep timings, massage timings (we are still massaging with olive oil- bathing them has not started) and any unusual behavior like crying too much or sleeping too much. I think it is an extensive record of the babies' day, but I have no idea if there is any use doing it.

They used to have an average of 35 ml formula every 90 minutes in February 2012. Once (26th Feb) we had to use suppository on all three to ease stool passing. Not a very pleasant thing to do, and after using it, it takes a couple of days to get them back on track and poop on their own. In March(one month old) the quantity increased to around 90 ml every two hours. Next change came in May when they started drinking 125 ml (though they have only 60 ml or even less at times), but the number of feedings decreased to 6-7 times a day (the average quantity they drink per day is somewhere around 500 ml). They maintain the same quantities now. Initially feeding triplets was through needle less syringes and bondlas. See page. Then we started using feeding bottles from Avent. Very durable, and hygienic if sterilized after each use. (We immerse them in boiling water). The formula we were using was Enfamil, but now we have shifted to Nan Pro. Nan Pro-1 is for infants, then 2, 3 and 4 are available, 4 for toddlers of one and half years old and more. It claims to have enough Calcium, Iron and Protein required for the respective ages. And it does not fatten the babies up. We are not keen to give them cow's milk (cow's milk does not digest properly for babies below one year of age. Even when they become one year, I don't think I will prefer to give it to them because nowadays we do not get pure cow's milk, and what we get as cow's milk seems to cause allergies and mucus in kids).

Father and grandfather feeding the babies

Today we gave them cereal for the first time, for lunch. We gave Ragi cereal sweetened with jaggery, supposed to have a lot of Calcium and Iron in it. I am concerned about the Iron intake since they need about 7 mg per day at 4 months old (since they are not breastfed- if they were breastfed, then it will naturally take care of Iron intake till six months old, after which they will need 11 mg per day in their diet), but they may not be getting that much now. The brand for Ragi we use is Ragitone. Three tablespoons of the powder (for all thee babies together) mixed in the specified quantity of water and one-fourth portion of a jaggery ball powdered and added to it. It is boiled till it is semi solid. It is real sweet and jaggery is very good for health. It is good for adults too. We plan to increase the quantity in the coming months. On alternate days we are going to give them Banatone cereal which is made from raw bananas.

Update August 2012
Now they also eat little bit of boiled banana and boiled veggies like carrot, cabbage, beans and cucumber.

Feeding Raman is most difficult. He likes his milk (Nan Pro), and sometimes cereal. He does not like to try different tastes. Chaattu and Aryakkutty eat without a lot of fuss.

Diaper use and Disposal issues 

Guilty feeling over formula feeding

There are some things normally people take for granted- like having eyes. Only when you don't have them do you realize their value. A new mother's ability to breastfeed her baby is similar to this. When she suddenly finds that she does not have any milk to feed the baby, she feels absolutely inadequate, and feels that she missed a very important phase in her life.

 It took a while for me to come to terms with my guilty feeling over formula feeding my babies. I read about Breastfeeding vs Formula in many places, and I was sure I was going to breastfeed. But for a mother of triplets formula feeding may not be a choice she makes, but a necessity. But here I am, voicing my thoughts on the subject, based purely on my experience. I hope this helps at least a few new mothers in alleviating their emotional stress. Probably it is not an issue in societies where formula feeding babies is a way of life, and is not frowned upon. But in our society babies are always breastfed, so a mother feels like a failure when she is unable to breastfeed her baby.

It was always taken for granted for me that I would breastfeed my babies, given the nutrition, the immunity it provides, the bonding that would develop between mother and child, and the sheer pleasure of breastfeeding. That I should think about what to feed my babies long before I actually gave birth was not something I knew. Much later, after I passed all the stages where I could actually make any change, I saw some websites and books where the mothers (especially those of multiples) took the decision to breastfeed and worked towards achieving that. However I hadn't thought about it because I was too preoccupied with making it to the 37th week. And somehow I assumed in my subconscious that I was actually going to be able to breastfeed the threesome, only that they should come out safely.

Then during the 33rd week (20th Jan 2012), the nurses came to me and asked if I was ready to breastfeed physically- because nipples tend to depress while undergoing bed rest. I said I was ready, but after checking the nurses told me that it was not actually enough for babies to suck. So they brought a syringe without a needle, attached its open end to the nipple and sucked it out. It was quite painful when they did it, so I took the syringe and started practicing by sucking them out. Not good enough. Besides, I read that they should start producing milk long before delivery. Mine did not. Then many mothers, many books and many doctors told me that it was not a problem, once baby started sucking, naturally breasts would start producing, they told me. The more they sucked, the more lactation would happen. I certainly hoped so. I had never even considered feeding them anything else for the first six months.

(Wikipedia on breastfeeding, as well as many other wonderful sites give detailed information on the topic- the hormone production, lactation etc. I strongly recommend that all would be mothers, especially of multiples, or pregnant after IVF, or mothers in their 30s, should read it and be informed)

After babies were born, I could see them only on the second day. It is always best to start breastfeeding within an hour of delivery, but for me, they were  in the NICU and I was in the room. Nurses asked me to express milk (suck it using pumping machine ad collect the milk, or as in my case use the syringe and collect the milk in a bottle.) and give it at NICU. No luck. I could not get even 10ml of milk. Dr.AG, the neo-natologist who had met us before, advised that I stick with formula and not try to breastfeed. I said I wanted to, so he said OK, try it. He asked the nurses if they got any colostrum from me, and they said not really. I was crestfallen at that moment. I hated the doc, hated the nurses, hated myself, hated all other mothers who could so easily hold their babies the moment they are born and breastfeed till the baby was full. Oh, how jealous I was! I heard stories about triplets' moms who could feed all three till they were full. Here I was, not producing enough to satisfy even one, even partially.

This went on till we were discharged. We got the babies one by one to our room. Doc said I shouldn't force the babies to suck, as sucking a lot and not getting milk would cause the babies to lose weight even more. Also it would frustrate them. The first day after I got my first baby, nobody would allow me to try feeding. The nurses would come every hour and tube feed him through the nose- 5ml of formula in the first couple of days. We were supposed to prepare the formula and keep it ready every hour (the recommended formula was Enfamil). At precisely every hour, baby would wake and start crying. Nurse would come, feed through nose, and he would stop crying and sleep. I would watch helplessly, like the ignorant and inadequate mother I was. I can still feel the frustration of not being able to pick up, cuddle the baby, or feed him. I was also fighting the raging hormones in me, getting depressed every now and then, crying at the silliest things. After the bed rest and all the care I enjoyed, I was suddenly supposed to get up, walk, prepare formula, change diapers, pick up the baby (damn, I have never held a newborn before, let alone a premature, low-birth-weight one) and do everything a normal person does.

The nurses were quite condescending towards me, as I was not even able to hold the baby properly. Also I wanted to be technically correct, and since the doc said the baby should not be overfed but just 5ml per hour, I wouldn't let the nurses feed him more, even when he cried. The nurses were talking among themselves that what a strange mother I was, not giving enough food to the baby. One nurse, who was especially concerned, advised me that it was only right to feed the baby till he stopped crying, whatever the doc said. I wasn't sure, so we limited the milk intake to precisely what was prescribed. And baby sometimes cried even after feeding.(Thankfully the dosage increased everyday and soon he got enough).

Anyway,the first night after we got our first baby in the room (Feb 17th,2012). Doc instructed that only the parents should stay in the room, so my mother left in the evening and Ramesh and I stayed with our baby. Sometime during late evening Ramesh went out to get something, the nurses wouldn't come for another half an hour, I was alone with my baby. Perfect chance. When he started moving in sleep I gently picked him up. That was the first time I was picking him up without assistance. I held him, lay him on my lap and put him to my chest. He tried to latch on, but both of us, especially I, was clumsy. Suddenly there was a knock on the door and I got tensed. Just imagine, having to feed my own baby secretly. (It all seems so silly and immature now. I could have just started feeding as soon as I got him, no matter what anybody says. But on those days it was unthinkable. We were all nervous, scared, praying and grateful that the babies survived and were healthy enough) Anyway when I opened the door it was Ramesh and although he too was telling me not to feed the baby, this time he said he would hold the baby so he can try and latch on. He did latch on and tried sucking, but nothing came I think. It was one of the most beautiful half hour of my life.

And so it went on. Next day the nurses helped with the feeding, but still no milk. We got all three babies, got discharged, came home, still no milk. We continued the formula, now fed through mouth, with the syringe first and later with a gokarna (a bondla) and still later with bottle. I was upset and very angry those days. And helpless. Anybody could feed the babies. That too upset me, but I knew I needed all the help I could get. Me, my husband and parents took turns feeding them. (In fact this made the babies to connect emotionally with the whole family even at a very early age, and how my parents and husband loved feeding them!)

As part of my Prasavaraksha (a post-delivery care for the mother) everyday a lady came to bathe me in the traditional way, and after the bath I ate hot rice with drumstick tree leaves. I had fenugreek, I bought and ate a lot of Lactare- granules containing asparagus, I tried using a breast pump every three hours, but all to no avail. There was some milk, but never enough. Finally I gave in, and the babies were entirely fed on formula.

Once my hormones sort of settled down, I started thinking a bit rationally and concluded thus-

1. It was a mistake to not think about feeding earlier on, a mistake I will never be able to correct, and thus no point in thinking about it anymore.

2. May be I should have started breastfeeding as soon as I got the babies. But then doctors and nurses know more than me, and they all insisted it was not good for the babies to suck and lose energy.

3. May be even after all preparations I might not have produced milk, due to my age,my IVF, medicines I took for OHSS etc.

4. I don't know if this is medically correct- at one time my eldest only was breastfeeding as he had more weight than the younger ones, and after his feeding, he used to throw up frequently. We were careful to burp all the babies after each feeding, and we always held them and laid them on their stomach in such a way that there was no gas formation, still he threw up. And I think it could either be because he sucked and got only air(causing gas) instead of milk, or because of the food I ate(it happened especially when I ate a little sweet, or mango or something out of the regular diet). So it is my understanding that the quality of breast milk, with all the advantages associated with it, depends a lot on the food the mother eats. If she doesn't have a nutritious diet, then may be the milk also will not have all the qualities it is supposed to have. On the other hand, formula has constant supply of nutrition, however inferior to breast milk. I am not recommending formula instead of breast milk, but I am saying that it should not be considered too bad if the baby can have only formula. Besides, by God's grace, my babies were not lacking in their immunity either, as can be seen from the way they were not any more sick than any exclusively breastfed baby.

5. Penelope Leach in 'Babyhood' says a lot about how it is a personal decision whether to breastfeed, how a working mother cannot always do it, how a mother who wishes to breastfeed but cannot due to low milk supply can still bond with the baby while feeding with a bottle (there is a distance factor- a newborn baby can clearly see things at a distance of 25-30 cm only, which is the distance of the mother's face when the baby is breastfeeding), and how it is rewarding for the rest of the family also if they are allowed to participate in the feeding-and-bonding-with-the-baby process. It is wonderful the way she says it, and it was sort of liberating for me.

update on 11/10/2014: I still feel a little sad about the missed opportunity to breastfeed, but now I am clear- it was not a mistake to resort to formula alone. The situation demanded it, and we did a very good job of formula-feeding. They were always fed in bottles sterilized by boiling, they were fed the right amounts at all right times. Sure, the formula is expensive, but even now they are fed that, and not cow's milk, or any other health powder. Enfamil was given till they were a year old, then Nan-Pro was given till they were two and a half. They had Enfagrow for a while, but did not quite like it, so they are continuing Nan-Pro. Now they have formula every morning 150 ml each, evening 240 ml and night just before sleep another 150 ml each.

One advantage of Formula feeding is that it enables the whole family to bond with the baby. Grandmother with baby. He loves the posture!

The video shows me formula-feeding my firstborn with a bondla

If you are a mother who was forced to formula feed your baby, these links will help in lessening your guilty feeling about formula feeding-

 http://jezebel.com/5934750/sorry--you-cant-guilt-trip-me-about-bottle-feeding-my-kids

http://www.babycenter.com/0_top-7-mommy-guilt-trips-8211-and-how-to-handle-them_3654967.bc

http://guiltfreebottlefeeding.com/

Did you feel guilty formula feeding? Please share your experience in the comments section. 

Triplets First Months

Triplets at one month old

Had a check up for triplets at one month old (pediatric) today. Raman 3.1 kg, Arya (Kutty) 2.58 kg and Chaattu 2.1 kg. Chaattu cried a lot last night. Ramesh sat with him throughout. We have slightly changed their pet names. Chaattu is now Balu, since we plan his name to be Balavinayakan. Aryakkutty became Arootty and Kutty. So now it is Raman, Kutty and Balu. 
My Prasavaraksha has started- it is a post natal care for the mother in the traditional way. (see post Tips). This is to be done until March 28th it is decided.

 NEXT: Feeding Triplets in the first months

Architecture for Multiples

Being an architect, I can't help this post :D  There are hundreds of things to consider while designing a home for adults, but when you design for houses with babies and toddlers, who will soon grow up to be teenagers, there are many many more aspects. But then designing a house for a family with triplets...well, you simply can't be too careful.

Most of us may not be building a new house right after the triplets are conceived or right after they are born. We would be much too busy. So modifications to the present house with some modifications to the furniture is all we can do. And then once they are toddlers we might be able to build a new house, or make more serious modifications to the existing one. In any case, safety, convenience and flexibility are the most important factors to consider while doing these designs.
What I have shown here are some very inexpensive (you could say crude) modifications and details. There are hundreds of sophisticated furniture designs available, anything you can get to make life easier is worth every rupee. And after the babies grow up you can always pass them on to friends or relatives with new babies, or sell them online .

Here is a room (can't really call it a room, it comes to 500 sq ft) design for a triplet (two boys and a girl), assuming that the house design allows a room of this size and openings. (But even if the site or house is different, you can go for very efficient designs once you give it serious thought). The left side plans show the use of the area when the children are babies or toddlers, right side ones show how it will be after they are teenagers.

Updated on Sept 25, 2014
Apart from the functional and safety aspects, there are experiential aspects too. Keep in mind that most part of the baby and toddler's life is spent at home, mostly indoors. So let him/her have as many experiential qualities to the spaces around. The colors, sights, smells, sounds, textures- everything matters. Let the home be a sweet place with rich experiences for the baby.

This image shows a typical verandah in a traditional Kerala house. Extremely useful and live space. 

A small addition to the 6 feet cot- to protect them from falling down. The door slides up.

Once they start moving around, a detail like this might be necessary on a few doors. The traditional half door are very useful.

Cribs like this one have many functions

Then we should see to it that all edges are rounded, staircases and steps are either inaccessible, or if they are accessible, they should have enough safety measures. Projecting cupboards have dangerous edges. So do tables, slabs etc. Electric wires, switch boards etc should be kept at sufficient heights. T.v, table/pedestal fan if any, must be such that the cables are inaccessible, and if in case they are accessed, the equipment should be in such a way that it should not fall on the baby.

Triplets at one month old

Movies for kids