Monday 19 March 2012

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.


Triplets Kerala

 NEXT: Feeding Triplets in the first months


Wednesday 14 March 2012

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.

architecture for homes with babies
architecture for homes with babies


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


architecture for homes with babies
A small addition to the 6 feet cot- to protect them from falling down. The door slides up.
architecture for homes with babies
architecture for homes with babies
Once they start moving around, a detail like this might be necessary on a few doors. The traditional half door are very useful.




furniture for babies
Cribs like this one have many functions
furniture for babies



furniture for babies


furniture for babies


furniture for babies

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.


architecture for babies


furniture for babies











Tuesday 13 March 2012

Tips to prepare for Triplets first months

Here are some tips to prepare for triplets' first months (from my experience)-

1. Prepare your home- you will not have time for this after  the babies arrive. So during your pregnancy, make arrangements to do some modifications  to the house and furniture. Try to arrange a space with good light and ventilation, where you can put a carpet on the floor and lay the babies. A comfortable chair close by, so you can feed them.
You need a counter with a tap and sink where you can place babies' bath tub and wash the baby without having to bend down. All necessary toiletries should be kept close by.
You should have cot sides so babies won't fall down. Find out nice spaces where you can have cribs placed.
2. Baby blues and postpartum depression- This is for the daddy. Your wife might be depressed and anxious for quite a few days after the babies' birth. Be patient with her. If you are not, then it can result in her being even more depressed, and that can be for a longer period, with at times, dangerous results. It is quite understandable that with three infants at home, the whole family will be very busy tending to their needs. But instead of concentrating all your attention to the babies, make the mom happy and energetic by giving her abundant love, so she can easily tend to the babies' needs- and you will be surprised to find that she can tend to them in a much better way. 
3. Feeding the babies- Read the post on formula feeding. If you are lucky to produce enough milk for the babies, then work out a schedule for feeding. If you have decided on formula feeding- 
- Be aware of the quantity of milk- consult the neonatologist or pediatrician
- Be careful to sterilize the bottle after each feeding.
- Take rotations in feeding. If you are feeding Baby- A in the morning, and daddy is feeding Baby-B and granny feeding Baby-C, in the afternoon, change it so you feed Baby-B, daddy Baby- C and so on. Look at the baby and smile and speak softly or sing softly while s/he feeds. It builds up a very strong bond.
4. Diapers- Read the post on diaper use. I personally find them to be very helpful. But you can always potty- train babies sooner, if you have the time and patience.
5. Monthly budget- Be aware of the financial demands- Roughly you should budget for the new life. Assuming that you are feeding babies formula alone, you will need one tin formula for three days in the beginning. After 3 o 6 months you all need one tin per day until they are three years old. That is Rs.400/- per tin, makes Rs.12,000/- per moth on formula alone. Then if you are going for diapers full time, you will need two packets (20 numbers) average, per day (for triplets). That is another Rs.6,000/- Other expenses like salary to the nanny (if you have one), baby clothes, feeding bottles, medicines/ visits to doctor, toys etc. will be additional to your monthly expenses, which itself may increase due to increased use of electricity, water use etc. Roughly an additional average expense of Rs.35,000/- can be expected in the first six months to one year.
    IVF in Kerala, Triplets Kerala, Triplet pregnancy blog, NICU
Baby-A.


IVF in Kerala, Triplets Kerala, Triplet pregnancy blog, NICU
Baby- B


IVF in Kerala, Triplets Kerala, Triplet pregnancy blog, NICU
Baby- C
6. You may find these items very useful in the coming months-

a. Good quality Feeding Bottles
b. A good quality Breast pump (Philips Avent Breast Pumps Manual Breast Pump I recommend this,     eventhough for me it was of no use), and Nursing Bra 
c. Baby carriers (Chicco Soft and Dream Baby Carrier New Fire (Maroon) - We did not use these        much either, but they are very useful while travelling or doing house chores)
d. Car seats
e. Re-usable diapers
f. Travel bag for babies
g. A basket in which bottles and food can be kept without spilling during travelling
h. A nappy changing table
i. Baby pacifiers
j. Baby nail cutter
k. A good audio/music player and CDs of lullabies. (our trio still need 'Omana thinkal kidavo..' to sleep)
l. Baby beds and cribs
m. Baby bath tub
n. High chairs for feeding
o  Potty
p. Baby hair trimmer (these last three items you will need only after several months)
and of course, toys, clothes, towels, absorbent mats, wet wipes etc.
 There are online stores providing specialized items for multiples. Good collection and very useful items, you can check them out. They are towards the expensive side, though.

7. See post on the Architecture for multiples

The trio
Baby A and B
Our babies were always made to lie down  on their belly, which was good in many ways. There is a risk called SIDS, but this happens only when we leave the baby unattended, in a situation where s/he can get hold of something that might choke her/him. We were always careful about this. 

As for me, a lady comes now to bathe the babies as well as me, a Kerala special postpartum care package. Feels good. She bathes me after applying turmeric, Rakthachandanam and coconut oil, and then feeds me hot rice mixed with raw moringa  leaves (drumstick tree), supposed to increase breastmilk. This, and many other tablets that I have had has no effect on the milk supply, but at least it feels good to have this hot rice and then breastfeed my babies (they latch on and try to drink, but I suspect all they get is gas) sitting on the bed. It creates a special bond between us. Blessed custom! 
We named them Suryanarayanan, Devasaraswathy and Balavinayakan. We call them Raman, Kutty and Balu.

The days are now too hectic, a lot of pressure on all of us, a lot of discords in the house, depression, health problems and so on. But this too shall pass.

Breastfeeding vs Formula

NEXT: One month old weights


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Sunday 11 March 2012

'Triplets Kerala' - back at home from NICU

So we - 'Triplets Kerala' as I call them now, and us, and my parents- are back at home from NICU. Things should have been much easier. But we are totally off-balance now. We are all hoping that these hectic days will be over soon.We are starting a new life. Many relatives and friends come everyday. A pleasure to see them. Feeling blessed with their love in our lives. 

We have a single floor independent house with two bed rooms (one attached), a living cum dining room with a prayer space, study space and common toilet, an entrance room which can also function as office space, kitchen and work area. It is a nice house.  A few years back when both of us were looking for houses to buy we stumbled upon this one. This was unwanted by many because it does not have direct car access, you can come till the previous compound in a car but then the way is too narrow for a car. There is no hope that it will ever change or widen. Another thing is that there is a sarpakkavu (a sacred grove where snakes are worshipped) right in front of the house. 
'Triplets Kerala' and 'Sacred Grove of Kerala'
The Sacred Grove in front of our house
In fact one generation before the house was part of a large area which contained many big trees, two big ponds, two sacred groves etc. There was only one house at the time- the owner’s- and the rest of the area coming up to around 2 acres was covered by these trees that it was very dark even during midday. There was a lot of wildlife including snakes, Asian palm civets, mongoose, and a variety of birds. People rarely disturbed the area. Then it was partitioned into various plots, some of the trees were cut down, most areas of the ponds were filled.(These were not completely filled as there is a belief that water bodies when filled should have some kind of an outlet- so tiny ponds of around 4 sq.m area was left open with walls and steps around. The plots were sold, for very good prices, as the land value was shooting up to the sky. One brother did not like another and wanted to trouble him, and so the right of way to the plot was only 4 feet wide. Later the plot was sold to another person who built the house and from whom we bought it. The sacred groves were both intact, but a lot cleaner and accessible and thus less sacred. Some of the wildlife remained too. We liked all these aspects, except the inaccessibility by car, but let that go, as we got the house of 1200 sq ft area and land of 6 cents in the heart of the town at an unbelievable Rs.9 lakhs in 2004. We park our car in the neighbour’s plot, for a small monthly rent. The house is deemed very lucky. The previous owner was very poor and jobless when he bought the land before land prices were shooting through the sky, with some money he got from his ancestral property. But after buying the plot and building the house as per Vaastu, he got many new projects and in six years he bought himself another plot with car access, close by, and built a mansion. After we bought the house I got my Government job, we had our first international tour sponsored by Ramesh’s office, and presently we got our three darlings. So we love the house.

But it seems a little crammed now, with seven of us living here. Mili was an integral part of our daily life before the pregnancy. She used live indoors, used to even lie down in the kitchen while I cooked. Now that the babies were home, my parents insisted that she be sent out, to sleep in the dog house or on terrace, else her hair might cause allergy. I tried to explain to them that it is good to be in close proximity with pet animals during babyhood, and it will lessen the chances of future allergies. But they were adamant, and I really did not have many options. We placed a table next to the dining table on which the feeding bottles, formula, bibs, water etc. are kept. The multivitamins and other emergency medicines like Paracetamol, Neosporin, cough syrups etc. are kept in the drawer. The master bed room with attached toilet and a small dressing area is our bedroom. The other bedroom next to it is being used by my parents, and they use the common toilet. The ironing table in the dressing space doubles up as diaper changing and oil-massage table, half of it being covered by a rubber sheet. Babies have not started taking baths. Once they start it, the oil massaging will no more be there. We are planning to bathe them in the counter slab of the work area, so we do not have to bend.

The feeding schedule for the triplets is synchronised now- every two hours they are given 30/40/50 ml of formula, the first feeding of the day being at 6.30 am. The intake varies sometimes as little as 15 ml only they drink. Multivitamins (especially vitamin D), iron and Calcium supplements are given at 10.30 am and at 8.30 pm. The olive oil massage is at 11.30 am, after which they have their formula and sleep soundly. They pass stools twice or thrice a day.  Baby-C usually passes stool after every meal. He cannot resist hunger for even a minute, and every two hours he starts crying and keeps crying till the milk touches his lips. Baby- A has bright green stool, it is slightly worrying, but doctor said that is not a problem as long as there is nothing wrong otherwise. He sleeps quite a lot during the day, but at night, he keeps me up till 3 am. Baby-C cries the most, followed by Baby- A, the other boy. Baby- B, our little girlie, does not cry at all, unless absolutely required. She smiles quite a lot, watches people moving around from her position on the couch in the hall. We show off by making her smile when guests come, and they enjoy it we think.
We go to bed after the 12.30 am feeding.  In the first week at home Baby- C used to sleep in my parents’ bed. But he used to wake up and cry in the middle of the night, and pass stool many times, so this became too tiring for my parents already exhausted from all the days’ work. So we made a different arrangement. Baby- A (Raman) sleeps in the bed room with me. Ramesh works in the study area late into the night, sometimes till morning. So both Baby-B and C’s cribs are placed near the study area and Ramesh rocks them occasionally using chords tied to the cribs. They sleep without much fuss, and at 2.30 Ramesh feeds them both formula, changes diapers and rocks them to sleep again. Raman (Baby-A) is a fussy sleeper. I walk carrying him for hours sometimes, singing to him. He sleeps as late as 3 am, but then he sleeps soundly till late morning. Baby-C (Balu) wakes up early in the morning, closely followed by B (Kutty).

Ramesh sleeps at 3-4 am. Then he likes to sleep till 9-9.30 am, and then he gets up, freshens up and leaves for site/office. I sleep by 2.30-3 am, because Raman sleeps only then.  So I sleep late, getting up only by 6.30 am for the first formula feeding of the day. My parents go to bed by 12 am, late for their lifestyle, and get up by 5.30-6 am. Then my mother prepares breakfast. They also help with the feeding. Then we put them back to sleep. Things should be fine here, but then starts the crying. Balu and Kutty don’t want to go back to sleep, sometimes Raman too wants to stay up.  Waking up early is fine, but all three would want our full attention as well. All of us would be sleepy, exhausted, and wanting some peaceful time before the hard work begins. Tempers flare up. Voices rise.  And every morning at least once I wish I hadn’t done the IVF.
Things aren’t that bad after sometime. After the second feeding at 10.30, and after everyone has breakfast, things settle a bit. I put the babies on the mattress in the living room, and sit with them, show them the toys, which they try to gab and try to put in mouth etc. Their hand- mouth coordination is not developed yet, so they just try to grab the toys. They smile at the sounds of the toys. I show them pictures. Raman especially likes to look at pictures of people. I read that they can see things as two dimensional only at this age, that too, things at a distance of 25-30 cm from their eyes. So I draw human faces and keep them at a foot’s distance from their faces. I also read stories to them, which of course, they don’t listen to, but they like the sound of my voice talking to them.
We got a maid from an agency. She comes at 9 am and leaves at 4.30 pm. She babysits during mid-morning so we can finish our chores. Her pay is Rs7500/- per month, of which Rs.2500/- goes to the agency. We tried to get someone more professional- someone with a training in taking care of babies, but no luck there. This particular maid is good. Before her there were two other maids from the same agency, both of whom had no skill in looking after babies. So they lasted only about two weeks or so, each.

I still have no milk. We are sticking with the formula. Although I am hoping that the post natal care (prasavaraksha) might increase the milk supply. The babies sleep in the afternoon. Full credit goes to my father in that he made it a point to establish the routine of putting them to sleep together. Raman sleeps in my arms and I lay him on the bed. Kutty and Balu sleep in their cradles.  All three sleep at the same time. This gives a much needed break and relief for us. We have peace for about two hours in the afternoon. Ramesh comes by early evening, relieving my parents from baby duty to some extent. I am able to spend so much time with them because my mother completely does the cooking. Soon, in another three months it will be time for me to rejoin my post graduate course. I have no idea how this will work out.

17-03-2012

Triplet pregnancy, NICU, Dr Tity Chacko, IVF in Kerala
Our Triplets



We posted photos and news about the birth in Facebook. I had not told anyone except a couple of very close friends about the pregnancy, so everyone who saw the update got a surprise :)

Breastfeeding vs Formula
Triplets Feeding in the First Months
Triplets one month old

Monday 5 March 2012

NICU days

22-02-2012

Ultrasound scan today revealed lack of albumin and hemoglobin for me. So I am getting a bottle blood transfusion now. Both babies cried today whole day. 

IVF in Kerala, triplets pregnancy, NICU

                    IVF in Kerala, triplets pregnancy, NICU


I am finding the transformation from a pampered- bed resting pregnant lady to a responsible, supposedly energetic mother of triplets very difficult. I didn't have to even sit up to eat just 10 days back. Now I am supposed to serve myself, eat, attend to babies even during meals and pick them up if they cry, wash my plates, have my bath (I am still having postpartum bleeding and using a number of maternity pads)- all this while still having the pain from the surgery, swollen legs (postpartum edema) and this rush of hormones which is making me depressed and unhappy and angry all the while..This indeed has turned out to be the most trying time of my life. That, before getting my third baby in the room.


Hospital bill is mounting. No idea how to pay everything. Ramesh has finally quit office and started work independently. I need to rejoin course this year- in July- for sure (otherwise my job itself will be in jeopardy), so we might all have to shift to Chennai, which again will cause a lot of expenditure. I feel faint thinking of all this.

25-02-2012


IVF in Kerala, triplets pregnancy, NICU


Got Baby-C also in the room. All three are crying a lot. C has a big bandage where his umbilical chord was cut. He cried a lot in the room. I hugged him and held him tightly to my chest, then he stopped crying. My mother holds him all the time now- she feels that he needs the warmth of a body. He seems to be content to lie down in her lap.

02-03-2012

Babies are still fed through the tube in the nose. Nurses come and feed them every hour, we prepare and keep the formula before they come. Now they have 10 ml every hour. Nurses still come to help me with breast pumping. We bought a pump for Rs.3000/-, but it is of no use. Nothing much is coming out. So we are sticking to formula. When Baby-A alone was given to us, we had some time to get used to him, to feed and change nappy and look at him. When Baby- B was given to us they facilitated a new, bigger room in the NICU ward. This room has two single cots which we join at night, a table, two chairs and an attached large toilet. I found it a bit difficult to handle two babies at once. Then suddenly Baby-C also was handed to us, two days before the specified date for his discharge from NICU. In a way it was a relef because it meant that we can go home sooner, but when he came to the room I was overwhelmed. All three started crying and tears welled up in my eyes at the helplessness. I didn't know whom to pick up, how to feed them together, how to soothe- nothing. All my physical discomforts seemed to choke my, and I sat there totally helpless and got all criticisms and scolding from my family and the nurses and the doctor for not doing enough for the babies. The doctor specifically told my mother not to help too much, else I might take that opportunity to shy away from my responsibilities. My mother wanted me to get good post-delivery care (prasavaraksha), but at the same time she wanted me to feed the babies and take care of them. My husband said that there was a belief that 90 nerves broke during a delivery and so 90 days of rest should be given to me. But that also was just words- no one could really let me take any rest, because we needed all the help we could have from everyone, including me. A physiotherapy team came and advised me to sit with my legs up always, never hanging it down, so the swelling would go. Also they showed me some exercises I was supposed to do while lying in bed. But none of these could be done as all of us were totally occupied with the babies. My mother helped me take my bath every day, which was a huge relief. I was still bleeding after the cesarean, and I sort of became used to sanitary pads. The moment I enter the bathroom one of the babies would start crying. I had to take several breaks during meals to soothe babies.

My father comes at around 8 am with breakfast, just like how he used to during my bed rest. He adores Baby- B. When my mother comes at around 10 am with lunch, me and Ramesh have our breakfast and Ramesh leaves to take care of office and sites- only the most important schedules. DrAG comes for the regular rounds and nurses drop by every hour. Rames is back by afternoon. They sleep long hours, and they don't wake up when they hear other babies crying. But when they are up, they cry most of the time. Then we feed them, change nappies and try to soothe them. Baby-C cries very softly though very insistently, and at night we would be so dead tired and asleep that we may not wake up for a long time to his cries.

We have not started bathing the babies- only oil massage now. Either me or Ramesh do the massaging. The whole body is massaged starting from belly button- push it inside, rub the nipples inside, then both hands are massaged with olive oil, both legs are massaged and thighs massaged inward to give the shape. Then back is massaged, buttocks in circular motion and finally face and head, ears also. Feed after massage and they are in for a long sleep. Now we use massaging olive oil, it gives a shining softness to the skin. 

Baby-A has a large birthmark- Doc said it is because that part of his skin was in constant contact with my uterus wall. Possible, considering how lazy he was to move around in the womb :) (I seriously think that was caused by my dear Lord Krishna touching him there :) Just like the story where squirrels get their marks on the skin when Lord Rama stroked them on the back). When the babies are not crying and are in a good mood, well fed, it is nice to sit and watch their faces. The eyelashes are just growing..when they came there were no lashes. Now it is beautiful to see the thick lashes coming. The color of skin keeps changing. The pink caused by extra hemoglobin is slowly fading replaced by their original skin color. They try to grab the tube from the nose. Baby-B has devised a technique- she somehow reaches for her face, moves the hand slowly to the nose and finally grabs the tube! Baby-A's tube came off twice. It was painful to watch him cry when they put it back on. I hope they remove all the tubes fast and they can drink through their mouths. Baby-A has constipation at times. We had to use suppository once. They placed the suppository while lying him on the stomach and he cried so much that I too cried. The nurses scolded me saying that if I start crying every time a baby cries, I won't have a time without tears. Supposed to brace me up. He pooped some and his poop is always dark green in color. Not a problem, the doc said. Baby-B poops twice or thrice a day, Baby-C poops after each feeding. Very loose and very yellow. He is supposed to be the least healthy, but I find that his system functions the most properly. He is thin, only skin and bones, beautiful eyes, but some relatives thought he did not even resemble a human child. I did not think so. He is a handsome baby, and once he gets his fat, he will be a heartthrob I am sure.

I don't believe in overfeeding the babies and making them fat, but they require some fat to develop immunity, and also to sustain them when and if it becomes difficult to take milk due to some sickness. They do throw up at times. Baby-C cannot bear hunger- especially because of the lack of fat, I think-he cries his heart out sharp one hour after a feeding, and does not stop until formula milk reaches his body. At night we were fast asleep the other day, tired from the day, and I woke up hearing an even, muted sound of a bird. Then I saw it was my baby crying, very quiet, but with a lot of hunger pangs clearly seen on the face. We quickly called the nurses and fed him and afterwards he slept peacefully. 

My legs are still swollen. I am supposed to sit with my legs up always. The physical education instructors came again and gave a brief about what exercises to follow- again. I am trying to dosome of them, but not very easy to do with all the pain.

03-03-2012

Two more bottles of blood transfusion, to ease the swelling on the legs. Ophthalmologist and ENT came and checked babies' eyesight, hearing, reactions etc. They looked very grave, and serious, but I think they were satisfied with the results. Anyway, we are satisfied- they always react to all kinds of sounds and lights. Babies got rid of their tubes and are being fed through their mouths- using syringes and gokarna. 

05-03-2012

Finally, back home!! After four long, eventful months!!

Morning was a frenzy of packing. Baby-A did not bother with all that and kept latched on to me, and my mother named him 'Raman' for that! Meaning he loves to eat. :) We have decided on their real names, but we are now calling them Raman, Arya and Chaattu. Raman sounds the most optimum name for Baby-A. Arya is my father's choice, and Chattu because he used to jump a lot while inside me!

There was no boiled water when we reached home. All pandemonium because babies needed water, and milk. Finally got around to fixing the stove, boiling and cooling water. Now we are using feeding bottles. The hospital is against the use of bottles, but we reasoned to ourselves that there is no chance that the babies will ever get to have breastfeeding. So why make things complicated? Feeding through syringe and gokarna is very difficult, especially now we are on our own.

My parents have decided to stay with us and help for a few more weeks. Thank God!

NEXT...Babies' first months
post on Breastfeeding and formula