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Archive for April, 2009

Last week I wrote about how chuffed I was that Tamba had sent me a certificate as a ‘small token of our appreciation for the valued support‘ I have given to one of their families, also giving me free membership and welcoming me to their community. I was all excited (yes, I am that sad), as it meant that I would be able to take the boys to a playgroup geared toward multiples so I  went to the website and tried to activate my membership, unsuccessfully. I emailed them, but received no response, so yesterday I phoned them and today I’m well p****d off. Basically I’m not entitled to my free membership as my daughter, who nominated me, has let her membership lapse so, unfortunately, I will not have ‘help to continue providing valued support to the family who nominated’ me. Now, if this were a manufacturer, store or advertising company who had misled and disappointed me in this way I would at this moment not be whining away here, well I probably would but I would also be composing a letter of complaint and suggesting that they were guilty of misrepresentation. I have read and reread the letter and no where at all does it state any conditions or refer in any direct way to daughter’s membership, it only alludes to her presumed membership by calling them ‘one of our families’. Apparently 79% of midwives recommend Tamba, not sure how that figure was arrived at, certainly I have never been asked. Perhaps they asked the parents of multiples, whatever. I shall continue to tell expectant parents of multiples about Tamba for want of an alternative, but I will always be a gutted grandmother.

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It’s gone, just disappeared into the ether. There is no trace of it, well not that I can find anyway. What am I currently searching for, my old. first ever, blog. It used to be on 20six but, alas, it is no longer. I am bereft. So many memories were housed there, it was my on-line diary. It charted my transition from ’empty nester Mummy’ into a Grandmother. In it I explored my emotions, conflicts, excitement and sadness. I wrote about my first and second grandchildrens birth’s. The sorrow when my daughter had a miscarriage at 16 weeks and then the joy when Izzy was born at home. These are ‘of the moment’ records concerning our family’s most precious times, and they have been totally erased and, what’s even worse, I can never,ever get them back. I’ve emailed the webmaster, but had no reply. I can’t seem to find any trace, no cache, nothing, a whole 3 years of  memories gone. I’m really sad about it. I thought I had a diary I could look back at but all I have is a message – ‘Error: The requested page has not been found.’

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Workbound

Every few weeks my work/homelife pattern dictates that I have one ‘rest day’ and ten working days, tomorrow is the final day in this pattern and I’m bushed. In the middle of it I went to a lovely homebirth, once again it was a rush to get my gloves on and there was no time at all to call the second midwife, beautiful baby girl, everything wonderfully quick, easy and natural. Mum and Dad very happy with their third baby and her relaxed arrival into the world.

I received a Certificate of Appreciation from Tamba . It was because daughter had nominated me for it as I provide her with support, it’s my job, I’m her Mum and her children’s Grandmother, I should support her. Still it is lovely to have a certificate and, even better, it gives me free membership of Tamba so the boys and I can start going to a twin group. That will be wonderful as it will be somewhere which is set-up to cater for multiples, I’m  hoping to be able to go somewhere with the boys and to actually enjoy myself and relax…..slightly!

Due to the glorious weather I have been able to get out and garden for a couple of hours in the evenings, such a wonderful way to unwind after a ‘heavy’ day. Now I’m just keeping my fingers crossed that the rain holds off until Saturday as I haven’t managed to mow the grass yet.

Tomorrow is Jack’s 5th birthday. It is terryfying how quickly time passes, I can still remember in minute detail the day he was born and I became a grandmother, it was the most emotional day of my life. Now he is a little school boy who constantly amazes me with his knowledge of dinosaurs and the solar system.

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Who is Margaret Haywood? She was a registered nurse, until yesterday when her registration was taken away from her by the NMC. Why? She participated in the making of a BBC programme which investigated the shortcomings at the Royal Sussex Hospital. Prior to the undercover filming the patient’s consent was not gained, however it was obtained following the filming and prior to the screening of the programme. The NMC have decided that  ” Ms Haywood did not fulfil her nursing obligations and found her guilty of misconduct.”

I will ask, as did Pulse,

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Twin trials

Today has been a bad one with the boys, even though the sun was shining. I had been really looking forward to being able to spend a day outside with them and I had thought that it would be so much easier, more space, lots to do, I could not have been more wrong, they would have tried the patience of a saint, and I am definitely not one of those.  Jamie and Louis are nearly 20 months old now and, so far, life with them has become easier in some respects, but more difficult in others. Easier, well they feed themselves, they can negotiate the stairs themselves, they will amuse themselves for short periods. There is possibly more but in my present frame of mind I am hard-pushed to think of any! More difficult, they are mobile. Yes, that makes life easier as I don’t have to carry them around but to go out anywhere, children’s play areas, the woods is so fraught with the ‘how can I keep an eye on, and retrieve two toddlers’ dilemma that I have to really psyche myself up for it. I have discovered one soft play area where I can go and it is so geared toward toddlers that it is a safe as I could wish. However, it’s the school holidays now and everywhere is heaving with little people, when you are trying to keep track of two adventurous little boys it is an absolute nightmare. When daughter first discovered that she was having twins other parents of twins warned her that she would have to buy two of every toy, she assimilated the advise, I scoffed at it, fool that I am. It’s true. If you want to avoid arguments, screaming, fighting, biting then you have to have 2. Cars, shape-sorters, books, not similar, no that won’t do, they have to be duplicates, otherwise carnage ensues. To be fair Louis is less likely to want what Jamie has, and even if he does he stops short of violence but Jamie, well he is a nightmare. In the garden I have 2 ride-on cars, not identical, Louis was unceremoniously pushed off. I have one child’s lawnmower, that caused a huge tug-of-war plus screaming. In the one wendy house there is a little tikes kitchen, I looked through the window just in time to see Jamie bite Louis’ stomach because he wanted to stand where his brother was. By the time Jamie had pulled his brother off the plastic climbing cube thingy I was ready to lock him in the shed. By now it was 4pm so, instead of that, we came indoors, I put  ‘In the Night Garden’ on and gave them both a biscuit. Peace reigned.

At this stage with the other grandchildren we were starting to take short walks with them holding my hand. If I needed to go to Homebase, or Comet. no problem. In to the car, get there, park, get out of the car and off we would walk into and around the store. If I needed to buy several items no problem, I would use a trolley. Grandchild would walk with me, or if they started playing up they would be put in the available seat. Try ‘popping’ out with toddler twins, it’s an exercise just getting out of the house but then, once you get to the retail park what then? There are no twin trolleys but if you use a pushchair then you have no free hands to carry anything. I invested in a set of twin reins, fab thing. Harness goes around my waist and then the boys are clipped to me. I dare you, just try it. Borrow 2 toddlers, put them in the car, drive to a superstore and then try to get from your car into the store with the babes on reins. It seems like hours but is possibly only 20 minutes. By the time you have made it to the store you will be seriously doubting the wisdom of entering. The journey across the car park will have elicited the usual toddler behaviour of stopping to examine everything, car wheels, cigarette ends, drain covers and the usual tripping over etc. No, don’t scoff, imagine that at least trebled. Twins are not double trouble, they are far, far more than that. By the time you have stopped one from sticking his fingers up an exhaust pipe, ‘Don’t. Hot. Burns,’ the other one will have run around your legs and be picking up a half full, soggy packet of crisps. You grab it off him and he throws himself down onto all-fours, you can’t pick him up because his reins are wrapped around your legs and anyway, by the time you have untangled yourself and righted him the other one is sitting in the only puddle for 6 miles. I do have a remedy, hard on the arms and shoulders, but less stressful, I grab the harnesses and carry them so they dangle at the end of each arm like a shopping bag. This causes disapproving looks from other pedestrians but I am becoming impervious to other people’s opinions, especially those who comment helpfully with observations like ‘Rather you than me’.  I am determined to get them functioning well on reins as it will, eventually, make our time together so much nicer. With Amy we would go out for wanders, through the woods, feeding the ducks, mini-expeditions and I really miss the recreational side of looking after a toddler, the fun things. Oh yes, the fun things like painting, play-doh, puzzles, just use your imagination and you may be able to guess why none of these activities rank highly on my ‘to do with the boys’ list. Uncontrollable mess probably sums up the first two, fights just about covers the last. Oh the joy of twins.

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Birthday pictures

Spot the birthday present

Spot the birthday present

 

My birthday cake!

My birthday cake!

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I’ve been musing, and I’ve come to an earth-shattering decision, early discharge from hospital after giving birth should not be encouraged. I can sense much sharp in-taking of breath, I know, it’s pretty radical stuff, now I’m going to explain myself.

Recently I made a day 5 visit, that’s the day we reweigh baby and take the neonatal blood screening test (aka heel prick; guthrie; PKU). This was the couple’s first baby, born by emergency CS, 2 day hospital stay, second visit by a community midwife. They had phoned before I left the office to ask what time a midwife would be visiting  as they had seen some ‘blood’ in baby’s nappy and were worried, I told them that I would make them my first visit and asked them to save the nappy. Mum and Dad had been to NCT classes so, when having looked at the nappy, I told them that it was normal and was urates from his urine they then produced an A4 handout they had been given, which showed photos of what they may see in early nappies! Having addressed the blood in the nappy worry I had a look at her notes, useless, the hospital had kept her inpatient notes so I had no idea how things had gone for either of them whilst in hospital. The midwife who had visited before me had recorded that Mum as recovering well, her scar was clean and dry, baby was breastfeeding, passing urine and meconium. I glanced at baby and saw a ‘worried’ looking baby. Worried. This is my description of an underfed baby, they do all seem to have this little sad expression, a furrowed brow, very difficult to describe but when I see it it makes me worried. I decided to examine his Mummy first and remove her suture  before I had a good look at, and weighed him, I had a feeling that she may be somewhat agitated after I had examined her little baby. I should say more agitated as she was extremely anxious about having her suture removed, but my incessant talking worked it’s usual magic and the stitch was out before I could finish my life history. As I undressed baby I asked her about feeding, she was breastfeeding, basically when she thought that he should feed, this was equalling about three times a day. I gave them my usual spiel “It’s normal for babies to have lost up to 10% of their birthweight ……..we plan what happens next on how baby is, what the nappies are like etc. might just come back in 48 hours if all seems well and re-weigh then to make sure that baby is putting on weight but we might ask them to go into hospital to have baby checked by a paediatrician”. Baby’s mouth was very dry, his skin was like an old persons, there was no elasticity, his poo was sticky and green. He really wasn’t bothered about me undressing him, a floppy little boy. As I put him on the scales he showed his startle reflex, little arms and legs shot out star-like, his eyes opened wide, even those seemed dull, and his cry sounded as if he had been screaming for hours, it was hoarse. The results of the weighing were not good, he had lost nearly 20% of his birthweight. I explained to the concerned parents that I would be happiest if he were seen by a paediatrician but, first things first, get some nourishment into him. He was awake and trying to latch onto my arm so I asked Mum to get comfy and we would put him to the breast, once he was feeding I could then contact the hospital he was born in, not one I work for. Basically the attempt at feeding was not a success, Mum obviously had no idea how to breastfeed and it really didn’t help that baby was so malnourished that even hunger was not going to keep him awake. I showed her how to hand-express into a sterile syringe and I went through the long process of referring him to the hospital. I nearly lost the will to live at one point, I considered hanging up on the officious, series of people I was put through to and just send them to the hospital I work for. In the end I resorted to the unspoken threat,’ Since you can’t seem to help, can you put me through to the head of midwifery?’ Works a treat, I was told that baby would be seen on SCBU.  On admission he was found to be severely dehydrated with dangerously high sodium levels; he was immediately put on an IV and a tube was passed into his tummy so that he could be fed easily. He remained in hospital for 8 days.

Following their second discharge from hospital I visited again. By this time baby was still not back to his birthweight, but was a different little man, alert, bright-eyed and peachy skin. His Mum was still anxious, and no wonder, she had spent over a week in a Special Care Baby Unit watching her newborn be jabbed, infused, and tube fed.

That’s the background to my desire to encourage women to stay in hospital for longer after giving birth. My concerns about this ‘early discharge’ culture has been growing gradually over the years, every week I come across examples of where a longer stay would have been beneficial but this latest one has been the most extreme. The couple involved were educated, one was medically qualified. They had attended NCT classes, hospital antenatal classes and breastfeeding ‘workshops’  but none of this theory had adequately prepared them to successfully nurture their first baby. The ward the woman was cared for on was safely staffed but this does not necessarily mean that there was time for staff to ensure that baby was feeding well, or time to reassure anxious first-time parents. The short stay meant that it was not evident prior to discharge that baby wasn’t breastfeeding successfully. WHO wish to promote exclusive breastfeeding, to be successful some women require more support than ‘workshops’ during the antenatal period, they would benefit most from a slightly longer stay in an establishment where there are enough staff to provide assistance and reassurance.

Guess what it is that has caused the early discharge culture? It’s staffing levels, the closure of smaller maternity units and the resultant loss of ‘beds’. What causes all this? Cutbacks. It’s a false economy though, I’m not talking the small cost here of re-admissions, like my example above, I’ll just reproduce the opening paragraph from WHO’s ‘Promoting proper feeding for infants and young children’ and it’s easy to see that a cutback in the maternity services has lifelong health implications.

‘Nutrition and nurturing during the first three years are both crucial for lifelong health and well-being. In infancy, no gift is more precious than breastfeeding; yet barely one in three infants is exclusively breastfed during the first four months of life’. (World Health Organisation)

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