Multiples

Keeping babies with you in hospital

I remember reading on here that some of you said they can't take the babies away from you without your permission. I'm wondering what type of wording to use in my birth plan to get that point across. The nurse teaching the class at my hospital said it was hospital policy for any baby born before 37 weeks to stay 24 hours in the NICU and any baby born by c-section to be observed for a certain amount of hours (I can't remember if she said 1, 2, or 3). If my babies are healthy, I don't see a why this is required (especially if they are born close to the 37 week mark). I had to laugh when she said they consider themselves a baby-friendly hospital and they recommend initiating BFing ASAP after birth, yet they take your baby(ies) away as part of the routine and don't allow skin-to-skin after a c/s.

Obviously if they are born soon, or if they are having trouble breathing, etc. I want them to be taken care of, but I don't want them to be taken away from me for 24 hours if they are close to term and completely healthy just because it's hospital policy.  

m/c 7/17/10
Dx: MFI- 3% morph
IUIs: Gonal-F + Ovidrel + b2b IUI= BFNs
IVF with ICSI= BFP! EDD 11/25/11
3/18- Beta #1 452! 3/20- Beta #2 1,026!! 3/27- First u/s- TWINS!
Our twin boys arrived at 36w5d due to IUGR and a growth discordance

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Be kinder than necessary, for everyone you meet is fighting some kind of battle.

Re: Keeping babies with you in hospital

  • Is there anywhere that allows skin-to-skin right after a c/s?  I mean, you're kind of a giant open wound in the middle of a sterile field at that point.  Where would the babies even go?  Granted, I was OUT for my section, but I'm pretty sure it's common practice to give the mom a few seconds to view the babies after they come out (or even after they're cleaned up), maybe even snuggle them up to her face while she's lying there, and then allow them to be held AFTER everything is over, and she's in the recovery room. 

    Their policies don't seem that extreme to me.  Before 37 weeks is technically considered a preemie, and they want to observe to make sure a problem isn't missed (because it is EASY to miss the warning signs of potential problems).  Being born by c-section means there's a higher chance of the babies having breathing problems, because all the crap wasn't squeezed out of their lungs on the way out of the vaginal canal. 

    Their polices are probably a little bit on the "overly cautious" side, but I doubt you'll be able to get them to change it.  It'll probably be a "this is what we're required to do, if you don't like it, deliver somewhere else" thing. 

    Good luck. 

  • I'm not sure what my hospitals policy is but I had a c/s and my babies went from the OR to recovery with me ( I held them in the bed to recovery)  Then I did skin to skin and BF in recovery.  After an hour or so they took the babies to the nursery to give them a bath and do an assessment.  They were back to my room an hour or so after I got to my postpartum room.

    So I guess what I am saying is if they cant meet your wishes 100% then maybe a situation like mine might be an option?

    I do agree however that the 37 week for NICU time is stupid.  There is a reason they have Pedi's in the OR, to assess your baby. If it is needed fine, but otherwise not necessary IMO. 

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  • image leslie13510:

    Is there anywhere that allows skin-to-skin right after a c/s?  I mean, you're kind of a giant open wound in the middle of a sterile field at that point.  Where would the babies even go?  Granted, I was OUT for my section, but I'm pretty sure it's common practice to give the mom a few seconds to view the babies after they come out (or even after they're cleaned up), maybe even snuggle them up to her face while she's lying there, and then allow them to be held AFTER everything is over, and she's in the recovery room. 

    Their policies don't seem that extreme to me.  Before 37 weeks is technically considered a preemie, and they want to observe to make sure a problem isn't missed (because it is EASY to miss the warning signs of potential problems).  Being born by c-section means there's a higher chance of the babies having breathing problems, because all the crap wasn't squeezed out of their lungs on the way out of the vaginal canal. 

    Their polices are probably a little bit on the "overly cautious" side, but I doubt you'll be able to get them to change it.  It'll probably be a "this is what we're required to do, if you don't like it, deliver somewhere else" thing. 

    Good luck. 

    Someone on PgAL that recently had a c/s had skin-to-skin after her c/s. They put her baby on her chest in between the curtain and her face, not in the sterile field (I know they obviously couldn't do that).

    I don't know, maybe I'm being unrealistic but my friend had her twins at a different hospital at 36 weeks, they were perfectly healthy, and they weren't taken away from her for a whole day just because they were early. I know if they were born soon, they would need observation/ intervention, I just think it's a little ridiculous if they are born at 36w6d that they would have to be taken for 24 hours because they were a day before term.

    m/c 7/17/10
    Dx: MFI- 3% morph
    IUIs: Gonal-F + Ovidrel + b2b IUI= BFNs
    IVF with ICSI= BFP! EDD 11/25/11
    3/18- Beta #1 452! 3/20- Beta #2 1,026!! 3/27- First u/s- TWINS!
    Our twin boys arrived at 36w5d due to IUGR and a growth discordance

    FET: Medicated FET moved up to 5/23 due to ovulation
    Transferred a 6BB hatched blastocyst- genetically normal female embryo
    BFP! 5/28- 5dp6dt      
    6/1 Beta #1- 223! 6/3 Beta #2- 567!

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    Be kinder than necessary, for everyone you meet is fighting some kind of battle.
  • image Kmarie823:

    I'm not sure what my hospitals policy is but I had a c/s and my babies went from the OR to recovery with me ( I held them in the bed to recovery)  Then I did skin to skin and BF in recovery.  After an hour or so they took the babies to the nursery to give them a bath and do an assessment.  They were back to my room an hour or so after I got to my postpartum room.

    So I guess what I am saying is if they cant meet your wishes 100% then maybe a situation like mine might be an option?

    I do agree however that the 37 week for NICU time is stupid.  There is a reason they have Pedi's in the OR, to assess your baby. If it is needed fine, but otherwise not necessary IMO. 

    I would be fine with this... I just don't want them taken away for hours just because of a c/s or a day just because they happen to be a few days pre-term.  

    m/c 7/17/10
    Dx: MFI- 3% morph
    IUIs: Gonal-F + Ovidrel + b2b IUI= BFNs
    IVF with ICSI= BFP! EDD 11/25/11
    3/18- Beta #1 452! 3/20- Beta #2 1,026!! 3/27- First u/s- TWINS!
    Our twin boys arrived at 36w5d due to IUGR and a growth discordance

    FET: Medicated FET moved up to 5/23 due to ovulation
    Transferred a 6BB hatched blastocyst- genetically normal female embryo
    BFP! 5/28- 5dp6dt      
    6/1 Beta #1- 223! 6/3 Beta #2- 567!

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    Be kinder than necessary, for everyone you meet is fighting some kind of battle.
  • i had my singleton at 36w and he was with me after his initial check in the nursery - there was no issues... i had skin to skin right away (it was vaginal birth) and he was with me in the room the whole time (unless we sent him back to the nursery to rest!)

    with the twins- i had a c/s- and was with them within one hour of the surgery - they were born at 38w and brought into my room once i was - and i did skin to skin and nursed right away then.... sure, it was an hour later- but there were no issues at all.

    they were with us any time we wanted them... we sent them back at night so we could sleep though :)

    I used to be Goldie_locks_5 but the new nest is so screwed up that I was forced to start over.
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  • image ColleenS629:

    Someone on PgAL that recently had a c/s had skin-to-skin after her c/s. They put her baby on her chest in between the curtain and her face, not in the sterile field (I know they obviously couldn't do that).

    I don't know, maybe I'm being unrealistic but my friend had her twins at a different hospital at 36 weeks, they were perfectly healthy, and they weren't taken away from her for a whole day just because they were early. I know if they were born soon, they would need observation/ intervention, I just think it's a little ridiculous if they are born at 36w6d that they would have to be taken for 24 hours because they were a day before term.

    I've never heard of skin-to-skin during a c-section before, that's kind of awesome.  Either way, I can't imagine any doctor allowing it when they're also in the process of pulling out a second baby, and they'd have to have the first one looked over and checked out fairly quickly after delivery, so you couldn't really stand around and wait until the second one is out either. 

    And I agree that their policies are overly cautious.  I'd bet there are reasons for them (maybe they've dealt with lawsuits over issues that weren't detected at birth?  I don't know).  While I wouldn't really like it, I'm still betting that it's a put-up or deliver elsewhere issue. 

    You could always call the hospital and talk to the L&D department about it.  Or schedule a tour, and bring it up then.  Maybe the nurse in your class was even generalizing, or even overexaggerating somehow?

  • I have to be honest with you.  My hospital doesn't take the baby AT ALL, NEVER ZERO  (unless the baby is sick and NICU of course).  And I'm kind of freaking out about it.  After my first delivery I needed some rest - it is NOT easy giving birth and put on top of that TWO babies in the room.  There will be PLENTY of time to bond with your baby so if they take the baby for a few hours after they are born I would prob be resting getting ready for them to come back to the room with me.  You might feel a lot different after you actually give birth about their policy but if you don't there prob isn't much you can do if they are born at 37 weeks and they still take the babies, I doubt they will make an exception to the rule.  I say you just relax and try and get some rest....giving birth is so hard on your body its hard to even describe to someone if they haven't done it.  GL to you, I hope you have them after 37 weeks so this isn't even an issue for you.  

    "I have four children. Two are adopted. I forget which two. -Bob Constantine

    "All for Love,' a Saviour prayed 'Abba Father have Your way. Though they know not what they do...Let the Cross draw men to You...."

  • Our hospital also had the "born prior to 37 weeks" they go to the special nursery policy for observation.  But if everything looked good they would be brought back.   My girls were born at 38 weeks and were waiting in the post-op recovery area for me when I was wheeled in.  I was able to hold them, etc then.  I was not able to hold them, skin to skin (other than face to face) until I was in recovery.  They didn't have to be sent anywhere other than the nursery to get checked for vitals and whatnot.  I wouldn't worry about it too much and just wait and see what happens and when they are born!
  • I would start by finding out how to make a birth plan that is recognized by your surgical team. At my hospital, the admitting nurse could enter it in the system, as could the postpartum group, but just getting it approved by my doctor meant nothing. The anaesthesiologist was the one in charge of the OR and what was being done. I had a great one who signed off on skin-to-skin contact in the OR, but logistically it didn't work. The babies were still brought first to the isolettes in the room to be wiped off and get their Apgars, etc. and then were handed to me to hold with one arm while supported by my DH and doula. Everything happened too fast to want to unwtap them and hold them closer until I was wheeled to my room. If there is a policy to remove them from you and you want them to do differently, discuss it well ahead of time. Once I was strapped down and given meds, I was suddenly a lot more calm and a lot less assertive. Personally, I was really emotional about DS going to the NICU for observation for two hours. It was absolutely NOT a welcome break to be separated from my newborn baby. DS was monitored for breathing issues and DH was with him, while DD was with me in recovery, and even being all drugged up, I was desperate for my babies to both be in my arms.
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  • image missfire:
    I would start by finding out how to make a birth plan that is recognized by your surgical team. At my hospital, the admitting nurse could enter it in the system, as could the postpartum group, but just getting it approved by my doctor meant nothing. The anaesthesiologist was the one in charge of the OR and what was being done. I had a great one who signed off on skin-to-skin contact in the OR, but logistically it didn't work. The babies were still brought first to the isolettes in the room to be wiped off and get their Apgars, etc. and then were handed to me to hold with one arm while supported by my DH and doula. Everything happened too fast to want to unwtap them and hold them closer until I was wheeled to my room. If there is a policy to remove them from you and you want them to do differently, discuss it well ahead of time. Once I was strapped down and given meds, I was suddenly a lot more calm and a lot less assertive. Personally, I was really emotional about DS going to the NICU for observation for two hours. It was absolutely NOT a welcome break to be separated from my newborn baby. DS was monitored for breathing issues and DH was with him, while DD was with me in recovery, and even being all drugged up, I was desperate for my babies to both be in my arms.

    This is how I feel too. The nurse just told me this over the weekend so I was planning on talking to my OB about it this past Monday at my NST but she was sick so I had to see her parter who doesn't do deliveries. She doesn't have office hours next week either, I'm seeing her partner again. By the time I get to see her I'll be 35.5 weeks (at the earliest). Hopefully I'll be able to see her then and talk to her about it. 

    m/c 7/17/10
    Dx: MFI- 3% morph
    IUIs: Gonal-F + Ovidrel + b2b IUI= BFNs
    IVF with ICSI= BFP! EDD 11/25/11
    3/18- Beta #1 452! 3/20- Beta #2 1,026!! 3/27- First u/s- TWINS!
    Our twin boys arrived at 36w5d due to IUGR and a growth discordance

    FET: Medicated FET moved up to 5/23 due to ovulation
    Transferred a 6BB hatched blastocyst- genetically normal female embryo
    BFP! 5/28- 5dp6dt      
    6/1 Beta #1- 223! 6/3 Beta #2- 567!

    image

    Be kinder than necessary, for everyone you meet is fighting some kind of battle.
  • image leslie13510:

    Is there anywhere that allows skin-to-skin right after a c/s?  I mean, you're kind of a giant open wound in the middle of a sterile field at that point.  Where would the babies even go?  Granted, I was OUT for my section, but I'm pretty sure it's common practice to give the mom a few seconds to view the babies after they come out (or even after they're cleaned up), maybe even snuggle them up to her face while she's lying there, and then allow them to be held AFTER everything is over, and she's in the recovery room. 

    Their policies don't seem that extreme to me.  Before 37 weeks is technically considered a preemie, and they want to observe to make sure a problem isn't missed (because it is EASY to miss the warning signs of potential problems).  Being born by c-section means there's a higher chance of the babies having breathing problems, because all the crap wasn't squeezed out of their lungs on the way out of the vaginal canal. 

    Their polices are probably a little bit on the "overly cautious" side, but I doubt you'll be able to get them to change it.  It'll probably be a "this is what we're required to do, if you don't like it, deliver somewhere else" thing. 

    Good luck. 

    This.  Their policy sounds normal to me. 

    At birth I got to snuggle them and I had a good 10 min in the delivery room to meet and at least have the babies held up to me.  I didn't get skin to skin, but I was numb from the shoulders down so I couldn't hold them anyway.  

    I delivered 36 weekers who appeared healthy, but policy said they had to go straight to the nicu.  My h was with them the entire time and got to hold and feed them while my spinal wore off.  If they did fine after 24 hours they could room in with me and we'd all go home together.  The night they were born BOTH had to go on cpap after they started grunting and having breathing issues.  Mack had to go on a vent for a pda that they discovered 2 days later. They spent 12 and 19 days in the nicu.

    Mine isn't a common case, but situations like mine are why they require pre-term babies to be monitored.  Apparently healthy babies start to struggle well after the initial observation window is typically over.  If I was 37+ weeks (and healthy) they would have gone to recovery with me and never left my sight.  Hopefully you get to 37w with no problems and your babies get to stay with you. 

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  • image leslie13510:

    Is there anywhere that allows skin-to-skin right after a c/s?  I mean, you're kind of a giant open wound in the middle of a sterile field at that point

    Yes. It's harder with twins because it's a small spot on your chest. I fought really hard to make it happen but they didn't come when scheduled, so they were short staffed. I'm still really pissed about it. I have a "baby friendly" c-section plan in my blog if you want to see, but almost none of it happened due to my baby unfriendly hospital. Honestly, if it's important to you, I'd switch hospitals.
  • I just had my b/g twins at 35 and 5 after a c/s for pre-eclapsia.  They were required to be observed in the transition care unit to determine if they would be sent to the NICU or to the newborn nursery.  They needed to show they could regulate their temps, eat, breathe, etc for 6 hours.  After the 6 hours, both babies were good to come down to me.  While it was hard because I couldn't go with them, I knew they were being watched by the NICU teams (they each had one), and when I got them, I knew they were healthy and ready to be with me.
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  • I delivered at 36w4d via c/s, and the babies only left my side for about 20 minutes after my c/s. There was no hospital policy about going to the NICU or nursery for observation unless medically necessary. I delivered, and they brought the babies to the isolettes to clean them up and do Apgars. Then, they brought them over to DH and I to see. They then stayed in the OR with us for a few minutes, and then DH went with them to recovery while they stitched me up. DH was with them the whole time in recovery.

    Then, I was wheeled to recovery, and we did skin-to-skin. They were with me in recovery and then when my room was ready, they put the babies in the bed with me and wheeled the three of us up there together with DH walking beside us. It was hospital policy that the babies had to ride with mom to her room if they were healthy. That was about 7pm. They were allowed to stay with us until midnight when the nurses came to take them to the nursery for a bath and to do some assessing. That lasted about an hour.

     

  • my hospital allows skin-to-skin right after delivery only with vaginal births. they will give you as much time as you want before they take them to weigh them, assess them, etc.

    but for c/s it's a totally diff ballgame. they wouldn't even lift my babies for me or H to see them. he wasn't allowed to peak over the curtain at all, and could only approach the bassinets after the pedis assessed them.

    i was totally out of it for my c/s (like blacking out) and i barely remember it, but i do remember they put a baby on each side of my head and let me see them for a minute and a picture before whisking them off to the nursery. my girls were born at 37w1d and needed no NICU time.

    they were in the nursery away from me for probably 8-10 hours, but i was in recovery that whole time anyway and MH had full access to them. honestly at that point all i cared about was that my babies were being fed and cared for since i wasn't able to.

    and like PP said, i'm guessing if certain things are their policy, there's no way to get around it and you might be told to deliver elsewhere.

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  • Mine were born at 37w6d so there were no hospital policies we had to buck but here's the right-after-birth and postpartum parts of my birth plan (stole this from a friend. In retrospect I'd make it shorter; I think it's more wordy than necessary):

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    After birth, I?d like:

    • To hold each baby skin to skin right away, their health/condition permitting
    • If a baby needs warming up, for them to stay on my torso with blankets
    • To breastfeed each baby as soon as possible to facilitate bonding and help expel the placentas
    • To wait until each umbilical cord stops pulsating before being cut
    • My husband to cut the umbilical cords
    • Not to have the umbilical cord pulled on during the birthing of the placenta
    • To see the placentas after delivery

    Cesarean Section Delivery (Emergency Only)

    I feel very strongly that I would like to avoid a cesarean delivery if at all possible.
    If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.

    If I have to have a cesarean section, I?d like:

    • To discuss anesthetics before being given any (if time permits)
    • To remain conscious through the delivery.
    • My husband present at all times during the operation
    • The screen to be lowered a bit so I can see each baby coming out
    • One of my hands to be free so I can touch each baby as he is delivered
    • Each baby given to my husband right away (as long as the baby is in good health)
    • To have the I.V. and catheter removed as soon as possible after surgery
    • To breastfeed my babies as soon as possible

    Postpartum

    After delivery, I?d like:

    • All newborn procedures (including vitamin K shots and eye cream administration) to wait at least 2 hours for nursing and bonding
    • To defer the Hepatitis-B vaccine. We will make sure our babies get this at a later date.
    • All newborn procedures to take place in my presence
    • My husband to stay with the babies at all times if I can?t be there

    I plan to breastfeed exclusively. I would like the assistance of a nurse trained in lactation consulting as soon as possible.

    Please do not give supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity. Please do not give either baby a pacifier.

    (I did get to kangaroo Baby A while Baby B was delivered, then kangarooed both of them. We had all newborn procedures take place in our presence and delayed nonessential ones for a couple hours to allow time for nursing and bonding. Our hospital was very cooperative with it. They have "family-centered maternity care.")

    fraternal twin boys born january 2009
  • Missfire, that's interesting about your anesthesiologist being in charge. My OB was OK with every aspect of my birth plan (there was one point he had me change but that was it) and he was definitely the one in charge during delivery. The anesthesiologist came in to do my epidural around 3:45 and then I don't even remember if I saw him again after that. Started pushing at 5:45, babies born 3 hrs later.

    We discussed it and my OB let me deliver in the L/D/R room. There was an OR team prepped and ready to go, waiting out in the hallway, during the whole pushing phase. They would've rushed me to the OR just down the hall if I needed an emergency c/s. Fortunately all went smoothly though.

    fraternal twin boys born january 2009
  • image macchiatto:

    Missfire, that's interesting about your anesthesiologist being in charge. My OB was OK with every aspect of my birth plan (there was one point he had me change but that was it) and he was definitely the one in charge during delivery. The anesthesiologist came in to do my epidural around 3:45 and then I don't even remember if I saw him again after that. Started pushing at 5:45, babies born 3 hrs later.

    We discussed it and my OB let me deliver in the L/D/R room. There was an OR team prepped and ready to go, waiting out in the hallway, during the whole pushing phase. They would've rushed me to the OR just down the hall if I needed an emergency c/s. Fortunately all went smoothly though.

    It was because it was a c- section. The OB is elbows-deep in a uterus, so the anesthesiologist is in charge of the room in general. Mine was great, except that after DD was pulled out, I kept asking if she was okay, and she could hear me but wasn't helping me get an answer. I had to go through my birth wishes with four different people starting a month before my scheduled c-section, and in the end, the anesthesiologist on call just got to decide that day. I agree that your hospital may not deviate from their policies, but if they want to do something that is not in the best interest of you and your children, fight fight fight! Your only concern is the health of your family.
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  • image missfire:
    It was because it was a c- section. The OB is elbows-deep in a uterus, so the anesthesiologist is in charge of the room in general. Mine was great, except that after DD was pulled out, I kept asking if she was okay, and she could hear me but wasn't helping me get an answer. I had to go through my birth wishes with four different people starting a month before my scheduled c-section, and in the end, the anesthesiologist on call just got to decide that day. I agree that your hospital may not deviate from their policies, but if they want to do something that is not in the best interest of you and your children, fight fight fight! Your only concern is the health of your family.

     Ohhh, got it. That makes sense.

    fraternal twin boys born january 2009
  • FWIW, I was pretty high during my scheduled c-section and I don't know how I could have done skin to skin with one baby, let alone two.

    As soon as the girls were born they swaddled them up and brought them over to me so I could kiss them, etc.  DH got to hold them right away and then went with them to the nursery.

    I think the mandatory 24 hour monitoring in the NICU is silly, but what can you do? My girls were born at 36 weeks 3 days, and didn't end up in the NICU until day 3 when they couldn't hold their temps. 

    We sent them to the nursery every night so we could sleep...it was amazing. I was BF too- so they would wheel them in every 3 hours, wake me up, let me nurse, and then take them back.  Take advantage of it.

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  • The first night I kept them with me in the room, then the 2nd and 3rd I asked if they could take them to the nursery for a couple hours! I was desperately trying to BF though so I told the nurses to bring them back any time they looked hungry. But those couple hours of uninterrupted sleep were nice!
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  • Even with my daughter being full term perfectly healthy I was not allowed to hold her after the birth and I wasn't even a C-Section! She was taken to be washed and cleaned on the other side of the room and the first glimpse I got was because the scale was on an angle that I could see if I twisted around like the exorcist. After I was put in my room it was still three hours before they brought her to me saying they had to wait for her first bowel movement and urination, I was so angry because they gave her a bottle in the nursery when I specifically had stated and written that she would be nursed. I then had to get a nursing professional to help me get her to latch properly because they had given her a bottle. Some hospitals are horrible! See what you can work out with the doctors, staff, and hospital administrators, also see if there is an alternate hospital that can accommodate you better. 
  • My LOs were born at 36w0d.  I got to see them for a second in the OR as they were born, then after they were cleaned up, we got a quick picture and snuggle, then my DH was allowed to carry them out to the waiting area to meet family on the way to the nursery (accompanied by a nurse who was very sweet to take pics for us!).  They weren't showing any respiratory distress or major issues, but because of their low birth weight (4 lbs 9 oz and 4 lbs 2 oz) and GA, they were required to go to the Special Care Nursery at that point for further observation and evaluation. 

    They both had low blood sugar (possibly as a result of my GD) and they were given some formula (I had ok'ed this) to see the result.  DS had to also basically have his tummy suctioned as they found it full of phlegm, after which he took the formula.  At the 6 hour mark in the SCN, they made the call to release them to the regular nursery and/or my room, with the caveat that for the first night (as it was the middle of the night at this point anyway) we just visit for a bit then they would go for observation overnight in the regular nursery.

    After that first night, the LOs were doing well enough that I was allowed to have them room in with me (or send them to the nursery, our call).  We were all released together.

     

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