How are the girls doing?

Fine, thanks for asking.

Our last weight check was on Monday. They had gained only 3 and 2 ounces respectively since their last weight check six days earlier, which was a disappointment. In thinking through the possible causes for the fall-off in weight gain, we realized a few things may be at play:

• At the last weight check, their gains were so good that we were told we could let the girls direct the nighttime feedings -- feed them when they wake, and there's no need to wake them on strict three-hour schedules. Well, obviously they couldn't be trusted. In the week between the weight checks, mean time between nighttime feedings would stretch to four hours, then five. Eight daily feedings turned into seven, or perhaps even six. So we cracked the whip on them and now we're back to waking them up to eat, which means less sleep for us but more food for them.
• At the suggestion of the lactation consultant, we switched nipples from "fast" to "painfully slow." Sixty ml feedings that once took ten or fifteen minutes, tops, were now stretching to 45 minutes. And the girls would just tire out and give up, sometimes leaving as much as 20 ml of the bottle to go to waste. Anna in particular was hard to get to finish a bottle with the slow nipples. To remedy this, we switched to another set of nipples that seems to be a happy medium between too fast and too slow.
• Anna picked up some kind of nasal congestion, probably from Patrick. This may have put her off her feed a bit.
• In combination with these three factors, we had substituted two breastfeedings for two bottle feedings. I think this may have been okay had it not been for the other factors. But overall the girls were expending more energy in return for fewer calories, and that's why they weren't gaining the way they should.

If you ask me, and in a sense you did, all signs are pointing toward a much bigger weight gain at their next appointment on Monday. And in the non-food department, both girls are showing all signs of good health.