Another note of thanks.

A few days ago Ginger pointed out something I hadn't really thought about.  At both CPMC and Peninsula, we knew the day shift nurses pretty well, and the evening shift nurses too.  And we always took the opportunity to gush to them about how grateful we were for the entire NICU staff.  Because we had to go home to the boys every night, and (unlike some, who were able to room in at the hospital) we didn't visit the girls in the middle of the night.  And that means that there was an entire shift of nursing staff who cared for our girls every night and early morning, but whom we never even met.

Now that we're the ones caring for Anna and Evelyn between the hours of 11 p.m. and 7 a.m., the full import of this is sinking in.

Whoever you were, thanks.

So, they're still fraternal, right?

Right.  We think.  Or, now I should say, we assume.  Weeks ago at CPMC we were told they had different blood types, which pretty much settled it.  And we weren't going to pay for zygocity testing, so we were pretty certain we could leave it at that.

But at the doctor's on Tuesday, the nurse checked the chart again and mentioned that they're both B negative, just like their mother and their maternal grandmother.  This is the second rarest blood type in the U.S., second only to AB negative.  So it's good that we have some people in the family who are available to be harvested for any emergency blood transfusions.  If something happens to Ginger, we can tap into the twin of our choice for her.  An added bonus is the fact that I'm AB positive, the third rarest, also known as a "universal recipient," meaning that I can accept transfusions from any blood type.  It's essentially the complete opposite of a universal donor (O negative).  Because my blood already contains both A and B antigens and the RhD antigen, I can accept blood from pretty much anybody.  (People who know me well are already nodding, saying, "Yeah, it figures.")  So in the event of an emergency, I can already tap into Patrick or Charlie at my option.  Still, it's good to have a couple of kids who can help Ginger out if need be.

A few years back we were on a road trip and stopped at the In-N-Out Burger in Rohnert Park.  A fire engine was parked outside, so after our meal I took Patrick and Charlie outside to see it while Ginger straightened up our table.  An elderly Hispanic woman who had been sitting a few tables away approached Ginger, and said, "You must try again.  For a girl.  Someone who will care for you when you are old.  Boys will not do this."  She must have been psychic or something, although I doubt she could see either the twin thing or the blood type thing coming.

By the way, back to the whole fraternal/identical thing, we know they look nothing alike.  It's as plain as the nose on Evelyn's face.  But the nurses and doctors all say "Not necessarily," which seems to undercut the meaning of the word "identical."  Whatever.

What was new this past week?

You might have noticed that the posting volume on this blog has decreased.  This is because our life now runs on a three hour cycle, like the tides.  (Assuming tides change every three hours.  If only there were a way to find out -- some kind of searchable interconnected set of computers containing such information.  Memo to self: invent this and make money off it.)

The first week and a half of having the girls at home together resulted in a kind of rhythm.  It definitely requires two people, but it can be done.

A bit of that changed on Thursday.

We met with our lactation consultant.  This sounds like a made-up job, but it's not -- it's deadly serious.  She did many things, all of them helpful, and then she prescribed a course of blessed thistle, goat's rue, and fenugreek seed.

Regular readers of Bambine al Dente will assume that the foregoing paragraph is some kind of punchline, the kind you've come to expect of me.  I assure you it is not.  Each of these is a traditional herbal remedy to increase milk supply.  If you look up the Wikipedia entry for "galactagogue" you'll find a list of some of these herbs.  You will also find the statement that "[c]linical evidence for their efficacy is often lacking," which is a refreshing dose of skepticism by Wikipedia's standards.  This being Wikipedia, of course, another article vouches that one of them can increase breastmilk supply by 900%, which beggars belief, since if one did so, one would quickly be shanghaied into the dairy industry and never heard from again.

Whether or not there is clinical evidence, there is some anecdotal evidence, and if there's one thing I came to learn in helping (ha!) Ginger breastfeed our two older children, it is that you do not cross La Leche League ever.  You cannot even make breastfeeding jokes in their presence, and trust me, that's a shame because many breastfeeding jokes are hilarious.  These people have the power to make you disappear from the face of the earth.  Oh, and they're also really nice, as long as you agree with them that you Will.  Breastfeed.  Your.  Children.  Which we did, so we're cool, right?

Anyway, fenugreek is a spice and it's been used since ancient times.  You can find the capsules in any health food store.  Take enough of it, and your urine will begin to smell like maple syrup.  Which is nice, because who wants their urine to smell like pee?

Goat's rue is an invasive weed.  Apparently there's a survival guide that says that it can be used as a fish sedative.  Keep this in mind if you find yourself in the wilderness with a handful of goat's rue and some hyperactive fish on the hoof.  Like many medieval technologies, it's served up in a tincture -- you put a drop under your tongue.

Blessed thistle is an herb about which there is nothing interesting to say, except its name, which sounds like a mild swear word.

I'm focusing on the hippie-dippy crunchy granola aspect of the lactation consultant's advice, which is fun but totally unfair.  She is a medical professional, and she acted as such.  She gave us a lot of good information and help, and it's all working by degrees to keep the milk supply up.  We're talking about the wisdom of the ancients that used to be passed down from mother to daughter, but got lost some time after the invention of powdered infant formula.  Now there is an entire profession dedicated to keeping this knowledge alive.  So the techniques and herbal medicines that the lactation consultant recommended are invaluable.  You can't put a price on that kind of wisdom.  Oh, wait, you can.  $150 an hour with a two-hour minimum.  And yet I'd pay it twice if it gives us healthy babies.  Maybe even three times.  After that, don't push it.  I've got college tuition to think about.

What does this all have to do with the rhythm of the household?  Everything.  Because aside from the new age medicines, the lactation consultant also pooh-poohed our bottle feeding techniques.  Which is fair, because we're rank amateurs when it comes to bottle feeding.  Since we exclusively breastfed our boys, and because Ginger was at home full time (or at worst working very part time), we never had a lot of need for pumping and bottle feeding until now.  And now it's every moment of every day.  We had been using the bottles and nipples that the hospital gave us for free.  Bad idea, says the lactation consultant.  The hospital uses those nipples because they are really convenient for the nurses -- i.e., they're fast.  Milk actually pours down the baby's throat, and she has to gulp to keep up.  If you want to transition to exclusive nutritive breastfeeding, you need to train your baby to work harder.  The baby needs to earn its meal.

So she put us on a course of super-slow nipples.  This, in turn, has extended the time it takes to feed one girl from ten minutes flat to something more like 30 or 40.  And we're supposed to periodically interrupt the feeding by tilting the liquid away from the nipple to give them some non-nutritive sucking time, which they'll need to be familiar with also.  So if both of us are home, every three hours we're in for about an hour's worth of work -- or an hour and a half, if the person on duty needs to do both girls.  This has vastly expanded the time it takes to feed them.  It's all for the good, I know, but still a serious bummer.

Finally, the lactation consultant happened to mention that preterm infants are frequently quite easy to please, at first.  Feed them and they'll sleep, because developmentally they're still in utero.  When they reach term age, they'll act more like normal newborns.  So our sweet, easy little angels are only that way for a brief time, and then we might see some fussiness.  I told you I might regret posting about how "doable" this whole project is.  That day of reckoning might come sooner that I had thought.