Twin Tea Time

I shouldn't complain. I should be happy. I should be in an ever upswinging arc of excitement. But the truth is I'm exhausted from working so much and waiting so long. I'm impatient, I know. It is so hard and painful to be infertile and childless. Though not anwhere close by any stretch of the imagination, it is also hard to wait and be so far away from your babies too. It just feels like these babies exist only in my imagination (at least on this side of the planet), and I keep wanting something to reassure me this is really happening. Maybe the baby shower will snap me out of it in early August. If that doesn't hopefully when I begin pumping to try to start up my milk supply August 15th then I'll have my head back in the game. Pumping 8 times a day will make it very real, very fast I would imagine. 

 The "schedule" Dr. Patel has emailed to other client's as well as what other client's have told me say that week 23-24 you get another report. Today is the last day of week 24. I wonder if since we got an unscheduled report 4 weeks ago, does that mean we don't get one now? The report just says they are doing fine when we get it along with a bunch of medical info that is meaningless to me even though I can decipher the report down to the fine details.  And no news is good news. I know this. As soon as I get a report I'll just want another one anyway. So how come everytime someone asks me how the babies are doing and I have nothing to report other than my assumption that all is well because I haven't heard anything, I feel this urge to stifle back a tear from the corner of my eye. I guess all it is is that I just miss the two babies I've never met. I hope to have dinner next week with a local gal who had a baby by Dr. Patel, and maybe she can tell me if it was just as hard waiting for her as it is for me...because I don't know anyone who can relate to exactly what I'm going through.

So today in the hope to brighten my mood I went to the Newcomers Tea to welcome the newest members of the Mother's of Multiples Club. It was very nice, and I took notes on how to make my home family friendly but not look like a daycare center. It was babies, babies everywhere. I'm trying to take the advice to enjoy it while I can, but I'm really just jealous. Let's go already! Over eight years without children, so let's get this show on the road. They ask if I'm ready. I am, but of course I'm not really. There is a lot left to do on the house. Besides, however many ways you may feel ready, there have to be a hundred ways you don't know what to expect in how it will change your life. I know that. Have I mentioned I'm impatient?

At the tea party there was an entire room to the right of the door that became a parking lot for all the double strollers, but they spilled out into the hallway and living area too. I took a picture because it got me tickled!

The Last Supper

So last night for my 35th Birthday Dinner my mother spent some gift cards on us for a lovely meal at Ruth's Chris Steakhouse.

It was certainly yummy, but I kept joking that it felt more like a last supper than a birthday supper. As in "enjoy a nice meal out while you can because when the twins are here in 3 months you can kiss these kinds of luxuries goodbye!"

I don't mind of course. I'm still in a wierd phase where it doesn't feel like this is really happening though. Aside from finishing up some house preparation for the twins, the baby shower date is set and we are 1 month away from achieving the "ready by the end of the 2nd trimester" goal. My shower is August 4th, and that is right after the date that should our twins be born they have around a 95% chance of survival with virtually no chance of developmental disabilities. That is the "breathe a whole lot easier" date for me. It's also the date I should have a back packed and ready to go in the spare room! At this stage of pregnancy the "What to Expect..." book says most Mom's to be get impatient with the pregnancy and anxious for it to be over and the baby to be here, so maybe I'm mimicking those stages too.

My in-laws did throw a wonderful party the other night, and I wore a traffic cone yellow silk saree I'd never worn before. But I picked the bright color to match my mood. It was the first time I'd been around that side of the family since the big announcement. I was right there next to his visibly pregnant cousin, but it was wonderful to get just as many hearty "Congratulations!" as she did. With the whole twin thing it felt like I was stealing too much of the attention. Sure, there was lots of unsolicited advice but I mostly take it in stride. There was some very strong opinions on Indian names, and I learned I was pronouncing one of the ones I picked slightly incorrect. But it was so wonderful to have that side of the family celebrating our good news with us...something I have waited so many years for. It scares me a bit to acknowledge it so publicly but we are only a month away from breathing easier.

I'm sleeping far too much these days. On one hand I'm working a lot of overtime and following the "sleep while you still can" advice people say all the time to me. But admittedly I'm also sleeping too much because I'm hoping to dream about the babies. Generally it is a bad thing to prefer dreams to reality, but they are SO CUTE in my dreams. Lately it is a boy and a girl, though for some reason in this last one I was still worried about telling them apart for some reason. I'm always tremendously incompetent as a mother in the dreams, but I still wake up happy because they are so adorable and I got to see them, so to speak. This last one they were so patient while it took me two hours to figure out how to make a bottle, and they didn't even cry! Yeah right!  I also changed a diaper wrong and his little thingie fell off as a result, and after trying to stick it back on I gave up and hid it in a Desitin jar instead of going to the hospital. So despite my tremendous incompetence in my dreams, after my overtime today I plan on eating the leftovers from my Last Supper and take a nap before I go back to work and hope to see them in my dreams!

500 Babies....and counting!

So just this past week Dr. Patel and the Akanksha clinic celebrated the 500th baby born through surrogacy! Technically it was twins, so they are at 501.  Video below. Wish I could understand the language!

Media links below:

http://www.dnaindia.com/india/report_anand-clinic-celebrates-birth-of-500th-test-tube-baby_1702932
It was twin celebration for Anand’s Akanksha clinic when a surrogate mother delivered twin babies three days ago. The delivery not only brought incomparable joy to a childless couple, but also marked the 500th birth of a surrogate baby for the clinic.

The clinic wanting to share their happiness held a small ceremony which was joined by not only the recently born twins but also many other surrogate mothers and their families on Friday afternoon.

Doctors at the clinic say that childless couples from around 29 countries including India, USA, UK, and Pakistan turn to Anand seeking help of surrogate mothers to give birth to their babies. According to them, babies born through In-Vitro Fertilisation (IVF) have shown a ratio of 253 boys and 247 girls at the clinic.

“It is a good feeling. After a long struggle and controversies we have been able to spread happiness to 500 childless homes,” said Dr Nayna Patel, who is considered to be one of the pioneers in IVF surrogacy.


http://todayhealth.today.msnbc.msn.com/_news/2012/05/28/11883566-a-baby-made-in-india-a-couples-dream-comes-true?lite
This second one is a good article, but does address some of the need for regulation and the recruiting done in Mumbai slums.


I found a few more articles today, but they are poorly written and full of misinformation and logical fallacies so I'm not posting links because I don't want to contribute to fear and ignorance. Heavy on the slippery slope arguements and short on actual facts or research. People make a lot of statements and they are not backed up, and from what I can tell they are based on fears or isolated cases rather than reality. It just reminds me that modern day journalism lacks the ethics or integrity to put out well written factual articles, and I feel sorry for people who read the garbage they write and can't tell the difference.

Father's Day Reality Check

I've been working so hard with as much overtime as I can get. At this point with so few updates and as time has drawn on... it is somehow feeling less real instead of more so. I keep thinking this is all some elaborate delusion that I've made up and I'm really locked in a rubber room at a mental hospital dreaming up the wish that I'm actually going to be a mother of two in three and a half months. The doctors and nurses give me pills but instead I rock back and forth in a trance pretending that all my dreams have finally come true.  The initial plans taking shape for a baby shower though may help it to become more real when I have a room full of folks celebrating, because surely that many folks can't participate in my delusion.

My first reality check was coming home after an exhausting double shift the day before Father's Day and finding that I really should have been more specific when I asked my husband to pick up some "dishwashing liquid."  Sigh. But kudos to the man for staying up late cleaning it up, going out at midnight to buy the right kind of soap, then waiting up another hour and a half to run another dishwashing cycle!

For Father's Day Vinnie and I celebrated by taking him out to lunch, then went to visit Babies R'Us. I don't know if it was a reality check or just sticker shock. Vinnie and I test out the super comfy gliders with matching ottomans, but the most utilitarian looking dark brown one that matches the nursery is $400.  Instead I am practical and purchase a changing pad cover for $11. Since 4th of July is coming up they have the cutest little red, white, and blue swimsuits and dresses...so I was a little frustrated about not knowing gender. So many cute clothes and I don't want to waste money if we don't get a girl. Sigh. But Vinnie does look awfully good in pink. I did get two patriotic onesies at WalMart the other day. So would it be a good idea to show up to my US embassy appointment with my babies in "I Love the USA" outfits?

Travel Problems & Solutions

I'm so excited that my little crib contraption arrived today! I have a plan....   My hotel doesn' t have cribs and they are harder to come by in India, but I want a place for my babies to sleep. It has to be at a safe angle as their primary sleeping place, and car seats at a 45 degree can occlude breathing so aren't ideal for sleeping...especially with preemies who have more apnea risk. Twins and preemie's also often  need to sleep on a tilt to help with any reflux issues early on. But packing an crib/bassinet is not very feasible.

All the travel bassinets I looked at cost $40 and were not looking sizeable enough for two.

So my solution is to pack the mattress for our Graco Pack n' Play which folds into fourths and will fit in the suitcase. This is firm enough, because adult mattresses are too soft for babies and not safe because there are typically blankets and adults on them. Some people may find me paranoid but it is a real risk, and so I'm just being practical and careful within reason based on the latest research. I have have heard the screams of parents who found their babies who had died of SIDS, and it stays with you whether you want it to or not.

The second part of my plan is to use the contraption below that I ordered off of Ebay for $7.29!

http://www.ebay.com/itm/New-Foldable-Baby-Crib-With-Mosquito-Net-Tent-Bed-/270941661191?pt=LH_DefaultDomain_0&hash=item3f1561a807

I'll bring some little clips to attach the sides of the mattress to the little mosquito net crib, but this gives us a light and packable crib that keeps insects out and a more secure space for our two little ones that is portable and large enough for two. With the clips I can roll up a towel under the mattress and tilt the whole thing at an angle if need be for reflux issues.

I've also figured out other solutions for our sterilizing issues in India due to water supply and not wanting to go through tons of bottled water rinsing and sterilizing. I'm not buying some "bottle system" with a custom fitting sterilizer contraption. I have mismatched bottles as well as pacifiers and other items that will need sterilization.  I won't have a microwave, so I bought the Baby Bullet Turbo Steamer. It can sterilize and plugs into the wall (converter must be used for India) and can also defrost frozen baby food or breastmilk, as well as steam other foods. It will use less bottled water too. For sterilizing on the plane Boots makes portable sterilizer bags, but I'll just use ziploc bags, a bottle of water, and some Milton sterilizing tablets.

I hope to fly back on the airline that has the double bassinets that hook on the wall, but if not we'll use my homemade Moby wraps I guess. Some carriers have baby carriers, so I'll have to research that more before we buy a return flight.

I'm bringing a hot plate to India and will buy a pot there, that way we can cook and bring our own meals if we want and boil something to sterilize it if we so desire.  For bathing the babies a boiling pot won't work I assume, so the Puj foldable bathtub should work just fine.  It uses magnets to clip it in the bathing position, but then it folds out flat. It is made of a semi-soft and waterproof foam. Excellent!



Ignorance

I came across some statements today that hurt and upset me. I haven't read much out there from folks who are of the opinion that Indian surrogacy is equated with exploitation, mostly because what little I've read seems to be based on ignorance and false assumptions. Let me analyze what I found, some of which I've already addressed.

In India, many Indian surrogates are of the lower castes and are, in fact, very poor.
True, they are. Your money is going much further and helping them so much more than it could in the U.S. Being poor does not make you an idiot who could not possibly know what they are getting into.

They live in communal houses and kept on strict bed-rest for the duration of their pregnancies.
False assumptions here. I don't know of any clinics that treat the communal housing like a prison cell, and in fact the women are free to come and go but choose to spend most of their time in the communal housing. It's nice, air conditioned, and they aren't choosing to waste all their new money on fancy shopping trips about town. Sure, naps are on the schedule to make sure they do take care of themselves, especially during the hottest parts of the day. Communal housing is actually a great thing, and at our clinic is an option most of the women choose to take. They get a nurse, a chef, medical care weekly, classes of all kinds, as well as a bunch of new friends who can understand each other. The housing is nicer than where they would usually live, and their family is free to visit. Bed rest can be stricter at the end of the pregnancy, but why is that bad?

They are (in most cases) transferred with MULTIPLE fetuses (sometimes 3 or more) to ensure a successful pregnancy, all without fully understanding what they are doing.
Where to start. Capital letters do not make your argument more valid. Again, why is it assumed that they won't understand what they are doing but an American surrogate will? Do you have to have money in order to make a responsible decision for yourself? They are perfectly capable adults who are counseled and aware of what they are doing, and selective reduction if necessary is done to ensure the health of the surrogate.  They have all been pregnant before, so that understanding of what it entails is a given.  Women all over the world, surrogates or not, are frequently implanted with multiple embryos (they are not fetuses yet) to try to get success. Twins may be riskier, but not necessarily so irresponsible that it is exploitation. They know going in that twins are a possibility. We did four embryos on the first try with no implantation whatsoever. This is typical in IVF and I don't consider it irresponsible. I understand some people have religious problems with reductions when you do get implantation of  more than one embryo. I don't.  I am a religious person too. I'm not going to even try to get into a religious argument here, because I've found that a person convinced against their will is a person of the same opinion still. I think we can all agree on Octomom though.

They are offered money for the use of their bodies.
So are American surrogates. Is there a point coming? While not in such an internal and lengthy way, we pay people for the use of their bodies all the time. If it is an informed decision I don't see why it is assumed as  exploitation for someone to allow another to make use of what their body can do that the other person's won't let them do.

They are not following their hearts.
This statement upsets me the most. So ignorant. The majority I'm sure are are absolutely following their hearts. Indian women are far more likely understand the pain of infertility more than American women, given the expectations placed on women in their culture. An American surrogate could do it for the money and not be "following their heart" just as easily as an Indian woman could. I think it is wonderful if a surrogate and the parent form a lifelong relationship, but why is it automatically wrong and immoral and exploitative if they do not? I have never met our surrogate, but I feel bonded to her and have sent her a letter of appreciation and gifts and know that she has heard from us just what this means to us. And frankly, even if she approached this in a business like way and she did not feel all that emotional or felt no bond to me, I do not fault her for that at all. As long as she cares about taking good care of our babies for 9 months, I don't see the problem here. Why is it for so many all about the relationship between the two women in order for it to be seen as mutually beneficial and moral?

One surrogacy can often mean for them more money than their family would make in a lifetime but it also mean seclusion. Many women travel hundreds of miles to live in the surrogacy center so that they will not be recognized and bring shame on their families for what they are about to do!
First of all, a "lifetime" is stretching it. And yes, seclusion is an informed risk she is taking. I think these surrogates are brave in taking that risk, because it is one more thing they are doing that is slowly affecting cultural change and empowering the women of India. And they travel hundreds of miles because India is a large country and the clinics are in the big cities typically and they will need to be nearby for regular care and checkups, not just to avoid judgment.

Many of the surrogacy clinics in India are not regulated and often the children are not allowed to go home with their parents (IP's) because of legal issues, faulty contracts, misunderstandings or government regulations. That is not the case here. http://articles.latimes.com/2011/apr/18/world/la-fg-india-surrogacy-20110418
http://online.wsj.com/article/SB10001424052748704252004574459003279407832.html
The regulation does have a way to go, I'll admit that much. "Often" is once again stretching things. There have been a select few folks with tons of press whose children were citizenless and could not return to the country of the parent's origin because they did not address in advance the laws of their home country not recognizing surrogacy as legitimate. So the parents stayed with the children in India. I blame the parents here more than the regulation in India, and it seemed like the laws of the home country were what was primitive in these cases. I would also add that too much regulation and you will be like Britain where if you are infertile surrogacy is next to impossible. If you want to know what I mean, read the free e-book by Bobby and Nikki at http://www.oneinsix.org/.  They went to hell and back in what is known as a "developed country", but in the "third world" of India is finally where they found hope.  I've been in contact with Jan Sjodin from the first article. They did have a very bad experience, though I've read about lots of folks who had good experiences at the same clinic. Hopefully this means that clinic has straightened up their act, but it is very sad that happened to them. I hope there is some more regulation to prevent that. I can't say I know enough to know that could never happen in America, and I seem to recall some stories of American surrogates who took advantage of intended parents as well.  Everyone needs to inform themselves of the risks, protect themselves legally, and in my opinion go through people and clinics with an extremely good reputation because that to me is the best protection because the law is always changing and only now seems to be catching up. The second article is a mostly balanced one, though the author tries to artificially darken the connotations by saying the surrogate is "haunted" by her memories when she expresses that she does wonder still how the child is doing and prays for her. I will wonder how our surrogate is doing and pray for her for the rest of my life I'm sure, but that does not mean I'll be haunted anymore than this woman she interviewed is. I am baffled that the person who made these statements even read this article, because the two are not congruous.

Although surrogates are often happy to see the extra compensation, we save for a vacation, or a down payment on a new car, maybe even help pay off our debt, we don't NEED the money.
Really? Seriously?Again with the capitalization. According to who? While I'm sure most surrogates want to help people, money is the primary reason most are doing it. I'm certain it is only the surrogates who are already friends or family members who ask for no compensation who truly are not doing it for the money.  And I don't know about you, but I'm happier if a person who does need the money is getting it, rather than an American surrogate who is using the money to finance other things she wants but doesn't need. And I'm sure many surrogates in the U.S. have plenty of financial needs that are being met. Why is it better to give the money to an American surrogate who wants a new car instead of an Indian woman who at times has struggled to put food on the table for her family? That is just an example, but I don't think it is so much of a stretch to be a fallacy.

We don't do it for money, we do it because we see a need and have an overwhelming desire to help and make a difference. We don't get rich here but we are also not poor.
Yeesh. I already addressed this. You can be altruistic and also accept compensation, and it does not depend on where you live in the world or how much you had to start with.  Yes...being poor sucks in many ways. But it doesn't automatically make you less of a human being or less capable of making good decisions for yourself. And it doesn't mean that two women reaching across the world to help each other are engaging in exploitation just because one of them lives by what the other defines as poverty.

Cute twin pics/Packing recommendations

Working so much overtime will be worth it in 3 1/2 months, but right now it is just hard work! So I found some cute pics of twins to keep me motivated. 


I must take a photo just like this one in October!



This man is the Master! Look a that technique...those complex angles. No pillows or Boppies!




 So now for something useful. The below links is to a blog for a guy that had twins through a Delhi clinic and here is an excellent packing guide and notes about what can be found in Delhi. Thanks SKhan at Life with Two Little Khans!

http://cyberkhanfamily.blogspot.com/2011/12/what-worked-for-us-in-delhi-and-what.html

Interpreting scan results & updates

We got an update today! I think the only reason we got it earlier than the predicted schedule of 23-24 weeks is because I sent Dr. Patel an email asking for a signed copy of our surrogacy agreement and to verify if our package of sarees and pictures and thank you letter to Manju was recieved. So excited, and today happens to be our eight year anniversary. I showed my husband the blog and he loved it!

So we are at 21 weeks along, though I say that because we are 20 weeks and 2 days, so that to me means in the beginning of week 21 right? Who the heck knows. I've seen all sorts of online calculators but I enter the same info and they give me different calculations on due dates and such, and with twins they are full term at week 37 anyway. I'm not really sure what week begins or ends a trimester because apparently there are 3 different ways to calculate it, though around 27 week mark seems about right:

by Development:

This uses actual developmental stages to divide up a pregnancy. From LMP to 12 weeks the embryo develops all the major organs and becomes a fetus. From 12 weeks to 27 weeks the fetus continues developing and reaches viability. From 27 weeks on the fetus finishes development and prepares for delivery. Here the second trimester begins at 12w 0d and the third at 27w 0d.

by Gestation:

With this method you take the 40 weeks of gestation and divide into three equal stages. Here the second trimester begins at 13w 3d and the third at 26w 6d.

by Conception:

This method is where you take the 38 weeks of post conception development, divide by three, into the three equal trimesters. Here the second trimester begins at 14w 5d and the third at 27w 3d.
What is the length of the first, second and third trimesters?
The length of the trimesters is often a source of confusion. The word trimester means 'three months'. Three periods of three months each, gives pregnancy a beginning, a middle and an end period.
These periods match the developmental stages to divide up a pregnancy.

• Beginning: From LMP (last menstrual period) to 12 weeks the embryo develops all the major organs, becomes a fetus, and the placenta takes over control.


• Middle: From 12 weeks to 27 weeks the fetus continues developing and reaches viability.


• End: From 27 weeks on the fetus finishes development and prepares for delivery.

As a side note, 28 weeks seems to be the magic number where a baby has a very high chance of survival with little to no chance of developmental delays. My brother's twins were born at 28 1/2 weeks and they are both fantastic with no problems, though it did take another full 3 months in the NICU before they could go home.

So when you get these scans from Dr. Patel, what are you supposed to do with them? Other than trying to figure out what part of the baby you are looking at, of course... I am not sure on most of them what I'm seeing if it isn't the head, and lately they seem to get even blurrier and harder to tell instead of easy like the first ones were. Maybe they are doing more close ups. Dunno, but this latest scan is the first time we have gotten shots that appear to the be fancier 3D Doppler kind. It says on the report "2D Echo" so that is probably what refers to these two shots.  Check them out! The 2nd one I don't have much of an issue telling what I'm looking at on the left side, but the 1st one I have no idea what is in front of my the baby on the right. Is that the other baby's feet or something?:
 
 


















I'm not going to pay out of pocket for a local radiologist to look them over when Dr. Shah (Anand radiologist on report) and Dr. Patel already have and say everything is fine. That would be going overboard. Okay, okay...so I did have my Dad call in a favor and forward the last two to a radiologist friend just to see if he could determine gender. He isn't sure cause they are scanned in with big fax stripes and so blurry by the time we get them by email, but he agrees we may have at least one girl. But I can scarcely see the A or B mark on each pic that tells you which pic is for which baby, so unless you have a double gender shot with both babies in it (highly unlikely) or see a boy and a girl clearly, you won't know which twin you are looking at in each photo and could think you have two boys when you are looking at the same boy for example. Plus they don't tend to take shots from the right angle since they aren't really trying to detect gender. I don't honestly care because I just want them healthy, but it would make packing clothes so much easier because gender neutral stuff is harder than I thought to find.  I can tell you that when you see a split screen pic with two images in it that it seems to be of the same baby every time.

So what does all of it mean beyond the pictures? I just go to the very bottom and look for the sentences first, since it is easiest to understand and seems to sum it all up. I'll put what I've been able to decipher from Googling, but I'm just a layperson and NOT a doctor or radiologist so I could be very wrong. I know a bunch about physiology and anatomy from taking two college courses for fun on the subject and getting my Emergency Medical Technician in 1995, but that hardly makes me an expert so take everything below with a grain of salt. I assume if there is a real problem Dr. Patel would email you and tell you. It says stuff like:

• DCDA twin pregnancy-Dichorionic/diamniotic twins. It means they are fraternal and don't share an amniotic sac. This is good because there is no risk of twin-to-twin transfusion syndrome. If it was monochorionic (MA) they would be identical twins. The chorionic part is actually referring to the placenta, and sharing a placenta means the syndrome above is a possibility. Identical twins are the only kind that can share an amniotic sac, and there is a high survival rate but there is an added risk of cord entanglement or compression.
• Variable presentation. That seems to simply mean the baby moves around and doesn't stay stuck in one spot. From what I understand, that is a good thing.
• Posterior high placenta. That means the placenta is in the back of the uterus. This is good, and I think where Dr. Patel tries to get the embryos to implant on purpose since both of our twins implanted there. A low lying placenta is the only place I know that is definitely bad, but I'm not sure what medical term that would be. That means there is a chance of "placenta previa" and the baby will have to be born by C section. Google it. So when you see "no previa" on a report that is a good thing.
• Fetal growth 7 AF normal. Sounds good to me. I think AF is amniotic fluid. Not sure what the 7 is for. I found AFI charts online to show normal fluid levels, but I can't  interpret it that in depth and it is probably different in twins.

• Fetal heart normal. Awesome!
• Low resistance flow in both uterine artery--PIH least likely. PIH means Pregnancy Induced Hypertension, so least likely is a good thing. That means low resistance flow in the uterine arteries are a good thing too.
• No fetal malformation. Definitely good.
• No growth discordance. This is good. It means one is not growing significantly faster than the other.
• EFW-Estimated fetal weight. Ours is in grams, but it shows the conversion to lbs too.
• Note* In the measurements section there appears to be a column for "last" measurements to measure growth. Ours is always the same number as the most current measurements on every report, so I think he doesn't re-enter old data in the new reports for whatever reason. So don't freak out and think your baby hasn't grown.
• LMP-Last Menstrual Period: This is a way of calculating the gestational age.
• GA-Gestational age: This column is next to all the measurements from the fetal biometry section I describe below. You want this to be close to
• EDD-Estimated date of delivery. I think in the first column it is calculating it based on the LMP and the other based on GA, which makes sense because I've seen that there are several ways of calculating due date and these are two ways.  This never seems to change more than a day or two for us and reflects the 40 week date. With twins 37 weeks is full term though, and delivery can depend on other factors and 35 weeks is frequent with Dr. Patel and twins.  
• HR-Heart rate. It starts off in the very early weeks the same as the mother's, then by week 9 rises to 175 BPM (beats per minute). In the middle of the pregnancy it is often 120-180 BPM.
• NT-Nuchal Translucency. Ours says normal at the very bottom, which is good. See more about this below.
• NB visible. I think this means nasal bone. I take it that it should be visible, so woo hoo! This was right next to "nasal triangle normal" so that makes sense.
• Fetal biometry is basically the section where they take various measurements of your baby in order to determine the fetal growth is normal. On some scans they have done a side by side comparison in a separate section to establish any growth discordancy.  This linke shows charts of what is normal percentiles if you want to totally obsess about it: http://www.centrus.com.br/DiplomaFMF/SeriesFMF/18-23-weeks/appendix-03/normal_fetal_biometry/appendix-03.htm   Abbreviations from this section as follows:
• BPD - biparietal diameter: Transverse diameter of the head between the protuberances of the two parietal bones of the skull
• OFD- occipito-frontal diameter:  The diameter of the fetal head from the external occipital protuberance to the most prominent point of the frontal bone in the midline.
• HC-head circumference.
• AC-abdominal circumference
• FL-Femur length (thigh bone)
• HUM-I think this is humerus length, but not sure.
• The names Hadlock, Jeanty, Hansmann are all referring to which growth table the doctor is using on that particular measurement on the scanner.
• Fetal cranium: This section is all about measurements of the head, including the left ventricle, the cisterna magna (CM), and cerebellum (CEREB).
• Ratio section: These have the previous mesurements in a ratio format. It takes these ratios and compares them to a normal growth chart, and the percentages on the right show you what is normal for how many weeks along your baby is. You want it to be somewhere in that percentage range.
• 2d Echo section: ASC AO stands for ascending aorta and MPA diam stands for main pulmonary artery. These kinds of scans I think are designed to check for good blood flow on major arteries, so that makes sense because it doesn't get more major than these two arteries in the human body. This section also has measurements on the uterine artery flow, which admittedly is way too hard to interpret. But the summary section at the last page will say what it did on ours hopefully that I referred to above, which tells you all is okay. We had another report that had similar abbreviations and a section for "Ductous Venousus," (DV) which appears to be an important fetal vein that shunts approximately half of the blood flow of the umbilical vein directly to the inferior vena cava.
• PI Pulsatility index
  RI Resistance index, Pourcelot’s index
  S/D ratio Systolic/diastolic ratio
  Vmax Velocity maximum (same as PSV and MPSV)
  MDV Minimum diastolic velocity
  PPI Peak to peak pulsatility index
  PSV Peak systolic velocity (same as MPSV and Vmax)
  MPSV Maximum peak systolic velocity (same as PSV and Vmax)
  TAMV Time averaged maximum velocity (same as TAMX and TAPV)
  TAMX Time averaged maximum velocity (same as TAMV and TAPV)
  TAPV Time averaged peak velocity (same as TAMV and TAMX)

When you get the first trimester screening report around week 11-14, it is written in mostly plain English. A few points for interpretation:

• Cord-3 vessels is what you want and is normal. 2 can still result in a live birth but poses more risks.
• The Nuchal translucency test is the portion of the ultrasound which tells you an estimated risk of certain genetic disorders. It screens for Down syndrome (trisomy 21, meaning an extra copy of chromosome 21) and other disorders that are caused by extra copies of chromosomes (trisomy 13, trisomy 18), as well as congenital heart defects. Fetuses who have an extra chromosome may have more fluid at the base of their necks — a spot known as the nuchal fold — and this can make their necks larger. This fluid can be measured on a sonogram during weeks 11 to 14 when the base of the neck is still transparent. I think the results are easy to understand and self explanatory. Here is a screenshot of that portion on our report.

I found online this list of abbreviations for ultrasound reports, so if your reports have different stuff than mine maybe this will help:

ABO - May be seen in reference to blood test to check what your blood group is

AC - Abdominal circumference

AF - Artificial feed i.e. bottle fed

AFP - Alpha fetal protein (test offered at 16weeks to assess risk of problems with babe such as Downs syndrome)

ANC - Ante natal clinic

APH - Ante partum haemorrhage. Bleed whilst pregnant

BF - Breast fed

BO - Bowels opened

BNO - Bowels not opened

BPD - Bi parietal diameter. One side of the head to the other (ear to ear direction)

BP - blood pressure

Br - Breech

CEPH - Cephalic (head), in regards to presentation means head down

CRL - Crown to rump length i.e. Top of head to baby.s bum

C/S - Caesarian section

CTG - Cardio toco graph. The machine that they use on delivery suite to measure contractions and baby.s heart rate over a period of time
Cx - Cervix
= d - Usually in relation to fundal height (uterus size) means is right for dates

EBM - Expressed breast milk

EDD - Estimated date of delivery
ELSCS - Emergency lower segment caesarean section
Eng - Engaged
EPU - Early pregnancy unit
FAU - Fetal assessment unit
FBC - Full blood count
FBS - Fetal blood sample OR fasting blood sugar
FL - Femoral length (thigh bone)
FMF - Fetal movements felt
FHHR - fetal heart heard regularly (sometimes seen as FHH)

GTT - Glucose tolerance test

G2 P1 - Gravida 2 (2nd pregnancy) Para 1 (1 child living)
GA - General anaesthetic
Hb - Haemoglobin i.e. Iron levels
HC - Head circumference
IM - Intra muscular
IUGR - Intra uterine growth retardation i.e. Small baby for dates
IV - Intra venous (going into vein)
IVI - Intra venous infusion i.e. a drip
LA - Local anaesthetic
LMP - Last menstrual period
LOA - Left occiput anterior i.e. the back of baby.s head is to the front left side of your abdomen (where you want it to be)
LOP - Left occiput posterior i.e. back of baby.s head is to the back left side of your abdomen (where you don.t want it to be really)
LUSCS - lower uterine segment caesarean section (sometimes seen without the U )
Mec - Meconium (babies early poo)
Multip - Has 1 or more living child
MSSU - mid stream specimen of urine
NAD - Nothing abnormal detected
N/Eng - Not engaged
NNU - Neonatal unit

NICU - Neonatal intensive care unit

NPU - Not passed urine
OC - Oral contraception
OP - Occiput posterior
OA - Occiput anterior
Palp - Palpable i.e. what can be felt
PIH - Pregnancy induced hypertension (high bp)
PMH - Past medical history
PPH - Post partum haemorrhage. Bleed after baby is born
PR - Via rectum
PU - Passed urine
PV - Via vagina
Primip - First pregnancy
Reg - Registrar

Rh - Rhesus

SCBU - Special care baby unit
SHO - Senior house officer
SPD - symphisis pubis dysfunction i.e. loosening of cartilage at front of pubic bone (v. rough definition)

TOS - Trial of scar

Tr - Transverse ie Lying sideways
U&E - Blood test checking urea and electrolyte levels
USS - ultrasound scan
VBAC - Vaginal birth after a caesarean section
+ve - Positive
-ve - Negative

VE - Vaginal examination

Vx - Vertex, used in relation to presenting part/position. Means head down.

Book Review: The Sacred Thread

So in my anxiety during this 7-8 week gap between baby updates, I desperately search for other blogs of folks who've done surrogacy in India. I find plenty, but most are from the Surrogacy Centre in Delhi. Only two used my clinic, and don't go into the ridiculous level of detail that I would like them to because I'm obsessed and it's all I can think about.

Along the way during my Googling, I find that a woman named Adrienne Arieff has written a book called "The Sacred Thread." She had twins and used Dr. Patel AND wrote an entire book about it.

I frantically order it from Amazon.com.  It only takes a few days to arrive but feels like forever. Below is the summary of the book from their website http://www.thesacredthread.com/. Order it on Amazon or read other reviews here: http://www.amazon.com/The-Sacred-Thread-Family-Half-ebook/dp/B00540PBR8

When Adrienne Arieff and her husband Alex learned they were unable to have children, they considered, like millions of American couples, the traditional options. And then they chose what many would consider the most unlikely and unexpected path: surrogacy.
In India.
The Sacred Thread, Adrienne Arieff’s compelling, insightful, and informative chronicle of her journey into the heart of India to become a mother. With the help of an inspiring Indian doctor, an Indian surrogate named Vaina, a loving husband, some skeptical friends, and a cast of surprising and hospitable Indian friends, Adrienne experiences her own unique path to motherhood. Along the way she discovers the challenges and promises of the growing global phenomenon of foreign surrogacy— what it is and what it means, both for Indian families and for the American couples who seek them out.
After three pregnancies, three miscarriages, and dozens of tests and disappointing diagnoses, Adrienne and Alex realized they must seek an alternative route to their happily ever after. Adrienne’s doctor advises that she consider a possibility as far from her mind as motherhood once had been: surrogacy. After Alex reads in the New York Times of the Akanksha Clinic in Anand, India, where a Dr. Patel works to bring together two women from disparate cultures to help each other, the couple immerses themselves in research surrounding a phenomenon they’d never heard of: foreign gestational surrogacy.
Several months, hundreds of research hours, and thousands of dollars later, Adrienne boards a plane for Mumbai. There, in the 107 degree heat of Indian summer, she meet Dr. Patel, undergoes IVF treatments, and forms a deep bond with 26 year old Vaina, a surrogate mother who would eventually give birth to Adrienne’s children. Whereas most women like Adrienne return home after the fertilization, Adrienne was unable to stay away. Placing her life and business on hold, Adrienne packs up and moves to Anand for the duration of her surrogate’s pregnancy, immersing herself in the culture and traditions of India, and shaping a lasting friendship with her surrogate, Vaina. As Adrienne and Vahina share their stories with each other, aided by the visionary Dr Patel, they witness first-hand the challenge and promise of international surrogacy.
The stories of these two women—an American woman and an Indian woman—are intertwined, creating a surprising and heartwarming narrative that results in the birth of twin daughters, Emma and India, but also gives birth to a transformative and mutually beneficial relationship between Adrienne and her surrogate Vaina. The Sacred Thread offers a unique and revelatory look at the landscape and culture of India through the lens of an American couple searching for family, an Indian family searching for a future, and a doctor offering a chance for both to find what they seek.
A timely, challenging, informative, and heartwarming story, The Sacred Thread offers one woman’s perspective on a trend that illuminates our global interconnectedness. Above all, it is the story of a unique friendship between two women from two entirely different worlds, who, with the help of a committed physician, are able to reach out to each other and cooperatively change one another’s lives, through their physical and spiritual gifts to each other.

I think that reading this book will keep me busy for another week while I wait for an update and keep me calm. Who am I kidding? I read it in about 6 hours between midnight and 9am the next morning and go to work dog tired the next day.

There are a few things I disagree with or had a different perspective on, but partly I think I went into this with a better understanding of Indian culture and had some more adjusted expectations. But I'm so glad I read it and it eased my mind and gave me the sense that I know what is happening with my babies on the other side of the world. I went from anxiety to being in a much more relaxed state after reading it, which is the most important thing I can say to anyone expecting through Dr. Patel who thinks about buying it. If you are thinking about using Dr. Patel then this is a great book to read to get you more prepared in the emotional/culture shock sense, especially if you have never been to India.  The only thing that prepares you for the finer details is just reading the Dr. Patel surrogacy blog as well as this blog and any other links I've mentioned. We all have to do our own research. I truly appreciate the time and effort she put into this book, and her style of writing does bring you into the story with her. I did laugh out loud several times. But most of all as she sees her twins being born and brings them home healthy, I let the hope that will happen to us in 3 1/2 months finally take roost in my brain and settle in.

Things I learned and random thoughts on the book below:

* I love her descriptions of the town, how it has grown because of Dr. Patel's business, and the impact it has had there. These are things I was too self absorbed and nauseated to look around and notice while I was there.

*She describes the outlook and percieved perspective of the surrogates well, and they do vary widely. Some surrogates have very personal career related goals for the money, others dedicate it to their children or community, but many do let their husbands utilize the money as they see fit. I didn't know that Dr. Patel counsels them about how to best handle their new windfall of money to help build a better future for themselves and their family, and operates a trust at the clinic and makes sure the money is issued to the surrogate herself.  The book did remind me of the roles of men and women in this culture that I do take for granted at times because I am such an independent woman and used to gender equality and "love marriage."  It helps to hear more about the life of a woman in a small village with an arranged marriage, and what can be see as exploitation can also be seen as placing trust in her husband and his role and decisions in the family. It is very different, but as much as I am for the equality of women it isn't necessarily different in a bad way. It made me think. It reminded me of one of my favorite books "The Spirit Catches You and You Fall Down" by Anne Fadiman, that helps you look beyond what you know and see that what the West judges about the East can often be hasty and misinformed.

*Her experience getting bitch slapped by a cashier at the Ahmedabad embassy after she bawls her out for raising a fee and having  inconvenient hours and making unreasonable demands is an important reminder. Unless you are getting completely swindled, if someone in an official capacity says jump you say "How high?" When it comes to getting your babies home, play by the rules even if they seem to change them every 5 minutes. You have no power here. My mother always said you catch more bees with honey than with vinegar. No where is this more true than India.

*Don't email Dr. Patel incessantly with long emails full of questions and demands, and try to understand when the communication is slow, incomplete, or non-existent.  I learned that 5-8 new clients arrive every week, and the NICU has a few new babies every week. She also runs an OB/GYN clinic for local women, which I had suspected  because of all the locals in the waiting area, but this book confirms.  She is crazy busy. She is a force of nature with so many balls in the air juggling, that your anxiety and control issues about your growing baby or your questions about whether you choose her clinic must barely register. She has bigger things to worry about with the influx of people to her daily, like caring for the surrogates and patients and babies right in front of her. She has a lot of life and death in her hands and is also a mother and wife who is a community leader changing the lives of so many.  She would rather help as many women and families as possible of those who always find their way to her in high numbers, and I think that is admirable. There is another path where I could see them focusing on building the business and marketing to Westerners and making the appearance and communication the priority. Somehow I think if that happened this clinic would not be the passionate force that it is, and things that matter most would get delegated. I like that Dr. Patel tries to do so much, because it is what tells me about this clinic's ethics and integrity and heart behind it are in the right place. Seeing what kind woman Dr. Patel is makes me trust I came to the right place.  I'm frankly amazed that she manages to be as hands on as she is. But in the end, she puts priority on the things that matter despite so many demands for her time. I could learn something from her about that. Though I really would like to know if my package with my contract  arrived with gifts and a letter for my surrogate, but like the rest I will have to wait for a response or not get one. But this book reminded me to keep my requests for information in perspective. I wish I could find a way to help as many people in such a profound way as she has, but for now I'll just hope that this blog helps just one person. From my posts on an infertility forum two women have sought me out and are now going to Dr. Patel's clinic for an attempt, one after talking to me on the phone for an hour about my experience. Woo hoo!

* I knew the surrogates were well cared for, but I didn't know how much. They have a cook that makes balanced meals for them. There is a nurse on site that takes care of them, and ensures they each take their pre-natal vitamins. They have a sonogram machine there it sounds like, or have easy access to because it is close to the clinic. They get checkups weekly. They offer more classes than just English classes, and many of the women study books and take it very seriously. Religion is a big part of India, but also a big part of the surrogate's lives with many ceremonies and blessings occurring with Dr. Patel's participation. They have a strict schedule for the surrogates that includes plenty of naps, especially at the hottest parts of the day. The family may visit the surrogate more often and freely than I thought previously.

*You don't have to feel guilty if you approach this more as a business arrangement and don't develop a relationship with your surrogate. Dr. Patel says that a bond or relationship not really the point, and I am with her on that one. But other women feel a strong connection and need to bond with their surrogate. They are the exception, of which Adrienne is a huge one. I have never met our 2nd surrogate, but I know that when I do we will share a connection, however brief, that lets her know just how much what she has done for us means to us. My incessant sobbing at the sight of her and unintelligible "thank you's" will fully get that point across I'm sure. I think in the end as long as you find a way to communicate your appreciation beyond just the financial compensation, that is what really matters.

*I'm not sure how long ago she did surrogacy and when she wrote the book. Some things seem different. I think there is a Domino's and not a Pizza Hut, and there was nothing in our contract about providing breastmilk that I read.  I think that the Rama Residency has a better rep now than the Laksh Hotel as a meeting place for Dr. Patel's clients. Either way, they are both nices places to stay. I'm note sure if they both existed at the time she was there.

Induced Lactation

http://www.asklenore.info/breastfeeding/induced_lactation/regular_protocol.shtml

I'm convinced that more women who adopt or do surrogacy would breastfeed if they only knew it was possible. I have PCOS, so chances are that combined with not having been pregnant AND having twins I will not produce enough. That's fine. I'll be proud and consider it a success if I produce some. Everyone has their own opinion that I won't get into, but for me I need to try breastfeeding and see if my body that has let me down will finally help me be a mother in this one important way. I'm not saying anything bad about bottle/formula feeding and in all likelihood we will wind up supplementing with formula.

Dr. Patel has had several mother's do induced lactation with success, so I know it is supported there. You can pay for breastmilk for at least the first two weeks there, but they get a different surrogate to pump it and then you may need to arrange for delivery to the NICU or your hotel. It is inexpensive but an extra charge.

If you are determined, you probably can do it. A man can breastfeed if he wanted to. It has more to do with the sucking action of a baby on the nipple, and not as much about supplements and hormones. But the best chance you have is to follow the Newman Goldfarb protocol. Google or see link above.  I did lots of research, but the best place hands down to go is to go to the website at the top of this post. You can also search Yahoo groups for "induced lactation" or "adoptive lactation" and I found great resources there. I won't repost the plethora of info I've gotten from the website and two Yahoo groups, but suffice to say that you can find an answer and inspiration for everything at these places.

I have extensively researched the two types of SNS, or supplemental nursing systems. Medela is not worth the money from all the reviews I've read. It seems appealing, but it breaks and leaks. The Lact-Aid is the way to go and the below link has practical tips on how to use it.

http://paddedtushstats.com/2011/08/04/using-a-lact-aid-system-for-low-milk-supply/

You will probably have to chart to make sure your baby is getting enough to eat if you are doing this. Sample below, but I found a twin site somewhere that sells a cool log book for twins for this purpose. http://www.trendsintwos.com/store/WsDefault.asp?One=401

There are lots of supplement you can take, and I'll probably take them all. Fenugreek is the most reputed for helping increase supply...even if it does make you smell like maple syrup. A healthy diet, lots of water, and oatmeal at least once a day are good for lactation. Oatmeal is a "galactologue" that promotes lactation, and below are two lactation cookie recipes. I've made and frozen two dozen of both, and they taste fine to me.

Major Milk Makin' Cookies
Recipe by Kathleen MajorDetailed recipe with photos found here

1 1/2 c. whole wheat flour
1 3/4 c. oats
1 tsp baking soda
1 tsp salt
3/4 c. almond butter or peanut butter
1/2 c. butter, softened
1 c. flax
3 T brewer's yeast
1/3 c. water
1 tsp cinnamon
1/2 c. sugar
1/2 c. brown sugar
2 tsp vanilla
2 large eggs
2 c. (12oz) chocolate chips
1 c. chopped nuts of your choice

Preheat oven to 350 degrees Fahrenheit

Combine flour, baking soda, cinnamon and salt in a bowl.
In a large bowl, beat almond butter, butter, sugar, brown sugar, vanilla, brewer's yeast, flax and water until creamy.
Mix in eggs.
Gradually beat in flour mixture.
Mix in nuts and chocolate chips.
Add oats slowly, mixing along the way.

Place balls of dough onto greased baking sheets or baking stones.

Press down each ball lightly with a fork.
Bake 12 minutes.

Momma's Milk Cookies
recipe by Danelle Frisbie

2 eggs
1/2 c. unsweetened applesauce
1 c. flax
1 1/2 c. whole wheat flour
1/2 c. melted butter
2 c. Agave nectar
3/4 c. walnuts (crushed)
2 c. chocolate chips
3/4 c. raisins
4 T water
1 tsp vanilla
1 tsp baking soda
1 tsp salt
4 T brewer's yeast
3 c. oats

Preheat oven to 350 degrees Fahrenheit

I have found greased cookie sheets work best, but you can also use parchment lined sheets or a baking stone.

In a bowl mix flax and water until thoroughly mixed.
In a large bowl mix flour, baking soda, salt and brewer's yeast.
In another bowl mix together butter and ONE cup Agave nectar (the other cup will be used later). Stir well until the butter and nectar are completely mixed.
Add eggs to the nectar mix, stirring well after each one.
Add vanilla, stir.
Add the nectar blend to the flax and mix well. (A hand mixer or mixing bowl works best)
Pour the nectar/flax blend into the large bowl of flour and mix well.
Mix in walnuts, chocolate chips, raisins.
Mix in oats.
After everything is blended together well, add the applesauce and final 1 cup of Agave nectar and stir through well.

Scoop onto sheets, and press down each ball of dough lightly with a fork.
Bake 13-14 minutes.

And lastly, a good collection of info I found on Freezing and Storing Breastmilk.

Freezing Tips from Moms

Now that you have pumped milk, you may be wondering what exactly to do next. There are several options for storing breastmilk.

Many moms choose to just store their milk in the fridge (rather than freezing it) if they're going to be using it soon. This is actually the preferred method of storage, if it will be used within a few days. Remember when choosing this method to store the milk in coldest section of your fridge, NOT in the door.

Some moms have found a system, like the Milk Mate System to be helpful. This stores the fresh breastmilk in a way that you don't have to guess which bottle is older, as it is dispensed from oldest to freshest.

If the bulk of baby's milk is expressed breastmilk, plastic containers are the best choice for storing in the refrigerator as more of human milk's leukocytes or white cells adhere to glass.

When freezing your milk, there are several things to take into consideration. The type of container chosen may be important if the bulk of your baby's milk is frozen milk. In that case, freezing in glass is best because it is less porous and offers the best protection in the freezer. If the frozen milk is for occasional bottles, the type of container is not as important. Also keep in mind that freezing does destroy most of the leukocytes, so whenever possible the bulk of baby's expressed breastmilk should be "fresh" vs frozen.

Hard plastic containers of any kind are also good choices for both refrigeration and freezing

Another option is to use milk storage bags that are designed specifically for human milk. These are available from several sources, including on line sources as well as local stores like Kmart, Target, and Wal-Mart stores. These bags are pre-sterilized, thicker, coated with polyethylene, and lined with nylon, which prevents the fat from sticking to the sides.

NOTE: Some moms wonder about using the bottle liners, such as those for the Playtex or Gerber "disposable" bottles. Most experts recommend against using these because they are not as durable as the bags designed specifically for freezing milk. The seams of the bottle liners may burst during the freezing process, and precious breastmilk wasted.

Can I Freeze My Milk After It Has Been Refrigerated Several Days?

Yes - most sources seem to indicate that you should be safe to use ALL the storage options in succession if you need to.

For example, storing freshly expressed breastmilk at room temperature for up to 10 hours, THEN in a refrigerator for up to 8 days, and THEN in a freezer for 3-12 months (depending on the type of freezer).

You're likely to get to stretch your storage times to the maximum (or even a little longer) if you don't "use up" all of your "warmer" storage - for example, you can expect a longer storage time if you freeze the milk immediately (if you know you'll want it frozen) rather than keep it at room temp for 10 hours, then refrigerate for 8 days and THEN freeze the milk.

Even though storage times may be decreased, most bf experts suggest *not* throwing out any milk before the maximum storage time unless when you warm it you notice that it has a very distinct foul smell.

Remember: When using your frozen milk, always use the "oldest" milk first, or rotate your stock of milk. A simple way to do this is to use fresh milk from fridge through most of work week, and then once or twice a week thaw a bag or two of frozen milk. You can freeze a bag or two of freshly pumped milk to replace what frozen you've used.  This keeps your stock "rotated" and still allows baby to have bulk of milk be fresh milk.  

A Few Tips from moms on freezing ebm (expressed breastmilk):

• Freeze in small amounts - 2 or 3 oz increments - it thaws faster and less waste. (Kim)
• Make "breastmilk shingles" - I used the Avent bags with the plastic locking clip. I always lay them horizontally, so they would freeze in a flat shingle. This made them thaw faster, and take up much less space in the freezer. After they were frozen I would take the plastic clip off and put the bags into a big freezer Ziploc with the quantities and amounts listed on the outside of the bag along with the date. This made it easy to find the quantity I needed as well as the milk I should use first. btw, the plastic clips have come in handy for all kinds of things now that they are not being used for ebm. . (LaRee)
• I like the Gerber bags. They Ziploc. I would store them in a large Ziploc with the range of dates on the outside. It made it easy to rotate but I never had a lot of stash. (Lori)
• You know how Medela and other expensive brands sell the bags for freezing/storing? Well, Gerber has one that is just as thick, good for freezing, and stands "up" when you pour the milk into it- making it MUCH easier to not spill your liquid gold! They are so much cheaper of course and you can buy them at Wal-Mart - right beside the expensive ones! After storing them in the bags- I would then place them in a BIG plastic bin- and store them in a freezer- "ideally" the big box freezers, but- if you need to put it in your refridge/freezer- make sure it's definitely in a plastic container so the bags don't touch the side walls of the freezer- since most freezers have an "automatic defrost" and your milk will defrost too if it's touching the side of the freezer. (Adele)
• I am a paranoid freak, so I will put the milk in one Gerber bag and then put another Gerber bag over that bag. LOL! Then I put several ebm bags in a Ziploc bag labeled with the month/dates of the milk on the outside so I know when I need to use that milk.
• I have also used the Lansinoh before, but those were way too expensive and did not have the "Ziploc" feature that the Gerber bags have. The hospital also gave me sterilized urine sample cylinders to use for frozen ebm. I know that sounds yucky, but my LC said it was a great way to store milk. I only used a few and found them too much of a pain, if you are going to have to wash them and reuse them.
• I have heard that Tupperware ice cube trays (they have a lid on them) are great to use for smaller serving sizes. (Karen)
• Making Milk Cubes (or "Boob Cubes") - pour the milk into a scrupulously clean ice cube tray & freeze. When it's frozen, pop the cubes into a FREEZER Ziploc. Since most ice cubes are between .5 and 1 oz, this is a GREAT way to deal with small increments - and you only thaw what you need. You might be able to find Oxo trays (covered), as does Tupperware(Freezer Mates Fresh & Pure Ice Tray) .
  
  I do NOT recommend the Oxo trays for anybody who routinely spills half the ice cube tray on the way to the freezer, LOL. When using them, it's best to have the lid already partially on the tray when you put the milk in, so you don't jerk an already full tray when you put the lid on. (Hope that makes sense) Mine go in the dishwasher every day, and are holding up pretty well. I think the cube is about .6 oz in volume.

You can figure the volume of an ice cube pretty easily (if it's important to you) by just filling up a measuring cup with water, finding out how much it takes to fill the tray, and dividing by the number of cubes. It's approximate though, depending on how much you fill it on any given day. Be sure to use a FREEZER Ziploc to store the cubes once they're frozen. (Sharon)

• I use a clean ice tray and Freezer Ziplocs. I freeze the milk in the ice tray and then put the cubes into a freezer bag. I like it b/c I know each cube is 1 oz and I can pick and choose how much I use without having to thaw the whole bag or use lots of expensive liners for freezing (I use the cheep liners anyways when I use a bottle). (Darci)
• I always liked the Mother's milk storage bags. They have this really neat top that opens into a diamond shape and stays open (easier for you to pour in the milk) then you just pull it shut and fold it over (kind of like a chips ahoy bag). They are about 8.00 for 25 bags. Although I think I might try some of the other ideas this time around :o) (Dottie)

Special thanks to the moms who have shared their tips on storing/freezing breastmilk!