I have a cold, so I challenged myself to create several days of blog posts from just one evening of photos. Enjoy! It's been nine months since I embarked on my latest breastfeeding adventure - tandem feeding three children of different ages, or, as my friend Megan calls it, "triplex nursing." As I have found since I first began tandem nursing when Michael was born, success and sanity rest in setting appropriate boundaries. We have experimented and adjusted during the past several months, and I will document here the current status quo we are enjoying:

• Vi nurses on demand, day and night
• Michael was nursing on demand as well. I had to curtail the amount he was nursing, not because of excessive demand as in Nikki's case, but because of potty training. Michael's bladder fills quickly during a breastfeed, causing him to run to the toilet, come back for more numnums, and back and forth. Sometimes he wouldn't quite make it to the toilet, so he would clean up the mess then want to nurse again. In response, I initially curtailed further numnums if Michael wet his pants. This dramatically improved his accuracy in getting all his waste in the toilet. However, the back and forth to the toilet was still taking a lot of time and diminishing Vi's ability to nurse on demand.
• Now the rules are almost the same for Nikki and Michael. They each get "after breakfast numnums". Michael gets one numnum. I then require him to go use the toilet, wash his hands, and come back wearing the same clean, dry pair of pants. Once his hands are washed he has his second numnum on the other side. Nikki gets one numnum on one side if Michael keeps his pants dry during his mid-numnum toilet run. This is to give her an incentive to go with Michael to the outside toilet and encourage, rather than distract, him in his task.
• Both children also get "after nap numnums," though if Nikki acts up during naptime she forfeits her treat.
• If Nikki and Michael wake up around the same time from their nap, they each want their numnum first. If it's an odd day, the child born on an odd day goes first. Even days yield the opposite result. This has led to Nikki paying close attention to our calendar.
• Neither of my older children have any numnums either before breakfast or after dinner.

Nikki is heading toward her fourth year, and I am starting to explore alternatives to nursing in order to get her down to one breastfeeding session per day. Suggestions that might be attractive to Nikki but not Michael would be very welcome, as I don't believe he's ready to wean yet. For instance, I'm not particularly interested in cow's milk as a straight-up substitute, since I don't want to give Michael the wrong impression.

From one thing to another to another to another... being a mother is a very busy job. A lot of what I do involves responding to requests. "Mama, can I have a numnum please?"

"Mama, can you open the bathroom door for me please?"
Add in nappy changes, food prep, cleanup, and demand-feeding Vi, and it all adds up. Nikki is limited to a maximum of three opportunities to breastfeed per day: after breakfast, after lunch, and after nap. Since I'm not often able to give her a numnum immediately after meals or naps, Nikki has been concerned I will forget her numnum and has started asking many many times. Michael started asking just as many times. And they both got more and more desperate, dissolving into tears on a regular basis, often in less than the time it takes to wash the rice cereal off their bibs after breakfast. I discouraged whinging by asking Nikki to sit on a stool quietly. But as soon as she was released from her quiet contemplation, there she was asking again. Quietly. Politely. With a please. But still asking! And then Michael asking too. Time to try another tactic. I told Nikki that she could ask for a numnum one time. If she asked a second time, there would be no more numnums that day. It took a couple of days to figure out what asking one time and only one time means. For instance, it does not mean asking, being told your request has been heard and then responding "I'm only going to ask one more time." Now that the "asking one time" rule is clear, life is much more peaceful. Nikki asks once for each of her three numnums and accepts that she needs to wait until I have a good chance to nurse her. Michael only asks when he needs a topup (two or three times a day, plus any extra for bumps or overtiredness). Vi is pretty laid back yet makes the most of her opportunities by nursing very efficiently. Triplex breastfeeding is back to being doable again. Related post: Best Breastfeeding Health News of 2009 - by Breastfeeding 1-2-3

Since my latest tandem nursing update, I have had some feedback from mums who are in the second half of their pregnancies and nursing children less than two years old at the same time. I think it is wonderful that we can be geographically far apart, yet experiencing similar things together. We're all in the same boat - except this is the second time around for me. I'll offer what little wisdom I have. Where I don't have personal experience, I'll point you to one of my favorite resources for breastfeeding mamas.
photo credit: Kirsten First, I think you have to make a decision about how long you want to nurse your older child. Whatever your response: 'I'll just try it for another week' or 'until she is two' or 'I can't stand it any longer and I'm feeling really resentful of his requests,' it's important to know how you feel about continued nursing. If your toddler's requests are making you angry, it is time to stop. No amount of breastfeeding benefits will overcome the negatives associated with a resentful parent. And don't feel bad if you fall into this category, either. Tandem nursing is a unique challenge and it causes even the most committed lactivist to rethink her nursing ideals and what she can handle. Ready to wean? The best I can do is point you to Kellymom's comprehensive breastfeeding website and her weaning page for lots of information. In my opinion, once you are in the second half of your pregnancy, continuing to nurse the older child is actually the easier option. Gentle weaning often involves offering lots of substitutes, both nutritional and distractional. All of these substitutes must be offered not only when you feel slow and tired during the second half of pregnancy, but especially when you are spending a huge portion of your time attending to a newborn who just wants to nurse, sleep, and be carried around. A few of the benefits I have seen from tandem nursing: -- Tandem nursing meant a great deal to Nikki when Michael came along. She still got to sit on mama's lap and have numnums. Nursing has always been very important to her and I think she would have resented her little brother if he had gotten to nurse whenever he wanted and she had already been weaned. -- Tandem nursing was a huge blessing to me as well. Emotionally, it meant that in the midst of all of Baba's (wonderful, much-needed) entertainment, there was something special that Nikki and I shared which meant my 'big girl' still needed me. Yet it was something I could easily provide since nursing was pretty much all I was doing anyway. -- On a more practical level, Nikki enthusiastically and quickly dealt with any engorgement. That and the fact that I had been nursing continuously for 17 months prior to Michael's birth meant that breastfeeding him was a cakewalk compared to the excruciating pain I dealt with during Nikki's first few weeks of breastfeeding. -- Tandem nursing made my life in those early weeks easier in other ways as well. Nikki's interest in the numnums meant that if a meal wasn't on the table right away, she could wait a bit. When I have a newborn, schedules go out the window, and I think that Nikki was able to go with the flow more readily since she was demand feeding alongside her brother. Want to tandem nurse your toddler and newborn? The babymoon is always a bit of a blur for me, but here are my best tips. (1) Set low expectations in all other areas. My expectations during the babymoon, or first six weeks of the newborn's life, are to (a) breastfeed, and (b) lie in bed as much as possible in order to rest and let my perineum heal. My husband's expectations are to have as much time off as he can following the birth and to take care of the essentials (meals, dishes, laundry, diapers, and toddler entertainment) during the babymoon. My toddler's expectations, which we set for her, are that the new baby will sleep a lot, nurse a lot, and cry a lot. During this time I gradually start doing more things and my husband gradually less until we reach our new equilibrium as a newly expanded family. (2) Prior to the new baby's arrival, strategize how you might set your toddler's expectations on frequency/length of nursing. I thought this wouldn't be an issue for us since Nikki wasn't nursing a huge amount in the weeks leading up to Michael's arrival. I had never set any limits on her nursing, and in my idealistic child-led-weaning mind I never planned to. However, once that new baby milk came in, I was faced with a toddler who would have gladly traded in her three meals a day for an endless supply of numnums. Seriously, she hardly ate solid food for the first week at least. I was nursing pretty constantly those first few weeks of Michael's life, and I had no resentment toward Nikki - like I did much later on - but I did sometimes need to cut one of Nikki's feeds short in order to attend to Michael. And sometimes I just wanted to read a chapter in a book without nursing anyone. -- an easy way to shorten a feed for a toddler is to say either before they begin or while they are in the midst that they can nurse until the count of 10 or 20. After I count out loud to the number I've mentioned, I break the latch with my pinkie. I don't use this very often, but I haven't received any protest when I do use it. -- standing up, especially accompanied by looking very busy, is usually an effective way to avoid being asked for numnums by your toddler. But this can be tiring! -- when I was lying down in the bedroom, Nikki could come in and have numnums by invitation only. This was where Baba's toddler entertainment meant the world to all of us. -- you can try other things, such as telling your toddler they can only have numnums at certain times (like after breakfast and after lunch for Nikki), or only a specified number of times a day (in conjunction with a sticker chart or similar). I would recommend that you wait for limiting number of feeds until after your toddler is back on solid foods following the 'can't get enough colostrum.' Otherwise, you may encounter some very emotional resistance to your reasonable suggestions. -- in addition to nursing, I had some fun new board books saved for after Michael's birth to read aloud to my toddler. Michael also brought a gift for her when he arrived to help keep her entertained. I also sang quite a lot, which was sometimes all she needed. (3) Try nursing your toddler and newborn together. In addition to being time efficient, this is also a great way to stave off jealousy. Both children are getting exactly the same thing at exactly the same time. Not often as a parent that you can do that for two children with such different abilities and energy levels. My hormones started giving me fits after months of simultaneous feeding, but I didn't have any problem with it initially. I remember that my biggest wish was to figure out a comfortable way to lie flat in bed while nursing both children simultaneously with them propped on pillows. Maybe this time around I'll actually succeed in that quest! Related posts: week 24: tandem nursing update - 27 April 2009
a year of tandem nursing - 20 February 2009
breastfeeding challenges: blocked ducts and milk blisters - 27 August 2008
tandem nursing: first five weeks - 16 March 2008
Michael's birth story (with a picture of my first tandem nursing session) - 11 February 2008
breastfeeding: an encouraging word - 24 October 2007

First off, a photo of me at 23-weeks pregnant ready to go out with some girlfriends on Thursday night.

 

Next is a picture taken today where you can actually see my 24-week bump. We've just made it over a hump in this pregnancy. Not only are we over the halfway mark, we have also made it through the time of low milk supply. I noticed this at around 20 weeks with both tandem-feeding pregnancies, that my little nursling(s) had a time of being a lot less interested in breastfeeding. I can tell when my milk supply declines because my children do not ask to nurse as often, and when they do nurse, it is only for a short time. During this pregnancy, I wondered if Michael was about to wean. I had to convince him (not too difficult, but still...) each morning after having one numnum to nurse on the second side to relieve my feeling of fullness on that side. At that point he was more interested in racing in to help with breakfast prep. Even Nikki sometimes went a day without asking for any numnums at all. This lasted for about two weeks. Then, as suddenly as the reduced interest started, both kids were again back on the breast. The tables are turned: now I find myself urging Michael to go check out breakfast after he's fed extensively on both sides. And Nikki is back to asking for both her 'after breakfast' and 'after lunch' numnums - she hasn't missed a day since. I'm very happy that Michael has continued to nurse even through the supply downturn. For one thing, the World Health Organization and UNICEF recommend that all children be breastfed until at least age two, and longer if the mother and child desire. Also, I think feeding a newborn is much easier when the milk is already flowing and my breasts are adjusted to the rigors of nursing. With Michael, I was able to skip the usual discomfort associated with breastfeeding a newborn. It was also very gratifying to see him start gaining weight immediately. For those mamas who wish to wean during pregnancy, I would encourage them to do it right around 20 weeks and not wait! When the sweet milk for the newborn starts getting mixed in, it will be very difficult to convince older nurslings to give up their numnums for something from a cow.

Following the anniversary of Michael's birth, I thought it would be appropriate to celebrate the completion of a year of tandem nursing - defined as breastfeeding siblings that are not twins.

This is a picture I took of myself using my phone. It shows Michael and Nikki on my lap just after I had finished nursing both of them at the same time. This photo was taken in September.

This will be a longer post than normal, because summarizing the key points takes me back to when I was just nursing Nikki, before her brother arrived.

Nikki is a determined nurser! Even when my milk supply reduced, as is normal during the second half of pregnancy, she kept at it, ensuring a continuous supply.

Right after Michael arrived, the milk, which was already flowing, changed to full-fat, top-of-the-line luxury-edition colostrum. I ensured that Michael got first dibs, but there was plenty left for Nikki, too. In fact, thanks to Nikki, I never had any oversupply/leaking issues that are common in those early days as a newly nursing mother's body adjusts supply to meet a newborn's demand.

Immediately after the birth, Nikki went from 2-3 short feedings per day to feeding almost as frequently as her newborn brother. I would nurse them at the same time, and let them take turns, but basically I was nursing two children on demand. (Though Nikki was in her own bed, so I only fed Michael at night.)

The astonishing thing was that I could see Nikki growing day by day. Just as Michael was putting on healthy amounts of weight, Nikki was adding to her height - I noticed it as I lay in bed nursing Michael and saw her walk past the bedside table. The table was not shrinking. Those new-baby numnums were producing rapid growth in both my children.

I love how tandem nursing enabled me to show Nikki that the love - and the numnums - are not in limited supply. Her place in the family has always been secure, and continuing to breastfeed her is one way to demonstrate that unconditional love.

However, even in the early days I began to feel conflicting emotions that fought with my high ideals of (a) waiting to wean until Nikki is ready, and (b) don't offer, don't refuse.

Specifically, I felt very strong impulses to physically push Nikki away while she was latched on and nursing. So strong that at times the moment she would finish nursing, I would immediately and firmly create some space between us, usually by moving her off of my lap.

Sometimes, I would even dread nursing Nikki, and I would make myself busy to avoid a request or put her off a bit. But my feelings were not consistent, because at other times, I wouldn't at all mind her request for numnums and would be happy to accommodate.

As I began to think about what made the difference between resentment and acceptance, it dawned on me that I felt much better about my nursing relationship with Nikki when I nursed her on her own.

Even though it is more convenient to nurse both at once, I decided from that point forward to always nurse Nikki separately. I explained to her that I wanted her numnum time to be special just for her. I also explained that Michael needed to be happy before she could start nursing. She quickly caught on and enjoys bringing Michael a toy or two before asking to nurse.

The next step in resolving my unwelcome feelings of resentment toward Nikki was to limit the number of times she nurses each day. After the huge increase in feedings when Michael was born, Nikki's requests had tapered off to a range between 4 and 8 times per day. Thinking back to pre-Michael days, I knew that Nikki had in the past willingly chosen to nurse only 2 to 3 times per day.

Various circumstances contributed to my desire to limit Nikki's feedings. For one thing, I did want to get some things done in addition to nursing my children. At the same time, our morning routine further convinced me that my ideals of demand nursing were no longer working in a tandem nursing context. Every morning as I staggered out of bed toward my breakfast cereal, I was greeted with demands from my equally hungry toddler, "numus, Mama? Mama, numus!!" Reasoning with Nikki that we were just about to eat only resulted in increased desperation on her part. I knew this was something I needed to fix.

That's when I came up with the idea of "after breakfast numnums," and "after lunch numnums." (I don't do "after-dinner numnums" because the kids have baths and bed after dinner and once they move into their own beds after co-sleeping their first months, numnums are excluded from their bedtime routine. This ensures that putting the kids to bed and settling them back to sleep if they wake in the night is a gender neutral activity!)

Now Nikki no longer mobs me the moment I appear in the morning. Instead, she asks for her "after breakfast numnums" sometime between breakfast and lunch, and her "after lunch numnums" sometime between lunch and dinner. I have also added "after nap numnums" as a special treat for her on those rare occasions when she gets some shut-eye during the day. And of course she gets immediate numnums when her head connects with concrete after another girl tackles her during playgroup...

I haven't faced any issues of resentment toward nursing Michael - just as I never did with Nikki before her little brother came along. And I no longer resent Nikki's nursing either, now that the boundaries are firmly established.

The one frustration I am currently facing with tandem nursing is that Michael will nurse for 45 minutes (he nurses a lot in addition to eating a lot!), then stop and get down to play. Nikki will seize the opportunity to ask for her "after _____ numnums" and I will oblige. The moment Michael sees that she is nursing, he's back at my side, crying as if he's being robbed. So sad. And as soon as Nikki finishes, Michael wants another turn, even if it's only for 30 seconds. My hope is that in time, Michael will learn to occupy himself contentedly while he waits.

This past year has been a journey for me in so many ways. It has required flexibility, boundary-setting, and modifying my own and my children's expectations. I am so excited that I am able to continue to give the gifts of extra health, intelligence, and security to my children via breastfeeding.

Recommended further reading:

Love, Limits, and Tandem Nursing by La Leche League

Tandem Nursing Information by kellymom

Baby-Led Weaning--What Does It Mean? by La Leche League

Here are a few ways I entertain my two young children at the same time:

• bouncing them on my lap - Michael close in for little bounces, and Nikki out on my knees for bigger ones
• alternating kisses or raspberry blowing
• watching the cat
• singing, especially songs with motions
• dancing while holding one or both
• playing all together with a toy Michael enjoys and/or can chew
• nursing or holding sleeping Michael while reading to Nikki
  
• tandem nursing

What about you? What are your tip and tricks for entertaining two little ones at once?

I think breastfeeding is one of the greatest acts of love a mum can show her baby. After nearly two years nursing first one and now two precious little ones, I know a fair bit about the womanly art. And while it's worth every sacrifice, it's not always easy.

For instance. During the past two months, I have been battling a vicious cycle of blocked ducts and blisters. Oh the pain! Blocked ducts mean any contact with the swollen areas is excruciating. (Try holding a squirming baby!) And the blisters on my nipple that, for me, inevitably follow any blockage, mean an incredibly painful latch. Blinding pain on latch meant I avoided feeding on that side, which led to more blockages, and on and on.

Enter The Ultimate Breastfeeding Book of Answers . I have been following the advice on blocked ducts on p154 as follows:

• Take ibuprofen and wait a couple hours. Attach child or simply hand express , putting as much pressure as you can bear on the blockage in order to clear it.
  
• Pierce the blister using a sterile needle, and squeeze out any milk trapped behind it. This often releases the blockage.
  
• Apply all-purpose nipple ointment (he provides a by-prescription recipe on p136) after the blister has been opened.
• Try ultrasound therapy to prevent recurrence of blocked ducts.

After a couple months of pain and applying the first two treatments myself at home, I asked for help. Ben's company provides a health unit staffed by nurses who call in specialists on an as-needed basis. In this case, a top breast cancer surgeon arrived at the health unit to see me 40 minutes after the nurse made the call. He examined me and read about treatment of blocked ducts (yes, I brought the book!). He pierced my milk blister and gave me a supply of sterile needles and gauze in case I need them. He also prescribed the all-purpose nipple ointment. And a nurse is looking into the possibility of ultrasound therapy to prevent recurrence. I could not have asked for a better consult. Now I only wonder why I waited so long!

Ben took a picture of me typing this post. No room for a laptop on this lap...

I have been incredibly blessed on my return to Cairo to be invited to a 'baby group' full of breastfeeding mums. Most are also cloth diapering and a few are babywearing as well. Since I'm one of the few who has a second child and also because I'm tandem nursing , I get asked a lot of questions and am able to share my experiences and information I've picked up along the way. Big change from other groups where the mums get saucer-eyed and shy away when I mention home birth or sleep sharing. Attending the baby group this morning and also receiving some questions today from my dear friends Megan and Jill made me think that I should give an update on several different aspects of my own brand of mothering that I haven't mentioned on here in a while: sleep sharing, baby wearing, and cloth diapering. Sleep Nikki shared a bed with Ben and me from day one. She indicated that she wanted more personal space for sleeping when she hit 10 months , and that's when we purchased a crib for her to sleep in downstairs. Since then she has slept through the night every night. She is a phenomenal sleeper. While we were in England for Michael's birth she switched from two naps to one 40-minute nap per day, and she was going to bed at 6pm and waking at 7:30am. Here in sunny Cairo and with her dad's early schedule, she wakes at 6am, so I put her down at 4:30pm in order to give her the 13.5 hours she needs at night. Still one 40-minute nap, which is thankfully flexible on timing. Ideally I put her down at 11am, but with the baby groups all starting at 10am, on those days she ends up with a 1 or 2pm nap. Like today. Michael sleeps in our bed. He's less demanding than Nikki was at this age , and he wakes only twice in the night - once at around 3am for a diaper change (I'm leaving him in cloth at night and he doesn't like to feel the wetness) and feed and then again at around 5am to feed before his sister wakes up. It works out pretty well. At first I tried  to feed him more often at night since Nikki always wanted to, but he just wanted to sleep, so I guess I won't complain about that! He also sleeps on my back in the Mei Tai during Nikki's hour-long bedtime routine. We have a baby hammock for Michael which he enjoys for short periods of time during the day (eg when Nikki is having her diaper changed, or I'm getting dressed), and he will also sleep in the hammock if put in there when he's already sound asleep. Based on our experience with Nikki, we're not keen to rush him into his own bed before he's ready, hoping that when he is ready it will be clear to us and also at that point he will sleep straight on through without any difficulties. Babywearing Before leaving for England, Ben and I purchased a Cairo-proven tandem stroller off of some expats who no longer needed it. I had thought that I would start using it once I got back here, but so far babywearing has been so convenient that I have not familiarised myself with the complexities of unfolding the pram. Fortunately wearing two children is not at all uncomfortable if the correct carriers are used, and if the carriers are used correctly. I have used three different carrier combinations so far:

• Nikki in the Ergo on my back, Michael in a pouch on my front
• Nikki in the Ergo on my back, Michael forward-facing in a wrap (buddha carry) on my front
• Nikki in a Mei Tai on my back, Michael facing me in the Ergo on my front

The first combo, with Michael in the pouch , was the one I used on my five minute walk to the doctor's office the other day. Handy for a short walk, but not recommended for a longer trek. My favorite wrap for a little one is the forward-facing buddha carry in a wrap. The baby gets to see the world go by, and all skin is protected from the sun except the face peeping out, which can be protected with a hat. I'll wait to do this again until Michael can hold his head up a little longer. I also love having Nikki in the Ergo on my back. Very secure, quick and easy, without the ties from the Mei Tai trailing around and getting dirty if I have to re-tie when I'm out. Until Michael has sufficient head control for the front-facing buddha carry, I will continue placing him in the Ergo on my front, with the super handy sun / sleep cover pulled up to protect his baby skin from the sun and to support his head while sleeping. This also lets me show off my beautiful new Mei Tai, so it's a happy combination all round. Cloth Diapering Not since the La Leche League meeting I attended when nine months pregnant with Nikki have I been in a group with so many cloth diapering mums as I was this morning. One mum uses prefolds with a diaper wrap. Another loves her Bum Genius all-in-ones . A third is so against throwing anything away (even toilet paper!) that I think she is a strong candidate for elimination communication . My Ella's House hemp nappies are going strong. Nikki moved to the larger size while we were in England; perfect timing to have all the small ones available for Michael. The wraps are my favourite part of cloth diapering, and of course I had to buy all new ones for a boy this time around. Fun! Here is my best estimate of the cloth diapering supplies I now need for two children, washing daily except weekends:

• 20 small cloth nappies (ella's house - hemp nappy - poppers, size small)
• 20 small cloth nappies (ella's house - hemp nappy - poppers, size small)
• 40 boosters (ella's house - fleece topped hemp booster )
• 48 cloth wipes (green baby co - organic cotton washable wipes with a bowl of tap water at the changing station)
• flushable/washable liner sheets - a necessity for Nikki since she started eating solids ( ultra bio-degradable nappy liners )
• 5 medium "boy" diaper covers (two Tots Bots , two Nature Babies , one Wacky Wrap )
• 5 large "girl" diaper covers (two Tots Bots, two Nature Babies, one Wacky Wrap)

Among the beneficial lifestyle choices we have made in recent years, tandem nursing is the latest in a series of other controversial decisions: getting rid of our TV, natural family planning, becoming a full-time mum, birth at home without drugs, cloth diapering, and extended breastfeeding. Here is my take on nursing two, with five weeks of experience.


Pros

• An easy way to take care of two children at the same time.
• Availability of numnums reduces my older child's jealousy of the newborn and anxiety about being replaced.
• Both children are visibly growing and thriving on an abundant supply of newborn baby milk.
• Boosts my natural postpartum weight loss.
• Innumerable benefits for my children - health, IQ, and sociability.
  

Cons

• Can feel like I am nursing constantly, but that is usually true of anyone exclusively breastfeeding a newborn.

Often toddlers who were content to nurse only a few times a day, as my older child was, suddenly demand far more for the first six to eight weeks after their sibling arrives. According to midwife Sangeeta, the milk switches from 'skim' to 'full fat' during these few weeks and neither the newborn or the toddler wants to miss a bit of it.

• Haven't yet worked out how to take a nap while feeding two at once.

With My Brest Friend, sitting on the sofa is no problem, but I have not yet figured out how to lay flat in bed in order to get a nap while feeding both at the same time. Resting in bed while nursing is one of my favourite perqs of breastfeeding, so I am determined to figure this one out.

• My toddler requests numnums much more frequently when she is bored, and I find it a challenge to provide a variety of other activities for my older child when nursing is the easy option.
  

Play-doh, picture books, peek-a-boo...

• The distress of my older child when I ask her to wait a few seconds while I get her younger brother latched on first.

She must fear that I will suddenly refuse her access to the breast, since she can patiently wait in all other circumstances. I think this fear goes to the very heart of anxiety over being replaced by the new baby. So I will keep reassuring her and racking my brain to come up with ways to communicate how special, unique and irreplaceable she is while continuously caring for her little brother.

My God shall supply all my needs, according to His riches in glory.

On 7 February at around 1130am, I started feeling cramping pains. Nothing particularly regular or painful, though I did have to breathe through a couple of them. I continued as normal, but I asked Ben to help me pack a hospital bag before we went to bed.

At 2am 8 February, my waters broke, waking me from sleep. I woke Ben at that point, and then again a half hour later because I was pretty sure I was having contractions. Ben moved furniture and started inflating the birth pool. Ben also called my amazing doula, Nicky Wesson, and she agreed to come straight away. My contractions were around 2 minutes apart.

At 3am I woke Ramona, a friend licensed as a midwife in the US who was staying with us, to give her Nikki's baby monitor as Ben and I were both labour-focused at this point. Ben called the Birth Centre. Both of my assigned midwives, Emma and Tanisha, were with women in active labour, but they would send two other midwives. And they told Ben to call the paramedics if I started feeling like pushing.

At around 0330 I threw up. My mind told me this was transition, so I asked Ben to get Ramona. I asked her to tell me what was going on since I had just thrown up. She told me that it is often a sign of transition, but it was really quick, so it could just be a sign of labour. The next contraction came and I was pushing. She asked if I felt that down low; I said 'yes.'

Ben had just filled the birth pool to the minimum, and Ramona said I could get in, 'because this is definitely not early labour.' She and Ben managed to pull my socks off between contractions, and I was immediately more comfortable in the water. Nicky arrived soon after I entered the birth pool.

At 0345, midwives Caroline Flint and Sangeeta Freeman arrived. Sangeeta checked the baby's heart tones which were excellent and my blood pressure which was also good. Labour was extremely intense, and neither Ben nor Nicky left me for a moment. Ramona brought hot water to top up the pool, and she also managed to take some photos. Here I am at a pause between contractions, with Sangeeta, Nicky, and Ben.



At 0502, Michael arrived and I picked him up out of the water.



He will give His angels charge over me.

Michael had not yet realised that he was no longer in the womb and that he needed to take his first breath. So the midwives took him, rubbed him with a towel, removed mucus from his mouth, and administered a couple puffs of air. Ramona called the paramedics just in case, but Michael was breathing on his own before she was off the phone with them. You can see from the photo that he was pretty un-phased by the drama.



Jehovah Jireh cares for me.

My daughter, Nikki, woke at 0600, and Ramona brought her in to meet her brother. Nikki and Michael met over a breakfast of breast milk.



After Nikki finished nursing, Ramona took her to begin her morning routine. This is a picture of Nikki with Ramona just before Ramona left the next day.



We were glad Ramona was here for the labour and in the hours immediately after, when she spent time with Nikki and gave Ben and me a chance to bond with our son.