4.16.2013

How Does She {Breastfeed Twins}

“Breast feeding twins is pretty much impossible so I would get used to using formula for your babies.”
 – pediatrician hospitalist

On the day of discharge post c-section and the birth of my twin babies, the pediatrician attending to my girls during their stay came by to make his final examination of them before their release.  I had just gotten through tandem feeding my tiny babies and he nonchalantly made this statement to me, leaving me completely speechless.  Really?  Thanks for the support and encouragement, sir. 

When I was pregnant with my twins many people expressed skepticism that I'd be able to breastfeed both of my babies. I'm one determined Momma though and wanted to do all that I could to make that happen. Our journey hasn't been without some trial and error though so I thought I'd share what I've learned with my girls in the hopes it might help other Moms struggling with the early days of breastfeeding.

Formula Supplementation
At birth, my little girls were pretty petite at just 4 pounds, 8 ounces and 5 pounds 14 ounces.  The main focus became making sure they were getting enough and gaining weight.  The smaller baby, Jolie Grace, missed the NICU for her weight by just 49 grams (a just about a tablespoons worth), so I became determined to keep her weight up so that they both could come home with me when I was discharged.  In the beginning while my milk was still coming in and weight was of major concern I supplemented with about 1-2 ounces of formula or if I had pumped enough, breast milk, after each time they ate.  I would nurse for just 15 minutes at a time so that they wouldn’t burn too many calories working to get the milk.  The bottle was much easier of an effort and after 15 minutes at the breast, I would offer the bottle and they would eat just a little more. After the first month the girls improved at feeding, my milk supply became efficient, and my life got so much easier.  It was tough feeding them once, and then feeding them both all over again.
To some breast feeding mothers, formula isn't ideal, but until you start producing enough milk for your baby or babies, it might just be the only option. That was hard for me to accept, but finally I came to grips that it wasn’t about me at all- it was all about making sure my babies had enough to eat and grow. With this realization my confidence increase and my anxiety levels dropped and I knew they were getting enough and that's all that matters.
Breastfeeding: Using Your Resources
If you are having difficulties with breast feeding, my number one pieces of advice- don’t stop offering the breast. The desire is that eventually your little one will get the hang of latching and in hopes to successfully breast feed, the baby needs that familiarity of nursing versus bottle feeding.  That will not only stimulate more milk, but can be practice and encouragement for your little one, too!  I was lucky that neither of my girls had an issue with latching, but I knew what to look for in an incorrect latch and quickly attempted to correct it.  Which brings me to my next tip: Be sure contact your hospital lactation consultant and see about going in for her to help you. From the moment I arrived to recovery I started asking for my lactation consultant.  I was really lucky for the support I had in the hospital from those LC's. At my request they came in every day I was there for at least an hour to help me learn what is a correct latch and what to look for and change if I started having troubles with feeding. They totally prepared me for when I was at home- and I was thankful because, even as prepared as I thought I was, I was still clueless.
The Pump
The greatest increase in demand comes from pumping.  I was hooked to that machine 8-10 times every day during the first 6 weeks or so. Because the girls’ mouth were small and were not successful in emptying my breasts during a feeding, I had to make my body think that they were so that the supply and demand theory would kick in and increase production. Eventually my body figured this out and started to produce enough for both girls and I didn't have to supplement with formula any more.  Pumping soon after a feeding will help your body think that you still need more milk and, again, more milk will be produced. There are a ton of theories and ideas out there for how long you are supposed to pump.  I've heard to pump 5 minutes after you notice the 'last drop', some say to pump at least 20-25 minutes and no less, others say just 10-15 minutes is enough. Personally, I would make sure to pump for at least 20 minutes, or until your breast feel soft and empty. Even though pumping so often in the beginning seems terrible, it's not forever. If I am at home, I pump just once a day in the morning after their first feeding.  I can get anywhere between 5-8 oz after feeding them. During my work week I pump three times in my 8 hour day and express about 30 ounces total.  There were times in the beginning that I would cry because I wasn't even getting 1/2 an ounce during a pump session. I worked so hard and couldn't get results to save my life. It's important for your body to believe you 'need' the extra milk and the stimulation from the pumping will promote more milk to be made.
Increasing & Maintaining Milk Production
Some things I've tried that didn't do much:
·         Mothers Tea- To me it tastes and smells horrible.  I didn't seem much change at all in my milk supply.
·         Fenugreek- smells of maple syrup (it is the additive that is actually added to pancake syrup) and I didn't see too much of a change in my milk supply. I was taking 4+ pills a day and decided after finishing a bottle that it wasn't worth it to purchase again.
What works for me:
·         Multi-grain Cheerios. No joke! I eat a bowl of Cheerios every night before bed and notice a huge change in my milk supply for the next day. There are studies that say oatmeal is helpful and since Cheerios are and oat based cereal I can see why it works for me.
·         Stay hydrated. I can tell in my milk supply when I don't drink enough throughout the day. I try and drink at least 100mL/day of water alone. Not counting the water I get from fruits, vegetables and other food sources. 
·         Eating a balanced diet.  Occasionally, a mother’s calorie or fluid intake can affect milk production.  Excessive dieting can reduce milk supply, but sensible dieting is generally not a problem.  I have read that it’s best not to do anything consciously to lose weight until after the second month. This gives your body enough time to successfully establish a healthy milk supply that is less likely to be adversely affected if your caloric intake is restricted. I had no problem dropping the baby weight, but I wasn’t doing so with effort. 
o   Breast feeding a singleton baby you need an additional 300-500 calories/day.  Breastfeeding twins  you need upwards of an additional 1,000 calories/day  
o   There are no foods that you should avoid simply because you are breastfeeding. It is generally recommended that a nursing mother eat whatever she likes, whenever she likes, in the amounts that she likes and continue to do this unless baby has an obvious reaction to a particular food.
The main thing needed to maintain an ample milk supply is simple –The more often and effectively your baby nurses, the more milk you will have.
My girls are eating more and more these days. They now eat between 5 and 6 ounces at each feeding. Between the two of them I need to pump almost 40 ounces while I’m at work.  I cannot help but have a twinge of anxiety every time I increase each feeding amount.  I am fearful I won't be able to keep up, but so far I haven't had any problems.
I expect that there may come a point that I'll have to supplement with formula and I'm okay with that. But, I'll still give them what I can of breast milk.  What matters is that I am giving them what they need whether it be from breast milk or formula.  Either way they are healthy and growing the way they need to.   That’s definitely a success in my book. 

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21 comments:

chelsey said...

I can't believe that doctor said that to you - way to be encouraging, right?

Good for you for sticking with it!! I'm planning on breastfeeding my girls, but I've already come to the realization that I'll probably have to supplement with formula. Going into it with that mentality, I don't think I'll be quite as upset if it does happen - and if it doesn't, then woohoo!

Beesmama said...

Great for you! Keep up the great work! I breastfed my first sone until he was TWO (with lots of comments from others who thought that was WAY too long...); now baby #2 is 11 months-still going strong:)

AMCallahan said...

Good job momma! I can't imagine keeping up with two, my one is hard enough.

I do want to say that 5-6 ounces seems like a lot of BM, they shouldn't need to take more than 4-5 ounces at a feeding. BM unlike formula changes to meet their needs so you shouldn't have to up the ounces as they get older. Try pace feeding when bottle feeding and you should notice quite a difference in intake.


Cara Fulkerson said...

Thank you so much for posting this Amber. I am due with identical twins in September. I found your blog through Pinterest and have read so much of your old posts already. You are giving me such hope for a successful breastfeeding journey. I breastfed my son (now 2) for 11 months with much success but I'm scared to death by twins. I just couldn't wrap my head around how to nurse 2 babies. I am more confident to know that it IS possible, just stay focused:)

Anonymous said...

I concur with @AMCallahan!

Amanda Torres said...

Glad you didn't take the advice in the beginning! It's so nice to hear a good successful breast feeding journey, and you're doing it with twins! Good for you!

The Joiners said...

Hmm, this advice sounds vaguely familiar? :) Thanks for being a resource for me and for all of your other readers!!

Megan. OneFifteenDanville. said...

Pediatricians can be so uninformed, and give out such awful advice. I feel so sad for mothers who don't know any better than to blindly follow the advice of their baby's doctor. Good for you so being so diligent to make sure you're babies get the yummy pure goodness of Mommy's milk. Sure, it's more work, but so so worth it! You are awesome!

~Kari AND Blair~ said...

I love reading your blog! I just wanted to say I nursed my twin girls for 14 months!!! There did come a time (when I went back to work) that I had to supplement formula. I am a teacher and could really only pump 1 time a day, and would only get 10-12 oz max...That was not enough to feed my girls.

SO, I finally accepted that they get formula during the day and I nurse in the morning and as soon as I got home from school, and at night.

This worked for us. There were MANY times I wanted to quit, but then remembered how good it was for them, and I just couldn't bring myself to stopping! I am soooo glad I did.

Eventually, the girls just stopped. There was no weaning phase! Actually, I tried to nurse 2 days after they stopped to one that got hurt and she acted like I was insane!!! ha.

I also did not have much support from the hospital or lactation nurses. I had a friend who worked L/D and she was a BF'er herself and she was soooo much help to me!

Glad you are BF'ing...Keep it up!!!

Meredith said...

I am appalled at that pediatrician's comment. As far as needing to supplement in the future, I seriously doubt you'll need to. I worried about producing enough for my two giants but so far my body has been able to keep up with them. I really think the hardest time is in the beginning and once you're past that, you're good. Not to mention you'll be adding solids pretty soon so the girls will most likely need less breast milk. This is all my opinion--don't know any of it for sure but it's my best guess! :)

Lexie said...

Thank you for posting this! I have twin girls. Just a week younger than yours. And I'm also breastfeeding.

I'm a nurse. So I've had good support of BF, from the hospital. It was a BF group that I went to, early on, that made me feel like I could never feed 2 babies. Needless to say, that was the 1st and last time I ever went there.

But we've been doing well. I never tried anything to increase my supply. As in teas or vitamins. A friend of mine is a LC, and told me just to stay hydrated, to eat good fats, whole grains, and to start pumping before my babies were born.

When I learned of my induction date, I started pumping. It wasn't a long time, but it definitely helped my body to prepare.

From the beginning, I've fed my girls. Then pumped a while, after each feed. Maybe 15 minutes. That's helped me, to keep up with my girls. :)

I've been back to work for just over a week now. And I've found that I need to pump about 3-4 times, during my shift. I work pretty long hours. Once, I pumped 5 separate times. But I think that was just a reaction, to being with babies at work.

It's a tough road, some days. But I wouldn't trade it for the world! I can tell in my production, if I haven't had enough fat intake, or enough water. Because my production is drastically different. Or if I'm really stressed. Like my 1st day back to work.

But I feel really lucky to have support. From my husband, friends, and co-workers. It does a lot, to motivate me! And my sweet girls, well, I'd do anything for them. :)

We've never had a latching problem. I'm finding now, I need to feed them separately. Because 1 of my girls likes to bother her sister while they nurse. It distracts both of them. This is a new thing. And usually results in them nursing less. So we're feeding separately now.

My girls are also, not big fans of the bottle. I notice that when I get home from work, they're almost relieved to BF. And I love it!!

Anonymous said...

Just found your blog through Shay...love it!

I wonder how many times that doctor's comment discouraged a mom from breastfeeding that probably would have been just fine!

I breastfed my son, but have had supply issues with my daughter. I can't say enough about lactation consultants...mine gave me a lot of great tips to get my supply back. It's weird though because I have to work really hard to keep it up...even though I exclusively breastfed. My daughter is 10 months now and we are using formula 100% of the time.

My daughter is a petite thing and her ped wants me to work on helping her gain weight. I've been reading a lot about coconut oil and have started adding a little to her food. Was wondering if you have heard of adding it to a baby's diet? Thanks!

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The Groves Family said...

Hi Amber- I found your blog through another I read as was so excited when I realized it was yours because my husband works in Irving with Jordan! I love reading about everything related to your babies but especially your breastfeeding! I have a 2 1/2 year old that I BF for 18 months and am due in 2 weeks with our 2nd and plan to BF again. I think BF is what I am most nervous about bc I was so successful the first time around and want to be able to do the same thing for this baby. Your updates and words of advice are so appreciated and great motivation for me starting this journey again!

Darcy Potter said...

Oh big HUGS Amber!!! I just love reading this blog and love hearing your trials and tribulations of being a new mommy like myself :) Overall I just enjoy hearing how much you love your little girls and life itself! Good for you for sticking to breastfeeding and not giving up! Breastfeeding is such a hard job with one let alone two, but I, like you, feel like it is so rewarding :)

Darcy from Vancouver, WA

Mrs.Hammar said...

Thanks for this awesome post! I am pregnant with twin girls and have a 14 month old son. I BF him until he was one. So I'm so hopeful that we will be sucessfull with the girls! Your girls are just precious!

NAHoneycutt said...

Thanks for sharing! I have twin boys due in July and Im most nervous about breastfeeding. I've really enjoyed your posts. Their aren't many twin blogs out there that post regularly and give good info. Thanks for taking the time to do it. Best, Nichole

Danya said...

Thanks for this post! I had my twin identical boys three weeks ago. Lucky me had the same pediatrician rounding everyday I was in the hospital since it was the weekend. He told me it would be impossible to nurse my babies. He had the nurse being me formula "just in case" and even bullied me the day we discharged saying I'd have to come in every day for a weight check. What he didnt know is that you never tell a mama what she can't do! We nursed then fed with a syringe of breastmilk then I would pump again for the next feeding. The very next day they were up 3 and 5 ounces and at their 2 week checkup they had both surpassed their birth weight! I'm so thankful for the lactation nurses, my family, and hubby for supporting my decision and not letting the "expert" bully me!

This is my second time nursing as I have a 3 year old I nursed for 15 months so I'm thankful I knew what my body was capable of. So glad you posted this info for mamas who are unsure. Trust your body and give it time to allow your milk to come in. Seek help from a lactation consultant if you need it...stay informed so you know when it is needed to supplement and when it's just people that don't believe you can.

Alissa said...

Thank you SO much for posting this! I plan to look at this again once I have my baby! Seriously, I have looked up quite a few articles on breastfeeding tips and read as much as I could from my baby books but nothing has clicked so easily in my mind as your post! Much easier for my pregnancy brain to wrap around! :)

Jessica Knoetzel said...

Found you through the breastfeeding or formula link up, looooove love love your blog! I can't beleive your doc said that?!?! That's what I hate about society these days, it's like they almost PUSH formula on new moms giving them no choice or help for nursing. You are awesome for nursing twins, keep up the good work. :) My breastfeeding article can be found here: jessiejoathome.blogspot.com
Excited to follow you! :)

Melissa Baltz said...

Hello! I just found your blog through Pinterest and have been scouring it for twin info- I am newly pregnant with twin girls via IVF. I have a question for you though- how did you learn all that you know about breastfeeding? I am specifically after information like proper sterilization, how long milk stays good for, etc... I have books on how to breast feed (positioning), but need just the pumping logistics. I will go back to work after three months of maternity leave and feel like I better have this figured out pretty well before so I can have my office ready to simultaneously serve as a pumping station.
Thanks!

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