Friday, March 21, 2014

Breastfeeding Twins: A Delicate Balance

Yesterday marked the first "official" day of spring.  Which also meant, as Scott pointed out, that yesterday was the spring equinox meaning the Earth's axis is "just so" and the suns rays are hitting the equator in such a way that you can easily balance an egg on a table...or something.  Of course we had to see this for ourselves and, whaddayaknow?  He was right.  Except he was not (which he admitted after the fact), the whole egg on the table thing is a myth - it's no easier to balance an egg on a table on the equinox as it is any other day - but still, it looks pretty cool to see an egg balancing on a table.

Speaking of balance, I have a baby for each boob.  How's that for balance?  All joking aside, I do have to say I am pretty proud of the fact that breastfeeding two little people is going so well (for now).  I'm not out of the woods yet, but my milk supply has met the demand and Haven and Mira are gaining weight as they should.  Don't get me wrong, breastfeeding two at once is not easy, is a colossal commitment and there have definitely been moments where I wondered "why am I doing this?" But then I focus on my goals and remember why I made this choice. (For mothers who choose to formula feed whether by choice or necessity,  fear not - here's a great account from one twin mom and her journey, for a different perspective).

I absolutely loved breastfeeding Isla and did so for sixteen months (stopping only when we discovered I was pregnant with twins).  In my experience, it's an amazing mother/baby bonding exercise and - let's be honest - you cannot beat the calorie burning factor (I have already shed 30 of the 50 pounds I gained) and, hey, it sure is nice to be able to fill out a top for a change.  Oh yeah, and it's really, really good for our babies.

So what does it take to establish breastfeeding for twins in the early weeks post delivery?  Well, I am no expert but have been successful thus far.  Aside from a lot of dedication and patience, here is what has worked for me and my girls:
  1. Initiate breastfeeding as quickly after the birth as possible.  I began nursing Haven and Mira within an hour of their delivery.  Of course there are always situations that arise which might prevent this from happening, but if you can - try to nurse your babies within three hours of birth.  They say the most important time to establish breastfeeding and milk supply are the first seventy-two hours after delivery, so do what you can to set that off on the right foot (that includes pumping if your babies are in the NICU).
  2. Room in with the baby at the hospital.  Again, this might not be possible for NICU babies (and that is okay, there are many, many success stories of women successfully breastfeeding NICU twins) but if you can, room in with the baby and do not opt to have the nurses take them to he nursery overnight.  As mentioned, the first seventy-two hours are critical to successful nursing and having your babies at your side, ready to nurse on demand (or every two hours at least) will help to establish that and greatly increase your chances for success.
  3. Begin tandem breastfeeding right from the start.  I was very fortunate  to give birth in a very pro-breastfeeding hospital.  Unless you tell them otherwise, it is assumed you will breastfeed and they do not supplement with formula, give pacifiers and lactation consultants are available at your disposal.  My lactation consultant advised I start tandem nursing from the get-go and I am thankful for it.  Now, my girls feed at the same time almost every time.  If only one wakes up hungry, I wake the other and feed them together.  This is a humongous time and sanity saver.
  4. Invest in a good twin nursing pillow.  I have the Double Blessing Nursing Pillow and it is, hands down, a lifesaver for me.  I brought it to the hospital with me as well and it makes positioning the babies and nursing two at once so much easier. (Side note: I nurse Haven and Mira with the football hold).
  5. Start tracking feedings/diapers/sleep times.  I bought a journal similar to this one, but after a few weeks I found it suuuuper annoying and was told about the Baby Connect App (for a smart phone) by another twin mom.  It is SO fantastic, totally user friendly and is completely customizable.  I keep track of each individual baby's feedings, pees and poops and when they sleep and wake.  This has been so helpful for me, especially for charting which baby was on what boob, when (I switch them every feeding to ensure a balance in the milk supply) and tracking diaper output, which is the only real way for a nursing mom to know if her baby/ies are getting enough to eat.  When you are nursing two at once it is incredibly easy to get confused (remember, you are sleep deprived and there are two of them) so just keep track of it.  Trust me.
  6. Feed every two hours, around the clock.  This is where things get tricky.  For the first few weeks, in order to establish milk supply, it was recommended to me to feed the girls every two hours no matter what.  Occasionally I have let them go three hours between feedings (mostly at night) - but the general schedule is to put them on the boobs every two hours.  It's a ton of work and doesn't leave a lot of "me" time in between, but hey, it's all for good reason, right?  In another week or two I will stretch this out a bit.
  7. Be prepared for pain, and a lot of it.  The hospital lactation consultant told me to "accept no pain" and, if I did feel pain, to re-position the baby/ies to ensure a proper latch.  Well, that is way easier said than done when you have a babe on each boob.  I am convinced that, no matter what, the first week or two of breastfeeding involves some pain.  For me, it was the same with Isla and after a couple of weeks my nipples "broke in" and got used to the constant stimulation.  Like breaking in a new pair of shoes, the first couple wears might result in a blister or two, but before you know it - your feet (and the shoes) will adjust and you will walk pain-free.  Yes, I just compared my twins to a pair of new shoes.  
  8. Have support.  This is incredibly important.  I would not be able to do this if not for Scott and my mom.  Because we have a toddler at home, the above schedule doesn't allow for too much time to tend to her.  Of course Isla and I have our special "us" times during the day, and story time at night is always reserved for her and I, but if you plan to nurse every two hours around the clock, you will NEED help on the home front to care for any other little ones. Luckily I almost always have my mom and Scott around to help divide and conquer.   It also helps to have someone be on call to get you water/food or the remote while you are nursing.  Not to mention when you start tandem breastfeeding, you will need help positioning the babies and ensuring proper latch, and it definitely helps if your partner can be on diaper duty so you can focus on feeding and getting into position (tandem nursing requires a tremendous amount of prep).
  9. Stay hydrated.  I chug water, coconut water, and Mother's Milk Tea like they are going out of style.  I also take Motherlove More Milk Plus, a (horrible tasting) herbal supplement which is supposed to aid and boost milk supply.  Whether or not it has helped me with my milk supply is hard to say, but it can't hurt.  Hydration, on the other hand, does effect milk supply so drink up.
  10. Co-sleep.  This is very controversial, I know - and many doctors and pediatricians do not advocate co-sleeping (of course, like anything, there are many advocates of this practice as well), but it is a personal decision and I went with my mommy instincts here and am glad for it.  It has worked for us, though my comfort is sacrificed (I dream about sleeping in the blessed supine position).  We do not plan on co-sleeping much longer, but for these first few weeks I have found it very beneficial.  I sleep more or less sitting up with our babies on their backs on the nursing pillow, ready to feed when the time arises.  It's much easier for all of us this way and we all get a little more sleep because of it.  
  11. Stay focused and positive.  I mentioned that there are times when you will want to throw in the towel and give up.  At times, you will feel frustrated, discouraged and maybe even angry.  There will be times when it will seem so much easier to have someone bottle feed while you get a few more zzzzzz's.  When your nipples will hurt so much you will wince and grimace in pain upon latching.  It DOES get better and it DOES get easier.  Try to remember that this will one day be a distant memory and this time in the trenches will be a thing of the past in a few weeks. 
Any other tips I have missed?  Feel free to share in the comments.

Additional Resources: If you are interested in more information on successfully breastfeeding twins, I highly recommend reading the book Mothering Multiples: Breastfeeding and Caring for Twins or More by the La Leche League.

13 comments:

  1. Thank you for this post! This is so interesting to me. I remember feeling overwhelmed just feeding my son! Can't imagine "double timing" it! You are awesome. And proof that it can be done. I call BS on the 'no pain' thing too. There was pain, and then it stops. We weren't doing anything wrong, you just have to build up that tolerance or callous or whatever it is.

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  2. The thing I miss about having a baby the most was the closeness of nursing. Cherish every second of it. You are so lucky you are documenting it so well, it can be such a blur. Good Luck! I'm so glad it's working out for you.

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  3. Bravo! I love successful nursing stories! My son is turning 1 this weekend and still nursing like a champ; I love it and love when other mothers feel the same. :)

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  4. I loved breastfeeding, the closeness, the peacefulness. It was me and the baby time. I nursed both my babies, but I never had any pain. My Dr told me to use a rough facecloth on my nipples while in my bath, everyday, starting 2 months before due date. Didn't have a moment of discomfort.
    Congratulations, and cherish every moment. I wish I could turn back time and do it all over again.

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  5. So happy that things are going well for you. Nursing is so wonderful for the whole family. It is a huge sacrifice; but sooo worth it. It does get easier. You can do it!

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  6. Hi Brittany!

    Congratulations on this awesome new adventure.

    Love your blog and your writing in general, and as a fellow twin mom (my girls are 21 months old), am especially looking forward to keeping up that part of your journey. You're an inspiration already!

    Your experience with breastfeeding sounds much like mine eventually turned out to be, but I'd add something for those of your readers who may not see smooth sailing with twin breastfeeding right off the bat. My twins were born at 34 weeks (after signs of Twin-Twin Transfusion in babies, and HELLP Syndrome in mama, forced an early eviction), and, though healthy, they were just too sleepy and didn't quite have strong enough sucking reflexes to nurse well for a few weeks. Amazingly, on my 40-week due date, it was like they woke up and "came out of the womb," demonstrating both the kind of hunger and the feeding reflexes that so many full-term babies do upon birth, and we were off to the races. Breastfeeding from then on out was awesome (though I went back to work full-time a couple of weeks later, so they got pumped milk most of the day), partly because we had spent the preceding 6 weeks practicing as much as possible. I credit our success to a few things we did consistently in those early days: 1. I pumped every 3 hours, and built up a good milk supply that way; 2. We put the babies to the breast at every feeding, let them try for a bit and nuzzle around (though they were too weak to get much), and then finished the feeding by bottle; and 3. The girls and I had LOTS of skin-to-skin time. I think it was also just a lot of good luck, frankly. But, on the advice of some twin parents who were a few months ahead of us, we practiced patience, held out hope for that 40-week moment when things might kick into gear in a new way, and did what we could to enable that to happen. All of this to say: for those who have preemies, who hope to breastfeed, and who have the inclination and support to hang in there, it's possible, even if it doesn't happen right off the bat!

    I nursed and pumped for my girls until they were 9 months old, at which point I relented to the demands of our particular life and switched to formula, and that, too, was the right fit for us at the right time. The girls continued to thrive, and all is well! On that note, I appreciate your adding the encouragement and resource for those of us who go the formula route!

    All my best from a ways on in the twin trenches. It's a crazy, delicious ride, and I've found that it's always really fun to meet others---twins or twin parents---who can relate to this unique experience. Congrats to you, Scott, and sweet Isla on these two beautiful new additions!

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  7. I totally agree with #3. Feeding on demand is a nice idea, but with twins, if you feeding and not the other you'll be a nonstop nursing machine! :) I lasted 5 months, which I was pretty proud of considering I went right back to working full-time and had no family or friends to support us. I also used the Brest Friend nursing pillow, which I totally recommend. Great job on nursing twins, it's so good for your babies!

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  8. You're hilarious, nice simile - though I hope the blister part isn't synonymous. Not good...

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  9. I just wanted to say:
    a) Congratulations! This is my first time posting here despite reading for years - I should have congratulated your family sooner!
    b) Yayyyy for a scrolling blog where I can scroll down to read multiple posts! Hitting the older and newer links after scrolling through comments was okay, but this is much nicer. Thank you!!

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  10. I just wanted to say congratulations and that it sounds like you are doing an amazing job! I have eight month old twins that I am breast feeding and it is still going really well. The first few months though were really hard in terms of fatigue - what helped me was pumping so that my lovely husband could feed the babies between midnight and 5am (usually just one feed). This in no way affected my supply and let me get some rest. And I didn't believe it at the time but it does get easier!
    And yes, we have a big dent in the couch from my huge pregnant self and then the hours and hours of tandem feeding :)
    Oh, and eat, eat, eat! Feeding three requires a ton of calories.

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  11. Your experience breastfeeding twins sounds much like mine, especially the part about dreaming about laying down to sleep again someday! What I did? I bought a craftmatic adjustable bed. Saved my life. My babies and I co-sleep comfortably for 11 hours a night! Nursing, reclining the bed when I can, and they love the massage feature as well. It was an extreme step to take, but it was an awesome investment!

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  12. You can use different home comfort accessories to have a safe and comfortable time. You can use different types of cushions to sit properly. You can get the best knee pillow, drawing table, footrest, donut cushion, lumbar support cushion, bed lever, and bath aids, and many other aids accessories.

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