Thursday, June 13, 2013

Breastfeeding Twins

If breastfeeding, images of it, or talk about it offends you, this post is not for you.  I will be candidly talking about my experience nursing my twins and sharing a couple pictures of them nursing.  You've been warned.

Gilligan & O'Malley Nursing Tank - I have been wearing these nursing tanks basically every day since I came home from the hospital.  They are super comfortable and have held up really well over time.  They are great to wear under a t-shirt, tank or sweater.  I was a 34B pre-pregnancy and went up two sizes. Some of my mommy friends with larger chests said they didn't offer enough support. I haven't had that problem, but it may be something to consider if you're well endowed.

BeBe Au Lait Nursing Cover - This nursing cover was a godsend for the first few months while we were getting comfortable in our nursing relationship. It's lightweight and has a firm yet flexible band at the neckline which makes it easy to look down and see if your baby is latched properly or needs re-positioning.

Boppy Pillow x2 - The Boppy gets my vote for the best piece of baby gear ever invented.  It's the perfect support pillow for nursing a singleton.  We used it to prop them up while bottle feeding. It's a great aid for when they are still a little wobbly sitting up.  We, kind of by accident, found that the Boppys provided the perfect support for tandem nursing in bed. I position the Boppys on my sides and they offer enough support for my arms that I can tandem nurse both babies while lying on my back.  I know I didn't explain that well, but there's a picture further down that shows the babies positioning while nursing. While you don't need two of everything for twins, you do need two Boppys.

Medela Pump In Style Advanced - A double electric pump is a must, in my opinion, especially if you plan to go back to work at anytime.  Even before I went back to work, I used the pump on a daily basis.  I would pump once a day while giving the babies a bottle. They were never great at taking a bottle, but they would always take it.  Sometimes it just took an hour for them to finish 4 ounces.  My favorite part about this pump is that the bags attach to the flanges so you don't have to pump into a bottle and then pour it into a bag to freeze it.  There are also nipples that screw directly onto the pumping bottles.  Easy and less dishes = win.

Bella B Nipple Butter - This nipple butter is great because you don't have to wipe it off before nursing.  It's soothing, natural and safe for baby.  Enough said.

My Brest Friend Twin Nursing Pillow - We used the twin pillow for just about every feeding until 2 or 3 months.  It was really great with helping us tandem feed in the beginning.  It's made of a firm foam which is perfect for supporting little, floppy babies. It was especially great when I needed to burp one baby and keep the other happily nursing. Added bonus, it has a pocket on the side where you can put your phone and a burp rag.

Lansinoh Soothies - Your nipples will be sore in the beginning even if your babies have a great latch.  Keep a few of these in the fridge and pop them on whenever your nipples are sore, instant soothing.

And now for our breastfeeding story.

Long before we even started trying to get pregnant I was sure I was going to breastfeed my children.  When we found out we were having twins, I knew that it might be more of a challenge to exclusively breastfeed, but I was still determined.  I ordered the My Brest Friend Twin Nursing Pillow, read Mothering Multiples and started researching twin nursing success stories. 

I knew that each week I was still pregnant gave us a better chance of successfully nursing. When we wound up in the hospital at 32 weeks, I adjusted my expectations.  When the NICU nurses come in and talk to you about feeding tubes, any preconceived notions of how you plan to feed your babies go out the window.  I remained hopeful, and thankfully we made it to 37 weeks before delivering.

Immediately after delivery, the babies' blood sugar dropped and they were taken to the nursery to be given formula. The nurses fed them with a syringe since they knew we hoped to breastfeed.  Brooke joined me in recovery first and she latched immediately. When Harrison joined us, he latched right away as well but had some issues with latching properly.

The lactation consultants, LCs,  at the hospital were great at helping with Harrison's latch.  Both babies were consistently latching well and eagerly nursing by the end of day one. The babies roomed in with us and continued to nurse well overnight.  In the morning they went to the nursery for their pediatric check-in and they had lost enough weight that the doctor was slightly concerned.

The LCs brought us in a Medela Symphony pump, a great pump if you're interesting in renting a hospital grade pump, and we began pumping to help stimulate supply.  The babies continued to nurse well that day and night.  When they went into the nursery the next morning for their check-in, they had lost even more weight.  Over 10% of their body weight.  In hindsight this is partially due to inflated birth weights from my being hooked to an IV for hours before they were born.

We continued nursing and pumping that day and also began manual expression/massage while the babies nursed to help stimulate production.  By the end of the day the babies were becoming fussy and nursing constantly.  That night we got to the point where the babies were hungry and I wasn't producing enough to satisfy them.  Around 1am the babies were crying because they were hungry, and I was crying because they were hungry and I couldn't satisfy them.  During this time the nurse on call came in and told me I shouldn't expect to be able to exclusively breast feed twins.  This got me crying even more.

So there we were, the three of us crying and poor Rob is trying to say the right thing.  We decided that the babies needed more than what I could give at that time, so we had the nurse bring in some formula.  They each sucked down an ounce right away and then passed out.  While Rob fed them I was crying hysterically thinking I was a failure. By their next feeding, I had enough milk to keep them satisfied. When they went for their morning check-in they had lost a bit more weight but the drop wasn't as severe as it had been the previous two days.

Our day nurse sent us home with tons of formula samples.  It was great to have them as a back up, and there were a few time where I got frustrated and really considered using formula, but never did.  We were able to donate the samples to friends that needed them.  By their one week appointment they were back above their birth weight and they continued to gain quickly.

Tandem nursing using the My Brest Friend

Harrison had problems with spitting up/reflux for the first three months.  Our pediatrician didn't think it was serious enough to warrant any meds, so thankfully we didn't have to do that.  I was just constantly covered in baby barf for 3 months.  I tried cutting out dairy which didn't help.  It did seem like avoiding soy made a positive difference.  

I think a large part of our problem was that I had an oversupply and overactive let down.  We started going to the nursing moms support group at our hospital each week.  If your hospital offers one of these, I highly recommend going.  It was great to be able to discuss any nursing issues with a registered LC and with other moms going through similar difficulties. 

After talking to the LCs we decided to stop alternating breasts and assign each baby their own side. This made a big difference for us.  The babies each regulated their own side and the constant spitting up slowly got better.

This is how they nurse while we lie in bed.  We still nurse in this position today.

We had one bout of oral thrush around 6 months.  Since they both had their own side, only Harrison got thrush. (That was a blessing) It took us a couple months, and finally Diflucan for me, to finally get rid of it. There were a couple clogged ducts here and there as well, but thankfully no major hurdles for us.  

Here we are, just past a year and still nursing strong.  They are down to only nursing before naps, bedtime and once overnight.  I say only, but it's still 4 times a day.  They were nursing 4 times a day and 4 times at night as recent as 3 months ago.  It made for a very tired mommy, but I definitely think co-sleeping and nursing on demand throughout the night helped my supply.  I am planning to let them self wean when they are ready, or start the weaning process just before they are two, whichever comes first.

A few pieces of advice to new moms trying to establish breastfeeding: 
  • Seek help if you're having issues.  The advice and knowledge of a trained LC will benefit you more than you know.
  • Don't hurry to set a schedule for your baby.  Let him nurse on demand until your supply is well established.
  • Drink, drink, drink! I have a Bobble which has constantly been at my side since I was pregnant. If you think you've had enough water, have another drink.
  • Don't be too hard on yourself if things don't go exactly as planned.  There is nothing wrong with having to supplement, exclusively pump, or having to feed formula exclusively. Only you know what's right for you and your baby.

I feel very fortunate that our journey has been as smooth as it has. The first couple months were exhausting, but the constant nursing was so worth it. I hope I am this lucky with any future kids that we might have.  If you made it to the end, thanks for sticking with me through a super long post.  I probably could have written more, but wanted to keep it as brief as possible.

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