Nursing twins and supplementation

[Julia'sMom]

So...I know I posted a while ago...and I thought I had it beat...but apparently not. We went for the 3 month weight check and neither twin was gaining like they should have been. DD is 9 lb and DS is 9lb 14 oz. They were born at 6lb 5oz and 6lb 11oz. So...I'm back to formula. How do you ladies do it? How do you juggle nursing and then bottle feeding without impacting the current milk supply?

Please don't suggest pumping. I'm barely keeping it all together now and have no time for that too. I do need to pay some attention to older sister as the jealousy is creating acting out issues that are only improved with more attention.

[Llyra]

Have you ever considered supplementing at the breast, with something like an SNS or a Lact-aid? It takes less time that way, and it can really help boost your supply if it's lagging a bit. My youngest two are twins. They're 3 now, but between 2 and 4 months DS didn't gain much. I know my supply was lagging-- I had been sick during that time and chronically dehydrated and letting DH give bottles too often. The SNS saved us-- it let me get DS back on track, and my supply back on track too, and it takes less time than bottle-feeding.

If you haven't seen one-- it's a little bottle that you pin to the shoulder of your shirt. Then there's a tube that you tape to your chest. The tube runs alongside your nipple, protruding about an inch beyond it. Once baby is latched, you open the flow on the tube, and the milk that's in there flows along with your own milk. When your own milk stops flowing, baby keeps sucking, because of the milk in the tube, which stimulates your supply.

It even has two tubes, so that you can tape it to both breast at the same time, for tandem feeds.

It takes a bit of fiddling to learn how to do it, but once you get it, it works pretty well. A good LC will have them, or you can order them from Medela.

Once baby is finished, stick the bottle part and the tubes in the fridge until the next feed, when you fill the bottle again. You'll want to wash it once or twice a day in nice hot soapy water.

Because the tube runs alongside your skin, you don't even need to warm the supplement, since your body will warm it. That's handy, too.

Good luck! Breastfeeding twins is hard, hard, hard work, and any mama that is still doing it by three months is a HERO. Do you know how rare that is? My pediatrician says she'd never seen a mama with twins continue breastfeeding beyond about two months. And that's a big ped practice, too, and one normally very supportive of breastfeeding. So you should feel proud of yourself for getting this far!

[dividedsky]

i nursed and supplemented with a few ounces of formula afterward for the first 6.5 months due to low supply. i also thought i had it beat a couple of times only to bring them in and find that they weren't gaining so well. that might just be the worst feeling on the planet, no?

i don't know if it will work for you, but i just tandem nursed first and then gave a small bottle, except for at night. it was a lot of work and a total pain... i won't lie... but in the long run, i'm absolutely glad that i stuck with it. when they were small i'd make a giant pillow mound on the bed, plop them both in, and give them the bottles at the same time. when they were able to go in high chairs, i put them in and gave both bottles that way (so much better!). i also did not have the time to pump - i needed that like a hole in the head...

as they became better nursers my supply got better and i was able to drop them down to like 2oz of supplement at a time. when they started with solids, they were getting such a small bottle that i started to slowly drop them (all the while doing weekly weight checks @ a local breastfeeding center, but i was also a neurotic first time mom).

i say stick with it. it's worth it, if only for being able to nurse at night alone... and if you have questions feel free to pm me.

[Kat's Mommy]

My babes are 9 weeks old right now, and I breastfeed and supplement with formula due to low supply.

I always offer breast first. I have one side that has ample supply of milk, and the other does not, so one baby is always left super hungry. Sometimes I will tandem nurse.

I try to exclusively breastfeed at night. Sometimes it works, sometimes it doesn't, and I've learned not to beat myself up about it.

When I start to stress out, I try to remember that from 1 to 5 weeks, I was nursing, pumping and bottle feeding until my DS learned to latch at 5 weeks.

Good luck!!

[Callimom]

Nursing twins is hard hard work.
Are you able to take care of your needs as well - ie are you eating healthily? drinking enough? taking supplements? (probably silly questions in the early days I know but it does make a difference.)

I had a couple of supply "crashes" early on. One of my twins didn't latch for the first 2 months so was finger fed, and the other was a tiny wee bird and tried mightly but just couldn't move enough milk for to keep a supply up for two.

I used blessed thistle, and fenugreek on and off for much of the time my twins were under 6 months, particularly around the increased nursing needs at the 3's and 6's .

Can you integrate perhaps one session of pumping at some part of your day to help increase supply? Maybe right after dinner when your partner can be on kid duty, and you have hopefully had 20 minutes to sit down and have a good meal?

Can you call in the troops and ask for a week of meals and some help so you can do a bit of supply rebuilding (sleep, eat - you know the basics )

In the end, as one of the PPs said, nursing twins is hard, and rare and you are doing a fantastic job. Just to encourage you, after we got through the early supply and latch issues my kids were off supplementation at about 4 months and went on to nurse for 4 years - tri-andeming with their baby siste for 2 of those years. The early days are by far the hardest and you are doing great.

Karen

[Megan73]

Have you considered domperidone?

[Julia'sMom]

Thank you so much for the support. I do think that is the worst part. I just feel so guilty whenever they are weighed and fall short, like I'm failing.

I'm with you DividedSky. I tandem them first and then offer a bottle, first to one and then the remainder to the other. I haven't gotten down feeding both with a bottle at the same time yet. At night I skip the bottles. They do still feed every 2 hours, maybe 3 at night. I'm so tired and feel like my whole day is feeding, but I do pray that this is a growth spurt, as someone mentioned. Please tell me the feedings will eventually space out to be easier.

Thanks again for the support and sorry for the rambling. I should be in bed.

[~bookcase~]

big - i know it can feel really bleurgh when the weight isn't happening how you expected!

how drastic is their gain in terms of falling off centiles? are you sure you have a low supply? how often have they been weighed and have they had any colds/ illness etc?

it's tempting to top up at every feed (and maybe you must do that to get their weight back. i haven't looked at the charts or calculated so this is general info) but if the weight gain just needs a little increase you may be able to offer a full bottle of formula at say, 4pm, which will be enough to increase the weight without ecroaching on your supply. when you top up at every feed:
1. it's a pain in the ....
2. it can be the start of baby taking more from the bottle than breast, your supply slows down and that cycle perpetuates iyswim.

a single bottle is less likely to cause that; you just make less milk at that time of day.

the supplementer is a good alternative to bottles because it maintains the demand on the breast at the same time as giving a little boost. maybe using that twice a day would help if you liked that option.

i think the less faffing about the better and i would make my decisions based on offering as little as possible supplement as infrequently as possible. call it lazy

i would also use domperidone for a bit and see if that helps.

you've doing a fab job mama. lucky babies

[midwestmom]

I didn't read all of the replies, but I had supply issues and ended up needing to supplement at some point too. I was terribly worried about my supply as well so I used lact-aids and only supplemented at the breast. Hugs mama.