Fraternal Twin Weight Gain (or lack thereof)

[littlebearsmama]

My twin girls were born ten days past their estimated due date weighing 7 pounds and 7 #'s 13 oz.

I nurse them on demand exclusively.

At nine weeks old, they weigh 8 #'s 1 oz, and 8 #'s 8 oz. and I'm concerned. They spend ten to thirty minutes on the breast each feeding and wet about six diapers each per day. However, their bowel movements are quite irregular, only having one every one to three weeks. They are growing in length and head circumference, but their measurements are low percentiles.

Do twins gain weight more slowly than singletons? Does this sound concerning to you? I really don't want to supplement, but their health is my priority.

Any help would be appreciated. Thanks.

[Delaney21]

I would be concerned about only pooping every 1-3 weeks!  3 weeks is crazy long, in my opinion.  My DS would go 10 days and be completely miserable, until we helped him go.  I cut dairy out of my diet and he began pooping regularly.  Can you try cutting out dairy and see if that helps?

[~Adorkable~]

Can you get a scale good enough to get a feel for how much they eat in a session, that might help you feel better or understand if something is lacking. Do they seem happy and full after nursing?
Mine often don't seem full and since I also pump a lot I then give them a bottle of EBM and they suck it down! It's frusterating that they don't seem to take what they need directly but at least I'm getting it in them, very frustrating. But mine seem clearly hungry if I don't so if your babies seem happy that is maybe not the issue.
I would be worried about the pooping so rarely as well. Mine at 11 weeks and only rarely if every miss a day.

For me pumping to supplement them and for a freezer stash has upped my supply a ton, it's a hassle but one I'm very glad I'm doing.

[mamalovex3]

I would highly recommend seeing a lactation consultant.  They are expensive but totally worth every penny.  Mine gave a huge discount to twin moms.  My twin girls are also 9 weeks old and I am exclusively breastfeeding on demand.  I had a lot of difficulties in the beginning and the LC was extremely helpful in helping me to up my supply, ensure a good latch, and just supporting me!  At this age, babies should be gaining an average of 4-7 oz per week.  You could try pumping and offering a supplement of EBM after a feeding to see if they're really getting enough.  Good luck!

[littlebearsmama]

Thanks, Everyone.

      I have been cutting down on my dairy intake to see if that will make a difference with their diaper situation, as well as adding more fat to my diet in the forms of coconut oil and flax oil to see if that helps them to gain any weight.

      My health care provider and I have decided to moniter the girls closely for the next two weeks with breastfeeding journal entries and weighing. From my journal entries so far, I've got someone attached almost every hour of the day. They've definitely got lots of time to nurse, but maybe they aren't taking all that they need at each feeding as was mentioned before.

      If there is no improvement in the next two weeks, I will begin pumping my milk to give after a nursing to top them off, and if all else fails, I've got a good source of goat's milk, though it's my last resort. Hope that I don't have to use it because bottles seem so inconvenient.

      Lactation consultants are hard to come by in my neck of the woods. We live in a very isolated part of the state and we'd probably have to drive quite a way to find one...unless they can do a phone consultation (hmmm...I'm going to look into that).  

     Thanks for your responses. It's nice to have new ideas and support. Wish me luck.

[mauri456]

Do you know how low they got weight wise with the normal initial weight loss?  You would calculate their gain from there.... so really it depends on how much they've gained from their lowest weight.   I know that my pedi wanted to see more like an oz/day in the early days.   Their weight gain slowed to about 4-5oz/week around week 8 or so.  They still at 4 1/2 months gain 4-5oz/week....

Really at 9 weeks old the minimum gain should be about32 ounces... (4oz/week for 8 weeks as the first week they were probably loosing)   but that is from the lowest weight they had.   

I also agree that the infrequent pooping may be a concern... it's hard to say for sure... but 3 weeks is a LONG time, esp at such a  young age.  I read that for the first six weeks they should be going a few times/day.  I know my girls did.  Now it is normal for EBF babies to slow down their pooping but 3 weeks seems too long. 

I agree about what PP said... if you can't find an IBCLC is there a La Leche Leader around that can help evaluate nursing?   I also agree with somehow finding a scale to measure their input.  Of course it can vary feed to feed but the general rule is that babies need 24 oz of breastmilk/24 hours.   So if they nursed at 9 and then at 12 they should take in 3 oz a piece.   (of course time of day can vary, baby's appetite, etc)

I do know that at that age I couldnt really do ANYTHING but nurse nonstop.  I felt like all I did was sit on the couch nursing them.... so even them nursing every hour is not concerning. 

If it got to the point of needing supplementing (which I hope it doesnt!!!!) maybe consider donor milk over goat milk?  The first week I used another mama's milk due to jaundice issues with one of my babes.   I was so glad to use the perfect nutrition for her....  if your babies were older (9 months plus) maybe goat's milk would be a good option, but they are quite young for that....

[littlebearsmama]

     My girls are twelve weeks old now. The midwife came by to weigh them recently and they've each gained. One gained 7 oz and the other 9 oz. in two weeks which I'm happy about.

     Their bowel movements seems to be closer together so they go every week and a half now. I've been giving them probiotics to see if that would help to keep them more regular.

      I even tried pumping to have enough milk expressed to give them extra after their feedings at the breast. What a chore! Besides dealing with nipples, bottles, etc, it took me forever to pump an ounce and a half. I just never get reallly full since the girls are always nursing. Since they are indeed growing, I'm postponing any future pumping sessions.

     My girls are alert and happy most of the time. They don't look or act sickly. I can also tell that they are starting to fill out their clothes more and one even has a double chin. Maybe they are just going to be slower growers. What a change from my first baby boy who was wearing six month clothes at three months! I guess every baby is different. I'm doing all that I can, but my instincts tell me that the girls are okay. I"m still open to whatever they may need from me.

     Thanks so much for all of your suggestions and replies. It's nice to know there's somewhere to go for more answers and ideas. I'll keep you posted.