Stuck Supplementing Nursing With EBM Bottles, Why? feeling like such a failure... updates in post...

[~Adorkable~]

 UPDATES in POST 15 and 22!

Babies never seem to get enough when nursing and so im stuck with pumping and bottles, please help

Short version:

• healthy twins born 36 weeks, now 12 weeks old
• babies started on bottles since they were later term premies and had very hard time latching or nursing
• once breastfeeding started they dont seem to get enough and seem to need pumped milk in bottles to make it thru their day
• i have no idea how to get them to nurse more
• they usually stop in 5-10 minutes acting full
• other times they act too hungry to even start nursing and just flip out and trash rather than latch on
• i seem to have great supply
• babies dont seem to have any physical issues hindering them
• everyone is growing and soiling diapers really well
• i am %1000 committed to these babies getting my milk for as long as i can, hopefully a year, at the very least 
• help

Full version:

ok back story

babies were born 36w0d and were 5lbs3oz and 5lbs10oz, other than that they were healthy and happy. both seem to be too small and tired to latch on in those first days and after struggling with just about everything including syringe feeding we broke down and gave bottles on day 4.

at no time have they had anything but my breastmilk, i have had little to no trouble pumping and seem to have great supply

on day 10 after a lot of work we finally got DS to latch and drink with the help of a nipple shield, DD (the smaller one) followed the next day. they would only drink for a minute or two before falling asleep usally and so the bottles came out still as their primary food delivery

at first the biggest issue was them not opening their mouth enough to get my nipple in or get a real latch, they have been checked out by a pediatric dentist for tongue tie and dont seem to have any structure issues except maybe high pallet on DD, both such very strong when you get something into the right spot.

we always thought as they got older and closer to their full term EDD they would get a lot better and also assumed at some point i could stop supplementing my breast with the bottles….

ok so they are now 3 months

they both have shown me that they can nurse well, the nipple shields have been ditched long ago and sometimes they latch and go at it like there was never a issue. other times they seem to hungry to latch or too whatever to keep at it long enough to fill up. they almost never nurse for more than 10 minutes, usually even less. when they finish they  seem at the time to be satisfied.

But…

if i were to offer them a bottle right after nursing ,they chug it down and drink enough to real make me wonder how much they ever got from my boob

if i dont offer a bottle after nursing they slowly get hungrier and hungrier as the day goes on and really flip out at some point. i have latterly spent the day in bed many days now just nursing over and over and they quickly get to the point where they refuse to nurse like they are full but fuss and cry until they get a bottle.

other times they act too hungry to even start nursing and just flip out and trash rather than latch on, even though i know they know how.

oh and it would be hard for it to be about the boob being more work, cause if anything i let down hard, one side is really fast and is sometime a bit too fast for them, the other side is slower and usually makes them very happy (DD will take the fast side no problem, DS is a bit turned off by it)

they are growing great and have wonderful diaper counts, poop is good and any occasionally greenish so i'm not to worried about the foremilk/hindmilk balance or too much let down.

my day is already so unbelievably full with twins, having to pump up to 4 times a day and deal with bottles is just making it so much harder. its just crazy that i cant get this working for us, please help

i am %1000 committed to these babies getting my milk for as long as i can, hopefully a year, at the very least. but i really dont know how i can do this the way i am now, logistically and emotionally it is overwhelming

on a personal emotional note:

this is tearing me up, to have my babies reject my offer of a breast when they are clearly so hungry is heartbreaking and infuriating all at the same time. i have made it thru everything else that 3 months of twins can throw at me and been pretty much fine, but this takes me down. i have felt so much sadness, frustration, rejection and failure and at times anger as this has played out and then a whole new round of self loathing for ever feeling that frustrated with these beautiful babies that are clearly not doing this to spite me.

there has to be a way out of this

Edited by ~Adorkable~ - 1/3/12 at 7:44pm

[LSUtwinMama]

First of all,

You post sounds a whole lot like what I went through with my girls. They were born at 30 wks and spent 6 wks in the NICU. They weren't able to even attempt nursing until they were a month old and by then they'd grown used to the bottle.

It took months to get them back on the breast and it was exhausting for all of us. When I was working to get them used to nursing, I would switch between the breast and bottle several times during a feeding to keep them from getting frantic with hunger. It also helped to have the slowest flow nipples on their bottles (unlike yours, my girls would get frustrated with slow milk from the breast).

Once I was comfortable that they could breast feed well and get a good amount of milk at a feeding, I dropped bottles "cold turkey" at 4 months old and spent a long weekend having a "nurse in" in bed. I know that might not be an option for everyone, but it worked for us. They spent the whole weekend nursing on demand and cuddling skin-to-skin and by the end of the second day, they were nursing for about 20-30minutes at a feeding and no longer acting like they needed a bottle to "top them off".  The first day and night was ROUGH but I knew they weren't starving so I toughed it out. They didn't cry, but they were very hard to get settled that first night.

I wish you the best of luck! Hang in there.

[Megan73]

First, it sounds like you're doing so, so well at getting BM into your twins!

A couple of things... Have you tried breast compressions and switch nursing so they get more milk while nursing? Also, have you considered using an SNS instead of bottles? I'm sure it would be awkward with twins but it could help keep them at the breast longer and stop the breast refusal.

[Parker'smommy]

It sounds like nipple preference to me. They like the bottle's flow and while they may nurse to put off hunger, they prefer the bottle, and wait for it. It almost sounds like that after the initial letdown, where the milk comes down fast and hard, they lose interest in nursing. 

I like the other poster's recommendation to put off bottles entirely...cold turkey. It will probably mean a pretty rough week, and they may be irritable and cranky, but they need to forget about the bottle and know that it is not an option and that they just need to nurse to get momma's great milk! I think this is a great recommendation since your supply is good and they know how to nurse, they are just refusing to do so. 

Good luck!!!

[~Adorkable~]

Originally Posted by LSUtwinMama 

Once I was comfortable that they could breast feed well and get a good amount of milk at a feeding, I dropped bottles "cold turkey" at 4 months old and spent a long weekend having a "nurse in" in bed. I know that might not be an option for everyone, but it worked for us. They spent the whole weekend nursing on demand and cuddling skin-to-skin and by the end of the second day, they were nursing for about 20-30minutes at a feeding and no longer acting like they needed a bottle to "top them off".  The first day and night was ROUGH but I knew they weren't starving so I toughed it out. They didn't cry, but they were very hard to get settled that first night.

I wish you the best of luck! Hang in there.

how did you know that they could breastfeed enough to take that plunge?  i often spend most of the day in bed sleeping and nursing with them, heck i often dont get out of bed with the twinfants!  do you think the skin to skin thing is a really important part? i know it help increase supply, but it being early spring we are usually pretty dressed in this house. they do certainly get lots of naps on my bare boobies after eating, we both love that.

What do you mean by ROUGH if you said there was no crying? sounds pretty un-rough. my babies will flip out and cry and scream if they are hungry and they get themselves so worked up that they past a point where sadly i feel like there is no chance of them being even able to nurse at that point.

am i understand it wrong? do you think that i could get my babies on to  boob once they are freaking out? boy i really wish i could
 

Originally Posted by Megan73 

First, it sounds like you're doing so, so well at getting BM into your twins!

A couple of things... Have you tried breast compressions and switch nursing so they get more milk while nursing? Also, have you considered using an SNS instead of bottles? I'm sure it would be awkward with twins but it could help keep them at the breast longer and stop the breast refusal.

thank you for acknowledging that i'm getting my milk in my babies, i have had some folks say thinks unwittingly that suggested that it was a shame they dont always get their milk from me. i have corrected them in that i simply am not breastfeeding then full time, but they certainly do get all their food from me! (this is not to slam those that do need to supplement, it is just not the case with me and i took offense to the inference that my milk was somehow "less" once it was in a bottle)

i do breast compressions specially on the slower left boob to help get things flowing, though in general i do not think slow if my issue, but i may be totally wrong. they say that the baby is more efficient than the breast pump, since i can pump upwards of 20 oz in 20 min on a good morning and 12-15 oz in 15 minutes almost anytime, can i assume that my babies should be able to get all the milk they need? they usually drink between 3 and 5 oz a bottle feeding, could they really be that bad at breastfeeding that they cant get that out of me? 

im wondering if i should be doing some detailed weighings and figure out how much they are really getting in a good nursing session and if they really are nursing for a while and not getting those 3-5 oz, then .....?

do you really think a sns or lactaid would help them? or would it just reward lazy bad suckling?
 

Originally Posted by Parker'smommy 

It sounds like nipple preference to me. They like the bottle's flow and while they may nurse to put off hunger, they prefer the bottle, and wait for it. It almost sounds like that after the initial letdown, where the milk comes down fast and hard, they lose interest in nursing. 

I like the other poster's recommendation to put off bottles entirely...cold turkey. It will probably mean a pretty rough week, and they may be irritable and cranky, but they need to forget about the bottle and know that it is not an option and that they just need to nurse to get momma's great milk! I think this is a great recommendation since your supply is good and they know how to nurse, they are just refusing to do so. 

Good luck!!!

how do i know they "know how to nurse"? this is at the heart of the matter

and in general, maybe im a wimp, but the thought of TWO 3 month old hungry, tired screaming babies for days or even a day does not seem workable, they really do seem to work themselves up past a point where they can ever latch, maybe im totally wrong, that is why im hear asking all this

[gemasita]

My LC said there is some evidence that babies get more out of the breast if they bottle-feed first (if they are bottle-feeding partly).  Sounds counter-intuitive...unless you have babies that are really impatient!  My little guy is patient so we breast-feed first and then bottle-feed but tonight, I did try the bottle in the middle of the feeding.  I wonder if you could try breast-feeding in the middle or at the end of the feeding?  Sounds like your babies are not patient enough to breast-feed when they are really hungry.

We did do one before- and after-feeding weight on my guy out of curiousity...he got about the same in 10 minutes as my pump did in 20!  Which is only an oz since I have low supply but at least it gave me an idea of what is going on.  Wonder if you can do some weights or have an LC come for a visit to look at a feeding.  That helped me so much.  I had a lot of questions about what exactly was happening during a feeding at the breast and it sounds like you do too.  (Plus, I was way off!  He gets all I have out very fast.)

Also, the Lact-Aid doesn't reward them for a lazy suck.  It supplements less when there is a good flow and more when the flow slows down.

[~Adorkable~]

tomorrow i'm going to weigh them before and after a morning nursing, that is the one that seems to be working for them and then maybe a evening one, those seem like functional for them

my scale only goes down to 1/2 oz measurements, but i think it will give me a general idea.

[Debbie Page]

You are amazing. You have devoted your life to these babies and are giving them lots of breastmilk. It's so hard when babies have trouble getting the milk out and you know it's there. There are a lot reasons babies have trouble getting all the milk from the breast in a reasonable amount of time. Who is helping you figure all this out? It's a lot for mom to have to do.

[~Adorkable~]

Hi Debbie, welcome to MDC! Feel kinda flattered that your first post was spent reassuring me! If you have any questions about see boards and wed site, please feel free to PM me ( private message, it under the pull down by my name at the left there), I'm happy to help!

[~Adorkable~]

As for your question, I really don't have anyone IRL (in real life) helping, the LC I saw was kinda a dud, I am thinking of seeing her again maybe she was having a bad day. There is also one around here that deals with multiples, I'm going to look her up. Thankfully my DH (darling husband) is very supportive and helpful in all matters baby, he is bummed to watch me struggle with this so much and has asked me "if it was worth it" since clearly I could go to exclusively pumping with out much problem. I have explained and he understands and agrees how hard that would be in the long term and how sad it would be since it seems like these issues are winnable.

[gemasita]

Adorkable - I just wanted to tell you that I had my first-ever bouts of breast refusal today.  It was devastating!  I gave in with a little bit out of the bottle because DS just wouldn't calm down.  What do people who don't have expressed milk in a bottle do when there babies are so hysterical that they won't nurse?  It made me nervous - happened twice today when DS just got too hungry.  I was in tears.

[PatioGardener]

Originally Posted by ~Adorkable~ 

tomorrow i'm going to weigh them before and after a morning nursing, that is the one that seems to be working for them and then maybe a evening one, those seem like functional for them

my scale only goes down to 1/2 oz measurements, but i think it will give me a general idea.

I've been pulling for you guys (you and the babies!) - I hope the weigh-in gave you some good info.

[~Adorkable~]

Originally Posted by gemasita 

Adorkable - I just wanted to tell you that I had my first-ever bouts of breast refusal today.  It was devastating!  I gave in with a little bit out of the bottle because DS just wouldn't calm down.  What do people who don't have expressed milk in a bottle do when there babies are so hysterical that they won't nurse?  It made me nervous - happened twice today when DS just got too hungry.  I was in tears.

so sorry you had to experience this, wouldn't wish it on anyone. yeah i have no idea what folks do that dont have a bottle to fall back on.
 

Originally Posted by PatioGardener 
I've been pulling for you guys (you and the babies!) - I hope the weigh-in gave you some good info.

thanks, the weigh in did give me some interesting info, i still need to do a few more days to confirm some thoughts but here is the info:

Weight Before and after feeding:  they nursed other times that day but i was out of the house or tandem nursing and could not to weight checks

A:

7am nursed right 5min drank 2.5oz

10:20 am Nursed left 10min drank 4oz

7pm nursed left about 8 min drank 1oz (noticed a difference)

B: 

7am nursed Left 5 min drank 2oz

10:30 am nursed right drank 4.5oz

7:30pm nursed right about 10min drank 5oz

here is what i get from this so far..

the good:

• right is always faster boob regardless of time or baby, but both babies drink good from both
• they can get milk out of me at nearly 1/2oz a min, so that seems great (this was the greatest thing to learn, really reassuring! this is almost the exact same as my pumping rate)
• they actually are drinking their full meal when they focus those numbers are similar to what they would take in a bottle

the bad:

• they seem to act the same whether they get a little or a lot, it is hard to tell from when they unlatch, they dont nurse longer to get more when they are not seeming to get the milk
• they clearly have at least two different nursing modes and one simply does not transfer milk, i can dell the difference some times and that 1oz nursing she was clearly not swallowing like the other times

The question now

• how do i get them to do the better latch/nurseing style?
• how unless im in a quiet calm room do i figure out what they are doing at a given nursing? it is sometimes very tricky to tell, other times it is clear

Edited by ~Adorkable~ - 4/14/11 at 2:38pm

[gemasita]

It's hard for me to tell too....

[~Adorkable~]

i want to let you all know what an amazing turn of events our nursing life has had. things stayed pretty much where i described in these posts. very hard. i pumped every day for 6 months, i continued to feel rejected by my darling babies, i really dont know how i got thru it.

So about a month ago, while traveling and camping no less, both babies nearly at the identical moment decided that nursing straight from my breasts were the way to go! they have never looked back!

i want to repeat that for the full awesome of this:

My babes decided to breastfeed exclusively for the first time ever at 6 months old!

it took days and then a few weeks to fully trust it, but low and behold i would come home each day with my bottles still full of the milk i had put in them in the morning. They even stopped using a bottle overnight, and instead realized that their binky was what they wanted some of the time and other times just got pulled into bed with me to nurse and blissfully drift back off.

It has now been a month and i only pump every few days, maybe 2 times a week for special needs like when we flew (so both could drink during landing) or tonight my husband took them so i could go get my first pedicure in over a year and a half!

i have no idea how i stuck it out, but amazingly i have gotten thru it and i have two wonderfully nursing 7 month old twins. i'm in heaven!

[PatioGardener]

You rock!

Congratulations, mama! You have all worked so hard for this - enjoy!

[gemasita]

I am smiling ear to ear at this news!  It is awesome!  Babies are amazing.

[homemademom]

Amazing! That is so wonderful!

[rinap]

I am so, so happy to hear this. I'm having similar problems to those you described; my twins are two months old and I get very discouraged sometimes. They mostly nurse during the day, but are on bottles of EBM at night. It's exhausting to feed them then pump at five in the morning. It's wonderful to hear that it's not too late for nursing to become full time.

Thank you.

[~Adorkable~]

Rinap, if you want to talk at any time, please let me know. Welcome to Mothering.com and please come check out the multiples area, we gals need to stick together so we can cheer each other on!

Parenting Multiples