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Breastfeeding twins at birth

post #1 of 13
Thread Starter 

Just looking to educate myself so I can effectively advocate for my babies at birth.  I am expecting twins in April and plan to exclusively BF.  I want to avoid supplementing if possible, so I want to arm myself with knowledge about twins and whether the docs and nurses are more likely to push formula for them (whether I deliver at term or early).  I will be delivering at a baby friendly hospital, FWIW.  Hopefully I won't have problems, but just in case I want to be well informed.  How do I know when its necessary?  When I was talking with my ped about DDs food intolerances, she commented that it is common to supplement twins early on and mentioned to be sure to use an appropriate formula if necessary.  

 

A bit about my history- My DD is 2.5 and was born at 39w6d and was BF until age 2--never used formula.  We never had any problems and I made more than enough milk for her.

 

 

I hope my question is not too broad--basically I want to know under what circumstances I would truly need to supplement with formula.  Or any other pertinent information.  TIA

post #2 of 13

Congrats on your twins pregnancy!
 

I do not have experience personally with twins, but wanted to offer maybe hitting a LLL meeting or two in your area.  Or maybe finding a leader that would be willing to chat with you.

 

Good luck to you.

post #3 of 13

If you're planning to deliver in a hospital, see if you can meet with the lactation consultant prior to the birth, and then see if she can come in when you deliver.

 

My own experience was a planned c-section, so it was easy for the LC to be there, but it also ment that my milk production was slowed.  My goals were to be able to tandem feed before leaving the hospital. Do you know of the EZ2Nurse pillow?  It was probably the best thing I purchased for the infancy stage.

 

For me, as a first time mom with newborn twins, the whole nurse every 2 hours thing was what I believed. I didn't realize that it could mean "nurse every 45 minutes". Having another adult with you in your room is ideal, as is having someone else stay with you for a while after you come home-- a third adult, if you can manage it.

 

I started pumping in the hospital, too, just to increase supply. We also were given Haberman Feeders, which are supposed to help encourage a strong suck for if we decided to use a bottle for feedings. I also had no formula in the house, so we couldn't turn to it in a moment of frustration.

 

My boys were born at 38 weeks, and about 3 years later I had a singleton at 40 weeks. There was a big difference in the general fussiness and nursing prowess-- but there are confounding variables, so it's hard to say for certain that the gestational age is the real issue.

post #4 of 13

oops wrong thread.

post #5 of 13

Talk to the lactation consultant early and often. And realize that while with a single baby you feel like you're nursing *all the time* with two, you really will be, and you need to have someone else around to take care of the non-nursing baby (it was quite some time before I could nurse two at once, and I still don't do it often). And pay attention to what issues *you* are having. Because it won't always match what those around you think your problems will be. Everyone worried about my supply, but my issues were with latching. Yours may be something different.

 

I also wound up pumping every two to three hours for the first couple of months because my girls had trouble nursing. We were able to avoid formula, and now they're only nursing, but it took three months to get there. (and I've been very lucky with my supply:all the bottles were my breast milk  and I have been able to send supplements to a friend who has been struggling)

 

So my big recommendations: get lots of support, and pay attention to your body and your babies. And be flexible. Sometimes a few bottles, a little formula, or a little donated milk can get you through a tight spot and on to the nursing you clearly want to do. Be kind to yourself. Twins are hard and it's all about compromise.

post #6 of 13

You will need to eat even more calories than you ate during pregnancy, but lucky you, you will finally have room again in your tummy to eat.  Also, it is very important to get enough water.  At least 1-1.5 gallons every day, minimum!  I struggled with supply in the first weeks because I wasn't getting enough food or water, or time to eat or drink, really.  Once I paid more attention to me, the problem resolved quickly.  You need someone with you to help remind you of these things, and to bring you food and water even if you haven't asked for food and water.  

post #7 of 13
The fact that you already nursed a baby puts you in a good situation, because you will have the ability to make even more milk with your 2nd (and 3rd) babies. An LC told me that, and it really helped ease my mind.

Whether you need formula really has to do with your supply in the beginning and, if you have preemies who can't nurse yet, how much you can pump. I only had to rely on formula because I couldn't pump enough, but by working hard at my supply I was able to transition them off of formula and EBF. That is very possible, but it is not easy.

I'd speak with an LC at the hospital when you check in but before the birth, to arrange for a pump to be brought to your room within a couple hours of delivery, regardless of how things work out. I had to have a c-section and my babies were taken to the NICU, so while I was stuck in my room by myself I was able to pump, eat, drink, and rest all the things that can really help your milk come in. Of course, hopefully you'll have a vaginal birth, and have your full term babies in your room, but the pump is still going to be really good to start early on.

The other thing to consider is bring a wrap to the hospital with you. I should have bought one before my twins were born, but I didn't realize how useful it would be for newborn twins! I didn't get my Moby until a few months later. You can do a double hold with them in there (in an upright hold with their faces against your upper chest), kind of like the first photos on this page: http://babywearingtwins.wordpress.com/2010/03/04/gorgeous-guest-stars-zina

Skin to skin contact is a huge factor in having milk come in and building a strong supply, and if you can strip them down to their diapers, take off your top, and keep them in a wrap for awhile, it will keep them warm against your skin and snug and keep you covered. Much easier than juggling two near-naked newborns in a hospital bed and trying to get them next to your skin with a hospital gown! (Actually, bringing button-up pajamas would be really useful for easy skin to skin access.) Don't know if you want to learn to do a twin hold with a wrap so soon after giving birth (takes some practice to do well), or if you have an experienced doula who could help you with it, but think about it as an option. If they are in the NICU you won't need it (the monitor wires won't work well with the wrap) but you'll absolutely want to do the skin to skin kangaroo care in there, too. I always wore button up shirts tot he NICU so I could unbutton and put the babies against my skin, one at a time. I just wrapped my shirt over them. smile.gif

As for when else you'd have to supplement, besides a preemie situation there is the possibility of your milk coming in late, the babies having jaundice, being very underweight and needing some supplementation (like you adding formula to pumped breastmilk to increase the calories), or for various reasons you guys have a rough start and they lose a certain percentage of body weight in the days following their births (13% I think? something like that). The good news is that none of that means it has to be a long-term situation. The bad news is that you really can't plan or prevent any of that from happening.

If it does, you'll have to figure out how to roll with it for the time being, and without beating yourself up. One thing that really helped me was what our neonatologist said--"just think of formula as the medication they need right now." Perfect metaphor. It's a temporary thing they need and is only a part of the picture (you're doing a lot of other things for their health, too). They won't be on it forever but it's sure wonderful that it is there for their moment of need.
post #8 of 13
Thread Starter 

Thanks so much for the responses!

I am very blessed to have a wonderful support system both at home and by way of IBCLCs whom I trust nearby.  I was not as wild about the LCs in the hospital last time, so we will see what that's like this time.

I'm mostly worried about the potential of having a section and it's potential effect on my milk coming in or my supply, as well as the potential to deliver early etc. and all the issues that medical intervention may contribute too (i.e. pumping me full of IV fluids affecting the weight of babies, etc).  I just don't want to be in the situation where formula is recommended too quickly and feel pressured.  I know the baby friendly hospitals are not supposed to recommend formula unless medically necessary, but I'm not sure what that means--it seems ultra vague and I'm concerned that most anything could be termed medical necessity--therefore, I want to arm myself with knowledge beforehand so I have tools when I am exhausted and overwhelmed. 

 

Spring Lily- thanks for the idea of the Moby in the hospital.  I hadn't thought of bringing my moby to the hospital.  I did wash it and am sooo eager to tuck the babies in it when they arrive.  I love, love, love babywearing and I'm looking forward to resuming once the babies are born.  (I had to stop carrying DD --2.5-- altogether at 6weeks when I developed a large SCH and was hemorrhaging.  My last time wearing her was the day before on a long hike in the woods and I miss it sooo much!)

 

Have to run because DD needs snuggle time--(have been trying to post a response for a while!) Thanks again mamas!joy.gif

post #9 of 13

I had a section and started pumping two hours after surgery in order to get my milk to come in - the best thing I ever did. We also had Haberman feeders and they were great, really no nipple confusion at all because they had to "work" to get the milk out. I also give birth at a baby friendly hospital so there was a sticker on each of the bassinets that said "no formula" and the nurses respected that. I landed up nursing the baby in the nursery and pumping for the baby in the nicu because they needed to measure his food intake because he was so small (under 4 lbs). We never had formula in the house for them and I nursed for 18 months, so it is possible. I also had consultations with the LC at the hospital, but I didn't like her so much so I called in a friend who is a LLLC and she came out to the hospital to help me nurse and show me how to properly pump.

 

Good luck!

post #10 of 13

If you haven't picked it up  yet, I would highly recommend the book "Mothering Multiples: Breastfeeding and Caring for Twins or More!". It's published by LLL and is full of good info on nursing twins under ideal and less than ideal circumstances (c-section, premature, NICU etc). I would also make sure when you check with the hospital LC and see what her experience is with twins. If it's not wowing then I would look for a private LC, LLL leader, or post-partum doula who has lots of experience with multiples. 

post #11 of 13
Thread Starter 

Fortunately I feel confident that if I don't like the LC at the hospital I can and will call those I do know and like right--I feel very, very fortunate to have such fantastic support in that way.  

I do already own the book Mothering Multiples; thanks for the suggestion.

 

 

Do I need to pump right away if I have a surgical birth or should I play it by ear?  Alternatively, should I pump right away after even a vaginal birth?  I think my milk came in by day 3 with DD...

post #12 of 13
Quote:
Originally Posted by ThankfulMama View Post

 

Do I need to pump right away if I have a surgical birth or should I play it by ear?  Alternatively, should I pump right away after even a vaginal birth?  I think my milk came in by day 3 with DD...


I'd play it by ear. THere's no harm in having your milk on hand should you need the option of a bottle. Pumping also encourages your body to make more milk. But it takes a bit of time, time you could be resting or holding babies.

 

I usually pumped right after I nursed. There was very little there, but it really helped encourage supply, and that little bit did build up over the course of the day.
 

 

post #13 of 13
Thread Starter 

Thanks so much for the advice and support ladies.  Now that we are into 2012 I am realizing just how quickly this pg is starting to go.  Hopefully I can post a success story in a few months.smile.gif

 

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