Originally Posted by QMtwins
I am needing to get another ounce or so in them and in order to associate milk/fullness with the breast and give my body stimulation from the suckling at the breast, it was recommended to use the SNS.
Both are stong nursers. Right now they are at the breast 8+ times a day. As of 2pm they have breastfed at least 5 times since midnight. I am not limiting their time at the breast at all. If they cry, that is generally where they go as soon as can be managed with 2 other 2.5 year olds around! I'm pumping a couple times a day to encourage my milk supply and then giving it back to them by the SNS, occasionally bottle by my DH.
My doc thinks they need that extra milk that I pump or use donated milk...she estimated the amount/day. So, now I'm just working on the best way for us to get it in them without damaging our breastfeeding at all.
My NICU friend and I've seen video of it too, has used cup feeding with brand new babies who have need for milk and can't get it directly from the mother's breast...we just were not having any success with the cup and the point of my original post was to see what expereinces others might have had with it. I don't know anyone in my area, even the lactation consultants, who have used cup feeding.
Maybe using the bottle is the easiest way to go.
Thanks for reading!
I apologize for still being a little confused.
I understand the part about how the ped wants you to get another ounce per day in the babies. Whether your ped is correct about the amount, I can't tell, based on what you've written. I guess I'd have to look at her calculations in order to understand that. I was just wondering, however, whether your ped is taking into consideration the following factors listed in:
The reason that I ask is because when my dd was that age, I found that counting the number of wet diapers was a much more reliable indicator than counting ounces. Don't get me wrong, because I kept track of both, but the number of wet diapers was a more direct and accurate measurement than counting ounces.
I also understand that it is generally good to get a baby to associate milk with the breast. However, I am confused because you say that the babies pull away the tube and fiercely try to latch on without the tube. (Do they succeed in latching on? It sounds like they do.) So, unless I am missing something, it sounds like the babies already have already established a definite understanding that latching onto the breast leads to milk.
I can't figure out what you mean about associating fullness with the breast. Do you mean that you want the babies to associate their stomach's fullness with something about your breast? Or do you mean that you want your the feeling of fullness of milk felt by your breasts to, well I don't really understand what you meant. Could you please clarify? Because my understanding is that when you offer the breast, the milk will come out of the breasts, whether or not the breasts feel full. (And at about ten weeks, the breasts will feel less full than before, but the milk nevertheless gets created to meet the demand.)
I definitely understand why you want to give your body stimulation by suckling at the breast. What I am really confused about is why nursing with the SNS will do that more effectively than nursing more often without the SNS. What really confuses me is that it takes a lot of time to prepare the SNS, and that is extra time that I would think could instead be used to offer the breast more often. From my experience from when I used an SNS, offering the breast without SNS more often, is no work at all, compared to all the work required with the SNS.
Also, my understanding from how the SNS works is that the SNS gives the baby a little taste of milk before the breast lets down in order to encourage the baby to suck more vigorously to get the breast to let down its own milk. But, unless I am misunderstanding you, when you say that your babies are strong nursers, it sounds like your babies are already able to get the milk to let down from your breast, correct? So that's why I can't figure out what the purpose of the SNS is for in your case.
Okay, the babies are at the breast at least 8x per 24 hours and between midnight and 2 pm, were on the breast 5 times since midnight. So 8x per 24 hours is an average of once every 3 hours. From midnight to 2pm is 14 hours, and at the breast five times during that 14 hour interval, means that the babies are averaging 2.8 hours (~3 hours) between feedings.
I understand what you mean when you said that you are not limiting time at the breast. I guess my question is whether you are encouraging the babies to feed more often by offering the breast before the babies cry. You said that if the baby cries, then the baby goes onto the breast as soon as you can manage. It would seem to me that if you want the babies to get more breastmilk, you would want to offer the babies the breast before they start crying. In other words, instead of feeding 8x per day or every three hours, offer the breast 10x per day or every two hours. (How you would accomplish the logistics with two babies and 2 toddlers running around, I have no idea. Perhaps cross-posting in the Multiples SubForum would give you practical suggestions.)
I understand the part about how you are pumping, to encourage your milk supply, and then giving it in the SNS and/or Daddy delivered bottle. Speaking as a person who pumped around the clock for two weeks to successfully build up her supply from a total zero, and then maintained the supply for three months doing round the clock pumping and no nursing, I have to tell you that pumping is much less effective at encouraging milk supply than offering the breast more often.
Furthermore, and I know this first hand, the extra time messing with the pump and the SNS and/or the bottles takes a lot of time, and that's time that would be more effectively used at offering the breast more often. In the time that it takes to pump and deal with the SNS, you could feed twice from the breast and put a lot more milk into your babies.
Now, forgive me if I'm asking the obvious, but are you feeding the babies one at a time, or both at the same time? Because I have read that mothers with twins, even those mothers without the two extra 2.5 year olds running around, feed both babies at the same time so that they can get fed often enough. (I apologize for guessing because I don't have any experience about twins, but I thought some of my friends with twins mentioned that unless you feed the babies simultaneously, then there just aren't enough hours of the day to feed the twins.)
Okay, so again keep in mind that I know nothing about twins. But here are my thoughts. My first choice would be to offer the breast (no SNS) a couple more times a day instead of, or in addition to, pumping. Second choice would be either bottle or cup. Second choice would be cup if you had legitimate concerns about nipple confusion, but I don't understand why there should be worry about nipple confusion because breastfeeding babies often get introduced to bottles at age 3 months without any problem with nipple confusion. If the baby were just a few weeks old and nursing relationship has not yet been strongly established, then I could understand the fear of nipple confusion. The problem is that, in my experience, the cup is very time consuming and messy, or at least it was when my dd was 4 months old. When my dd was 4 months old, one measly ounce took 45 minutes, and the sitter ended up wearing a lot of that ounce. By comparison, at three months old, my dd was able to put a way a lot more than one ounce in a single nursing session, and she was able to do this even though was a super slow nurser. So I can't really think why you would choose a cup over adding extra nursing sessions (no SNS). Bottle would be fine for a strong nurser, as long as you pump at least once (perhaps twice) for each bottle feeding session in order to prevent your supply from dropping. If you worry about nipple confusion, then you should use the slow flow nipple, and not the fast flow nipple. The only advantage that bottle or cup has over more nursing sessions is that the bottle or cup can be done by Daddy or someone else, but it seems to me that the time saved by having someone else doing the bottle or cup feeding would be offset by time that you would lose by adding the extra pumping session to keep your supply from going down. So it just seems that given the choice between bottle and extra nursing sessions, the extra nursing sessions would be more effective and less work.
BUT, and this is a big but, I don't have four children (two of which are nursing), so what seems to be less work for me might not be true for you.