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Discussion Starter · #1 ·
I am sitting here with a 104 fever and mastitis for the 6th time in the 4 month I've been pumping for my twins.

I pretty much exclusively pump for their nutrition, but let them comfort nurse as needed. They don't get enough nursing to maintain their weight, even after multiple nursing vacations, nipple shields, ect.

I seriously don't know what to do. I can't keep getting infections every two weeks. The antibiotics kill my supply, I'm not able to care for my twins when I'm sick, and I've even ended up in the hospital twice. They've never had formula, except the first couple days in NICU before my milk came in. . I provide 80% of their nutrition and use donor milk for the rest.

I want them to get breastmilk. It's their birthright and they deserve the best. I know the risks of formula. I DON'T want that... but I don't know if I can keep going this way. For one thing, the mastitis (or the antibiotics) kills my supply. I have to use more and more donor milk during each attack. I'm running low.

I don't think it's my pumping habits. I pump at least 6 times a day, usually one a power pump. I don't go more than 6 hours without pumping, though mostly it's 4. It's not easy finding time to pump with twins, I don't know that I can find any more time. I pump every single time they're both occupied or asleep. I can leave them to cry while I pump more, but I don't like that idea either.

Someone's got to help me. I don't know what to do.
 

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Oh big hugs, mama! First of all, you may not feel like it but giving your twins breast milk for the first 4 months is quite the accomplishment! Congrats!! Pumping is hard work and you already have double the work, or more, with two babies!

The first thing I would be looking for in your case would be improper treatment of infection. Maybe you need a different antibiotic or a longer therapy. It seems like keflex, dicloxacillin, and erythromycin are the most effective choices for mastitis. In your case I would say at least 14 days. Amoxicillin is not an effective treatment (in general).

Other things I'm thinking - are you using the correct size breast shields so that all the milk is being drained? Are you pressing into the breast with the shields? Is your immune system otherwise compromised - I'm sure you have late nights, early mornings and all sorts of other stressors! Are you taking a daily vitamin? How about adding some vitamin C and garlic to strengthen your immune system? Eating and drinking enough? I like how you said someones got to help you! Is there anyone, friend or family, that could give you more support? If someone offers you help take them up on it - yes, it would be great if you could bring dinner by one night, mow the lawn, pick up some groceries for us!

Good luck.
 

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: to the above


Definitely need to look into WHY it keeps coming back. Either the bacteria is not being completey killed and is just rebounding or you aren't getting your breasts drained well. I would think it's the former if your supply is low to begin with.

How about probiotics? Are you taking any? What strength? How often? You need to rebuild your body's normal flora and it will help you keep the bad bugs at bay. I take Reuteri when I get sick with the boobie fever.

Lots of love coming your way. It was hard enough to exclusively nurse twins, pumping would have made me completely crazy.
 

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That sounds so difficult! It sounds like you are trying so hard to bf your babes and doing well in light of the circumstances.

I don't have any advice except to say that if you try suggestions offered here by other mamas and for some reason mastitis continues to plague you or your supply drops low or you are not able to fully bf your babes anymore for any reason, IT IS OKAY. It is NOT your fault. You'll know that you gave it a hugely honest try. At some point there are decisions that need to be made concerning how you can best take care of your babies and yourself (b/c you need to be well to take care of your babies, too). If you need to switch over to a mix of donor milk and formula or all formula, that is just fine; your babies will continue to thrive!

I hope that bf-ing will take a sharp turn for the better, but above all, I wish you peace with whatever outcome.
 

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Just sending lots of hugs and good wishes your way. I don't know if you know the LLL leader in your area, but I found mine was incredibly helpful during some difficult early twin-nursing times. She had all sorts of ideas I had never considered (and some of them worked!). Just another idea, and tons of hugs.
 

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Discussion Starter · #6 ·
Thanks for the hugs and thoughts. I think the main problem is that I'm very allergic to penicillian and sulfa drugs. All the main effective drugs against mastitis are off-limits to me. So I'm taking an ineffective antibiotic in large doses, trying to get rid of the infection. It's not working very well, which means the mastitis keeps coming back, and probably will keep coming back until I'm done pumping.

I'm going to take a lot of these suggestions to build up my immune system and try to get rid of it that way. I'll get some probiotics and vitamin C and probably start taking garlic regularly.
 

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Hugs! I had recurring mastitis early on and almost threw in the towel. I started taking lecithin capsules (1 capsule twice a day) and haven't had a problem since (and that was 3.5 months ago). I'd highly reccomend starting that - it thins your milk to prevent clogs. Also the last time I had mastitis my midwife told me to take two homeopathics to treat it and it worked. I took both phytolacca and brionia - both in those tiny balls by bioron. I can't recall the stregnth she mentioned but I bet you can google it. I took both every few hours for a day or two and it cured me. I never had to use the antibiotic she prescribed just in case.

Best of luck! You're doing so awesome feeding two babies!

Cindy
 

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Have you tried to use cabbage leaves? They work better for me than anything else I've ever tried. Rinse a leaf, pat dry and put it in your bra. Change when it starts wilting. Relief comes very quickly. Maybe you could try it while you take the antibiotics to make them more effective?
I'm in awe of anybody who can breastfeed more than one baby at a time...that's awesome and I hope you feel better soon.
 

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I am amazed that you are able to pump 80% of their milk! Way to go!! That is really an accomplishment, especially considering the mastitis and how hard the first 4 months are with twins. We had a really rough start too, I know how hard it is to get two preemies to learn to nurse AND be pumping.

I'm really surprised that you can pump that much milk but they wouldn't be able to get enough by nursing. That sounds so strange, because you actually produce more when nursing than pumping. Do they have latching issues...?

You might already know these, but putting it out there just in case:

* Many MOMs report that their twins tend to need to nurse more frequently than singletons. Maybe to keep up supply? They may need to nurse as much as every 1-2 hours all day. To help my smallest gain weight I actually offer her the breast every 1-2 hrs, so even before she starts signaling that she's hungry.

* Nipple shields restrict the flow of milk. Mine were having trouble holding the latch when they were preemies, so I used the shield. But then they weren't able to get a full meal and it turned into a vicious cycle with formula and bottles for us. Getting rid of the shield when they were old enough actually made a huge improvement.
 

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Quote:

Originally Posted by Spring Lily View Post
* Nipple shields restrict the flow of milk. Mine were having trouble holding the latch when they were preemies, so I used the shield. But then they weren't able to get a full meal and it turned into a vicious cycle with formula and bottles for us. Getting rid of the shield when they were old enough actually made a huge improvement.
^^agreed - i think the nipple shields really messed me up. ditch them asap! i'm currently supplementing w/ formula, and i often wonder if my supply issues are due to not responding well to the pump (awesome you can pump 80%!!!) and the shields. if they can get 80% with them, i wouldn't be surprised if they can get 100% without!

my boys currently get about 50/50 breastmilk/formula after trying everything. i got to a point where i couldn't do the pumping any more - i have no help and so no time., huge kudos to you - you are [email protected]!!!!!!
 

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Discussion Starter · #11 ·
The main problems we have with actually nursing are..

My daughter has a very weak suck. She's actually got a great latch, but can't get enough milk on her own. She's working weekly with a speech therapist and I'm hoping we'll get her nursing enough to maintain her weight eventually.

My son has a terrible latch. He resists every effort to latch without the shield. We try several times a day, but it's not working so far.

And our main issue... I've got inverted nipples. I thought all the pumping would resolve it eventually, but it didn't. Even when pumping they don't extrude. I try to latch the babies anyways, but they just struggle the whole time to stay latched. I don't know that I'll ever be able to latch without the nipple shields.

Combine the above problems with recurrent mastitis, allergies to effective antibiotics, ect....

I don't know. It seems sometimes that everything is working against me. I honestly don't see a way to get rid of the pump
 

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wow, feeding twins must be tough enough and dealing with recurrent mastitis on top of that! you are a super mamma!

one thing that comes to mind when reading your post though--do you think you are pumping often enough? i think to avoid mastitis, esp if you are particularly prone to it, you need to pump every 2-3 hours. i have read several places to never go more than 3 hrs without pumping. i think i read that you pump every 6 hours?

lechitin is also recommended but i am not sure of the dose. i think a pp mentioned this already.

good luck. i hope you are able to find a solution where your twins are still able to get breastmilk.
 

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Discussion Starter · #13 ·
Not every 6 hours... at least 6 times a day. I usually pump every time the babies are asleep or otherwise occupied. Sometimes I manage to pump 8 or 9 times a day, but I always make sure to get at least 6. I also pump several times at night, since they're sleeping 8-10 hours a night. It helps to keep ahead of them during the day.

I do give myself 5-6 hours of sleep at night. I found my supply actually went up when I started sleeping more.
 

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Quote:

Originally Posted by pbjmama View Post
The first thing I would be looking for in your case would be improper treatment of infection. Maybe you need a different antibiotic or a longer therapy. It seems like keflex, dicloxacillin, and erythromycin are the most effective choices for mastitis. In your case I would say at least 14 days. Amoxicillin is not an effective treatment (in general).
Congrats on making it this far. You've already made such a big sacrifice for your babies!

I second keflex if you haven't tried it yet--and most people who are allergic to penicillins can still take it (I had no reaction during my c-section or 6 wks PP).

It doesn't sound to me like you're going to be able to get rid of the pump either. I would suggest trying some of the things that have been suggested here, but if its not working for you, that's okay too. Obviously you know and want to do what's best for your babies. Remember, your health (emotional/mental health too) is very important to them! Good luck with your decision. Please give yourself credit for what you've done for them so far.
 

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Discussion Starter · #15 ·
Unfortunatly, I can't take Keflex. We tried it twice, but I started having breathing trouble.

I went out ant got some vitamin C, probiotics, and soy leichen. (sp?) I really want to get to at least a year, but I'll be happy at this point for 6 months. Though, honestly, I'm taking it day by day and hour by hour at this point.
 

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Skybluepink02, I think what you've done is amazing! I'm not a mama of twins (I have one wonderful girl :) ), but am I an EPer and pumping is a lot of work on top of everything else! And that's before mastitis. So, whether or not you decide to continue, I hope you'll give yourself big applause for all you've done. You deserve it!

Quote:

Originally Posted by skybluepink02 View Post
Thanks for the hugs and thoughts. I think the main problem is that I'm very allergic to penicillian and sulfa drugs. All the main effective drugs against mastitis are off-limits to me. So I'm taking an ineffective antibiotic in large doses, trying to get rid of the infection. It's not working very well, which means the mastitis keeps coming back, and probably will keep coming back until I'm done pumping.
I'm allergic to 5 classes of antibiotics (including everything in the penicillin family and all the sulfa drugs), so I too had the challenge of finding something that I could take. Although I was told that it was not usually prescribed for mastitis, because of my allergies, I was prescribed Clindamycin and it did clear up the infection.

One other thought: are you sterilizing your pump parts between each pump? A couple of lactation consultants we saw said that was not necessary so initially we didn't. As I got recurrent yeast infections, I mentioned this to my OB and my daughter's pediatrician and both highly recommended sterilizing the pump parts between each pump. I got more than one set so I wasn't have to clean things all the time and usually I run them through the dishwasher. To be balanced: I have gotten mastitis once and some yeast infections even when I was doing the cleaning the pump parts between each pump routine, but my breasts are definitely happier and healthier overall. It might not help, but it probably won't hurt.

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Originally Posted by skybluepink02 View Post
I do give myself 5-6 hours of sleep at night. I found my supply actually went up when I started sleeping more.
I too find my supply increases when I'm better rested!

Quote:

Originally Posted by skybluepink02 View Post
I really want to get to at least a year, but I'll be happy at this point for 6 months. Though, honestly, I'm taking it day by day and hour by hour at this point.
I applaud you on the hour by hour, day by day approach. When I first starting pumping, I wasn't sure how long I keep up with pumping, but I thought "if I only do this once, it's a bit more milk that she's getting." And then with each pump, I thought, "I'm committing to this pump and I'll decide about the next one in a few hours." And slowly it began a routine and then I thought, "well, I'll pump for another week at least." And then weeks became months. And now I'm still pumping after 14.5 months! :)

I do think it's so important to take care of yourself. As my DP reminded me frequently, the pumping is good, but being able to be a happy, healthy, rested mommy is even more important. We agreed that if pumping got in the way of that, it wasn't worth it.

I'll be thinking good thoughts for you. And last, but certainly not least, congratulations on the birth of your twins! :)
 
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