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Thread: Breastfeeding Twins

  1. #1

    Default Breastfeeding Twins

    My b/g twins are 4 weeks old and b/c there was concern with their weight gain, the last 3 weeks consisted of breastfeeding 1 and supplementing with expressed milk and giving expressed milk to the other baby and swapping at the next feed. During this time, I was also pumping after every feed and generally feeding every 3-4 hours.

    Since my 1 mth visit w/ pediatrician, I want to go back to exclusive BF but at this point, the babies are feeding on demand and I want to work towards tandem feeding and on a more fixed schedule.

    Can anyone please provide me with some tips and tools to help me achieve my goal? I am so lost now as I have been instructed by my pediatrition to BF both babies for 40 min., then offer a bottle supplement (expressed or formula) and b/c i feel that have oversupply from all the pumping I have been doing, I also need to pump often to relieve my discomfort. Meanwhile worrying that if i pump too much i dont have enough milk for whoever wakes up for the next feed.

    At this point, feeling completely overwhelmed by what I am suppose to do and not sure if I am doing the right thing towards the right goals?

  2. #2
    Join Date
    May 2006
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    20,799

    Default Re: Breastfeeding Twins

    Welcome, mama! Before we start in with advice, can you post your babies' weight history for us? Birth weight, lowest weight, weight at each check-up. That will help us judge whether or not there's truly an issue that requires supplementing, or whether your doc just has you working your tail off for no reason. Also, can you tell us how breastfeeding is going for you? Is it comfortable to nurse, and how do the babies do at the breast? Do they feed actively, or do they doze off quickly?

    I can understand your desire to have the babies on a schedule, but believe me when I say that breastfeeding and schedules do not mix! Scheduled feedings almost always result in miserable, hungry babies who don't understand why they have to wait to eat, a miserable mom who feels like she must ignore her instinctive response to her babies' cries in order to stick to an artificial schedule, and a lowered milk supply. Milk is produced on a supply = demand basis, and if you restrict demand your body interprets that as a reason to reduce supply.

    You're doing something truly amazing right now, and I know that it's incredibly hard work. Nursing one baby is immense work when everything is going perfectly. Nursing, pumping, and supplementing one baby is even harder. And multiply that work by two... You deserve a really big round of applause for making that happen! It will get easier, I promise.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: Breastfeeding Twins

    Hi Mommal, thank you for your reply. I try my best but i just feel like I'm not sure what I am doing and I really could use some guidance so i know i'm on the right track.
    I also need some order in my life with these two and if their feeding and sleeping can have some resemblance of a "schedule" (as in at least feeding together and sleeping together) then i can feel like I'm not all over the place with them.

    Here's their birth history: (they are 1 month and one day old today)
    Baby Girl: Birth weight 2.6kg, 1 week 2.5kg, 1 month 3.3kg
    Baby Boy: Birth weight 2.8kg, 1 week 2.6kg, 1 month 4kg

    During the first week, I breastfed both and supplemented, but b/c they lost some weight, we were told to supplement more. Breastfeeding however, has not been a bad experience so far. I dont get sore nipples thank god. Baby boy feeds much better and appears to suck much faster than baby girl. However, they both fall asleep quickly once on the breast. I also think they are latching properly and quickly but baby girl is much more lethargic on the breast whereas baby boy will suck continually mostly. Also, once I give a supplement bottle, they can both eat up to 120ml so it seems they aren't even feeding well from my breast.

    At this point, I am trying to tandem feed several times a day, but every time i have a chance to feed them together, they both appear hungry soon after but at different times. So hence, i end up putting them back on the boob individually and the following feeds afterwards are all scattered and I dont feel like i can get them back on track together. Not to mention getting them back to sleep is impossible it seems. Whereas every other forum thread i read, indicates that other babies sleep so much, why aren't mine sleeping alot too?!

    Lastly, I think i have engorgment issues and/or OALD since my right boob is constantly spraying the children's face with milk. My boobs always feel extended and I have tried to pump less to prevent further upping my supply since yesterday. how and when can i get my boobs to get in sync with my children if I am constantly feeding two kids?

  4. #4
    Join Date
    May 2006
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    20,799

    Default Re: Breastfeeding Twins

    Thanks for answering my nosy questions! Based on what you've posted, it sounds like you may have been talked into supplementing when you didn't really need to. Babies are supposed to regain their birthweight by 2 weeks, and yours were close by one week. Some weight loss in the first few days of life is normal, and as long as the babies do not lose 10% of birthweight the weight loss should be considered to be in the normal realm, and not necessarily cause for supplementation.

    The fact that your babies latch on nicely and that you are not in pain when you nurse suggests that the basics of breastfeeding are pretty good! New, small babies are frequently sleepy at the breast, but there are ways to cope with that, including:
    - Keep the babies cool, because a cool baby is an alert baby. When it is time to nurse, strip them down to a diaper or onesie, and keep a fan blowing in the room you're in.
    - Keep the lights dim. New babies sometimes close their eyes in response to bright light.
    - Switch nurse. Babies find the breast a very comfortable place to be, and often doze off as a consequence. But you want your babies to be businesslike at the breast. So, the moment they seem to be nodding off, take them off the breast, burp them, change their diapers, and switch them to the opposite breast. This will teach them that nursing and comfort sucking is going to be rudely interrupted unless they stay active.
    - Use breast compressions to speed the flow of milk.
    - Annoy them. An annoyed baby is an alert baby. Tickle the soles of their feet, rub them with a wet washcloth, rub a wet washcloth against the grain of their hair.

    Babies who get a lot of bottles are often lazy and sleepy at the breast, because they know that they will eventually get fed via bottle. But taking a big meal from a bottle does not necessarily mean baby isn't getting much milk from the breast, because the mechanics of bottle-feeding are different from those of breastfeeding. A baby doesn't need to latch well or suck well in order to get milk to come out of a bottle. The milk just drips continuously, even after the baby has transitioned from sucking for food and is only sucking for comfort. This means that most babies will eat significant amounts of milk from the bottle even after a good nursing session.

    I don't know much about nursing twins, but my understanding is that you want to try to tandem nurse them every time to help them synchronize their feeding patterns. This may mean putting one baby back onto the breast even though she/he doesn't seem hungry.

    Getting your breasts to be in sync with your babies is generally as simple as nursing on demand and not pumping. Because you got thrown this curve ball where you've been supplementing, you haven't been able to forgo pumping and simply nurse. But at this point, I think that's what you want to strive to do- phase out the bottles, nurse the babies, and watch your body adjust to supplying just the right amount of milk. I think it might be a very good idea for you to see a lactation consultant, preferably an IBCLC, for some hands-on help in making that happen.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  5. #5
    Join Date
    Mar 2006
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    10,440

    Default Re: Breastfeeding Twins

    Hi mama,

    Congratulations on the twins. There are several mamas with twins here, and hopefully they chime in here.

    At this age, you are constantly feeding babies and Mommal is right. From what I know, you try to tandem nurse every time. Not saying at all that if one baby is hungry to not feed the one until the other me is ready, but you feed before they are starved. Does that make sense? You wake the sleeping one and feed.

    Pumping....probably really sucking a lot of time. I would quit that and just nurse. Feed baby girl on the side you are engorged more on, as it might help her to stay awake if the milk comes down faster.

    Every baby drinks milk from a bottle if presented with one at this age. They have no choice in the matter. It's drink or drown. So they drink. And so they get overfull.

    It's very typical for babies to need to eat often, like every hour or so. Three of my four were like that, even the bottlefed one (I EP for him, due to a cleft palate). Ate.all.the.freaking.time. It's exhausting.

    Try laying back in bed and nursing. And breast compressions, tickling their ears, things like that may help them stay awake a but longer.

    You can do this
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  6. #6
    Join Date
    Jun 2009
    Posts
    5,257

    Default Re: Breastfeeding Twins

    May I suggest the book Mothering Multiples? The author also has a website as well, with lots of pictures of mommas doing different twin nursing positions. http://www.karengromada.com/

    I also strongly urge you to get the book The Womanly Art of Breastfeeding (8th edition, 2010.) This is the most comprehensive and up to date science and evidence-based breastfeeding manual available to mothers, and it will clear up many concerns & questions you may have.

    I think it is really important to understand what is normal and expected with newborns, in terms of weight gain, nursing behavior, and general behavior. Because breastfeeding is so poorly understood or not respected by some in the medical professions, babies are notoriously given unneccesary supplementation, and this leads to any number of issues. I cannot speak to as whether that is the case here. But it is something you might want to consider.

    Generally speaking, mommal is correct, and sceduling feedings is not helpful for breastfeeding or for babies. But...

    Sometimes a mom with twins does feel she needs to schedual for her own sanity, especially if she is pumping and supplementing and all that as well! So the first thing to figure out is-do you need to be supplementing and pumping? If you don't, or you can at least cut back on that, that will help simplify things alot. But even so, you still may want to schedual feedings. OK.

    As long as you understand good breastfeeding management, and what is normal behavior for young babies, & unerstand that babies nurse for food and comfort and that is part of the whole process that allows babies to get plenty to eat and keep your milk supply where it needs to be, it is likely OK to schedual as needed if you cannot function any other way. Figuring out tandem nursing works for many moms but not all. The point is, to arm yourself with solid breastfeeding and new baby knowledge and then figure out what will protect your milk supply and also work for you and your babies.

    There is a specific multiples forum here too, and your local LLL Leader may be able to put you in touch with other local moms who are nursing twins. Go to a LLL meeting if you can!

    and here is a nice article about what is normal and expected in the early weeks: http://www.kellymom.com/bf/normal/newborn-nursing.html

  7. #7

    Default Re: Breastfeeding Twins

    Mommal - thanks for your tips. I have attempted more tandem feeds, but its tough when both babies seem to be on their own schedules. But they are also tandem feeding better since I've been putting them on the breast at every feed and they are getting more use to it.
    I've also started pumping less and only pump to the point where the pressure is decreased in the breast. This has helped getting my breast slightly more in sync with the babies needs. hopefully it will continue to be more regulated soon.

    I'm meeting w/ a lactation specialist this week so hopefully I she can identify additional issues or provide more tips on how I can breastfeed more efficiently with the babies.

    Aprilsmagic - your tip on putting baby girl on the more engorged breast definitely makes sense and will surely keep her on her toes! And the more reclined feeding has appeared to help with the milk spraying! thanks.

    lllmeg - I do have a copy of mothering multiples. I think I will need to go back and see if theres anything in there to further assist me in going back to the breast.
    schedules, you're right, I was so hung up on trying to work towards a schedule to help me keep my sanity that I think I have myself and the babies too much pressure. FOr now, I'll just try to work towards tandem feeding, and weaning them off the bottle and trying to get my breasts to sync with their needs for now. I will think about scheduling them a little later when they are more comfortable with the boob again.

    As I am currently living in Sao Paulo Brazil and do not have access to twins groups or LLL meetings, all your comments, encouragements and tips have really given me hope and peace of mind that I'm heading in the right track. Thank you so much and happy new year!

  8. #8

    Default Re: Breastfeeding Twins

    Hi!

    I am a new mom of twins and am exclusively BFing. By the way, I was also told I needed to supplement at the beginning but I quickly cut that out when I got better (from a LC) advice. I also was pumping for a while - first to increase supply, then to relieve pressure. Here's the advice I can offer:

    * Find yourself a great LC to come to your home - it made all the difference to me, and BTW I went through two before I found the right one!

    * For the sake of sanity I tandem feed on cue - whoever's hungry first initiates feeding for both. For me, that means my son pretty much always initiates feedings, but my daughter always eats regardless. I aim for feedings every 1.5 - 3 hours and never let more than three hours pass (except at night now that they're a bit older). My LC advised feeding for 20 min, but I go until they seem satisfied.

    * Once the supply was good I pumped only to comfort until after a couple weeks I didn't have to pump at all anymore.

    I hope that helps a little! I also had no idea how hard it would be! At about the 2 month mark we all became happy, comfortable, and organized, but it did take that long and it wasn't easy! But it has definitely been worth it!

  9. #9

    Default Re: Breastfeeding Twins

    Roebling, i am so envious of you being able to tandem feed. I try tandem feeding at least once a day but i find that my twins feed better individually. Plus I dont have a proper pillow that helps support them for tandem feeds so I end up demand feeding these two little ones. I generally feed them between 20-30 minutes now and they are already slowly starting to decrease their bottle supplement in take. I'm assuming that means that they are sucking well on the boob.

    but its encouraging to know that it is possible to bf exclusively as i was a bit concerned if my supply would meet their demands without needing to supplment. twins are only 1 month and 1 week old at this point. lets see how we progress.
    Mother of B/G Twins

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