TWINS - need advice boosting supply

[@llli*doubledragons]

Hi! I'm a first time mom of twin boys born at 38 weeks (full term!) on May 7 and May 8, 13-1/2 hours apart; they're 4 weeks old now. I know the advice is to BF within the couple of hours of delivery. Because I was still in labor with the second baby my first baby didn't nurse until his brother arrived. The only bonding I was able to do with baby 1 was skin to skin while I was still in labor. I feel like it delayed our bonding and stunted my milk. And I had some random infection after while still in the hospital which made me exhausted and made it difficult to nurse.

Baby 1 lost 12% of his 6.3 birth weight and baby 2 lost 10% of his 7.2 birth weight; baby 2 had some high jaundice and their ped was fine with BF but we also wound up supplementing formula in the hospital to get their weights up and flush out the jaundice; we are still supplementing. (We're probably at 85% milk, 15% formula.) The advice I got from the hospital LC to increase supply was to pump, pump, pump 8 to 12 times a day with a minimum goal of 6 times a day, so we rented hospital grade machine and I feel like now all I do is pump, though I've never been able to fit in more than 6 pumps a day with the need to sleep and feed myself. I don't feel like my supply is boosted and now they're taking more at each feeding (100mls each!) and am concerned I'll never be able to catch up to their need.

I BF either one of them maybe once a day. I feel really guilty that I'm missing out on the bonding and find when I nurse one it's so easy. (I've tried tandem and am not sure I'm coordinated enough to do it on my own.) But if I nurse them one at a time then that's all I'd do all day and frankly, at 3 am it's nice to have my husband in their room with me, feeding one of them.

So, I'm looking for advice on how to boost supply as well as strategies for efficiently nursing them throughout the day and would I still need to pump to boost supply? Maybe I switch them off during the day? Nurse one and bottle feed milk to the other? Thank you for your help/advice.

[@llli*mommal]

Welcome to the forum and congratulations on the new babies! How wonderful that they arrived full term, at terrific birth weights, and- I am assuming- vaginally? Having all three of those things at once is becoming rare for twins, but your LOs are lucky to have been given such a great start.

Your LC gave you good advice about pumping. The best way to increase supply is to remove more milk more frequently. Babies are usually better at removing milk than even the best pump, so I think the best thing for you to do would be to simply nurse the babies as much as possible while watching their diaper output very carefully. As long as diaper output stays on track, you can be sure that your babies are getting enough to eat.

I can only imagine the special, time-consuming challenges of nursing and mothering twins. That's why I hate advising you to work even harder than you already are! But the mechanics of milk supply are the same whether you are nursing one baby or three babies: remove more milk more often, and nurse the baby or babies directly and on demand, and supply should be no problem.

How about going back to the LC, or to a different LC, for help on positioning the babies so that you can nurse them simultaneously?

[@llli*aprilsmagic]

Nurse, nurse, nurse. Pump around nursing. Babies are better for your supply than any pump.

It sounds like you are EPing. And that IS a drag. You can work back to breastfeeding instead of pumping by nursing

I have several friends who have successfully nursed twins and even triplets, so it CAN be done.

You need to find a different LC to get help on nursing them at the same time.

[@llli*lllmeg]

Congratulations on your babies! Here are a few suggestions-

Contact your local LLL if you have one, even if you don't, just contact any LLL groups you can find. They may be able to put you in touch via phone with other nursing twin moms or Leaders with twins. It would really help to talk to experienced moms who have been there.

Get the book Mothering Multiples and/or visit the authors website: http://www.karengromada.com/ Lots of pictures etc. of tandem nursing positions, tips etc.

If you truly have low milk supply, the book Making More Milk covers all the many ways to increase it. The website www.kellymom.com has v. good articles on low supply. But I agree with pps-nursing frequently is the single best way to increase supply, it is often all that is needed. If your babies cannot nurse, then pumping frequently is in order, but if your babies can nurse some of the time, no reason they cannot nurse most or even all of the time.

It is different for moms of twins and sometimes a supplemental bottle from dad or another helper or feeding scedules make sense for twin moms when they really do not make good breastfeeding sense in the early weeks with singletons. Good general early breastfeeding management (nurse frequently, do not supplement or pump unnecesarily) is the same no matter how many babies there are, but the fact is often twin moms are in that newborn survival mode much more intensely and for longer than moms of singletons. So you have to do what is going to work for you. But if you can adjust things so you do MOST of your feeding at the breast, rather than almost none of it, you will be able to eliminate so much pumping and that will usually make life waaaay easier.

[@llli*doubledragons]

Thank you so much. It's encouraging. I joined LLL and attended a meeting about a week before I was put on bed rest. I haven't yet made it to a live meeting because the idea of getting them both organized and out the door without help sounds so overwhelming right now. I borrowed Mothering Multiples from them and read a lot of it. I know there is a twin mom leader in our group and my husband and I joined a parents of multiples group early in the pregnancy and I know some twin moms there were able to successfully breast feed both babies. I think I just have to jump in the pool as it were, and get out in public. Oh, and I don't think I have low supply per se, just not quite enough for two. If we had one or one and a half babies we'd be golden.

[@llli*lllmeg]

Your LLL Leader(s) should be available by phone. No need to wait for a meeting for help! Call the twin mom Leader-we all signed up to take help calls- that is our "job" as an LLL Leader. If you cannot get in touch with a local Leader, please feel welcome to pm me.

If you have twins and "don't have enough for two," then you have low supply. Biologically speaking, mothers are perfectly capable of making enough milk for twins.

edit: just to clarify, of course it is possible you do not make enough and also possible you will not be able to increase supply enough, in which case supplementation is needed, and that is fine. But too often, it is assumed it is biologically normal for a mother to not be able to fully nurse twins. I disagree with that, twins are relatively common biologically speaking and so being able to nurse twins should be just as common. This mindset that mothers cannot make enough for twins often undermines moms of twins from breastfeeding should that be their desire. When it comes to supply, you or any other mom of twins can use the same milk increasing techniques a mom of a singleton would in order to boost supply, and probably see at least some result.

[@llli*newmom1987]

I agree with the above comments, nurse, nurse, nurse. As being a twin myself(have a twin brother), I can still hear my mom telling me how she nursed us. Shs tells me you were up at 1am to nurse, and then your brother would be up a 2am to nurse, and then you at 3am to nurse, and your brother at 4am to nurse, and the cycle kept repeating. But she did it and ebf my brother and I for 6 months. Yes it will be exhausting, one is exhausting at times, but that is the best way to build up your milk supply. Keep practicing the tandem nursing, you might be able to get the hang of it after all. The bonding is one of the greatest rewards I get from breastfeeding, I wouldn't want any other mother to miss out! You are doing amazing. Good luck to you.

[@llli*aprilsmagic]

The way my ladies have BF twins was to cradle hold one baby and football hold the other. They need pillows. At first they latched one baby on, put pillows to hold that baby then latched the second. Someone can demonstrate this for you. If one woke to nurse, they woke the second or dreamfeedingher the second so nursings were simultaneous as much as possible.

One pumped some (but she was also following BabyWise and therefore scheduling which is bad for your supply) but the other three did just fine and never used a pump or bottles after the babies were released from the hospital. So yes, it can be done, it is biologically normal. Just hang in there and keep working on it.