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Thread: Woe is me - trying to keep supply up with 6 mo twins

  1. #1
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    Default Woe is me - trying to keep supply up with 6 mo twins

    I have 6 month old twin boys whom I have been exclusively breastfeeding since birth. Up until a few weeks ago all was going swimmingly. I was always fighting supply (had to be diligent about pumping exactly the amount of expressed breastmilk they were fed etc.) but was hanging in there. They're huge so I can only assume they were getting enough. They were feeding on demand every 2 or 3 hours and were eating 3 or 4 times each during the night for 5 months.

    Then I reached my breaking point and comforted them through feeding times during the night and eventually did the evil cry it out. I just couldn’t keep up with the nightly feedings. 6 times a night is a lot.. Until that point I was sleeping with one or the other of them just to make life easier. I was also advised by every twin mom out there that I was an idiot for not having them on a schedule. So I tried that too. Every 3.5 hours. And all of this ended up in a big, guilty disaster i.e. a substantial supply drop.

    Since they go to bed at 7 I generally spend much of the evening pumping. So during the day they get the breast, what I pumped the night before (17 oz or so) and about 12 ounces out of the freezer. The only time they don't get topped off, so to speak, is after the morning feeding. And then I nurse them at 7 and again at 8:30 before their nap.

    We go the pediatrician tomorrow so I assume we'll be starting with solids after that. Do you think this will help me get back to exclusive breastfeeding? We're going on vacation in 3 weeks and I can't even imagine bringing all these bottles. And the hospital grade pump certainly can't travel (I do have a PIS). So I'm desperate to fix this in a hurry. Another obstacle is our 2 year old. I try to spend as much time with him as possible. So spending a few days in bed breastfeeding the little guys really isn't an option. Unless it's my only choice, of course.

    I suffered through the really dark days of breastfeeding newborn twins and I hate to quit when it's getting more pleasurable for us all.

    I feed them one at a time (never could master the both at the same time thing) and drink 3 or 4 cups of Mother's Milk tea a day (and have been from the beginning).

    Any suggestions? I would be really devastated if this were the end. The topping off thing is a very slippery slope and my frozen stash is nearly depleted. I just bought some organic formula but am desperate not to use it.

    Help! I was planning on going another 6 months AT LEAST!

    Thanks in advance for your help.

  2. #2
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    vacation with 6 month twins and a two year old your brave
    I've never had twins before so I cann't give you any good advice.
    I know it must seam like nursing babies is all you get done?
    do they sleep all night long? I don't know what I would do..
    don't feal bad if you have to add some formula! Thats not so bad! any amount of breastmilk is good for baby!
    good job mom!
    you should check out that book:

    MOTHERING MULTIPLES: Breastfeeding and Caring for Twins or More! Revised Edition.
    By Karen Gromada

    Mothering Multiples covers all aspects of caring for multiple babies including possible complications of pregnancy, preparing for a multiple birth, coping with newborns who might need to spend time in a NICU, establishing a milk supply for multiple babies to adjusting as a couple, and caring for toddler multiples. A La Leche League bestseller for 15 years, this revised edition provides updated information based on current research as well as the experience of parents of multiples. Also available in a gift pack Softcover, 380 pages. No 143-12

  3. #3
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    Hi there!

    First of all, <<<hugs>>> to you! You are doing so great! What a wonderfully huge job it is to provide BM to your twins and have a toddler to care for as well. You sound like a truly committed mom and I would hate for you to feel guilty. We all do the best we can do at the time and you have been doing great!

    Maybe with a little support and information we can get you back on track. If you could take a look at these questions and get back to me with some answers I can try to help you see what is going on.

    May I ask how do you know you have had a big drop in supply?
    How can you tell that they need to be "topped off" after feeding at the breast?
    Can you provide growth stats for the babies? (Birth weight, lowest weight, current weight)
    How have their wet/dirty diapers been?
    Am I to understand correctly that they are sleeping from 7pm to 7am without waking?
    How many times in 24 hours are they nursing?

    Again, let me just reiterate...WOW! You have been doing a tremendous job and should be very proud of what you have done so far!

  4. #4
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    Thanks so much to both of you. Kate - to answer your questions...

    I guess I just assume that my supply has dropped because the boys will drink 5 ounces or so each of pumped milk after I nurse them. They nurse, are ok for 15 minutes or so, and then get very cranky and show all their hunger signs. And they suck down that bottle like they've never seen food before. After that initial feeding one acts frustrated and the other disinterested. The frustrated one has two teeth so offering him the breast when he's frustrated is a little scary. He bites me at least once a day and although he's the chubbier one has always been the less efficient nurser/less good latcher.

    Growth stats: they were 6lbs 9oz and 6 lbs 10oz at birth. They lost a little more than 10% of their bodyweights in the hospital but were quick gainers once my milk was in full gear (had a c-section). Now they're both around 20 lbs (I'll know exactly after their doctor's appointment tomorrow).

    I've long since stopped counting diapers. Should I start again? In fact they've both had some wattery poops lately which I chalked up to teething.

    Indeed they're sleeping from 7ish to 7ish without a peep. I'll pump in the middle of the night if I have to but I'm still in recovery from the first 5 and a half months. Should I?

    They're nursing, on average, about 6 times each per 24 hours.

    What are your thoughts on Domperidone? Or am I just lazy and looking for a quick fix?

    Breastfeeding them was difficult but not impossible. This nursing/pumping business is just about killing me though!

    Thanks so much for your interest and help. I really appreciate it.

  5. #5
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    Oh, just one more thing to throw into the mix before I answer:

    Could you be pregnant?

    (Not to totally throw you off your rocker, but just thinking of all things here!)

  6. #6
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    7 IVF cycles later I doubt it. Oh and wait - it's not even possible. Breastfeeding and my sex drive. That's a whole 'nother post!

  7. #7
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    Kate, you haven't said anything that makes me think you need to top off your babies. I am a mother of identical twin boys, go figure from my name here. Anyway, if they are sleeping so long, I think that the 12 hours off is affecting your supply at least a little. Even if you are pumping during this time, pumping is not as effective as nursing.

    I used to nurse my boys and put them to bed. Then, once it was getting close to my bed time I would go get a baby and nurse him, put him back, and switch babies. That way, they had another feeding at late evening. Then, I could get them to sleep for several hours without waking up. Following that, I would recommend nursing them first thing in the morning and pumping immediately afterwards to attempt to completely "empty" your breasts when they are most full. Save the milk for emergencies and simply nurse, nurse, nurse throughout the day.

    The fact that they eat bottled milk/formula (I was unclear on what you are using to top them off.) is not necessarily a sign that they need it. Many babies drink from bottles even when they are full.

    I gathered from your post that you stay at home with your twins. If so, this gives you the great opportunity to just nurse them whenever they need it. Do this as often and for as long as they like during the day. You might also consider waking up one other time during the night to feed them. As for feeding them together, I highly recommend it. It was very difficult for me at first and I was completely unsuccessful at it until I bought a twins nursing pillow. This is a device from Heaven and it enabled me to satisfy both babies at once.

    You mentioned solids, keep in mind that solids don't help babies sleep through the night, nor do they necessarily decrease the amount of milk that the babies will take. Solids should be a supplement to milk, not a substitute. Don't start solids unless your babies show the signs that they are ready, and not all babies are ready right at six months. My boys nursed exclusively to 8 months and didn't start eating solids regularly until well after nine months.

    Keep up the good work and try to have faith in your body. It's working great, so just let it.

  8. #8
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    Ok, let's see what we can come up with!

    First, as the PP said, just because dss will take a bottle does not necessarily indicate a low milk supply. Bottles have a much faster flow than the breast and some babies will simply "drink or drown". That is why I asked about their output. If they were having lots of wet diapers and regular dirty ones (whatever is normal for them) without "topping" off, then they are probably fine. Can you look back to when you weren't "topping them off" to see that they were having good output?

    That being said, 6 times in 24 hours is not a very large number, nor is it extremely small. As you said, they are growing fine. But we want to get you away from all of that pumping...so here are some suggestions:

    Instead of giving the bottle of expressed milk after the morning feeds when they seem cranky and are showing hunger signs, could you offer for them to nurse again? They might surprise you and go back for seconds! I know you said one tends to bite when not interested. We don't want that of course. Some moms find minimizing the distractions can help with this. Nursing in a quiet room might help. You may see this behavior go away once supply is increased. You also might try giving him a frozen washcloth to suck on before feedings. If he is sore it will numb his pain, so he doesn't take it out on you.

    Since they are sleeping so long at night I do suggest that you get more nursing times in with them. I agree with the PP that you might find some success in trying to get them to feed before you go to sleep. I can only imagine how tired you are...and you probably think I am crazy to suggest waking a sleeping baby, but if supply is a concern, you may want to do this for a little while at least. Some babies will nurse while practically asleep and just go right back down without ever really waking. So you may not disturb them that much. Maybe you could do that around 9pm or so? Or right before you head off to sleep. Then, maybe you could sleep through the night and wake up BEFORE them, say at 5:00 or 5:30am and pump. Then, when they wake up you would nurse them, of course, right away. Then you could try nursing them throughout the day as often as they show the need. If you try this for a few days, you may see an improvement. Do you think this might work for you?

    You asked should you pump in the middle of the night as you were before...well, maybe you could see how the other suggestions go first. But, yes, you could always do that. Are you still using the rental pump?


    Domperidone is certainly an option, but I want you to realize that it has been found to increase milk supply "when used in combination with frequent nursing and/or milk removal" according to LLLI Breastfeeding Answer Book. So, you still need to stimulate the breasts a lot! I wouldn't think you are "lazy or looking for a quick fix" for asking about it! You are covering all of your bases. If you are considering that I would suggest discussing it with your doctor/ped.

    I know this seems like a lot...and you really have your hands full. You mentioned not being able to have a "nurse-in" because you have a toddler to care for. I have been there! (minus the second infant, of course!) Is there anyway someone (relative, neighbor girl, dh) could spend some time with ds, so that you can really concentrate on feeding the babies these next few days?

    Ok, let me know if I have covered all of your concerns and how you feel about this. I feel like I need your input before I go on!

    Take care,

  9. #9
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    This is all SO very helpful and I really appreciate all your time as I know you have your hands quite full as well.

    So the waking a sleeping baby thing. Ouch. I guess this is where I really have to put my money where my mouth is. It's a tough one though. I love love loved nursing our toddler and only stopped because I'm 39 (38 then) and needed to get on the ball if we wanted to have another one. But our nursing relationship was wonderful. With these two I've never really experienced any of that pleasure. The only pleasure I derive from nursing them is knowing that they're getting the healthiest option. When older DS was little we savored every minute of his babyhood. With twins it's more like diaper diaper boob boob spit up spit up rock put down rock put down etc. All work, given the fact that the big guy needs my attention too and he's the one who knows the difference really. So what's my point here. Hmmm. I guess just that life has been pretty rough for a while now. And on days where I was able to keep records they often ate 24/25 times between them. So maybe I'm just asking permission to not wake them up and re-enter those dark days. I was a little depressed, I think, and I'm loathe to go back there.

    But I only have 16 ounces or so left in the freezer. That should cover 1 day or 2 if I'm lucky (Identical - they're getting pumped milk - mostly from the evening before and a little frozen). And then it's either stinky formula or figure this out. Oh and here's the other thing. I pump virtually all evening long away. Would waking them really make that huge a difference since I'm pumping during that time anyway (I pump at 7:30 and again before bed at 10:30ish)?

    OK I'm even annoying myself here. About the nurse-in scenario. How many days do you think it would take? Is it really possible that these guys (especially the one) could nurse, act all agitated, drink 6 ounces from a bottle and really have been satisfied by the nursing after all? It's weird. Three weeks ago they just nursed. No pumping/topping off or whatever and I can't even remember what it was like when they acted satiated after just nursing.

    For what it's worth the bottles I have are the ones that screw onto the pump. They are cheapos with newborn nipples. I'm trying to make them suffer with them! Oh and yeah - I still have the good Medela hospital grade pump (thank god).

    Now I know this is nursing 101 but let me ask anyway. if I were to start pumping at 5am wouldn't my 7am supply be diminished for a time? And then wouldn't this just exacerbate the problem? Or no?

    Here's another thing. Is it possible that the guys are now spoiled by the bottle thing? Our older son would barely take a bottle ever so that was what I was used to. These guys have always had ebm every now and again so that I can have a babysitter and take older DS to music class and stuff. So they're pros. Maybe just too into it? Sometimes I nurse, they fight, squirm, bite, look away and get cranky and out come the bottles. I don't usually get to the pump right away but 15-20-30 minutes later I can get10 ounces or so. Which leads me to believe, I guess, that they're not drinking all there is. But how can I make them? Especially toothy. The frozen washcloth sounds like a good idea. But it's his brother that is all drooly and is definitely actively teething. He does it just for kicks. When they act like the breast is drained it also feels like it is to me. Bu the ability to pump then is weird, no? And in theory they get more than the pump can, right? Why didn't I appreciate those days when i had to practically sleep with pillows in my nursing bra in order to keep from leaking everywhere?

    They were 19 pounds each at their ped visit today and are 6 months and a few days. So they're giant beasts. This shouldn't matter, right? Their older brother is and always has been a skinny little dude.

    The ped said no to Domperidone, saying that past 6 months the rewards from BFing didn't outweigh the risks associated with taking an unapproved drug.

    Identical I do know solids are more about practice than nutrition at this point. I was just somehow hoping that they might magically make up the differential here. Sadly, I get that the answer is no.

    I haven't done any diaper counting without the topping off thiing because I can't get away from doing that. I know I sound like my mother-in-law (and many mothers in law) but they seem so hungry and unsatisfied that I can't not offer them something.

    I know I'm rambling on and on. It's the sleep thing. Still haven't recovered. maybe I'm just too fatalistic about this and just need to nurse nurse nurse and have them be uncomfortable for a few days until my supply picks up? Oy. This is so not fun.

  10. #10
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    Default Re: Woe is me - trying to keep supply up with 6 mo twins

    This is all SO very helpful and I really appreciate all your time as I know you have your hands quite full as well.

    Oh please! My life is soooo much easier than yours! Instead of breastmilk it is broccoli, and instead of bottles we are dealing with the dreaded BARBIE!!!! Do not even worry about bothering me!

    When older DS was little we savored every minute of his babyhood. With twins it's more like diaper diaper boob boob spit up spit up rock put down rock put down etc. All work, given the fact that the big guy needs my attention too and he's the one who knows the difference really.

    I SOOO hear you on this one! These are very normal feelings, whether there is one new baby or two. It became so rote with dd #2 and I really felt badly about that. I didn't feel like I was enjoying her much either. I had a 16-month-old and newborn, and as much as you love the new baby (s) it is just different. It is always SO different the second time. You are just doing the best you can and the twins are lucky to have you for a mom...so don't be too hard on yourself!

    So maybe I'm just asking permission to not wake them up and re-enter those dark days. I was a little depressed, I think, and I'm loathe to go back there.
    Permission granted! <<<hugs>>> Sleep deprivation is not a pretty thing. If you need to sleep to do right by your children no one will think less of you.

    I pump virtually all evening long away. Would waking them really make that huge a difference since I'm pumping during that time anyway (I pump at 7:30 and again before bed at 10:30ish)?

    It might, as they are much better at removing milk than a pump. But go ahead and continue this if you feel it is working. I think what I was trying to get at is that maybe you could try not to keep offering them the bottles of EBM at all and see what happens.

    About the nurse-in scenario. How many days do you think it would take? Is it really possible that these guys (especially the one) could nurse, act all agitated, drink 6 ounces from a bottle and really have been satisfied by the nursing after all? It's weird. Three weeks ago they just nursed. No pumping/topping off or whatever and I can't even remember what it was like when they acted satiated after just nursing.

    Many moms experience an increase in supply after a couple of days. According to the LLLI BAB: "breastfeed more often, every 1 1/2 to 2 hours during the day and at least every 3 hours at night...within a few days the mother's milk supply should show a substantial improvement". They may be a little frustrated in the beginning, but they will get it!

    Here's another thing. Is it possible that the guys are now spoiled by the bottle thing?

    Yes, yes, and yes! That is why I said above that they may get a little frustrated, but they will work and get the milk and then realize (hopefully) that there are no more free rides!

    Now I know this is nursing 101 but let me ask anyway. if I were to start pumping at 5am wouldn't my 7am supply be diminished for a time? And then wouldn't this just exacerbate the problem? Or no?

    Not usually. Typically when suggesting pumping to increase supply, LLL will suggest a 1 hour wait between feeds/pumping. So you would have plenty of time to "make more milk" before dss wake up. (actually your breasts are always making milk, but are of course more full at certain times). I thought you might capitalize on the fullness of the morning breasts!

    BTW, how long do your pumping sessions last?

    Maybe just too into it? Sometimes I nurse, they fight, squirm, bite, look away and get cranky and out come the bottles. I don't usually get to the pump right away but 15-20-30 minutes later I can get10 ounces or so. Which leads me to believe, I guess, that they're not drinking all there is. But how can I make them? Especially toothy.

    Ok, LOL over "toothy"!!!

    Smart boys. They have figured this whole thing out!

    They were 19 pounds each at their ped visit today and are 6 months and a few days. So they're giant beasts. This shouldn't matter, right?

    If you are asking if they would need more because they are so big-no. You can make enough to satisfy them. You said yourself you have been!

    The ped said no to Domperidone, saying that past 6 months the rewards from BFing didn't outweigh the risks associated with taking an unapproved drug.

    Ugh! I won't go into the idea of dimishing benefits after 6 months. But according to my handy BAB again..."Domperidone is approved for use by brestfeeding mothers by the AAP. It is not available in most pharmacies in the US, but it is not illegal and can be ordered by US mothers with a doctor's prescription through compounding pharmacies in the US..." Now quoting info from Hale's Medications and Mother's Milk: It is classified L1, which in the risk category is "safest" and it is listed for the AAP guidelines as "Maternal Medication Usually Compatible with Breastfeeding". So, I am not sure what would lead your ped. to say this.

    I haven't done any diaper counting without the topping off thiing because I can't get away from doing that. I know I sound like my mother-in-law (and many mothers in law) but they seem so hungry and unsatisfied that I can't not offer them something.

    You are offering them something...it is just slow flow for right now. It will pick back up if you can really try to eliminate those bottles!

    About solids...I'll save it for tomorrow! What else did ped. say-or don't I want to know?

    Hang in there!

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