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Thread: Difficult evening feed with 6.5w old twins

  1. #1

    Default Difficult evening feed with 6.5w old twins

    For the past 2 weeks, it feels like my supply drops around 6pm. Once my twin girls go to feed anytime between 6-9 or so, they nurse for a bit and then pull of and scream when they can't get anymore milk. I assumed that my supply was low and have then been giving them 2-3 oz to supplement, as well as pumping to try to increase my supply during this time. After doing some research, it seems like if they're feeding fine at other times (they are), I don't have a supply issue. Is this true with twins? Both my pedi and my MFM said that it was fine for me to supplement and most twin moms need to. I feel like this information is incorrect and that I should try to keep the girls latched, although that seems impossible once they realize that the milk isn't coming out. I generally try to hand express when they start to scream and if I can't get any out myself that's when I give a bottle and try to pump (tonight I only got 1 oz pumping). Any thoughts? Is it possible that my supply is getting drained because there are 2? I'd loveee to be able to go back to just giving the breast.

  2. #2
    Join Date
    Jun 2009

    Default Re: Difficult evening feed with 6.5w old twins

    Hi and welcome to the forum. congratulations on your new babies!

    Is it possible that my supply is getting drained because there are 2?
    Not really, because this is not how it works. Mothers do not have some finite amount of milk that they make. Your body produces milk all the time, and what tells the body to make enough milk is the milk being removed from the breasts with enough frequency and effectiveness to tell the body to make enough milk. So when all is normal, twins tell the mother's body to make more milk than if there was one baby, with the amount they are nursing.

    Milk availability being 'lower' some parts of the day than others - late afternoons, evenings and early night being a typical time for lower milk supply- is normal and common with all lactating women. And evening fussiness is also very common. This is not the same as low milk production. Low milk production means mom does not make enough milk overall for her baby or babies to gain normally when only breastfed, suggesting mom may want to try techniques to increase her overall production and/or to supplement if and as needed.

    Supplementing is not required from a medical standpoint unless one or both of your babies is unable to get enough milk from you overall to gain normally. Sometimes this happens even when production is fine, because some babies do not transfer milk as well as they should. In that case, it is not a problem of low milk production but of poor milk transfer. Of course overtime, poor transfer leads to low milk production.

    Supplementing will tend to cause a baby to nurse less, and this in turn harms milk production. That is why when a breastfeeding mom gives any supplement, it is suggested she also pump her milk and also do other things to increase her production so that the supplementing itself does not cause a lowering of milk production. So it is good you pump around when your babies get supplements. Try not to worry about how much comes out when you pump. There are many reasons this amount does not indicate actual milk production. What is important is that you do pump with the best pump you have when you supplement, in order to protect your milk production.

    So I think the first thing to figure out is 1) It your production is truly low, causing any weight gain issues for your babies and
    2) If it is, how to correct that problem or at least prevent it from becoming worse.
    If your babies do appear to be gaining ok, then maybe instead of supplementing, getting more help with soothing upset babies will help.

    Also, it is true that some moms do not make enough milk. This happens to mothers of singletons as well as mothers of multiples. Sometimes there are preexisting conditions that cause insufficient milk production. But by far, the most common cause of low milk production is non-optimal breastfeeding management, which basically means, the most common cause of low milk production is baby being supplemented unnecessarily, or over supplemented, or supplemented appropriately but without steps being taken to address the core issue of low milk production. Other possible causes are poor latch causing poor milk transfer, as well as meal scheduling (stretching out times between feedings,) sleep training, overuse of pacifiers or swaddling, and baby not being in close proximity to mom most of the time.

    So, while it is probably true that most twin moms supplement at some point, I know of absolutely no evidence that this is something that would happen at such a high rate if breastfeeding management was optimal. Obviously moms of multiples are under much more time pressure than singleton moms, and may consequently rely on some of the above techniques more. Additionally since so many more twins than singletons are born earlier or weighing less, or spend time in the NICU, etc. there is an added pressure as well as additional actual need to supplement twins. But none of this means that your babies need supplements at this point. Many moms of twins and even higher multiples do make enough milk that they do not need to supplement. So it truly just depends on the individual situation.

    I am going to link a few articles as well as suggest some books that may help. low milk production: http://kellymom.com/hot-topics/low-supply/

    Pumping: (one ounce or even less may be entirely normal to pump in your situation) http://kellymom.com/?s=not+pumping

    Mothering Multiples: http://www.karengromada.com/

    Books: Making More Milk

    Mothering Multiples
    Last edited by @llli*maddieb; June 8th, 2017 at 11:46 PM.

  3. #3

    Default Re: Difficult evening feed with 6.5w old twins

    Thank you so much for your reply! The past two nights I've managed to omit the bottle and solely nurse!! Knowing that my supply isn't low during the evening really helped me focus on not giving in with a supplement. Just nursing is so much easier for me, so thank you!

    I do have another question -- I'd like to pump solely to be able to leave my girls with my parents (or family) every now and then so my husband and I can have a date night, and maybe at some point go away for a few days. A few weeks ago I was pumping after my feed that happens somewhere between 8-10am. I'd feed, burp then pump -- so the pumping probably happened 25-45 minutes after the babies had stopped nursing. I really hated doing this so I stopped. Reasons for not liking it included (1) it made that feed feel like it went on forever, (2) it seemed like the girls weren't getting enough milk on their next feed (I experienced similar problems as I had with the evening feed -- them pulling off and screaming, as if they couldn't get enough milk), and (3) I had heard that you should pump within 15 minutes of the feed. I always felt stressed about taking too long, but because the girls were having some spit up issues, I never wanted to lay them flat too soon so I could pump sooner.

    What I'm getting at is I'm having a hard time finding info on how to pump just to build a freezer supply for occasional bottles. Is it possible to just pump in between feedings, or is that going to hurt my supply for the next feeding? And whatever route I go, do I need to do this every day?

    And I think my last question is: my girls have been taking a bottle just fine (I introduced at 3 weeks). Do I need to continue giving a bottle every so often so they won't reject at some point? Or since they've taken it several times will they continue to moving forward, even if they aren't getting one on a regular basis.

    Thank you for all of your help!

  4. #4
    Join Date
    Jun 2009

    Default Re: Difficult evening feed with 6.5w old twins

    Ok, for pumping to leave bottles- when are you anticipating going on a date night? And how long does it have to be? And how far away from your babies would you have to be to have a date? And how private would you actually have to be (this is a nice way of not asking what a "date night" would mean.) I do not need to know the answetrs to any of these, they are just things to think about.

    In my opinion, pumping and giving baby bottles to get some time away from babies is one of the hardest ways to get time away from babies. Here are other ideas:

    Keep things short. If you need 2-3 hours to have some intimate totally private time together, take only that time. Your babies would not have to eat anything during such a short, one time separation.
    Date night at home: Have your family member come over and watch babies in one room while you two a have a private candlelit meal and watch a movie or dance or whatever. Take your babies to nurse them as needed throughout the evening.
    Date night out with a baby sitter coming along. Same idea as above but you get to go out.
    Date night (or date afternoon) with babies. Your babies will probably stop being so fussy in the evening fairly soon, but you can also pick any generally less fussy time of day to take babies with you to a movie or the park or a restaurant or whatever. Your kids will never be this easily portable and frankly unobtrusive again. so it is a good time to take advantage of that.
    "Alone" time with your husband with babies close by. They won't have any idea what is going on, I promise. Yes you may have to develop a sense of humor about being interrupted but that is true with any age child.

    If none of that makes any sense to you, or you just want to pump anyway as a safeguard, my best advice is to pump whenever you find it works best for you, and this may vary day to day with some days possibly being able to pump more than once, and of course there are bound to be many days you never pump at all. This is fine. You do not have to pump exactly the same amount of times every day any more than your babies are likely to nurse the same amount of times every day. There is no need to pump every day unless babies are being supplemented every day or you have low milk production. And in that case the milk would probably be for immediate use, not for storage.

    As far as "rules" that give precise times how long after or before nursing you should pump, you can dismiss those as nonsense. The lactating breast is always making milk and it is utterly unpredictable when baby will want to nurse. 2 babies, double the unpredictability. Just like with evening production, if we are talking healthy babies, one nursing session here and there were baby does not get much milk because you just pumped is not the end of the world. Yes it may lead to a fussy feeding but your baby and your body will quickly make up the shortfall.

    As far as going away for a few days....well. Never mind how difficult it would be to pump enough milk before hand to feed two infants for 2 or 3 entire days, you would have to pump night and day the whole time you were gone. This does not sound like a restful or romantic get-away to me. Add in the possibility of disaster (pump breaking, getting stuck in an airport or on a plane or in a car for hours without being able to pump, etc.) and you really might have some serious problems including becoming ill. Unless a trip out of town is totally unavoidable, I would suggest put any ideas of that kind of lengthy separation from our babies aside for quite a while. When moms do have to go away that long when nursing infants, it usually makes the most sense to bring the babies along. When this is not possible, some moms find what works best if the separation is more then 24 hours is to overnight expressed milk back to babies at home.

    my girls have been taking a bottle just fine (I introduced at 3 weeks). Do I need to continue giving a bottle every so often so they won't reject at some point? Or since they've taken it several times will they continue to moving forward, even if they aren't getting one on a regular basis.
    Well if I tell you that studies indicate that it does not matter when a bottle is introduced, and then you do not give a bottle for a long time, and then your babies refuse the bottle, you will be pretty mad at me, right?
    There is nothing surprising about your babies being fine taking a bottle. What the only study in this area I am aware of showed is that most babies take bottles fine no matter what age they are introduced. A sizable proportion of babies resist bottles initially but eventually take them- again, similar percentage does this no matter what the age of introduction. A small percentage resist bottles to the point it is a pretty difficult problem, again, similar % no matter what age they are introduced. But there is no way anyone can predict for you what either of your babies would do as far as bottles go going forward, or how often you would have to give them a bottle to prevent any issues. It has simply never been looked at with that kind of detail.

    Of course what people forget is that bottles are not the only way to give a baby expressed milk. So even when a baby resists bottles, they are unlikely to simply go hungry.

    Based just on my own reasoning and experience of baby behavior, I suggest think about whether your babies never resisting bottles is an important goal to you- important enough to put up with the inconvenience of possibly entirely unneeded pumping and bottles. If it is, then I would suggest give babies a small amount (1/2 ounce to 1 ounce) of milk in a bottle once or twice a week. Mostly this would be to help you see early warning signs of bottle resistance forming, but it is not so frequent that it is likely to cause nipple confusion (where baby refuses to nurse, usually a much more serious issue than baby refusing a bottle) and it is a somewhat manageable amount to pump. Of course if you are simultaneously trying to build a freezer stash, then you have to think about how these "practice bottles" are impacting your ability to save "enough."

    Sorry for the novel. Hth!
    Last edited by @llli*maddieb; June 11th, 2017 at 04:04 PM.

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