Breastmilk supply issue with 5 month old twins

[mom2twins]

I have boy/girl twins that have just turned 5 months. Up until now I have breast fed them exclusively, but am finding that I can't keep up with their increasing needs. I give them one bottle of pumped milk per day also. My son will take 8 oz or more if you let him, while my daughter takes between 5 1/2 and 7. I don't know how much they take when they breast feed the rest of the time. I don't seem to "run out" of milk while they feed, and they do not get fussy, however when I do a yield I get only 4- 5 1/2 oz from each breast. Not even close to the 8oz my son will take from a bottle! He has begun to get hungry now before his scheduled feeds and has started getting up earlier in the morning hungry. I have tried to pump after every feed to increase my milk supply, but it does not seem to be working. My question is: Should I start to give solids, and if so when? Before or after the feed? I know when you start solids typically you give 2 times a day in addition to milk. But, because I am not producing enough at each feed, do I do give solids with every feed, or supplement the other feeds with formula or pumped breast milk? I was hoping someone may have had this same issue, and can provide suggestions.

[Samuel's mum]

Welcome to the boards:)

I've PMed one of our members who bfed her twins for over a year. Hopefully she'll be along.

I hope you know that a reduced pumping yield does NOT mean an overall reduction in supply. They are 2 separate things. We no longer recommend a yield to judge supply. More here:
https://babywhispererforums.com/index.php?topic=65905.msg856803#msg856803

Pumping yield can often reduce around now as breasts get more accustomed to baby's stimulation and in addition pumps can get tired after months of several use.

A few questions -Could your son be going through a growth spurt? And when do you 'schedule' feeds? Do you tend to be a little flexible about the schedule when growth spurts are happening so he can increase your supply naturally? What kind of pump do you use?

He obviously has a big appetite as 8oz is a huge amount of ebm.

Starting solids before 6 months is a personal choice. It is crucial that when you DO start quantities are very small and imperative the meals come AFTER a milk feed and that they never go to the breast full from solids. Do that and your milk supply will drop dramatically and quickly. You should NOT offer solids with every feed if you do start. 3 meals a day will be reached after several weeks if not months and remains the limit for quite some time. Milk is what it is all about for the first 12 months.

With that in mind the focus is your supply. I would probably hold off on solids until you have had a go at all your options. If his nappies are wet and he is content and weight gain is OK your supply is fine. You mention they are not fussy during feeds so this sounds like a pumping issue which as I say is not a supply issue per se.

Make sure you are drinking plenty assuming the temperature is rising where you are.
You could consider taking a herb which naturally increases your supply like fenugreek. Other people can tell you more about that.
How long have you been pumping after feeds?

And a huge well done for making it to 5 months with exclusive bfing.

[Mum of 3 + 2 stepkids]

Hi, and yes well done to exclusively BFing TWINS for 5mths. Thats wonderful!!!

I pump twice for one feed, theres many people that also do the same. My DS has is now 5mths & 3 wks and yesterday was the first time he has had solids. I have been holding out since he turned 5mths and im glad as 'MILK' is the most important thing and also its better for there tummys to digest nearer to the 6mth mark.
Like Emma says its personal choice but im glad to have waited. Im only giving him a 1/3rd of a rusk with bm for a week before i introduce a little more.

Another thing, with the bottle feed do you use a special bottle for slow flow? If not it might be an idea to look into getting one. Reasons for this is that when feeding from the breast the flow is controled and comes in stages. With a bottle it floods out and there is no work involved, so very easy to drink more than lo's would need.

Kate x

[VickyB20]

Hi mom2twins!  And well done for breastfeeding twins to 5 months.  I know from personal experience how hard it can be!

I completely understand very many of your concerns.  It is so hard to be confident that a lo is getting enough when breastfeeding because of course you can't measure it.  And when you're feeding twins, there is the added doubt in mind about producing enough for two.  I'm sure that you're not 'running out' of milk.  Boobs are amazing apparatus and are apparently miraculously effective at producing what is needed! 

Try not to worry about your boy taking 'so much' from a bottle.  It's quite normal for breastfed babies to guzzle down from a bottle... it's so much easier for them to suck from a bottle and is not necessarily a representation of a more general hunger.

How often are you feeding them?  At 5 months, mine would occasionally go for 4 hours between feeds but very often it was 3 or 3 1/2.  During growth spurts, I would end up feeding them both before and after naps - so about every 2 hours I suppose and they were having milk in the night until over a year old.

Are yours still having a night-feed?  Has their sleep been affected at all?

I introduced solids with all my 3 at 5 months.  But they took such tiny, tiny amounts that it didn't really make any difference to them feeling full, IYKWIM.  In fact, none of them really started eating any quantities until about 7 months.  I would highly recommend looking into 'Baby Led Weaning' (check out awesome thread on Feeding Solids board), which I did my default with my twins when they turned spoon-phobic and was soooo much easier with 2 + toddler than spoon-feeding purees would have been.

If you do choose to introduce solids by spoon, as Emma says, ensure it is after milk feeds and tiny amounts.  Milk is absolutely the most important nutritional source until they are 1.

Do feel free to PM me if you have any more questions and I'll keep watching this post!

Well done for choosing to breastfeed twins.  It's a hard choice but one that you will always feel proud of!  I know I do!

Hugs.

Vicky
x

[mom2twins]

Thanks to everyone for their responses! I hope this reply goes out to everyone, as I didn't reply right away to each post as I read them. I'm new at postings
To answer a few questions: The babies moved to a 4 hour routine several weeks ago. It has seemed that they get a little hungrier in the evening and I usually feed them at about 3 1/2 hours then. So, a typical feeding schedule has been 7am, 11 am, 3pm, 6:30pm ,and close to 11pm DF. They take 2 long naps of 1 1/2-2 hours and a catnap around 5pm for 30-45 minutes. They go to bed around 7:30-8:15 pm.
They both were sleeping until 6:30-7am. However, recently my son started to wake earlier and earlier, until he was finally waking during the night to eat again. He has also woken up early from naps hungry. I have gone ahead and fed him when he woke early and just let my daughter sleep through. It has been going on for perhaps 2-3 weeks now.
The pump I use is a Medela Symphony rented from the local hospital. I have been pumping after feedings 2-3 times per day for about 2-3 weeks now. I contacted a lactation consultant from the hospital when I began having issues. She said that because the babies are sleeping through the night, and have a 4 hour schedule this could have decreased my milk supply. The options I was given were to pump to try and increase supply- including a middle of the night pump as all night is too long to go without feeding or pumping, feed more often, supplement with formula, and/or start to feed cereal. I had just started to get a decent nights sleep, so was not thrilled about waking up to pump in the middle of the night. I have been pumping several times a day to increase supply, and supplement with a little formula when I don't have enough pumped BM to be able to give them a full bottle. A few days ago I started to give them a little cereal twice a day after a breast feed. They seem to be taking to it quite well. My daughter eats a little, and my Son, well, he just loves to eat. So, he has taken anywhere from 1/4 T- 1T each time. He has since then, been sleeping through the night again, and not waken early from naps hungry. I had planned to give them only a little cereal and no other solids until they are 6 months. The only concern I have with moving back to a 3 or 3 1/2 hour routine is disrupting their naps. I have just gotten them to start taking nice long naps and am afraid that changing anything will disrupt that.
I hope I have provided enough additional information. Does it sound like I am doing everything I can? Do you all have any other suggestions? Thanks again!!

[Mum of 3 + 2 stepkids]

I would say your doing really well, keep going. It may just be that your ds needs that little bit more than your dd. I don't think i would change to 3hr, but if he needs that extra feed then give it to him in the and over a couple of days he should up your supply to what he needs.

Kate x

[VickyB20]

I agree!  You're doing great and you're listening to what your babies need.  So carry on what you're doing.  I reckon if you can sneak in an extra bf for your ds that might just help with the supply and satisfy him a bit more. 
Well done you!
xx

[mom2twins]

Thanks so much! I am feeling much more confident about this now.  I appreciate your advice and support.

[Mum of 3 + 2 stepkids]

 

[VickyB20]

How are you doing?
xx

[fifibobandmore]

Wow momoftwins you are doing super with your twins. I take my hat of to you I had trouble getting my 1 son on to a routine and yoiu have done it with 2 and exclusiovly breastfeeding them as well. You are amazing and well done to you are are doing an excellent job at listening to your twins and giving them the best start in there life

[mom2twins]

Hello all! We are doing good.  DS has not been waking early to eat anymore. I am continuing to give cereal 2 times per day. Sometimes I skip the evening cereal feed if they nursed for a long time. I wonder if sometimes I am now over feeding them... My DD is spitting up more sometimes after a cereal feed. DS has reflux anyhow, so hard to tell with him if he is spitting up because he is too full or just from the reflux. They both take the cereal well and seem to enjoy it. I give them at the most 1T mixed with 1 oz of milk. Does this sound like the proper amount? I am still having trouble pumping enough to give a bottle every day. It seems I have to pump 4 or more times after a feed and then right before I give the bottle to have enough to feed them. Thanks so much for the encouragement for bf twins. They are changing so much now that we are having new "issues" with breast feeding. I joke that I could do a segment for Animal Planet as it seems I have 2 baby monkeys now. They poke each other, pull each others ears, hold hands, and even pull a breast out of their siblings mouth while they are trying to eat. They get distracted very easily also and try to roll around. It's very entertaining, but exhausting! Hopefully this is just a developmental phase and they will calm down again. It is making bf very hard. But, I still enjoy this special time with them so much.

[Mum of 3 + 2 stepkids]

Hi mom2twins, sounds like you have a fun packed day with your two monkeys. Im the same if i pump after a feed, im lucky if i get out and oz. DH gives a EBM bottle at 6.30 and i was pumping a full feed then but lately im feeding and giving the bottle so thats enough so im pumping an hour after that feed to get about 1.5oz woohoo!!!!

Have you tried wearing a neckless (one each) for them to play with while feeding?

Kate x

[VickyB20]

I think from about 5 months I almost always used to feed my twins individually.  They were pretty efficient nurslings by then and I used to find it the best way to avoid them pushing each other off the sofa / whacking each other in the eye / pulling each other's hair / etc, etc.!

It sounds like you're doing a truly fabulous job.  The amount of solids sounds great and I think you're absolutely right by dropping the 2nd cereal feed if they've had a long nursing session.  Milk is definitely still the most important thing, and will continue to be until they're around a year old.

WELL DONE YOU!!!

Vicky
xx

[mom2twins]

I never thought to us necklaces before. That's a good idea! Better than giving them each a toy to hold. They'll just wack me or each other with it! If I can hang in there with it I'll keep feeding them together. Even a little time saved helps. But, they are getting bigger and harder to feed together, so we'll see.