breastfeeding twins

[kayra]

here we go...
I wasn't able to BF DS but have been more confident about trying this time round, however the whole twins things does add a different dimension
So far I've been feeding but we have had to supplement to make sure they don't lose too much weight and initially it seemed my milk was slow to come in. So although I was feeding they just wouldn't settle to sleep. Since we've been supplementing (more and more it seems) they've been better at settling for a decent nap/sleep. (I've also been pumping to aid stimulation, they've been getting that too)
I met with a lactation consultant today and she said that if we give formula it will decrease my milk production. She said it looks like I have enough milk to feed them, however although my milk does seem to be more/better than a couple of days ago, the question to seems whether the twins are able to get it all because they're pre-term thus not sucking all that strongly. The LC didn't seem to see that as a problem but did indicate that it most likely meant be basically BFing round the clock.....
Now with 1 baby that seems hard enough but I don't know if I can do that with 2! How does one ever get into and EASY with that? And although I have a BF pillow for twins etc I just can't imagine being in that position for hours on end.. inevitably they're dosing throughout the feed etc.
So, I don't know what my question is  I really want to bf them but can't quite cope with what that means for the next weeks, till their suck is stronger and they can fill up more quickly. My mum says we could carry on with more supplementing at night so we get some sleep at least and then during the day spend more time on the breast. That kind of makes sense to me but it does take me back to the question of an EASY, this afternoon I was basically feeding one or the other sometimes both at the same time for about 6 hours straight, they're finally sleeping now but I haven't the foggiest idea of when the next feed might be..I realise they're barely a week old but I think the 'unknownness' is hard on my planning personality 
sorry it's ended up as a bit of a brain dump, can't think properly, any thoughts would be appreciated 

[Khalam's Mama]

Hi no btdt but lots of respect for you trying to feed them. If they can't get all the milk maybe you can pump at the end of the feed and give them that so they are getting it all still and it will stimulate you to make more than if you top up with formula. Do you get enough for your oh to give the rest on a bottle while you get one decent stretch of sleep?

[kayra]

thanks!
I have been pumping either half way between feeds or at the end of a feed but it's no way enough to make up for a whole feed, I've only been getting about 15mls or so when I've pumped.
If I decide to let them suck more during the day, ie an hour or so per time, I don't think I'll have much time to pump afterwards and I just can't bring myself to pump at night

[Khalam's Mama]

You probably aren't getting enough rest with all that, but rest when you can and make sure you eat and drink plenty too. Do toy need 1000 extra cal to feed twins if you need 500 extra for one? If so you will need to be eating very regularly I imagine.

[Shdef]

Oh Kayra, you are doing so well!

Here is a little article about milk supply and settling for naps afterwards by Emma, who used to mod here but is now an LC.

Babies not going down for naps after a feed means really that they want to stay with you, going down better after a ff really means that they are having a harder time to digest it. But you have started mixed feeding, and with having twins, that might be your best choice for getting rest. Have a wee look!

http://www.emmapickettbreastfeedingsupport.com/twitter-and-blog/low-milk-supply-101

[Buttonbobs]

Hi honey, I have no btdt and didn't manage brilliantly with BF and E anyway, but my mum BF my twin brothers and did supplement the whole time. I know that an LC will always warn you of the risk that this will deplete supply and I suppose they may get more used I a bottle, but I suppose for me having been through a horrible two months feeling guilty every time E went near a bottle, I think I would want to tell myself to remember that what works for you, works for you. I.e. Do today what you feel you can cope with today and no more. Get lots of rest, eat lots, and try your hardest not to worry about the next day or the one after that.

And as for EASY, you can worry about that later, they are so small and should  arguably still be with you 24/7 so a lot of cuddling now can't be a bad thing (unless you need a break).

Not overly helpful practical advice I know, but it comes with ((((hugs))))

[kayra]

thanks so much.
I guess I "need" them to settle for a decent sleep after they've fed even though I understand that the fact that they wont unless they're supplemented or have been feeding for ages doesnt mean i dont have enough milk, does that make sense?
not sure about the calories but i'm not cutting back by any means and i'm drinking alot.
Naomi you're right about figuring out each day at a time, goes against my nature but it seems its the only way to survive at the moment.
they're so dosey at the breast bless them!

[ZacsMumme]

Kayra your AMAZING
No btdt obviously but I have a friend who Bf her twins. She said she had to Bf them at the same time (where possible) or it was just all.day.long.

She got a lot of support through LLL and in Nz we have a FB support pages 'breastfeeding NZ' do you have LLL there - maybe they have other twin mums who you could meet and talk to to for advice?

Make sure you have lots of good fats in high arvo too keep your supply and energy up. .. Get that baking roster going (not you baking obviously though!)  I know it's not always practical but do you have someone at here to support you most the day while things settle?

(((Hugs))) and as Naomi says, do what works for you, one day at a time and you'll be at 3 mths in no time I promise

[weaver]

Hi Kayra,
So much love and support to you and your babas, you're doing a great job.  I have no experience of bfing twins, but I have a friend who does and she is a now bfing peer supporter for twin mamas so I cheekily asked her to have a look at your post. 

Here's what she said:
She sounds amazing and it's great she's seeking support.

It's great that she mentions she has a planning brain as she's going to need it! Please pass on that it's entirely possible and extremely time efficient in the long term to establish bf, though it can be a challenge to start with.

One way she can feed on demand is to lie in bed and prop herself up a little with pillows and both babies can feed from her breasts with their bodies lying down her body. This gives the skin to skin and opportunity  for her to dose a little if safe needs it. Or watch a box set....
(google 'laid back bfing twins or biological nuturing twins' for positioning ideas... here's a link http://www.biologicalnurturing.com/)

If her milk supply is a concern she can express and bottle feed the milk to give herself a break from feeds and an opportunity for others to help. Some mothers feed one baby at a time and express from the other breast at the same time to provide milk for the other babies next feed. Expressing can be a great habit to establish to allow for breaks and to increase supply but it isn't for everyone.

Tandem feeding can be a challenge in the early days, once babies have built strength and latch this can be more easily done. The early days of establishing bf are a challenge and especially as she has a little one already she should not feel bad about supplementing. As long as she maintains her supply and perhaps expresses at the times if the formula feeds and builds up a supply if her own milk this can then replace the formula feeds. There can be a lot of concern about nipple confusion for young babies but most babies manage this very well, bottle feeds for younger babies can be easier, though latching them on for a short while to give them some time on the breast can be helpful. This can also make expressing afterwards easier too, though this would mean an extra pair if hands would be needed and is not always practical.

In terms of weight gain charts are based on bottle fed babies so aren't always representative though it's anxiety provoking with ore term babies.  Twins are exceptionally strong, they've had to be right from the beginning, as are there mothers! She might enjoy reading this article in the twilight hours for some comfort
http://www.economist.com/node/18678953


If she wants she can contact the Tamba breastfeeding peer support device which is free for all twin mums whether they are members or not tambabreastfeeding@gmail.com she can speak to someone/text/email whatever she prefers.  There is also an information booklet free to download with advice. 
http://www.tamba.org.uk/Parenting/First-Year/Feeding

HTH.  Thinking of you and sending cuddles to the LOs. 

[Shdef]

There are sedatives in breastmilk and once your milk has caught up with having two, just in a few days, they will settle much better after a feed! I would suggest a ESA instead of EAS for now and worry about everything else later! Much later.

Great support links! You might always also want to supplement, which is absolutely fine, they are getting so much goodness from you already!

Lots of hugs, one (part of the) day at a time!

[weaver]

just in a few days,

Yes, this is very important to remember - things change very quickly in the first weeks, and particularly around milk!

Take care of yourself!

[katie80]

Hi Kayra, you've gotten great advice already, but I wanted to add in some (((hugs))) and tell you you're doing a wonderful job!!

I guess I "need" them to settle for a decent sleep after they've fed even though I understand that the fact that they wont unless they're supplemented or have been feeding for ages doesnt mean i dont have enough milk, does that make sense?

Yes, this stood out to me because I've been there. Charlie is the least settled of all my kids, even from the beginning, yet he was the one to regain birth weight the quickest, so clearly was getting the milk he needed. It sure does help to have a full tummy, but there are a lot of other factors going into it, so don't let those thoughts weigh you down.

I too would try not to even think about EASY right now. They're not old enough to really have any A time anyway (although they may just because that's what they do). Just concentrate on feeding them and getting some rest for yourself. Let others take them and hold them to sleep or put them in a rocking cradle or swing or have them dose with you. The routine will come with time.

Keep up the good work, mama, and relish the snuggles!

[kayra]

thanks for the encouragement. My parents are with me 24/7 and have been helping with everything, I'd have gone crazy without them!
There isn't exactly LLL here, but the LC I met with yesterday is basically the same thing. I think what I struggle with with LLL kind things is that they tend to really frown upon supplementing and I feel as if I'm expected to kill myself for the sake of breastfeeding (i know i exaggerate, and the LC yesterday was actually very nice but at the end of the day what she suggests ie complete demand feeding with twins would be so hard 24/7.)
Thanks for asking your friend Anne!
I do want to sync them but like your friend says it's hard till they get better at latching. I must say each feed they seem to latch better. I will look at those links, thanks.
I nurse them every feed at least 30minutes and then they get a formula top up of 30-45mls, sometimes even more, so there's never a time they only get the bottle.

I must say, I'm very tired, trending the bags under eyes look but emotionally I feel well and I'm SO thankful for that. With DS I was just so overwhelmed by everything I vividly remember wishing my mum would take him and bring him back a few months later. This time round I'm just calmer-mind you I did have a moment on tuesday where I had knots in my stomach and felt like I was drowning but thankfully that passed and I'm doing ok overall
it's taken me all day to finish this post  so just seen the other replies thats interesting about the sedatives in the milk, didnt know that.
yes the easy is out the window for the time being, i cant even guess when the next feed will be and there isnt any a time like you say, mostly a very long e and a variable s.

[*Ali*]

Hugs and kudos to you for BFing twins.

As pps say I would not even worry about EASY anytime soon.

At 1wk old they probably only need about 45-60ml (1.5-2oz) of breast milk so I would definitely consider cutting back on the top ups.
http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

Can you do anything to keep them awake during feeds so they take more from the breast? I was advised to do things like put a wet flannel in DS1's head, blow on his head or cheek (not his mouth or nose so he can't breathe), strip him down to his nappy and tickle his feet.

The hormones that promote milk production are highest in the middle of the night so those are the feeds that will help stimulate your production the most. Therefore if you can bear to I would try to bf for those feeds as much as you can.

As pps say things change so quickly at this age with BFing that it really is a case of what seems unbearable now will be better next week and even better the week after. 6wks seems to be the turning point for many in terms of feeds settling down into a pattern.

[*Liz*]

I have a friend who breast fed twins. She has already BF 2 previous children, but found with her smaller boys (they were about 6.5lb compared to her 9lb singletons) that they were sleepy and it was much harder to get going. She pumped and supplemented, but eventually did get there  . They were a few months old before they were exclusively breast fed - so maybe slowly does it??? I think a lot of her tops ups were ebm after the first few weeks though.

Obviously milk can be a bit slower after a section. Can't remember for the life of me if Clare had a section or not  .

I agree with Ali that the top ups might be a bit much though - you just want the odd oz to keep things going really.

Personally I think EASY is out the window until 6-8 weeks. Always seems pretty pointless with all those changes and growth spurts  .

DS was a 5.5lb teeny baby, and starting BFing was tricky. He was also very sleepy on the breast. But once he woke up at 6 weeks there really was no closing those eyes again!! I know your twins are a good healthy weight, but these smaller babies still are a bit different IMO. Megan was 7.5lb and VERY different. Better latch, stronger suck, just easier!