So after a long pause in blogging, I'm back. At least for now, inspired by a class I am assisting in teaching tomorrow at Enlightened Mama on breastfeeding multiples. The following was taken from an email written years ago while I was BFing my second set of twins. It was sent to a new M.O.M. (that's mother of multiples) who was looking for general advice from an experienced, breastfeeding M.O.M. I sent her a long email, including much of what follows. Please read and enjoy for what it is worth. Sorry, it is a little disjointed.
First - realize you will be spending lots of time in a chair feeding babies. If you can't accept that, then you will have a hard time succeeding. Set up a 'nursing nest' somewhere convenient in your house with a comfy chair and a TV tray next to it with all the essentials. Mine has magazines, paper and pen for jotting down grocery lists etc., lotion, nipple cream, my breast pump (on floor below table) and even my laptop so I can read what's going on! (even if I can't type). It makes the time spent nursing seem pretty short. It's in the living room in a place where I can also see the kitchen so I can keep tabs on my 4-year olds.
Second, realize that building supply may take time - it did for me. Only perhaps 2 weeks with my first babies (but they were nursing constantly!), but probably almost a month for my second set before we were totally done with formula. We used Enfamil Gentleease, because our first babes had so much trouble with food sensitivities. When I did try to use the samples of regular formula they did seem to make our babies more fussy.
Feed. Supplement. Pump. You dont' have to supplement every feed, but you will know when your baby is getting frustrated at the breast because she may come unlatched, crying. Try pumping for 10 minutes every time you supplement. But don’t stress yourself out – you have 2 tinies and perhaps even some older children to care for. even if it's not right after you supplement with formula, do after a another feeding that day. This comes with a caveat though...I didn't worry about pumping until my milk came in at 2 or 3 days. You need a break those early days. I refused the pump at the hospital and the lactation consultant gave me a raised eyebrow. I reminded her that I had done this before and was sure the milk would come in as long as I gave my newborns plenty of boob-time (which I did...I would let them go for 45 minutes if they wanted to). You can pump in the hospital if you find it convenient, it may help your milk come in faster, but if it is stressing you out, just skip it. Your milk WILL come in if your baby is given time at your breast, don’t be afraid to wait out the arrival of your milk without a pump!
I too breastfed right after birth. Tell your hospital staff that you want to breastfeed as soon as possible after birth. For my first set of twins they were 35 minutes apart and I had Baby A at breast before B was born to help with contractions. It was awkward laying down, but it worked. With my first(s) they brought the babies to me to nurse every 3 hours...asleep, awake no matter what. It was a little over the top for term 7lb babies and totally exhausted me. The second time was a little too far the other way. If the babies were sleeping, the nurses would say 'You want us to wake them, why?'. Times change I guess. Just try to nurse them at least every 2-3 hours, until your milk comes in.
If no specific directive from your pediatrician, nurse them every 2-3 hours during the day plus whenever they 'request' it. I'm sure they will let you know if htey are hungry at night. This means that you may need to wake them up during the day to feed them. Granted, if they just finally fell asleep after a long fuss and 20 minutes later it's been 3 hours since you last started feeding them (this was always the case with our first twins!) don't kill yourself waking them right on schedule like I did at first! Just be reasonable, let them get some rest and start it all over after they got to sleep for 45 minutes. With our first set we succumbed to the relatives’ requests of 'why wake a sleeping baby?!?' and entertained visitors all day, and fed babies all night. After a week we learned our lesson: Feed baby during the day or baby will wake you all night!
Get a prescription nipple cream if you need one. There will be alot of action on those nipples and I had problems with cracking both times. supposedly, you should never have troubles if your baby is latching correctly, but I just don't know that's totally true. With hungry full term twins who are let nurse on demand I had trouble with one nipple both times even though the lactation consultants said her latch was fine. and strangely enough, the same babies didn't bother my left nipple. (or didn't bother it as much). I'm convinced it's because my right boob and nipple are much bigger than my left, and their little mouths just weren't big enough to nurse in a totally compatible way. So just realize that there no matter how 'properly' you and your babies are, there may be some soreness. whenever my nipples got really sore, I just pumped that side for the next 12 hours and it would start healing nicely. (prescription steroid nipple cream also very helpful here!)
I agree tandem nursing saves lots of time. It is very difficult to tandem nurse though in the hospital. I did it a few times with our first set just ot practice. The second set I only did it at home with the boppy in my 'nest'. It is difficult because that babies don’t know how to latch on their own yet, so if one comes undone, you don't have enough hands to get him re-latched. Don't stress over tandem. I recommend trying side laying nursing in the hospital though - this was a life saver for me! I don't htink I could have nursed twins without being able to snooze a little while I nurse. If it makes you nervous, set a radio alarm to quietly wake you in a few minutes so you don't fall into a totally deep sleep. I always turned on the lamp as my subconscious reminder not to fall into a deep sleep and that worked for us.
I am no lactation consultant, but I highly recommend using bottles for supplements and even if you don't need to supplement, doing at least a bottle a day with breast milk. My first set of twins refused all bottles at about 5 weeks because they didn't get one often enough, and boy was perhaps the most difficult aspect of thier first year of life! My first hospital stay they never offered bottles and we cup fed. When I had the second set of twins, they (the hospital Lactation consultant) said that nipple confusion doesn't really happen and I should just use bottles because its' so much easier. I agree.
Finally, when it comes to maintaining an adequate milk supply, I found that it was helpful that when my babies slept longer stretches at night, I would wake up dripping. When this happened, I went and pumped then the babies would drink that the next night when they were stockpiling for thier big long stretch. But it worked because it evolved into them sleeping through the night at 3 months yay! I pray for that for all MOMs!) and I would pump before I went to bed (if it was a late night for me) or early in the wee hours (if I turned in early that night). Then they would drink that the next night when they were clusterfeeding and stockpilingso they could sleep and what they didn't drink I stuck in the fridge.
Good luck and best wishes to all you !!!!!