My big long Breastfeeding Post

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 !!!!!

Getting Ready to Breastfeed Twins

With all the benefits of breastfeeding, many moms strive to nurse their babies at least for a few weeks, and some for much longer. While breastfeeding one baby has a steep learning curve and struggles, breastfeeding two or more can bring a whole new variety of challenges and complications. The most common challenges to breastfeeding twins relates to the fact that many twins are at least slightly premature.  Even a birth date at 35 weeks – which is only 1 week shy of what is considered ‘full term’ for twins - can affect a baby’s ability to nurse efficiently. And even breastfeeding healthy full-term twins brings a set of challenges that most moms and lactation consultants have never encountered.

Honestly, I want to warn you that the greatest challenges of breastfeeding for me were not logistic, nor physical. They were mental – either self-imposed, or imposed under the pressure of a well-meaning but short-sighted lactation consultant or nurse.

If you want to breastfeed your twins - exclusively or not -and make the whole experience a lot easier on yourself, I recommend you invest some time researching and learning now before the babies arrive…finding time to read and comprehend a book while playing ‘Hot Potato’ with 2 crying newborns is simply not enjoyable or effective! Read (ok, at least skim) a good comprehensive book on breastfeeding like this one...

Find a breastfeeding 101 course from le leche league, your hospital, birth center or birth and parenting education center. Nothing beats the getting the 411 in person from someone who knows what they are talking about!

Get a phone number of a lactation consultant or counselor. Try to get a referral from a friend or acquaintance who had a good experience. Also, find out how she charges - if by visit, or for calls or both. (Some may charge two fees for twins, even if they only have one visit with you. You really should not have to pay for twice when they truly only have one visit, unless they are doing extensive coaching/examination of each baby and spending twice the time doing it). Also, you should also call your insurance company to find out if L.C. is covered. - Note sometimes it is covered better or only during your postpartum hospital stay, but not thereafter. If you do have questions or problems breastfeeding when the babies arrive and sleep is in short order, the hardest part is already done –finding an expert to call, and all that’s left for you to do is pick up the phone!

Create a ‘nursing nest’. You will be spending a LOT of time with your little nurslings. You might as well do it as comfortably as possible! If you have a rocking chair, glider or other comfy chair you plan to use, create a ‘nursing nest’ with it. (If you don't have a special chair, pick a spot on the couch or other chair with space to keep supplies nearby) This means choosing place that makes the most sense for your lifestyle and schedule. Yes, instinctively you may want to place it in the babies’ room, but that may not be the best option depending on your family and preferences. For instance, since I had 2 older 3 year olds, I put my nursing nest in the living room so I could watch and interact with my other kids and make sure they weren’t getting into trouble! Next to my chair, I put a TV tray that could hold my laptop computer or a book or magazine. On the window sill of the other side of the chair, I put a small basket in which I could store all sorts of essentials – nipple cream, TV remote, an extra burp cloth, tissues, my breastfeeding reference book and my big kid’s favorite finger puppets. I also kept the boppy leaning right next to the chair as well as my breast pump.

Here are some other recommendations just based on my personal experience...

Nursing Bras

Buy just one or two nursing bra in advance, buy different styles so you can decide which you like best after you are nursing. Get one that fits even while you are pregnant, but err on the large side as your bosoms will soon have superhuman elastic capabilities. It was much easier to know what fit well AFTER I was actually nursing. Then you can stock up on your favorite bras. I also highly recommend nursing bras with one-handed access – NOT SNAPS! Sometimes you just don’t have 2 hands available when you have 2 babies!

Comfort measures

I recommend getting the gel pad ‘soothies’ and a good nipple cream. I like the cocoa butter oil-based version that is not sticky like the lanolin and it goes on nicely even if you’re a bit chaffed.

Breast Pump

You don't usually need to buy this ahead of time because first, it is hard to know what you will need, and also they usually have them available a the hospital. Though, if you are pretty sure that you want a pump, you can buy ahead of time and shop for the best deal. If you will be going back to work at some point, you will probably want to plan on buying a good pump. Some moms who stay home hardly, if ever, use one. If you aren’t going to buy your own breast pump, try to rent or borrow one. It will really help you build supply for the first several weeks and when your babies have growth spurts. If you do borrow one, you should probably buy all new parts for it at a baby superstore near you, or order online.

Find other M.O.M.s who know

Get connected with a good twins club/ moms club in your area. You will no doubt have questions or need input that is best found from other mothers of twins who have recently been in your shoes. If you can’t find a local club, join an online forum like are available at babycenter.com  that has mothers of multiples groups (like this one).  They are usually free of charge and full of compassionate women who have wisdom and experience they are eager to share.