Tuesday's Twin Tidbits - Breastfeeding

One of the most common questions I get from other moms is whether or not the twins are breastfed. And the answer is Yes! They are almost 15 months and I currently still nurse them in the morning and before bed. For the middle of the day feeding and snack they get a sippy cup of frozen breast milk. I will probably wean them completely in the next few weeks.

Prior to having children I always thought that I'd love to be able to breastfeed. But, wanted to have realistic expectations because I knew that it doesn't always go smooth. Once we found out we were having twins, it was really important for me to find out as much as I could on how to sucessfully breastfed them since it's a little different then nursing one baby. One of my favorite books is Mothering Multiples: Breastfeeding and Caring for Twins or More. It talks about a variety of different scenarios from having premature twins to latching issues to different positions for tandem feeding.

The first few weeks of breastfeeding the twins wasn't easy. They latched on great and enjoyed eating but Everett was not gaining weight. My milk took about a week to come in due to me having a csection and my body not going into labor on its own. During that time our pediatrician wanted us to give Everett a small amount of formula to help with weight gain until my milk came in. I was not happy about this, but being a new mom, did what she said. I had read enough though to know that I didn't want him on a bottle yet. So, we used a syringe that I would stick in his mouth while he was latched on, this way he would think he was still only nursing. We did this for about a week at every feeding. It was terrible! Quite the task to nurse him and squeeze milk into his mouth with a tiny syringe. At his two week appointment the lactation consultant told me that I could have been using pumped breast milk, I didn't have to use formula. They just wanted to make sure he was getting something. Would have been good to know! Luckily, after about a week, my milk fully came in and he had gained his weight back so we were able to stop. 

While we were in the hospital the lactation consultant was great! She showed me a variety of different ways to feed the twins tandem so when I was ready it could go much faster. I did try it a few times but decided that while they were so little and didn't have much control over their body it was much easier to feed them separate. I did this till they were about 4 months old. Once they were 4 months they had much more control of their head and I could hold them both at the same time to nurse. The most important part of tandem feeding them was my nursing pillow. I couldn't have done it with out the My Breast Friend Nursing Pillow - Twins Plus. 

My Breast Friend Twins Pillow - Football Hold (not me pictured)

The football hold worked best for us. (Pictured above) This allowed me to have control of both their heads and their bodies could wrap around me and stay in place. This was such a time saver! It was also nice because I didn't have to entertain one while the other one was nursing. As great as it was to save time, it did come with its own challenges. Just like sleep, my twins have such different eating styles. Emery likes to eat quick and be done. She nurses in about half the time as Everett. Everett is what I like to call a grazer. He likes to take his time. Also, due to his reflux he needs to be burped a few times throughout the feeding. As you can imagine, this was quite the task. I would have to pull him off, set him on the end of the pillow, burp him and then get him latched back on. Doing all of this while trying not to disrupt Emery who is still nursing. It did take some time to get used to, but we all figured it out. 

I tandem fed them until they were about 9 months old. At 9 months they started to get really mobile and would crawl off the bed and move around when they were finished eating. If I was still feeding one, this was a problem and meant I couldn't continue to feed them on the bed. So back to single feedings. By this age they had gotten really efficient at nursing and only nursed for 5-10 minutes so it wasn't as time consuming as when they were little. 

Here are some things that I found useful. Please know that I know by no means are these the only way to do things, they're just things I found important that worked for me!

Nursing Tips:
- Let your nurse know at delivery that you plan to breastfeed. This is so important! Skin to skin as soon as possible is not only so important for the baby but also for your body. It helps the baby stabilize their body temperature and stabilizes their heart and breathing rate. It also helps regulate the moms hormones and help with milk production.
-Nurse on demand the first few weeks. This is especially important the first week or so while you're milk is getting established. Breastfeeding is supply and demand. So initially the more your baby nurses the more milk your body will make. This is SO important for nursing twins while your body is trying to figure out how much milk it needs to produce. 
-Welcoming the Milk. When you're milk does come in you will feel like a dairy cow. I was not prepared for this. Over night it was like I had stuck two rock hard basketballs under my shirt. To help with engouragement you can take a hot shower or put a hot towel on your breast. This helps to soften you and help the milk let down. Do this before nursing. After you've nursed you can then ice to help with the pain. I know for me I was so engoraged that the babies couldn't even latch. I had to pump just for a few minutes so my breast were soft enough for them to latch on. This should only happen for a few days. 
-Wait at least 4 weeks to introduce bottle. This is kind of a controversial topic that you can find lots of different information on. But, to avoid nipple confusion, it's best to not give your baby a bottle for at least 4 weeks or until breastfeeding is fully established. When you do introduce the bottle, have dad or someone else do it so the baby doesn't get confused. 
-Find a bottle that takes the baby about the same time to finish as it does to nurse. This might take a few trials to figure out. You don't want the baby to down the bottle too quick or not have to work for it at all because then they'll start to prefer the bottle over nursing just because it's easier. We tried 3 different bottles until we found the right one. 
- Sore Nipples. While breastfeeding is getting established you will probably have sore nipples. This is partly just from your nipples getting used to the process. Another common reason for sore nipples is improper latching. This is SO important. An incorrect latch can cause such pain and can mean that the baby isn't get the correct amount of milk. Early on while my nipples were sore I really liked Lansinoh Lanolin Cream.
-Hydrate. Drink a ton of water! I would always have water with me while I was nursing. This was just an easy time that I was sitting still so could actually finish a full glass. Your body is producing and using so much liquid while nursing that you need to replenish it. 
-Eat! Your body is working so hard to make milk that it needs more calories. This is especially try if your breastfeeding twins. You need double the calories. I had to eat 3 meals, and at least 3 snacks in order to feel good. The first few weeks I had to learn this the hard way. Even in the hospital I wasn't eating enough and a few times thought I was going to pass out just from burning so many calories and not replacing them. Snacks/Meals high in protein is a great way to hold you over. One of the nurses gave me graham crackers with peanut butter to eat during the middle of the night. I loved it! I continued to eat this as a snack throughout the first year. 
-Watch your weight loss. - I know for every mom it's important to lose the baby weight. Just be sure to do this slowly. Breastfeeding alone burns so many calories and helps your stomach shrink down. But there are always those last 10 pounds or so that seem to be the hardest. If you lose weight too fast it can cause your milk supply to drop. For me this was so important since I was producing enough for two. Around 3 months I started running again and in order to keep up my milk supply and replenish the calories I lost while running, it just meant I had to eat way more then I was capable of. I quickly noticed a drop in my milk supply so had to stop running and find a way to exercise that didn't cause quick weight loss. I know this isn't the case for everyone, but just be aware of your body and how much it can handle. 
-Herbal Supplements. - Starting at about 4 weeks I started taking Fenugreek and MothersLove: More Milk Plus. I took these every day for the first year. 
-Always pump in place of a missed feeding. - I really feel that this was a huge reason I was able to keep up my milk supply. Anytime someone fed them a bottle I ALWAYS pumped. This meant if we were out at dinner I would pump on the way home or if they spent the night at my parents I would pump close to the time they would have been nursing. This sometimes can be annoying and I do not enjoy pumping, but it was so important for my supply.  In order to keep up with supply and demand my body had to continue to produce the same amount of feedings.
- Watch for gassy foods. - Some babies can be sensitive to certain foods that the mother eats. This is just something you have to pay attention to and learn your baby. The first 3 months or so both of the twins were sensitive to how much dairy I had and to broccoli. I knew that if I ate too much of either that I would pay for it later. This might require you to do some trial and error. It also won't be this way forever, but while their little stomachs are adjusting it may be best to eliminate these things from your diet. 
-Eat Oatmeal for breakfast. - Luckily, this was easy for me because I love oatmeal. Oats are a great way to increase milk supply. The easiest way I found to incorporate them into my diet was to just make a bowl of Old Fashioned Oats for breakfast each morning. But there are tons of ways to add these to your diet.
-Increase Milk Supply Naturally with foods. - There are a ton of different resources available on ways to increase your milk supply with food. The most useful one I found was an ebook from  More Milk Naturally. It has recipes for breakfast, lunch and dinner as long as list of foods that can be added to your current meals. 
-When you do wean, take it slowly. - I too had to learn this the hard way. Technically, my body overproduces. I would pump around 20+ ounces most times that I pumped. This mean that when I was ready to start cutting back on nursing my body pretty much went through shock. I had to take about 2 weeks between each feeding that I wanted to drop. Even then I would got clogged ducts and have to add a few more days. Just be very careful with clogged ducts because they can lead to mastitis. I did get the start of mastitis one time and just had to lay down and take it easy, take advil to reduce the fever, and make sure that the breast that was starting to get infected was getting completely drained. If it wasn't getting drained from nursing, then I would pump afterwards. Within 24hrs the symptoms were gone.

Twin Nursing Tips:
-When they're newborns and you're doing middle of the night feedings I found it works best to wake them up. So say baby A wakes up first hungry, feed him and put him back to sleep, then if baby B is still asleep go ahead and wake her up and feed her too. If  you don't you'll be awake all night. The few times I didn't do this I would fall back asleep and then the other baby would wake up about 30 minutes later. It was terrible. 
-If you're tandem feeding them and one twin wakes up before the other twin I wouldn't let the one sleep any longer then 30 more minutes. This helps too keep them close to the same schedule for sleep but also is important for tandem feeding. (I'll do another post on schedules).
- If you're tandem feeding then find a comfortable spot where you can sit with the twin nursing pillow. For me this was our bed. As you can imagine the pillow is quite wide, so you need space. 
-You also need a spot that you can set one down when they are finished but they're close enough for you to keep an eye on them.
-If you're individually feeding them then you'll need a place for the other twin to hang out while you're feeding the other one. I usually used the bouncer. I would sit in a comfortable chair, usually my glider, with the bouncer at my feet. That way I could bounce them with my foot or just tickle them. It worked great since they were still sitting with me and could see me while I nursed the other twin.
-Pump before you go to bed, even once they've dropped this late night feed. This helped a great deal with my supply, especially once they started sleeping through the night. It made less time between the last feeding in the night and the first early morning feed. It also allowed me to stock my freezer with breastmilk! 

In the end, be proud of yourself for however long you breastfeed. It may be the first month or it may be for a year in a half. Either way you are giving your child such a special gift. It is such a selfless act that does not always come easy. Be proud of yourself and your body!