Thursday, April 5, 2012

How To (Breastfeed Twins) Part 1

I realize that this is really late in coming, and you may wonder if I even remember those days (I do....)
But I want this site to be a great resource and although I have talked a lot about it, especially in the early days, and there are labels over there on the right where you can click and see the different posts where I may have mentioned it, but I never did an actual post about how I did it, and what worked for me (us).
So....without further ado:

How to {Breastfeed Twins} Part 1
Here is Part 2

This is what scared me the most about twins, really. I didn't have the greatest experience breastfeeding Jack and I wanted to have that with our second child. 
So, as soon as I found out we were having twins, I began to panic. I knew it could be done, but I wasn't sure I could do it. 
I mean, one was hard enough for me...two? And have a 2 1/2 year old to worry about as well?

Most books I read made it seem so easy, just lie in bed and let them suck away. 
This made it sound so blissful and easy, and was not going to be realistic. 

But I knew I wanted to try, and so I set small goals. 
Knowing, that when they were delivered and if they had any NICU time would play a part. 

I asked questions, read a ton and watched videos. 

Nothing really can prepare you.

They were born at 36w3d via C-section (transverse and breech) and as soon as I was stitched up and wheeled back to the room, they allowed me to breastfeed.
I was so thankful. I was out. of it. Those drugs did a number on me, but the nurses just basically did it for me.
Christian latched on immediately and I was so relieved!
Camden had a lot of trouble, so they introduced the "shield" which helps premature infants latch on when they don't have a great knack for it yet.

Bam. We were doing it. I focused on just re-learning how to breastfeed, by doing them one at a time. Breastfeeding while recovering from a major surgery is painful....very painful.
Because they were a bit early, and a little small they wanted to make sure they were doing okay and getting what they needed. 

They had us syringe feeding, me pumping, then breastfeeding and then formula feeding. 
At EACH feed. For EACH baby.
It was ridiculous. And looking back now, I wish I could have, they only need me. I will pump in between feeding times to get my supply in, but they don't need these dumb syringes and bottles and formula.
But we were beyond exhausted, and felt this is what we had to do. They were so concerned with weight gain, it felt like they were just trying to get "ahead" of the game....but after chatting with our NICU nurse later she was upset that this is how to OB wing handles things and is a firm believer that even with twins, breast is all they need and that shouldn't be standard (she's amazing by the way)

So, my milk came in rather quickly after the c-section and I was really happy.
Unfortunately the babies were both admitted to the NICU (you can read why here)
So that really through a wrench in the works.

I was committed to providing them my milk and the opportunity to breastfeed. But they had them both placed on NG tubes when the were first admitted, so I was only going to pump for awhile.
I pumped and pumped and pumped like a crazy woman.
Once they were stronger I started breastfeeding them again.
The amazing NICU nurse said, "Let's not waste time, let's get you tandem feeding!"
So, with her help we started tandem breastfeeding in the NICU.

After some back and forth between nurses and Doctors, I was starting to do that at every feed. And both boys were on the shield at this point (Christian to just give him a break so he could focus on breathing)

It was quite the ordeal. But with the nurses help, I managed and felt really good about it, so that once we were all home (10 days later) I was doing that exclusively. 

For the first 3 months, I pretty much exclusively tandem fed around the clock.
Without Trevor's help, it would have probably been impossible (for me)
He was incredibly supportive, and was able to be home for almost 2 months with us.
We had meals provided every day for almost 2 months and people to help clean and care for Jack on occasion. We really had an incredible support system. are the basic details after that long back story ;)

I had the huge Brest Friend Twin Nursing Pillow, which provided a nice level base.
It attaches with a belt and has pockets on the side where I kept the nipple shields.
The cover is washable! And there is a little pillow you detach for your back.

For daytime feeds, I would sit in a big comfy chair, pillow strapped on to me, and a pillow under each arm to prop the nursing pillow up a bit, and also allow for more support for the boys. 
I would sit all the way back, and even sometimes cross my legs. 
Trevor would bring me one and I would latch him on one side, "football" style, and then he'd bring me the other and I'd do the same.

The main difficulties I had were: they both used a shield for awhile and those things are messy and can come off easily with really new babies. 
Both of my babies were huge pukers, with some acid reflux issues as it was really really messy. One would start puking or spitting up, and I'd have to try and pick him up and burp/clean while keeping the other latched. Usually the other one would come off and we'd have to re-latch. It was quite the process and the only thing different about the night was I would sit in bed to do this....with lots of pillows.

We would always wake the other one, when one baby woke to feed. It really helped save our sanity and also get them on a schedule. 
If Camden woke at 3:00am to eat, we'd wake Christian. They will always eat, even if it's just a bit. 
If we hadn't done this, I'd have fed them every hour of every doing this we kept them on the same schedule and I knew I'd have sleep.
With one baby you can very much go "on demand" and just let them call the shots, but you just cannot do that with twins (especially if you have another child) at least I don't think so. 
I was already on the verge of a breakdown doing it this way, I think I would have been commited if I hadn't.

*NOTE* Identical twins usually fall into sync on their own with sleep/eat cycles because of their DNA. This isn't always a given, but it does seem to happen this way more so than with fraternal twins. 

Camden, we found a few months in, had a bad tongue tie issue. We had that clipped and it made things much easier, and also getting off the shield really helped. If your twins are using those, my advice is to wait until their actual due-date and then begin to wean. Start out using it, and then after they are feeding for a bit, sneak it away...and try this off and on.
Also, try and latch them at a "non feeding" time, when they are happy and maybe a bit sleepy so they don't get frustrated because they are so hungry. 

Make sure you eat plenty (much more than you would normally, and more than the average breastfeeding Mom...because you are feeding two children!) and drink a TON of water!!!!!
And always have everything you need ready to go, so you aren't scrambling when they are ravenous. 

I used an app on my itouch that allowed me to time each baby, kept track of who ate from which side and for how long and how long they'd gone since the last feeding.
This saved my sanity. Trying to keep track of it all is impossible with your lack of sleep and brain having that with me at all times helped me to keep track of what was going on with each boy.

I did start pumping at night and after some feedings to keep up my supply, and allow Trevor to feed some so I could sleep. Since they had had bottles from the get-go it was no big deal. 

With twins, there is no "hooter hider" or any modesty. You have to be okay with you just baring it all. If people are coming over, you may want to go to the bedroom, unless it's a close friend...then just warn them, you will see everything. There is no hiding that! :)

Pumping after feedings does draw out the time, and it's exhausting. It's a great way though, to keep your milk supply up which is usually very difficult with two, especially if they were in the NICU. 

See a Lactation Consultant immediatley, and make sure she is pro TWIN breastfeeding, and not just pro...but will support you. I saw mine several times, and she got me through some moments where I thought I'd quit.

My goals were, the first 2 weeks.
Then make it to 6 weeks. 
Then take it a week at a time.

I almost quit several times, and looking back on it now.....I think I may have started feeding them individually sooner as I think I would have been even more successful.

I was told (by many a person, blog, article) that the ONLY way I could stay sane was to tandem. And even then...I may go crazy (which is true).
But I felt such pressure by that (mostly myself) that I think I did it because I was taught that way from the beginning, and I felt like I needed to do it that way.

I did learn how to do it myself (that's for the next post) but once I started letting myself feed them one at a time, I became more relaxed and less stressed. 
Some people get it right away and they have low maintenance babies and the tandem thing is no big deal. 
But mine were small, and pukers (I'm talking make sure you have a bath towel nearby) and cried a lot, and did the NICU thing...I mean, we had a rough first 3 months. 
I think the bigger they get, the easier it would be to tandem because they can hold their own and aren't so floppy (distracted, yes!)

So, don't feel pressured to tandem. 
Some Mama's breastfeed one, and bottle feed breast milk to the other...and then switch the next feeding.
Some tandem at night, and do it individually during the day or vice versa. 
There really is no wrong way.

It is hard. No matter how you look at it, it is one of the hardest things I have ever done. And even though I only made it 5 months, as opposed to my planned 1 year.....I did it. And they got good stuff and I'm thankful I made it that far with all of our circumstances. 

Support is key, you have to feel supported by your family to do this. 

In the next post I will talk about:

*Milk Supply Issues
*Feeding one at a time
*Balancing breastfeeding twins with another child in the mix
*When things don't go as planned


  1. Funny that you posted this when last night I was thinking of asking you how you did it. I have 6 week old twin girls and a 2 1/2 year old son. I for the most part pump and try to nurse a few times a day although very difficult when I am by myself with my older son. I find some pumping sessions there isn't as much milk and I worry about having enough. Although my twins weren't admitted to the NICU, one was only 4lbs 15oz. We were lucky that at Riverbend in Eugene they had donor BM. At first I felt a little weird about it but now I am so thankful for those women who donate. She needed to be eating so much and with only colostrum in I would have had to resort to formula. Anyways, I am looking forward to your next post.

  2. Yay! Better late than never, seriously! Gah, those darn nipple shields. I agree about the tandem pressure and glad you mentioned it. I hardly ever feed them at the same time anymore, it's been a few weeks I think, we go in spurts. 5 months is more than most, YOU ROCK!

  3. Woo you go mama! I luckily had an amazing eater and latcher in Mia so I could get her going than fidget with jack but he (still) isn't a good eater so I quit trying to nurse him around month 3 and we've stuck with bottles and pumping (ugh I loath the pump) ever since. It can def be done though so twin moms should not stress! We're 10 months in and still going strong! I'm going to start weening at 1 year and hopefully be done soon after that though bc it's def been exhausting!

  4. I think you have definitely made your blog a great resource for twin mamas out there. It is really difficult breastfeeding twins and I know what you mean about feeling like you were going to lose your mind. As for identical twins syncing with their sleep and eating cycles more quickly, mine did not get that memo! Hmmm, maybe I should have told them that from the get go and saved myself a lot of grief. =-)

  5. I found feeding them individually was much easier. That could be because I had four singletons first, or it could be that they were a week old before they were even in the same room as each other. They were a good two months old before we could tandem feed, and that was never feasible in public or if one baby was frantic. I used tandem feeds mostly for bedtime and first morning feed. Nice post!

  6. WOW, you did tandem all that time?! It was so hard (in my opinion) to tandem feed when they were really little. Sure, it probably would have saved some time, but like you, I pumped after feedings too, so there was essentially never enough time anyway!
    I felt a lot more relaxed just being able to nurse one at a time (one right after the other), then pumping....I usually had one that wanted more than what one breast would produce, so she got an ounce or two out of a bottle as well.
    I agree, nursing twins was by far the hardest thing I have had to do so far in life! We made it a year (BARELY), and after calculating I determined that I had spent literally 2 months solid of my life nursing or pumping for my girls. I'm so glad now that I did it, but wow, it was hard!! Good for you momma! You did a great job!!!

  7. When I have kids, you're the person I am going to talk too.. You have so much knowledge on all this and more... I don't even begin to know what all this means.. Thanks for sharing all your experiences and for being so honest.. This is so helpful to new moms and moms to be!