December 21, 2014

FIAO 5.6 - Feeding The Twins - Breastfeeding; with a twist!

I haven't done much research on it yet but I'm beginning to wonder how many women's journeys with feeding their children are as unique as mine. As I've said before I am very indecisive and tend to see both sides of something relatively easily. Just like everything else in my life this has become more apparent in my choices of nourishing the girls. Ten years ago I was anti-breastfeeding. A year ago I was absolutely sure I would do it. Finding out we were having twins originally strengthened my desire to nurse but as their arrival date drew closer I started to freak out. The idea of being a human milk machine terrified me. I pictured days spent glued the couch nursing on and off, bloody and bruised nipples and very little sleep for the first few months.

Ultimately I made up my mind to try exclusively breastfeeding but if it didn't work I would exclusively pump or formula feed if absolutely necessary. I fully support formula feeding but I wanted my girls to have breast milk either way. I was (mistakenly) under the impression that EPing would be easier, less stressful and less time consuming - because who has any extra time with newborn twins at home?  Unfortunately for us I didn't really get to actually make a choice in the beginning. My girls were formula fed in the NICU, with what little colostrum I was able to get to them, from day one. Because of their prematurity they had to learn the suck-swallow-breath reflex and the NICU wanted their feed amount to be documented, especially if we wanted them off the feeding tubes. So I pumped. Then, due to wanting to wean, I supplemented with formula (about 8 oz/day mixed with bm) for about a month total. And then, like magic, at around 3 months my baby girls decided to latch. So now, I breastfeed. Exclusively.

I have literally done it all with the exception of using donor milk or a wet nurse. I am not going to debate the benefits or downfalls of breastmilk or formula (not today at least although that would make a fascinating Great Debate post later on). Instead I want people to understand and learn from my experience.

Exclusively Pumping (for twins!)

For three and a half months, every three hours, around the clock, I hooked my heavy boobies up to a machine and expressed milk because I wanted my babies to have breastmilk. I don't even know why really. Yes, I know people think it's "better" but again I fully support formula feeding and only believe it is "better" for your wallet and because it is natural, as in not made in a factory. Really I figured if I was making it anyway then I wanted my girls to have it. So I pumped. Starting 6 hours after my c-section I was a mad woman about it. I pumped for 30-40 minutes, despite being told never to exceed 20 by numerous nurses and lactation consultants. I figured "oversupply" would not be a concern for me - I had two babies to feed and needed to build a stash!

I pumped while I visited them and all night long as if they were home. It was the hardest thing I've ever done, coming home that night after leaving them in the hospital and having to pump for them. It was also the night my milk came in so I had over 12 oz. to give them the next day which was the first time I really felt like a mom. I bought all sorts of pumping accessories (see links below!) and created the perfect pumping spot to streamline the process. Once the girls were home I fed them and pumped at the same time. It was perfect. They were eating on a schedule of every 2.5-3 hours (although I would have fed on demand they just carried this on the from the NICU themselves) and I wasn't a human milk cow with babies attached to me for days on end. It was the best of both worlds and it worked for us.

After three months, I was over it. I almost quit at 6 weeks, then managed to force myself to make it to 12 weeks when I promptly dropped from 8 to 5 pumps per day, effectively eliminating my middle of the night pumps and stretching my daytime pumps to every four or five hours. I lost about 10 oz. in the process but I was making 70 oz. per day at that point and they were only eating 50 max so it was fine. At 14 weeks I was absolutely ready to start weaning. We supplemented with formula on and off from the beginning, usually depending on my supply, which varied. I wanted to take in kids soon and definitely could not pump then so we started upping the amount of formula they got, which allowed me to bank a ton of breast milk while slowly lowering my supply to avoid mastitis. Then, at 15.5 weeks Juliette latched for the first time and my journey with exclusively pumping abruptly came to an end.

Pumping and Nursing

I continued to pump for about a week but would try to nurse every chance I could. I learned what positions worked best and got myself comfortable with tandem nursing. CJ was a little worried about missing out on his "bonding" time during the evening feeding, which he often did on his own while I pumped and had some me time. However, something unexpected was happening: the more I nursed, the more I wanted to nurse. Then we started to notice something strange about the girls' behavior after nursing vs. after a bottle. They never seemed full or satisfied after their bottle - even when we upped their oz. to 5 or 6 in one feeding. We knew they weren't still hungry but still they would cry or suck aggressively on their pacifiers. They do not do this after nursing. They decide when they're done but at 4.5 months never nurse for more than 25 minutes and they are always content after - either sleeping or playing. So we decided to drop bottles altogether. I now pump only if someone else is with them and they've had a bottle recently. Sometimes I will pump if I am engorged before bed for comfort but I can now go 9 hours overnight and wake up pain free or nurse at 3am if necessary. I pumped tonight for the first time in 10 days as we were out to dinner (first night out as a couple since they came home!) and they were asleep for the night when we got home.

Exclusviely Breastfeeding

My experience with nursing is far from typical so I won't even attempt to give advice on how nurse a newborn. It took three months for either of my twins to latch, despite many futile attempts in the beginning. I admit I wasn't pushing it after a few weeks, just trying it when I thought of it. But the closer I got to ending my pumping journey the more I wanted to experience it - even just once. And at 13 weeks, Vivienne latched first followed by Juliette at 15 weeks. I was shocked. Not only was it easy but it felt so much more natural and comfortable than the machine that had been tugging at me for so long. I didn't feel that "bond" instantly although I have a new appreciation for the closeness it creates between mom and baby.

The major plus for me does not apply for moms who start out nursing twins - time! My girls were already sleeping for 6-8 hours at night and were eating on a 3.5 hour schedule by the time we started so I only nursed 6-7x/day. Some of my other twin mom friends nursed upwards of 15/day in the beginning - per baby! The girls were already 10 lbs. so learning how to tandem feed was much easier than weeks ago when I was trying to position two five pound china dolls on the My Breast Friend pillow in the NICU.  Their suck was strong due to months of practice and they already knew what to do and how to do it - things they originally had to learn thanks to initially eating formula with a tube and then a bottle. Feedings were peaceful and quick - 20 minutes max compared to 45 with a bottle due to needing to burp more and holding upright after finishing.

And then of course the amount of time I saved making, warming and cleaning bottles. It was so much easier to just pull down my shirt and feed my kids than to do all that. Again, I know our transition to exclusive breasfeeding was unique in that it was easy and for that we are so grateful. I also know for a fact that it was only so because I stuck it out from day one and did the dirty work keeping my supply up - and then we got lucky with two little late latchers. Now we have really found what works for us. For now.

Not all babies will latch. Not all mamas will produce enough (or any, in some cases). Not everyone is comfortable with it and, simply put, not everyone wants to do it. But if you can and want to do it then breastfeeding (with breast or a bottle) is so worth it. I know when it comes down to it feeding twins is hard, no matter how you do it, but having done it all I have learned some things worth sharing.

If you want/need to Exclusively Pump:

If you can't nurse for whatever reason but want your children to have breast milk, are worried about affording formula or want to be able to nurse in the future then get educated and start pumping! Here's some tips to get you started:
  • Invest in Pumpin' Pals and a hands-free bra or necklace, like the Simplicity from  LactaMed. Or make your own by cutting holes in a sports bra.
  • Get your hands on a hospital grade pump to build your supply. Call your insurance company ASAP and find out what they provide.
  • Learn about massage and compression - it makes a huge difference. 
  • If your baby is in the NICU look at a picture of him or her while pumping at home.
  • Commit to 7-9 pumps per day around the clock for at least 20 minutes for the first 12 weeks. This will establish your supply and then you can drop pumps as desired until you start to see supply drop. 
  • Research galactagogues and try them until something works if you need a supply boost - I had great success with Bob's Red Mill Five Grain Cereal as well as drinking a dark beer just before or while pumping.  
  • Pick a few shows to watch on Netflix during MOTN (middle of the night) pumps. 
  • Rub excess milk into nipples after pumping - it is great for soothing sore nipples and healing any other skin issues.
  • Drink a TON of water, eat a TON of food (do NOT worry about reaching your pre pregnancy weight but focus on fattening up that bundle of joy!)
  • Continue to try to latch your baby - you never know when they will get the hang of it, but also it is a great stimulant for your nipples and will help you produce more. 
  • Join the facebook group Exclusively Pumping Group and the Babycenter board The Exclusive Pumpers. The support is vital to making it through this journey.
  • Learn the signs of and how to handle clogged ducts, mastitis, thrush and nipple blebs (those are super fun. not.)
  • Do not ever feel bad if you have to supplement with formula or donor milk.
  • Most importantly: do not let yourself believe for one minute that you are giving your baby less than a nursing mother does. You ARE breast feeding and if anything your journey will be bumpier and more exhausting than nursing but it is so worth it if it's what you want.

If you want to nurse:

Again, my experience is unique as I did not nurse my newborns but I have learned a few things:
  • RELAX. Baby feels your stress and gets stressed and will not latch or stay latched if they are anxious. Remind yourself that even you cannot force your baby to latch. Also, once a baby has latched you cannot force them to stay and drink. You can only provide a calm, safe place for baby to eat. They will decide when and if they will do so.
  • Try out every possible nursing position in every place to find the ones that work best for you. I prefer tandem nursing on the couch and side-lying nursing in bed because I can rest too. Neither of which I was comfortable doing without practice and patience.
  • Invest in coconut oil for sore nipples (this actually applies to both pumping and nursing).
  • It's worth repeating: Drink a TON of water, eat a TON of food (do NOT worry about reaching your pre pregnancy weight but focus on fattening up that bundle of joy!) 
  • Ask for help at the first sign of difficulty. Often women have no idea why it's not working and feel so defeated that they give up and regret it later. Whether it's a poor latch due to a tongue tie, low supply or fast letdown there are things you can do to help. Talk to an IBCLC or contact your local La Leche League. WIC also has lactation consultants on hand. The support is out there, you just have to look for it.
  • If your baby has been exposed to a bottle first invest in a nipple shield. They can help ease baby into nursing without too much of a battle at the breast.
  • Again, do not feel guilty if you have to supplement or switch completely to formula. 

If you want/need to formula feed: 

I've only done it for a little bit so far you but if you do need to supplement or choose to formula feed here's my advice:

  • If you're supplementing figure out which way of giving it works best, whether you have one bottle a day or mix it through out the day with bm. No baby eats the same way as others.
  • Don't just assume any brand will be fine, even those with similar make-up. Cheap isn't always good. Neither is expensive.
  • Do your research on formulas and find what works best for baby and your budget. 
  • Ask your doctor for samples. More often then not they are more than happy to give them to you.
  • Email and write to baby companies letting them know of your arrival for samples and coupons.
  • Do not buy all of one bottle until you know for sure your baby will drink from it and you won't lose your mind cleaning them.
  • Learn the signs of reflux and allergies as many babies can have difficulty keeping a bottle down for a number of reasons leading to miserable nights and more than a few ruined clothes.
  • Do not ever let anyone make you feel guilty for feeding your baby formula and do not feel the need to justify yourself to anyone. If they judge you they are the ones with the problem, not you. Be educated and confident in your decision. Own it.
The most important thing I have learned in all of this? Do not judge a parent for how they feed their child. Just because you see a baby with a bottle does not mean they aren't breastfed. Just because a baby is formula fed does not mean Mom didn't want to breastfeed or is lazy or doesn't love her baby as much. Nursing is amazing. Pumping is incredible. Formula feeding is awesome. Because at the end of the day as long as you are feeding your baby, you're doing the best thing for your baby.

How did you feed your baby(ies)?


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