Getting Established with Breastfeeding Twins
I first met Lactation Consultant Trish Warder three years ago as I needed help to get my babies breastfeeding. My girls were around two months old and I had really struggled to get feeding established but was slowly losing the battle. I was at a point of almost 70% bottle feeding them with formula, but I wasn’t ready to give up on my dream to breastfeed my babies.
Trish quickly discovered that both of my girls were tongue-tied which was causing the pain I was experiencing plus the reduced milk intake and fast diminishing milk supply, despite what seemed like HOURS of pumping.
Once we remedied the tongue tie issue, within a week we were back on track to fully breastfeeding, working with one baby at a time until both were fully breastfed.
It took over three months of blood, sweat and tears to get breastfeeding underway for me, so in the hopes that you don’t go through the same experience, I have asked Trish to share some of her amazing experience and advice with you.
Preparation is key and it is vitally important that you seek help early. Having help in your own home, with an experienced Lactation Consultant like Trish, could be the difference between you having success with breastfeeding, or not. Read on for some of the key things to consider in your breastfeeding journey.
Enjoy and all the best with your breastfeeding journey
The success of breastfeeding is associated with events occurring in the first two weeks of life, if not in the first 3-5 days after birth (Journal of Pediatrics 2002)
So how do we get off to a good start with breastfeeding?
For mums in general, it pays to spend some time in pregnancy really learning about breastfeeding. Your antenatal classes are a good start. Maybe some reading and speaking to other mums; especially those who are breastfeeding successfully. Attending a La Leche League meeting (breastfeeding support group) would certainly give a lot of practical and visual information too.
In this day and age it’s not uncommon for mums-to-be to have never held a baby or actually seen another mother breastfeed…let alone breastfeed twins. Mums with twins really need information that is specific to you, so your histories will have bearing on how feeding is managed.
While generic information helps, we also need more specific information for your situation. For instance, twins are often early and it’s not uncommon to have a caesarean or for early babies to go to Baby Unit. Certainly feeding issues are more likely, so it makes sense to have more knowledge, more strategies and generally be more organised.
Using a Lactation Consultant
Consider having a one on one consultation with a Lactation Consultant to ensure you have a clear understanding of breastfeeding. I’m in Auckland and the NZLCA Lactation Consultants website will help you locate other Lactation Consultants in your area.
The more prepared you are, the better. How often do you hear “it didn’t work for us”, or “I tried really hard but it all fell apart”? Make sure you have a game plan because knowledge is power.
Mothers often feel overwhelmed, overtired and overdosed on advice after birth. And what’s worse is that the advice is not always correct for you and your babies! With an overload of advice, who should you follow? People may be saying opposing things so understanding more will put you a step ahead. If you have learnt the basics in pregnancy you will be able to better identify what is useful for you.
So with that in mind, you won’t be surprised to hear that a lactation consultation with me takes 1 ½ hours. This is because there is plenty to cover. Here are some of the things we talk about:
Your concerns, your questions. Finding out what you know; clarifying information. Extending it.
Answering questions like: what does supply equals demand really mean? what is demand feeding? how do we get a routine? how do we settle a baby? understand a baby’s behaviour? And so on.
You will have heard that breastfeeding and breast milk has a bucket load of health benefits for your baby and indeed for your health, but how many of these do you really know?
Then I need to take into account your previous feeding history, your medical history, obstetric history, how these may impact your feeding, your expectations and goals. And there’s more: priorities in getting breastfeeding going, what is normal versus abnormal? what to expect? tips on helping you survive, when to seek help, where and how?
It’s great if you have already met a Lactation Consultant. She is there to talk to and to see if needed. It’s so much better to go through this information ahead of time and have a personalised game plan.
Getting the Basics Right
To get breastfeeding off to the best start the basics need to be kept in mind.
I think there are three priorities:
- Feed the baby
- Grow the milk production
- Protect your mental health.
1. Feed the Baby
A newborn baby grows very fast after the initial weight loss on day 3. All mums and babies learn together and at their own pace. Babies are unique individuals with different personalities, appetites and abilities. However they need to be fed early (within the first hour), frequently (>8x per day) & efficiently (he/ she is really feeding & swallowing lots after the first few days).
Mothers and babies need to practice their positioning and latching. It makes sense that you may practice with your babies individually at first. With time many twin mums prefer to tandem feed both at the same time. It’s one of those things that you work towards because time is precious. Understanding the mechanics and finer points ahead of time gives you a big advantage. Feeding can get out of control so easily.
2. Grow the Milk Production
Milk production needs to grow rapidly and most mothers can produce all that is required and more. Having said that, if feeding is not managed well in the early days, some mothers don’t make full milk production.I have certainly worked with mums who have previously had a poor milk production but subsequently had an oversupply!
Did you know you have colostrum (the first milk) from 16 weeks in your pregnancy? You may never see it but it’s there. And within 5 days of birth our breasts can be producing 500ml. Of course it varies and a lot is dependent on how well the breasts are stimulated.
The baby’s job is to drive up the milk production however many babies are not capable at first. They may be early or ineffective or have other needs. Twins may come into this category. Maybe one feeds well and the other doesn’t and will require a ‘top up’ of your milk.
The first week after birth is a very important time for your milk production to grow. If one or both of your babies are not feeding well, in other words they can’t complete the job themselves, and need extra milk then protect your milk production. Grow your milk production by expressing your breasts. Otherwise breastfeeding may get harder after a few weeks instead of easier. We don’t want that! Most mums are hanging out for the time when feeding becomes quicker.It’s true to say that getting the feeding sorted makes life a lot easier.
Consequently pumps often play a part with twins- but it’s important to know that they are not all equally effective. Don’t buy one in pregnancy! Different pumps have different abilities and are used for different jobs. You will need specific guidance and the tips that will make using one easier for you.
Mastitis is a painful blockage in the breast and it occurs mostly because the breast needs to be better drained. Yes, it is as painful as your friend told you! But you can learn how to identify an early blockage and prevent it getting out of control. More mastitis occurs with mums of twins as she has two babies learning to drain the breast.
A little about your diet. Yes, do eat well- but research says that breastfeeding mums need a mere 500cals more per day per baby. So as you can see, the amount you eat isn’t a deal breaker for creating a good milk production.
3. Protect your Mental Health
Spend time now setting up an awesome support network. All new mums need good support especially in the early weeks. Twin mums need more support as you have two babies, after all! You need to be mothered. You will be tired and needing lots of love, positivity and practical support. And probably less advice! You will need the opportunity to get to know and feed your babies. There is much more feeding than you will ever imagine and there is no magic one answer to surviving.
Make sure you organise your support team ahead of time. Chat with people ahead of time- explain what you want. They may be keener to feed your babies and sit and chat but that’s no help at all!
Think meal rosters, house cleaning, a general dogsbody to be your helper- and yes, to bring you lunch and a cuppa. And yes, to hold and settle a baby while you have a rest. Invaluable. Even if you have to do a contra with a friend who has already had her baby and you can help out. Or maybe you can buy in some help just for those early weeks. It’s well worth looking at that possibility. Be good to yourself- buy that help in- ask for that extra help. Surround yourself with those who are positive about breastfeeding- this helps when we are feeling tired and low- others won’t help you achieve breastfeeding.
Set your environment up including feeding stations with everything you need on hand and definitely sometimes allow yourself to cut corners- for instance while we have to feed our babies, bathing is not a priority.
Finally, be realistic in your expectations. Be patient and kind to yourself. Remember the priorities:
Grow the baby.
Grow your milk production.
Protect your mental health.
Be prepared for challenges, particularly in the first weeks, and get help quickly:
Mothers, get help for yourselves if you have sore nipples, painful breastfeeding, mastitis, milk production issues or if you feel that things are not improving.
For your babies; get help if they have latching problems, poor growth, inadequate output, require other milk for top ups or are unsettled or sleepy.
All mums are special; twin mums doubley so!
Trish Warder has been working with New Zealand families for thirty years. She worked at Princess Mary Hospital (before Starship) then Plunket and the Plunket Family Centre.
She enjoys education and worked with the teenage mums at Bethany Centre. She has also worked as a Childbirth Educator and has facilitated Preparing to Breastfeed workshops for pregnant mums.
She has been a IBCLC/ International Board Certified Lactation Consultant for 25 years- seven of these were as a Hospital Lactation Consultant.
She now works in private practice in Auckland as a Lactation Consultant and postnatal midwife.
Trish sees mothers at home or in the clinic.