Nurse, Bottle, Pump, Repeat: Breastfeeding Newborn Twins

I knew before I was pregnant that I wanted to try to breastfeed my babies. I also knew some people find it really difficult, some people find it really rewarding, and some people are just not interested. I'm in the "fed is best" camp and think you should do what works for you and your babies, whatever that may be in terms of feeding. I have not heard or read two breastfeeding stories that were exactly the same. Every baby is different, even when they're twins! This is the beginning of our story and what worked for us.
Nurse, Bottle, Pump, Repeat: Breastfeeding Newborn Twins. A look into the first few weeks of nursing newborn twins, including how I pumped to establish my supply, how we supplemented for the first few weeks, and how our journey with breastfeeding went.

Preparation: 
Ben and I took a breastfeeding class at the hospital where I was going to deliver. I can't recommend this enough. The lactation consultant who was teaching the class was phenomenal. She was encouraging and gave us twin specific advice. The most helpful part for me was the videos about latching. We saw how a baby should latch, what it should feel like, and told to stop and relatch the baby as many times as needed to get a good latch. I followed this advice, watched closesly at how each baby latched on and popped them off and tried again as many times as I needed to for it to feel right. I had a little soreness at first (two babies means a lot of breastfeeding sessions) but no real pain. I'm not saying this will be the case for everyone and we were fortunate not to have any problems like lip and tongue ties but it is possible to breastfeed twins pain-free! 

In the Hospital:
After the babies were born, we were taken back to labor and delivery and I was able to try and nurse them for the first time. I was worried that they were going to have trouble with their suck-swallow-breathe coordination since they were born at 36 weeks and 1 day but they did just fine! My little, tiny 4 pound 14 ounce Baby A was a champ at latching and sucking from the start. Baby B was a bit mucous-y because he came out pretty fast and was not as interested in nursing but we still had him try. The combo of this, being a bit early, and having a touch of jaundice made him a lazy eater for the first few weeks of life. If you know him now, he is basically the opposite.

I met with a lactation consultant (LC) right away and they got me a hospital grade pump to use in my room. I rented the same pump through the hospital to use at home for about a month. The babies were late term preemies at 36 weeks and 1 day so the doctors and LCs were concerned about nursing tiring them out (I've read mixed things about this since). They did not want the babies to use more energy eating than they would gain from nursing. The breastfeeding plan we made for our hospital stay was for me to nurse each baby for 10 minutes, then pump for 10 minutes to help establish my milk supply. Any colostrum I pumped would be syringe-fed to Baby B since he was not nursing as well as Baby A.

breastfeeding newborn twinsWe would repeat this process every 2.5 to 3 hours. Ben and I used the alarms on our phones to keep track of when to feed and I used the app Feed Baby Pro to keep track of the amount of time they ate. The babies' blood sugar levels were monitored every few hours and at one point Baby A's dipped a little and we opted to give her some formula to bring it up and keep her with us in our room.

At Home: 
We were sent home after two days with our hospital grade pump, pump parts, syringes, and newborn formula to use until my milk came in. The breastfeeding plan we made with the LC and our pediatrician to use at home was similar to our time in the hospital but included more supplementing to keep their weight up. I would nurse each baby for 10 minutes, pump for 10 minutes, syringe-feed Baby B the pumped colostrum, and supplement both with a bottle of formula. Ben or a family member helped with most of the feedings but if I did it alone, I would breastfeed each baby, then put them in my lap to bottle feed while I pumped at the same time. I quickly learned about the need for twin moms to be as efficient as possible!

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My milk came in 4 days after the babies were born. Once my milk was in, we used pumped milk to supplement instead of formula. Most of the time I was able to keep up with what the babies needed but we continued to use formula when needed.

Baby A continued to be a great latcher and feeder. Baby B ended up jaundiced enough to need treatment. He was more and more sluggish with eating which made it hard to get rid of his jaundice just through eating. It's a nasty little cycle! At one week old, we spent one night at the hospital so he could be under bili lights. After that, he was a much better eater and didn't need syringe feedings. 

Staying Organized:
For those first few weeks when we supplemented each nursing session, we had a system of bottle and pump preparation that helped make it easier during the night. We set up feeding kits for each night time feed. In each kit was the milk I already pumped, measured for each baby, preassembled bottles (we used Dr. Brown's (affilate link) which have a lot of parts), and clean pump parts:

night_feeding.jpgThis made the night feeds a little less painful because we didn't have to think about what we needed and didn't have to wash anything in the middle of the night. 

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The LCs recommended breastfeeding the babies separately until we were all good at nursing, then I could work on tandem feeding. While nursing the babies one at a time and with Ben helping with bottles, the whole process start to finish usually took 45 minutes to an hour. It was definitely tiring and it sometimes felt like all I did.

Cutting out the Pump
After about two and a half weeks, the babies started spitting up a lot after their bottle feeds. They had been consistently putting on weight and were getting enough milk from breastfeeding alone so their pediatrician said we could stop the bottle supplements. Let me tell you, it was such a difference once I just breastfed and was able to cut out the pumping and bottle feeding. Our feedings went from 45 minutes to an hour to just about 30 minutes, even less if I tandem fed. Tandem feeding logisitics will be a whole post on it's own!

tandem nursing newborn twins

Besides the efficiency of it, I never loved tandem feeding during the newborn phase. When they were so little, I felt like each baby always ate better by themselves and I could pay attention to their latch and sucking better. Around 6 months old, it became much easier to tandem feed but I still prefer feeding them one at a time. Here's a rare tandem feed from last week:

breastfeeding 6 month old twinsI ended up refereeing some ear, hair, and face grabbing seconds later but they were fed and that's always what counts, right?

Nurse, Bottle, Pump, Repeat: Breastfeeding Newborn Twins. A look into the first few weeks of nursing newborn twins, including how I pumped to establish my supply, how we supplemented for the first few weeks, and how our journey with breastfeeding went.

 

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