Breastfeeding/ Slow Growth/Triple Feeding - HELP PLEASE!

I am writing here as a last resort. I am about ready to throw in the towel.

I have twin boys born at 38 weeks. I also have a 19, 18, & 16 year old that I all solely nursed without supplementing for a year each. I was much younger. I am now 42.

The twin were 5 lb 12 oz and 6 lb 12 oz at birth. They dropped to 5 lb 3 oz and 6 lbs before leaving the hospital. I was so proud of myself tandem feeding right away. They both seemed to latch on and feed well. I wanted to solely nurse for a year. I felt like super mom!

I guess I wasnt doing as well as I thought... Neither were growing much. At the 3 week weight check they were both 6 lbs 8 oz. The larger one wasnt even back to his birth weight. He was spitting up quite a bit after each feed and I didnt have breastmilk to go back and replenish what he spit up. The Dr showed me a chart of how they were both below the 3% range and they needed supplementing. At the same time, they started getting picky and wanted to only nurse alone.

I also went through mastitis and was on antibiotics so I started taking fenugreek. And then I rented a hospital scale and I became maniac about weighing them.

So they are now 4 weeks old .... and the new process as instructed by the pediatrician was to be nurse each one for 20 min (which was more like 40 minutes because they were getting fussy latching on). Then I would supplement with both breast milk and formula. I could pump about 2 oz total of breastmilk, but they wanted 2 - 2.5 oz EACH after nursing. Then I would pump for the next feed. My 30-45 minute tandem nursing just turned in to a 1.5 - 2 hour process. Then I break for an hour and start over again... I am losing my mind!

Their weight is substantially increasing and my strength to continue nursing is substantially decreasing.

The latching on continues to get worse & now they just want the bottle. I give up! I REALLY wanted to solely nurse them without supplementing. I was so proud of myself when I started. Then I was torn between starving my children, their need to grow beyond what I could provide, and my selfishness of wanting to breastfeed from the breast.

Now, without encouragament, I am planning on just pumping until I dry up and giving them a bottle of breastmilk and formula until it is just formula. I pump about 4 oz total and they eat about 6 oz total from a bottle. So I am not keeping up.

Where did this all go wrong???

Writing this with tears running down my face...Please help me!

Angie

 

:hug: I am so sorry! I am mad at that doctor for telling you to just supplement instead of helping you figure out why they weren't gaining as fast as he would have liked. I know others will get on and ask all the right questions to help you find a solution. Just know that you are not alone. The vicious supplementing/pumping cycle sucks and is hard to break. And you're not being selfish wanting to breastfeed, you're being a wonderful mom to work so hard trying to give your babies that gift. :hug:

 

You can pump and supplement if that's what you want to do, or you can breastfeed and supplement.
I never had access to a pump so I was never able to try pumping for supplementing or increasing my supply. I breastfeed my twins for 15 months, they got bottles all along.
I would suggest getting a bottle for breastfeed babies. I had one twin who had nipple confusion issues and perfered the bottle, so I changed her to a bottle that was more like a breast--she didn't like it, but I insisted and she learned to use it and I eventually changed her back to regular bottles since I only had one special bottle.
So what I did was to set formula feeds on a timed schedule--I started with every 4 hours, then dropped to every six hours then to 8 hours (3 feeds a day) I breastfeed on demand around that. So if they started fussing two hours after a bottle they only got the breast until it was time for the next bottle. I made the bottles the amount the formula package suggested for their age, if they finished that and wanted more they got the breast.

I know it seems like you are doing nothing but feeding right now--but that will change quickly. Even with my singleton at 4 weeks he was still taking at least a half an hour to feed and feeding again about an hour after he had finished. But by 6 weeks they stablize--they go through a growth spurt but after that 6 week growth spurt they get a lot better at eating quickly and going a little longer between feeds. It seems like forever while you are living it--but it's really so short (as you know, I bet you marvel that your first baby is already 19!)

There are some other posters who can give you better actual tips to manage your supply issues, but I wanted to let you know you CAN supplement and continue to breastfeed and suggest the special bottles so they don't get lazy--I think one brand is called Breastfriend.

 

Angie,

:hug: I'm so sorry you are going through this. No wonder you are on your last resort- you are worn out, or should be, from that nursing/pumping/supplementing schedule. :hug:

Here is the good news:
1.) They are only 4 weeks old. I know it feels like an eternity while you are doing it day in and day out, though. Your supply is still being established.
2.) You know they are physically capable of nursing. There aren't any physical issues (micro-preemies or a shallow latch or anything).

Here is what I would personally alter:
1.) Stop pumping. It's exhausting and you do need to rest to make milk. Hear me out on why.
2.) Instead of doing BM/formula in bottles, use an SNS (supplemental nursing system) to stimulate your breast everytime they eat; every moment they suck. This should help with supply. As you make more milk, less formula should go in the SNS.
3.) DRINK water. EAT (oatmeal, brewer's yeast, mother's milk tea). REST.
4.) Once they get adept/more willing to nurse and you are feeling a bit more rested, ditch the SNS and do a nursing marathon to bring that supply on up.

I know it's super hard.

I also liked Meximeli's suggestion about bottles at specific times- that's a good way to get a solid chunk of rest for you when others are home.

Please update us with how it goes- I will be thinking of you. :hug:

 

I know it is hard. You are really in the thick of it. Please don't beat yourself up over it. You are doing great and you're right to say you are a super mom!

I have nothing to add to the wonderful advice you got from pp's, except to hang in there. It'll get better. I promise.

 

this is exactly what i was going to say! especially about the SNS (here's the one Medela sells) - it irks me so much that doctors never suggest this when they suggest supplementing. it's a simple solution to the supplementing problem that still allows baby to be at the breast, stimulating milk production & learning to latch & suck effectively.

is there any way you can get some more support at home? friends, family, or a postpartum doula? anyone who can take care of everything else around the house right now so you can focus on resting & feeding your babies. check out DONA for more information on doulas.

last, but not least, whatever you decide to do going forward is the right decision for you. don't beat yourself up - having twins is hard. period. we all get through those early days as best we can and no one can ask for anything more. :hug:

 

Big hugs!! I hope you can find a wonderful plan to continue breastfeeding!!

I was thinking about the SNS system, I hope that can be a big help for you.

One thing that I don't think anyone mentioned was to actually have a lactation consultation. They could really help you with positioning and latching and ideas on how best to feed (SNS etc). My hospital has local lactation weekly meetings that are fun and really more like a mom's group where if you have a question you can go to the side and ask and they will help you. Otherwise it is a baby related topic that someone is showing or explaining. Or maybe you can get a private consult.

You will get through this. I loved reading all the posts here, so many great ideas! I love that we have this wonderful resource! Please make sure to keep us updated.

 

Its hard to put a time limit on it, because you never know how long it takes an individual baby to get to the end of the feed. If they don't get to finish the breast, they don't get the fatty milk that makes them grow. They just get the watery foremilk that hydrates them.
If you are still taking fenugreek you will want to add Blessed thistle to it. The best herb you can take is Mothers Love More milk plus tincture.
When the baby is well attached on the breast I would definitely do some Breast compression to help aid in milk transfer. Keep them awake and your breast draining.
Massage the heck out of your breast when you pump.
PP had a great suggestion, can you work with a good LC? How about a La Leche League leader? someone who can come support you, help come up with a plan and see you through it?!
Where are you located?
Im so sorry you are struggling!!!!!

 

A big hug! You are doing so well and it can be so hard in the beginning with twins!

Another idea to try might be a nursing marathon. This requires you to have some help so you and the babies can retire to bed or a huge confortable couch and do nothing but rest, work on latching and nurse on demand for a few days. Constant demand (i.e. constant nursing) can help increase your supply. But it is very exhausting and emotionally demanding so you really need someone there to take care of the babies' other needs (such as diaper changes, baths) and to pamper mom a bit and keep you supplied with lots of fluids and healthy meals.

I am among the many twin moms who had to supplement at first. We lived the demanding and often tearful schedule of nursing, pumping, making additional formula, bottle feeding etc. for about 3 months before my supply was fully established and before the weaker of my babies was consistently getting enough from the breast alone. We then fully breastfed and never needed formula again; we weaned at 18 months. I had very supportive and knowlegable staff in hospital, a postpartum midwife who came to see me 2-3 times a week at first and about once a week until we were fully breastfeeding (I had the luxury of my insurance paying for these visits - I know the cost can be an issue) and a pro-breastfeeding pedi; so I agree with PPs on trying to get professional advice and on trying to find pedis that are supportive of and knowledgable about breastfeeding, e.g. breastfed babies have slightly different weight gain curves from formula fed.

GL!

 

I too say ditch the pump! Why on earth use a pump (which is less effective at removing milk than a baby) to get milk that you'll turn around and give to baby? Just put babies back to the breast instead of pumping. Yes this will mean more frequent and likely longer nursing sessions, but it will save you the time at the pump and all of the time washing and preparing bottles which is equally if not more equating than just lying back and nursing. Trying to find different nursing positions where you can rest while your baby or babies nurse as well. Maybe a recliner or a side laying positions so that you can doze and get some rest. If your babes want to nurse for more than 20 mins at a time, then by all means let them. Plunk yourself in bed or on a couch with all that you need within arms reach, and nurse them as much as they are willing to. The SNS is a great idea too if they truly do need additional supplementation while your supply builds up. At this early stage of the game most women's bodies are very responsive to increased time/frequency of nursing, so if you can tackle a nursing marathon style day or two or three then your supply should boost fairly quickly. Add to that lots of water, rest as much as you can, and eating oatmeal or other galactagogues will really help!

Also don't stress on the tandem nursing. I too wanted to do that from the beginning, but to be honest we really only tandem nursed once in a blue moon (maybe once a week at the most?) until they were about 8 months old and then we tandem nursed max once a day and only now since about a year old have we tandem nursed for almost all feedings. It took a while for all three of us to figure out the tandem thing and for me it only really worked when they had developed really good head and muscle control.

Whatever you end up doing, in a few weeks and then months all of this will seem like a lifetime ago, so try to keep your spirits up and focus on the end goal rather than focusing on the here and now which is undeniably emotionally and physically draining.

Good luck!

 

Hi.... i know exactly what you are going through, I was there a couple of months ago.

My boys are now 3.5 months. Here is my brief story. I have a 4 yr old whom I BF for 2yr7mo wanted to do whatever I could for these boys. Started out tandem in the hospital, so proud of myself... started going to the doc, and sure enough even at 4 weeks we were still not back at birth weight (6.6 and 7.1 36.2weeks). During those 4 weeks, with weekly or even bi weekly doc weight checks, I was told to supplement. Truth be told i maybe did it once a day and only 2 oz. I was pumping after 4-6 feedings a day to increase, but i was only getting less than a half oz a side, and it was exhausting me. I was also taking fenugreek and blessed thistle from the beginning (still am). I think I lead the doc to believe I was supplementing more than I was... but i was certain i could feed them without supplementation (with my DD my milk didnt come in for 10 days and i did the SNS and all sorts of stuff and wanted to avoid the SNS at all costs this time). At 4 weeks she was finally ok with the gain. I convinced myself we didnt need to supplement any more. For the next couple weeks I could not figure out why my babies cried all the time.... turns out they were just hungry. At the 2mo appointment their weight was still lower than the doc wanted. I realized that I had to forget what I wanted and get some fat on my babies. I did a lot of research and decided to make my own formula using the Nourishing Traditions Raw Milk formula recipe. I found a farm to buy raw milk from and acquired all the other ingredients.... that was a month ago. I have been supplementing with it 2-3x a day 6-10oz for each of them a day and they are gaining fabulously! They are still hungry from time to time when I just do not have enough milk for them, but I refuse to add in any more supplements. I just got a prescription from my OB for domperidone, a drug with a side effect of increasing milk supply. It is my one last attempt. The back of my mind wonders if I should try pumping again, but there just is not time. They nurse every 2 hrs and usually for 40 min, add in the supplements to 3 of those feedings and i am lucky to be able to change their diaper and potty myself before it is time to start again, much less pump. So my hope is that on domperidone I will be able to increase my supply and can ditch the formula supplements... if not, we are close to 6mo and hopefully solids can fulfill any gaps my milk leaves.

feel free to PM me if you want to talk more about my experience... but i say ditch the pump, nurse those babies! supplement when you need to, and it does get better!

 

Thank you to all of you for your support!!!

I am so glad to hear that when others say I have breastfeed for "X" number of months - it doesn't always mean without supplementation! I have let go a bit of my "super mom" attitude and I have come to realize that supplementing with breast milk or formula is ok. I must rather enjoy the satisfaction of seeing them drowsy and full. We call it "milk drunk."

They weighed over 7 lbs today with a diaper on! I can see the progress of the past week.

Last night I skipped the 2 hour feeding process in the middle of the night. I pumped for 20 minutes and went back to bed and let others help me feed, change diapers, etc. I feel like a new woman.

I have decided that I produce about 2.5 oz a side at each feeding. They are happiest with 3.5 to 4 oz. Wherever it comes from... it is ok.

They are latching on and there is only slight nipple confusion. We even tandem nursed once today. I guess the more rested I am, the better the whole process goes.

And yes, it still takes up my entire day! I left the house for a total of 2 hours this week. But it is only for a season. And it is all worth it!

From all of you .... I learned about the fatty milk. I contacted a lactation consultant. I look forward to the 6 week mark and the stabilizing of my supply. And most of all, I learned to be ok with what I can do and not always strive for more.

Thank you so much! The breastfeeding of these boys continues!

 

It sounds like you're in a much better place now.. rest works wonders! I think you've been given some really terrific advice here. I will just add that I am glad that you've found the key to getting through bf'ing twins; being forgiving and gentle with yourself. You're giving them breastmilk every day as often as you can which is a beautiful thing.

 

thanks for the update! it's amazing what a couple of hours of uninterrupted sleep can do for a new mommy. keep up the good work - i'm so glad to hear you've been trying different things & finding what works. :good:

 

So happy to hear that you're feeling better after a little rest!! :youcandoit:

 

If you haven't seen Jane Mortons video yet, take the 10 minutes to watch it! Its a great video and really helps maximize your output for the times that you do pump! VIDEO

Also really doing some breast compression whle the twins nurse. The more you squeeze out, the more your body will produce.

Great job! Im so happy you are feeling better

 

Great advice. I want to add that you get 2.5 oz per side from the pump, but women can only pump 1/2-2/3 what a baby can get. Thus, the amounts they are preferring IS likely what you are producing.

I want to go back to early posts and say that it sounds like your ped is not very knowledgable about breastfeeding. Most are not, and I can say this because as a pediatrician I know that there is no formal breastfeeding education in residency programs. I learned everything I know about breastfeeding from doing it myself, reading to learn more, talking to LC's, and this forum. So, the growth of your smaller one of over a pound in 3 weeks tells me that it doesn't matter he was at the 3rd percentile. My DS was 5 lb 6 oz when he was born and he has remained at the 3-5 percentile since then. He follows the curve and I don't expect him to gain fast because he is built small. Also, another pp mentioned different growth charts. Most peds use the CDC growth charts which are based on formula fed babies. Look up the WHO charts and use those when you chart their growth.

Also, limiting the time at the breast and then giving a bottle after just teaches the babies that if they hold out that 20 min, they get fed without having to work at it. I would save the bottles for feedings that you skip when others are helping you. I also agree that tandem may be too difficult at this stage. I didn't tandem until mine were 3 months old or so, because I liked to have both hands to keep baby awake, compress my breast to help with milk flow, etc. Even then, I only tandemed when time was of the essence because I liked being able to spend a little 1 on 1 time with each of them.

Keep up the good work and use sites like kellymom to get your info, make a plan for slowly dropping bottles as they get stronger and nurse more actively, and know that it always gets easier.

 

Hi there! My twins were born at 35 weeks and we doing awesome with nursing. They lost some weight while in the Special Care nursery, maybe a little more than a singleton usually does, so they started me with the supplementing and when they sent us home I was charged with the near impossible task of nursing, pumping, breastfeeding, bottlefeeding, supplementing twins etc etc etc. They started having issues with bottles and latches, and all that stuff. A few weeks in, I felt like I was going to DIE. It was so hard. They had a nurse come by my house to check their weights every few days and I felt so stressed out about every time I watched those numbers light up on that scale. And I had nursed 2 children before them so it wasn't like I was inexperienced. By the time I went for their check up with our family pediatrician I was in tears...like sobbing tears. And he said, "Well, I think you should just put all the pumping and supplementing aside and just nurse them!!!!" And that's what I did. And it became SO much more manageable because I could just focus on one thing and put all my energy into that one method rather than being all over the place. They were about 3 weeks old. These are some things that I did to help to make the transition.

1) I stopped trying to tandem nurse. I nursed them one at a time, but I would do one and then the other right after. I focused on getting them latching good and "teaching" them how to nurse well but just giving them that one on one attention. When ever I tried tandem at that age they did not latch well, they sort of slid down and I would get sore, etc. and it just created issues for us. I knew that I KNEW how to nurse one child so I used my previous experience with this to help build my confidence and their ability to nurse more efficiently. I just focused on nursing ONE baby...but doing it TWICE! Do you get what I'm saying?? I'm sure this helped build my milk supply too. (And I ended up nursing them for 16 months!)

2) I got help from a Lactation Consultant. We had one that helped us so much at the hospital. I found out that if I made an appt. to bring the babies to the hospital to work with her it would be covered by insurance. (If she came to our house, it wasn't covered.) So I went in for an appt. at least 1-2 times and communicated with her via email often. She was soooo willing to help because I think she was thrilled to see how determined I was to nurse twins..she was willing to go above and beyond to help.

3) If in the end you find a system of pumping, nursing and supplementing that works for you and you are happy with....then go for it with no looking back!!! My sister nursed her first 3 children, then she had twins and she pumped for a few weeks and then bottlefed. You do what you gotta do. They will be fine and healthy and you will be a good Mom no matter what.

So mostly I just wanted to give you some encouragement. It seems like I was in a very similar situation as you and it was possible to switch to nursing at that point without too much difficulty. So don't be afraid to try it if you want to.

Hang in there. One of my 2 year old twins is sitting on my lap while I'm typing this message and she's singing the "Wheels on the Bus"......this will be YOU someday!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I never thought I'd get here, but here I am. Keep taking it one day at a time.


shannon

 

I just wanted to add that feeding them one at a time actually took less time than the whole nursing, pumping, bottle thing.....so it was actually more efficient use of the time and as they got older they got really fast (as you know.) And then I would tandem nurse them if I was in a hurry.

I love how doctors sometimes tell you to do these things that are next to impossible in reality. THEY should try feeding each for 20 minutes and then supplementing and pumping!!!!! And then starting all over as soon as you finish with no time to eat, sleep or think!!!!!!



Shannon

 

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