Getting started nursing twins...

There is a ton of information, some good, some bad, some incorrect, some phenomenally supportive and what some might consider miraculous out there. But, without a good base, nursing a single baby or twins can be the most difficult, self-defeating activity ever attempted by a nursing mom. This thread will be a collection of tips (1 tip per post reply, please!) for getting started with nursing, whether you have one or two, but mostly if you have two.
Topics... click or scroll down.

• 
  Latching
  Positioning
  Building Supply
  The ins and outs of Pumping
  Nursing Paraphenalia
  Benefits by baby's age
  The Stages of Breastfeeding
  Breastfeeding WIKI Links

This thread will be maintained by the TS moderators, so if you add to it and your post gets deleted, look back through the appropriate subject area... it'll be there with a noted thank you!

 

Latching...

The Attachment page discusses the key to succssful nursing -- latch.

The basis for ALL successful nursing is a good latch. We all know that the baby must get as much of the breast into his mouth as possible. How in the world can this be accomplished? Try this "new" method! While I personally cannot vouch for it, a friend of mine, as well as other TS'ers, say it's a miracle latch!

The Latch poster Print this, buy this, follow this!

Rebecca Glover Breastfeeding Educational Aids This link points to the main page if you are interested in perusing yourself.

 

Positioning...
So, you've figured it out... two boobs... two babies... you're good to go. Got the latch down. Now how in the world do you hold two babies such that they can both eat; and eat successfully?

This is a good website showing drawings of positions. Check out that link specifically. Breastfeeding Twins

Here are a series of photos, on positioning twins from Breastfeeding.com: Breastfeeding Twins!

Another great site... LOTS(!) of pictures... all the possible combinations of positions too! (Thanks LisaGoeke!)
Karen Gromada

 

Building supply
Ok... got the latch down *and* you have now figured out how to position each baby... whether or not you are tandem nursing.

But, you don't think they are getting enough! While we all know that there is only a super-small percentage (1% maybe?) of women who cannot produce enough milk, we also know that the other 99% of us can!

It's all about supply and demand. The more you nurse, the more your body will think it needs to produce.

You've got the concept down, but still think there is a problem? Try these ideas then...

Herbs... aka galactogogues Note: Most of this came from Mehera, another successful TS nursing mom of twins!

• Fenugreek - Start with 1 cap, 3x a day and work your way up. Typical dose is 2-3 caps 3x a day. Do not take it if you or baby has a peanut allergy because fenugreek is related to chick pea (both are legumes) and often people with an allergy to a legume will have an allergic reaction to fenugreek. Discontinue if baby gets diarrhea. Sometimes makes moms gassy but taking it in combination with blessed thistle often counteracts that. Also can make baby gassy and/or irritable. Fenugreek has a hypoglycemic effect so watch for symptoms especially if you are hypoglycemic or have diabetes. Do NOT take while pregnant as it's a uterine stimulant!
  Blessed Thistle - one of the better ones. Works well in combination with fenugreek. Be careful if you have hay fever type allergies as it can aggravate them.
  Brewer's Yeast - High in B12 which is a vitamin we use up in great quantities when under stress. (No, it's not the same yeast that causes thrush.) You can use other sources of B12 instead. The pills aren't as hard to get down as the powder which tastes disgusting.
  Mother's Milk Tea-- usually contains some combination of fennel seeds, coriander seeds, chamomile flowers, lemongrass, borage leaves, blessed thistle leaves, star anise, comfrey leaves, and fenugreek seeds; some formulations contain mint which can be drying to some women (see below for list of what some of these things are and what they might do)
  Marshmallow (the herb, not the candy with the similar name) - works for some women for reasons I have not been able to determine.
  Red Raspberry LEAF tea (not raspberry flavor which usually doesn't even come from raspberries or so I'm told by a chemist I know) - this is generally recommended for any sort of "female problems". It is high in calcium and vitamin C which is good while nursing.
  Alfalfa - be careful if you have hay fever-type allergies as it can aggravate them. I can't remember why this one is supposed to work. Guess I need to check the archives because it's been posted here before.
  Evening Primrose Oil or Flax Seed Oil - have essential fatty acids which we often don't get enough from food. Therefore even if it doesn't increase supply, it will give your milk more of the "good" kind of fats. The theory is that it improves your hormonal status and that allows you to make milk more efficiently. EPO in particular is a naturally occurring prostoglandin, (which is why it's recommended as a vaginal suppository to help ripen the cervix post-term in the pg woman).
  Fennel - I'm not sure why it's considered a galactogogue but it gets recommended a lot and seems to work for some. Like a lot of galactogogues, it is supposed to be good for stomach ailments.
  Saw Palmetto - not recommended very often but most supermarkets carry it so it's easy to get which is a plus in its favor. Again it is supposed to be good for stomach ailments.
  Root beer (brewed from the actual root, not the commercial stuff) - Not sure where this recommendation comes from either but we talked about it on the Pump List before and I vaguely recall that whatever the logic was made a certain amount of sense.
  Anise seed - don't know why it's considered a galactogogue or how well it really works. It's also supposed to be good for stomach ailments.
  Protein - in any form. similar theory as to why it work work as for brewer's yeast.

Pumping...
It has been suggested (and proven) that pumping for 10-15 minutes after each nursing session can help build supply. The additional stimulation produced by the pump triggers your body to produce more. You may not get much while pumping, but it is a signal to your body and over time, will help.

Do you need to this this forever and at every session? Certainly not! But in the first 6 weeks, while your body is trying to adjust and your supply is getting established, that's a good time to help by pumping.

Foods

• Oatmeal - use in any form; quantity needed varies. Like many galactogogues, it's considered good for stomach ailments, is alkaloid and has a high GI index. Other than that, no one knows why it works though we do know that it increases the amount of testosterone in the blood.
  Gatorade - perhaps because of the electrolytes in them.

Prescription drugs

• Reglan - many moms have tried, used and been sucessful with Reglan. While it's intention was certainly not as a milk producer, it has a "side effect" for nursing moms that it does increase milk supply. Only your OB, GP or physician can prescribe Reglan for this purpose.
  Domperidone - again a prescription drug that has been effectively used by some women to increase milk supply.

What to avoid!
As long as we are talking about milk producing herbs, foods and such, let's talk about the opposite. Here are some things to avoid as they tend to suppress milk production:

• Sage
  Thyme
  Mint (note: some "cinnamon" candies are actually made with mint oils)
  Decongestants
  Oregano
  cabbage leaves in the bra (but you can eat cabbage)
  Birth Control pills

Everything but birth control pills hurt milk production because they are drying. While sage, thyme, mint, etc are drying, usually in the quantities that most moms consume them in, they may make no noticeable difference. So having a mint candy once in a while (which is mostly sugar and hardly any mint) is probably okay but if you've been guzzling mint tea or something, you might want to stop. Sometimes a typical Thanksgiving meal has enough combination of all these spices that some moms do notice a supply drop the next day.

With birth control pills, it's the hormones. Combination pills almost always affect supply although the older the baby gets, the less chance of them doing that. Some women find they can take them okay once their baby is past a year old.

The mini-pill (and related bc like Depo-Provera) is generally considered okay though there is anecdotal evidence that for *some* women they impact supply. Also, they should *never* be taken before 6 weeks postpartum as it's the withdrawal of progesterone following the pregnancy that signals the body to make milk. If you take the progesterone pill or shot during that time, your body gets an opposite signal.

 

Pumping Pumping can be a blessing and a curse. It's a blessing in that you can provide your babies with the "best stuff on earth" but let others do the feeding. It's a curse because it requires a series of finding time, pumping, cleaning, bottling, bottle feeding, cleaning and repeating at the same interval as all other feedings. Some moms find that pumping works better for them.
Some (like me!) find a combination of nursing and pumping works. And, some find that pumping is such a nightmare that they want to throw their pump away!
Babies can ALWAYS pull more than a pump Babies are the most efficient milk elimination devices around. If you are having supply problems, a nursing baby is the best way to correct it. If you need to produce more, a nursing baby is the best way to build it. If you have clogs you need to take care of... a nursing baby is the best way to correct it.
Not all breasts are made to pump. Huh? Not pumpable? That's correct! Some women's breasts do not respond well to pumping. Babies can pull much more than a pump. Sure the pump can stimulate your body into thinking it needs to produce, but not as effectively as a baby can. So, if your baby nurses for 'x' amount of time and is happy for 'y' amount of time, but at another session you only pull 1oz, it's likely it's just because of this "phenomenon" and not to worry! You do have enough of a supply! Your baby will tell you that by being content for 1/2-3 hours between feedings and by having the appropriate number of wet and poopy diapers.
When to pump?It really depends on your situation... In the NICU -- pump after each practice nursing session and around the clock, giving yourself one 4-5 hour break at night. SAHM moms -- never? Some SAHMs never pump. They just don't need to or want to. For a freezer stash -- the best time is right after the first morning nursing session when your breasts are the fullest For building supply -- after each nursing session for an additionl a 5-10 minutes. When going back to work -- any time your baby would have otherwise nursed. In an 8 hour day, I personally found I had to pump 3x a day for my twins, but only 2x a day for my son. When you have clogs, mastitis, thrush -- this may help alleviate or correct the problem. If you have thrush, you must use the milk then... and not freeze it! Other -- if you would like family and friends to feed your babies, then you can let them! Just pump in replacement of a nursing session.
Pumping exclusively If you find that nursing is just not going to work for you, but you still believe in the "best stuff on earth" being breastmilk, then you can certainly pump and provide that milk via bottle. It's still the good stuff, just provided in a little different manner! In this case you'll need to pump every 3 hours around the clock, giving yourself only one 4-5 hour break at night.
Tips to help make pumping easierHave your babies in front of you while you pump. Looking at them can mentally stimulate your body to produce Have a picture of your baby with you. Ditto the above. Close your eyes and meditate while you pump. Relaxation is key to producing milk. Stress can hinder your supply. Imagine milk flowing from your body. Sounds corny, but it works!! Massage your breasts. As the pump pumps, use your hands to massage, starting at the top and work your way down to the nipple. Use a double electric pump. Single or manual pumps are great for one-off pumping. If you need speed and efficiency, get a double electric.
How to pump video.
Which breastpump to buy?I tend to be biased to Medela having purchased, owned and operated two separate pumps (the first 7 years before the 2nd) and being "married" to my pump. I owned the Medela PIS original. Best pump on earth IMHO!
More details here as they are submitted!

 

Nursing Paraphenalia
All the *stuff* that goes along with nursing. And you just thought you'd buy the babies a crib and playpen!

There are many helpful items utilized by nursing moms. These include chairs, pillows, necklaces, foot stools, lanolin and other items. Sometimes they help early on. Sometimes they help later on. Some women find they need them for a whole year. Others find the can't stand them. Read over, consider, get more input and then make your own decision!

• Chairs - Nursing one baby is relatively easy in a comfortable reclining chair. Nursing two requires a bit more strategic planning. You may need to add pillows under your own arms for support. You may find it's completely and totally impossible to do in a single-person sized chair.
  Nursing pillow -- the most recommended pillow for nursing twins is the EZ-2 Nurse Pillow. There are two kinds... the inflatable and the foam. Both have their pros and cons. The inflatable is very portable, but may be less flexible when being used. The foam version isn't as portable (simply because it's big!) but may accomodate babies better as they grow and "reshape" the pillow with their bodies.
  Boppies -- great if you are nursing one. But with two, you need more support. Otherwise, two boppies are wonderful for tummy time!
  Nursing necklaces -- these are necklaces designed to entice a baby to remain facing mom while nursing. The expectation is that baby will stay focused on nursing while playing with the necklace.
  Foot stools -- Great for helping MOM keep her posture while sitting, for ergonomics and for raising your knees up slightly to help support babies head.
  Lanolin - the miracle nipple salve. Lanolin can be applied to your nipples to help maintain moisture. It has been suggested that lanolin shouldn't be used all the time as the excess moisture could lead to thrush. But, use on a regular basis, after pumping, when learning to latch (it's helpful in learning to latch!) or when there is a milk blister or other nipple based problem. Lanolin was my God-send for the prevention of milk blisters! You do NOT have to wipe off lanolin before baby eats.

 

Breastfeeding benefits for your baby... by age

The following article was written by Diane Wiessinger regarding the benefits of breastfeeding ... for a day, a week, a month, a year and beyond.

Benefits to breastfeeding... by the ages and stages

Direct URL: http://www.parentingweb.com/lounge/dw_wean.htm

 

Hope you find these WIKI articles useful!

[Wiki]Breastfeeding_Twins_Part_1[/Wiki] (Educating Yourself)
[Wiki]Breastfeeding_Twins_Part_2[/Wiki] (Planning and Prioritizing)
[Wiki]Breastfeeding_Twins_Part_3[/Wiki] (Support and Flexibility)
[Wiki]Breastfeeding_Twins_Part_4[/Wiki] (Keeping Track of Who, What and When)
[Wiki]Breastfeeding_Twins_Part_5[/Wiki] (Sleep and Supplements)
[Wiki]Breastfeeding_Diet[/Wiki]
[Wiki]Weaning Toddlers[/Wiki]

 

The Stages of Breastfeeding