Need supplementing advice and encouragement

Okay, so I've been exclusively bf'ing for almost 6 months now. One baby has had weight gain problems and I've been supplementing her with EBM (pumped at night and from frozen stockpile) for over a month. At their last appointment, BOTH babies were BELOW the 5% for weight. I am TORN UP about the whole thing. I can only guess that it's a supply issue since one side has a TON more milk than the other.

At any rate, I am literally sick over the fact that they're not gaining. I now need to supplement both babies and get their weights up. I will supplement with the EBM I pump at night and use up the freezer stash until it's gone (won't be long now), then I'll move on to formula. I feel proud I made it 6 months with exclusive bf'ing. Anyway, how do I work the supplementing so it's the least PITB as possible? It sucks that we'll be living the worst of both worlds here by juggling both bf'ing and bottles. But weaning them is not an option for me.

Any advice is appreciated. Anybody else have such teeny babies???? I feel horrible. One baby is just over 12 pounds and the other is just under. Everyone who sees my babies comments on how tiny they are.

 

Since they are 6 months old, I wonder if introducing some solids would help with their weight gain? Did you pedi have any recommendations about that?

 

I'm sorry I really don't have much advice to give. I did want to say my singleton only weighed 14 lbs right before 6 months (and she weighed 7 lbs. at birth). I'm not sure what percentile that is. Are your girls reaching milestones when they are supposed to? Do they seem healthy otherwise? My daughter was extremely active and still is...I think she has a high metabolism as do I. Her "chubbiest" time was between 5 and 9 months. It seemed like after she took more solids and started walking at 9 and a half months her growth rate slowed a bit. Do the best you can and don't beat yourself up if you end up using a bit of formula. If you can start some solids maybe try to get some really "rich" ones...avocado (might have to mix it with something else), protein foods (not just fruits and veggies)..??

:hug99: :hug99:

 

My girls are both right on target for milestones, and one of them is very much ahead (has been rocking on hands and knees for a month now).

Our ped. didn't offer any advice at all. Our appointment was at the beginning of the week and I was told both babies were 25th percentile and not to worry about their weight. Unfortunately, their office calculated them as being 4 months old, not almost 6. So, when I looked up the correct percentile, my heart absolutely SANK in my chest.

I know our ped. is okay with starting solids, and I have given both girls a few tastes of "salads" (as my dear 3-year-old says = solids, avocado, rice cereal and banana). I might start to give them more, but since their weight is so far behind, I want to make sure they get either EBM or formula, as a last resort, because the nutrition is so much higher than most other age-appropriate foods.

 

I BF for only 4 months - and not exclusively. By 6 months, mine weren't 12 pounds yet, even though they were exclusively on formula by that time. BUt they were growing on their own curve, regardless of what percentile they were at. Look at the personal growth rates, not in comparison to unrelated children.

I wouldn't rush to supplement them with either EBM or formula. I would put them to the breat more, not less. If you absolutely need to supplement, I would use the supplemental system (ask a LC). That way they are getting supplemented, but are still at the breast.

 

Yeah, my first thought was what growth curve are you looking at? The formula one at the hospital? We have a growth chart in the quicklinks at the top of this page (click the link about our moderators and you should find it). It has a breastfed chart in it. I have an internet friend whose twins NEVER were on the charts.. but they were on their own and are healthy 2 year old right now!

 

Do you eat enough food? I really had to eat quite a bit of food and I have never had a problem with my kiddos weights -- at 10 months my sons are pushing 25 and 23 pounds each. I ate sweets with abandon too, since I craved them -- I have lost all my pregnancy weight (but not much else) but my take is that getting good supply is more important than my weight loss at this time. I also have seen my food cravings change as my kids have gotten older -- less sweets now, more protein and carbs.

Just a stab at what might help.

Teri D

 

I looked at the BF chart and one baby is maybe at 5th percentile and the other is definitely below it. Believe me, I eat plenty. I have the retained pregnancy weight to prove it.

Both of my babies are "demand fed," so they both are at the breast frequently. As soon as they're up from their naps, before naptime, and anytime in between if they seem agitated, unhappy, or fussy. I'm in to feed them at night multiple times. One baby has not been a good nurser, but the other one always has and her weight gain stalled at the 5th month.

Every mom has to follow her own instincts and I know my babies need more nourishment. I am already doing everything in my power to give these babies as much breastmilk as possible, staying awake into the wee hours of the night to pump enough for the next day, and sleeping only from midnight/1 am to 6 am with 4 interrupting feedings. Plus caring for an older child full-time at home!

I would just like some advice on how people supplemented to make it easiest on them. I can't imagine I'm the only one on this board who has supplemented?

Thanks!

 

If you supplement (and I certainly won't judge you for doing so) then you could offer them 1-2 oz's of formula/ebm after a few feedings each day. The other thing you could try to kill to birds with one stone, is to put some ebm/formula in a sippy and have them learn to drink from it too. You could do that with your solids meals.

HTH

 

If you are pumping at night then maybe you could use only formula at the last feeding to fill them up before bed time. Then at your first pumping you'd just have more breast milk for the stash. Also, at a few feedings during the day you could pump and let someone else feed them formula while you pump and then they'd have more breast milk to drink at the next feeding if you don't let down as well pumping. Anyhoo - that'd only be 4-6 bottles a day. I just wash mine in the dishwasher alsong with the pumping stuff. Run it on high heat wash and do it every day so you aren't washing bottles.

Does this make sense?

Will they drink alot from a bottle? My first son seemd to really be chubby (not high in percentiles??) but I attribute it to getting breast milk from the bottle...... allt he good stuff and very little work. Are your girls also lower in length? Heck, they just may be petite.

Good luck!
Merijo

 

If I remember correctly, there is a member who presently breast-feeds her little ones about 80% of the time and offers a bottle a couple times during the day. I believe it is Tracymcg. I would imagine she would be more than helpful to you. She posted a schedule a few weeks ago where it stated that she offers a bottle at night and I believe in the middle of the day. I don't know if she offers a bottle after nursing or what. I hope you're able to get your questions answered and sounds like you have great motherly instinct!

 

I don't breastfeed (and never did) but at 6 mos my dd weighed just over 10 lbs (on formula and solids) and at 13.5 mos is only 17 lbs...I wouldn't stress it if they're healthy and growing on their own curve...both my kids are 25th percentile for height, DD isn't on the charts for weight and DS is only 5th percentile at 19.5 lbs - BUT they consistantly grow 2 inches and gain at least 2 lbs every 3 mos when we go to the pedi - and he's ok with that!

 

Have you seen an LC? I had trouble with one of mine gaining weight and it turned out that he had oral weakness (they were 6 weeks premature). Plus, I'm sure she could give you advice on how to get them to gain weight..But I agree with Excitedk. Perhaps try that? Good luck!

FWIW, I have a 4 year old who gained weight s l o w l y. I supplemented with formula and that didn't help with the weight gain. Neither did solids. She's just a small kid.

 

Well, I tried the idea of giving them each a bottle of formula before bed. So, during the day I'm supplementing with my EBM from the night before. I supplement EBM during the day on an "as needed" basis if one baby is obviously still hungry.

My oldest was a very slow gainer at just 1 pound a month, but with one of my twins, I went from her having a round chubby face to her looking scrawnier and scrawnier by the week. She had been gaining a pound/month from birth, but then stopped getting that anymore. Once I started supplementing with the EBM, it was very noticeable that she was a happier baby and she feels heavier to me. When I started the extra EBM, you should have seen how DESPERATE she was to drink more. And this baby hates the bottle! I am a much happier mom, too, because my little chickies are being fed enough. SHEEW! Both babies are happier (they don't cry as soon as I set them down for a minute) and they're taking MUCH longer naps. A WIN/WIN!

Another thing that has helped is trying to make both babies stay on longer. One is very distractible and isn't nursing for as long as she used to. I thought it was just that she had learned to nurse quicker, but then I realized that she's just being a spazz. It does get frustrating, though, 'cause she's 'on again, off again, on again, off again'.

 

I'm so glad to see this thread. I have 16 week old girls that weighed in at about 9 lbs each today. They were on a 5% growth curve until this month when they had fallen below the curve. My ped has been suggesting supplementing for a while but not pushing it but today he STRONGLY suggested I give them "extra calories"... Intellectually I know it's ok. Emotionally I feel devastated. I have a 5 year old and a 2 year old and breastfed both exclusively (and kept bfing for 2 years). I know twins are different but I still can't understand why I'm not able to make enough milk to nourish my children.

Here's the thing: maybe, just maybe, if I wake the girls more often at night and stop exercising and eat more I'll make more milk. On the other hand, I'm at my wits end- my husband is getting his MBA, working full-time at a new job, my 5 and 2 year old boys need my attention and I am so frazzled at home with everyone that I'm having fantasies of driving off to live in some random Motel 6. I just don't know if I can do any more. And even if I did I'm not guaranteed it'll even work.

So I decided to do it- After the third breastfeed I gave each girl a 4 oz bottle of formula and they sucked it down even with me feeding them. Now I feel so guilty that my girls have been hungry all this time. I guess what I need is to know how to do this formula thing without losing my breastmilk. And what kind of formula to feed them... I got an organic soy formula at Whole Foods. But I don't know if soy is good or not....

gotta go... any advice is welcome. And thanks to the op for the thread!

 

Hi Beebs!! How much did they weigh at birth? When were they born? Have you ever done a test weight to see how much they are getting at the breast (it tests several weights to get a good idea)? How often are they nursing? For how long? have you done anything to help increase your supply (pump, fenugreek, etc)?

Once we get a better idea of your situation we can help more

 

At birth they weighed 6 lb 4 oz and 6 lb 5 oz and they were born at 37 w 1 d with no issues, no NICU time. Because I fed both my boys with no issues, I didn't really worry about supply early on. I got frustrated pumping because I hate to do it and there's never anything left over after they eat. Each of them drains a side. I definitely get more full on the right side- always have. I alternated girls on sides so nobody was ever stuck with the side with less milk. They gained slowly but Stella was back up to birth weight by about a month (they went down to 5 lb 6 and 5 lb 10 oz) and Charlotte was almost there. They kept gaining slowly and we went back every month, but they gained almost nothing in the last month. They also only poop every other day or so.

Here are the potential problems:

I nurse every 1-3 hours during the day but at night they sleep and sleep. We have one baby with me and the 5 year old and 'my' baby nurses on demand next to me at night. The other baby would be with my husband and the 2 year old (he only wants to sleep in his bed and will wake up freaked out if there's nobody with him in the middle of the night and its really hard to get him back to sleep so we split up.) When my husband's baby wakes up, he brings her to me and we trade. I would nurse them at about 8 pm and they'd sleep for the night. I'd nurse 'my' baby through the night but Matt's baby would sleep til 2-3. Each baby would get to nurse and sleep with me through half the night. Lately his baby has not been waking up so she sleeps from 8-5. Seems like a long time for a 9 lb baby. I try to get him to wake her up but he says he will and doesn't. If I put my baby in the co-sleeper she'll sleep most of the night, too. So I try to keep her next to me.

I've been exercising and try to eat extra calories to compensate (need the exercise to reduce stress) but have lost 17 lbs In the last three months. I'm still about 30 lbs heavier than normal, though.

I don't have much time to pump because of the 2 and 5 year olds. Also when I pump througout the day I still only end up with 2 oz total.

I have mother's milk tea but haven't used it yet.

I don't know what you mean by test weight.

What do you think?

 

Beebs - firstly, you are amazing! 4 healthy children under 6, you deserve all the praise in the world, SuperMom! :bow2:

I went through every BF trauma in the book and tons of comments/stares that the boys were "so small". As a first-time mom in a family of chubby babies, my guilt about their growth (and DH's) was off the charts along with insomnia and weight loss. OB and Ped were more worried about me than babies. But sounds like you're on a good path to take care of yourself. Well done.

Here are a few thoughts on calories, sleep and fenugreek. Hope these help.

Adding calories - mix cow's milk formula, if not allergic, 50/50 with EBM in bottles. Best of both worlds - calories (for your peace of mind) and consistent BM. I was able to BF and formula supplement until the boys were 14 months (yes they were walking). So I figured they got all the BM they needed. Ped agreed. And I didn't have to pump as much (yeah!).

Overnight feeding support - transitioning to sleeping through night. This may help with getting 2 yr old on an easier routine for him while giving him the added attention you know he needs. (You're such a good mom.) Have 2 volunteers each assigned a baby for week-long overnight shifts. First Years Night/Day double Bottle Warmer made this arrangement super-easy. DH, my dad and sister (volunteers) absolutely loved the warmer - idiot proof, you can use it in your sleep.

Fenugreek supplements - easier than tea, just pop them with your vitamins. Helped me build up supply quickly. With overnight support I was able to store up BM by pumping before/after some sleep.

Balancing intellectual with emotional motherhood is the toughest thing anyone can do. For reassurance, you may want to see the posts on another forum about size/weight. (Helped me a lot.)

Seems like most moms in your situation have twins that end up perfectly fine. So I guess there is every reason to believe yours will too!!

:hug99:

 

QUOTE(Beebs @ Jun 27 2007, 07:52 PM) [snapback]309767[/snapback]
I am so frazzled at home with everyone that I'm having fantasies of driving off to live in some random Motel 6.


I cracked UP when I read this. A month ago, a friend of mine asked about bf'ing and was curious if I'd ever considered switching to formula, since it's been so difficult. I told her that honestly, I would NEVER put them on formula. I have, however, considered running away!

As an update, things have been going well with the supplementing, and they are still almost 100% on breastmilk. They are also sleeping longer stretches at night, too. They are very happy during the day now and only fuss if they're sleepy.

 

First of all, if your pedi's not concerned and they're meeting milestones, chill. LOL! It's so easy to stress about those stupid charts. Been there, done that! But those charts are just averages of white, formula fed babies 20+ years ago. They don't reflect a lot other than to give a way to gauge how your baby is in comparison to that group. My kids are short, it's in their genes. So they're always between 5th to 15th percentile for height. One son is also thin, so at 5th %ile for weight, too. But he's strong as an ox, eats like a horse and never stops moving. But they're all healthy and very smart. The charts don't tell you any of that. Now one of my twins is so small that she's no where near the chart. But more than that she's not on the chart, the problem was that she wasn't gaining weight at all. She just didn't eat well, wasn't efficient at it, at all. We supplemented for her. I was given high-calorie formula for awhile, but that's expensive. So when it ran out, the Dr told me to mix formula into EBM. After we got her to where she wasn't starving (at about a month), we backed off some. At 3 or 4 months, I was so fed up with pumping and nursing that I quit pumping and just gave her a bottle of formula/day. At 18 months, she's still nursing, though eating lots, too. She also gets regular milk now, but I mix in evaporated milk for a calorie boost. She's never come anywhere near the chart. What my doctor was concerned about though was if she was following her own curve. She mostly has.

I think you're doing fantastic, and just want to give you permission to relax and keep up the good work! As for other specific advice, I'd start solids, but always BF first. That way they get all the milky goodness they can, then fill up on the other stuff.

 

Hi Beebs - Good to see you here (I know you from the ovusoft multiple buddy group)! Sounds like you are doing an amazing job! I have a 3 year old and my twin boys are 5 weeks and it's already been incredibly difficult. I can't imagine how much harder it would be with two kids plus the twins. I just want to give you hugs to keep up the good work and your spirits.

As to supplementing...

I've been using some formula to "top off" nursing since we were in the hospital and the pediatrician basically threatened to keep the boys in the hospital if their weight didn't go up. I had a C/S and by the 3rd or 4th day they had both lost 10% of their weight which put the smaller one at 5 pounds. I was upset but the idea of going home without my boys was enough to convince me to get over it and give them some formula. We only offered it after a breastfeeding so that they would still nurse vigorously and luckily their weight started to turn around by the day I was to be discharged. Then we were afraid to stop supplementing when we got home until we knew that they were gaining steadily. Once their weight was obviously on track, I started to try cutting down on the number of times formula was offered. We mainly use a little bit in the fussy evening hours - anywhere between 4 pm and 10 pm generally and only if one or both of them seem really hungry after feeding. Sometimes I end up nursing them almost non-stop at that time of day and I get so sore that I just can't do it anymore. Then we offer 1-2 oz of formula and it usually buys me an hour or two of rest until the next feed.

In the last 2 weeks we haven't given them more than a total of 6 ounces of formula combined in a 24 hour period. That's not too much and I think as long as we're cautious about using it I feel OK that it will not hurt our nursing success. I try to focus on building supply during the day by not using formula then and using formula to get a bit of a break during the evening and possibly longer night sleep. This seems to be working well to minimize the negative impact on nursing.

I'd love to use EBM but I get so little from pumping and have so little time between feeds that it doesn't really work. My sanity and rest is also an issue there!!

One other thing we have done a couple of times is have my DH give a bottle to each twin while I skip a nursing session to get some sleep at night. I've only done it two times and the extra rest is so nice. I worry about supply, but I think sometimes being too tired can hurt supply too so it seems like a worthwhile trade-off.

I also have to go back to work full time when they're 16 weeks old so I know I'll probably have to use some formula then - just can't imagine pumping enough for twins (This was a HUGE struggle for me with my DD who was exclusively BF and given only EBM when I returned to work). As long as they can be 80% BF until I go back to work and we can keep a BF relationship after I go to work, I think I'll be satisfied that I'm doing the best I can for the boys and myself.

Thanks to the OP for this thread. I'd love to hear how other twin mommies are using formula with BF and what works and doesn't work.

 

You've recieved so much great advice, I don't have much to add, except a word of encouragement.
In my case I supplemented from day one and breast feed for 15 months. My girls got bottles of forumla at set time though out the day and were breastfeed on demand throughout the day and night. (well I went back to work at 12 months so the last three months was really a nice slow wean).
On thing I didn't see suggested that we did was we coslept. I think that way they ate a lot more overnight and I also slept more because I usually fell back to sleep while one was feeding and didn't wake up until the other was fussing to be fed.
Also at six months, definately start a introduction to solids program. I used gerbers high protien ceral as we are mostly vegetarian so I was worried about them getting enough protien.