rough day, feeling ready to give up

I know it's going to get better, but these two are driving me nuts since last night. The cluster feeding part of the growth spurt seems to be over, and their demand is up. No supply problems, I'm still oversupplying. I don't think their digestive system can keep up with their demand though or something -- they're grunting and groaning and straining, passing gas and having massive poops, pretty much constantly since last night. Previously they'd eat, then sleep pretty well for a couple hours, then have some grunting and groaning and gas, then repeat, whether they breastfed or took a bottle. Starting last night they basically have been grunting and groaning and straining almost nonstop, sometimes squealing or screaming, sometimes arching their backs, sometimes doing it during their feeds. (They are almost 10 weeks old, but adjusted age 1 week.)

When they get a bottle feed, they'll drink the whole bottle in pretty much one go -- 3oz now, and sometimes they want more. They spit up some but they generally do well and then sleep well after. When I try to breastfeed, they swap which one is going to eat well and which one is going to fuss and scream and spend the whole time trying to poop. At their noon feeding today, my husband had warmed up bottles even though I was planning to breastfeed, so I figured I'd try breastfeeding and if they were not eating well give them the bottle. I managed to get both of them to nurse for 10 minutes (again, one did well and the other fussed and screamed), then offered the bottles because I wasn't sure they'd gotten enough, since I had pumped only 90 mins earlier. The one who ate well took another ounce from the bottle, and the one who fussed took TWO ounces from the bottle, without any of the fussing they'd been doing at the breast. Then both of them puked all over the place and screamed a bunch more.

Anyway, my husband didn't get much sleep last night (he got up this morning and let me sleep) and is in an epic bad mood, and I am just really stressed out and frustrated. I've called the lactation department at the hospital and left a message about scheduling a consultation, but it was so depressing to see them eat so well from a bottle after I'd spent half an hour trying to get them to nurse that I'm tempted to give up on nursing and just pump everything and bottle feed. At our last visit the pediatrician had suggested considering baby zantac to help them be more comfortable and maybe nurse better but I don't know if reflux is the problem or not. Please help! When is this going to get better??

 

Mine had similar symptoms when they were having trouble with dairy. That might be something to consider.. after 48 hours without me eating dairy they were doing really well. It might be something to try!

 

So, yes, they took extra ounces from the bottle. And then promptly threw up all the extra. Could they maybe not be hungry and are just looking for soothing/are tired/over stimulated?

If you want to switch to exclusive pumping, then for sure you can. But all of the other issues aren't necessarily going to resolve themselves because of that.

It's also possible that they prefer the flow rate of the bottle because it's faster. Have you tried breast compressions when they're breast feeding to see if that keeps them focused?

It could also be their age and that they're starting to "wake up" more now. You may find their fussiness increases over the next few weeks, usually peaking around 6 weeks after your EDD. I know that's not what you want to hear but it's a short period of time that if you can ride it out will be over before you know it. :hug:

Take a deep breath and look at the big picture. It's easy to feel like BFing is the source of all baby ills (and sometimes it is) but often there are many, many things going on and it's just about learning and growing and getting used to each other together.

 

Jen, if it was a food sensitivity, wouldn't they have the same fussiness with their bottles that they do with the breast? The bottles just have expressed breastmilk in them, not formula.

Rachel, thanks for the idea -- I tried squeezing my breasts while they were on their second wind of nursing and they seemed to do a little bit better. I think maybe my let down is faster than the bottle, but then after the initial burst it's slower than the bottle. I don't really *want* to switch to exclusively pumping, because if I could get breastfeeding to work well it would be really convenient, but if it's going to be this stressful and this much of a hassle every single time then I don't know if it's worth it. I feel like there's going to be some point where they all of a sudden mature enough to be really good at feeding, but I don't know when that point is or how much more of this I have to go through to get there. I feel like since I had preemies I've got that initial newborn first couple weeks stretched out to three months.

 

That's true! I missed that, sorry.

I do agree with what Rachel says.. they do go through crazy fussy stages, but babies will not go hungry. Stick with what you're comfortable with. I know for me sticking to BF'ing as much as possible paid off in the long run because I didn't have to deal with bottles and all that junk. I agree that they are probably looking for some kind of other comfort and such. How is sleeping going otherwise? Are they pretty consistent with their napping/sleep cycle? All of that tends to be a constant change too, and can affect your nursing routine.

And I promise you all of this will be a distant memory at some point. I promise. It sounds like both you and your husband have your share of frustrations right now too so maybe try and schedule a break for both of you (one at a time) to get out of the house and/or get a solid night's sleep. That alone can do wonders for improving your patience with all these crazy things babies torture us with.

 

First, I just want to give you a big hug and tell you I know exactly what you are going through! Here is a summary of things that may be helpful to you that you could try NOW based on what I have learned from breasting my preemies and my TERM babies:

1. If you had been pumping like a mad woman while your babies were in the NICU (like I did), you probably have over supply. Your tiny babies only take a few ounces but they may only be getting foremilk, not the hind milk. Too much foremilk can cause fussiness and could explain why they are fussy at the breast and not a bottle (which has a mixture of pumped milk). You could try to pump a bit out before each feed. The foremilk looks watery. I would suggest pumping until your pumped milk starts looking darker white, then try to feed. If your babies are anything like mine, you will have to pre-pump for about 2-3 months after their EDD. At least, that is when mine started taking more at feeds.
2. If you don't want to pre-pump, my doctor suggested giving 1/4 teaspoon regular adult Maalox before every feed followed by gas drops. This really helped my two singletons... I wasn't given this advice with my twins.
3. If you think your babies may need extra comfort, try to nurse them swaddled. The snugness across their bellies may be soothing and help with gas. If they will take a pacifier, try that after a feed too.
4. I stopped nursing my twins after 6 weeks at home and while the decision was tough, I felt a tremendous amount of relief. My babies need their mama sane... not the freaked out crazy emotional hormone bag that I was. I say with this with caution because I always regretted not sticking it out, but it was the right decision for us at the time. Life was a lot better for us after that. I exclusively pumped for 10 months. I was able to BF my singleton babies for well over 1 year.

I hope something here is helpful to you! I totally understand how the newborn stage lasts FOREVER when you have preemies!!! And, of course a lactation consultant it a safe bet. You could also rent a baby scale if you are still worried about how much milk they are transferring from you. Good luck!!

 

The lactation consultant would probably help give you some peace in the short run.
Newborn preemie twins are so, so hard. I promise you it does get better.

Now, my boys did have a dairy sensitivity that around 6w I finally tried giving up dairy. They were gassy, breathed like Mack trucks, had green, mucousy poop and my one son was borderline colicky (aka the worst baby ever!) By day 3, I thought it made a difference. By day 11, EVERYBODY could see the changes. I've since read that hind milk/foremilk imbalance can mimic these symptoms so I do wonder if that was related.

During their gassy times I spent a lot of time bicycling legs and also I had to redouble my efforts at burping- no burps weren't an option. DH's most effective burping was holding the baby up with his armpits, supporting the head and kind of jiggling a burp out.

When it's so, so hard now, I can promise you it does get easier. And you will sleep again.

 

Thanks everyone, your encouragement really helps a lot! The girls did much better overnight last night and even went four hours between feeds once. I fed them one at a time and squeezed my breasts while they were eating, and they nursed for 10-20mins without fussing. Not sure if that made a difference or if they just passed through whatever digestive issue they were having. I tried tandem again around noon today without as much luck. They were fussy with a couple of bottle feeds too, so maybe it was something I ate and is passed through at this point? Their poop schedule seems to be back to normal too -- yesterday they were pooping a whole bunch all day, where usually Allison has tiny poops all day and Cecilia has one huge poop per day. I'm going to breastfeed again in a couple hours (one at a time again since it worked well last night) and we'll see how they do.

We do give them gas drops on the same schedule they got them in the NICU, 0.6ml every 6 hours. We go back to the pediatrician Friday for a weight check so depending how they're doing I may ask about something for their reflux. Here's hoping tonight goes smoothly like last night.

 

you can give them gas drops every time they eat - you don't have to stay on the NICU schedule - they are not harmful...my daughter had to take them until she was 2

 

Okay, so the girls are doing a bit better now, and I went to lactation today. After observing their feeding, the lactation consultant suspected that my oversupply is probably part of their problem because the overflow of foremilk is too much for them and is not only choking them some but upsetting their tummies. The plan is to hand express some before starting a feeding so that they won't get a big flood of foremilk, at least until my supply levels out more. Also, we tried without the nipple shields and she thought that it was probably better to keep the shields for now since the girls were having trouble maintaining a latch without them. Once my oversupply levels out (prob. when I'm back at work) we can try again without the shields, or try occasionally taking the shield off halfway through a feed. Her other suggestion was that if I wanted to work on weaning the shields to do it with one baby at a time and have my husband give the other baby a bottle at the same time.

So anyway I feel a lot better about it now. They weighed them before and after feeding and it looks like they're getting 2 or 2.5oz when breastfeeding (as opposed to 3 with the bottle). This explains why they get hungrier sooner with breastfeeding, but it's enough that they're satisfied after eating and still growing. Cecilia topped the scales at 7lb 1oz! Allison was 6lb 15.8oz, which is more than double her birth weight.

 

Great update! glad you are getting some help and some answers!
all your effort will pay off! good job mom!

 

That sounds like a great plan! And I'm glad to hear you're feeling better today. Will you be following up with the LC at all down the road or just as needed?

 

This is great news!!!