Schedule or On Demand?

Hi! I am new to this board, but will be joining you all shortly . My babies will be delivered by c-section on Tuesday, Oct. 23rd (assuming they do not decide to come earlier!) I have gotten so much great advice from the expecting forum and I have already found lots of great info on this board.

I am planning on tandem breastfeeding and I was wondering if you tried to implement a feeding schedule right after birth (every 2-3 hours) or did you feed on demand, and if so for how long? I have read a few different books about breastfeeding twins and one swore by a schedule set up right after you bring them home and another advocated feeding whenever they wanted to eat. Just wondering what worked for all of you.....

Thanks!

 

I am not bf'ing anymore and the biggest reason is that I could not get them on any kind of a schedule. They wanted to eat every 45-90 minutes, which I think is the norm for breastfed newborns. DH had to go back to work when they were one week old and I just could not handle all those feedings myself. Since I have switched to formula they eat every 2-3 hours on somewhat of a schedule, at night I wake one when I feed the other.

Hopefully these women will have some good advice for you, I really applaud everyone who is able to breastfeed, it is HARD!!

 

My advice is to not expect a schedule or even an easy time tandem nursing for at least a month and maybe two. If you can set yourself up for success by realizing that the first few months are really hard nursing twins and you will have your hands full learning to get to know them, their cues, their growth spurts etc. you will have a much easier time. I feed mine every 2-3 hours when they want it. I have had a day or two when they want it more during growth spurts but not many. It gets easier each week and I'm meeting with a lactation specialist tomorrow to discuss the possibility of a schedule. Many things go into it including when they are born (mine were born at 36 weeks) you must use adjusted age.

The books need to be better about warning women that the first few weeks/month are HARD - scheduling is laughable at first. However, it DOES get easier and it is abosolutely worth it to get through it. I think nursing is easier than formula just because of fixing bottles and the tummy problems that formula babies tend to have but the first few weeks breastfeeding is not easier. Just be prepared for some hard days and hang on. It's all worth it.

I read every book, printed schedules, had lofty plans etc. before they were born. I don't think I'll be implementing any of what I read for at least a few more weeks.

Congrats!

 

Yes, breastfeeding twins can be a challenge and I suggest not expecting a schedule. Mine ate about ever 1.5-2 hours for the first few months!! Feeding on demand will also help with your supply! Congratulations on making it this far with your pregnancy! :hi: Welcome to the breastfeeding forum! There are many ladies here who have experienced so much! I hope you find what you are looking for!

 

Welcome to the BF forum! Look forward to seeing more of you here before too long.

I am strongly against scheduled feedings, especially for newborns, for many reasons:

Breastmilk is digested in 90-120 minutes. Newborns' stomachs are the size of a walnut (or even smaller if they're preemies). And babies double their birth weight in 6 months max. They NEED to eat when they're hungry, not by the clock.

Babies nurse much better when you feed them in the early stages of hunger. They are more calm that way, more patient as they figure it out. If you wait until the late stages of hunger (ie crying for food), they will sometimes be too frustrated to nurse effectively.

Breastfeeding is all about supply and demand. Whenever the babies remove milk from your breasts, that tells your body to keep making more. If you restrict the amount of milk they take by feeding only on schedule, that restricts the amount of milk you produce. If you don't feed a hungry baby, that tells your body that that milk is not needed, so it won't make as much. Feeding on demand is critical for establishing a good milk supply, especially for twins.

Also, on a more philosophical level, I believe that putting babies on a schedule is cruel. I don't get hungry or tired by the clock, and neither does any adult I know - why should my babies? Even die-hard schedule fans wouldn't tell a baby with a diaper dripping poop, "No, you have to stay messy, it's not time for your diaper change yet" - why should satisfying their hunger be any less of a priority? Just imagine what it's like to be a newborn. Your whole life, you've been in a snug, dark, warm place where every need is met automatically. Then all of a sudden you're out in a cold, bright world, and even hunger is a new experience. You can't soothe yourself at all yet, and can only blindly hope that somebody will make you feel better when you need something. How would you feel if your needs were consistently ignored, because it's not "time" yet?

I also believe that scheduling can undermine your confidence as a parent. If you're sticking to a strict feeding schedule, and the baby is hungry before the next feeding time, then either a) you know your baby needs food and choose to ignore that need or b ) you are so caught up in doing everything by the clock that you have never learned to read your baby's cues. I have actually heard schedule fanatics say "If I weren't on a schedule, I wouldn't know what to do with my baby!" When actually it is much easier in the long run if you just look at the baby, not at the clock. If you can read your baby's cues, then you're almost never left guessing what they need. And happy babies=happy mama.

What really helped me keep my sanity with twins is feeding them at the same time, or one right after the other, and putting them down for naps/sleep at the same time. If one is hungry, wake the other one up to eat too. Feeding on demand is a lot easier if you can manage to get their demands in sync.

I totally agree with pps - expect the first weeks to be a wild ride sometimes! You'll probably spend the better part of most days with at least one baby at the breast. But it is SO worth it. In the long run, BFing is so much easier - none of the fuss of preparing and cleaning up bottles, none of the expense of formula, and more comfortable babies who get sick far less often. And though BFing newborns can be a grueling job sometimes, once you ride out that tough part, it is just such a special bond. When you go to the pedi and find that your babies are growing like weeds on YOUR milk - when your baby unlatches just to look up at you and giggle - when you transform a fussy baby into a mellow, cooing one by nursing - it is the best feeling in the world!

Good luck! I hope you have an easy delivery & recovery.

 

I just wanted to say AMEN, to fuchsiagroan! I could have written that (if I had time of course!).

The only thing I will add to the PP is that I always tandem feed. Meaning, if one wakes up and is ready to eat, I get the other up and offer the breast (dreamfeed). Usually newborns don't refuse, even if it's just for comfort. While this didn't get them on a 2-3 schedule, it kept the two of them on the same "schedule"--KWIM? I think it did wonders for my milk supply as well. Now they are naturally on a 2-3 schedule, but that's b/c they grew into it; not b/c I forced it on them.

Just relax and hang in there. In the beginning you will feel like feeding the babies is all you do. But it doesn't go on like that forever.

 

I really think feeding on demand is the way to go, it will help get your milk supply where it needs to be and most likely alot less crying!!! I ditto getting them on the same "schedule" meaning I always either tandem fed or fed one then the other and still do!!!

 

I also used a system of modified demand (feeding both when one showed signs of hunger). Yes, they sometimes ate every 90 minutes for part of a day and their pattern eventually emerged (about 9 weeks) as clustering in the morning and before bed with 2.5 hour intervals during the majority of the day and only one wakeup at night. I was very, very happy with their schedule and cannot imagine trying to force them into feeding every x hours when their natural tendency was so far from that. I also don't believe they would have slept so well without all of those daytime feeds. Oh, and the fact that they are ID twins probably helps with them having the same natural schedule but I don't have any studies to support that.

 

Thanks for all the great advice. I'll let you know how it goes. I'm sure I'll have many more questions and concerns so expect to hear from me a lot! I REALLY want to make breastfeeding work!

 

Ditto to the Brava! on fuschiagroan's post.

I also want to add: don't expect anything but crazy intensity for the first few months. Keep in mind that breastfeeding while the most natural thing in the world, isn't always the easiest. Different babies have different latching skills, different sizes, etc.

I would DEFINITELY advise meeting with a lactation consultant (the hospital ones will be available at no cost) BEFORE your delivery. Establish a relationship with them, they can be really helpful.

I had an emergency c-section and my girls were in the nicu for a few weeks so i pumped RELIGIOUSLY every three hours; i am convinced, as are the LC's, that it's what established my strong supply.

I agree, babies need to eat on THEIR schedule. they have just emerged from a dark place where they hear mama's heartbeat all the time; the world is a bright, cold place and they are not ready for it. They ARE ready to be close to your body and smell you and feel your softness and get the nourishment and comfort of what your body can provide for them.

Also keep in mind that it can take babies a while to 'get' the bfing thing. But in the very beginning, all they really need is your colostrum, and although it will seem like very little to you, it is PERFECT for them. And with perseverance, most babies will get it (ok, i'm crying a little as i thikn of my girl who never did)

I was never able to tandem feed (in fact, i had to pump for one of my girls), and while many women can from the early days, a lot also say tht it requires much more head control (and mommy control).

My girls ate every two hours in the beginning, and yes, it WAS all i did. But it was worth it to me. And the hours i've spent nursing my baby were among the happiest and most satisfying ones of my life as a mother - even in the middle of the night when i was so exhausted i didn't think i could handle it another feed, another day.

And use this board, it got me through a LOT. can't wait to hear your birth story!

 

I think the answer lies in your philosophy of parenting. Most bf proponents believe in a feed on demand model -- this is what I did and it worked real well for us. We ended up in a routine by 4 months that pretty much stayed the same til 10.5 months or so and then the bf-ing started to trail off as I weaned at 12.5 mos.

Bf=ing on a schedule can be done, but it an disrupt sleep in one of the kiddos and I can't quite figure out how moms deal with growth spurts if they schedule feed.. but I know some moms who've done it.

Good luck with the birth.

Teri D

 

I have to admit that I fall more on the "scheduled" side of things. I've never thought that this meant you should ignore a baby's hunger cues, or try to hold off a baby who is clearly starving. Rather, I think it's completely possible to organize feedings so that they fall roughly 2.5 to 3.5 hours apart....I think this makes life much easier for mom, and helps the baby to sleep better, too.

I followed a basic 3-hour eat, wake, sleep pattern with my older daughter. She started sleeping 8 hours at night at 2 months, and 12 hours at night by 6 months. She was exclusively breastfed, but I honestly don't think that had anything to do with it -- I think it was more the routine.

With my twins, I've had a different experience. They came a bit early, didn't latch, one was sick, etc. -- so I never established a good milk supply. However, I implemented the same sort of feeding/napping schedule, and they got mostly EBM in the beginning, and now they get about 60% EBM and 40% formula.

And, both started sleeping 8 hours at night at 11 weeks, and now they sleep 12 hours straight....this is with NO crying-it-out, BTW.

I think there is a lot of misconception about what scheduling really means....I can't imagine there are very many people who actually make a starving, screaming baby wait 15 minutes to eat, just because it isn't 11:30am, or whatever. That's nuts. Of course, you have to be flexible.

BUT, I think it's also counter-productive to stick a boob in a baby's mouth every time he fusses, especially if it's only been 45 minutes since the last feeding -- I think this just encourages the baby to "snack" frequently. And, that's where basic parenting philosophy differs -- many on-demand feeders are fine with this, but I am not. I value my time, my sleep and my sanity way too much -- and, I know it's possible to have an exclusively breastfed child who *doesn't* do this.

A PP mentioned that it's cruel to implement a schedule, but I disagree. I swear, we scheduled types are not all ogres! My DS has a bit of a cold right now, and didn't eat well all day yesterday. This morning, he woke up crying at 6am, when normally he sleeps until 10am.

I gave him 4 or 5 minutes to settle back down, and when he didn't, I got him up, changed his diaper, sucked out his nose, and then fed him -- he hadn't eaten since 10pm last night. He then went right back to sleep. And, I'll now get both babies up at 10am, and feed them as usual....just wanted to point out that scheduling feedings *doesn't* mean that you don't respond to your babies' needs.

Anyhow. This can be debated forever....but just wanted to give an alternative view of scheduling, since I might be the only one on this board who feels this way.

 

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BUT, I think it's also counter-productive to stick a boob in a baby's mouth every time he fusses, especially if it's only been 45 minutes since the last feeding -- I think this just encourages the baby to "snack" frequently.


That's as much a misrepresentation of on-demand feeding as "making a screaming baby wait 15 minutes until 11:30 on the dot" is of schedule feeding. The beauty of feeding on demand is learning to read your baby's cues. My babies fuss plenty during the day, and believe me, they do NOT get a boob stuck in their mouth every time! I know my babies well enough to know pretty much what they're "saying" most of the time: "I'm bored," "Give me a different toy," "I need a hug," "I just pooped," "I have gas," "This teething is killing me," "Hey, don't walk out of the room, I want you here!" "The other baby scratched me," "I'm getting really tired" --- as well as "I'm hungry, I could really use a snack now." And if I offer the breast when they're not hungry, they just don't take it.

I don't see what's so difficult or crazy-making about offering snacks when the babies desire them, especially when BFing - just whip out a boob, and you're done. That simple.

Demand feeding also does not mean chaos or no routine whatsoever. In my house, we nap, nurse, play, and nap. Bedtime routine is the same every night: nurse, baths, another feeding, cuddle and sing, bed. During the day, they usually nurse about every 2.5 hrs (except for growth spurts and the usual late afternoon cluster feeding smorgasbord); it can be longer than that if they get a really long nap, or shorter if a short nap. Demand just means that whenever they need a snack, they get one. We have a sane, happy, laid-back home (no doubt due to sane, happy, laid-back babies & mama!).

I seriously doubt that scheduled feeding has anything to do with when babies sleep through the night. Some babies STTN early, others don't, regardless of how they're fed. If anything, more frequent, on-demand feeding should help them sleep longer at night, since it allows them to tank up more during the day. I feed my twins the same way, and one of them is a great night sleeper (either STTN, or taking just one feeding around 4 am), and the other usually still wants at least two night feedings. It's just a roll of the dice. Babies are individuals.

I realize that your babies had other problems that prevented them from nursing well at first, but scheduling their feedings may also have contributed to your milk supply issues. BFing experts agree that demand feeding is THE best way to establish and increase milk supply, and that restricting the times your baby/babies can nurse is harmful to milk supply.

 

Fuschiagroan, I hear ya -- differenting parenting philosophies, you know? I don't think we're going to convince each other.

I'm thinking about your post, and I want to reply -- but right now I have to go feed two babies, LOL. I'll be back to post later!

 

I never fully understood the milk removal thing -- babies are going to take in the same amount of milk during the day, on average. If baby A eats five times, and gets about 25 ounces total, and baby B eats nine times, and gets about 25 ounces total -- how does that affect milk supply? Wouldn't the mom's body figure out to make that amount in the course of a day, no matter how many times the baby ate? It's not like demand-fed babies eat more overall, do they?

So, I guess I fall on the side of encouraging the baby to get full feedings fewer times, instead of snacking. No, it's not a big deal to cluster feed in the afternoons, as you do, but I also chase a demanding 3-year-old, take her to activities, etc. -- so I just don't have the luxury of feeding all afternoon -- it really would make me crazy.

I think I struggle with this because there seems to be a big difference between breastfeeding one baby, and breastfeeding twins. (Maybe that's the DUH statement of the year, LOL.) With my older DD, I had no problems breastfeeding about every 3 hours and still establishing good supply. If she had a good nursing, she never demanded to be fed earlier than 2.5 hours later. We didn't cluster feed (and she wasn't fussy).

But the more I read this board, the more I realize that no one has managed to exclusively breastfeed twins that way. I guess it must be a milk supply issue, right? They have to eat more frequently, because the body just can't make enough milk for two babies to get enough at one feeding -- or so I'm gleaning? So perhaps it's not possible to establish a 3-hour schedule and exclusively breastfeed twins?

In my own situation, I built my supply with the pump only, and yeah, I did shoot myself in the foot by not pumping enough -- I didn't pump every three hours at night like I would have done had I been breastfeeding directly, and I'm sure that affected things. (I was in bad shape after delivery, and pumping and bottle-feeding took its toll...)

But in terms of the babies actually eating, I fed them every three hours when they were newborns. If I had waited for them to demand a feeding, they would have starved to death, because they never wanted to wake up on their own. (How does demand feeding work in that case?)

And once they got a little older, establishing this from the beginning meant they were already on a good 3-hour schedule -- so, that's when they demanded to be fed. When I put them down for a nap, I know they will sleep 1 hour and 45 minutes, and wake up almost exactly in time for the next feeding.

And honestly, I don't see how this is a bad thing! Since my kiddos are gaining and thriving, I fail to see how I'm being cruel to them....

You mention that you nurse further apart if your little ones take a longer nap, and closer together if they take a short nap. How does that work, seriously, with the rest of your life? I'm not sure if you have older kids, but what if you had to pick them up from school? What if you worked from home? What if you had *something* to do at a set time during the day, whatever it was? Doesn't it make life harder if you don't know if a baby is going to be hungry and wanting to eat at that time?

Also, you mentioned that your babies won't take the breast if they're not hungry. But, don't some babies often nurse for comfort, or just like to suckle? I know there are women who have babies on the breast ALL day, day and night, and they say that the babies demand it. Okay -- but that's just not for me.

About the sleeping through the night -- I dunno. Obviously you can find a book out there to support any theory you like. But I have a hard time believing that I was blessed with three genetically good sleepers, LOL. I do think that following a schedule helped, at least.

Anyhow. I didn't mean to imply that everyone who demand-fed lived in chaos. That's no more true than saying my life is perfectly seamless because I have a schedule, LOL. In the end, I think it has more to do with your personality, and what works for you....I think there can be happy, healthy babies with both methods.

 

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I never fully understood the milk removal thing -- babies are going to take in the same amount of milk during the day, on average. If baby A eats five times, and gets about 25 ounces total, and baby B eats nine times, and gets about 25 ounces total -- how does that affect milk supply? Wouldn't the mom's body figure out to make that amount in the course of a day, no matter how many times the baby ate? It's not like demand-fed babies eat more overall, do they?


I've read that this has to do with women having different storage capacity. For many women, a big feeding every 3-4 hrs is totally different from small feedings every 1.5-2 hrs, because the breasts can only hold so much. If you can't store up enough for those big, infrequent feedings, milk supply will drop, because the baby/babies will take less milk over the course of the day. Then there's also the issue of the babies' stomach capacity. Some babies may not have big enough stomachs to take in enough at big, infrequent feedings. (Imagine if you fasted for 3 days - would you be able to eat 3 days' worth of food in one sitting at the end of it?) So again, they'll take less milk, which leads to supply problems.

But of course, if your breasts can store a lot, and the babies have big enough stomachs, it can work. Just doesn't work for many moms/babies.

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But the more I read this board, the more I realize that no one has managed to exclusively breastfeed twins that way. I guess it must be a milk supply issue, right? They have to eat more frequently, because the body just can't make enough milk for two babies to get enough at one feeding -- or so I'm gleaning? So perhaps it's not possible to establish a 3-hour schedule and exclusively breastfeed twins?


It all depends on your expectations. It is very common for babies, twin and singleton alike, to need to nurse more often than every 3 hours. Wanting to eat more often than that doesn't mean that they haven't gotten enough at a feeding or that there's a supply problem, just that they're being normal babies. After all, it only takes 90-120 min to digest breastmilk.

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But in terms of the babies actually eating, I fed them every three hours when they were newborns. If I had waited for them to demand a feeding, they would have starved to death, because they never wanted to wake up on their own. (How does demand feeding work in that case?)


Of course you have to wake newborns to eat sometimes! Especially sleepy preemies. I had to do that a lot with DD - she was a VERY sleepy little girl. But of course that's very different from trying to artificially stretch intervals between feedings with a wakeful, hungry baby.

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You mention that you nurse further apart if your little ones take a longer nap, and closer together if they take a short nap. How does that work, seriously, with the rest of your life?


Easy! If I have to go out for something at a time I choose (chores, exercise), then I go right after feeding them. If I have to go out for something at a set time, like a dr's app't, I make sure to tank up the kiddos before I leave. During the day, I know that they CAN go 2.5-3 hrs between feedings, so it works out. They're old enough to cope if they feel like a snack & don't get it occasionally when I happen to be out. I know their patterns, so I can time things pretty well. And worst case, if I had a horrendous wait at a dr's office, or my car broke down or something, they could get a bottle while I was out.

QUOTE
Also, you mentioned that your babies won't take the breast if they're not hungry. But, don't some babies often nurse for comfort, or just like to suckle? I know there are women who have babies on the breast ALL day, day and night, and they say that the babies demand it. Okay -- but that's just not for me.


Again, that's an extreme, and NOT representative of demand feeding in general. Sure, babies like to nurse for comfort. And that's as legitimate a need as food. However, if it got to the point of having a baby on the boob literally constantly, then of course I'd try looking for other means of soothing the baby. But it's not like you either schedule feed OR have a baby on the breast nonstop!

About your great sleepers - I think you got lucky! VERY lucky, in fact. You ought to go buy a lottery ticket... :lol: But anyway, what's the argument connecting scheduled feeds and STTN? I've never understood that.

Anyway, I'll agree to disagree with you on this one. Obviously nobody would do things their way if they didn't think their way was the best! And let me make straight that I'm not bashing you personally here. From what you write, it sounds like you're taking great care of your family, and like you are more of a demand feeder than you know - just that your babies' demands are much more clockwork and infrequent than average!

 

I agree with every word that Fuschiagroan said. I do think that sometimes a "schedule" is needed. For example, my 34 weekers would sleep through feedings. So, they were on a 3 hour schedule, but that meant the MOST they could go without a feeding was 3 hours. If they wanted to eat at hour 2, then they were fed at hour 2, and so on and so forth.

My boys are one, and were exclusively bf'ed on "cue" (Oh and I do have a younger child as well) . After a few weeks, THEY put themselves on a schedule. I had nothing to do with it.