Monday, April 22, 2013

Nursing Twins: How we do it

Because I know you're curious?

Well, really because I know I was super-curious and anxious and terrified when I found out I was expecting twins.  I knew that it should be no problem nursing twins, since our bodies create whatever supply our babies need.  But I still had no idea about the logistics of all of it, and I couldn't find a lot of resources on the internet to help me out.

So here's how we did it in the beginning, and here's how we do it now!

First days:

The babies were little at birth - 5lbs8oz and 6lbs2oz, respectively.  In comparison to John Paul, who was over 8 pounds, and Cecilia, who was almost 8 pounds, it was a totally new experience getting them latched.  Their mouths were tiny!  We tried getting them latched in the recovery room, but they were just not up for it - couldn't get their mouths open wide enough, and they were tired (understandably so - when you're that small, the trials of labor probably wear you out!). 

2 weeks old - Mary Claire (L), and Elizabeth (R), almost back up to their birth weights
We got Mary Claire nursing pretty well once we moved to a private room, but Elizabeth wouldn't latch.  And wouldn't latch.  And wouldn't latch.  I told them pretty much immediately that I was going to want to see a lactation consultant, because I knew we'd have issues.  After about 8 hours of no nursing, we started getting worried...  But the nurses assured us that it didn't become an issue that required supplementation until 24 hours post-partum.  They immediately brought me a pump to help stimulate production, but I had Mary Claire nursing pretty well already, and I figured that was better than a pump (one upside to having twins!). 

I had a lactation consultant in twice during our 36-hour stay, and they helped a LOT with getting Elizabeth latched and making sure Mary Claire was latching well.  Cecilia had a shallow latch all through the time I nursed her (until she was almost 18 months) and I wanted to avoid that!  They showed me how to use a football hold to nurse the babies (something I had never done!) and got me a pump to take home with me (which our insurance reimbursed 100% - Obamacare is good for something, at least!).  Once I was comfortable getting Elizabeth latched on my own, we were ready to go home.

Best hospital tip?  See a lactation consultant, even if you don't think you need one.  Nursing a singleton is a piece of cake compared to tiny twins, and you need all the help and advice you can get!

First weeks at home:

We were still having trouble getting the babies latched sometimes - they preferred to sleep, and it was really tough getting them awake enough to nurse for long periods of time.  They had lost a significant amount of weight in the hospital, and if I hadn't been confident in my ability to provide nourishment for my babies, I very likely would have supplemented.  But we had weight gain issues with John Paul, my milk hadn't come in yet, and I knew things would pick up.

But they didn't pick up soon enough.


Sleepy babies under blankets, thanks to their big brother.
Elizabeth (L), Mary Claire (R)

At a weight check at the doctor's office, neither baby was gaining weight quickly enough.  We had been instructed not to let them sleep longer than 3 hours without nursing.  Now the limit was 2 hours - it was time to get those babies eating NOW!  Our awesome pediatrician was understanding of our unwillingness to use formula, and I knew my supply was more than adequate, they just weren't nursing often enough.  Elizabeth especially would latch and then fall asleep and refuse to nurse, so I started pumping and supplementing her with a bottle if she refused to nurse.  This approach worked pretty well, but she was spitting up a lot more than what I felt was normal.


Right before their baptism - way too small for their gowns!
Mary Claire (L), Elizabeth (R)
At our next weight check, Mary Claire's weight gain was fine but Elizabeth was still just under what the pediatrician wanted to see (I don't remember exact numbers anymore...  those first weeks are such a haze!).  She wanted to avoid having to do any extensive tests that would require urine collection or blood draws, so she asked me to spend a day pumping and only feeding Elizabeth by bottle so that we knew *exactly* how much she was taking in.  She also recommended getting a baby scale of our own so that we didn't have to come into the office for every weigh-in (can you tell how much I love her?  She would call me on her lunch break with different strategies because she knew we wanted to make this work).  Elizabeth had plenty of wet and dirty diapers and was hitting her milestones just fine, so I thought she might just be a slow gainer...

So I started doing weighted feeds with Elizabeth, we spend a Saturday pumping and bottlefeeding, adding breast compressions every time she nursed, and after six or so weeks her weight gain was finally where it needed to be when she was exclusively nursing!

Logistics of the early weeks:

Newborns nurse a lot.  For looooooong periods of time.  Thankfully, I had just joined our local Mothers of Multiples group, and they have a lending library of nursing pillows that they lend out to breastfeeding moms.  No need to shell out $50 on a specialty pillow that was good for no other purpose (boppies at least are awesome for tummy time and assisted sitting, even if you don't use them to nurse)! 


Right after they had both puked down my shirt...  Elizabeth (L), Mary Claire (R)

I would camp out on the couch with my kindle, the laptop, a giant water bottle, and my sister or husband at my beck and call :)  For those first few weeks, I almost never even got up from the couch during the day.  I tandem-nursed the babies almost exclusively using football hold, sometimes with one in cradle and one football, but that didn't allow me any freedom with my hands. 

The one time they ever slept together - Elizabeth on top, Mary Claire on bottom

Once a baby finally stopped nursing, I'd call for someone to come burp her and put her in the glider for some napping (or just hold her for some napping - you know how newborns are...).  Switch.  Repeat.  The big kids watched a lot of TV during these first several weeks, because it was just too much for me to try to entertain them in my half-asleep haze.


Sometimes they would just stay asleep on the pillow because I didn't want to try moving them...  Holding hands in their sleep is maybe one of the cutest things about twins!
Elizabeth (L), Mary Claire (R)
At night, I wasn't willing to get out of bed to nurse both babies at once, so I started pumping after the babies finished nursing for the evening and then putting the bottle on a bedside table.  I'd finish nursing the babies, Andrew would put Elizabeth in the glider on the main floor, I'd take Mary Claire to the swing in our room, and Andrew slept on the couch until Elizabeth woke up to nurse.  Sometimes they would switch off needing to nurse all night, and I just lay there in bed, sleeping nursing, switching, handing them to Andrew to burp and diaper.  There were frequently times when I couldn't remember which baby I had, when I referred to them as John Paul or Cecilia, and when I woke up with an extremely wet shirt because Elizabeth had re-gifted me all of the milk she had just consumed.  But I was getting at least *some* sleep, so it worked.


Exhausted after a long night of nursing, all swaddled up.
Mary Claire (L), Elizabeth (R)
If the twins wanted to nurse at the same time, Andrew would give one of them a bottle while I nursed the other.  Since breastmilk is magical, that bottle I pumped at 10 would be good until 6, and it was *usually* all finished by then.  If not, I sadly dumped it down the drain, trying not to cry over spilled milk...

We also had a not-insignificant number of nights in which Elizabeth refused to sleep and would only be calm with Andrew wearing her in a wrap while rocking in the glider.  Fun times!


And then...  The babies were 2 months old.  My help was gone.  Andrew was back at work.  My sister was back on the road living her hobo life.  WHAT WAS I GOING TO DO???

Well, what WAS she going to do???

Part II here - beyond the newborn days

Score!!!

28 comments :

  1. This is invaluable to me. THANK YOU.

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  2. I am so glad you shared this, Rosie. I know mothers of multiples will find it helpful, but it's also encouraging to regular moms.

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    1. I'm so glad! I scoured the internet for real-life stories of nursing twins when I found out we were having two, but there just weren't enough for me! I tend to over-research anyway :P

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  3. You had help for two months??! You've said before you are a teacher. Are you still teaching? Full time?

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    1. My sister stayed with me for almost two months and I'm SO glad. I don't know what I would have done without her! I mean, I would have figured it out pretty quickly, I think, but I think a lot would have had to slide.

      I went back to work when the twins were 11 weeks old, and I teach half-time so I'm gone 5-6 hours/day with plenty of time to pump during breaks. Next year my schedule will be a little more tricky for pumping, but the twins will be 1 in November so at that point I won't have to worry quite so much about output.

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  4. Is it weird how excited I am to read the rest of this? I am sharing on FB and bookmarking for myself in case we ever need it.

    You are amazing. Udderly amazing (you see what I did there??)

    But seriously, you rock.

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  5. I love reading every single post you right about the twins and I love staring at the pictures. DH is a twin and I was at the start according to the doctor, and I know DH (and Sadie) area always disappointed when we go in for ultrasounds and there's only one baby in there!

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    1. My husband was more excited than I was when we found out - "Two babies! We'll each always have one to snuggle!" he said :P

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  6. I am just in awe! I would have so easily switched to formula, you have a lot of patience and determination. Awesome!

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  7. Breastmilk is magical haha. Major kudos too for sticking with it-I'm constantly amazed at how the body adapts to the babies' needs. And now they are cute little chubbies all because of you!

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  8. Wow, you are amazing! I'm glad you posted this- I'm always curious how the adjustment is from single babies to multiples. I love the pict. of them holding hands.

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  9. Loved reading this! Brought up memories of a few short months ago when all I did was breastfeed alllllllll dayyyyy looonnngg!! The laptop was essential, you're right about having that right there! As much as I miss those days, I'm so very glad 10 minutes four or five times a day is all it takes now! :)

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  10. Absolutely amazing, and you are so wonderful not only for doing this, but for being willing to share your story so beautifully.

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  11. Rosie, you are so awesome! And I am so proud of you! And I wish I could have nursed you and the other three for longer, but I am so happy and proud that you understand and told me so in a way that made sense and wasn't just "Oh you did the best you could and I want you to be quiet so yeah that's all." And your babies are so beautifuw wike Mawwy! And I can't wait for part 2, so hurry up and write it!

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    1. If I can work up the motivation, I'll write it! But probably not until next week sometime - we'll see how much free time the kids give me. Last night Andrew had a late rehearsal so once the kids were in bed and things were cleaned up, I had a lot of time to sit and write.

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  12. This is great, thanks for sharing! I'm in awe of how mothers with multiples do it. I'm a LLL leader, so I've tried to help moms with twins, but never having any experience with them myself, it's hard. It's so good to read this!

    Your babies are beautiful!!

    -Amelia

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    1. LLL was the first place I took all four kids by myself because I knew there would be plenty of moms to help hold babies :) I'm excited for the summer so I can start going to meetings again!

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  13. Amazing. I love all the sweet twin pictures!

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  14. Melissa had me take a gander at your blog and I am so glad I did! Congratulations on being determined to make tandem nursing work for you. Your sweet girls got the very best start with nutritional magic!

    I tandem nursed but with a newborn and an 18 month old. Then I did it with all the rest going through five kiddos. The last was the farthest apart in age by three years but, yes, we did that and that was during the early 90's. Folks thought we were weird but that's fine with me.

    Again, so wonderful of you to post and I will tell other mom's of twins (or more) to read what you share.

    Robyn

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    1. I was kind of hoping to keep nursing Cecilia through this pregnancy, but my supply was totally dried up by about 5 months in. And it's a good thing she ended up weaning, because I hadn't been gaining weight and I really needed to!!!

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  15. You are amazing. Good on you for your patience and persistence.

    We had almost no issues with getting both of our girls exclusively nursing but that was luck and not me. Well, probably nursing our previous kids helped (I'm glad it wasn't my first experience breastfeeding. I would have been a lot more nervous). For their first month our girls pretty much only woke to eat, every three hours. Since they're going throguh some kind of horrible teething sleep regression right now I miss my entire three hour blocks or sleep!

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    1. I'm so thankful that they weren't as alert as my singletons in the beginning - they slept almost all the time until they were about 2 months old! Definitely made the adjustment easier :)

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  16. I shared this with a friend whose twins were born just three weeks ago!

    BTW, I would have cried about having to pour liquid gold down the drain, too. :)

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    1. The nice thing is that if we had to pour any out, it meant they slept for long enough that we didn't have to use it!

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  17. This is So Awesome. Truly, good for you for doing this for those sweet babes!!

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    1. Thanks! I'm so glad those early days are over, but it was so worth the work!

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  18. Hooray for you!!! I had twins (with a 4 yr old and 2 yr old already) and nursed them for 20 months. It was so worth it! I found 2 of those humongous nursing pillows at a consignment store and kept one in the car so I could nurse at friends' houses when we were finally up for leaving ours.

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    1. That's awesome! I'm definitely excited to see how long we go, and curious to see what happens when they finally decide to wean (although it's likely that they'll just wean when I get pregnant again, like my first two).

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