(Disclaimer – I’m not a doctor or lactation consultant and do not intend any information in this article to be utilized without you discussing your situation with a professional first, this serves as general information only.)
How can I maximize breastfeeding success at the hospital?
As much skin-to-skin as possible! We had 2.5 hours of skin to skin after birth. While I understand this may not be the case for everyone, this allowed the babies time with me and the ability to nurse when they felt ready. Frequent skin to skin and latching in the newborn stage is the best prescription for a healthy milk supply. Keep your babies with you at all times and nurse whenever they need to. My husband also did skin-to-skin with whichever baby I was not nursing to keep the babies comfortable and facilitate bonding.
Think twice before introducing bottles or pacifiers. Most baby-friendly hospitals do not allow pacifiers anymore as they reduce the amount of suckling at the breast. Also, any amount of formula given will fill the babies’ tiny tummies and reduce their desire to breastfeed. Their capacity for milk is SO small, about the size of a marble, and your colostrum is the perfect amount. If they are not able to latch, absolutely make sure you are pumping every 2 hours or as recommended by the lactation consultant. I nursed and pumped, and when I pumped I was able to give the babies the colostrum in a clean syringe. Since we lived 2 hours from the hospital, I even brought some with me (prefilled with colostrum) for the drive home and kept offering small amounts to the babies to keep them satiated.
How do I manage once I get home?
Accept help if it is offered. My mom came to stay for 5 weeks, as my husband had to go right back to work. I know this is not an option for everyone, but if you have any friends or family that are willing to pitch in, even just to clean your bathrooms or prepare a meal, it will make your life exponentially easier. Nighttime was really hard. My husband wanted to help even though he had to work. We figured out a system where if the babies stirred (or if it approached 3 hours since the last feeding), I would get up, change their diapers, and wake my husband. He would then help me position the babies for nursing and go back to sleep. It was pretty terrible -we didn’t sleep much at all and we had very colicky babies who cried ALL the time. But, my husband truly wanted to help and this was his way of participating in the babies’ care with me. There were many nights when my mom would come in and help us rock the babies to sleep if necessary and we were really thankful for another pair of hands. She also helped a ton during the days when my husband was at work. Recovering from having twins was very tough on my body – you tend to have more bleeding, bloating, swelling, and overall bodily changes than with a singleton. I was also extremely hungry and thirsty all of the time. I struggled to find a single second to care for myself, even with help around the house.
Understand supply and demand. Breastmilk is produced on a simple, supply and demand system. Nursing often is the best way to ensure adequate supply – not taking herbal supplements or eating certain “galactogenic” foods. My babies were late-premature and extremely lethargic. There were times when I needed to wake them to make sure they ate every 3 hours. It was a little hard because people questioned whether or not I should wake them to eat. They’d always stood by the old adage – “never wake a sleeping baby.” But, when you’ve got 6 pound twins that are struggling to gain weight – the adage no longer applies. After the babies began to steadily gain weight and my milk supply was more established, I started to let them sleep a little longer at night. Also, as discussed earlier, I tried to avoid bottles as much as possible and completely avoided pacifiers. In the beginning, I was able to pump a decent amount of milk and it was very tempting to give the babies bottles. However, I waited until at least 4 weeks to introduce a bottle, and even then, used them sparingly! I never introduced a pacifier. This is probably a whole post in and of itself, but pacifiers can reduce the amount of suckling at the breast and result in decreased milk supply. This certainly is not the case for everyone, but I know my twins struggled with latching and weight gain, so I didn’t want to introduce anything that would potentially derail their progress.
Tandem nursing has to happen. I hate to say this, I really do. I hated tandem nursing – I admit it freely. I still hate it 16 months later. The first 3-4 months or so, you pretty much have no choice. The babies’ tummies are so tiny and breastmilk digests very quickly, usually in about 90 minutes. This generally means that your twins will want to nurse every 2 hours or less (counting from the START of the feeding). For example, if you start nursing at 7 am, they will want to start nursing again at 9 am. This leaves you with about 2 seconds of time for yourself.
But, in all seriousness, think about this situation. My newborn twins took about 40 minutes to eat per nursing session. When I nursed them individually, it was 1 hour and 20 minutes into the feeding cycle before I was done nursing completely. That means there was a mere 40 minutes before twin A would be screaming for her 18th breakfast. In the meantime, there are diapers to be changed and babies to be soothed before the cycle begins again. This plan literally gives you no time to yourself. After about 3 days of being home, my husband BEGGED me to tandem nurse. I told him I couldn’t do it. He told me I couldn’t NOT do it. With tandem nursing, we usually had at least an hour of reprieve before the twins were hungry again. It’s never enough time to get everything done, but this is not forever, it’s just for now. I’m really grateful that my husband was so supportive of breastfeeding – and of me! He truly wanted me to have some time to myself because he knew how how utterly exhausted I was!
If you feel any pain, please address it with a professional – or two, or three. In the beginning, my babies’ latches were very uncomfortable. I asked the lactation nurse in the hospital for some help because I felt like they weren’t latching deep enough. She would basically come into the room, say it looked “fine,” and leave. A few times, she just latched a baby on for me and walked away, never taking a minute to teach me anything. I had no idea what I was doing, and no one cared to show me! I learned very quickly that it may not be a good idea to solely rely upon the professionals at the hospital you birth in. I’m studying to be a nurse myself (hoping to work in lactation), and there are many lessons I’ve learned about what not to do.
I developed mastitis about 7-10 days postpartum. My babies weren’t latching effectively and I was so engorged. I could not get relief! Before I knew it, I was lying in bed shivering and sweating. I called a local lactation counselor to do a home visit. The second she walked in the door, she looked at my reddened, inflamed chest and said “oh honey, that does NOT look OK.” Within minutes, I was on the phone with my midwife to get antibiotics. She tried to help me learn to latch the babies properly and I felt much more confident after her visit.
The mastitis eventually cleared, but sadly, the latching issues did not subside. I looked into my twins’ mouths and discovered they both had tongue and lip ties. They were also having trouble gaining weight and my pediatrician was sending me home with backpacks full of formula samples. I ended up having to see several more lactation specialists. I was exhausted, I was in pain, and I was dejected. The lip and tongue ties are something I will address more fully in a later post, but my point is – don’t seek just one professional if you need help. Sometimes a second opinion is necessary. I think a lot of people give up because they can’t find solutions to their pain, but each person you consult may have different experiences that can lend themselves to your situation. Don’t stop searching for answers!
Not all pediatricians give the best breastfeeding advice. Pediatricians see A LOT of babies. They see babies who are happily breastfed, happily formula fed, and everything in between. To them, your breastfeeding experience is not personal. They don’t understand your struggles or that you have a special place in your heart for wanting to nurse your baby. What they can see is that your baby needs to gain weight. Thanks to formula, they know exactly how to do it – and fast! As parents, we need to advocate for ourselves and for our children. This doctor sees your baby once per month or less, and they may not feel like they have a responsibility to respond to your emotional needs as the child’s mother. They don’t know you, and you are not their patient. You’re new to this, and they’ve seen 1000 or more moms in the same frantic situation. It is important to them that lines on the babies’ growth charts ascend and that they meet their developmental milestones. It is up to you to express just how important breastfeeding is to you and your family. It is up to you to stand your ground. It is up to you to seek out a new pediatrician if you think he/she is not supportive of your goals. They work for you!
Ditch the breastfeeding app and/or spreadsheet. I’ve always been a super neurotic, hand-in-assignments-a-week-before-they-are-due type of person. It’s no surprise that, by the time I was 30 weeks pregnant, I had a clipboard ready with my own expertly designed excel spreadsheet to document my twins’ every feeding and bowel movement. The minute the babies were latched on, we’d start recording the time and which side they were on. Initially, I was so proud of my super-organized spreadsheet. But after a little while, it became such a chore. When I went to my first breastfeeding support group, the lactation nurse told me to throw my spreadsheet in the trash. I was shocked – I thought this was what I was supposed to do? She looked at me, and said something to the effect of, “oh sweetie, please, you just have to stop this.” And I’m so thankful I did. She instead suggested I use a simple tally system to record how many times each baby ate and how many dirty diapers they had per day. The stress was lifted! I never realized how much pressure I was putting on myself to fill out this self-imposed form 800 times daily. Once I received the “permission” from someone else to let it go, my life improved dramatically. Stop with the neuroses. Feed your babies and take care of yourself when you can!
I’d love for you to comment and start a conversation!
What was your experience with the hospital lactation staff? How about pediatricians? Is there anything you wish you would have known in hindsight?