Wednesday, February 3, 2010

Show Me the Milk--My LC and Breast Feeding the Twins

My newborn twin boys are 2 weeks old tomorrow (born at 35 week, 5 days) and I was advised in the hospital to breast feed but to also supplement with formula.
It was not really pushed on me to be breast feeding exclusively nor pumping on a set schedule.
I was so out of it from the drugs/C-Section/gas pain, that I went along with it.
Once I was home I got more serious about breast feeding and pumping, but was doubting whether or not I had 'missed' the window of my milk coming in.
So, we continued to supplement with formula for the rest of the week.

I asked my pediatrician about it at the twins one week check up and she told me to STOP breast feeding except every 3-4 feedings and to pump every two hours around the clock.
I doubted this advice, but tried it out for 2 days. I still did not produce enough to feed them my breast milk and was starting to get really down on myself for not getting it right.

Finally, 9 days after they were born, I contacted LC, Sheri Bayles, who was horrified at my Ped's advice. She had me start to exclusively breast feed that day and pump 10 minutes after each session from 6am-10pm. From 10pm-6am, just breast feed.
The goal was to get them eating every 2.5-3 hours from the breast. Max is a super sucker, so we put all hope on Max to 'bring' my milk in as his brother was not going to be our sucker champ.

I have been doing this schedule now for 5 days and it's working! My tits have milk in them after all. I have them on the same schedule and do tandem breast feeding at every feeding. They are pretty good at letting us know when they are hungry and if they go past 3 hours, we wake them up.

If one wakes up but the other one is still asleep, we wake them both up--otherwise I would not get any sleep at all and everything I've read said I need to have rest to produce my milk.

I'm still not getting that much from pumping, sometimes 1-2 cc, sometimes up to 10cc's, but either way, not very much. So we have 'topped' off with formula a couple of times in the middle of the night (2 nights), but that's it.

Hopefully, if I keep this up, my milk supply will continue to increase and I can get enough from pumping we will have a bit of a back up supply to 'top off' with instead of the formula.

I'm also eating steel cut oatmeal every morning, drinking Mother's Milk tea, taking Fenugreek and Blessed Thistle 3 x day and drinking about 1/2 gallon of water daily.

However, at their Pedi weigh in yesterday, she wanted to see more of a weight gain. They haven't LOST any weight, but Max has only gained 1 ounce over his birth weight and Sebastian has gained two. Of course, she is a doctor and they seem to always seem to be hell bent on 'fattening them up', which of course, I want them to gain weight, but I also want them to be breast fed and not have to rely on formula if I can help it.

I also just found out that my thyroid levels are wacked out again. My TSH is 5.76, where it has been between 1-2 for the entire pregnancy. I have an appointment with the endocrinologist tomorrow to re-adjust my meds and see if this makes a difference in both my energy level (maybe it's NOT all just sleep deprivation!) and my milk supply.

Any other advice would be very much appreciated.


mamaandmummy said...

Good for you, girl, I'm so glad you decide to get a 2nd opinion. I'm glad things are going smoother and you're able to breastfeed almost exclusively. That's awesome! Keep it up!

jessie said...

Glad you found a system that worked!!! You'll notice your pumping output increase as you continue - you're telling your body you need more so it's all about supply and demand. I think doctors like the numbers but I've heard to allow bf babies 3 weeks to really gain.

Maybe they could be weighed before eating, fed, and then weighed after to see how much they are taking in?

My SIL EPed for her twins for 5.5 months and that worked really well for her because they had trouble gaining in the beginning and this way she knew how much they were getting.

K J and the kids said...

I had a hard time feeding exclusively with my first set. Pumping never helped. With the second set I found a pill called donperidone. THE BEST INVENTION EVER ! Get a prescription but look online to find the cheapest way to get it. Out of the USA is the best way. Any ways. good luck. I think you are doing FANTASTIC.

sandra said...

I am so glad you got a second opinion.

You are doing an amazing job!

oneofhismoms said...

I've said it before and I'll say it again, lactation consultant is worth every penny. It was the best money we spent on the new baby, both times.

anofferingoflove said...

No advice, just want to send lots if encouragement! You are doing a great job!

I am also horrified by your ped's advice to stop breastfeeding (WTF! ). How are they going to learn if you take the breast away completely? I'm also dissapointed in the lack of support from the hospital. They should have given you better support and help. Good for you for seeking out a LC, sounds like she is just what you needed.

Bella said...

That's great that your supply is increasing!! You're a champ for sticking with it!!! Keep it up!

tireegal68 said...

I don't have any advice but I wanted to say I think you are doing great. And if the doctor who told you your babies are too skinny is the one who told you not to breastfeed I say pooh pooh to him / her.
It seems that they are never satisfied. Keep doing what you are doing and go la la la when you hear stuff that does not make sense to you.
Good to hear advice about the LC - I will bear that in mind for someday (fx)
You're a champ for tandem breastfeeding. I bet if your thyroid gets adjusted you will get some energy back. Go mama!
From the twin who got all breast when her sister got some bottle because she couldn't get the hang of the bottle ( I was just faking!)

poppycat said...

No advice but I'm so proud of you Puffer. You are doing a great job and you are being tenacious in getting the answers you need to make this work. Keep it up. Those boys and boobs will be big and fat in no time.

Carey said...

Keep up the good work mama... remember, you've got twins, not just one baby :) Not that you'd forget LOL But sometimes it helps to keep things in perspective about these sorts of things - the same rules don't always apply when there are two!! None of the supplement things helped me produce more milk (did not try domperidone, but Steph took it religiously - she was just never a big milk producer despite her best efforts) - I had no problems supplementing w/ formula if we had to, the important thing to me was having a positive experience with the babies. If I was stressed out/frustrated about BFing, I felt it carried over to them. Plus, the occasional bottle gave Steph a chance to bond (which I felt was very important to everyone) before they were big enough for her to also BF effectively (they were preemie and not really capable of efficient BFing for a few weeks) And even later on, they got EBM in bottles almost daily - my supply was not enough for the two of them most of the time. Keep doing what you are doing - you'll find a wealth of differing opinions out there - trust your gut and enjoy the process; these days pass quickly!!

Two Moms, Two Monkeys said...

Hey Mama! Just wanted to say that you are doing an amazing job! Tandem feeding was always hard for me but I was told that was the best way to stimulate your milk supply so keep it up! I think you are doing everything you possibly can to give your boys breastmilk and if you still have to add a little formula that is ok. They are getting both the experience/comfort of breastfeeding as well as the nutritional benefits so consider yourself lucky. As Carey said, two is not the same as one and its way more than double the work to breastfeed twins. My boys are 10 months old (almost) and I'm still getting up to pump every 3 hours just to keep up!

As for fattening them up, ask your ped about human milk fortifier (HMF). Its extra calories you can add to your breastmilk. We had to give this to the little guy because with his lung issues he was burning more calories than his brother just breathing. Since I wanted to do breastmilk exclusively, I was told to add HMF to the little guys breast milk so that I didn't have to supplement with formula. It is expensive though (like $1 per packet and you use 16-20 packets a day per baby) but I think some insurance covers it if it is prescribed.

indigoscot said...

my dp also is hypothyroid and her endo said that tsh being elevated can definitely affect milk production! hopefully you can get the right dose of synthroid and be producing like a champ! fwiw, her levels are normal and she has an abundance of milk, seriously she could be feeding twins at this point! so there is hope! :)

Laurie said...

Im so happy the BF is going better! One thing I've found that helps while pumping is to massage the breast. I'll often get another ounce or more! Keep up the good work!!! Those babies are lucky to have such a strong, determined mama!

Mommy D said...

I hope the Ped isn't freaking you out with the fanatical obsession with weight gain for the babes.... Both of my munchkins were under 6 pounds when they were born and took their time gaining as they were BF babies and BF babies are normally leaner.... Keep up the pumping it's so worth it and your output will increase as you contine pumping and BFing.

Pomegranate said...

Two of the moms at work told me yesterday that if they could do it over they would skip the birthing class and do a breast-feeding class instead. That was the biggest challenge of having a baby for both of them.

I'm glad you're finding your way of getting it to work. It's too bad there's so much bad information still out there (like from your pediatrician) about breast feeding, but at least people are talking about it and that there's some information if you look for it, I guess.

B and D said...

The plan I followed for a few weeks was nurse, pump, supplement and I did that around the clock for a while (granted I only have one so that makes a difference!). Whatever I pumped I would give back to him after the next feeding and if that wasn't quite enough at the end of the day (because your production will decrease as you move towards the evening hours and then picks back up early in the morning), we'd top him off with formula to make sure he was getting 3oz a feed every 3 hours. My LC said he should average an ounce per hour, but that also depends on your milk. Some women produce milk that has more water in it and therefore the baby needs more to be satisfied over the course of a day.

Anyway, we would guess-timate on the amount of formula but normally he really only took it in the evening. And even then we were on so little after a week and then none after 2 weeks. I also did a lot of before and after weights using a scale I rented. I would say just keep after it (the pumping, eating, and supplements) and see what happens. But know that even if your best efforts aren't quite what they need, they are still getting a lot of breastmilk even if you have to sneak a little formula in here and there. Don't beat yourself up too much!

One last thing. I have a twin friend mommy who did have success with the Fenugreek and Mother's Milk tea (herbs 4x/day and tea 2x/day) and I also read a triplet blog where she is 100% BF and I think she takes like 17 of those Fenugreek pills a day or something like that (on top of around the clock pumping). I could email you the link for her blog if you'd like to read her entries for reference and support :)

You're doing great!! Keep it up and just enjoy the babies. Before too long they won't be so newborn anymore and you'll wonder where the time went (I do everyday- my little one is now 3 months).


reproducinggenius said...

Aren't lactation consultants the best? It sounds like you found a really good one. One other resource you might look into is La Leche League meetings. They're present in every city, and it might be a nice way to get some support a little bit down the road.

I'm so proud of you for being so determined to make this work. Your body knows what to do, and it sucks that some doctors just don't trust the human body to work! You will continue to get more each time you pump, and as your babies grow too. Even now, five months in, when my son has a few days of eating more, my supply increases to meet his needs. That is just the beauty of breastfeeding.

You're doing such a good job!

Carrie said...

I am so proud of you for everything you're doing! You're both such great moms already, working so hard for your little babies. Sending you lots of good juju for the days, weeks, months ahead!

Anonymous said...
This comment has been removed by a blog administrator.