Today marks the last day of the first month that my babies have eaten nothing but breastmilk. So it seems like a good day to celebrate and to write a bit (or, a lot) about how breastfeeding has gone for me so far. If this isn’t your fave topic, I suggest checking out these cute things.
The Beginning: I really tried to prepare for breastfeeding twins, and I truly thought I was prepared. I read several books, went to a free class at DC’s Breastfeeding Center, and spent lots of time talking to friends who have breastfed to get their advice. Turns out what I was NOT prepared for breastfeeding preemies or NICU babies. I was also not prepared for pumping. Looking back, that was a failure on my part, because many twins are born early and spend time in the NICU. I guess at the time I thought I’d make it to at least 37 weeks and avoid all that drama.
The First Week: Because I developed pre-eclampsia (suddenly and somewhat severely), I had a C-Section at 35w6d and after the babies were born I had to be on an IV of magnesium sulfate for 12 hours. At the same time, the babies were in the NICU. This means that not only did I not get to breastfeed them in the first hours of life, I didn’t even meet them until they were about 18 hours old. Already my plan to put them to the breast early and often was out the door.
Right after my C-section and before the magnesium, I was given a hospital grade pump and I embarked on the first of many pumping sessions. The lactation consultant at the hospital encouraged me to pump 8 times per day, so I did. I didn’t get any milk at all for a few days, and when it finally began to come in, I was getting maybe 1-2 ounces per pump. I never had a lot of milk, or got engorged or anything. It felt like I had to work for every drop from the first day.
When the babies were about one day old, a NICU nurse/nutritionist came into my hospital room to request my permission to give them 5ml of formula. I was still pretty foggy at this point, and I remember asking a lot of questions. I was concerned because I had read about nipple confusion, latching, etc. But, at the same time, I had two five pound babies who were in the NICU and needed to gain weight, so I didn’t feel at the time that I had any other choice but to say yes to this. (In retrospect, I wish I had explored my options and not rushed into anything. But, I was making the best decisions I could at the time I was making them.)
Both boys drank their 5ml bottles in a flash. They were very hungry from the beginning. Soon they were eating 20ml, 30ml, 40ml, and more at each feeding, 8x/day. A few days into their NICU stay, they were eating “ad lib,” which meant as much as they wanted every 3 hours. I was definitely not making enough milk to keep up.
At the same time, I was pumping 8x/day, and practicing breastfeeding with them all day in the NICU. Their feeding times were 8am, 11am, 2pm, 5pm, and 8pm (plus through the night but I never spent the night in the NICU with them). My goal was to be there for as many of those feedings as possible. Each feeding went like this:
- Holden got 5 minutes to practice breastfeeding on one side.
- Holden got a bottle of formula for 25 minutes and was allowed to eat as much as he wanted.
- Teddy got 5 minutes to practice breastfeeding on the other side.
- Teddy got 25 minutes to eat as much formula as he wanted.
- Then I would go pump for 20-30 minutes.
That whole cycle took 1.5 hours, and then it would all start over again 1.5 hours later. Generally, the boys would eat formula all day, and then the NICU nurses would feed them any breastmilk I had pumped in their nighttime bottles. They never lost more than a couple of ounces during their NICU stay (between IV fluids and unlimited formula) and they learned to love the bottle very early on.
Once We Came Home: The boys came home from the NICU when they were 6 days old. For a few days, we kept up the same schedule as the NICU (feeding at 2, 5, 8, and 11 AM and PM). I would attempt to nurse both of them, sometimes together/tandem, and then give them a bottle, and then pump. As you can imagine, this is pretty unsustainable. To only have ~90 minutes of “free time” not feeding or pumping, around the clock, is pretty insane.
Early on I had a lactation consultant come to the house to help. She was wonderful, and gave me a lot of tips on better pumping (bigger flanges, not washing pump parts every time, etc) and on better breastfeeding. She weighed the boys before and after a feed and confirmed they were at least getting some milk. She came back again 3 weeks later and helped us even more. She helped me with tandem nursing, and we tried to latch without a nipple shield (with some success).
Oh yeah, during this whole time I used a nipple shield, because the boys were just so small and it gave them something to really latch on to. Most of the time, we still use it now. I’ve had enough struggles that this is one battle I chose not to fight. Because it helps, I use it.
The early weeks and months I was still not making a ton of milk, and certainly not enough for two VERY hungry boys. We supplemented with formula every day for awhile, and then every few days. I did a lot of things to boost my supply: I watched webinars on how to pump more effectively, I took fenugreek and ate oatmeal and drank water. I pumped like a maniac. I asked twitter for help, and I read everything I could about low supply on the internet.
I also kept practicing breastfeeding with both babies. Sometimes Teddy would be better, and sometimes Holden would be better. Neither of them have ever been great. Part of the problem was that I was pumping so much that sometimes there wasn’t enough milk left over for them. But if I stopped pumping and just put them to the breast, they wouldn’t empty the milk supply, and then supply would drop. I was in a really tough spot of HAVING to pump to keep up supply (because the babies were not skilled enough yet) but yet the pumping was hurting my nursing progress. I felt like I could never catch up, let alone get ahead. Plus, the clock felt like my enemy. It was ALWAYS time to pump or feed or pump again. Very relentless.
Two Months In: Around the start of the new year, I started taking a drug called domperidone as a last-ditch effort to boost my supply. It’s not FDA approved and I had to buy it from an overseas pharmacy without a prescription. However, all the research led me to think it was relatively safe. This drug has definitely saved my breastfeeding career. When I started taking it I was probably making about 35-40 ounces per day. I’ve been on the drug for two months now and I think I’m making 55-60 ounces per day. I can’t attribute all of my progress to it, as I still pump like a maniac, nurse as often as I can, and also take other herbs/supplements from time to time. But just having more milk to offer the babies has been amazing.
Right Now: The babies are nearly four months old. The good news is that for the past month, they have only had breastmilk. I’ve also frozen about 40-50 ounces. It feels like such a huge accomplishment, but that’s less than these babies drink in a 24 hour period. Crazy, right?
The bad news is that I don’t think I will ever “just” breastfeed my babies. Right now, Teddy is much better at it, and I generally nurse him throughout the day. Usually, he still needs a bottle afterward. And some days we are out and about and he just gets bottles. Holden’s just not really up for eating on the breast, but I still try about once each day to get him to try. I rarely tandem feed them anymore. Too much frustration for everyone involved. They are too dang long for both of them to nurse in the football hold anymore!
I guess I consider myself a “recreational breastfeeder” who is one step away from being an exclusive pumper. I’ve really, really resisted being an exclusive pumper. I WANT to have a nursing relationship with both of my babies. For one thing, it would be SO MUCH EASIER if they just ate off the breast instead of me pumping, making bottles, feeding bottles, washing pump parts and bottles, etc. Also, I’d love the closeness and comfort that nursing brings. But I also have refused to make myself crazy about it. Plus, it’s nice to be able to leave the house and let another adult feed the babies.
The Future: When Andrew went back to work, I feared that my ability to pump would go away, but that didn’t turn out to be true. Now I’m worried that when the boys become mobile, I won’t be able to pump 6-7 times per day. And when that time comes, I will probably have to start giving them formula again. I’m okay with that. I don’t want to miss out on being a good mom because I’m stuck on the pump. But right now, I can find enough time in the day (usually when they’re sleeping) to pump enough.
I’d like to see if when the boys get a little older if they will be more into nursing for comfort. Right now sometimes it seems like they don’t even know who I am, let alone that I make the milk. But I wonder if that will change in the next few months. I’d like to keep up their skills at least at a minimal level so that if the time comes that they are more interested in the breast, it could be possible to offer it to them. But I also realize that at four months old, that ship may have sailed. They just might be bottle-fed babies. I’d rather have happy, full bottle-fed babies who sleep at night than hungry, angry breastfed babies who don’t sleep well.
I admit to having major envy of twin moms who are able to successfully breastfeed. I so wish that we could have gotten there ourselves. But I also know that I literally did everything I could to make this work. Ultimately, the babies have big appetites, and they got hooked on bottles very early. It’s really hard to overcome that. My supply was always one step behind them, and that’s been really hard.
But I also feel proud of myself and I don’t beat myself up too much. I’ve had a ton of support from twitter, internet friends, and real life friends. I know formula won’t harm my babies and I’m sure that they’ll drink it again in time. I think about giving up often, but at this point I’ve finally got my supply up to meet their demand so it seems silly to quit now. I just keep going one week at a time.
That’s my story for now. I know there are more chapters yet to come. I truly appreciate all the cheering and support that you all have given me. I hope I can offer help to new moms down the road. In the meantime, Teddy is waking from his nap so it’s time to feed him… ; )Tweet