Breastfeeding Supply Challenges
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I get a good chunk of my hits from moms looking to or having trouble breastfeeding twins, and their google searches often imply that they’re about ready to give up. Ex: breastfeeding twins is too hard, breastfeeding twins about to give up, breastfeeding preemie twins no success – and that’s just today. I can understand that, because it’s not at all easy to breastfeed multiples in the beginning, even if everything is going according to plan. If that’s you, please check out the category I have for that purpose, because perhaps my experience, or the links I’ve posted there, will be helpful to you. I recently read a new twin mom’s frustrated post about supply issues with twins, and thought I’d paraphrase my own reply here in case it’s helpful to anyone.
Kellymom has some decent information on both breastfeeding multiples and on supply issues.
I think something even lactation consultants rarely seem to understand is that the situation of having more than one is particularly problematic with growth spurts. My intuition and own experience lead me to suspect that getting through growth spurts with twins is the second biggest issue that eventually leads to low supply (the first being not establishing a good supply in the beginning).
With one baby, the baby demands more during a growth spurt, and in a day or 2 your supply increases to meet the demand. Some fussiness is perfectly normal here; it’s part of the process. With twins, however, your actual supply needs to increase doubly, and while your body can most likely do that, it cannot do so twice as fast. What tends to happen then, is that the extra fussiness leads to doubts about supply, the doubts lead to more supplementation with formula, the supplementation leads to less stimulation, which, in turn, leads to not building the necessary supply. Which is to say, none of this means that your body is actually incapable of producing the milk. Some women have genuinely low supply, but this is an often misunderstood issue.
It’s a complex logistical problem though. Over the months, I came to learn that my boys get much more from breastfeeding than I can produce with a pump, so your supply may not be as bad as it seems. I know this is a lot to balance, but if you nurse on demand (at least during the day), have lots of skin-to-skin contact, and pump after every feeding you can manage to, you might find that you can get past the hump and keep breastfeeding even though you’ve been told you have low supply.
I couldn’t deal with the fussiness in the evenings when my supply was lowest, so I fed them each one bottle of expressed breast milk then, but always bf first, and I pumped after every feeding too. I had a weak suckler in the beginning, and he got much better after a couple of months.
To the exhausted, confused, hormonal and overwhelmed new twin mom reading this in the middle of a long night (as I would’ve been): whatever you decide, best of luck to you. You are doing a very hard thing, you’re doing your best, and that’s all anyone can ask of you.
*when I say “at least during the day”, I’m not suggesting refusing an infant who wants to eat at night. I mean that when one woke, we woke the other too so we could be more likely to get at least a couple of hours of sleep in a row. For me, especially later in the game, the biggest dips in supply came when i was completely exhausted. It takes a ton of calories and energy to produce milk for twins, and I think the need for sleep needs to be dealt with even if it means trying to feed the babies together whenever possible. Neither baby ever seems to mind being woken to eat in the slightest.
I was pretty lucky, breastfeeding was farely easy for me after the first month. I had some issues in the beginning getting one of them to nurse enough but that ended quickly. I did have to supplement them because they were sometimes still hungry after they emptied me out. But I nursed them until their 2nd birthday and I’m very glad I did. One of them was a milk hog and would try to take both sides. He nursed all. the. time. I thought he would be attached to my breast forever.
The first month was the worst for me. I think both of them were permanenty attached to my breasts. And they were both “tongue tied” so they had latching on issues. I stuggled on with it despite my nipples feeling like they were constantly on fire. As they got a little older, they lerned to compensate and latch on better. After that, we did alright. I nursed my guys until they were 13 months old without supplementing really very much at all–they actually did not want to have much to do with a bottle at all, and we tried various different nipple types. Which was fine because I did not leave them with a sitter too much when they were really little. Oh, and I tandem fed as much as possible (always with the football hold) which I think helped tremendously.
I think I spent the first four months on the couch. Tandem nursing was hard for me to do by myself before they could sit up, so I always nursed them singly. As soon as one was nursed, changed, & swaddled, the other one was ready to go . . . My little girl averaged 11 sessions a day, my little boy averaged 13. At first these were 25 minutes sessions, then 20, then 15, and by about 6-8 months they took 8 minutes to empty a boob. You can email me for the chart that I used to keep track of everything — I made it so I just had to circle the time of the feeding, and the output of the diaper.
It was helpful to have everything I needed within reach — diapers, wipes, water, snacks, tv remotes, and especially safe places to put them down. For the longest time they slept side by side in a swing that was right next to the couch, I barely had to lean over to pick someone up.
I criticized myself for all the housework that didn’t get done, and for how constantly extremely hungry I was. I shouldn’t have. As my body healed and got adjusted to the workload, I did more. And when the nursing sessions slowed down, I ate less. I wish I could’ve trusted myself from the get-go on those issues and not wasted a minute being critical. And just this morning I was wishing that I’d kicked everyone out of the hospital room (ok, my mom was there ALL THE TIME, and it was not comforting to me)– it’s normal for them to lose weight in the hospital, but I think my milk would’ve come in faster if I’d been less self-conscious about focusing on the nursing. There are some posts on my blog as well, I’ll make a category for them.