A question for Tiktok/Mears/Hunkermunker etc. re twins and hospital formula top ups

[fustilarian]

Hello,

Just been reading over some of your past threads and mulling over the arrival of my twins, and I realised I am probably going to need to get into kickass mode to defend them from formula in hospital. I want to get as much ammunition for my predicted war as possible in advance so that I don't weaken when I am told they are starving....Would you be able to give me a bit of extra oomph (or, tell me I'm talking rubbish and that all twins need top ups...hmmm)?

So..

I am 37 weeks now (more or less full term) with the twins and am due an elective c/s at 39 weeks if I don't go into labour before (only for 2 reasons, mainly past emergency c/s and also crazy positions of both of them). I am healthy and fine and so far on all the scans they have been fine and normal size for dates. So fingers crossed they won't be too tiny. In other words, all being well they should be normal babies, if a little small.

I come from a line of militant breastfeeders and only stopped feeding my toddler about half way through this pregnancy so I am experienced. I plan to have skin to skin in the op theatre and thereafter as much as possible with non stop boob on offer if necessary. I can't really be bothered to express colostrum before they come, and don't want to accidentally bring on labour, but I will take all my expressing kit into the hospital ready to go.

I'm not that concerned about feeding two of them, and my feeling is that it will be fine. My DD was a great feeder and whilst I do give her lots of credit for that I think that my efforts to feed her round the clock in the hospital did pay off.

BUT- every single mother of twins I have met at my twins club and elsewhere has been pressured into top ups, usually in the SCBU, given in, and regretted it later. Why is this? Are doctors just afraid of twins?

What do I need to know? What shall I say to the docs/midwives? When should I really listen to them if ever on this topic? How can I stop myself giving in to the pressure?

Sorry for such a bombardment but I can see you are all brilliantly evangelical so I'm hoping you won't mind! Thank you in advance...

[PinkTulips]

i'm not an expert but i do know the woman across from me on ward had twins weighing 7lb4 and 8lb5 and exclusively bf them while in hospital and was never, not once, pressured to formula feed. she was offered help with the babies but not once was formula suggested, even though they were feeding incessantly and she was knackered.

she knew it was there if necessary, they knew she knew that and no more was said.

just thought i'd share that so you know not all hospitals will pressure you about ff.

similarily my ds2 was in scbu at this time and although i was told they'd recommend ff they said 'but we know bf is your choice and we will support you in that no matter what, if he has ff it has to be your choice, not ours'

[fustilarian]

Oh thank you Pink Tulips, that has cheered me up before bed!

Well let's hope that's how it will be for me!

[tiktok]

Can't think why your twins would need formula, and if they do need a bit of a boost from expressed breastmilk in the early days you can hand express - better, usually, than a pump at the start, so you can prob leave your expressing stuff at home

[MilaMae]

I was never told to top up when I had my twins. They suggested/helped expressing and cup feeding the smaller twin but never pushed formula on me or other twin mums I know. Far from it, I had my own place in the ward fridge, expressing machine etc.

Where the problem is with twins is they buggar off and leave you to it. Tandem feeding 2 newborns is NOT easy ,they don't spend time helping you with latch or position.

Also if you've had a section with twins like I my sister and bestfriend did positioning is a nightmare without help. It bloody hurts you can't lever yourself out constantly to ring the bell let alone pick up and feed 2 babies. DP was booted out at 10pm after that I was on my own.

Also mine were non identical so had completely different bodies,appetites and didn't always want to feed at the same time when newborn so tandem didn't always work anyway.

Basically twin mums need a lot of extra support with breast feeding and I don't think you in anyway get it as the vast maj of staff on wards have never had twins so just don't see where support is needed. I had mine in a huge teaching hospital that saw masses of multiple births being linked to 2 top IVF clinics and they were seriously lacking in support and knowledge of twin birth aftercare. If they couldn't get it right I have to say there isn't much hope elsewhere.

Sorry to be so glum but wish I'd known all this before. If you can get dp/your mum to stay in and help round the clock in hospital it would help big time.

[fustilarian]

hmmm- thanks tiktok, I'm hoping that they won't have any reason to suggest it, maybe it is my local hospital, but every twin mum I know has been quite strongly pressurised... don't know why really.

Milamae- thank you too, sorry you had a difficult time- did it get easier later? I'm going to have probs having someone there a lot as my mum will be with my DD and my DP will be dropping in and out looking after her too. I can imagine it is difficult getting two latched on in the hours/days after a section- I was going to try slotting them both in a sling and more or less keeping them there, or at least one at a time. And taking tons of pillows with me. That's about all I had planned so far to make it easier. Mine are also non id and the boy looks to be a bit bigger than the girl so I can imagine the same thing as you re different appetites/shapes.

[MilaMae]

At least you've mastered the latch thing before,mine were my 1st so I and dtwins didn't have a clue.

[hunkermunker]

Fustilarian, you need Marsy's words of wisdom

Good luck with everything - congratulations on your imminent twin arrival!

[Littlefish]

My lovely sister had twins 6 weeks prem. They were both in SCBU - twin 1 for a week and twin 2 for 3 weeks. She expressed so they could be tube fed, whilst having skin to skin with them whenever she could. As soon as was practical, she started breastfeeding them. She carried on feeding them (tandem) exclusively for 6 months, using occasional bottles of expressed breast milk. She finally stopped breastfeeding them when they self-weaned at a year old.

She also had a c-section and used one of those v shaped breast feeding pillows with the twins in a rugby ball hold (their feet under her armpits, if you see what I mean!).

Good luck!

[Littlefish]

Sorry - forgot to say that they didn't have any formula top ups at all while they were in SCBU.

[KristinaM]

sorry i have no twin advice/experience, but just wanted to say that i went home the next day after my c section, with the reluctant blessing of the hospital ie i didn't have to sign myself out

so if your babies are well you might want to go home asap, assuming you will get plenty help at home with feeding rather than in hospital

i found the MW very unhelful in picking up the baby for me to feed. they kept telling me that a bf baby doesnt need fed for the first 24 hours and offering to take him off to the nursery " so you can get some sleep" stop annoying us

also my c section baby fed like a dream, compared with my traumatised intrumental vaginal delivery baby

good luck

i have a friend who has bf two sets of twins and didnt have top ups. like you, she is a very determined person

[fustilarian]

Thank you all, really helpful and encouraging stories! And that link is great hunkermunker- she makes it sound very straightforward...

Been chatting to my midwife today who said that you can ask for skin to skin whilst still in the operating theatre- I never knew that before- and that it still helps with breastfeeding even if the skin is the dad's and not the mum's apparently.

I'm feeling totally up for it now! Strangely, I feel like going into hospital is going to be a relaxing break having had no more than half a day 'off duty' with my toddler since she was born. I'm sure I will be eating my words soon...

Thanks again.

[Littlefish]

What a lovely link Hunker. I fondly remember my sister removing biscuit crumbs from the babies' ears as she munched and breastfed!

I also remember waching her in awe as she tandem fed, whilst simultaneously hemming the edge of a blanket! That's multi-tasking for you.

[niche]

I had my dts at 39ws (induction) and after I mentioned my plans to bf, formula was never mentioned. I was more or less just left alone to get on with things (they were dc 3&4). Congratulations and hope everything goes smoothly for you.

[curiositykilled]

I have no experience (yet - 27 weeks pg with twins, two older breastfed dcs) but why don't you write in your birth plan that you plan to breastfeed and would prefer not to be offered formula? Then stop worrying about it.



Can be nice to talk things over with the hospital midwives and visit the delivery suite just to get over the fear of the unknown and that paranoia everyone gets. There's no reason to think hospital will be anything other than a relaxing break! A relaxing and necessary break getting used to your new babies.

[1stMrsF]

I wish that I had been able to avoid the formula top ups that DT1 received but she only had them because she had a tongue tie, really struggled with breastfeeding and wasn't feeding well, consequently got low blood sugar, went very sleepy etc. so paediatrician insisted. However, once the tongue tie sorted and we were home, just fed very frequently and dropped the top ups within a few days. So, whilst I wouldn't want to dissuade you from your mission to avoid it, if you do experience things in the hospital that aren't exactly what you want, then when you get home it's possible to move on.

I agree totally with Mila that the problem is the difficulty of coping with twins. When the night staff did offer help, they took DT2 (no tongue tie problem) 'off my hands' and topped her up too to settle her (she trumped them by only drinking 10ml and then refusing thereafter!). So, with no sleep at all for 3 days and very little help, it's pretty difficult to fight your corner. On the positive side, I had skin to skin in the operating theatre, bf them both in recovery room and some amazing day staff helped me keep DT1 bfeeding before every ff.

Even with this experience, DT2 has been totally bf, DT1 has had only occasional top ups and no ff for weeks now and they are 3 months old and I'm still bf. I never tandem feed as I couldn't get on with it (I would advocate feeding separately to start with in order to build a bf relationship with them separately) and I've still managed. They are also fed on demand, which people also told me I couldn't do with twins. Get home and do what you want to do, and if you don't have the best experience in the hospital, try to let it go and not regret anything - you will not be yourself in the first few days!

In answer to one of your questions, it gets a whole lot easier, and now I'm so so pleased I persevered through the difficult weeks. Good luck!

[Judy1234]

My twins were born at 40 weeks. However I had an independent midwife and we came home from hospital the same day. Why not do that? Then they cannot give you top us because you're back in your own house? They are not allowed by law to keep you in hospital if you choose to go home.

I virtually always fed thet wins at the same time and it's not hard in a big bed at home such as a double bed.

If you feed them one after the other.. I just can't imagine anyone doing that and having any time for themselves or their work but I was back at work prety quickly after with them brought to me for feeding. It's dead easy to fee them at the same time. Also if one wakes always wake the other and feed it. Much more efficient.

[Aidensmama]

there should be no reason why you can't bf your twins.

I hope your twins are well and don't need scbu but if they go to scbu for whatever reason and they can't go to the breast to feed you should be encouraged and supported to express and give it by either feeding tube or small amounts can be put into babies mouth by syringe (not all hospitals allow this so it's best check at the time), only if they are unable to go to your breast. As bf babies they should not be offered a bottle or dummy without your permission.
If for any reason they require more fluid than you can initally provide (by this I mean the amount that the scbu staff will calculate each baby needing if they are not allowed to demand feed)until your milk comes in for example if they became SEVERLY jaundiced or consistantly low blood sugars, the drs may suggest topping up with formula but this should be given in conjuction with your breast milk and decreased as your milk increases. Or they can be given iv fluids, if they can't feed they should be on these anyway so formula is not required and you can express to get a small supply in stock.

In no circumstances should you be discouraged from bf.

If you are married and your twins do go to special care the staff may ask dad if they can have formula as he has parental responsibilty too (i'm sure you already know this) so make sure he is fully aware of your wishes/decision.

KRISTINAM as with your experience some MW do believe babies don't need feeding for upto 12hrs but the length of time is individual as all babies have different amounts of fat stores to use up.
As with a singleton feeding asap and as often as they want (demand) (can even be done in theatre with right support) and lots of skin to skin are important. Dad can skin to skin too.

Most hospitals now have bf consutants/support peers in place to help and support mums and auxillary staff also take a more active role in supporting mums too as midwives may unfortunately be too busy to give you assistance you require.

Also you should not need to take your own expressing stuff in as it should be provided for you and you should also be taught how to hand express correctly.

I'm sorry to drone on a bit but I hope this is of some help.

I hope everything goes well and you have a positive experience with your twins.

[TeaSleepFood]

Hello,
I had 7lb twins (each) born by elective CS at 38 weeks (T1 breech). I told the lady who got my gowned for theatre that I wanted skin to skin and they put the blood pressure cuff on and the leads for heart monitoring on in such a way that I could slip the gown down to BF straight away. They were very helpful in organising everything for me.
Similarly I didn't have much help in the BF in hospital but it all worked out ok even with DS tongue tie. If they feel as if they are feeding differently and one is more uncomfy than the other - tell someone. Then tell them again. Then tell someone else! You are the one that knows.
Most hospitals welcome you to a pre admission visit and you can then become a bit more familiar with their routine and express your wishes before you arrive and get all emotional. Just a thought.
Best of british and remember - you are already a great mum!

[fustilarian]

Thank you all for really great and reassuring replies. I am feeling totally upbeat about it all now, not least because I am now 38 weeks and 1 day, with 5 days to go to the section and feeling very excited.

Thanks again! I'll let you know how I get on.

[tkband3]

Haven't read through all the replies, so apologies if I'm duplicating but...

My DTs were born by elective CS at just over 37 weeks. Although I didn't have skin to skin straight away, once they joined me in recovery (after being checked by the paed), I managed to feed them together immediately, so we had skin to skin within 30 minutes of so of their birth.

I spent 4 days in hospital and during that time, I was offered formula, but I was adamant that I wanted to breastfeed. I wouldn't say all the midwives were particularly supportive, but a couple were, especially the ones on at night. Fortunately my mum was looking after DD1 (who I'd successfully fed for 9 months) so DH was able to spend a lot of time with me in the hospital, particularly in the evenings.

I didn't manage to breastfeed my DTs for long, but I didn't know about mumsnet then - if I had, I'd have had the sage advice of Marslady whose wisdom hunkermunker has already linked you to. Mars is off-line at the moment, but if you need any specific advice, I am sure she would be happy to help and I could text her for you.

Best of luck.