mixed feeding and hot weather

[tiggersreturn]

I'm feeding my dts 20 mins bf and 60-90ml nutriprem every 3 hrs but with recent hot weather I wondered if I need to add cool boiled water or if they could bf again if they appear thirsty? Does anyone know. Dts are 7 wks and were born at 33 wks

Congratulations on your DTs! I have twins too - they are 3 now though. You are doing a great job breastfeeding them.

I would say offer them the breast if they seem hungry or thirsty - offer them the breast as often as they will take it! No need to offer them cool boiled water or water the formula down. More breastfeeding will stimulate your breasts to make more milk so you can't go wrong. The more breastfeeds the better. Don't worry about sticking to a 3hr schedule.

Thanks for the encouragement. I don't have much of a clue about formula feeding as I ebf ds1 until he was just under 6 months and then moved to formula in the day while I was at work, bf at night and solids so water was a different issue by that point.

Are you hoping to get to exclusive bfing with your twins?

That would be nice but i doubt it'll happen. Both were feeding from me with top UPS due to low birth weight when we first got discharged on day 5 when they were 34+2. However dt2 started refusing to feed from both breast and bottle and we got readmitted on day 10 for what turned out to be hypothermia in both which had caused the feeding issues.

When dt1 came out of the incubator he still wouldn't open his mouth. I tried and tried until after about a week he ripped his nose tube out at handover time and when he refused to bf again tried a bottle and he took it very slowly.

At this point I was feeding dt2 with just small top ups and they suggested I drop them as I seemed to have loads of milk. I tried and he lost weight because he put so much energy into feeding. I'd been expressing as well but not huge amounts (have never been good at it and finding time Btwn feeds not easy) . So that knocked my confidence quite a bit . Then we got home and dt2 stopped feeding for 24 hours. I didn't have a pump as discovered then that one from ds1 had broken. Not great for supply as I had to give him formula for fear we'd end up back in hospital 4 dehydration. I couldn't undress him for fear we'd end up back in hospital for hypothermia (both were on cardis & hats all the time as only way to keep them warm as still v little).

I got a bf consultant to come round and she suggested nipple shields as she thought the non-feeding was due to tiredness rather than refusal. Dt2 loved them and one time when dt1 was complaining with a slightly parted mouth I managed to shove,the shield full of milk in and after that he became much better although I still often have a battle to get him to open his mouth.

So now I have 2 babies who mix feed 1 of whom will only bf with a shield. I think the most I hope for is to manage to bf 1 entirely for a feed and bottle the other and then swap each feed.

I still have an older ds and a medical condition that does not get on greatly with bf so not sure how to make it work any better but happy to hear suggestions.

Should have been dt1 refused to feed at beginning. Sorry for long post.

Wow, you have been through such a lot. What a credit to you that you are continuing to offer them your milk. Every feed counts so well done!

You did amazingly to be discharged at 34+2. My SIL's twins were born at 34+5 and were in SCBU for 2wks.

They are still very young and it is great that they are both breastfeeding at all - this is a good sign that they may get strong enough to fully breastfeed eventually if you want that. Feeding twins is exhausting so don't worry too much right now. Just keep feeding. I wonder why the breastfeeding counsellor thought that the nipple shield would make it less tiring? It doesn't make much sense because they still have to suck just as hard (I would have though harder?), but I don't have much experience with nipple shields and if that is the only way your DT will feed then keep going with it.

A great book to read is Mothering Multiples: Caring For Twins And More by Karen Kerkhoff Gromada. Also The Womanly Art Of Breastfeeding has great tips for getting back on track after a slow start.

Thanks. It's reassuring to know that there may be hope even after a bad start. I think the problems were caused by too early release. Dt2 was the only one who went to scbu on birth (he was 3lb 13 and dt1 was 5lb2) and that was for just under 2 days. The main problem was that neither could regulate their temperatures and this then caused major feeding issues with dt1. If that had been picked up maybe it would have been different.

The nipple shields were suggested because dt2 was very little (at that point still under birth weight) and has a little mouth. The consultant suggested the shields as they would hit his sucking reflex with much less effort on his part. I think dt1 is just more of a laid back/lazy personality and prefers everything with no effort on his part. I've tried him without shields part way through a feed but with little success.

It is definitely possible to get back on track after a slow start and you may need to wait a few weeks until they get bigger and stronger. It's a shame you feel that your care has contributed to the breastfeeding problems - you trust the HCPs to know better don't you .

But you have done a great job after what must have been a traumatic time. Keep going as every drop of breastmilk matters!

If you want any advice later you can find me on Facebook (search for Formby Doula) or email me at formbydoula(at)hotmail(dot)co(dot)uk