Right, bear with me this might be a long one!
My twins arrived 10 weeks early by EMCS under GA. Clearly not the best start to bf.
I started expressing and after gut priming the NICU staff were tube feeding the DTs with expressed milk and fortifier, but neither of them could tolerate it, so moved onto expressed milk with 25 per cent prem formula. A couple of weeks in my expressed milk supply was not keeping up with demand, so they moved to 50:50. I went onto Domperidone and boosted the pumping regime, and managed to increase output. The DTs stayed on a 50:50 balance of EBM and formula, but despite the volumes going up I managed to bank quite a lot of milk in the freezer which came home with them (although has been used up since).
When we began breast feeding Dd showed some good interest in trying to latch, was dropping her jaw etc, but kept pulling on and off and couldn't sustain it, while Ds didn't really even try. So we tried shields, they both got feeding well, and we're still using them now.
In the last couple of weeks in NICU they were on a four hourly schedule and I was breast feeding once or twice a day, pumping the rest of the time, with them having bottle feeds or top ups of 50;50. They came home on the same schedule 4 weeks ago (now 11 weeks old), and now I need to work out where to go with this!
My dilemna is that using bottle top ups at every feed is really labour intensive and drags out feed time to about 1 hour 45 mins if I'm doing them on my own. I haven't really found time to regularly pump - I had been doing the 2am feed as bottle only for speed (so DH can go back to sleep also) then pumping afterwards, although for the past couple of days my supply at that time of day seems to have completely diminished. So we're using pretty much all formula in the bottles.
I attempted to taper down the top-ups, and once or twice have offered boob only, and they simply don't seem to get full enough to settle.
I'm aware if we tried to move to exclusive breast feeding it will be more time consuming (if I even could!), so I have been trying tandem feeding occasionaly. I can do it, but I don't think they feed so well in that position. Obviously they would need to feed more often as well, and I don't know if that's even feasible with twins. They are not yet efficient feeders - can keep going for up to 40 mins each, or can be lazy.
I also don't feel that bf'ing is always a very positive bonding experience - they both pull on and off, scratch and tug at the breast, pull off the shield etc etc. When trying to tandem feed it leaves me pretty beaten up! BUT I worked so so hard to come home with breast feeding an option, and I don't want to give up on it right now.
On top of everything they both have reflux, Ds much worse, which means he vomits regularly and profusely. So they are both on meds that need to be administered 3x a day (so ideally need some bottles at least).
From their point of view what we're doing is working as they're both gaining weight, getting their meds, and getting some boob time, but I would like to streamline things if I can. Any ideas on how to make this sustainable ??