Feeding twins- different issues

[ByeBabyBatshit]

I have three-week-old twins born at 32+5 (current corrected age 36+3) who I brought home last week from SCBU. For the latter part of their stay in hospital I was BFing them during the day, and they were tube-fed formula at night. For the last week they've been exclusively breastfed. However, their weight hasn't been increasing very fast, so I've agreed to give Nutriprem 2 formula for one feed a day.

Twin 1 feeds fantastically on bottle or breast, but gets very bad wind. He's had Infacol for several days, but it's not helping. He doesn't get distressed, but makes a lot of gassy noises for hours after feeding. I try to wind him during and after a feed, but he's always twisting around trying to get back on the breast, even when he and I both know he's full.

Is there anything I can do to alleviate the wind?

Twin 2 feeds OK on the breast but when we bottle-feed him the formula (using Tommee Tippee Closer to Nature slow flow teats) he sucks and sucks but does not take in much formula- the amount in the bottle only goes down by about 5 ml.

He has a tongue tie, but he has a strong suck and seems to breastfeed OK, so I don't know if that's a problem.

Any recommendations for different teats to try?

Also, one more problem: I have a different level of milk supply in each breast. If I express, I get about 20ml from one side and 60ml from the other. How do I ensure both babies get enough when i breastfeed them, without getting totally wonky boobs?!

Congratulations on your two babies :)

My DTs both seemed very windy when they were little and I used to worry about it and try to help them bring up the wind long after they stopped managing any burps. I eventually came to the conclusion that a lot of the windy noises were from beyond the stomach, so they were never going to be able to burp up that wind! They did fart like troopers in the night and early morning though! The 'wind' situation improved for us at about 6 weeks (I don't know how that gets adjusted for prem twins as mine were born at 38+ weeks).

With regard to expressing, try not to worry that you can get more from one side than the other. It really isn't an indication of how much each side is producing. For the first few weeks I tried to make sure both babies fed from each side during the day (as I was worried about them getting used to one side each and rejecting the other side). All this did was mean I tied my head in knots trying to remember which baby fed where last time, and it sometimes meant I was offering an 'empty' feeling breast, which felt wrong. At 3 weeks I decided that they would have one side each for a day, then switch sides the next day - that was far less difficult to keep track of and both of my babies feed happily on either side :)

For the baby that is struggling to feed from the bottle, could you try feeding with a cup or syringe? Your midwife or HV should be able to show you how, or maybe a local Breastfeeding group? It can take a while for baby to learn to cup feed, but you might get them to take more that way.

Good luck with your babies and congratulations on breastfeeding them :)

I would get the tongue tie snipped asap. it my help twin 2 no end. wind....argh. is nutriprem milk-based? some little ones have an issue with cow milk protein....maybe one for your consultant?

Congratulations - and well done for bfing after a tough time.

I can't add anything to what Happy said really. I got very worried about winding the right way then the problem just seemed to go away. TBH if DT1 wants to keep feeding I would let him (comfort feeding is so important to them).

My understanding is that breasts don't get empty - whilst a baby is feeding you will make milk if you are feeding regularly enough. I did the daily switch like Happy so they got to switch sides and help prevent supply/mastitis issues.

If you are still worried I would see someone qualified (LLL leader/IBCLC level) - especially as you have weight issues to deal with.

Good luck.

For twin 2 I would switch teats. My premmie twins couldn't get on with tommee tippee at all. I used Nuk latex teats as they are really soft and easy to suck. I've recently moved them on to (age 11 weeks corrected, 20 actual) Nuk silicone teats as they were glugging the milk too quickly!

The milk that you express is not a true indication of your milk supply as
expressing is never as effective as your baby feeding
When the twinkles were newborns I would always offer the fullest breast to the baby that required feeding at that time. When they were 6 months old, I began weaning them onto solids and I allocated a boob to each baby. Spud has the right and Sprout the left.
Spud was always a windy baby and still is!
We never attended baby massage classes but we had a brief one off session at a postnatal group. We were shown a massage technique which The Beard mastered which was small clockwise circular movement on Spuds abdomen this would usually result in a loud fart.
If your baby is still searching for the breast, it maybe worth putting him back to the breast to continue the feed and wait for baby to come off. I would find that when I thought they had enough they would go and find a small gap in their big toe that would need filling before they were truly done.
Have you visited your local breastfeeding support group? They maybe able to check baby's tongue tie and see if it requires snipping as well as offer you support.