Exclusive breastfeeding Twins

[butterflyexperience]

I feel like screaming

My twins are 21 weeks and both are below the 0.4 centile line.
Boy twin is deemed to be at a lower weight than girl by the charts and hv is recommending I give a formula bottle to help with weight

I really don't want to do this

I have worked so hard to get this far

I just don't know what to do

Any other ebf of twins out there? How'd you get on?

Bump for someone who has experience, but ...
Have you got a nearby support group? Some pro-bf hcp's to give another perspective on the situation.
Have they dropped centiles, or were they always there?
Do they seem healthy and happy?

Well done to get this far, Butterfly - you've done really well; it's hard work with twins however you feed them.

I ebf'd my twin girls for a month, then introduced one bottle a month from there on - this was more for me, really, than weight gain - I had DS (21months) when they were born and it was just easier to start introducing formula so other people could feed them from time to time.

With DS I was quite a evangelical bf'er - with the girls I was more relaxed. I think with your first (or mine, at least) I was a bit PFB 'isn't he pure, nothing man-made will pass his lips' .

By the time you're onto your second, you realise that by the time they're one, 'well-meaning' aunties and friends will have fed them the odd biscuit, sweet, crisp etc and it all seems to matter a bit less - plus I am a firm believer that a happy ff mum does more good for a baby than a stressed bf'ing mum. And just because you're introducing a bottle, it doesn't mean you have to give up on bf'ing - it's not all or nothing. Mine were mix-fed for 5 months before I dropped the last bottle.

This isn't meant to be a bf'ing vs formula post - more to say that I think you're more relaxed about the whole thing as a second time mum and realise that there is not right and wrong - I wasn't so much like that first time round.

Clearly what you do is up to you, but I know at your stage with DS, I'd have been reluctant to introduce a bottle - but second time around I was much more relaxed about how the girls were fed. That's what I'm trying to say (in a long-winded way )

I second the support group recommendation to get another perspective and some ideas. Where do you live? There are twin specific peer supporters in my area.

How is your supply? My (single) baby was slow to gain weight until i was taught breast compressions with really increased my supply and then her weight seemed to pick up. I also fed at least 3 hourly (waking her for feeds - though often this wany nescsary as she woke anyway) which helped, though realise this is a lot tougher with twins.

Also, are you well hydrated? Keeping myself hydrated also helped my supply.

You've done a brilliant job to get this far - 21 weeks is outstanding. Please head along to a local breastfeeding support group - they will make sure you're feeding as efficiently as you can be.

All percentile are in the normal range - there will always be some tiny babies and some great big ones. 50th isn't some perfect ideal to aim for, despite what some HVs think. However, it's important that your babies are on the right centile for them. If you and your DP are tall people, it would be strange for them to be on the lower percentile. However, if you and your partner are small people, it would be normal to have tiny babies.

What's important is that your babies are fed, nourished, developing well and happy. Do you get plenty of wet and dirty nappies? Do they seem satisfied after a feed?

One tactic you could try to squeeze in extra calories is to introduce one or two more breastfeeds a day.

If you do introduce formula, it's better to offer one bottle feed a day than to top up after every feed. By introducing one bottle, your supply will be maintained and will adjust to the fact that one feed is coming from somewhere else.

Please get plenty of real life support. It's always difficult to get the full picture without seeing mum or babies.

Hi butterfly, I'm 20months in to ebf my twin boys so I've got a bit of experience! Dtwin2 was always below the bottom of the chart, he's only just made it onto it now. I think he just is a small person, but I was lucky enough to have HCP who recognised that and didn't put undue pressure on me.

The big things with him were, he was consistently gaining weight and he was responsive, did pees and poos at regular intervals and was obviously having milk. If any of those things isn't happening or is worrying you it mihgt be worth investigating further. If the baby is just a small baby I'd say stick to your guns.

The La leche leaugue are always very helpful and the NCT breastfeeding phone line are good too. If you're anywhere near me I can always pop bye and offer some support - I know how hard those early days/weeks with twins are! I'll send you a Pm.

Oh and well done! You're doing a brilliant job.

Rather than just say give then formula, make you doubt yourself & your body and attempts at end (which is amazing btw) has anyone actually sat and watched them feed, asked how they behave at the breast etc? You could rely do with speaking to a lactation consultant.
The breast compressions are a good idea, will boost supply too. Also letting them comfort suckle & completely finish before taking them off so they've fell asleep or come off milk drunk. Do you let them cluster feed at all usillt evenings?

End = ebf

21 weeks is really good going! I'm 3 weeks in and planning to swap one feed with a bottle of formula once they hit 6 weeks - they are both gaining fine but I can't do anything else and have two older DC to entertain. I'm with sara upthread, more relaxed about mixed feeding this time esp after feeding bottle refusing dc2 for a year.

If you have concerns about supply and latch how about TAMBA peer supporters, or bfc who specialises in multiples (I can give you the name of someone in Surrey).

Congratulations, you have done a brilliant job! YY to seeing a bf counsellor or lactation consultant in real life. You can find out about local bf groups etc... here I don't think this list is exhaustive but a good place to start

HV's usually only have the most basic bf training (about the same as a peer supporter in my trust) so they don't have the info necessary to really advise a bf mum (not bashing hv's - they have a lot of areas of baby/toddler/child development to cover!)

Were they premature? This can affect the weight they are expected to be which may be lower than for babies born at full term. You could try posting on the multiples board here to see if anyone has experience of this, and littleonar's suggestions are good too.

It is normal for breastfed babies' weight gain to slow down at about 4 months or so but obviously it's worrying when they are off the charts and of course this could be a sign that they aren't getting enough, but it really needs proper help in real life, we can't advise you over an internet forum, just make suggestions. I agree "just give formula" is not a helpful first resort and there are most likely other things you can try first, so I would suggest getting in contact with organisations or people who can help you with your specific situation ASAP.

Loads of different links with info about breastfeeding twins

Links about premature babies

Ways to help your breastfed baby gain weight

Thanks for replies have just logged on
Will read and reply

More info:
I have two older dc who I ebf for over 1 year so I know my body can do it

I eat and drink enough

I think b twins issue is his latch.
He also is teething and I think he is on some sort of strike as had hardly fed today

I do give the twins a formula bottle at 5/6ish as I need to do dinner and ferry older dc to after school activities so literally can not sit and cluster feed them at that time

I just don't want to give them another formula bottle as I've worked so hard to get this far.

Both babies are bright eyed and bushy tailed and hitting development milestones

It's just their weight is low.
However they are in the correct size clothes for their age,

Also dh and me are tall so unlikely to have small dc
Twins were born at 36 weeks

I feel I have struggled to get professional help as they lack experience with twins so are afraid to advise in case they are wrong

I find I get best advice from other twin mums

My plan is to express in the day as much as possible to give to boy, see lll to get advice on his latch and maybe start weaning

They fit into clothes for their age? Blimey, my 20 month olds are still in 9-12 month old stuff. I think they sound fine, but just to double check:

Twin b is gaining weight?
He's bright eyed and bushytailed?

That's all very positive. Not all babies are on the chart. As I said, my Dtwin2 has only just hit the 0.4centile, but no one has worried as he's been gaining weight along his line.

Fwiw I've been told by HV at every weigh in that I might have to consider topping up, but Dtwin2 happens to also be under consultant care due to his allergies and he's been saying he's actually a bit on the weighty side for his height! It's about looking at the whole picture.

OTH I don't want to give you advice over the net, but I think you sound like you know what you're doing.

That's odd, if they're in the correct clothing size how can their weight be such an issue? Most people I know with small DC had to go several sizes down with clothing. Mind you at 5 months I suppose they are closer to 6 than 3 months.

If they are alert when not feeding and doing enough poos and wees (I appreciate it may be harder to keep track with two) then it's generally considered they are getting enough.

Are they on adjusted centiles for their age and twin-ness? (I am not sure whether they need to be, but it seems like it could be a possibility, as twins are usually born smaller just due to lack of space!)

I reckon your tallness is less likely to have an effect than the fact that twins are generally smaller at this age. Later they'll probably have a growth spurt and catch up with other DC their age.

I would definitely see if you can find anyone experienced with twins in real life either through TAMBA or LLL or somewhere else like that.

On a non twin note.

Wonder weeks would say they are going through a developmental leap at this time and that one of the characteristics is refusing to feed.

I didn't know this Nd presumed it was teething. Maybe it was a mixture as giving ds some bonjela seemed to help relax him in irder to feed.

Hth

Thank you all for your input.
I feel some what reassured

Yes they are in 3-6 month clothes from Next (diff shops do sizes differently)
Yes they are very happy and alert. Love to play with their toys

Interesting about development spurt. I think boy twin is going through a nurse ring strike due to teething

They are both below the 0.4 centile line

Am trying to get enough info on this matter so I can make an informed decision without hurting the twins

I agree that I think they will catchup later on as the men in our families are all over 6ft and broad

Ha, Bertie, I had a chart above my feeding chair for the early days with the twins. Each twin had a column for pees and poos, it was the only way I could keep track. Also used to swap boobs every 24 hrs or I'd get really confused - so twin1 on the right for a day then at 6pm I'd do the swap over!!!

Also, my DD (not a twin, so my 'control' group) was on the 10thcentile for AGES and we're both 6 foot or over. She's recently shot up and is now on the 75th. It's easy to get hung up on the charts, but they are population wide. I think you start to worry if they loose weight or stay the same weight for a while. Or if they're listless etc.

Good luck butteryfly.

Here's some links from Karen Gromada's site, I've found her to be invaluable with multiples stuff: here

Thanks red

Expressed 3.5 oz today for b twin 22:00 feed

He sicked up 1oz

Why do I even bother...

Wish I could just give them formula but I know the guilt would eat me up

Who ever said this would be easy was lying....

You know, formula is just another food. You can continue to breastfeed alongside. If you want to do it, then do it - especially if you are planning on weaning soon. Just think of it as another weaning food :)

Trust me - my DS is 5 now, and I look back and I think why the hell was I so ridiculous about the idea of formula? I breastfed him for 4 years, and actually formula would not have made one jot of difference, nor would it have undone anything. It is just a food. Do what you think is best.

As well as examining latch, my bf consultant suggested the following when DTs weight was struggling: breast compression, swapping them from boob to boob (I tandem feed so it's a palaver but worth it I think), and getting supply up by putting in 3x expressing sessions for 48 hours (I never managed the last one not sure any twin mum with other kids could!).

If it's hard to get to a bf cafe or get hold of a consultant I improved my latch with one by stopping tandem feeding during the day and watching videos online like Dr Jack Newman.

But then after all that at 8 weeks I did give a teatime bottle (also have DS1) and then at 12 weeks ended up every other day giving a lunchtime bottle to one of them, now at 23 weeks it's both. Giving them formula made me feel terrible at the time and I still feel a bit of a failure, and I feel I did better for DS1 (7 months ebf) so I've got that guilt too. But actually they're healthy, their weights have shot up, they're twins so it's all different. They will also be on solids fairly soon.

But fingers crossed you don't need to introduce more formula unless you decide you want to.

Thanks high voltage
I will look into breast compression and that video on improving latch which I think is key

Any idea to why switching improves feeding?