help/advice needed on b/f premature twins

[hazlinh]

my friend's just had twins, at only 26 or 28 weeks, I cant remember and they're currently in baby ICU. they weigh about two pounds each.

she wants to try expressing and giving them EBM but the nurses in her hospital apparently not very supportive, possibly a bit anti-B/F, saying there's no point as theyre still tiny and they were going to feed them formula!!! She's quite aghast but she prolly feels powerless to fight them! need advice from all you lovely EBM experts out there

There is no reason at all why she cannot feed them EBM alongside anything else that the doctor (and this is a medical decision) feels the babies need. She needs to start expressing straight away and keep it up 6-8 times every 24 hours. She will have tons of milk - far more than the babies can take - in a few days if she does this, but she can freeze it, and she needs to express to keep up her supply. She can phone TAMBA and get information from \link{http://www.tamba.org.uk\TAMBA's website where there are details of their helpline....they are very good on bf, and will give her every encouragement. They will also be interested in which hospital is giving such poor support. Good luck to your friend.

Sorry - link has come out crap:

TAMBA

I'm currently pregnant with twins, and really scared this could happen to me. All I know is from the little research I have done, that breast milk is the best thing by far for prem babies as it helps them fight off infections. Your friend needs to push, push push to get them to have her breast milk, it will give them the best chance possible. I have read that prem babies who have beem formula fed are more at risk from infection and take longer to come out of special baby units.

It might be hard to express as she was not that far along in pregnancy, and it is by no means guaranteed that she will have loads of milk yet, but at this stage the babies will need very little, so she really needs to find someone supportive who can help. Also some hospitals have 'milk banks', where other mothers have donated breast milk, and I would say this is a better option than formula. Unfortunately my hospital doesn't have one.

I really do not understand that with all the hard work these nurses do in special care, they then ruin it by giving prems babies formula... Aghhh! Sorry just makes a bit mad!!

hazlinh, I had identical twins at 27 weeks, [DS1 died aged 5½ hours] DS2 was in NNU ITU for 3 months and I expressed which at first was only about 1cm, they froze it as DS2 could only be fed by IV fluids, after several weeks he could be tube fed with the EBM oneml every 4 hours. I was still expressing. I very much doubt that they will be able to have EBM now if they are 26 weeks even tube fed. Are they ventilated or on CPAP?

Tell her to do kangaroo cuddles but it won't be for several weeks until they are stronger.

Which hospital is it?

In the end though he did need formula as well as his needs overtook what I made, but I did feed him, he started to look for it about 2 months old[when I would have been about 35 weeks]

A friend of mine has recently had twins at 28 weeks and is expressing, she's managed it for 6 weeks so far but it is exhausting as she's having to do it every 3 hours. Their hospital seem to be supportive though.

Good luck to your friend.

thanks for the quick replies and the words of encouragement.
tiktok, have passed on your words of wisdom to her. she's having a hard time tho, and hasnt been able to express even a drop of milk! apparently she only first expressed 24 HOURS after the birth and thinks she may have left it too late? is that true?
one of them is on cpap, she will definitely have to freeze whatever milk she's expressing anyway. but the first hurdle now is to get some milk out!

Smelly, Katie, dont worry, it's not a UK hospital, I'm sure Uk hospitals are not like this, and at any rate, it's only ONe particular nurse thats not very supportive in her hospital, the rest are OK,but not exactly going out of their way either. My experience was completely different, where the nurses all but put a gun to my head to make me b/f!and one of them said she breastfed her dd to 20 mths.
immediately after giving birth, they put my dd to my breast to suckle (altho there was nothing at first).

In what country is the hospital, Hazlinh? It's not too late for your friend to express, not at all. There are places (eg., in Africa) where people (mistakenly) believe colostrum is bad and won't offer breast at all until the "real" milk comes in around 3 days post-partum... it doesn't prevent successful breastfeeding in the long run at all.

Throckenholt is away on holiday or I would nag her to reply... Just to reiterate it "can" be done. She successfully expressed for her premie twins (born 34 weeks, little one under 4 lbs) until they were 10 months or so old. I remember her saying before on MN that taking fenugreek & getting up to express in the middle of the night helped a lot in terms of maintaining supply. She had a very intimidating electric pump in the living room, and (I think) just expressed about 1/2 hour before she expected the twins would need feeding. Did supplement with some formula, but I think it was 80-90% breastmilk, which gets you most if not all of the benefits.

Certainly not too late, as zebra says....crucial thing is to do it often, though.

I have a friend whose twins were born at 28 weeks both under 2lb's - they are now 16 months, she expressed and then breastfed both to 6 months, it can be done!

hi there...the good news is that my friend has finally managed to express a little amount of milk. I've told her to get some fenugreek, and she has taken one, cos the bottle says to take one a day. but i tink i read in an old thread here that u need to take 3 tabs a day three times a day...and then stop when you're happy with level of milk production. or am i hallucinating??

zebra, She delivered in Kuala Lumpur, Malaysia, at one of the 'best' most expensive private hospitals, so there you go.can never tell, can you?!

another query..the twins will be in hospital for at least 2 months, and presumably bottle-feeding during that time (after going off ventilators etc). There will undoubtedly be problems later on trying to get them to breastfeed, I assume. How can this be overcome??

Don't want to sound too pessimistic, hazlinh, but without frequent skin to skin, kangaroo care and gentle practices at bf, the chances are reduced that they will breastfeed.....they won't be doing any direct feeding for a while yet, as they won't have a sucking reflex, but the support for future bf should be there now.

It may be ok, and people do bf against huge challenges, but she needs support from the medical and midwifery and nursing people around her....she needs to express regularly round the clock, and she needs the chance to connect with these little babies.

La Leche League is everywhere in the world, and there should be a contact in Malaysia - see their site here

hazlinh, when I was taking fenugreek I took 6 capsules a day (each capsule 550mg, so 3300mg or 3.3g total daily). At first I took 2 with each meal, then switched to taking all 6 at breakfast time. HTH

hi - bit late on this thread - I have been on holiday.

I thought the most important thing you could do for premies was breast feed - so I hope your friend has the confidence to fight against the system there.

zebra pretty much said what I would have said - but if you want any other info please ask.

Smellymelly - have a wander over to www.twinsclub.co.uk particularly the forums - you will get lots of support there.