Breastfeeding twins - not enough milk

[twiniemum]

My twins are 3 weeks old born at 35w+4d. I am currently bf and "topping up" with formula because all healthcare professionals recommended this. DD2 lost 12.5% of her birth weight but she is gaining weight steadily. (DD1 lost only 2%)

I am feeding on demand approximately 2 to 3 hourly. MW/HV think both girls latch on quite well. They feed for approx 20 to 30 minutes each time but soon will demand for more after half an hour and we have to give in with formula. I am still finding it difficult to tandam feed at the mo coz they are still quite small (2kg each).

It is still early days I know but what should i do?

Should I continue with BF and top up with formula or just BF on demand and offer as much as possible?

TBH formula was great help coz it stop the crying (x2).

Some advice would be much appreciated.

twiniemum - it's a real challenge to feed twins whatever they're having - and you have the hardest option, breastfeeding and formula feeding What a shame the HPs were not able to support you in full bf, though of course I don't know the full details.

If your babies are hungry after 30 mins - then it is fine to bf them again This is no harder than getting out the bottles and topping them up and it is the only way to make sure you make the milk they need. You will have milk - don't thnk 'I can't have any milk yet'. Breastfeeding will be as good at stopping the crying

Would you feel ok about simply putting them to the breast again?

Personally I exclusively breastfed at that age, but the crying in stereo was awful and as I hadn't tried a bottle at that point I don't know if that would have stopped them!
I can recall feeding them every hour at this stage - I didn't really put them down other than when they were asleep!.That was hard on my ds1 and my dh, but it didn't last for long honestly - the feeds stretched out after 8 weeks.
The crying is hellish - no one can understand if thewy've not had twins.
Re the tandem feeding have you had advice on different positions of holding them? My 2 had their heads pointing in the same direction and ds would lie on top of his heavier sister - didn't seem to bother them!Later they had their heads together and bodies under my arms.
Good luck.

If you want to increase your breastmilk then you need to breastfeed more. Why not try giving the breast again rather than the formula? Of course you don't have to completely drop the formula. You can try reducing it by 1oz per feed.

How do they feel when they latch on? If you feel that they latch on well then it's worth giving exclusive bfing a try. They seem to be feeding well. They may well be going through a growth spurt.

If you want to talk it through you can CAT me. Oh and pop over to the d'y ever threads if you have time. Lots of twin and triplet mums there.

(ditto tiktok)

Not much else to add except that if you haven't tried using a twin feeding pillow then that may make it easier from a practical point of view. You can also carry or support twins in the wrap-type slings (eg Moby wrap)which may be a help settling but not for very long age-wise. One of my local bf-ing counsellors successfully breastfed her twins years ago - when we ask in awe how she managed she always says she got her partner to bring the babies to her for all the night feeds & settle them again afterwards so she never had to get out of bed. Max kudos to you for giving it a go & hope you can manage to get it working for you.
PS Here is a section on the Aussie bf-ing forum about feeding multiples www.lrc.asn.au/forum/viewforum.php?f=10

Many thanks for all your reply,

I have tried tandem feeding and currently feeding them this way a few time a day, not all the time. Still finding it difficult to position them because they are premies. I will keep on trying.

wrt the formula feed, the consensus of all professionals are towards using formula feed and it is very difficult and confusing. The fact that the my premature twins are not gaining weight when i exclusively bf during the first week at home did not do my confidence any good.

I will try to reduce the amount of formula. Wonder how long it will take my body to adjust and produce equivalent amount of Breast milk to replace the 50ml Fomula feed ( per session ) ? any idea?

twiniemum - are they both having 50 mls at each feed? How much do they weigh?

I am bfing my 18 wk old twins and went through a very similar situation to you in the beginning when I was advised to top up with EBM/formula after every feed because they had lost too much weight - almost 20% in one case.

We struggled on like this for a while, but doing all the pumping for the top-ups was massively time-consuming and I can honestly say the best thing I ever did was to ditch the top-ups and stick the babies back on the breast on demand. It took a few days but once they got over their birthweights they began to pile on the pounds just fine.

Like you I also struggled with tandem feeding and always felt they had a better latch when feeding separately, so I did a mixture of both. Tandem feeding using a cushion was brilliant for silencing that tandem crying which is soooo tough on the ears and the nerves (as all twin mums will agree!)

Good luck with whatever you decide. It is so hard in the early days when you have two feeding non-stop, but it really does get easier as the weeks go by.