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[nothingbyhalves]

I was advised to ask your advice.
Twin boys born at 31 weeks, now 10 weeks old! Have established breast feeding eventually with the help of nipple shields (they were tube fed in special care), which i appreciate is disapproved of, but after weeks of trying to get them to latch on they only would accept shields. That was 4 weeks ago.I am now trying to introduce less sheild feeding, but its a slow process. Boys are thriving according to health visitor, but i'm concerned that some days they only feed 7 times, and wish they were gaining more weight.

They have 1 bottle a day of my milk which i express to maintain supply, this is mainly on advice of neo natal community nurse to help with weight gain, and to give them vitamins and iron in. Also on advice of neo natal nurse each boy has a breast each to feed from.

Problem: I think my supply is decreasing. When i express I am getting less than the last few weeks. I've done skin on skin and are doing this every evening now. I've ideas why this is happening.

I'm under a lot of stress as boys have numerous hospital appointments for things ranging from MRI's and sweat tests for suspected CF. Also I think we all have thrush, but doctor has checked a disagreed with me (he barely looked in their mouths)When I feed them it is very painful, as in tears running down my face painful, but the pain is like shooting pain from my shoulder to the nipple. My nipples aren't sore. I haven't got any lumps. I haven't got a fever.

Boys are feeding on demand, usually around every 3 to 4 hours. For 15 to 30 minutes. I really don't want to give in to formila. Having worked hard to get to this stage. My sister the midwife just says its my fault for using shields and expressing too many bottles. Please some advice!

Hi - hope I can help. What a difficult start - twins at 31 weeks is going to be hard work, whatever you do, and it's wonderful you got breastfeeding underway, despite it all.

I think it's unkind of your sister to say what she did - sometimes, shields are a tool which helps, and while they have drawbacks, they can be useful. I don't understand her comment about expressing. It is always essential to express to build up and maintain a breastmilk supply for babies of 31 weeks.

Feeding 7 x in 24 hours is very infrequent for any baby, as you suspect. It may be enough - you say there are no weight gain probs and the boys are healthy. But most women need more stimulation than this to get a supply going, even with twins. There may be long gaps between some feeds, too - presumably the expressed bottle is instead of a direct bf? Long gaps = less milk. So if you can work out a way to feed or express more often....that will be a good thing. I don't see any reason for formula in what you say here.

What absolutely needs sorting now is the pain you're feeling. This is intolerable, and someone needs to check out what can be done for you. It might be a latch and attachment issue, it might be thrush. There should be a bf specialist somewhere in your area who can explore this for you.

Hope some of this helps but even if it does, a talkboard can never be enough....you need real life help. Good luck

nothingbyhalves - how are things today?

fantastic advice from tiktok!

My DS was born full term but was reluctant to feed and didn't feed at all for over 24 hours after being born. Getting breast feeding established is hard enough without criticism from other people and I think you're doing brilliantly

It was difficult for me getting advice around positioning and latching on and only got help by chance because my DS needed feeding while my health visitor was there. She was very helpful and sensitive about it and showed me how to get my DS latched on properly. If you can talk to you HV ask her to watch as you feed your boys. It can be a bit embarrassing but it's worth getting good hands on (!) help as soon as you can

just a thought - can you compress or get any healthcare professionals to come to you?

I found that all the appointments I had interfered with BF - and when I simply said to my GP that I had too many appointments I found they were good at compressing them together.

Also can you go to a breastfeeding cafe or get someone to visit you at home?

It sounds like you are doing a fab job - and I imagine it is super tough with 2. Good luck

I forgot to mention that I also had horrendous shooting pains during and after feeding for a week or so - the GP said that it was not thrush but congestion in the breast caused by engorgement. It's gone away mostly but I still get the occasional pain now and again. Could it be the same thing for you?

Also I've found that with expressing the amount I get varies widely from around 50-60mls to 150mls. It seems to depend on the time of day and how tired or stressed I am. Weirdly when it is most important for me to express (e.g. planning babysitting) I get the least! I have to remind myself that my body is not a machine!

Hi nothingbyhalves- I have been in a slightly similar situation to you- DS was born at 30wks, took us ages to get him to b'feed and only managed it through using nipple shields. I then couldn't seem to get him to wean off them until he was five months old. Amazingly in spite of all warnings we kept going- although I did end up with a couple of bouts of mastitis which some suspected were due to the poorer drainage when using shields.
You are doing so well- having a prem, let alone twins, is incredibly stressful and I know too well how tough it can be getting them to feed directly from you.
Like tiktok said get the pain sorted, if it means shouting for attention! Sounds like it could be an attachment issue, as I have had a lot of probs with similar pain (which at first I thought was thrush too) due to DD2's latch and also problems of engorgement. Get a breastfeeding counsellor to come to you and observe and give hands on help. Also I suspect you may need to feed them more frequently- all 3 of my babies were small and until they passed 9lb or so I was advised to feed them every 2-3hours, even if it meant waking them (stripping down to vests, changing nappy etc.- keeping themcool and awake) to feed. Sounds cruel, and it's very hard on you too, but worth it in these early months until they get bigger. DS would also feed for at least 30 mins at a time- I felt like I was permanently welded to the sofa for the first few months. Luckily he was my first so I could just follow his lead and spend a very large portion of each day feeding. But you also need to make sure you're getting plenty of support to do this- someone to help make meals, do the shopping etc. so you can focus just on feeding while making sure you get some rest and plenty of good food too. (and make sure you drink gallons of water)

You have done so well getting this far- you're completely right- you shouldn't need to move to formula.

If I can help any more at all do let me know- also DD1 has CF so if you want to chat about that at all (though assuming hopefully that your boys tested negative) just CAT me.

Keep going- and big (unmumsnet like) hugs too xxx

OP - how's it going? Several people have responded to your thread. It's a good idea to come back and respond to their responses