Need support/advice re problems bfing 6 weeks in

[PrincessScrumpy]

I have bf dtds for 6.5 weeks with two bottles (one of formula and one of expressed milk) through the night so dh can help and I can keep sane. We started this at 3 weeks when I was struggling with thrush pain.

This week I've had mastitis, which has calmed with expressing, but now everything has changed in the last 2 days. My boobs feel less full and dtds are feeding a lot longer and just don't seem settled after. I'm ill with a cold but dh let me have a lay in this morning, I expected to be engorged but no. I usually express mid morning and get between 100 and 150mls but today I didn't even get 50mls and yesterday I just about got 50. dtds are also starting to go for longer between feeds 4-5 hours (sometimes not regularly, and not at the same time so I feed one every 3 hours then have to feed the other when she wakes - tried waking her but she wouldn't latch as she wasn't hungry)

I'm trying to rest (but also have dd1 - 3) and drink lots, but on top of me feeling like I don't have much milk, dtds aren't latching well, they've got lazy as despite being prem, they were ok at it (not brilliant like dd was but after a few attempts they would latch well enough), but now my nipples hurt.

Basically it's all going wrong and I'm tired and emotional, feel like heading for formula but worried I'll regret it in a couple of weeks.

Not sure I have any answers for you but I found it tough going around the 6-8 week mark. With hindsight the boys were feeding more in the evening as they were going longer in the night. I felt exhausted and drained (and I don't have any others). I found it useful to focus on the short term ie just one more feed/one more day. It got easier fairly quickly when my supply caught up with demand in 2-3 days time. I'm so glad I carried on as the benefits for the boys are huge and its easier for me to bf now than worry about bottles etc.

Do you think being ill has made expressing harder work? It sounds like you have done a great job so far, especially with the demands of an older child too. I hope you can manage it if that's what you want - but if you do switch you've done them a lot of good.

(not that my twins are even half cooked yet, let alone here, but I'm adding my experience)

I had mastitis twice when DD was about 7 and 8 months old, as she went from being a good feeder to too nosey to latch on properly, and if I took her off she didn't bother going on again, so I'd persevere with a bad latch and bang, mastitis. Twice. The first time was worst, but I have rarely felt so ill. I couldn't even move the arm on the mastitis side properly. I think it took a while to recover from that and my milk supply went mutant. I'd feel like there wasn't much in the day, and having never managed to express anything, ever when DD was tiny, I was whipping off 150ml at 11pm (!?!). DD wasn't feeding then and I didn't have much for her at her bedtime. It did settle down, but took about 2-3 weeks after the mastitis had gone for me to feel my milk supply was back to what was needed (especially after time 2 of it) so i think right now will be hard to judge.

I think I wouldn't stop straight away, but maybe to let yourself recover, add in an extra bottle of formula for when you feel too tired etc, as so long as you're still feeding, from what I was told with DD the supply-demand system will kick off again when you feel better if you start feeding more/expressing more.

I spoke to my midwife briefly about feeding at my booking in appointment, and her view was that once a baby is an 'established' breastfeeder, you can add in bottles without a problem- she was suggesting from 2-3 weeks, exactly as you did. She also said tandem feeding is an art few women can, or choose, to master and the vast majority of twins are mixed-feeding twins, be the bottle of expressed bm or formula.

I assume you're using the magic Lansinoh cream on your nipples? I found never missing applying it after feeds helped a lot rather than waiting to get sore/ sorer.

You sound like you're doing amazingly with the girls and your older DD who sounds so sweet (and happy, and secure) with wanting to sleep under the twins' cotbed . I will hope to do half as well as you once mine arrive. Good luck.

Also wanted to say you're doing a fab job with twins and another child / children so don't beat yourself up if its hard work. If you do want to carry on (and it sounds like you really do) then I would also consider rejuggling your feeding routine so you can feed them in the early hours - my twins were premature and on the SCBU for quite a long time and the midwives would come and wake me to express at 2am - they said that was the most important one of the day. I used to express every 3 hours to start with and when we got feeding established once they were home, I would always wake Number 2 if Number 1 had woken for a feed. I know you say she wasn't hungry but I would try over the course of a couple of days to get them into the same routine. Good luck!

Thank you all for the advice. I'm feeling very negative this evening and think the thrush is coming back. I dropped the night feeds as both girls were struggling to latch on at night as they were too sleepy and the pain was worse at night (I think everything seems worse at night). I express once a day and really don't have time to do it more as I just don't think it's fair on dd1.

SCBU only ever got me expressing in the day. We were in for 8 days.

I fed both dtds this evening and after 45 mins each were still grumpy so I offered a top up in a bottle - both took 90mls. dtd1 also had an extra feed this afternoon as she was so unsettled and rooting. It's probably a growth spurt. Can't quite make the decision to ff despite leaning that way.

I also have 6 week old girls and a (mild) bout of thrush. Bf has been a bit easier for me I think, mainly because they are putting on weight really well. Even so we had to top up with formula over the first few days and we never seemed to get rid of formula completely. So mos days one or the other will get 30 or 60 ml from a bottle. Usually after a projectile vomit or inthe evenings when I, and most women it seems, are running low on milk. The wondering " do I have enough " after each feed was awful until the scales showed me thatthey were gaining well. Its also hard when you are a bit more empty and they seem to cluster feed. There are times in early morning or evening where I feed one or other for 2 or 3 hours without stopping. I think that the babies must be getting something or they would give up. Also this kind of feeding is serious stimulation fir your milk supply so after a day or so like that you should see more milk. I don't feel at all bad about using formula when the still seem hungry after a feed. Any breastmilk they get is great. No mum can stand their babies going hungry. I think that some night feeding might be important for maintaining supply, but otherwise if you bf first you should be confident that you are building up your milk and you can gradually use less formula. It's a very stressful game juggling two babies, two boobs, breastmilk formula expressing. Don't be hard on yourself you must do what feels right for you and your family. PerhaPs you cantry to keep at least one or two breastfeeds a day as any beastmilk you give them is a great gift.

They have an enormous 6 weeek growth spurt. If you want to keep up with the breastfeeding then you need to try to feed them yourself to increase your milk supply. Just keep putting them back on the breast over and over again until they're settle. A couple of days of doing this, and trying to do at least one night feed, will reinstate your milk supply. Feed ing more often is the key to increasing your milk supply. It really will only take a couple of days to get back

the reason why it's important to do night feeds is that you have much higher prolactin levels at night, the hormone which helps milk production, so it is really important to do one feed between 2-5am when these levels are at their highest.

So, in brief, try to increase the breastfeeding not the bottle feeding, if you want to continue with breastfeeding your babies. If you start relying on topping up, you'll end up giving more and more formula and making less and less milk

Good luck with it. The growth spurt will be over in a matter of days if you just go with the flow and you'll be back to having nice settled babies agaihn, until the next one! (about 3 mths!)

My twins are now 18 months old - one weaned herself when we returned here from England, but the other one doesn't seem to want to stop yet. What has this got to do with your problem? Well, for a good few weeks, things were awful trying to feed them. I won't bore you with the details, but they both ended up having tongue tie, which once snipped, made a huge difference to them and me. I was still expressing very frequently and would even get up to express when they were being given a bottle of ebm. Seems silly now I look back on it, but I was paranoid about my supply diminishing.

After a while (sorry, I can't remember how long), they seemed to be feeding every 3 hours - this was a revelation at the time, so I started to make the feeds 3 hourly and not feed them before the allotted time. Fairly swiftly, I noticed that I had gone from being able to express about 200mls (from both sides combined) to struggling to get about 70ml.

A friend who used to be involved in La Leche told me that if I wanted to carry on breatfeeding them, I would have to spend the next 5 - 7 days feeding them whenever they squeaked, just to get the supply back up. I felt that as I had gone through so much, the tongue tie, learning to tandem feed, terribly sore nipples (thrush we thought, but turns out it could actually have been the tongue tie causing it), I didn't want to give up

When the girls were in NICU, I was also told that between about midnight and 2am is prime expressing time - no-one was really sure why, but it really was the case.

At my most desperate time, I called a private lactation consultant (who has since become a good friend) and it was her who diagnosed the tongue tie and helped no end to improve the latch.

Good luck with whatever you decide to do - I can't imagine how hard it is with an older child as well - I only had the girls to focus on and that was super hard!

Thank you - they were actually diagnosed with tongue tie today! Feeding has improved over the weekend so I'm much more positive!

Wohoo! That's brilliant. Well, obviously not brilliant that they have it, but at least it's now been identified. I found it such a weight off my mind, that it wasn't all my fault of poor latching technique etc and that probably helped my feeding experiences to improve dramatically too.

One of our girls was able to have hers snipped at the doctors (a specialist doctor though) whilst the other one's was further back and deeper and could only be dealt with by laser - at a dentists of all places! This dentist was the only one in NZ who was allowed to perform it and/or had the right equipment. It cost a bit of money, but was SO worth it. Hopefully both of yours are easily released.

You may find a few people pretty squeamish about it, but I didn't see much discomfort with the one who had it released at the doctors - she was mainly angry about having hands in her mouth. The laser one was slightly less pleasant, but there were no side effects (a small 'scab' for a few days, but it didn't affect her at all. In the same situation, I would do it again in a heartbeat.

Probably within a week of the second girl having hers released, things became very very much easier. It may have also had something to do with the mantra that I began to repeat to myself whenever I was feeling a bit over the number of feeds in a day, that as long as it didn't hut any more, I would sit here and feed them at whatever time of day for as long as required.

I'm so pleased for you that things have improved. Please keep us posted with progress.