Advice on top up feeding for newborn twins

[Indecisivelurcher]

Hello! After some advice please. My sister has 5 day old twins. She's been struggling to breastfeed due to extensive nipple damage from poor latch in the first couple of days and has moved to expressing and bottle feeding. However she's finding she's constantly on a back foot having to pump then feed, unable to get ahead and build up a stash. For this reason she's thinking to introduce a limited amount of formula. She would like to know whether she's better off replacing a whole feed with formula, or topping up after a feed. Logically she's thinking to swap out a whole feed, pump that one, and in this way start to get ahead. But just wondered if anyone has advice to offer. Fwiw she's got a 3yo who she breastfed to over 2yo so she does have a good bf track record as it were, so not after advice on that I don't think. Any advice gratefully received! She's tried the bf helpline but not much help today.

I have 3 week old premature twins. I am topping up after a breastfeed during the day if it feels like they have fed long enough - with one night time feed bring a full formulae one

Ah thank you for responding! I'm about to call my sister to see how they're getting on.

Not really an answer about top ups but has she thought about nipple shields? Worked for me when had premature twins struggling to latch on.

Personally, I would swap out one whole feed as a one off so she's ahead and can top up with expressed milk next time. But, actually, she should do what will be easiest / work best for her. No point trying to do something because she thinks she "should" - with a 3yo and new born twins, she has her hands full

DD1 was bottle fed at first and then I switched her to BF which was a big struggle but totally worth it.

Anyways, nipples got badly sore.... lanolin cream is very good for it and .... well..... not wearing clothes.... I was home alone with the baby all day and neighbours couldn't see in our house. May get a little darker for her.

Thank you both! She's swapped one feed to formula and doing much better in general, finding her feet. She used nipple shields for a while with her first, but I'm not sure if she's tried them with the twins yet. I get the impression she's happy to stay pumping and bottle feeding tbh because she thinks it'll suit them better as a family. Whenever she did get one of them latched successfully she found them very sleepy so taking too long to feed them both really. One twin in particular is very painful to feed, so going to get tongue tie checked. And try again in a few weeks when they're more awake and that bit bigger. If it doesn't work out I think she'll carry on as is. Mostly breast milk sounds like a fabulous job to me personally.