I feel for you. My twins were born at 35 weeks and avoided SCBU (largely down to steroid doses during my pregnancy when I had early labour scares) but they were both born without a suck reflex and were tube fed for the first week of life. I expressed like mad and tried breastfeeding them before every feed but it was largely disastrous. The stronger twin would feed for ten minutes, I'd get exhilerated thinking I'd finally cracked it, only for her to zonk out after ten minutes and then wake up 20 minutes later starving hungry and screaming. Ocasionally she'd get herself in such a state that she wouldn't even manage to latch on (too busy screeching). The second twin was even worse and just didn't have the strength and couldn't latch on. I think she latched on once in the first three weeks and fed for ten minutes before passing out (only then to wake up screaming twenty minutes later.....). To say I was frazzled was an understatement and I got very tearful about it all.
I think the key is perserverence and essentially sitting on the sofa feeding as often as you can. In the early days you might need to do these 'little and often' feeds to build their strength. It will be boring and exhausting and I think that's why a lot of mothers with premmie twins give up on breastfeeding quite early on as it can be a bit of an uphill struggle. But it can be done and if you wanted to exclusively breastfeed you could do it.
If you keep offering them the breast and then topping them up with EBM they will get stronger and their latch will improve. It really is just a question of time in this sense and a bit of a catch 22 in the early days. They're too slow to feed but they need to feed to gain weight and strength to enable them to feed more efficiently.
A few ideas off the top of my head (I'm no expert though and I'm sure someone will come along who will be able to offer much more detailed and useful advice):
- Keep expressing and offering each baby a breast feed before each feed. It will get their strength up.
- Equally, you could try nipple shields for feeding as these make it much easier for the baby to feed from you (a nipple is much softer and therefore much harder work). Although people jump up and down and get antsy about nipple-teat confusion I did this and neither of my twins had any problems switching between the two. In fact it really helped - I'd offer them a feed from my breast and if it failed I'd slip on a nipple shield and see if that helped. Sometimes it did and sometimes it didn't (if they were really hungry and hysterical and had got themselves worked up into a lather). At this point I fed them from a bottle.
- Use formula. There are two camps on this and breast milk IS better for your baby, but I know a lot of twin mums and a lot of us have used formula for top up feeds. WE all wanted to exclusively breastfeed but you need a lot of support, a lot of patience and a lot of sofa time and that can be in short supply when you're struggling with newborn premmie twins. I split fed mine and they got EBM, formula and top-up breast feeds from me and it worked well. Not as well as exclusive breastfeeding, but I'm really proud of what I achieved in the circumstances. Formula is not the Great Evil and no one will think ill of you for using it. In my house I was in the 'Whatever Gets Me Through' mentality. Which got me through. Just about.
If you do want to breastfeed totally then I think perserverence is key and maybe trying nipple shields for a bit. Also, try strengthening your milk supply by upping your food intake. Lots of dairy and carbs help and the following really helped make mine nice and fatty.
Almonds - really good for milk supply
Coconut yoghurt - coconut is excellent for milk supply, as is dairy obviously. I used to eat tubs of the Rachel's organic coconut yoghurt every day and it made my milk really thick.
Cake - honestly. YOu can't beat a nice slab of cake. I ate a lot of madeira cake!!
Water - drink lots. A pint for every feed/express. Squash is okay if water is a bit boring and herbal teas are good (chamomile, peppermint).
I hope this helps. In the end I split fed for four and a half months - EBM, formula and top-up breast feeds. I gave up as my milk supply dwindled (which is does when you mostly express as it doesn't stimulate supply in the way that breastfeeding does). And fittingly, my second twin, the weaker of the two had my last feed. I lay with her on the sofa and she drained me on both sides and I watched her feeding really strongly from me and felt really good about what I'd managed in the circumstances.
I hope this helps and best of luck. It all gets easier with every week that passes.
Kx