Can't cope BFing prem twins - copied from BFing forum

[firsttimetwins]

My twins were born 9 weeks ago at 32+0. Spent 4 weeks in SCBU, where they were bottlefed a mixture of formula and EBM. I couldn't breastfeed in SCBU cause not relaxed enough. In SCBU, settled into a (very strict) 4-hour routine, which they have more or less stuck to by themselves (we feed them early etc. when they demand it). Been home 5 weeks and been breastfeeding and giving EBM, now introduced the odd bottle of formula if don't have enough EBM. Tried to BF both babies at same time but they're not proficient enough, I need both hands for each baby to help them latch on again when they fall off. Can't really feed one then the other because each takes an hour per feed, plus when the other crying I can't handle BFing. Am coping very badly with feeding one when the other is crying, though I can cope with crying at other times. I have the Mothering Multiples book but find it a bit utopian and haven't found anything that addresses my particular problem. Have asked midwife and paediatrician for advice on combining breast and bottle but they were totally dismissive of the idea. I'm in Germany, where there is an extremely gung ho attitude to breastfeeding and essentially you're a crap mother if you don't exclusively BF. Basically am looking for tips/encouragement. Or am I a crap mother for not being able to cope with the BFing thing?

Not a crap mother at all. Firstly not all mums can BF - I couldn't, neither could my SIL. Secondly, a lot of mums give up BFing after a few weeks - but they keep quiet about it because for some reason bottlefeeding is seen as the work of the devil. If you want to combine, then combine. It is not up to the midwife - she's not doing it.

I'm also in Germany, although my twins were born in the UK. My health visitor there thought I was awful for not persevering with BF despite the fact I clearly had no milk and my kids would have starved. My midwife was only interested in healthy babies and wasn't really fussed how that happened and my doctor said anyone who tried to BF twins was mad because that would be all they would do all day (before I get yelled at, I don't subscribe to this view - some mums manage this fine).

You should do what you feel happy doing. Do not wear yourself out or beat yourself up over this and don't let anyone else beat you up for it either.

My twins were 6 weeks early and had virtually no suck reflex. They were formula fed from the beginning because their lives depended on it. My milk came on Day 3 and after that I had enough supply but they could not suck. I was loosing my mind trying to express, bottle feed EBM and also nurse (so I could evetually stop expressing). With the lack of sleep and rising stress my milk supply started to dwindle so I started to top up with formula which worked fine. But after 4 weeks they were still no good at nursing. I was loosing my mind and stopped BFing. Anyways the point I was trying to make is that mixed feeding is not a crime. Do yourself a favor and make it easy on yourself. Mine are healthy 9.5 kg 1 yr olds. Yours will be fine too.

I think you should do whatever you need to do and not feel bad about it.

However, there are many mums on here who have had twins/triplets and I'm sure they may be able to give you some tips on BFing.

Also IMO there is absolutely nothing wrong with mixed feeding if you have to.

Could you give one a bottle of EBM or formula so that they are fed and then BF the other one and then swap for the next feed IYSWIM?

If you do peresevere with BF it will get much easier as the feeding time will reduce as they get better at feeding, they will not need so much help to latch on so you may be able to feed them both together and they will be easier to amuse with toys etc so the one that is not feeding will not be crying the whole time! Hope that makes some sense.

I am not a mum of twins but I did have 3 in 3 years so know a little about juggling 2 very small people and baby crying while you are engaged in another task that is very important!

Thanks for all the support. I think the problem is that I feel guilty even giving a bottle of EBM instead of BFing, just because everyone here is so militant about BFing. I've been doing the one bottle one BF when my partner's at home to help, but I seem to be unable to do even that when on my own. But you're all right, I should stop doing in my own head and just do what works for all of us...

As for tandem feeding, have you tried the EZ-2-nurse breastfeeding pillow? It makes latching them on so much easier cos they balance without rolling off. It's much easier than with v-shaped pillows or pther supports.

Most breastfed babies don't last 4 hrs, so maybe you could try starting one feed a little earlier so the next baby doesn't go completely loopy by the time you get round to feeding them.

And basically, sit in front of the tv, remote, snack, drink and just feed them as much as you can. Let everyone else do the other stuff.

If you have to give a bottle of formula, then you have to. It's better to give the odd bottle than give up breastfeeding altogether! But there arguments for exclusive breastfeeding as I am sure you are aware of!

Personally I never bothered with expressing as found that so time consuming, time where i could actually be feeding my babies directly myself.

I really would give tandem feeding another shot! It could make all the difference. Place one baby on cushion, then the other, then latch one baby on followed by the other. Do the difficult feeder first (if you have one) so you can use both hands for that one. Then support the other baby under the shoulder blades, supported on pillow and let them throw head back when they open mouth, then shove them on quickly and definitely, before they shut their mouth again, with one hand!

Good luck, and remember to feel good about every breastfeed that you manage! You're doing them so much good!

I was going to suggest a pillow/cushion. I used one very successfully with DD and passed it on to my sister who used it to breastfed her twins for 9 months (exactly askathryyn2804 suggested - in front of the TV with the remote/snack/drink).

Ok, so here's the plan of action. DP is now off till Wednesday morning, so as of today I'm demand BFing the bigger of the two twins - her technique was really good at the start but I think I've let her get lazy, so we're both going to practice our technique while DP feeds the other twin EBM, and I'll BF her when she's hungry if the other twin isn't feeding. Then, if that goes well and I don't have a nervous breakdown (have been getting increasingly panicky and weepy at mere prospect of BFing but this afternoon I settled in with a DVD (no telly, unfortunatrly) and we had a marathon session and it was very pleasant), tomorrow afternoon or Monday I'll have a go feeding the two together, while DP is around to help and give a bottle if needed. Does that sound reasonable or would anyone have any alternative suggestions?

ftt.. that's sounds reasonable. Well done you.

i feel for you firsttimetwins i am having similar problems myself, exept my twins wer term at 38weeks. They are now 7 weeks and have been trying to combine feed for 3 weeks with formula to give myself some sleep and let dh have some time with them But this is not going well. ddt2 is doing really well and has no problem with formula exept after having 6 oz slowly, still has a 20min or so bf after. so the formula doesnt seem to fill her up.dst1 has refused formula and seems to hate anything to do with the bottle. he seemed to take the ebm with a liitle formula mixed in well the first few times, but ony when he is really starving and ithas been a while since he fed. ( they both cluster bf in the eve and i try and put a bottle in there somewhere.) i am struggling to get him to accept te bottle at all. this makes me feel bad as he is getting the best of the bf, and poor twin 2 is getting the formula, but she is really thriving on it and is progressing faster than her brother on weght etc.He is a very colicy baby, and has had very bad nappy rash since he was about 2 weeks old and had to have abx ( which he hated and it realy upset him so anything that is not my boob in his mouth seems to send him hysterical. also have tried tandem feeding but for same reasons as you have decided to feed seperatly even though i used the easy2nurse cushion. i wuold feel bad to exclusivly bf him and give the other formula. (even if its only a few a day) Has any1 else had one bf and one ff twin? how did u cope, any tips welcome please. also sorry for my major esay!

Lucy, I started with one fully formula-fed and one breastfed twin (not prem but problems with latching and jaundice)
I hated giving not bfng both, so I just kept on trying, and in the end both were breastfeeding by 7 weeks (with additional formula, as I couldn't keep up with supply after such a bad start.
I wouldn't necessarily recommend that approach (ie: all the formula I gave at the beginning)which was partly born out of very bad early advice in the hospital, and milk which didn't come in for 7 days after birth.
On the otherhand the top up formula I gave got ME through the first 6 months (others manage without it), and THEN I went on breastfeeding till they were two years old. I had phased out bottles by the time they were onto solids (by six months). At six months, I felt so much more rested and calmer that I think I was able to make more milk.

So anything is possible with twins, often you can keep supply going just by feeding one, and then get the other back on track eventually (if you want to)
The turning point for us was the formula fed baby's irritability and colic at night c. 7weeks. In the end my husband - who was in charge of the bottlefed baby just handed him to me in despair (after being woken about 4 times one night by THAT baby), saying "this baby needs his mother" And from that point I started breastfeeding the formula fed baby too.
Can't say I had any consistent strategy though

firsttimetwins

Sounds like a good plan!! Hope its working for you.

@FTT - I'm sorry to hear that you're having a tough time. I think the best plan is to have a plan, try it and if it works then great, if not then there'll be another plan to try next time (the babies are learning too, you're all in this together!). Sounds like DH is very supportive so yes, let him help with twin2 and work together to find a way to make it work for you and your family.

I'm pregnant with triplets and also live in Germany, and remember too well from DD1 how everyone from the little old lady in the street to the next door neighbour all love to offer their gems of wisdom. Ignore them! You are a fantastic mother and are doing an amazing job!

Hello again. Have managed to exclusively BF twin one since original post, and since yesterday afternoon have been feeding both simultaneoulsy every feed, though just topped up twin 2 with a bit of formula just to make sure as she is still very small and though she seems to feed well at the breast, I don't want to take any chances (she's still under 7 lbs). Hasn't been too bad so far - spent today based around the bed just feeding, something I should probably have done a good while ago. It was nice just to spend time with them lying on the bed between feeds, though they've napped so much today I bet they'll be up all night...! They both seem to be keen on a feed every 3 hours, which isn't too bad. Last night was tough, with a one-and-a-half hour feeding session from 2 am to 3.30, then up again at 5, but I'm sure I'll get used to it... Phoned LLL Germany, they were very nice but not really able to offer any specific experience/advice for premature twins except what it says in the Mothering Multiples book, which I've already read.
Feeling positive-ish at the moment, though I'm pretty sure I won't be exclusively simultaneously feeding after the first while, cause it certainly isn't something I could do in public.

Incidentally, how long does it take before they get faster and more efficient, usually? I imagine they won't always take an hour to get through a feed? Or will they?

CakeBuddy, congratulations on your triplet pregnancy!

Ok, so we had a bit of a relapse this morning... DT1 is doing ok, but DT2 really can't get her head round the tandem breastfeeding. She keeps crying to be fed then falling asleep after 2 mins on the breast. If it were just her I'd just keep feeding her till she sussed it out, changing nappies and sitting her up and so on to waken her, but because there are 2 of them, that's not feasible. So she got a bottle of formula this morning and I think what I might do is alternate breast/formula feeds for both from now on. I'm contemplating 24 hours demand BFing, then 24 hours formula. Anyone know if that's a system that might work?

I may be wrong, but perhaps you should alternate occasional feed breast/bottle rather than a whole 24 hours? I think I had a regular two bottles a day alternation going. So one day one baby got two bottles but was breastfed, and the second day the other baby got two bottles but was still breastfed. But that wasn't scientific, it was just me being desperate and confused.

Funnily enough you may suddenly find that trying to feed one with a bottle (make the bottle, warm it up, sterilize etc) and one at the breast simultaneously is more work than just sticking them both (however haphazardly) onto the breast, even if you then have to feed more often. It depends what help you have during day or night.
I wish I had just stuck with feeding them more often and getting people to help with that in the early days.
It did definitely help to think, at this fixed point in the day, I will give a bottle to one of them, but I CAN bfd as well, if it works...I think it was the cluster feeding in the evening that made formula necessary for me THEN.
I know what you mean about worrying about the littler twin's weightgain, and not wanting to compromise that; I had that issue and I think that is why I felt I had to just accept I needed to give extra formula.

I have to add that I had a maternity nurse for the first three weeks (twin expert), who was convinced I should stop messing around breastfeeding, and kept taking babies off and giving them bottles at the start. It really scuppered the breastfeeding, and I felt too tired and ill to really challenge her. I think that can happen with some relatives too, who are trying to be helpful but succeed in not supporting you in what appears to them to be a very chaotic feeding schedule. I used to look forward to her day off because then I felt able to feed the babies whenever I wanted without her glaring at me
Must stop posting on this thread sorry

Well done ftt!

Now, breastfeeding twins is HARD but it cannot get harder, only easier.

You are doing brilliantly to have a one day at a time approach.

Feeding both together takes pratise, but is perfectly easy with the passasge of time!

Breastfeeding twins is a full time commitment until they are 3 months (or about 3 month weight) then all of a sudden feeds start to take 5 minutes rather than 45.

Yours are premmies so they are doing great to be latching, sucking etc.

Personally I would keep trying to feed them together- it really is a MILLION time easier once you and they have the hang of it.

nothing wrong with topping up but remember this is the time they are establishing your milk supply, so go carefully.

Best of luck.

passage even

It's the latching that's a problem with DT2; she does this straining thing, as though she's fighting against her digestion, and when she strains she pulls herself off the nipple. I've been assured that the straining is normal and common, particularly in preemies, but it makes it impossible to feed her with DT1 at the moment, I think.

In terms of feeding being a full time commitment for 3 months - I could maybe handle it if I thought that the 6 weeks I've already done at home counted, but I'm not sure I can take another 3 weeks from now (due date was November 18th).

So today's plan is to breastfeed twin 1 entirely, and to breastfeed twin 2 when hungry but also to top her up with formula, and not to breastfeed simultaneously till we all get better at it.

I think it's a good plan to feed them individually until you get the hang of it. Do as much skin to skin as you can with DT2. Take it all day to day. Don't worry too far ahead. That's when it can seem difficult. When you've finished today congratulate yourself. Worry about tomorrow tomorrow!

Well done! You sound so much brighter and you're getting there.

I've only read your OP but I just knew there'd be something in there saying 'am I being a crap mum?'. No. You're not. No. You're not. No. You're not. No. You're not.

Repeat 10 times a day: I am a fab mummy!

Otherwise I'll put you in detention.

Apart from that I have no other advice but want to wish you loads of luck!

(Hi, Mars!)

Hey MrsMH.

I responded on your other thread.

I also had this romantic notion that I could or should breastfeed my triplets simultaneously - well 2 at a time anyway. I did it twice and had a photo taken. 3 years down the line it makes me laugh.

I am no expert but it seems to me you can have lots of touchy-feely time outside of feeding? wear them in a sling? I expressed and put them in their maxi cosis or on BF pillows to feed two or indeed 3 simultaneously. not ideal but with feeding taking an hour 5 times a day I felt this was ok.

Try to make sure she has a really good latch. If she's not quite on properly it is hard work to suck and that might be why she's falling asleep after 2 mins. Also try breast compression, massaging the breast as baby feeds to increase flow of milk.

Mars has got it spot on!! Definitely don't worry about tomorrow. Take every feed as it comes and do your best. If it doesn't quite work, try again next time! As I said in my reply to your other post, every breastfeed counts! Give yourself a huge pat on the back when it works, say 'oh well' if it doesn't and try next time!

You do sound much more positive, you're doing a great job