Combination feeding twins - experiences

[Torrach21]

Hi all

I’ve been pushing to breastfeed my twins but unfortunately due to illness, them being tiny and us all still struggling to get latch right and other issues my milk supply isn’t sufficient.

I am and have been trying all advice possible to boost supply but it’s now pretty late. to avoid being terrified of every feed and also to give some breast milk I’m thinking to officially move to combination feeding. We’ve had to top up with formula anyway due to their weight loss and some jaundice issues but doing that at every feed is hugely time consuming and I’m on my own for most of this. Being totally honestly I also had a really crappy pregnancy and didn’t leave the house except for doctors appointments for nearly 8 months so I need a routine that lets me get my mental health back to a better place. I have done a lot of reading before and after their birth a month ago (they were a few weeks premature) but a lot of it lacked specific experience wondered if people could share experiences of combination feeding multiples - did you rotate which got bottle/breast, was it certain feeds only, how did you manage nights etc. thank you

Congrats on your babies!

I can’t help with the formula side of things but so far as breastfeeding...
mine had their own breast. I would always feed that baby from its own side and ideally they’d be fed together. That definitely stabilised supply and meant each baby had a supply tailored to them.
Perhaps you could do a tandem breastfeed feed and then a tandem formula feed? That would mean you got a break from the breastfeeding if that’s what you are seeking to do.

As a side note, it took me a long time to establish breastfeeding. Or at least to feel I did because I really had no confidence and no guidance. Even if you are needing to supplement now it’s quite doable to go back to exclusive feeding. Once you have established a supply it’s easy to increase. The bigger your babies get the better they will be at removing milk.
Sounds like you are doing an amazing job.

My heart broke a little reading your message. I have twins myself, born at 33 weeks. They spent 3 weeks in NICU and during that time I expressed nearly all of their milk (the smallest one born at 3lbs and was just too small to BF).

Breastfeeding twins is a major undertaking, and many will be on here saying yes you can absolutely do it, yes you can see a breast feeding expert etc, but honestly it sounds like you're ready to move to formula. Before bringing my girls home I made the decision to move them onto formula (they were on the prem baby milk) and it was the best decision.

I absolutely needed a routine to keep me sane and formula feeding allowed me to do that. Quite honestly if you haven't had twins you have no idea how hard/demanding it is.

Please please give yourself a break and do what is best for you and your babies.

If you did want to boost your breast milk supply you could try hiring one of the hospital grade pumps, they are soo much better than any you can buy off the high street and may really help.

Just remember to look after yourself as well as your babies xxx

this is the type of pump I used in the hospital, it's a double one and I can really recommend it

www.medela-rental.co.uk/shop/symphony-double-breastpump-hire

I breastfed one and formula fed the other for similar reasons. Started trying to bf both but ended up triple feeding and couldn’t cope. T1 also had worsening jaundice and was losing too much weight.

I bf on demand T2 and DH did all of the night feeds with T1. T2 is still bf at 20 months. If you do want to keep combi feeding, get someone to wash all bottles, get yourself a perfect prep and ensure your partner is willing to get up in the night to help.

Good luck!

Rrrob that’s really interesting. Did you find you had a stronger bond with T2 and your partner with T1 or has it made no difference? I suppose you are able to compare the 2 ways of feeding directly side by side which is unusual.

Congratulations on your twins! Feeding preemie twins is HARD, mine are 14 moneths now and I shudder looking back at how tough those early days were!

You have options. You should do whatever works best for you and give any doubts the finger. I guarantee however you feed them, nobody will be able to tell in the long run.

I did combi feeding. One twin in particular was struggling to latch and was losing weight as soon as he was off his nasogastric tube. What worked for us in the early days was I'd chage them before a feed to make sure they were wide awake, spend 5 mins trying to feed them so they were hungry and working hard. That way I figured they'd get antibodies etc. Then if give them their bottle (same amount as they were having when tube fed). Afterwards I'd offer the breast and they'd generally have a relaxed comfort feed and nod off. Until they were past their due as I pumped for the bottle, then I ing some formula. It was recomended to me to mix formula with expressed milk as it contains enzymes that make the formula easier to digest, but I only had to pump half as much.

We kept that up as a routine for about 3 months or so. At that stage they were much stronger and found latching easier, so I ditched night time bottles as I hated the faff. I knew they still had bottles during the day so I wasn't worried about them starving, but the transiton was totally straightforward. A month and a half later I ditched all except for one daytime bottle (which was total formula, so no more pumping). They stayed on that routine until the ditched the last bottle (their choice, not mine!)a couple of weeks ago. They still breastfeed when they fancy it, but mostly they drink from a cup.

For me, breastfeeding was easier - I never liked bottles. So if you combi feed now, up can always gradually up the breastfeeding IF that's what you want. Or if breastfeeding is too tricky, then you can move to bottles (expressed or formula, whatever works for you).

Combi feeding was very convenient for me in the early days. If you want to do it, you'll be fine. Please don't feel guilty whatever chi you make.

Happy to answer any logistical questions you may have. Twins are hard work in the early days!

A lady I knew alternated the twins. She'd breastfeed one while giving the bottle to the other and then swap for the next feed. Seemed to work well for her.

Are you in the breastfeeding twins and triplets Facebook group? Lots of info in there and lots of people in there that combi feed also. I couldn't have managed to feed mine without the advice and support from the group so might be worth joining if you're not already in it.

Thank you everyone. I am in the Facebook group so will dig a bit more. Tiny Teacher - would you mind me asking how long did your feeding cycle take when it was mixed - I don’t mind it being near constant if productive but it’s been tough when I can see they are barely eating (even with all the tricks) and latching / relatching can take up to 35 minutes. I end up allowing them anything even with poor latch

Am I right that yours are only just past their due date? Mine were still incredibly sleepy at that stage. Feeding cycle was LOOONG. Do you have help?

If I had help (DH or DMum) then it went like this:
Change one baby
5 mins breastfeeding (or longer if they had a decent latch, but at that age they mostly didn't!). If they were failing totally to latch we just cuddled skin to skin with that time.
Pass them to helper (who would have just change other twins nappy) - they'd give a bottle while I breastfed the other. Bottle was only 1.5 oz initially.
Babies both burped after bottle, so by now had been awake about 30mins.
Pop both back on for comfort feed - I had agood sturdy breastfeeding pillow that was essential for this. They'd feed until solidly asleep (maybe 15 mins during the day) then I'd pop them in theirpram bassinet.
Do about 45mins in total. Repeat 2hours later.... (and if have used 30mims of that for pumping ready for next bottles)

In the evenings they wanted to cluster feed, so after then bottle of settle onfront of the telly with them on the pillow and just Lee them on for 2 hours, then when they woke we'd go upstairs.

If I didnt have a helper I breastfed both together before putting them in bouncy chair for bottles, but that rarely resulted in a good latch till they were a few weeks older and had better head control.