Formula fed premature twins!!

[Sophholt]

Hey, advice needed 😩 my girls were born at 34+4, Twin 1 weighed 4lb 14oz and Twin 2 weighed 4lb 15oz (there was 10g between them)
They only had 1 day in NICU and then a day on phototherapy for jaundice, they’re levels came back fine, they were happy with feeding etc so we was sent home from the hospital when they was 3 days old. We are formula feeding.
We got told leaving the hospital they should of been drinking 25ml every 3 hours or 35ml every 4 hours, so we decided to do the 4 hour schedule, we’ve stayed on this 4 hour schedule at home, they’re now 10 days old, twin 1 has been weighed today and she has put weight on, whereas my twin 2 has lost another 10g of her weight, the midwives have told me to change our schedule and that they should both be drinking 55ml every 3 hours!
They was drinking at least 55ml but every 4 hours, so today we’ve completely changed our schedule to every 3 hours and at 2:30pm they both had 30ml (1 oz) , then at 5:30pm my twin 1 had 55ml and my twin 2 wouldn’t take any more than 30ml again! We try everything, we get them naked, wiggle them, wake them up and basically really annoy them and get them woken up so they feed! I’ve been sat for over an hour trying to get my twin 2 to have more but she just spits it out. Even got faster teats!
I’m going to keep monitoring how much they are having tonight, then ring the midwives tomorrow with how much they’ve drank and what to do.
I just want my girls to start having as much as they should and start putting weight on 😩 they seemed to of fed better every 4 hours, and could have them both fed in 30/45 minutes, I feel like now we are doing every 3 they’re taking less and taking A LOT longer to feed.
Any advice? Anyone else’s babies born at this gestation and can share what they did!
What happens if babies don’t start putting the weight they should on or eating as much as they should?
I’m at a loss, they have soooo many full soggy nappies, plenty of poos too, they’re both so alert and seem to be doing great but after this I feel like I’m failing

Congratulations on your twins, good weights for their gestation!

Mine were 3.5lb at 34 weeks!

We were on 4 hourly and stayed there. I would if I'm honest go back to 4 hourly and try to increase the amount.
What formula are they on? We had a prescription for premature formula for weight gain.

I don’t think faster teats is the answer. My twins were also super sleepy and feeding was hard in the early days. Strip them down to their nappies, tickle their feet etc. It took until day 20 for mine to get back to birth weight. I would consider doing 3 hourly feeds of a slightly lower volume in case what you’re giving is too much for their little tummies.

@Rrrob
The only reason we got the faster teats is because the health visitor recommended it, as the slow teats make them suck more, they feed less as they get more tired! Since getting the faster ones it’s kind of forcing them to drink without them getting too tired to suck! But yeah, I feel like they won’t drink a lot every 3 hours, they both seemed to of got used to the 4 hour feedings as although we had set alarms to wake them up, every 4 hours they would start fussing and grunting like they were ready! Now doing 3 they just aren’t, and community midwife is expecting them to drink nearly 2oz every 3 hours, it’s so hard!

@rickyzoooooom
Yeah they were really good weights! They’ve done amazing. But yeah as I’ve said on another reply they seemed to of gotten used to the 4 hourly feeds to the point they’d start fussing and grunting ready for it, at 3 hours they just don’t seem ready at all, taking less, I think maybe waiting the 4 hours so they’re hungry and trying to get over 2oz down them would be better, I just feel bad going against midwifes recommendation of 55ml every 3 hours but there’s just no way they will drink that amount in a shorter time, it’s so hard because I want twin 2 to start gaining weight so do I do 3 or 4 hours, ahhhhhh, midwives are coming back out again on Friday to see if she’s started gaining!

@rickyzoooooom
Also they are currently on aptamil first stage milk, maybe if she doesn’t start putting on weight they will prescribe a preemie formula? I have read up on them!

Ah that sounds hard
It sounds like the babies have different ideas to the health visitor which is fair enough lol
My baby was born at 35 weeks and weighed 3.15 ounces so even less
We fed every 3 hours (set the alarm and did like you, changing nappy to wake her up) and she's never cried of her own volition for food
I had trouble getting her to drink 20mls each time. For so many weeks. It would take me an hour to feed her for ages and you'd be lucky if she could drink 20mls
So to me it sounds like they're drinking a good amount
I would trust your instincts
If they're not wanting to feed every 3 hours then do what you were doing before and see if they'll take more at each feed

I'm not a professional so I do think you need to ask your midwives for help but these are the things I would be thinking of asking them to clarify -

1. If nappies are soggy, plenty of poos and both are alert why is there such a concern
2. If its the 10g weight loss - then put that into context in that yes it is a loss, but its a small % (given each meal of 30ml weighs 30g, and a soggy nappy can then lose 30g) so when they are weighed as a one off can be highly influenced by whether they've just fed, wee'd or poo'd. One off measures surely need to be looked at in the context of how weight is generally moving over the 10 days - not just an isolated 1 day measure...

Its so stressful and I feel for you having such vulnerable babies. Can you do what they recommend with mums trying to establish breastfeeding - maybe each of you with one of the twins and hole up in a cosy spot, nice and warm, skin to skin and just focus on feeding and nurturing. Even if you feel they aren't taking much milk - just the act of cuddling them, with the bottle in their mouth as a comforter and forget about anything else - no visitors, no obligations. I realise in real life it can be hard to do but it may help...

Ps my health visitor at one point said the same (about her losing weight and how if she didn't put weight on she might have to go into hospital. Funny really my mum got a bit worried cos she was so small but I never was worried I always knew she'd be fine)
And the next time she came out to check on her she had put weight on. Not a huge amount but enough

Mine were born a bit earlier than yours (32w) but I had similar challenges when I got home. I had SCBU outreach nurses come twice weekly and make me feel guilty for them not putting on enough weight despite frequent feeding. I literally couldn’t feed them anymore than I did. It was unhelpful and stressful. Babies are not all the same, just do your best and I’m sure they will be fine.

Mine are now 8 years old and thriving.

Good luck

I assume they are still under consultant care? I would honestly call the consultant (or even NICU) and ask their advice. The health visitors are not experts in preemies in the same way.

It sounds to me like they were taking more in 24 hours in 4 hourly feeds than they are now on 3 hourly. They probably just don't feel hungry enough to stay awake - especially if it's taking an hour to give the bottle - that means their next feed is only 2 hours later!

Don't try to force them to take any more than they are willing to in one sitting or they will end up with a feed aversion. Try a smaller amount every 3 hours. They may take different amounts each.

Well they came out to weigh them both again, my twin 2 who had lost more weight has put on 160g and is only 50g off her birth weight and my twin 1 is 10g off her birth weight! So happy, we stuck with the 4 hourly feeds and they would sometimes drink up to 80ml!