Exclusively breastfeeding twins and having milk leftover to donate.

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Chances are if you’ve made it to my blog, you’ve seen both my breastfeeding photos and pictures of my marvelous milk stash on social media. You may want to know what my secret is to milk production, and you may be struggling with breastfeeding your own little one(s). While I’ve managed to respond to a few people individually, I simply don’t have the time to reply in great detail to every message and comment I receive. Hence this blog post. I have been intending to write about the topic for a while because I know there are so many mamas out there who need help. And I want to help! But it’s rather difficult these days to get to a computer for the amount of time required to address such a vast subject. At the same time I know there are mamas out there struggling RIGHT NOW who need help RIGHT NOW. My plan B (because Moms of Multiples always need a plan B, C, and D) is to release this blog post in segments as I have time to address each issue.

First things first. My experiences are not meant to replace the advice of a lactation professional’s. I am simply sharing my experiences. As a biologist, and mother of 7 exclusively breastfed children (including the three sets of twins and tandem nursing twins plus a singleton twice), I do possess a fair bit of knowledge on the subject. But my number one recommendation is always to consult with an International Board Certified Lactation Counselor (IBCLC). Kellymom has a comprehensive list of breastfeeding help resources. Although online resources can help you when it comes to troubleshooting many breastfeeding issues, nothing replaces meeting with a professional in person. As a first time mom, the 30 minutes I spent with my lactation consultant saved my breastfeeding relationship with the first set of twins (a relationship that was nearly sabotaged by nurses who pushed formula at the hospital). Even with the third set, I still had a few questions for a lactation consultant as these are my first preterm babies.

Starting off on the right foot.

During my first pregnancy, I read a fair amount about HOW to breastfeed. But reading how to perform an action and actually doing it are two different things, and in retrospect I did not find this as helpful. You may feel otherwise; it all depends on your learning style. For me, probably the action contributing the most to my success breastfeeding the first time was researching the importance of breastfeeding. I grew up thinking that formula was a normal part of having a baby–almost all kids do, unless you were blessed with hippie parents– and I had to remove myself from my cultural bias towards formula. Formula is NOT normal for humans as a species, breastfeeding is. People have been bamboozled by formula companies with unethical marketing practices for generations, and formula feeding has been passed on from grandmother to mother to daughter in this way. As a culture we are finally coming to the realization that breast milk is supremely superior to formula, thanks in part to the scientific community. Unfortunately the cultural bias towards formula as a normal feeding choice still exists due to generations of influence. Combine this with lack of support for lactating women, and Americans have some rather abysmal breastfeeding rates. While the World Health Organization recommends exclusive breastfeeding for the first six months of life, only a quarter of moms report following this recommendation. Thankfully the CDC has recognized the impact that breastfeeding has on health at an individual and a population level, and is aiming to increase breastfeeding rates with its Healthy People 2020 program. Part of reaching these goals is the cultural shift that needs to take place: more people need to come to the realization that formula, as the World Health Organization recommends, should ONLY be used as a last resort. It is with this mindset that I began my breastfeeding journey. Failure was simply not an option, and fortunately I have no medical conditions that prevented me from breastfeeding or affected my supply. If you are a mom who has been unable to breastfeed due to a medical condition or other extenuating circumstances I extend my sincerest sympathy to you. These words are in no way meant to be harsh for women who are truly unable to breastfeed.

Armed with determination, I was able to breastfeed my first set of twins through a singleton pregnancy until they weaned at 2.5 years old. It was not without struggle, but I forced my way through. My singleton weaned at 3, and the middle twins were just a couple months shy of their third birthday. I’d like to focus on my most recent twins as breastfeeding them has been a culmination of my past experiences and 10 years of research. I think sharing what I’ve done this time around will be the most helpful for other mamas:

  1. Antenatal hand expression of colostrum. In early labor I hand expressed colostrum to use in case babies needed to go immediately to the NICU, or in case I needed to supplement with a higher volume than I would be able to produce for two babies.
  2. Babies straight from the belly to the chest. Whether c-section or vaginal birth, healthy babies should be placed on skin to skin as soon as possible. Lana and Phoenix were both placed on my chest as soon as they were born and during delayed cord clamping.
  3. Initiate breastfeeding as soon as possible after delivery. With about 10 different pillows propping the babies and I up, Lana and Phoenix tandem fed as soon as their vital assessments were complete. We left the twin nursing pillow in the car until after delivery, but I would suggest having it on hand in your hospital room for the first feed.
  4. Feed frequently and on demand at the breast. Lana and Phoenix were late pretermers, so the challenge was keeping their body temperature and blood sugars up. This required a lot of skin to skin. I held them as much as possible at the hospital and the weeks following. They ate as soon as they showed any signs of hunger (smacking lips, rooting, light fussing, tongue thrusting).
  5. Supplement with colostrum if necessary. During labor and after, I hand expressed colostrum. After each breastfeeding session I used a syringe and sometimes a syringe and a feeding tube to top them off after a feed. This is necessary since milk transfer is an issue with preterm babies– they may look like they’re feeding well, but not be getting enough milk. The wonderful lactation consultant at the hospital helped me supplement since this was my first experience having small/early babies.
  6. Hand expression of colostrum can be more effective at milk removal than a pump. Prepare yourself by watching this informative video by Stanford University, and save the link for easy access when the time comes. Additionally you can ask your nurse for help. If they aren’t helpful you can politely ask for another nurse for further support/expertise. Hospital lactation consultants typically will come to your room depending on the facility, but you will see your nurse more frequently than the LC.
  7. Pump. Pump. Pump. There is a great debate in many breastfeeding social media groups, and I’ve even seen contradicting information from lactation consultants. Some will advise no pumping until 4 weeks postpartum because you risk an oversupply. My opinion on the subject is I WANT an oversupply. If you’re returning to work, feeding multiples, want a significant milk stash, or plan on donating, those first four weeks are a golden opportunity for stashing away milk. After my most recent delivery I was able to pump around 1000oz in the first 4 weeks. Not only did all this pumping help keep my supply up, I was able to donate the milk to a sweet baby girl with a formula intolerance. I pumped around 3x a day before my mature milk came in, and 2-5x a day thereafter.
    tandembfhospital
    Nursing Lana and Phoenix in the hospital.

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Starting off on the right foot will greatly increase your chances of breastfeeding success! Many of these tips apply to ideal circumstances. If you find yourself in a situation that needs troubleshooting, it’s best to address the concern immediately and not use formula as a first choice to supplement. Even one bottle of formula comes with risks of affecting the gut microbiome. Some hospitals have pasteurized donor milk available to moms who need it, but it’s best to use mother’s own colostrum.

“I didn’t start off on the right foot, and now my supply is low. What can I do to increase my supply?”

I will address this issue in a future edit/addition to this post, but for now you can head on over to @fuelyourzen‘s blog for tips. This amazing mama struggled with breastfeeding one baby, but has been able to successfully breastfeed her newborn twins. See what changes she made to go from struggling to success.

Segment two: click here.

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