Pumping & Breastfeeding Twins

Hi, I'm Ashley!  I did not have an easy start to breastfeeding. It is, hands down, the hardest thing I have ever done! Ethan and Felix were born at 35 weeks and 6 days, 5 lbs 6 oz and 5 lbs 11 oz. They were tiny and they had a tough time latching. They often looked confused and would stop sucking. Their little mouths were so tight and for weeks their latch was too shallow. Breastfeeding was painful to say the least. So, I pumped. And I pumped and I pumped. And pumped some more!

We were in the NICU for 1 week and I stayed in a mom bed the entire time. Day 3 my milk came in. They actually had a couple of feeds with donor breast milk before my milk came in. The boys were taking in 30 ml a feeding by the end of their first week and I liked being able to measure how much they were getting when we pumped into bottles. I liked that it didn't hurt to feed them, but they were still getting breast milk. They took to the bottle like champs!

I hadn't done much research on breastfeeding or breastfeeding twins, so I didn't realize how hard it would be. The nurses were very helpful and they respected every decision I made, but I got the sense that they didn't have a ton of experience with twins.The lack of sleep combined with poor latches, nipple confusion, and soreness led to more and more pumping... and less and less breastfeeding. 

When we got back from the hospital I still nursed and pumped intermittently, but I was finding it easier to pump (using the Medela Freestyle double pump) and get help from my husband with the feeds. I found it impossible to tandem nurse or nurse one at a time - how do you keep the other one happy when you're feeding the first one? Picture this: Brand new, severely sleep-deprived mom trying to breast feed a baby with a poor latch at 3 am while her other baby is wailing his head off. The whole process would take more than an hour and then we would have to start it all over again in two hours! I needed to do whatever it took to survive... and pumping and bottle feeding was the best thing for us at the time. 

I felt awful and guilty every day that I wasn't taking the time to practice breastfeeding. I wasn't giving them the chance to learn. I was being selfish, but boy did it feel better to pump. I received a lot of support from family, but also a little bit of pressure to nurse more...you know, those passive aggressive comments under the breath (e.g. "they should be able to latch by now..."). That kind of thing drove me nuts! I am a sensitive person, mixed with being an over achiever, and I cried a lot when I thought about how I was failing them and myself by not being able to breastfeed my boys.

I justified my exclusive pumping by telling myself, "They were premature so they are still little and unable to figure out how to nurse." Or, "I have twins so it is of course going to be difficult at first!" The boys were still healthy and getting enough food and that was the important thing. I really believed these points and still do, so that helped me get through the first couple of months.

A couple of weeks after we got back from the hospital I made a conscious effort to exclusively breastfeed. It was mid-January and I wanted to be a tandem nursing goddess by the time my sister came out to visit at the end of the month. I went out and bought that giant green tandem nursing pillow (My Breast Friend twin pillow) and a couple of tubes of nipple cream. I even washed the pump and put it away. 

After 24 hours I was in excruciating pain unlike I've ever felt before. I couldn't believe how awful it was - scabby, bleeding nipples, blisters, white tips, mastitis (I had about 8 bouts of mastitis over the past four months). Anyone who hasn't gone through it honestly cannot imagine how much it sucks every time you have to feed a crying baby (or TWO CRYING BABIES) with sore nipples. I believe I had a rough case because of their shallow latches. Attempting to nurse them at the same time made it utterly impossible. 

My mistake was trying too much, too soon. I wanted all or nothing. I was so determined to nurse, but I completely crashed and burned. I'm embarrassed to admit that I gave up after only a couple of days. I had to bring in the troops and come up with a better plan... I could absolutely not go on with what I was doing. My nipples healed after a few days and I was happily pumping again.

I continued to breastfeed them directly once every couple of days maybe... sometimes a couple times a day if I was feeling ambitious. For several more weeks that went on... Sometimes I went for days and days without nursing. The pumping was going quite well and I was making enough milk.

But I still had that nagging pressure to nurse. I really wanted the freedom of breastfeeding without having to wash pump parts and bottles all the time. I still had this image of myself tandem nursing like a boss...

So, my second BIG attempt to breastfeed exclusively was on! It was almost as though I had forgotten how much it hurt the first time. I went out and bought those gel pads to ease the nipple pain. And again I nursed at every feeding for about 48 hours this time. And back came the blisters and blood. I distinctly remember pumping strawberry pink milk one night (ugh). This was not getting any easier and this time I really cried, feeling totally broken and beaten.

I researched online and found affirming stories about exclusively pumping for twins (http://www.twintalkblog.com/2014/06/exclusively-pumping-for-twins.html). There were some HUGE pointers in this blog post that helped me:

- Get a hands free pumping bra (this was one of the best purchases I've ever made)

- Pump for at least 15-20 minutes so you get two or more let-downs

- Use larger suction cups than the ones that come with the pump

It helped immensely to read other twin mom stories. I was set on pumping only... I didn't want to breastfeed AND pump because I was losing patience and that seemed way too time consuming. 

I was going to give up on breastfeeding... but that's when the severe mastitis set in. My boobs were so hard and lumpy (and PAINFUL) that I had no choice but to nurse the boys. The only way to relieve the blocked ducts was to breastfeed. I got mastitis a couple times a week for a few weeks and I tried everything to reduce the swelling, from hot and cold compresses and hot showers to cabbage leaves.

Now my milk production was decreasing and the boys were getting HUNGRIER. Mid-to late Feb I was starting to get worried about the amount of milk I was expressing. So, after talking with a nurse I made a game plan with my husband and now that he was working from home, he would help me with the feedings until we established some kind of system.

This is what we did: At each feed he bottle fed one of the boys and I pumped on one side and breastfed on the other side simultaneously. The next feed the other boy got the bottle and I pumped and BF the first guy. This way I wasn't nursing with both sides every single feeding (reducing the wear and tear). I stopped pressuring myself to nurse at every feeding, especially at night. Sometimes I would just pump and bottle feed, allowing my nipples to take a breather. I think having more patience and allowing myself to pump and breastfeed gradually was the game changer. Having the support and help from my husband was absolutely necessary. 

I used the gel pads and the disposable pads to soothe and stop chafing. Gradually over a few weeks, the pain reduced. I only bottle fed at night because it was easier and I could prop the boys on a pillow and feed them at the same time. My breasts weren't lumpy and sore anymore. My milk production was back up. I could finally see the light at the end of the tunnel!

Now, I pump and/or breastfeed whenever I feel like it. There's no perfect routine - I just do what I need to do and it doesn't have to be the same every time. I TYPICALLY tandem breastfeed at around 8 pm to top them up and put them to sleep. Then my hubby and I quietly carry them to their crib. I pump sometime between 12 and 2 am (boys sleep through) to prevent the lumps. 

Depending on what's going on throughout the day and what kind of help I have, I either BF one baby at a time, tandem feed with my green pillow, or bottle feed and pump (usually having to top up each bottle with whatever milk stores I have in the fridge from the previous night). I can pump 20-30 oz over two sessions in the night so I put whatever left over milk into the fridge. 

Tandem feeding with the big green pillow continuously gets easier.

Boys normally get 5 oz each when they bottle feed. When I BF, it takes about 15 minutes for each of them to feel full and satisfied. They are 5 months and weigh just over 15 lbs.

I feel like a different person and I'm so glad I stuck with it...it only took 4 months! Now, it can only get better.

Side note: Wine and chocolate helped a lot during this process.

Side note #2: As irritating as unwanted advice can be, I secretly love the attention that I get from people when I'm out and about. I love questions like "How do you do it?" or comments like, "You are supermom!" Thank you to the people who open doors, let us go ahead in lineups, and shower us with compliments. I also have to chuckle when I get that second look and someone says, "Oh, there are TWO babies!" Double take!

It is too bad so many moms go through so much agony over feeding their babies - whether it's emotional guilt, exhaustion, pain, or feelings of failure... I want you moms to know that you are AMAZING and you are doing your best and what YOU think is best for your child. Nothing can get in the way of that! Your baby will be healthy and happy no matter what you decide to do and your decision is no one else's business but your own. My advice (take it or leave it) is to do whatever it takes to make yourself feel good and happy and enjoy this time with your little one as much as you can.