Thanks Bry. Here it is:
I breastfed my first born for 15 months and was committed to breastfeeding my second child. When the pregnancy turned out to be a twin one, I had the same intention. However, from the point at which I attended the twin antenatal days held at the hospital, the message from the health professionals seemed to be one of, whilst not actively discouraging exclusive breastfeeding, an implication that it was unlikely that this was practical or possible and that mixed feeding was more realisable. The two sets of parents who came along to talk about their experiences were either feeding their twins with Artificial Infant Milk (AIM) or mixed feeding.
I started to wonder if exclusive breastfeeding was possible with twins but, fortunately, the internet proved to be a good resource in finding other mothers who had exclusively breastfed and I corresponded with a few of them to gain knowledge and advice. I wanted to be as prepared as possible and read up on breastfeeding generally and found the La Leche book “Mothering Multiples” to be really helpful, although almost a little too detailed pre-birth. The prospect of breastfeeding for 12 hours plus a day seemed daunting, but at least I had an idea of what to expect. I also contacted the NCT in advance of the birth to get some contact details of breastfeeding counsellors in case I had any problems. Having breastfed already, I felt it was important to be able to access help urgently if a difficulty arose.
I started to tell people “I will be breastfeeding these babies” when asked, rather than the more equivocal “I hope to breastfeed”. I bit my tongue and nodded at well meaning friends who told me not to put any undue pressure on myself in case it turned out to be too much to take on.
After a straightforward elective caesarean birth, the twins were put to my breast immediately in tandem and fed for five hours!
The intensity of that first week was incredible. I could not have survived without the EZ2 Nurse feeding pillow or Lansinoh! At first, the babies did not have a strong latch and one would latch on and slip off after a few minutes, or if I latched one on and turned to latch on the other, the first would slip off as I did so and the process would need to be restarted. This had the effect of causing my nipples to be incredibly sore, which is to be expected initially in any attempt to breastfeed, but they had a lot more trauma than if I had been feeding a singleton. On the first night after surgery, bedbound as I still had a catheter in, it felt like I had buzzed the midwives a hundred times to help me latch the babies onto my nipples. My milk took a while to come in (I suspect it didn’t do fully until about nine or ten days as it was only then that I began to feel engorged) and the colostrum did not satisfy the babies for very long so they wanted to feed sometimes literally every five minutes or so. The babies were more settled in the day and frustratingly would be calm and sleepy during visiting hours when my partner was there – I kept insisting to him that it wasn’t like this at night (once home he soon realised this was true!) Late afternoon they would start to cluster feed furiously until about 7 am the following day. I was feeding almost constantly and getting about an hour’s sleep per night. One night I only slept from 4am to 4.25 am! I felt a little crazed with sleep deprivation by the time I left hospital but I knew that once home it would be easier as I had my partner and mother to support me, rather than having to share the nighttimes with an overworked midwife and ward support staff amongst twenty other women.
On the whole, the midwives at the hospital were encouraging of my intentions. However, among some of the staff, any complaint about how hard I was finding breastfeeding resulted in what seemed to be the knee jerk advice that I could “top up” or switch to AIM. For example, on Day 2, I complained about my sore nipples which had blisters on blisters and were cracked and a little bloody. “What can I do about this?” Rather than recommending nipple cream (which I found worked wonders) or expressing a little milk onto them and letting them air dry, AIM was suggested. When I said I was absolutely exhausted following four days of near constant breastfeeding, AIM was suggested instead of words of encouragement or advice that this initial intensity was to be expected but would pass. When things were really hard in the nights, I went so far as repeating mantras to myself, such as “Formula does not exist in my world” and reminding myself that if I was in Norway, I wouldn’t have access to AIM without a prescription and if I lived in some parts of the world, wouldn’t have access to AIM at all! On discharge, staff were delighted when I stuck it out and were very complimentary of my determination and efforts.
Once home, I continued to feed constantly for the next few days. That was my full time 24/7 job. My partner did everything else including putting the babies onto the EZ2 for me, nappy changes, winding, washing, clothes changing, cooking and my mother looked after our toddler. The babies had lost 8 and 9% of their body weight and, although they had been slowly regaining it, by day 7, when feeding had started to calm down a little, my community midwife was concerned that twin 1 had “static” weight gain. She had gained only 20g in 3 days. Her “protocols” told her that the weight gain should be averaging 30g per day. I had been pleased that the previous night the twins had slept for five hours but this was frowned upon and I was told I needed to wake them if they slept for more than 3 hours. She also suggested that I “top up” with AIM. When I refused, she contacted a colleague who suggested the same. She went away saying that she would return in two days to check on the twins’ progress. I was feeling really anxious and upset myself by this time and also quite undermined. This is where my contacts came into their own. I phoned the breastfeeding counsellor who asked whether the midwife’s charts were adjusted for twins (they were not) and whether she had taken on board the fact that I’d had a caesarean so my milk would be slower to come in. Also, she asked me how I thought the babies were doing (very well) and said she would not have a cause for concern unless they had failed to regain their body weight by 14 to 21 days. I consulted my GP who gratifyingly agreed: unless there was a “scrawny” baby who was losing weight or failing to thrive, then she was not worried until the 3 week mark. My La Leche book reminded me that AIM should only be given if there was a good medical reason for doing so and that giving AIM or expressing breastmilk at such an early stage and giving it via a teat might result in a baby that was less likely to want to suckle at the breast – I reminded myself that demand dictated my milk supply and settled down with my EZ2 for some determined hours of full on nursing. By day 10, twin 1 had regained her body weight and more (putting on 190g in two days) and twin 2 had done so by day 14. My milk came in and supply no longer seemed to be an issue.
It’s day 16 now and here I am at my computer typing up my experience so things have certainly improved! The babies are sleeping for 3 hour stretches and in the night they wake about 3am and 6am for a feed. It is so much more manageable and we have left the house on 3 or 4 occasions – life is resembling something approaching normality and we seemed to be over the difficult bit.
It’s been incredibly hard work and so tiring but I’m so glad I stuck it out. I have to be honest and say I don’t know how possible it would have been without the support of at least one other adult round the clock (my mum came and stayed for the first two weeks, in addition to my partner being there). The twins are doing fantastically and I feel quietly confident that we can continue to breastfeed and it will get only more straightforward as they grow and develop.