The girls are here and in need of BFing advice
Sorry I've been MIA. I had an OB appt last Wed and for the first time my BP was super high - they sent me to the hospital for a 24 hour urine test, let me go home Thurs when all looked well and called me in Fri a.m. to induce. Audrey and Edythe "Edy" were born Friday night and being the perfect identical twins both weighed in at 6 lbs 12 ozs. The hospital says they were both 20.5 inches but my ped says they are 19.5
They are wonderful but I am going crazy with BFing. They lost alot of weight and we've been at the Ped 3 times this week for weight and jaundice checks - yesterday they decided they are out of the woods but I've been supplementing with formula for the night feeds for two days now. They are obviously hungry and will nurse for 20 or so minutes then down 2 ounces of formula. Usually its just night but this morning I feed Edy and she was fine but Audrey nursed and nursed and then had 2 ozs of formula. I just feel like there's no way I'm keeping up with this and I'm constantly nursing so not sure when I could pump to build up more of a supply. I've pumped a few times after a feeding and only get about 1 oz from each side.
I'm wondering about moving to formula and pumping. I'd have to do a few formula only feeds to get enough BM for a feeding for both.
Any advice on how to do this and am I giving up too soon? They are only a week old today. I just want to make sure they are getting everything they needs and I'm not totally losing my sanity. TIA!
Re: The girls are here and in need of BFing advice
First, congratulations! I had similar issues with my girls when they were born. I always BF them first, then we offered them about an oz. of formula at each feeding. I started pumping about twice per day when the girls were about one week old. For a few weeks, I spent most of my time feeding babies or pumping. It was hard, but soon got much easier.
When I pumped, I used that milk to supplement instead of formula. Then, at their 2 week appointment, they had gained a crazy amount of weight, so our pedi told us we could stop supplementing. I started by dropping one bottle the first day, and kept dropping them based on their attitudes. By about one month, they weren't getting any bottles anymore, and I was able to start freezing some milk.
It was crazy hard, but very worth it for me. I hated having to heat up bottles in the middle of the night. I also had a very supportive DH, who basically did everything around the house while I was spending all of my time feeding. If it's important to you, I would say to try for a little longer. However, if it doesn't work out, don't beat yourself up about it. Good luck!
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Congrats on your girls. They are beautiful (I saw the pic on PAIF)!
I EP for both of my boys for 5 months due to a long NICU stay and reflux issues. I'm still pumping, but have to supplement for my bigger guy. Here are my suggestions for increasing your supply:
Pump. Pump. Pump. I know the girls are draining you, but if you pump after feedings it will signal your body to make more milk.
You could also try power pumping. Pump 10 minutes, break for 10 minutes, alternate this for an hour a couple of times a day for 3-4 days. This will mimic cluster feeding and signal more milk production.
Herbal supplements - a lot of women take fenugreek alone, but I had more luck with a combo supplement like https://www.amazon.com/Gaia-Herbs-Lactate-Support-60-capsule/dp/B0036THLJK There are also RX drugs that can help increase your supply.
Some ladies have had success by eating oatmeal on a daily basis. Not the instant kind.
What kind of pump do you have? I rented a Medela Symphony and it's covered under my insurance because of the multiple birth. Having a good pump is vital to establishing and maintaining a good supply.
Do not feel guilty about supplementing. Feeding your baby is the first rule of LLL. You do what you have to do.
Lastly, it can take up to 10-12 days for your milk to fully come in. Keep doing what you're doing and add in some pumping and I'm sure you'll see a jump in your supply.
GL!
ETA - make sure you're drinking lots and lots of water each day.
"Just keep swimming, just keep swimming..."
I personaly wouldn't move to pumping. It's less efficient, and I think takes more time.
I had the same thing happen with my girls. In the end, around 8 weeks we hit 6 oz/formula a day per baby as a supplement. That number never changed until I started dropping nursing sessions at 6 months. Finally at 8 weeks my supply caught up and continued to increase, but I just never seemed to be able to get those extra 12/oz a day out!
You're in the REALLY hard stage right now. You need to keep nursing as much as humanly possible (even though I KNOW it feels like that's ALL you are doing- trust me, I do know and it's hard), and even though it seems crazy, try to pump immediately after they are done nursing. Getting only an ounce or so is not bad considering how early on you are. I wished I had pumped right after feedings earlier, and done it longer. I think if I'd done that, I wouldn't have had to supplement with formula.
It's really hard at this age to BF twins, and supplementing can be so frustrating as your adding in washing bottles, mixing formula, in addition to BF. It sucks. I know. But I would encourage you to keep going if you want to BF. I almost gave up, but I'm so glad I didn't. One of my friends had twins 3 months before me and when I called her about all of this she told me that she regreted giving up BF BIG TIME. So that was my motivation to stick it out.
Hang in there!
I've heard over and over again from LCs that starting to supplement with formula is the beginning of the end of BFing. A baby's natural reflex is to suck when something is in their mouth, so it is super easy to over-feed them. Its possible that they are getting almost a full-feed when you nurse them, but then you are offering the formula right afterwards and they are going to drink it even if they aren't really hungry. Then, for the next feeding they will still be digesting the formula so they won't drink as much from your boob. So in turn you will produce less milk. Its the supply-killer cycle.
My advice would be to get off the formula ASAP unless you are okay with them always being on it for the next year. I would pump, pump, pump no longer than every 2 hours, and power pump like PP said. Every ounce that you pump while they are asleep you can offer it to them AFTER you nurse them--and they will drink it based on reflex. But the difference is that your supply is going to go up instead of down. And then eventually they will take a full feed from you as they get older and stronger. GL!
Regarding the bolded parts - be careful. Yes, the formula supplement can be a vicious cycle, but in many cases (like my own) my girls WEREN'T getting enough when they BF. I went in for weight checks 2 times a week (sometimes 3), and had a scale at home to monitor their weight. Also, I was able to almost EBF my girls until 6 months with a small supplement. It was my choice at 6 months to drop sessions and finally to wean at 9 months. It wasn't a supply issue.
Regarding the italicized parts - yes, the goal is to get them off the formula. But that doesn't mean depriving them of it.
The advice to pump, pump, pump following nursing is absolutely true.
Not trying to come down on you or anything, but I had a very close friend who had LCs convince her that she didn't need to formula supplement and that her body would take care of it (blah, blah, blah), and her daughter almost starved. It was really sad for her and the baby.
BFing is a leap of faith. They nurse all the time in the beginning (on and off for 6w). Any time you're giving them formula, you're telling your body that it needs to make that much milk.
I had an impossible time building a supply at the beginning b/c I was always nursing so just gave up on that idea.
If they're having 5 wet diapers a day and pooping on occasion (BF babies can go 5 days without pooping or something crazy like that), and gaining weight, just go with the flow and nurse them when they're hungry.
If you have to give them a bottle b/c you're just dying and need a break, do it, but try to not do it often, and when you can make up for the missed feeding by pumping. Ignore how much comes out and know that the pump is mostly for stimulation at this point because the babies are WAY more efficient than the pump.
They will eat after nursing b/c they like to suck on things. It doesn't mean they're starving.
Pumping after feeding will help build a supply if you feel it's necessary, but again, ignore how much comes out. It has nothing to do with how much they're eating. I wouldn't stress about it. It's more effective, in my experience, to nurse them more to build your supply. You could also try taking some more milk plus, drinking oodles of water, etc.
If it makes you feel better, rent a baby scale from a BFing supply store or a hospital (it needs to be super sensitive and accurate) and weigh them every couple of days to make sure they're gaining. (We did that only b.c our baby B was a tiny 4lbs8oz when he left the hospital and we wanted to be sure he was catching up.)
My best advice is to contact the LLL near you and ask for a rec for a LC who has experience with twins. The LCs (all 4) that I dealt with in the hospital both times were terrible. I was saved by a private LC that I paid $60 OOP.
SOOOOO jealous! The LC that I called who had twin experience charged $250 to come to your house for 3 hours.
We didn't pay.
Well, she only came for an hour. I would have paid $250, though. I just paid $50 for 2 cans of formula for when I go out (I still have a hard time finding time to pump since I have to pump 2x to get enough for both of them) I figure any $$ paid to an LC is cheaper than formula, lol. I just about passed out when I bought those cans! (One is organic and the other is sensitive for my gassy babies, that's why 2 cans)
I just read the responses above. I agree that it IS possible to not make enough milk, but I also agree that supplementing with formula is the first step to needing to do it all the time as the PP suggested (for exactly the reason she described.) That's why I'd count wet diapers for a while and get a scale if it gives you peace of mind.
The BFing support groups around here all have scales where you can weigh before and after to see how much your baby is feeding. It's not necessary and not 100% accurate, but it gives you an idea and can make you feel better if you're nervous. (Mine only "gained" 3oz, but they were acting full and gaining weight, so I didn't worry about it.)
My advice would be to go to a LC ASAP. baby A spent time in the NICU and both needed to be supplemented with formula for the first 3 weeks, without the LC I would have been totally lost. I think EBF is best but you want to transition them safely and the LC will help guide you through this.
My pedi was no help when it came to BF, one of the MDs in the practice- not mine- told me she had never met a MOM would EBF, and I will refuse to see her now.
I did a combnation of pumping, BF and formula and then when they had gained weight I eliminated the formula and eventually the pumping. If the girls were still fussy 1/2 hour after BF I gave them 1 0z of my pumped milk, but at that time my mild was really in and I could pump anywhere from 1-4 oz.
best of luck, you are doing a great job already!!!
I hardly ever post, but wanted to chime in and say don't give up!! It is soooo worth it if you can make a go of BFing. One of my daughters didn't latch until she was 9 weeks old and I ended up in pumping hell, but I stuck it out and am so glad I did. 5 months old and going strong.
It's ok for them to get some formula, but be careful because every bottle they get is one time that you're not telling your body to produce milk.The first few weeks can be AWFUL and you'll feel like quitting, but you can do it!
Congratulatons on your girls!! Love their names!
I was in the same boat with my boys who are almost 2 weeks. I had to supplement due to a hard c-section recovery and because I was not able to keep up with their demands for feeding. Both were BF 15-20 minutes and then easily eating 2oz of formula. Each time I pumped I was getting maybe 1/2 to 1 oz, and seemed to be less and less even after having a LC visit who helped me start cluster pumping to try to increase supply,. (LC here is $250 for 90min)
When my c-section incision totally opened up this week, I talked to my OB, pediatrician, and LC and I just made the hard decision to do all formula as my body and mind is at the limit and we all agreed that my recovery is best for everyone.
You have given them a great start no matter which way you go, I just wanted to share a different side. I hope it gets easier for you to continue to BF, it is hard work but you can do it!