Twins not gaining enough weight

WilP · October 2013

I have been breastfeeding my twins exclusively since they were born 3 weeks ago. I've been fighting the doctors since day one because they've been insistent that i supplement with formula. I know tht there are people out there breastfeeding their multiples exclusively and i know it can be done! My boys lost almost a pound before leaving the hospital and have been slowly gaining it back for three weeks. SLOWLY. They aren't losing and they've been getting plenty of wet and dirty diapers but they aren't even back to their birthweights yet. Today i asked to see a lactation consultant and she was totally not helpful! She said i should supplement and then in a few weeks when they are over the hump i can try again. My understanding is that doing that will actually cause me not to produce enough. When i asked about exclusively pumping her answer was " i don't care how u get the milk in them, just get it in them. We are starting to worry about failure to thrive". I was kinda hoping for more advice... Like how often to pump... How to increase my supply etc.

Is it time for me to give up and formula feed? I exclusively breast fed my dd till i got pregnant with the twins and stopped producing.. It breaks my heart to think i can't feed my boys breast milk. Wwyd?

PinkinProvence · October 2013

I have no experience since I haven't had my babies yet, but I would think that the lactation consultant was kind of rude because she is concerned about your babies' weights, and I would follow her advice to supplement. I know there are doctors and nurses who are not supportive of EBF with twins and just want the easy route, but I would think that a lactation consultant would advocate for EBF unless it was medically necessary to supplement.

I am sorry that you are having a difficult time, and it could be the practical advice you get from moms who have actually been through this completely contradict mine! I just know I would be very worried by the alarming "failure to thrive" comment.

Good Luck!

Stephanie2167 · October 2013

I've never nursed twins but I went through a similar thing with DD. It took weeks to get her back up to her birth weight. Luckily where I delivered they are very pro bfing so not once was I told to supplement. What I did do though is pumped and fed her with a bottle (mostly because I was so cracked and sore from her aweful latch). What about nursing and then offering a little extra formula in a bottle?

I also took Fenugreek to up my supply. Don't give up just yet. You're doing great!

10-4LilBuddy · October 2013

My babies are 8 days old and I am new to this. I started supplementing with formula a couple days ago while my supply was catching up. It wasn't either breast milk or formula. They drank both or either at each feeding. I gave them breast milk from latching and via bottle. No confusion at all. Then I gave formula.

I pump mostly because my daughter does not like latching. My son loves it though.

Giving them formula really helped us. It took a lot of pressure off me to produce.

pillowass · October 2013

I think you will find lots of moms who are able to supplement and continue bf'ing. I am actually pretty shocked that you are not hearing the alarm bells they are sounding. Failure to thrive is a big deal - your babies could be hospitalized and suffer long-term consequences. I would take the advice of your doctors and LC seriously, give them some formula, continue nursing frequently, and continue seeking support for your efforts to continue bf'ing if that's what you want to do. But don't put your goal of EBF above your babies' need for adequate nutrition.

badbridey · October 2013

I think I would try to see a different lactation consultant, get a second opinion. I agree with pps about trying to pump after feedings, or trying fenugreek, etc to help increase supply. I would at least try some of these other options first before supplementing with formula. Do you have a la leche league group near you? They might be a good resource to help with your questions if you can't see another lactation consultant.

raraavis28 · October 2013

pillowass said:

I think you will find lots of moms who are able to supplement and continue bf'ing. I am actually pretty shocked that you are not hearing the alarm bells they are sounding. Failure to thrive is a big deal - your babies could be hospitalized and suffer long-term consequences. I would take the advice of your doctors and LC seriously, give them some formula, continue nursing frequently, and continue seeking support for your efforts to continue bf'ing if that's what you want to do. But don't put your goal of EBF above your babies' need for adequate nutrition.

Agree w/ everything she says. We had some weight issues in the beginning, and I needed to supplement. At the very beginning I "beefed up" my breastmilk by adding Neosure powder to it. After LOs got back to their birthweights I got back to focusing on BFing (whereas I was doing a lot of pumping.....6-8x a day for 20-30 min....as well as giving some formula. Until they regained their weight I only had them "comfort suck" for about 10 minutes to keep in practice without wearing themselves out before they could get enough calories in). They got a mixture of nursing, pumped milk, and formula until 6 months when I went to straight formula and solids. So, while I wasn't able to EBF per se, they got the benefits of being mostly breastfed for the first 6 months and have been doing great.

With multiples you have to be ready for your original plans or expectations to change. If your babies need to put the weight on now, a little temporary supplementing isn't the worst thing in the world. It doesn't mean that you're not still a BF mom, but it can be a nice "safety net" while they get the hang of nursing and start getting their weights back. Also, for supply, just make sure you pump at every feeding time and drink tons of water! GL!

WilP · October 2013

I don't have a le leche near me. Im in a remote location. I am trying to pump for them now. I managed to get 7 ounces for their last feeding. Which tells me my body is producing. They just aren't drinking. Pumping may be the answer. I don't think either of my guys actually have failure to thrive. In the last three weeks we've battle colds and thrush which have cause them not to eat as well as they had at the beginning. So the fact that they re both still gaining is actually a miracle. they are both getting plenty of wet and dirty diapers and they are both alert and happy much of the time. Im determined to make enough milk to feed my boys. So im pumping to supplement. They were preemie so i think they were just to underdeveloped to suck well from me.

Dragonfly1226 · October 2013

K&A took a while to start gaining when they were born. Almost immediately I started pumping after every single nursing session and using what I got to supplement. Then if I didn't pump enough for the next supplement we used a little formula. The pumping helped my supply and the supplementing helped K&A gain weight. I cut down on the pumping when they got back to their birth weights. Now I pump once in a while after my morning nursing session just to build a freezer stash. K is in the 85th percentile for weight and A is in the 25th percentile. I EBF both of them.

I agree about talking to a different LC. However, we used a bit of formula at the beginning and it didn't prevent me from EBFing now. GL hon!

TheDairyQueenx3 · October 2013

sing4mysavior said:
Agreed. Not up to birth weight at 3 weeks is a red flag.
Of course nurse nurse nurse...but at this point I think offering pumped bm or formula AFTER nursing is not a bad idea. Hopefully soon you can transition back to just ebf if that is your goal. GL. Keep us posted.

(If exclusively pumping, try every 2 hours for 20 minutes during the day, every 3 hours at night.)

I agree with this. I will share that with my singleton he did the same thing and it took forever for him to start to gain ( well after the 3 week mark) I just had him to the breast constantly and pumped after he was done but he always refused because he was full ( I even tried to put the expressed milk in the tube that hangs around your neck and comes down to supplement because I thought he wasn't getting enough I just ended up drowning the poor kid in milk but it's worth a try!!). I was an over producer and I know he was getting enough just for what ever reason he wasn't a gainer but once he hit the 6-8 week mark he put on some and then turned into a chunky monkey. My twins are not here quiet yet but DS had a really hard time in the beginning and then bam! Cubby baby!

tootsscott · October 2013

I have no experience and pray that I can BF both of my babies, but I will certainly listen if a professional who deals with breastfeeding on the regular tells me to supplement. She knows better than I, and I agree with PP that if someone used the term 'failure to thrive' to potentially describe my situation with my children, I'd be changing something ASAP!

LottaLattes · October 2013

I haven't read the other posts, so sorry if I am repeating but I would try pumping right after every feed that you can (give yourself a break at night) and supplement with that. It will also help increase supply, though if they are being efficient, you won't get much. AND you can supplement with formula and your supply should still build. I ended up EPing, which honestly was work but a huge weight off of my unsuccessfully breastfeeding shoulders. They had a bit of formula once I stopped at 10mo, but were 99% on bm only. Good luck, and hang in there!

bumpuser924057 · October 2013

If you think it's an issue with how much milk they can transfer (and it very well might be, especially if they were early) then you need to get in and do a series of weighed feeds so you can see how much they're actually getting when they nurse. How much do they weigh, and how early were they born?

My kiddos were born at 37w3d and were both over 7lbs, but my boy twin took a full month to transition from formula bottles to breastfeeding after his NICU stay and I needed to start supplementing with my girl twin in the hospital - she was sleepy and weak, my milk took over five days to come in post c-section, and though she was able to latch well, nursing tired her out so she wasn't doing enough of it to get what she needed OR to stimulate me to make milk. We supplemented via a syringe with a long flexible tube so she got the formula as she nursed, and after a couple days it made a huge difference. I was able to stop doing that with her not long after I brought her home.

My twins are four months now, and they are mostly breastfed, but they each get a 3oz bottle of supplemental formula before bed and they get formula if I'm away from them and my mom has to watch them. There is absolutely no reason at all to throw in the towel on nursing if you have to supplement with formula; any amount of breastfeeding you can do with your children is a gift, both for them and for you, and it is NOT an all-or-nothing proposition. I wish I had been more flexible about that with my older son, who, like yours, was 100% breastfed, no formula ever. Twins are a whole other animal, seriously.

But definitely get them in and do a weighed feed with a LC if at all possible. I'm lucky enough to have an awesome group session locally that meets 3x a week and is only $20 per meeting; look around in your area and see if anything like that is offered. It was absolutely essential for me as I was working to get DS off the bottle and on the boob.

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