Saturday, August 31, 2013

My breastfeeding story : twin preemie breastfeeding

Y'all might want to know, my friend who wrote a guest post about being on bedrest during her pregnancy, gave birth to two healthy girls at 33 weeks.

That's like, monumental to me. I was just so so SOOO happy she made it to 32 weeks.

And then not a week later I get a message from her about breastfeeding. LOL!

So here we go again...I've told this story before.

But not on the blog. So now you get it. And hopefully it will help some little someone somewhere.

Quick & Dirty
  • preemies born at 29 weeks, 5 days
  • boy in NICU for 6 weeks; girl for 8 weeks [yes those two weeks in between were awful]
  • had to double pump with the hospital grade pumps while they were in NICU 
  • had A LOT of milk to spare when they came home
  • took SIX WEEKS EACH to train both me and them how to breastfeed
  • almost gave up a gzillion times
  • the boy ended most days with a formula bottle; she had a breastmilk bottle and I pumped the last of the day for hubby to do a nighttime feeding
  • by four months of age we had managed to get a four-feeding-a-day going
  • by six months they started solids
  • by seven months he started to wean [probably was just an ear infection in retrospect]
  • by eight 1/2 months I weaned her
  • not a day went by in my bf'ing life that I didn't PUMP, and sometimes I miss it
  • barely a day went by in my bf'ing life that I didn't use a bit of formula
Slow & Painful

THE NICU
I was both lucky and unlucky that our kiddos ended up in the NICU.

The night of their birth, the nurses looked at me, asked if I was planning on breastfeeding, and when I said yes, they mercifully, let me rest. They said we could work on it in the morning.

The next day they wheeled in the double hospital grade pump, and I awkwardly tried it with several family members in the room. DON'T DO THAT! I feel that pumping is even more private than breastfeeding. It's almost like going to the bathroom in a weird way.

Anyways, I got into the rhythm of pumping every three hours and after two or three times I produced something.

After two or three days, I was producing A LOT. I started to fill up their fridge with my labeled milk for my babies, who, sadly, could not partake just yet.

Over their six and and eight week NICU stays I stored up a lot of milk, even as we started to feed it to them via tube, and then via bottle, and towards the end of the two months, trying, via breast. Many of the different nurses gave me tips and tried to help, but it was all very frustrating. I needed to be alone with my babies to really give it a go.

I rented a hospital-grade pump and got into the rhythm of pumping at home every 3-4 hours, and pumping at the hospital in their pumping room while I was there, after I had visited with my babies for each 3 hour feeding. After seeing them, usually, I was bursting. At home, I taped photos of them to the wall near the pump to inspire me. And then, in what seems like a blink now, but seemed like forever then, we were all home. And the real work started.

Good thing I had lots of backup. This is hubby about to transport the precious cargo across state lines.
TEACHING PREEMIES
Home at last
It was incredibly frustrating to try and get them to latch and drink. The boy was not quite strong enough latch-wise, endurance-wise, and I'm afraid I may have been producing too much and choking him. I started to pump before I saw him in the NICU to just get practice. Also, my breasts being on the larger side, his mouth was just too small. My key to him was patience with his slow, lazy, rhythm and finding a comfortable hold for him so that his nose wasn't blocked. I had many practice sessions where I fed him with my pre-pumped breast, and then switched to a bottle of my breastmilk, and then I had to pump again. Sometimes this would make me miss my daughter's feeding, because they were scheduled 30 minutes after one another with the nurses. So many feedings I had to 'pick a baby.' This was incredibly heartbreaking.
I just wanted to go straight to pages of my breastfeeding books and take them both in my arms and tandem feed. But this beautiful picture was becoming increasingly further out of my reach. Little did I know, I would be successful within six weeks of this drama.
The main issue with my girl was also the latch, but she was too strong! It hurt like hell; it was like pinching. And I was getting incredibly chafed. I needed to find the right angle for her and me so that we were both comfortable. In retrospect, with the drugs she was taking and her being required to be off milk for several days at a time, she was probably just incredibly hungry in the NICU. Sniff. When I got her home, I just couldn't get it together with her. The boy was really getting it, and I seemed to have endless supply of breastmilk bottles from the NICU in the freezer. I thought I could last two months with this stuff! I started feeding her the bottle more and just enjoying my 'special' time with my boy. But after two weeks, my supply was waning, both in my breast and in the freezer. I told my husband I was just going to feed her formula. We panicked and called the doctors and got the name of the special preemie formula we needed. He got home from the store and said to me,
You need to try. Not for you, not for the girl, but for all the women who can't do it for one reason or another.
Now, as you can see, my husband knows me very well. I simply could not let my fellow mommies down. I certainly produced enough milk, there is no reason I couldn't feed it to my baby. I told my little girl, "One more week, I'm giving you. Let's get it together, girl." And lo and behold, she did. My father happened to be visiting for a week so he was able to take care of one child while I went about the routine of baby-to-breast, baby-to-bottle, and pumping with the other.
baby-to-breast ; baby-to-bottle ; breast-to-pumping; repeat 2762 times
It was time-consuming, exhausting, and just when you think you are done with the routine, you have to do it all over again. We started making little two-ounce bottles for 'bridge' feedings if it seemed like one of them was super hungry and mama was worn out. And, because they both had that all-too-well-known-preemie-thing acid reflux, we read somewhere that sometimes cold bottles helped. So we didn't warm up any bottles for them. I think this also provided the side-benefit of motivating them to latch onto the breast if they wanted 'warm' milk.
Thus, the two-ounce fridge bottle became a mainstay of our twyn household throughout their entire infancy. 
We had plenty of those little bottles because we also needed to feed them many medications this way.
In these early days, in a 24 hour period I calculated I spent 4-5 hours breastfeeding or pumping, and gave out 27 doses of medications. I did not count the diapers!!
MY REWARD: AGE 4 MONTHS
I read many books in the NICU [I didn't have the stamina to read them during bedrest.] One such manual, 12 hours sleep by 12 weeks old from babycoach.net, was my Bible. I was determined to achieve this magical promise of the title, and as they were preemies, did not expect to reach 12 hours of sleep by 12 weeks old. But I did achieve it by 5 months of age! And I made great strides at 4 months of age.

I completely recognize that I was lucky enough to be home and in control of all of these aspects of child-training at this young age, but if you are as well, I highly recommend it!

By this point I was able to tandem feed. Completely through trial and error, I discovered that sitting on the floor with my back against the couch, and with a child each on large pillows that were angled up on my thighs was my best method. I also very much liked EZ-to-nurse breastfeeding pillow as they got a little bigger. And then when they got too big, I had to go back to couch pillows and sometimes just put them straight on the floor with their heads on my thighs. I was lucky enough during my pregnancy to watch a friend-of-a-friend tandem breastfeed her 8-month-old twins at her invitation. I kept that image in my mind and her words that she never thought she'd be successful either.

By this point, I had a feeding down to 15 minutes! The kids got stronger and more efficient, and between all the feeding and double pumping, I was able to produce enough.

By this point, I had it down to four feedings a day. And, if you count in the fact that I was tandem feeding, you realize that that is less than 60 minutes of breastfeeding in a day!! 4-5 hours down to 1 hour. Amazing. Now my little boy still loved to wake up at 5 am for a night feeding, and I slowly worked on weaning him off of that, but that was the last bit of nighttime feeding I had for awhile. They, of course, had 'breakthrough' feedings occasionally, and that's when I used the two-ounce fridge bottles of breastmilk or formula I mention above.

By this point, we had a system for the end of day. I always pumped the end of my day away. It was actually a stress relief, I think. I did my three feedings for the day and for the fourth, I would pump while my husband would feed the kids bottles. One bottle, for my daughter who had a more sensitive stomach, was usually the breastmilk I pumped the night before. One bottle, for my son who was a little more hungry, was preemie formula. That allowed us to use the extra that I pumped at night for the next day's breakthrough feedings. We learned her stomach couldn't handle the formula at that time because she would wake up at night vomiting it up whenever she had it. It took a couple of nights to discover she needed to be 100% on breastmilk. Trial and error, folks. Trial. and error. [With what types of bottles and nipples and what times of holds, etc...everything!] And we suspected that little dude was a little bit hungrier because a) he was growing faster and b) I pumped more out of 'his' breast.
Oh yeah - that reminds me - upon struggling and reading up a bit - I made the choice to assign each child a breast. It was particularly helpful when we had our rounds of thrush. That was fun.
ONE LAST WORD ABOUT PUMPING & FORMULA
Oh my gosh I feel like there is SO much more to say - but this post is already WAY too long. The upping the ounces, the stretching the feedings, and the pumping. Oh! The pumping. If I had a little sister and she was having twins, I would buy her the most powerful and best pump on the market, and let her know that if she is going to breastfeed twins - and particularly preemie twins - she was going to need to pump. At least once a day. For the duration of her breastfeeding efforts. As the babies get older and bigger, it was actually somewhat of a stress relief for me at the end of the day. And it kept up my supply for when I was no longer nighttime feeding, and for when they started drinking less at the beginning of solid foods, and when the boy started to wean at 7 months, and then I started to wean the girl six weeks later [logistically, I was struggling with a bottle-fed child and a breastfed child. And I was starting to need to get out of the house more.]

Oh yeah, then there's engorgement at the beginning. And end. Another post for another day...

And formula. Again, if I had a little sister and she was having twins, I would get her that super strong breast pump that I mentioned, and then I would get her some premixed formula bottles. Tell her, in emergency, break glass! You're going to be pumping and your going to need formula in the house, even if it's just to supplement, or for a sitter, or for a few times a day. Or, in our case, every day, at bedtime.

You're having twins. Don't be a hero. Believe in yourself. You can do it. We all know the benefits of breastfeeding for both mama and child. But we also know the benefits of a happy, sane, mama. And you need to use ALL the tools at your disposal. I told myself during my pregnancy:
Six days - is my absolute minimum. I have to try.
Six weeks - is my goal. I have to try.
Six months - is my fantasy. I have to try. 
And I made it. To 8 1/2 months! And it's one of my greatest sources of pride. But it was not without the support of my husband, family (my mom especially of course), books, friends, twin mommies, and armaments in my arsenal.

Feel free to email me at twynmawrmom [at] gmail [dot] com or post a question in the comments here! There are more resources than you know, including your friendly twyn mommy blogger ;).

And you? Anything you learned about breastfeeding 
[perhaps twins] that you must share?

 

6 comments:

  1. Obviously I didn't have twins, but I had low supply and a kid with food allergies, so I spent a lot of time attached to the pump. Half the time I would feed him on one side and then put him on the other and pump the "empty" side. I'd usually get an ounce or two. Those little bits added up and kept me going until he was 21 months and primarily on soy milk.

    Thankfully, the next kid was a 5 minute nurser and I wasn't working by then, so he was much easier.

    Great job making it as long as you did!

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  2. That pump was my best friend. It came with me everywhere: baseball games, the car, airplanes, trains...and no, i dont miss it!

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  3. I am breastfeeding my twins and it is so painful. Everyone tells me it will get better as they get bigger. It has been two months since they were born but should I be looking at when they were born or from their due date? If from their due date, they are barely two weeks old. Iam frustrated and in pain from poor latching. Ready to give up!

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    Replies
    1. The only thing I can say is: don't give up iF YOU CAN. I know it's painful - it's totally painful! I feel like, with my daughter's latch, I developed a little callous that helped; and used a lot of 'lanisoh" oil that helped with the pain. As they get bigger and their mouths are bigger and they have developed stronger muscles, it will be easier. Have you tried a strong pump? If the pain is the same, then you know it's just breastfeeding. If you find the pump infinitely more comfortable, then the latch may need some adjusting, and you might want to consult a local lactation consultant, call your pediatrician, or local la leche group. If you can make it another month it will make a huge difference in comfort level/babies' health. Hang in there!

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  4. Thank you for sharing your experience. My twin girls were born at 34 wks & are now 11 wks old (5wks adjusted). My NICU breastfeeding & pumping experience was very similar and it was really comforting to read another mothers story. One of my girls has caught on & has to been able to latch for a few full feeds, while the other one is so close! The last 2 weeks of trying to nurse then from the breast have been full of ups and downs, tears of joy when it's gone good and tears of sadness when I've been on the verge of giving up. What your article did for me today was help me understand that "breastfeeding" doesn't have to mean every feed, every day - today one baby nursed for one feed and the rest of the day was bottles of expressed breast milk. And when I put them to bed each night all that really matters is that they are cared for and fed with love - no matter where it comes from. Thank you for helping me today, I needed it!

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    Replies
    1. I'm so proud of you! As long as you can try and give them some breastmilk everyday, I think you are on track. I also think that a combo of feeding methods & sources makes for versatile children!! Good luck, glad I could help.

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