Breastfeeding

Breastfeeding. I know how I felt about breastfeeding my twins: it was what we were going to do. Hopefully. I told myself that I would give my best to breastfeeding and, if it didn't pan out, that was fine. And here we are, the boys are 14-months and I haven't breastfed them or given them breastmilk since they were 2- or 3-months old. What happened?

Home from the hospital

The boys were born at 35-weeks, premature, but not too premature. However, neither of them had a very good sucking reflex. C did much better. It only took a little "reminding" each time I fed him of what he was supposed to do. O had no clue. I had to spend a significant amount of time with him every time I fed him to get him to suck. I had a lot of pressure in the hospital to supplement. This being my second successful pregnancy and delivery, my milk poured in much faster than it had with my first son (who was breastfed, but that is a different story). I felt that I wanted to only feed them my breastmilk, but every time they were taken to the special care nursery, they were given formula. It maddened me. As much as I argued, all the doctors and nurses-- from the special care nursery and our regular pediatricians-- told me they needed to be supplemented. When they were in my room with me, they were fed bottles of breastmilk and were breastfed. They were only supplemented our first day in the hospital before I put my foot down and said, "No." Regardless of what they told us-- our twins were born weighing 6 lbs 6 oz and 6 lbs 5 oz-- I insisted that they only received breastmilk, pumped or from the source. Let me tell you, there was much resistance from the hospital staff.

Even when I fed O a bottle, he would sit with his mouth open and let the milk drip into his mouth. He either had no clue what he needed to do or felt that the bottle nipple dripping system worked just fine. He would breastfeed when the milk was forced into his mouth. Otherwise, he would just sit on the breast, eventually tired of the open mouth position and cry until we moved him. In the hospital, O spent the first day at the special care nursery having his breathing monitored. I would walk down the hall (why the nurses felt I could "wait" to see my child, I have no clue) and feed him in there; then I would walk back to my room where my husband sat with C and feed him. I pumped. I talked to the lactation consultants. I fed again. The second and third days in the hospital, the boys rotated between our room and the special care nursery, especially O. Their temperatures kept dropping and so they would be taken back to be in the warmers. I pumped a lot then. I breastfed them when they were in my room. They failed the car seat test once. The fourth day we were in the hospital, we were admitted to the peds ward so I could stay the night with them. Their body temperatures kept dropping, though everything else was looking good. They were re-tested for the car seat test and passed. Their biliruben levels were borderline. Their pediatrician was an advocate for letting them go home, though many people wanted to admit them to the special care nursery. In the end, we were allowed to bring home our beautiful boys on the condition of bringing them into our pediatrician for regular biliruben tests and weight checks.

I was glad to leave the hospital. I did not enjoy the nurses who were not supportive of breastfeeding or the nurse who kept trying to put O in the special care nursery when other doctors-- even doctors from the special care nursery-- were encouraging skin to skin to help maintain body temperature. I did enjoy having a lactation consultant on-call, who would come to my room and help with the feeding when I needed her to. There were several lactation consultants who were exceedingly helpful. Some spent more time preaching about the benefits of breastfeeding instead of actually helping feed; I didn't like them as much. Going home was scary because it was just me, two babies, and a hospital grade pump. What now?

The first three weeks the babies were born I had help. My grandmother stayed the week after the babies were born and took care of my oldest, D. She took care of all his needs and I basically gave him good-night kisses. My mother was also there that week (two helpers!) and she took care of me; recovering from childbirth is a task unto itself. She brought the babies to me, changed, for middle of the night feedings. She made our meals, did my laundry, and nursed me back to health. She kept the babies on their feeding schedule--every 3 hours-- and got me into a routine. The second week, my grandmother left and it was just me and my mom. She helped situate babies for feedings, but I wanted to do everything that I could, knowing she would be gone the following week. We spent a lot of time at the lactation consultant, trying to figure out our feeding issues. The third week my dad came to town to help, switching out with my mom. When he was there, I tried to do everything myself, mostly having him hold or change babies while I got things done. He was my "safety net." After those three weeks, we were on our own. My husband was in summer school, taking 16 units, and I had a two and a half year old and newborn twins with breastfeeding issues.

I pumped a lot. I tried all sorts of things, but the root of the matter was the sucking reflex. My lactation consultant gave me all sorts of things to try, including nipple shields, which only temporarily helped. I started feeling stressed. I diligently worked at this for two weeks after they left, going to appointments, pumping. I felt we had to supplement at this point because, though my milk supply had been adequate, I was having issues keeping my milk supply up with pumping and no nursing. By this time, both babies were having major breastfeeding issues. O still had a hard time with his sucking reflex. C screamed at the breast, absolutely working himself up while I tried to feed him. I kept chugging along. I cried along with them. I was having a lot of pain pumping. I pumped at night for awhile. As my supply diminished, my heart-broke and I had a hard time rousing myself for the night pumpings. Around week 7, I was pumping for four hours a day; pumping alone took four hours a day. It took an hour to feed them-- with help-- and I still needed to wash pump parts, wash bottles, prepare bottles, work on nursing with them, burp, change, and get them to sleep. As you can imagine, I spent the majority of my time caring for them while trying to care for an almost-three-year old. I felt like I was in over my head and cried a lot. I cried bottle feeding, breast feeding, after laying them down. I could barely attempt to breastfeed C because, when he cried on the breast, I felt so incredibly heart-broken, almost rejected.

Around this time, 8 weeks after their birth, O stopped drinking breastmilk. I had been mixing breastmilk and formula for their supplemented bottles. O refused every bottle with breastmilk in it. He would not take it out of a bottle at all. He would not attempt to nurse. I had a weekly appointment with lactation consultant at this point, along with all their other appointments. There were bi-weekly weight checks until 4-weeks, weekly weight checks until 8-weeks, along with their regular pediatric appointments and biliruben tests. There was so much going on. I had these two newborns that needed care and love and a big brother that wanted momma time. Meanwhile, I spent much of the time at home crying over breastfeeding, which diminished my supply even more. The lactation consultant was such a sweet gal and very helpful and supportive. She had great advice and a lot of encouragement, but I slowly started to realize that my boys need mom. They needed someone that was present and had a grip on things. I started cutting back on the time spent pumping. I avoided the freezer, once neatly stocked with bags and bags of breastmilk. I put on my brave face, chin up, and new this was the best choice for me.

When two or three days had passed without using my breastpump, I started contemplating bringing it back to the hospital. To me, that was such a final decision. Nothing said, I am no longer breastfeeding like returning my pump. I held onto it for another week. Around the 10th week the boys were home, I decided to bring it back. This was such a heart-wrenching trip. I opened everything up in the office, showing her I brought it all back. I paid for the rental. I left. I came back. I ended up crying and telling her the whole story, why I wasn't pumping anymore, why I wasn't breastfeeding... I passed that hallway for a different appointment several months later and teared up thinking about my feelings that day.

I never even used my last couple bags of breastmilk. I still gave C the pumped milk in his bottles, using up my small supply. When I was down to 3-4 bags, I stopped giving them to him, preferring to still see breastmilk in my fridge, a reminder that I tried. When we moved across town, I finally threw the bags away. That was another emotional experience, saying good-bye to the last of my pumped milk.

That is my breastfeeding story. Yes, we had problems breastfeeding. Much of it was emotional. Much of it was a lot for me to handle at one time. It was a raw time for me. I don't get asked so much now, but when they were in infant carriers, people would occasionally ask if I was breastfeeding. Even at the pediatrician when the nurse would ask what and how much we feed them, I would cringe at the off-handed comments people would say, "Well, I don't know why you would want to breastfeed twins! Omigosh, can you imagine?" Yes, I can imagine. Or why people would tell me that at least I'm not breastfeeding because now I have my "freedom" or that my babies don't "need me" because I'm not their "milk cow." As if the thought that my babies get their food from a can instead of my breasts should be a comfort.

There are benefits to bottle-feeding. Once you figure out a system to leaving the house with enough formula and bottle-feeding supplies, you can go almost anywhere, no need to worry about room or privacy to breastfeed. Theoretically, other people could bottle feed them. Our twins had laryngomalacia and needed to eat in an upright position. I felt very responsible for feeding them properly and preferred to do it myself, or have my husband do it. Other times, bottle-feeding was awful. They only drank warm bottles (thank a cold around month 4 for that development) and so, away from home, I needed to find warm, clean water for them. There were many road trips to my parents' house that I wished I could just breastfeed them-- perfect temperature milk instantly-- instead of struggling with two mad babies rejecting barely room temperature bottles. I did do the Thermos system to have warm water with me, but even that can run dry when a trip away from home takes longer than expected.

The hardest thing for me to swallow over this whole breastfeeding experience have been the comments I receive from other moms. Online forums are awful places for moms struggling with breastfeeding. Moms throwing around facts as to why breastfeeding is the best and only option, claiming most moms just quit at the beginning. I don't care why you end up choosing to bottle-feed, the decision is never easy. Most moms want to breastfeed. Most moms know how good breastmilk is for their baby and want to give that to them. Why would a mom say, "Hey, I understand that this is baby's perfect food, but I prefer the high cost of formula over something that I can do for free"? It makes no sense to me. Our babies ended up on Alimentum. It was $27.49 for a 16-oz container. Do the math: two babies drinking 8 oz each a day adds up to 16 oz per day of formula, meaning they went through one 16-oz can of Alimentum a day; $27.49 every day of the week adds up to $192.43 a week on formula. Our pediatrician was extremely generous and gave us samples to last us a month (sometimes more) every time we went. A local twin mom, who switched her twins to soy, gave us their three-month supply of Alimentum (I don't know where or how she got the three-month supply nor do I know why she gave it to us for free. I am, however, grateful). With some savvy couponing, I was able to go many months without paying for formula. Buying that nearly $30 can to last a day always pained me.

I've had many personal conversations with other moms about their breastfeeding experience, the struggles they had and why they switched to bottle-feeding or how they pushed through and were able to breastfeed. Every mom is different. Every mom needs to make a good decision based on the demands of their own lives. We need to be supportive and encouraging to other moms. We all need to learn which battles we are going to pick in our own lives. We need to live and let live, especially when we are making grounded decisions for our own families. Even the containers of formula tell me that breastfeeding is the better choice. It made me feel like that bottle-feeding is only okay if you do it with a sense of guilt or shame. "You failed. You couldn't do it. You didn't stick to it." With all of the other pressures of parenting, the last thing I needed was something else to feel guilty about.

A friend of mine recently posted on her Facebook page that she made it an entire year breastfeeding her 30-weeker twins, no small feat. Things like this are joyous and should be celebrated. I am proud of her for accomplishing this. I know breastfeeding had many challenges for her along the way. I know breastfeeding was very challenging for me. She was a friend of mine that I called and cried to as I dealt with my nursing issues. Her support meant a lot to me. There doesn't need to be lines in the sand of "moms who breastfed" and "moms who didn't." We can all lift each other up, as her and I have done for each other.

Whatever decision you come to, for whatever reason, is okay. Do your best. Your best is exactly what your children need.

How to tandem bottle-feed twins with one Boppy pillow

Before you begin, find a comfortable place to feed. A couch is a great place because you have a large area next to you to place the babies and usually an arm or table within reach to put your supplies. You should have both bottles, a burp cloth (or two), and whatever you need (drink, remotes, book, etc) within reach before you being the feeding process.

Start by putting one baby to the far side of the Boppy pillow. The other baby should be set within reach.

Place the second baby next to the first. Grab the bottles, which are within reach.

Begin feeding. Notice my burp cloths are right next to me.

This takes a little practice, but when one baby finishes before the other, scoop him up with one arm. I put the palm of my hand on the back of his head, his neck and back resting on the inside of my forearm, and lift the baby to my chest.

Switch arms, so the arm underneath the baby you are holding now holds the other baby's bottle. (Compare how I am holding the baby to the picture above.) With your other arm, burp the baby you are holding.

I usually sat holding the baby who finished first until the second baby finished eating. When they are small enough, you could place the first baby on the couch next to you, if you do not want to hold him for the rest of the feed, or back on the Boppy pillow.

Using the same one-armed scoop manuever, lift the second baby to your chest to burp.

This is how I held them to burp two babies at once. You can bounce the baby who's bottom sits on your hand and pat the back of the other baby, switching as needed.

When the feeding is over, you can get up by putting one baby back on the Boppy pillow, and either standing up holding one baby or (briefly) setting the other baby on the couch as you get up.

It takes a little practice, but you can do it!