Ask the Moms – Ask the Readers!

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Categories Ask the Moms, Breastfeeding, Formula, Infants

We’ve decided to turn the tables today and ask the readers to help out.  Not because we have a lack of things to say on this topic, but because we know there is no one solution that works for every mom, so we thought we’d throw it out there.

Reader and new mom “Momma Miriam” is struggling with breastfeeding.  Oh my, how we’ve all been there.  While some people are blessed with strong nursers and an abundant supply, many of us were not.  Breastfeeding, for many people, is not easy.  Breastfeeding twins is not only harder, but in my opinion, even more difficult if you don’t get off to a good start.  Some people are able to power through the difficulties and go on to breastfeed exclusively for a year or more.  Some pump, some do a breastmilk/formula combo, and some elect to stop breastfeeding for their own sanity.

We here at HDYDI believe there is no one right way to feed your babies. Breastfeeding is wonderful, and the benefits for mom and babies are numerous.  But that doesn’t mean it’s the only way to go, or the right thing for every family.  We do believe that, sometimes, stopping is the right thing to do.

I’m going to paste Momma Miriam’s question in its entirety after the jump, and invite people to leave their advice in the comments (that includes us HDYDI moms).  I know, this could potentially be stepping into a hornet’s nest, as breastfeeding (or not) can be a very heated and personal issue.  We want everyone’s opinions to be respected, and we reserve the right to delete comments that are hurtful or in any way disrespectful.  Disagreement is fine, insisting that your way is the only way is not.  I’m sure comments will be long, varied, and thorough.  Momma Miriam, and all other new moms, we hope it’s helpful.  To those who have already blogged on this subject, feel free to leave links to earlier entries.  You can also see the HDYDI archive on previous breastfeeding-related entries.

I am hoping that the collective mother of twins wisdom on this site will help me decide if I should persist with trying to exclusively (or mostly) breastfeed my twin boys or accept that I can’t and look for other options. I don’t want to face the heartbreak of giving up something so important to me without seeing if there is anything else I could be doing differently. But I don’t want to keep believing I will be able to do something that may not be possible and is hard on my family and my babies.

I am in my 10th week of trying to exclusively breastfeed my preemie twin boys, and I am wondering if I will ever be able to make enough milk for them. My babies were born at 5 lbs each at 34.5 weeks and spent 7 days in the NICU getting tube fed and bottles (with some breastmilk that I pumped in the hospital.) After working with a local LC, one baby has been bare breastfeeding (without nipple shields) for about 6 weeks and one for 3 weeks, but they are just getting stronger at nursing now.

I have been breastfeeding (initially with nipple shields for only a few minutes at a time), supplementing with bottles, and pumping after almost every feeding since we all got home from the hospital. But with bottle supplements (a mix of formula and breastmilk) and help from family visitors, it has been a challenge to even get 8 feedings in a day. Even now with 8 semi-scheduled feedings a day, we sometimes go longer than 3 hours more than once at night and sometimes during the day.

Over the past two weeks, I tried to reduce the bottle supplements during the day with the advice of a local LC, and the babies cried more and needed more soothing. But I thought it was just a matter of time before their nursing demand would bring in more milk. However, when I went to the pediatrician last week, she said they were “falling off the growth chart,” and I needed to supplement them more not less. They were close to 8 lbs at 10 weeks. The baby who had been nursing longer had grown 9 oz in two weeks and the other had only grown 5 oz.

I am now breastfeeding them 8 times a day and supplementing with 60 ml bottles afterwards 6 times a day. The LC has recommended skipping bottles twice a day, bringing more fussing, which I can hardly imagine continuing much longer. I am afraid that this much supplementation (still a mix of breast milk and formula) will make it even harder for me to exclusively or even mostly breastfeed them.

I have worked really hard to get the babies to nurse, but I have only had them on only breastmilk for a week here an there. But the LC and pediatrician have said that having babies who were bigger and stronger would help bring in more milk. I have pumped 6-8 times a day with a Symphony pump, but that has not brought in enough milk for two babies without the help of strong nursers. I am taking 10 ml domperidone 4x a day and herbal teas, which haven’t made a dramatic difference in supply so far.

I want to have realistic expectations about breastfeeding my babies, but I also don’t want to give up too soon. Does anyone know if you can still develop a full supply this late in the game? If so, what could I do differently while still feeding my babies enough?

Thanks for any shared advice or experience,

Momma Miriam

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23 thoughts on “Ask the Moms – Ask the Readers!”

  1. Hey Miriam. I hope this format works for you.

    If you really want to up your supply, then my suspicion is that you need to ditch the 3-hour schedule for a little while (maybe a week or 2?). The only way your body will know to make enough milk is if you tell it you need more. If your boys aren’t strong nursers, then try more frequent sessions so they get frequent smaller “meals.” And while I almost never advocate waking a sleeping baby, maybe you want to keep nursing every 1.5-2 hours round-the-clock to trigger your body to make more milk, and help the babies get better at it. If you want to take a break and give them a bottle of (high-cal?) formula once in a while, then definitely pump during those times. If you’re having supply issues, you should supplement LESS and nurse MORE. Just sit and nurse all darn day, no kidding. It won’t always be that way, but that’s how you tell your body to boost production.

    That said, I stopped breastfeeding when my kids were 8 weeks old. I got similar advice (nurse all the time! when you’re not nursing, pump all the time!), but by the time I heard it, I thought it was madness. I was so tied to my 3-hour schedule, that I felt like it was the only thing keeping me sane. So, for my sanity, I went to 100% formula at 8 weeks. And you know what? It was fine. My kids were (and are!) happy and healthy, other people could help feed them. And possibly most important of all: I was happier. Yes, I was bummed that BFing didn’t work out the way I planned. But by 8 weeks, I was so unhappy and struggling so much, that I felt like I was going to lose my mind. Deciding to stop allowed me to relax and be happier, which made me a better mom. Don’t let anyone tell you that doing something for your own sanity is “selfish.” You have to take care of yourself, if for no other reason than, if you don’t, there will be nothing left to give your kids.

    It’s such an emotional issue. I stopped breastfeeding nearly 10 months ago, and it still sometimes creeps up on me. But it was the right decision at the time. And I did write up all of my “woulda, coulda, shouldas” a little while ago, if that’s of any help.

    Good luck to you.

  2. Hey–

    I think that breastfeeding is so wonderful if it works, and so, so stressful if it doesn’t work so well. I really believe that you need to do what is best for you and your family, and if sticking with BFing is it, then go for it. If it’s too stressful, then weaning off the pump may be the solution for you. That said, here is my 2 cents.

    My babies were 36 weekers and always gained weight well, so I haven’t had to do the supplementing that you have. I do have to say that they got MUCH better at nursing, so some of this may be simply a matter of time.

    A couple pieces of advice I have heard from an LC:

    1) Nurse frequently. Nurse often. Throw out that 3 hour schedule from the NICU. Aim for 10-12 times a day for a while instead of 8. BF babies often eat smaller amounts, but more frequently. You can watch a baby as he/she is sleeping and when the baby starts to stir, offer the baby the breast. The more often the breast is stimulated (hmm, sounds dirty, huh?) by baby or pump, the more your body will be sent the signals to make more milk. Every time that baby fusses, try offering the breast again. (I know, moo…but it gets better, I promise!).

    2) Pump more often. Ick, I know. But, if the babies aren’t eating more often, maybe you can pump one extra time in the morning (more milk then?).

    3) Get the weight gain monitored. You are able to request a weight check every couple of days from your pedi, or from an LC. This might help everyone feel better about the slow weight gain. You can also go in and weigh the baby before and after feeding the baby at the LC’s to see how many ounces baby is actually getting.

    4) Get a DVR set up and some good books. Seriously, this first period of BFing means you are sitting on the couch FOREVER. Watch some good tv. Read a nice book. Get comfy. Hmm, maybe a Netflix subscription? Or, learn to feed the babies while lying down on your side—I spent some nice evenings on the bed, watching tv with the fan going overhead. Scrubs was on at 7pm every night. Not my favorite, but I watched a lot of it for a while. Whatever can make that time spent more relaxing is great. Because, at first, it is a lot of time.

    I wish I had a magic answer for you. I think that the real question is trying to figure out what is right for you. Is it worth it to keep pushing through (it certainly was for me). Or, is it too stressful, during a really stressful time. It’s up to you. Maybe setting a goal of another 2 weeks, or 3 weeks would be helpful? You can always go past your goal if things are going well by then, but it gives you an endpoint if you need that to look forward to.

    Also, I recommend reading this post, which Goddess didn’t link you to (sorry, Goddess, but I think this is a great one) which does a nice job talking about the decision to stop breastfeeding, what she would do differently and what it was like to stop.

    Good luck—Rebecca (mom to Danny & Abigail, 15 months–breastfed until 12 & 13 months)

  3. Dear Miriam, oh my thoughts are with you! Supply issues are on my mind most days. I’ve tried herbs with no effect, and was worried enough to write into HDYDI just a couple weeks ago!

    From all my internet and soul searching, here’s what I can share:

    1) Whatever you do in the short term, your milk supply can still get established. Your twins are young. I think I read something about maximum supply being set in the first six months. Can’t say for sure when it is, but you have plenty of time.

    2) Pump even when you feel like there’s no milk in there, I do and am often surprised. Well, I’m surprised by both more and less than I expect sometimes, but it’s always worth doing.

    3) It may well be that for you a schedule is more important for everyones’ health and happiness than breastfeeding. I hate to say that, and wouldn’t if I hadn’t lived it too. You need to stay sane. If you can go to a 2 hour feeding schedule with some night feedings or pumping to get your supply, that may be what you need. But that’s asking an awful lot, at a time when you need all the energy you can get. What I’ve done is spend weekends on my couch, pillow round me, twins hooked up. We can hang there, watching tv, reading and napping for hours. It’s pretty nice. But not a magic bullet, come Monday my supply’s still not what I’d like. It rarely is.

    4) For your calculations, I produce somewhere between 1-2 oz per breast / per hour. 2 or even a little more in the morning, one or a little less in the evening. If it were closer to 2 more of the day I wouldn’t have a reason to worry. I’ve resisted the temptation to get a scale and weigh the babies before and after feeding to see what they’re eating. Life’s too short. But there have been times when I’ve wondered, and times where it would make sense to know.

    5) Someone told me that trying to empty a breast is like drinking through a straw out of a glass someone’s constantly pouring into. You’ll never do it. But the flow is faster the emptier the breast is.

    Most of all, we’re with you! Any amount of BM is a good thing to give your twins, and you’ve already done a great job. Don’t let supply issues weigh on you. Remember, you’re in the survival time, whatever you need to do to get by. It will pass and being a MOM will only get better!

    Best wishes!

  4. My story on “failure” at breastfeeding is in the linked posts that Goddess put in. A few things I did want to add that were not in my post. I know with the extreme sleep deprivation, it is hard to see the forest for the trees some days. Talking to experienced twin moms helped me a lot through my breastfeeding difficulties.

    1. What is more important to you – exclusively breastfeeding or getting as much breastmilk into them as possible? The reason I ask is because you can try different strategies depending on what’s more important.

    If you really want them exclusively breastfeeding, it may be best to nurse on demand rather than a schedule. Remember, even though they are 10 weeks old, they are 4 weeks adjusted. That is very early for a non-supplemented baby to be on a rigid 3 hour schedule.

    If you feel like you want as much bm into them as possible, it may be best to stick to your schedule and breastfeed, then pump while someone else bottle feeds. You don’t need to be involved in bottle feeding… we have plenty of tips for bottle feeding two babies with one person. This can be done even with tiny babies.

    2. It sounds like the one thing both your LC and ped agree with is that bigger babies will help build your supply. It is perfectly ok to supplement full bottles until the babies can grow enough to help build your supply.

    This is just a suggestion but you could entirely drop one breastfeeding session and pump instead… supplementing that dropped feeding with pumped milk or formula only. This may give you a daily break to reflect on things.

    The thing I wish someone had told me through my stuggles was that not every single feeding session HAD to be at the breast. That it was perfectly ok to give a bottle, pump instead, and get a break. And you can even talk to your ped about giving them higher calorie formula during those feeds. Yes, baby at breast is best for building supply BUT BUT BUT you need a rested, happy mama for successful breastfeeding. This may be one simple way to get a rest and to step away from the situation. I called my friends while pumping to get a break from the insanity and worry of feeding issues.

    3. Yes it is possible to build your supply later. I have a babycenter friend who struggled for the first 2-3 months with her preemie twins (also 34 weekers) so she got as much breastmilk into them as possible, understanding they were not going to EBF at that time. But over time, as her kids grew, she eventually EBF them. It can happen. If that’s what you want, you can build to it as your goal.

    4. Lastly, we took it one day at a time. I sat down with my husband we came up with a game plan for that day. He helped me commit to that plan. The next day, we would talk about a plan again. Sometimes we would get so caught up in thinking about the next few weeks or months that we weren’t make the right decision that day.

    Good luck. I do hope you come back and let us know how it goes.

  5. Some very good advice here, and I just wanted to add my support. I had my twins at 37 1/2 weeks and after some initial challenges, they were champion nursers. I breastfed them exclusively for a year, and never pumped. Here’s what worked for me:

    1) Park your butt and focus on the babies. I watched a lot of Oprah and Hogan’s Heroes and whatever else was on ALL DAY. My husband would leave in the morning and I’d be in my nursing chair, and he’d come home at night and I’d still be there. My cycle for nursing was much closer to 2 hours than 3. In between we all dozed off. Nothing much else got done for a while there.

    2) I alternated who nursed first and which breast. I had such mommy brain I had to write it down. My son had a better suck, so I think he stimulated production better. This way I alternated who got the first letdown and who got the second letdown. Since I had had a singleton before, I was always much more comfortable nursing one at time. Maybe if you are nursing both at once, try nursing one at a time to stimulate that second letdown.

    3) When they were very tiny, I’d feed them in the middle of the night when they woke up, but I did not wake babies at night. Mine steadily gained weight, and I think all 3 of our bodies adjusted fine. I was nearly bursting in the morning though.

    4) I’m sure you know this, but liquids and protein-rich foods seem to help. I drank a fair amount of milk myself and indulged in peanut butter. This is not the time for a low-fat diet. Babies need milkfat. Forget about losing pregnancy weight for a while.

    5) I also think my production was best when I was really well rested. Seems impossible with newborns, but I think the best advice someone gave me was to sleep when the babies sleep. I became a champion napper. I slept a LOT during the day.

    It sounds like I was a lazy bum, but really, this was just a period in my life where I really focused on this one task, and it paid off beautifully. It didn’t take long for the babies to grow and need less frequent feedings. I loved being able to take them anywhere and being able to feed them by just pulling my shirt up.

    Best book for me was called “Bestfeeding”
    Back when I was in music school, my teacher told me “this is the one point in your life where you can and should practice 7 hours a day.” It was shocking to hear, but true, and the same is true for initial breastfeeding. This is the one time in your life to give it the best shot you can. Forget vacuuming and running around. This period will be over soon.

    Good luck!

  6. Have your babies been checked to make certain that they don’t have short frenulums?

    This is the connector between the bottom of their mouths and their tongue and, if it is short, it can stop them from being able to nurse the nipple properly.

    This was an issue for my boys and several other babies I know, but it wasn’t diagnosed immediately. It appeared that my boys were nursing and ‘just not getting enough’ so I was supplementing with pumped bottles. But the reality was that they were trying to nurse and just not being able to manipulate the nipple properly.

    They had gone from a very respectable birth weight to falling off the charts. I used a nipple shield after they were first diagnosed, which helped by forcing their tongues down, but wasn’t 100% effective or pleasant for any of us.

    Once we had them snipped by a pediatric ENT (a short, painless procedure), their issues IMMEDIATELY corrected themselves and we could stop the bottles within a couple of days.

    I know other babies with feeding problems who had short frenulums that weren’t diagnosed until they were much older and with mine the pediatrician said nothing about it until I happened to ask because someone had mentioned the possibility to me.

    So, if you haven’t had them checked – it might be worthwhile.

  7. Wow – this brings back memories! I was *never* able to produce enough for my twins. We did the whole nurse and then supplement the entire time I nursed them. I stopped nursing them around 6 months, and they went fully on formula at that point.

    I was told that it doesn’t matter how MUCH breast milk they get as long as they’re getting SOME for the first 6 months it would help with the immunities and things like that.

    It sounds like you’ve been working really hard. You should be proud of what you’ve accomplished so far and figure out what’s best for ALL of you. This include you too! If you’re too tired and frustrated, I believe that this impacts the milk supply. (ya right, who the heck ISN’T tired at this point 😉 )

    I don’t have any great advice, but I wanted to let you know that I’m thinking of you! Let us know how it goes. :)

  8. Lots of wonderful advice here! I had my girls at 37 weeks and they are now 91/2 months. I’d first like to commend you on your efforts :) Nursing twins is hard when it goes perfectly so to have complications…well let’s just say you’re awesome! I agree with the feeding more often. My girls have always been small and at almost 10 months we have just moved into a 3-4 hour break in between nursing. When they were the size of your boys I fed them about every hour and half sometimes two. In most cases your body adjusts up or down to what your babies needs are. If you keep at your supply will increase when they nurse more. Do you feed them at the same time? That may help increase your supply. Another thing that will make a huge difference is to step back and relax. Pumping is by no means an accurate measurement of your supply. Even when you’re completely relaxed you still won’t pump as much as a baby could get from you. So add stress and anxiety into the mix and pumping is not going to produce much. You can also try offering the same breast to each baby every feeding to make sure they are emptying it. It’s hard…little tummies don’t hold much and breast milk goes pretty fast. Oh and some may disagree with this but I co-slept with my girls until they were 6 months old. I would prop myself up in bed with pillows buckle on the twin size nursing pillow and then tuck extra pillows where ever needed and I would lean back put an arm around each one and and let them nurse all night. Back then people would say oh I bet the nights are so hard but when we were co-sleeping it was the easiest part of my day. And the fussing, do they fuss after formula? Do they spit up a lot? Maybe reflux? Hope this helps. Good luck with everything!

  9. I was one of the lucky ones Goddess mentioned. They seemed to “get” it and I had a good supply. My boys were born at 34 weeks and got onto that 3 hour schedule while in the NICU and they stayed on it. That being said, I think there are a few things that contributed to my luck.
    First, you mention nipple shields. I must say that I think these helped tremendously. I know I was only supposed to use them for a little while in the beginning, but I used them for a good 12 weeks until the boys signaled to ME that they were done with them. It made things so much easier for their little mouths and, in turn, their suck so much stronger. I truly think they were the secret to our success.
    Second, I agree with others that hunkering down with the babies in my comfy seat and making nursing my “job” for a while contributed to my early success. I had the DVR set, a stash of books, my cell phone and a HUGE bottle of water. I found that the more I was relaxed, the better my let-down was. If I was tense or stressed, things did not go as well.
    Third, I pumped after every other nursing session. I found it to be too overwhelming to do it after every single one, but the LC suggested if I did it after every other, I’d build a good enough reserve supply.
    Fourth, set your expectations reasonably. There are two babies (I’m not sure if you mentioned if you have an older child as well?) and that alone brings additional exhaustion and coordination issues! Your mental and physical health have to be maintained in order to care for them. Sometimes exclusively pumping may be the answer, sometimes formula may be. Think about what you really want and do what is best for you.
    Best of luck!!!

  10. I was devastated when I realized I could not breastfeed. I tried with all my might for six weeks, supplementing along the way. Even if I had been able to produce, it was still way too stressful for me, as a new mother. I cried so much in those first three weeks. I felt like such a failure. And then it dawned on me: I wasn’t breastfed; my husband wasn’t breastfed; neither was my mother, or any of my friends or family members. And, they are all just wonderful and healthy.

    The day I decided to do what was best for my daughters and just give formula was the brightest, most amazing day of my first days as a mother. I saw the sun again. I was able to look at my girls and smile.

    Do not get me wrong, I’m sure the studies all mean well but they are just studies. There are other studies that don’t see the light of day. I have a friend breastfeeding around the clock and her new baby still got sick.

    In my honest opinion, breast is not best when mom is stressed out.

    Forget what society has told you and just do what feels right in your heart. Only you really know that.

  11. First of all…GO YOU! This is the HARDEST thing ever and you are doing it and working to get the answers you need. Whatever happens in the end, know you are doing your very best to get there and you deserve so much credit for that! I have 5 month old twin girls born at thirty-eight weeks. The advice I got and what I did to get through is very close to what Rebecca said. I was put on an every two hours schedule because my two were gaining very slowly and we stayed on it with very slow gain for a very long time (they were barely 8lbs at 3 months and were below the chart which is most likely designed for formula babies anyway) with just a few oz formula. A well trained and supportive LC is key! For me there came a time I knew I had done all I could do but I had to try everything and more first. I am still breastfeeding though just not solely breastfeeding. We call it the appetizer in our house. I watched LOTS of Netflix and nursed ALL the time and checked their weights at my LC’s house weekly. My pediatrician weighed them every other week and as long as their heads grew steadily and they gained some she did not force the issue though she wanted them supplemented with formula. Eventually at about 4 months after weeks of fussiness we figured out they grew to prefer the faster bottle. Be careful to choose a very slow flow bottle (you can flip a bottle over and see how fast liquid comes out. I found bottles later that were slower even though they were all level 1- too late to help). I opted not to pump trying to build my supply further because they were getting old enough that I didn’t want to sacrifice interacting with them to pump all the time and frankly the 20 occasional minutes I got between nursing were important for my sanity! While I still regularly grumble under my breath when I clean a bottle that I wish I was still solely breastfeeding, I think I can safely say I’m a better mom knowing they are now at a healthy weight and I don’t have to worry about the health of my breasts every time they latch on. That said, I don’t think I’d feel that way without knowing I tried everything first. And the earth didn’t fall off its axis when they got more formula than breastmilk. They are awesome kids. One thing is for sure- it WILL get easier! Get as much support as you can right now as ALL my best to you!

  12. Hi Miriam,

    I’m basically where you are right now with 7 week twins who were born 4 weeks early. My milk supply is very low and my babies are very unenthusiastic breast feeders. I’m doing breastfeeding then bottle feeding then pumping 8 times a day and it’s frustrating and exhausting. I saw several LCs a few weeks ago, one of whom told me to stop supplementing and force the babies to feed more aggressively with me. The next LC I saw, after she measured the babies before and after I breastfed them and realized they were getting 1/3 of an ounce of breast milk when I fed them said I couldn’t afford to stop supplementing and suggested that I make the breast feeding more about bonding and cut down on the pumping. I’m following 2nd LC’s suggestion. I just couldn’t handle the idea that I was depriving them of nutrition even if it was for a good cause in the end. I’m also on domperidon but at about twice the dossage you’re on so see if you can up your dosage and if that has an affect.

    I have to say that in all the advice I’ve received what I really, really wanted to hear was that it was okay to stop breast feeding and that I wasn’t a horrible failure if I did stop. So just so you can hear it (and I have heard it and I’m still breast feeding!) …

    If you want to stop breast feeding, if you want permission to stop breast feeding, you have my blessing! Stop, stop today if you want. (How does it feel to hear that? a relief or upsetting? And if you do stop I think you’ll still be a wonderful Mom working to nourish her babies in the best way possible!

    So know that there are other mom’s going through exactly what you’re going through now and any decision you make will be exactly the right one.


  13. Those first 3 months of nursing my twins were definitely the hardest months of my life! We went through a lot of the issues you survived, and I also pumped after every feeding. My supply seemed to catch up to the babes more quickly than you’re describing is your experience, but I know everyone is different. Just a couple of things to think about… are you nursing together or separately? My LC said it’s more stimulating to nurse together. She also suggested that when nursing 1, I pump on the other side, though I found that challenging and not at all relaxing.

    Do you have a good twin nursing pillow? I loved mine, both for tandem nursing (which I found challenging for a while) and for nrusing one, while using the other as a surface. I wrote thank you cards, holiday cards, ate, read books, etc. on that other side.

    If they are getting fussy between feedings, perhaps try nursing them on demand every time they fuss for it? You then obviously wouldn’t be able to pump each time, but you could see how it goes.

    My son became an effective nurser earlier than my daughter. My daughter would mostly nurse, then need bottles afterward for many weeks. When she got better at nursing, I discovered that she did well during the day, but not at night — if she nursed without back up bottles at night she would be fussing within an hour. So until she got better, during the night she would just get bottles and I would pump for her. I share this to say that not only every mom, but every child, even within a family, is different, so you may want to think about individual needs.

    Eventually I was lucky enough to get EBF going, but I know that’s not true for everyone. Whatever you do, you have tried really hard to get this to work and you should feel proud of all you have done, and comfortable with your decision.

    Here is a post I wrote about my first year of BF them (BTW, I’m still nursing at 22 months, though obviously, less frequently):

    Good luck, and you must update us on how things go.

  14. I have twin girls who are seven months old. They were born one day shy of 34 weeks and spent some time in the NICU (2 and 3 weeks). I began with a combination of nursing and pumping and am not nursing exclusively. I stopped pumping when they were around 6 weeks old.

    I have the advantage (???) of having an older daughter (20 months when the twins were born) who nursed successfully for a year. So I had some idea what to expect…at least in the feeding area.

    I agree with what has been said: feed more often! Also my LC told me the best time to pump was between 2 -6 am. I would try to get one pumping session in during those hours every night. (Painful, I know!)

    With that said, I wouldn’t be married to the idea of nursing exclusively. For some people, it is just too much trouble. If it is causing you more angst than pleasure, then maybe it’s not worth it?

    I hope you find something that works for you. Good luck!

  15. Miriam,

    Congrats on your twins. If any of my suggestions are a repeat, please forgive but I am trying to clean during nap so I don’t have time to read all of the above responses:). My girls were 6 weeks early and one stayed in the hospital for seven weeks (the other for 9 days). I totally credit my ability to breastfeed them for the first year to my incredible pediatrician who has her “black belt” in breastfeeding. My first one to come home had weight gain problems too because she was too small and sleepy to nurse enough. Here is what we did:

    She would nurse for twenty minutes on one breast. Then I would feed her pre-pumped breast milk from the bottle. Then after bottle-feeding her I would pump. I saved one breast for the baby still in the hospital and saved the remainder of the breast she had nursed from for her next feeding. After doing this, in one week, she had gained 21 oz. This gave her a chance to learn to nurse, and gave my breasts all of the stimulation to produce. I also would suggest a hospital grade pump. I think that made the most milk in the quickest time. If you do choose to keep breastfeeding, you probably will only need for a couple of months. I rented mine for like 60 bucks a month…so not too bad.
    Do you have an E-Z 2 Nurse pillow? This enables you to nurse them at the same time (football style). It give you ability to get them latched one and they are safe while you mess with the other one. Plus it is huge so it makes you sit on the sofa and just relax. Watch TV, movies, anything. Just don’t worry about anything else. Eat lots of food and drink lots of water. Good luck and know that your kids will be great, healthy, smart and fine no matter how the breastfeeding turns out. Let us all know how it turns out!

  16. Miriam,

    Your story is so similar to mine it makes me want to cry. I am sitting at my computer this very moment, pumping for my 4mth old identical boys. I have been pumping since the day they were born on March 1st- 5 weeks early. They spent 30 days in the NICU and were not allowed to breastfeed for several weeks and then only 2 times a day. Then I had to cut out dairy and soy AND then Lochlan had to switch to formula (we went through 5 before landing on Nutramigen AA- nearly $200 a week!). I was told that he may be able to try breastmilk again at 9 (NINE!!!) months and I wanted to give up soooo bad! However his brother, Thatcher could handle the bm. I pumped every 2 hours at first and then every 3 hours and then when I went back to work 3 weeks ago I switched to 5x a day.
    My supply tripled at about 8 weeks and I now pump enough to freeze half AND donate to a milk bank. I have sent away ~400 ounces for other NICU babies AND I’ve nearly filled my second deep freezer. I am hoping to stop around 6 months because the pumping is exhausting BUT I’m hopeful that I can give Thatcher bm for a year and try Lochlan again…so maybe I’ll be pumping until 8 or 9 months.
    Does that help? If you want to email or call me, I’d be happy to talk more…whatever you decide will be the right thing!

  17. Hang in there; this really is a TOUGH spot to be in. No matter what, feel good …no, GREAT…about what you have done to get breastmilk into your babies so far. The first few months are so hard in so many ways!

    The only thing I would add to the excellent advice above is to make sure that someone (LC or OT or Speech-Language Pathologist specializing in newborn feeding) has done an oral-motor evaluation on your babies to be sure they have the skills to transfer milk. One of my twins just truly didn’t have the muscle tone and coordination in his tongue/lips/cheeks to put it all together. He got SO MAD every time I put him to my breast. Even with a nipple shield, he didn’t transfer a drop. My daughter did a little better.

    Ultimately, for my sanity and ability to care for them, we decided to discontinue breastfeeding. Do I wish we had been able to work it out…absolutely. Do I feel like I did the best I could? Yes. Are my kids happy and healthy at nearly 4 years of age?? Yup! Was it the right decision for our family?…I believe it was.

    If you feel like you need to do frequent weight checks, you can get a little scale from Wal-mart for babies; I think it’s $60-ish. Trying to get twin newborns to the doctor (30 min. away) every week was crazy, so it was worth the investment!

    Ultimately, you just have to do what is best for you and your family. Choosing one over the other is not going to make or break your babies. Whatever allows you to be the best mom you can be is what you need to do.

  18. I nursed my twin boys for 12 weeks but always supplemented with 1-2 oz of formula after each feeding. We fed strictly on a 3 hour schedule. My word to you is: stop the frustration and struggling and exhaustion and go ahead and switch to formula if you decide to – WITHOUT GUILT!! IF that works better for your sanity and your family. With twins it is about survival, NOT about meeting everyone’s expectations. There is nothing wrong with formula feeding, and I think new moms are so pressured and exhausted without added stress about feeding. You need to enjoy your babies and feel confident in how you feed them, don’t lose perspective on that. The babies can thrive and grow and you will be so much more relaxed once you decide to let go of the guilt and feed in a way best for your sanity. Especially with twins you MUST give yourself a break and not get worn down, you will be a better mom if you give yourself at least some priority. With my first son I stressed and worried over every little thing, with the twins my attitude was SO much more laid back and they are FINE. There is NOTHING wrong with formula feeding, I was formula fed, my husband was formula fed, we are all fine. I think moms are pressured today to feel like failures if they don’t succeed with BF, but I repeat, that with twins, it is about survival… it is NOT about meeting everyone’s expectations. Good Luck to you!! PS Two things affected my decision to stop BF at 12 weeks: I went back to work, and I have an older son to keep up with and nursing made that difficult. I also hated pumping and refused to pump for the twins. Losing the guilt is tremendously liberating, and is the best gift as more children arrive.

  19. I just wanted to follow up on my earlier comment to say – I was a formula-fed baby and I think I turned out fine. I am very well bonded to my mother and I have no doubts about how much she loves me, but she had a physical issue that didn’t allow for her to breastfeed.

    If your babies are formula-fed, they will still think that you hung the moon and stars just for them. They will still give you milky grins and get excited when they see you coming their way.

    Also, sometimes I give the boys bottles of EBM when I am home just so that Daddy or Grandma or whoever is around gets a chance to bond with them too. Sometimes bottles are a nice way to spread the wealth.

    One other thing – if the breastfeeding does improve – I hardly ever tandem feed. I can do it, but I really prefer for each baby to get their own time and I feel like it makes breast feeding more stressful than it has to be with all the juggling and arranging and whatnot.

    I am wishing you the very best – be gentle with yourself!

  20. Hi Miriam,
    When my boys were newborn-3 months, I fed on demand…even if that meant they had just gotten done feeding a half an hour prior to “demanding” more. This sometimes meant letting them use me as a pacifier for, oh, I dunno, 2 hours straight! While I don’t recommend this to everyone, it definitely helped me build up my supply. Also, tandem feeding will help you make more milk. I suggest that you get yourself a comfy chair, an EZ2Nurse pillow (or figure out another way to tandem feed), a basket stocked with healthy goodies, a HUGE jug of water, and let those little babies of yours go to town. I second what other MOMS have said about relaxation and rest being huge factors in milk production. I find let down happening much sooner when I am sitting in a quiet room, totally focusing on my babies. Good luck!
    P.S. You will feel like a cow for a while. Not, “Ohmigosh…I am such a heifer,” but, “I’ll bet my nipples would get more rest if I lived on a dairy farm.” It’s a small price…

  21. Hi Miriam – You’ve gotten such great advice here! What a wonderful support network. This is such a difficult issue and such a personal one. But like a previous poster, I also want to emphasize that if it’s what you want, sometimes we just need to hear is that it’s okay to stop. My girls were born at 34 weeks … spent 20 days in the NICU … were tube-fed for almost the entire time … and they were the result of an FET (frozen embryo transfer) – between all of that and probably other factors too, I was never able to establish any sort of supply. I pumped for six weeks, and barely got enough to feed both girls one feeding per day. They got what I was able to produce and I’m glad for that. But I was stressed, exhausted, and felt very pressured to continue despite knowing in my heart that they were already getting about 90 percent formula anyway. Finally I just made the decision to stop – and it was all because someone finally told me it was okay to stop. Releasing that guilt made all the difference in the world to me. Remember that it’s okay to stop, if it’s right for you and your family. I wish I had been able to bf, and I wish we’d all had an easier time of it, but in the end it just wasn’t healthy for me or my babies to continue. That said, if you decide to continue, you also have all my support there as well. :) Best of luck to you!

  22. Miriam,

    I have a 2-year old son and b/g twins that are almost 3 months old. I nursed my first son until he was one but always always struggled to produce enough milk for him. I had to supplement during growth spurts and I had a Medela pump that I used constantly. When I found out I was having twins, I was terrified that I wouldn’t be able to nurse them both. After they were born, I would nurse them both and then supplement and pump. I did this after almost every feeding for weeks. I was exhausted and still not making enough to satisfy either one of them. I was so tired of washing so many bottles that I started nursing one and bottle-feeding the other and rotating every other feeding. I was making enough milk to feed one, but not both. That system worked out for us for a while, but then my daughter (who has bad reflux) had a very hard time keeping down my breastmilk. She would spew up almost as much as went down. I would then have to supplement with formula. When I went in for a well-baby check-up, my doctor asked me why I was going through so much anquish when it seemed so obvious that my son should nurse and my daughter should be bottle-fed. I told him how I felt that somehow I would be favoring my son and that I didn’t think it was fair. He convinced me that it would be best for everyone to just do that. He recommended a formula that has rice starch in it that my daughter is able to keep down much better.

    We’ve been following that system for over a month now and it’s working beautifully for us. When my husband is home, he feeds my daughter and loves having that bonding time with her. When he’s done feeding her and I’m done nursing my son, we switch babies so I can bond with both babies. I sincerely wish that I would have easily made enough to feed both babies and that all of that would have worked out, but I’m so happy with the way things are going now. Believe it or not, my son has actually gotten sick more than my daughter in the past 3 months and they’ve been exposed to the same things, so breastmilk is not a shield against all evils. I can honestly say that I don’t favor my son because I nurse him and that I have come to terms with not nursing my daughter and try my very very hardest not to get the least bit hurt or offended when people in public comment about why I’m nursing one and not the other. It works for my family!! Good luck finding what works for yours!!

  23. Hi Miriam,

    I just wanted to say that you are DOING A GREAT JOB. Breastfeeding twins is very hard, breastfeeding preemie twins is even more difficult. My boys were born at 32 weeks and spent 3 weeks in the NICU. It took us 11 weeks for them to be exclusively at-the-breast fed, but in the end it was worth it for us. (If you are interested, you are welcome to read our nursing story at: .)

    It can be done, but it has to be the right road for you and your family. Rest assured that whatever road you take will be the right one if you listen to your heart.

    Take care,
    Kathy G

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