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  Feeding Your Twins: Breastfeeding and Pumping

Breastfeeding, formula-feeding, exclusively pumping... which one is right for you?

As I mentioned in the previous unit's presentation, we twin moms need to be flexible with our options. You may have well-meaning goals, but circumstances can change them quickly.

I exclusively breastfed my eldest and expected to do the same with the twins. But even from the hospital, baby B was underweight. We were even running the risk of him having to stay at the NICU until he could pack on some pounds. Without hesitation, I chose to supplement with formula, knowing it would help him gain the weight he needed.

And thankfully he did.

For the first few months, I mostly breastfed the twins, but I also offered Baby B formula from time to time. And when I came down with thrush, I increased formula for both of them for about 50% of their bottles..

Other moms might have imagined nursing from day one. But an unexpected complication with feeding means they're pumping breast milk instead. Or they may have made up their minds to bottle-feed, but at the last minute decide to try breastfeeding. Anything can change with twins.

If you think breastfeeding twins seems daunting, you're not alone. Many have expressed how they want to breastfeed while admitting they're not sure how. In this lesson, we'll talk about breastfeeding and pumping for twins. You'll learn about:

  • Breastfeeding in the first few days and what to expect
  • Correctly latching your twins
  • Tandem feeding success (or feeding at the same time)
  • Keeping your supply up and adding to a freezer stash
  • Pumping best practices

Breastfeeding in the first few days

Many of the challenges with breastfeeding starts in the first few days. We're still learning how to latch, and our milk still hasn't come in. We're emotional from welcoming twins. And we're faced with the initial discomfort of breastfeeding.

What can you expect in the first few days so you can better prepare?

Your twins will nurse on colostrum.

Little did I know that a body wouldn't produce typical breast milk for the first few days. Instead, your body will produce colostrum, a yellow-colored type of milk. A few facts about colostrum *:

  • Colostrum has a high concentration of nutrients in low volumes. This is why, if you pump in the initial days, you'll barely get anything compared to later days. It's perfect for newborns though, whose immature digestive systems can't handle a large amount of regular breast milk just yet but still need those nutrients.
  • Colostrum is a laxative. This helps your babies pass their first bowel movements and rid their bodies of bilirubin. High levels of bilirubin are what cause jaundice.
  • Colostrum is high in antibodies, boosting your newborns' immunity.

Your milk will come in after three to four days of giving birth.

Toward the third or fourth day after giving birth, you might start panicking. Why isn't my milk coming in?! It's easy to feel helpless especially if you're doing all you can to help your twins gain weight.

But don't worry—it'll come in eventually. Your babies need the colostrum, so the days of not having regular breast milk are totally normal.

Your body will begin producing regular breast milk when your breasts feel engorged. You'll notice that the milk you express will look white and more liquid.

And remember how your breasts grew a cup size (or two) when you were pregnant? Expect it grow another cup size when you're breastfeeding.

Breast milk comes in two stages.

Another strange thing about breast milk is that it comes in two stages. When your twins begin a feeding session, the milk that comes out is called fore milk. It's lighter in color and has lower fat. After several minutes, the hind milk kicks in, which is creamier, whiter and higher in fat.

Fore milk quenches your twins' thirst, while hind milk provides necessary nutrients. If you pump, you'll notice the bottles fill up with a lighter fore milk before the hind milk comes.

When you nurse your twins, try to have them drain each breast so they get both fore milk and hind milk.

Breastfeeding might be uncomfortable at first.

Confession time: I struggled with breastfeeding the first month, and that was with my eldest, not my twins. It hurt, I got blisters, and I was ready to quit each day.

Even with the correct latch, you might still feel discomfort during the first days. But after a while, your nipples "toughen up." You feel more confident, and you're better able to latch the twins much better.

The strange thing? When I breastfed my twins, I felt zero pain. Just when I was anticipating another round of pain and discomfort, I felt none. Almost like I picked up right where I left off with my eldest. My body wasn't any different than when I first tried breastfeeding my eldest.

So even if you hear from others about their initial pain, it's not guaranteed you'll feel any of it.

How to correctly latch your twins

I mentioned many times the importance of latching your twins correctly, so how exactly do you do that? There are the most important pointers to remember when latching your twins:

  1. Squirt a little bit of breast milk over the nipple. Simply pinch the nipple until some colostrum or breast milk comes out through the ducts. The extra breast milk helps protect your nipples and is a familiar taste to your babies.
  2. Make sure your twins' tummies are facing yours. What you don't want to see is your twins lying flat on their backs and their heads turned sideways.
  3. Aim your nipple toward their upper lips and noses, notthe centers of their mouths.
  4. Wait for them to open their mouths wide. Their mouths should cover the entire aerola, or the dark-colored areas of your breasts. If their mouths and lips are only covering the nipple, then they're latching incorrectly. If they're not opening their mouths wide enough, don't force their mouths open with your breasts. Instead, tickle their mouths with your nipples until they open wide.
  5. Once they're latched and sucking, make sure their heads are tilted back. You want space for them to swallow and breathe comfortably. What you don't want is their chin pressed on their chest. Try this yourself and you can feel how uncomfortable it would be to breathe or drink.
  6. A few other ways to tell they're latched correctly? Their lips should be splayed outward, not tucked in. You should also be able to see their tongues if you pulled down on their lower lips.
  7. Once they're done, don't just pull them off the breast. This will hurt you since they've still got a suction on. Instead, insert your pinky inside their mouths between their lips and breasts to break that suction. You're adding air between the lips and breasts, making it more comfortable for you to unlatch.

Tandem feeding success

Besides latching correctly, another skill I'd encourage you to learn is tandem feeding. Nursing your twins at the same time will be one of the biggest ways to save you time and hassle. But if the thought of nursing two at the same time has you confused, don't worry. We'll walk through the exact process of how to set this up.

Before we start, I suggest you get a nursing pillow before your twins arrive. Then, bring this with you to the hospital so you can start on the right foot.

I made the mistake of assuming I wouldn't need one. Or that I'd rely on regular sleeping pillows. A nursing pillow makes a huge difference. I used the My Brest Friend pillow for twins. I loved how sturdy the pillow was. Once my twins were a little older and I more confident, I could nurse them hands-free.

Another fantastic twin pillow other moms recommend is the Twin Z pillow. The texture is softer, so this can also double as a resting pillow when you alternate burping. The Twin Z pillow is also useful if you plan to bottle-feed as well, and it offers back support.

How to get your twins into tandem feeding position

A typical tandem feeding position includes you sitting cross-legged on your bed or couch. You'd wear your nursing pillow around your waste. Each twin would be in a football hold—their heads are towards your breasts and their feet are to your back. Here's an example:

So, how do you get two babies to do that?

  1. Get your twins on either side of where you plan to sit. That could be on your bed, on the couch, or on the floor. Lay then down in the position they'd be once they're on the pillow, so heads facing forward and feet facing back.
  2. Wear your nursing pillow and sit in between your twins.
  3. Pick one twin up first and lay him on the nursing pillow, football hold-style. Make sure he has a good latch on your breast.
  4. Once he's secure and nursing, pick up your other twin and latch him as well.

In the first few days or weeks, try to have someone help you with tandem nursing. It can be overwhelming to manage on your own, so get your partner or family to help you nurse.

In that case, you'd sit with your nursing pillow, and someone can hand each baby to you.

How to burp your twins after tandem feeding

Burping two babies can be tricky. If another adult is with you, ask them to burp one baby while you hold the other. During the early weeks, you might have people visiting who can help. Your partner can burp one baby after middle of the night feedings.

But if you're alone, you can still burp both twins after tandem feeding:

  1. Once the twins finish nursing, unlatch both babies.
  2. Then, carry one baby over your shoulder and pat his back for about a minute.
  3. Set him back down on the pillow and repeat with the other twin.

At this point, you could either:

  • keep the the nursing pillow around your waist and lay the waiting twin down near you (he'll still be at an incline), or
  • remove and set the nursing pillow in front of you and recline the waiting twin on it.

What you want to avoid is laying your babies flat on their backs after they just ate.

When I first breastfed my babies, I chose to nurse one at a time. I tried tandem nursing once at the hospital and felt too scared to do it again.

But here's a word of encouragement I wish I told myself. Even if it feels awkward, try tandem feeding at least once a day. Choose the best time when you're not sleep deprived to practice (basically, not the middle of the night). And do it when someone can help. The quicker you can master tandem feeding, even for newborns, the more time you'll have.

Pumping best practices

Many moms who breastfeed also pump breast milk. Some return to work and would still like to be able to provide their twins with breast milk. Others need a meaningful break from the baby, and pumping allows others to feed the baby in the meantime. Some might want to pump if their babies are in the NICU. And still others pump to increase supply (more on that below).

What are some of the best practices for pumping?

  • Use a hospital grade pump. A pump can never be as efficient as a nursing baby. But if you had to choose one, go with a hospital grade pump. I used the Medela Symphony. These are pricey to own, so I suggest renting them either from your hospital or a local breastfeeding organization.
  • Start pumping at the hospital. Doing so stimulates milk production and sets you on the right track. You might only get a little bit of colostrum, but pumping plus nursing will signal to your body to produce extra milk.
  • Have an extra set of pump parts. Even if you'll eventually have to wash all those pump parts, at least you have the option not to at that moment. Sometimes it's easier to stash your pump parts in the fridge and wash them in the morning. Knowing you have an extra set ready to go before the morning allows for that to happen.

    On a similar note, keep several of the white membranes handy if you happen to use Medela. If you go back to work, it's even more important to have these at your workplace. These can tear easily, and a broken piece means you'd have to run to your nearest Babies R Us for a new pair. Save yourself the time and have a box both at home and at work.
  • Get a hands-free bra. Like the nursing pillow, I didn't get a hands-free bra until much later. I thought I could wing it by simply adjusting the pump parts inside my nursing top or regular bra. It was a hassle and affected my position. Once I got a hands-free bra, pumping became much easier.
  • Store breast milk properly. Breast milk can remain in room temperature for up to four hours. In the refrigerator, bottles and bags of breast milk can be stored for three to five days. Frozen breast milk is best used within six months (but once it's thawed, don't re-freeze it).
  • Thaw frozen breast milk properly. Don't thaw breast milk in the microwave or on the stove top too quickly (it doesn't heat through properly and some parts might be too hot). Instead, put it in the refrigerator the night before, or let it thaw in a bowl or warm water.

To exclusively pump or not?

A few moms choose to exclusively pump to give their babies breast milk without nursing on the breast. The most common reason is pain. Either the baby can't latch, or the pain is just too much for mom to handle.

I know several moms who chose this route, and they'll admit it's not an easy one. Exclusively pumping seems like an option if you feel scared or awkward about breastfeeding. But pumping all the time is a hassle and a huge time suck.

Not only do you need to take time away to pump, you also need to then spend more time feeding the pumped milk to your babies. Even if you pump and your partner feeds, that's still double the time than if you nurse directly.

This is true for any pumping scenario, such as pumping so you can get a break. You put in twice the effort (pumping and bottle-feeding) for the same result (getting your twins fed). So you can imagine how much more time consuming exclusively pumping can be.

If you decide to exclusively pump, remind yourself the reasons you're doing it to stay motivated. Also, allow yourself the kind of lifestyle where you can take your time. Maybe this is leading a less harried life, or having someone bottle feed or be with the twins while you pump.

How to increase and keep your supply up

Once you've got breastfeeding going, the next question is, How can I keep my supply up? This can be frustrating if you're not producing a lot, or would like to produce more than the amount you curerntly are. You might even want to build a large supply of milk before going back to work.

What are some ways to increase and keep your supply up?

Eat enough healthy food and stay hydrated

By far, a well-balanced diet and drinking enough water will help keep your supply up. Make sure you're consuming at least 1,000 extra calories a day—500 for each baby.

And just as you did when you were pregnant, drink plenty of water. You are what you eat, after all, including your breast milk. Your body can't produce if you're not consuming enough.

Pump in addition to nursing

Increase your supply by tricking your body into producing more through pumping. A few ideas that have worked for many twin moms:

  • Option 1: Pump 15 minutes after each feed, or at least the ones during the day. Your initial results may only be one ounce at most, but over time, you may be able to pump an extra five ounces!
  • Option 2: Pump one hour after every feed, especially if your twins are on an every three hours schedule (as is typical in many NICUs). You're able to squeeze out extra ounces but with enough time for your breasts to produce more by the time your twins nurse.
  • Option 3: If you've weaned from middle of the night feedings, continue to pump. This will happen once your twins are older, but it's another way to trick your body to continue producing milk. Let's say your twins normally wake up two times a night, but you've been able to successfully wean them down to one or even none. You could still wake up, even just once a night, to pump.

As with anything in parenthood, keep a healthy balance of your goals with your needs. Unless you have a specific goal in mind (building up x amount of ounces before work), don't force yourself to pump when you don't have to. You'll feel better rested, happier and healthier with extra sleep than extra ounces.

Next, we'll talk about formula-feeding and bottle-feeding. We touched on bottle-feeding a little in this section when we talked about pumping. Let's dive into how to best feed your babies with bottles.