Breastfeeding Twins: Overcoming Obstacles

nursingtwoI surveyed a group of breastfeeding moms of multiples to learn about the challenges they faced while nursing their twins and how they were able to overcome them. Here are some tips from this group of ‘been there, done that’ moms:

A first time mom of identical twin boys shared that she chose early on to always nurse her twins at the same time. She aquired an EZ-2-Nurse pillow prior to their births and was informed on how to set them up on the pillow using a double football hold (she did initially have a lactation consultant help her latch them properly and later, her husband, until she was able to manage all of that by herself). She writes:

“I think the hardest part to deal with was the pain of nursing for the first time. There simply was no relief, having both nipples assaulted at the same time. It took a deep and stubborn conviction in the importance of breastfeeding to get through some of the late night pain, which was more intense than during the day.

We all got thrush by our second week, so right about the time many mothers stop feeling pain, mine was just starting. Having my husband listen to my cries and be supportive was so helpful. He knew better than to try to talk me out of it, which would have been the wrong thing to do. I needed reasons to keep going, not to stop.”

She also suffered from a low milk supply and writes:

“I now know the most likely cause of my low milk supply was anemia. It took a D&C at 9 weeks before I finally stopped bleeding after the birth. That constant bloodlet put my body into pickle trying to decide how to allocate my resources. I ate like crazy, but I should have been supplementing a lot with iron. Iron supplementing still helps me to this day with energy issues and I believe women rarely have enough through regular Western culture eating habits.”

Another mom discusses how she overcame a low milk supply issue resulting from her c-section, while finding a creative way to supplement without the use of formula:

“My milk was delayed in coming in as a result of my c-section. The twins were both very hungry and totally ready for milk, not colostrum, by the time we left the hospital. I did not want to bottle feed or supplement with formula. I knew that the best way to get my milk in and establish a good supply was to keep putting them to the breast as often as possible, as exhausting as that was. I got a few sets of supplemental tube feeding systems from the lactiation consultant at the hospital before we were discharged and a beautiful friend, who I trusted implicitly, pumped and donated her own milk to me. I would tape the tiny feeder tube to my breasts and fill a syringe with her breastmilk. Then my husband would help latch the twins on and help me ensure the end of the tube was inside their little mouths. That way they were nursing at my breasts and stimulating my supply, but also getting full tummies of momma milk at the same time. I also took alfalfa supplements and watched my diet to be sure it was high in protein, iron and calcium. Hydration was also very, very important and I always had a full water bottle with me. Lastly, at first I did pump in addition to nursing them, but soon realized that this is a common trap twin moms trying to get started nursing fall into. Rest is also extremely important when trying to heal postpartum and establish a good milk supply. Pumping was cutting into my ability to rest when the babies were resting and really not doing very much to help my milk supply. My supply finally seemed to adjust to just the right level a few days after I stopped pumping and just focused on nursing, cuddling and napping with the babies.”

It’s not unusual for at least one twin to take quite some time in learning to nurse. A mom who experienced this with one of her twins wrote:

“The biggest issue we faced was that it took Cameron about 6 weeks to learn to nurse – which resulted in supply issues. I was pumping each time he refused the breast and additional pumpings between feedings to help boost supply. I was very concerned about the bonding issue – I felt so bad that one twin was getting that good comfort that only breastfeeding can give – so we did a lot of kangaroo care with him – holding him against our bare skin for cup or syringe feedings. We just did not give up and he eventually got it. Once he was latching it took some time to get my supply going but by the time they were about 3 months old we were exclusively breastfeeding.”

Another common problem amongst twins is for one or both to have a foremilk/hindmilk imbalance, as a result of tandem nursing and/or oversupply…

“When they were about 4 months old, my little girl developed consistently green spinachy poop. After consulting with a friend and La Leche League leader and doing a bit of research on my own, I decided it was most likely a foremilk/hindmilk imbalance. She was getting plenty of watery, hydrating foremilk, but not enough fatty, protein rich hindmilk. I switched from tandem nursing to nursing them seperately for a little while and used the compression technique to help push the hindmilk into her sooner in the feeding. Right away, I started seeing normal mustardy breastfed baby poop out of her again. Less than a month later, her suck got stronger and I went back to tandem nursing them with no problems.”

Another mom noticed a similar problem with one of her twins, despite the fact that she rarely tandem nurses them…

“…in the very beginning their nursing styles were so completely different that Claire was getting too much foremilk. Even with block nursing them she was getting too much so it was nice to have twins. After Ben would get done wolfing down his meal I’d put Claire on his side and let her finish his hindmilk. Worked like a charm.”

And yet another mom took a different approach to the same problem:

“The one issue we had was that the babies started having greenish, foamy poops. I did some research and learned that it was a hindmilk/foremilk imbalance or oversupply causing them to get mostly foremilk at every feeding. I had been switching sides every 24 hours, but decided to assign each girl a breast and it worked like a charm. And at almost 9 months old, they’ve still got the same breast I assigned them at 3 months old!”

Engorgement can become an issue for some moms. One twin mom mentioned her easy solution to this painful problem – she simply had her toddler nurse to relieve the engorgement!

An improper latch can cause all sorts of problems for singletons and multiples alike:

“I learned the hard way how painful it was to allow my singletons to nurse while improperly latched. I let it happen simply because I was so grateful to actually get the baby on the breast and to stop her crying, that I didn’t have the heart to unlatch her and start over until we got it right. I paid deeply for this mistake – by way of cracked, raw, and bleeding nipples. The pain would almost make me vomit, it was so bad, especially when coupled with the after birth contractions that nursing would stimulate.

So when I had my twins I was determined not to make the same mistake. It was harder, times two, to ensure a proper latch each and every time but the effort was well worth it. Nursing them was actually relatively easy compared to my prior two singleton babies simply because I minimized any pain involved by sticking with an appropriate latch. Any soreness I did develop was quickly remedied with lanolin, such as Lansinoh brand nursing lanolin cream.”

Smaller or earlier born babies tend to be sleepy, which can result in infants who fall asleep at the breast before adequately nursing:

“My twins were born on the early side of term. Although my smallest weighed almost 7 pounds, he was a sleepy nurser and would predictably fall asleep before my milk would let down. I consulted with a friend and La Leche League leader who showed me how to use the compression technique to stimulate his suck reflex. It was in this way that I was able to get him to nurse through an entire session. After a couple of weeks, he grew out of the sleepy thing. It also helped somewhat to tandem nurse in these early days because his twin – who was not a sleepy nurser – would stimulate let down for him so there was less work for my sleepy guy to do in order to get his milk.”

If you have any experiences you’d like to share, please contact us and we’ll be happy to add how you’ve been able to overcome breastfeeding challenges to this list.

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