Nov
12
2009In my last post, I mentioned that the nurse had suggested that the girls might have a milk allergy. I had cried. Life without cheese and chocolate… is that life? Luckily for my sanity last week, the Dr. had suggested that it was probably just reflux. I was so worn down that I couldn’t even consider life without milk!
Well, on Saturday the girls screamed and fussed and spit up volumes or didn’t spit up at all after every single feeding. It was terribly perplexing. At their 6 pm feeding I took a mental note of what I had eaten that day. Here’s a copy of that list:
- 2 cups of hot chocolate made with milk
- milk and cereal
- 2-3 pieces of string cheese
- pita pizzas for lunch
- a spur of the moment potato, egg, ham, and cheese casserole for dinner
Are you noticing the theme here? I overloaded the poor babes on milk and they were screaming about it.
Saturday evening I put myself on a milk elimination diet. No milk for two weeks. I pumped the 9pm feeding of the milk overload day and saved it to try on them after the milk is out of our systems. If they react adversely to that pumped feeding it’s another month on the no milk diet before trying them on milk again.
I’ll keep you posted on their reaction. But at least if I can’t have cheese, Whole Foods makes Vegan chocolate chips!
Nov
07
2009The middle two weeks of October passed with very little difference in routine. I fed the girls from the breast 2-4 feedings a day and pumped the remainder.
Setting up to nurse tandem by myself is quite the adventure. First, I heat the breast shields. Next, I set up my pillow and nursing stool on the couch that I want to use for that feeding. Then, I go change the first baby and bring her back to the couch. I lay her on the couch and repeat with the second baby. Then I strap on the pillow and pick up the baby who is to eat off of my right side. I put her on the pillow as I sit down and scoop up the left side baby. Then, I apply the nipple shields while both babies scream in hunger while flailing around doing there best to dislodge the shields from my nipples. Then you latch one at a time while hoping the one who is screaming doesn’t roll herself off. Whew! By the time that process is over and the girls are happily sucking away, don’t be surprised to find me asleep while they eat!
The last week in October was not a happy one. Derek’s sister had come up to visit and the girls were extremely fussy after each feeding. They were also spitting up quite a bunch. It seemed normal to me until I went to the Upstate Mother of Multiples Club Meeting Tuesday the 26th. Amber was feeding Aeralind and I was feeding Bronwyn expressed milk and the two of them practically spewed their entire bottles on both of us. Both burp cloths were soaked and every lady who held them was sporting spit up of some kind. They all encouraged me to call my pediatrician; that was not a normal amount of spit up!
So I called and told the pediatrician that their crib looked like a biochemical war zone with the amount of spit up. The nurse told me they probably had a milk protein allergy. I cried! Those 500 or so extra calories I’m eating a day are probably all composed of dairy. What was I going to eat?! I couldn’t imagine breastfeeding and not getting to eat anything with milk in it.
Just in case it was something wrong with the digestive tracts of the girls the nurse told me to come in that afternoon. I was exhausted from their spit up the evening before, but I managed the trip alone. Dr. Woodleif took extra special care of me since this was the first time I had gone to her office alone and she could see how stretched I was. I told her that the girls ate heartily and then would start screaming. They would scream and then spit up. Pause a little while and then scream and spit up again. They knew what was coming. She asked me if the girls arched their backs before the spit and I replied that they did; it was like ready, aim, rush to get the burp cloth!
Dr. Woodleif diagnosed us with reflux and not a milk protein allergy! I’m giving my 8 week old twins Zantac three times a day which seems totally crazy to me. However, as they developed the reflux they had gone from sleeping six hours a night to sleeping 3 hours and then being up 30-90 minutes screaming and spitting. I needed sleep again! It’s been about a week on the Zantac at this point and the difference is striking. We no longer need two burp cloths per baby at their night feedings. I am so glad that the problem was not one I was creating for the girls.
One of the other nightmares of breastfeeding twins are growth spurts. With one baby I’m sure that a growth spurt is incredibly exhausting since the baby wants to feed all the time. I think the physical exhaustion level is probably about the same for mom’s of multiples, but there is an added level of anxious exhaustion. Twins, even my apparently identical ones, do not go through growth spurts at the same time. Perhaps this doubles the physical exhaustion, but worst of all it disrupts The Feeding Schedule.
As a twin mom who wants a few moments during the day in which to pursue non-twin related activities, The Feeding Schedule is extremely important. Now I’m not so strict as to make my babies scream it out because it hasn’t been three or four hours yet. I pretty much feed on demand and hope they start stretching themselves to the four hours. But if one baby wakes hungry, then I wake the other baby to eat as well; if I didn’t do this, I would be engaged in baby care 2 1/2 hours out of every three! Normally waking one because the other is hungry isn’t an issue. The sleeping twin will greedily eat on the the hungry twin’s cue. But during a growth spurt, one of the girls will want to feed almost twice as often as the other.
The Feeding Schedule for about six hours normally looks like this:
- Hour 1: Change and feed the girls.
- Hour 2: The girls play for maybe 30 minutes while I do housework nearby. Then, they start crying to be put to sleep.
- Hour 3: Girls sleep and I get to do what I want!
- Hour 4: Change and feed the girls.
- Hour 5: The girls play for maybe 30 minutes while I do housework nearby. Then, they start crying to be put to sleep.
- Hour 6: Girls sleep and I get to do what I want!
The Growth Spurt Feeding Schedule looks like this.
- Hour 1: Change and feed the girls.
- Hour 2: The girls play for maybe 30 minutes and I do housework nearby. They both sleep for about half an hour.
- Hour 3: Baby A wakes up screaming for food. I wake Baby B and attempt to feed them both. Baby B falls asleep at the breast.
- Hour 4: Starts with both girls asleep, but quickly Baby B will realize she is very hungry and will demand to eat.
- Hour 5: Baby B is awake playing, but is then put in bed to sleep. I panic about having enough time to make dinner and scourge up some canned soup.
- Hour 6: Baby A is begging to eat again, I am crying and freaking out about the potential of being woken up every hour in the middle of the night. I attempt to let her scream it out until B wakes up but I can’t bear it for very long and attempt to make Baby B eat again.
- Baby A eats greedily and drifts off to sleep at the end of the feeding. Baby B refuses to eat or falls asleep at the nipple.
As you can see, my anxiety level increases drastically during a growth spurt. Add to that fears that the reason Baby A keeps waking is because you’re not making enough milk and you can imagine just how many tears are flowing some days when my husband walks through the door. He tells me immediately to go to bed and somehow, almost magically, when he wakes me for the next feeding he has them eating at the same time. They are mesmerized by him. What woman wouldn’t be mesmerized by such an amazing man?
This post sounds kind of drastically negative, but honestly most days now breastfeeding/pumping is more of a well oiled routine. I’m still using nipple shields and they are still growing. And best of all, I’m not having to buy expensive formula for two babies! Those savings mean that I can shop for more clothing that fits my new twin figure 😉
Nov
05
2009So it was October 5th, the day of the St. Francis Breastfeeding Support Group. It was quite the morning. I fed them at 8ish and packed the diaper bag and pump. By 9ish I was putting them in their carseats. Then, I took them out to the car. My OB would have flipped. I wasn’t supposed to be lifting more than 8lbs… what doesn’t hurt can’t kill you, right? I got there really early; early enough to wonder why on earth I was going. I was certain I’d be the only mother there who would end up pumping. After loading up the Double Snap and Go and deciding that I would leave my Double Blessings pillow in the car, I got up the courage to go to room.
St. Francis’s Breastfeeding Support Group is incredible. 2-3 lactation consultants were busy setting up scales and changing stations and supplying chairs with clean pillows. Addy, an elderly volunteer, was busy setting up quite a spread of food. Chicken salad sandwiches, a fruit bowl, cookies… I was drooling. One other woman was there early and she was busy feeding her 5 week old boy who was much larger than either of my girls.
I set up a little station for myself on the floor and pulled out the nipple shield. The other woman stared. I changed Bronwyn to rouse her and took her to the scale. She weighed 2952 grams (6lb 8oz!) I was really proud that she had gained so much weight. I sat down and latched her to the nipple shield. She sucked happily away and in fact continued to suck for her whole 15 minute time limit. I called one of the consultants over and asked her if I should stop her since that what was on our current feeding plan. She told me to just let her finish on her own.
Bronwyn and I finished and I took her over to the scaled to be weighed. Danielle was doing the weighing. Her finished weight was 3034 she had taken 82 grams (about 30z) which was exactly what was in her bottle at that time. Danielle gave me a giant high five as I held back tears of a different nature from my last visit to lactation.
I gave Bronwyn over to Addy, the elderly volunteer, who was more than happy to entertain her while I fed and weighed Aeralind. Aeralind took 26 grams when I fed her (1 oz). I was disappointed to say the least, but excited to eat some of the goodies on that table. Breastfeeding two makes me hungry and thirsty beyond belief! I munched on some stuff while holding Aeralind and since she hadn’t taken her full 3 oz, I stuck her back on. I ate while she ate and when we were both finished she had taken a total of 86 grams (3oz!).
I received another high five from Danielle. I was in shock. They were eating off me! Of course, we were still using the nipple shield to facilitate latching, but they had taken an entire feeding straight from the source! I was given the go ahead to replace two bottle feedings with breastfeeding and to gradually increase. That was a day of celebration and surprise and one of the best in my story thus far!
Nov
04
2009After I started producing more than enough milk for the girls and both girls had excellent mouth positioning on the BreastFlow bottles, I was certain that it would only be a matter of days before they’d transition back to the breast. At each feeding from the time we left the hospital on Monday until Saturday, I tried both girls on the breast for five minutes as I had been instructed. They would lick me if we could manage to keep them awake, but that could hardly be called success. I was doing everything that I had been instructed to do, why couldn’t we get this breastfeeding thing to work?!
At just about all of the night feedings Saturday night/Sunday morning, I cried in sleep deprivation and helplessness. I had been so strong in feeding them formula in the beginning, but they were a week old now. I just knew they should be latching! Surely there was something wrong with me that I couldn’t feed my girls from the source of their food. I was frustrated. Frustrated that I was “failing” at breastfeeding. Frustrated that I had to pump after every feeding; my arm muscles were killing me from holding those breast shields against my chest for so long. Most of all I was frustrated and terribly jealous that my sweet and helpful husband could go back to bed after feeding the girls while I had to pump for 15 minutes after he started snoring!!
I called that morning at 9 am to make an appointment with lactation at 12. Linda, the lactation consultant on duty that day, asked me how old they were in gestational weeks; I replied 37 and 4 days. She didn’t seem hopeful or encouraging after that comment, but she agreed to see us.
Derek and I loaded up the Double Snap and Go. Babies, diaper bag, expressed breast milk bottles, and my best friend: the breast pump. Safely in the lactation office we started with Bronwyn since she was the better sucker at the hospital. We stripped the little lady to wake her, weighed her, and agreed to feed football hold so Linda could help Bronwyn latch easier. It was the same as usual: no luck. We didn’t even finish the feed and weigh. It was obvious that she was unable to get anything. I held back tears.
Linda took Bronwyn and evaluated her sucking and said that I would be lucky to get her to successfully nurse by two months. At that point, she passed me a tissue. I needed it.
Next came Aeralind, but Linda held out little hope for her. It was much the same story. Knowing how distraught I was, she unwrapped two sizes of nipple shields. One fit me better and the other fit their tiny mouths better. We tried again. No luck. Nipple shields are nice because they simulated the bottle nipple that the girls were used to and made latching easier, but at the same time the girls had to be strong enough to suck the milk out of the silicone. Aeralind was not strong enough. Linda handed me some more tissues and gave me an encouraging I’m-proud-of-you type pep talk. She reevaluated our feeding plan that Danielle had made for us and changed it to try the girls at the breast once a day. In a strange way I was relieved, but still I was disappointed.
I wiped my eyes again. Derek started bottle feeding Bronwyn, Linda took Aeralind, and I made out with the breast pump as usual.
The next day I went out and purchased a Easy Expression Hands Free Pumping Bra. For me, that was a turning point. First, with the purchase I admitted that I would be pumping for a long time. Second, I was able to start feeding one of the twins at the same time as I pumped. That allowed me to get a whole extra hour of sleep every night! Not listening to Derek snore while I pumped made me that much less prone to a meltdown.
Over the course of the next two weeks I met my first obstacle to expressing breast milk successfully: the dreaded plugged duct. Apparently a pumping mother is much more prone to these than a nursing mother. For me the plugged duct presented with no pain. I just noticed a very hard spot in the left breast. Thinking that was odd, I read the little pamphlet the hospital sent home on the first two months breastfeeding and diagnosed myself. I applied a heating pad and massaged the heck out of the lump: 2 such sessions later it was gone. Getting rid of the plugged duct hurt much more than the plugged duct itself hurt.
I had two more plugged ducts on that side during those two weeks. The last was the worst. The heating pad and massaging in a hot shower did nothing but actually make the plugged duct hurt. I ended up massaging like crazy with my breast in a bowl of hot water. Finally, the plug surfaced but that side has never recovered on the milk supply front.
Week 3 ended with me solely expressing and my last week of full time helpers. I looked forward to Week 4 with apprehension about being alone for the first time. I knew I could not stay in the house alone for the whole week, so I planned one solo outing for that week. A trip to St. Francis’s Breastfeeding Support Group….
Nov
03
2009I’ve come across a startling lack of frank information on breastfeeding twins. Sure there’s a bunch of theory-based information (one of the best being Mothering Multiples by Karen Kerkhoff Gromada), but I have not found many tales from the trenches.
I’ve spent two weeks backpacking, a week kayaking the coast, I’ve trained for rock climbing competitions, run over a 10 miles, and I graduated college with a 3.9 GPA. But quite frankly, breastfeeding these two is the hardest thing I’ve ever done. This is my tale from the trenches almost 8 weeks in. I hope it will benefit others.
Aeralind and Bronwyn were born healthy at 36 weeks and 2 days. Neither required a NICU stay and both tiny 5lb babies rode in my bed with me to my room. I was beyond ecstatic that they were with me and, despite being in recovery for massive surgery, I attempted my first breast feeding about 1 hour after their birth. I’d read all the good books and even taken a class at the hospital. I knew exactly how to position them and how to make a “nipple sandwich” to stick in their little mouths. Aeralind was super eager and so I got her on (or so I thought) and then a little while later Bronwyn had her chance. The nurse took their blood sugar three different times that night and each time they “passed”. A few hours after that first feed, I had Derek help me get them tandem feeding. I felt wonderful feeding those little girls and so proud of my body. I thought I totally had everything under control.
The next morning I met Danielle the sweetest and sassiest lactation consultant at St. Francis. She was totally impressed with how well I could position them, but she was far less than impressed with the girls’ ability to latch. After several tries to get a better mouth positioning for the girls, she evaluated their sucking. Let’s just say their sucking… well, sucked. They had almost no suction power, their little tongues were all over the place, and Aeralind practically had to have her tongue pried off of the roof of her mouth just for Danielle to stick her finger in there. All was not well as I had assumed.
Danielle spearheaded our plan of attack. She immediately wheeled in my new best friend: the Breast Pump. I was to pump for 15 minutes every 3 hours (or every time we fed the girls). My first pumping produced about 4 cc of colostrum. Next Danielle whipped out the formula (GASP!). We couldn’t let them starve just because they couldn’t manage to latch and suck. With two curved tip syringes, Danielle halved the colostrum and sucked up enough formula to make 15 cc (1/2 an oz). She taught my husband and I to put our fingers in the girls mouths upside down, while simultaneously using the other hand to press the formula mix into the girl’s mouth.
I was excited that the girls were being properly fed, but I was disheartened and utterly exhausted from feeding them the night before and having my vitals being taken every time I fell asleep. Danielle put a sign on my door that no one was to disturb me and she urged us to let the nursery take and feed the babies that night. That was my last good night of sleep.
I attempted to latch the girls all of the following day (Sunday) and upon their failure to succeed each time, we fed them whatever colostrum I had pumped mixed with formula in a syringe. At 3 am that Monday morning I awoke and could feel my breasts doubling in size by the minute; my milk was coming in.
On Monday we were to be released from the hospital; Danielle had mentioned that she would prefer if we went home feeding them from a breast or a bottle rather than the syringes. Jennie was the lactation consultant on duty of that day. She was also the woman who had taught the breastfeeding class we had attended. Jennie was so tenderhearted and kind as she helped me mourn my hopes of having them on the breast before we went home; the girls were just not ready. Derek brought our bottles from home before we were discharged. I had registered for the BreastFlow bottles from First Years and Jennie was pretty impressed with the way the bottles made the girls open their mouths wide. We went home prepared to bottle feed.
The girls had to be woken every 3 hours to be fed. Preemies sleep all the time. Derek and I literally had to set the alarm clock to wake us up in order to feed them. It was pure torture. Then we had to strip the girls naked to wake them and if all else failed we had to place a cold wet wash cloth on their tummies just to rouse them enough to eat! At one of the middle of the night feedings Aeralind just could not manage to suck out of the BreastFlow bottle. Since it mimicked the difficulty of getting milk from a breast, she was having a hard time managing to get the milk out. We had to syringe feed her the rest of her meal.
At the pumping session following that crazy feeding, I suddenly filled both 2 oz jars I had been pumping into. That was the last feeding where the girls received formula. Finally! More than enough milk for each baby! After that I was pumping up to 6 oz per feeding and freezing away milk like crazy. Once again, I was encouraged that I would be able to do this and I was sure the girls would latch on at any moment now that all that good stuff was flowing.
All this occurred before the sun set on Aeralind and Bronwyn’s fourth day of life.
