I had a planned Caesarean section, and luckily, my recovery went smoothly. Breastfeeding twins, on the other hand, was a pain in the arse. Here are some pointers I wish I had known before giving birth.
At the hospital
I gave birth at Gleneagles Hospital, where the nurses weren’t pushy about breastfeeding, but they weren’t particularly helpful, either. There was also a lactation consultant who visited me daily, 5-10 minutes at a time. Not surprisingly, I didn’t leave the hospital feeling too confident about breastfeeding my twins.
Tip 1: Research breastfeeding before giving birth. My childbirth course barely touched on breastfeeding. Watch YouTube videos on latching and practice the motions. Read Kelly Mom and other reliable blogs.
From the first night, the nurses would wheel in my twins (who were sleeping in the hospital nursery) one by one so they could latch and stimulate milk flow. It was amazing to see them suck immediately at the breast, but boy, did it hurt! My nipples were extremely sore, neither of us knew how to latch, and the whole experience was unpleasant. By the third day, I had developed a cracked nipple.
Tip 2: Your milk will probably take a few days to come in. Don’t stress if you can’t lactate right away. Stress will suppress milk production. If latching is painful, try nursing over longer intervals so you don’t develop an aversion to nursing. Pack lanolin cream (I recommend Lanisoh since it is 100% lanolin) in your hospital bag to soothe sore nipples and to prevent them from becoming cracked. If nursing is too painful, try pumping instead.
The hospital offered me an electric pump so I could stimulate milk flow in between nursing sessions. My colostrum (concentrated milk full of antibodies and other nutrients) came in on the fourth day. I was thrilled but felt very uneasy about how to manage at home.
Our couch was soon covered with pillows and burp cloths for nursing. I tandem fed my twins with My Brest Friend for three months. I also wore a nursing bra lined with disposable nursing pads, day and night.
My husband and I watched YouTube videos on latching over and over. It took a lot of practice, but my twins and I eventually learned how to nurse properly. Each baby was very different in his / her style of nursing. My boy was impatient and wanted his milk as quickly as possible, while my girl had a tiny mouth and sucked very, very slowly.
Tip 3: Unless you are lucky and can nurse successfully before you leave the hospital, I would strongly recommend having a lactation consultant make a home visit as soon as possible. The earlier you and your babies learn how to breast feed correctly, the easier the whole process will be. You will probably have 50 unsuccessful latches before you get it right, so be patient!
To build up my supply, I used an electric breast pump in between nursing sessions. I was determined to feed my twins as much breast milk as possible, so I pumped every 2-3 hours, even at night. But I also supplemented with formula during the first two months. I felt comfortable doing so because I wanted to make sure that my twins were well fed and growing properly. Luckily I had my husband, helper, and confinement nanny to help with feedings. We fed the twins through every means possible—nursing, bottlefeeding formula, and bottlefeeding breast milk. My main focus was to make sure the twins had enough to eat, and my secondary goal was to establish my milk supply.
Tip 4: Have all of your caretakers become educated on how to position and latch your babies during breastfeeding. You will really need as many hands as possible to help when you are nursing. Set up a nursing station with lots of pillows, water and snacks, and Netflix / YouTube (you’ll have lots of free time while nursing).
I spent so much time with my pump—it was like my third child! I would strongly recommend buying a new electric pump (I used the Spectra M1 and Medela Pump in Style Advanced, and both are great). After 3-4 months, I ended up exclusively pumping because latching was very time consuming and was able to produce enough milk for my twins without having to supplement with formula. However, my pumping schedule consisted of pumping 15-20 minutes per session during the following times:
1am, 4am, 7am, 10am, 1pm, 4pm, 7pm, 10pm
I woke up twice each night to pump milk, mainly because prolactin levels are highest between 1-4am, and I didn’t want to miss my milk surge. I averaged about 80-90ml per breast during the day and 90-100ml per breast during my late evening pumping sessions. Overall, I pumped about 1.2-1.3 liters of milk per day, which was sufficient for my twins.
I was thrilled that I could pump so much milk for my twins. But milk production consumed all of my free time. It took time at work (I work part time, so time was especially precious), and I had to plan all our activities (and alcohol consumption!) around my pumping schedule.
Tip 5: A pumping bra is very useful so you don’t have to hold onto the pump flanges during your sessions. Make sure you choose the correct sized flanges for your pump. Also, rub olive oil or lanolin in the narrow part of the flange so you don’t develop any blisters from the friction. Drink lots of water, and queue up lots of Netflix shows!
At 7 months, I developed mastitis, which was awful. The flu like symptoms hit me all at once, and I was bedridden for two days. I took antibiotics for two weeks, and my affected breast was extremely sensitive for a month afterwards. I had to hand express my milk while my breast was healing. Two months later, I developed mastitis again. The symptoms were more debilitating this time, and I was struck with bad diarrhea from the antibiotics.
After I recovered, I decided to wean off the pump and feed my kids formula. My husband encouraged this, as he thought that my health and well-being were more important than producing milk. At this point, my twins had already tripled their birth weight and were eating solids three times a day. My original goal was to express milk for a year, but I agreed that I should be realistic and slowly cut out one pumping session a week. Interestingly, it has been three months since I have expressed milk, but I can still squeeze out a few drops!
Breastmilk has many benefits, and nursing is certainly great for bonding. Breastfeeding twins, however, is a huge challenge, and it can be immensely stressful to exclusively nurse. Be realistic! Mommy Facebook groups and friends will bombard you with pro-breastfeeding propaganda, but you should focus on what is best for you and your twins.
Kelly Mom (great website which answers everything about breastfeeding in a factual manner)
Exclusive Pumping (useful for those want to exclusively pump or who want to build up milk supply)
Science of Mom (science blogger; highly recommended for all topics)