Tandem Nursing Twins

Melinda’s Story Continued from Breastfeeding in NICU…

Chris (my hubby) and Tristan (our son) came to pick us up, and Tristan, was oh! So fascinated by these little people. I think he believed that they didn’t really exist, because we’ve been talking about these babies for a month now, and he hasn’t seen them, and he couldn’t go visit them, and every time I’d go to the hospital he’d cry and want to go with me to see the babies, and then I’d have to explain why he couldn’t come with me. They allowed him into NICU twice, but only in the visiting room, so he could see their beds from a distance, but he couldn’t see them.

He was so excited to see these little people, and when we brought them home, he wouldn’t leave their sight. He would just sit by their bassinets the whole time, Just sit there and watch them.

They came home on the 31^st, on New Year’s Eve, and the first night with them was just so much more relaxed, because we were at home, and I was then prepared. I had breast milk in my freezer, and with every feed, I would try to breastfeed them, and then if they didn’t feed, I’d just give them a bottle, and then express. So they had fresh breast milk every time because I would express and then feed it to them 3 hours later.

I became quite comfortable with that, but about a week later, I decided that I really wanted to get them on the breast and stop sterilising bottles and breast pumps. As I said to you, I didn’t know that I only had to wash the pump once a day, so I was washing and sterilising every single time, It was a lot of work!

I phoned around, a friend gave me a number of the La Leche Leader here in Durbanville, and she had Prem babies as well. She said: ‘Don’t worry about it too much, because their jaws aren’t strong enough, so you can’t rush this. They need to develop in their own time’. Connor was breastfeeding at that point, but Amelie was on the bottle, she couldn’t latch.

I kept trying and I was in constant communication with her. When my neighbour had her baby, she struggled to breastfeed, and she took her baby to the Panorama Breastfeeding Clinic. She told me how supportive they were, and how much they’d helped her. And if it wasn’t for them, she probably wouldn’t be breastfeeding.

My mom and I put both kids in the car, my first outing with them, and we went to the Panorama Breastfeeding Clinic. They were soooo helpful. They put me in a room, one baby first and then the other one. First they weigh the baby, then you feed them, and then they weigh them again to calculate how much they drank. They weighed Connor and said, he’s drinking perfectly and he is taking in enough milk. And then they did the same with Amelie, I fed, they weighed, and they said she’s not getting enough milk.

The nurse gave me a Pigeon nipple shield, and I said, “but I have nipple shields at home. I use the Medela one’s because my breast pump is Medela. I’ve used them and they’re not really working for me. And, not to promote any brand, but the Pigeon shields are nice and soft, and especially prem babies latch very easily onto them. She plopped it on, and Amelie fed like she’s been doing this forever. They weighed her again, and she took in enough milk.

That’s awesome! Problem solved!

Breastfeeding Preemie Twins

 

So I fed them with nipple shields, and I tried to tandem feed them. The feeding initially would go well, but after a few minutes of wriggling around, the nipple shields started slipping and would pinch me. And because the babies are so small, it’s really hard to handle them. I had a head in each hand and if I needed to adjust the breast-shield, I had to put that baby down and it was not that easy to pick him up again. So I couldn’t adjust the nipple shield, and once it started sliding, I had to take both kids off, re-adjust and put both kids back on. It was just difficult for me.

So I decided to feed them one by one. Because Amelie was so little, the breastfeeding clinic advised that I feed them every 2 hours. In NICU they were fed on a 3 hourly schedule, but now I needed to get them on a 2 hourly schedule. I fed them one by one, and they were still quite slow at feeding. Each feed would take about 45 minutes. So I would feed one for 45 minutes, feed the other one for another 45 minutes, and then it was almost time to start feeding them again. I would had time to quickly run to the bathroom, fetch a glass of water, and I’d be back to start their feeds.

I did that for a week, and I did not think that I was going to cope. This was not what I signed up for. During the night, I gave them bottles of breast milk. That allowed me to feed them together. They would both go to sleep, and I could sleep for an hour. Otherwise, I wouldn’t be able to sleep at all.

A week later, when I took them back to the clinic, the nurses were surprised at how much weight they’ve gained. It was almost 3 times the recommended weight gain. And the nurse said, “I know this is hard on you, I know you’re tired, but just continue with the 2 hourly schedule for another week.” So I did that for another week, and then when we took them back a week later to weigh, she said, “They’ve put on enough weight now, you can go back onto a 3 hourly schedule.” Which was a life-saver. I still fed them one, and then the other, except for their night feeds. The only feed that I managed to tandem feed was the one just after bath-time. Either my mom or my husband would help me to bath the babies, and then I had assistance for that feed.

I really wanted to feed them together. So our rhythm was: one-by-one feeds during the day, tandem feed at bedtime, and then during the night I would give them bottles.

Which was also nice, because feeding time was bonding time with them, and also because they were still so little, they slept a lot. This way I got to absorb them individually.

When did you have time to express the milk you needed for the night feeds?

At night, when I gave them their bottles. I had one of those bras you can attach breast pumps to, so I would attach the breast pump to myself and turn it on, and then I would feed them their bottles.

It sounds silly, because I’m expressing while I’m feeding, but that was the only way I could feed them together. To tandem feed them at night in the dark, I wouldn’t be able to do that.

I was still on the Espiride at that point, so I had a lot of milk. I only had to express once a day to get enough milk for all the night feeds.

At what point did it start becoming easier for you? Because this is radical… when I think how difficult it is for a Mom to keep up with breastfeeding one child in the early days, to breastfeed two… oh my word… and you aren’t topping up with formula at all… That’s amazing!

Did you ever top up with formula?

No. I met a girl at the clinic, who also had twins. She came to visit me right in the beginning to cheer me on, to support me, and she was saying to me, “you know you don’t have to be Superwoman. You can put them on formula. Or you could just give them one or two bottles a day.” That took this weight off my shoulders, it’s not one or the other, I could breastfeed them and give them a bottle. I was so happy about this solution, (although I just never got around to buying formula).  It made me feel like I had options and that breastfeeding wasn’t a prison. The twins are almost one and I am still exclusively breastfeeding.

It’s not that I wanted to prove anything to anybody, or that I wanted to be Superwoman, I didn’t want to impress anyone, it’s just that I wanted to breastfeed my twins… and I knew that it’s possible. On the Whats-app support group that I was on, there were so many moms who had successfully breastfed twins, so why couldn’t I?

I was still in contact with the lady from La Leche League. I asked her when I could take Amelie off the nipple shields, because I wanted to tandem feed more feeds. She said it’s normally about 4 months, because that’s when the jaw is strong enough to latch properly.

But with every feed I would try it first – without the nipple shield, and then see if she could latch without it. By about 3 months she managed to latch properly, and that was like the best thing, because I could pop them both on simultaneously.

So it was round about 3 months that things started getting easier for me, because then I could tandem feed them, and they were on a 3 hourly schedule. So they would feed, and then sleep, and then I could have time to breathe.

From there on, they feed shorter and they feed stronger … I had them on a 3 hourly schedule for quite a while though. I never demand-fed the twins. With Tristan I demand fed, but I could never do that with them because they were used to the NICU rhythm.  They were used to feeding every 3 hours, so I had to wake them up to feed them every 2 hours. But right from the beginning they were in a routine.

People started advising that I start stretching to 4 hours, but I just couldn’t. They woke up every 3 hours, so I felt they needed to feed every 3 hours. And then at some point, on their own, they just started waking up later and started stretching to 4 hours, but it was way after the recommended age.

They had a rough time up until then, so I just wanted to give them that little bit extra.

And do you have a goal to breastfeed them to a year?

My goal was to breastfeed them to a year, but I’m already thinking, they’re 2 months Prem, so maybe I should go on for 2 months longer, so they are at the corrected age, 1 year when I stop breastfeeding.

They bite me like crazy, that’s a new fun game, so I really want to stop, but I also don’t want to stop… I’m really enjoying it.

You’ll get through the biting phase, and it’ll all feel wonderful again soon. That biting phase doesn’t last forever.

A month ago, my best friend had to bury her baby here in Cape Town (she lives in Dubai). And I just… I had to be there for her for the day, and I decided to give my babies formula milk for the day, I didn’t know if they’re going to take the bottle, but they were so awesome. I tried a bottle the day before and they just took it like they’ve always been drinking bottles. The day of the funeral, I was away from them the entire day and they drank all their feeds from bottles. I don’t have enough milk to express anymore.

I took my breast pump with me, but I got no time to express. And yet the whole day, I wasn’t uncomfortable. I came home that night and immediately feed them, and the next day I went back to feeding them normally. And there was just milk again. I thought there might be a bit of a setback, that there wouldn’t be enough milk, but, all back to normal. One’s body is amazing.

What happened to your friend’s baby, Melinda? That’s so sad.

My friend also had twins. And they were also born at 32 weeks. Her story is heartbreaking and also beautiful… but it is her story to share.

At the time of the funeral, her other baby was still in NICU and she also had to express. At the airport… on the aircraft…

That’s one thing about having a baby in NICU – breast feeding is the only option. They need breast milk. They cannot go onto formula milk. Their intestines aren’t developed enough, they cannot tolerate it. There’s a special kind of formula milk they can go on, but it’s super expensive, so the hospital would rather opt for donor milk before they put them on formula milk.

And actually all babies need breast milk, to be really truthful. Every child does, it’s just most people don’t recognise that.

When I had to buy formula milk… and I know a lot of Moms formula feed because they have to, or have to top up with formula milk, so there’s no judgment in that – but I stood there, reading the backs of all the formula tins, and I thought, “I can’t put this in my kids”. But you know, millions of kids survive on formula milk every single day.

I would also feel that way. I haven’t to this day, bought formula, so I know exactly how you feel.

Luckily, I had enough milk, so the top-ups that my kids needed could be breast milk.

And of course, you were still on the Eglanol/Espiride.

If I look back now, and talking to you, I wonder, how I survived those first few weeks? But the Eglanol did take the edge off, so that you’re not so emotional. “This is my job now, and I need to do this”. You’re not super emotional about it.

Do you have any advice for Moms going through the same thing? What was really helpful for you?

Not to isolate yourself. For any Mom, not just for prem-moms or twin-moms. Select a few people that you would trust. A breastfeeding Consultant, or the Clinic-nurses, or a very close friends that you know has successfully breastfed. But get your cheerleaders around you, to give you advice, or say, “maybe try this, or maybe try that…” And also, not too many people, because then there’s conflicting opinions. So go with someone that’s in the know, someone that recently had a baby, or someone like the Clinic Sisters. They deal with this every day, but they also are up to speed with latest research, latest techniques, what works better, so that helps a lot. You need that support network.

I found this support group, a WhatsApp group for twin moms. I never met any of these moms in person. There’s over 100 members on there, so it’s crazy. What’s great about is, when you post a question…. for instance, “I’m struggling with sleep training”… you’ll get 20 people answering you, but 10 of those will be people that believe in what you believe in. Say you support co-sleeping. 10 of them will probably say put them in a cot, and 10 of them will say go for it, continue to co-sleep. And that’s what you need. You immediately disregard the opinions you don’t agree with, but then those 10 people who do agree with you, just reinforce that what you’re doing, is the right thing. Even though 10 others didn’t agree with you. You just need that voice telling you that what you’re doing is good.

Bottom line: Whatever you’re doing is good. Whether you’re breastfeeding or bottle feeding, co-sleeping or letting them sleep in a cot, baby carrier or stroller… loving your child is all that really matters. You just need to get people behind you that share your opinions. You know, because there are days that you doubt yourself. Like I said, “Who’s crazy enough to tandem feed twins?” And I found out there were like 20 Moms on our group who were successfully tandem feeding twins. And I thought, “If they can do it, I can do it.”

So Support is my recommendation.

One last question…could you share the most beautiful breastfeeding moment for you and your twins?

When I managed to tandem feed them both without the nipple shields. For me then, that was the first time (and this is going to sound really stupid), when I was really breastfeeding – no pumps, no nipple-shields, no anything, just me and the babies. The way I had it with Tristan all the time. It was three and a half months before I had that with the twins. And it was a huge accomplishment for me.

… And doesn’t Melinda make it look effortless? 

We honoured and celebrated Melinda’s exclusive breastfeeding achievement at our World Preemie Day Event

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For more personal stories about Breastfeeding Preemies, I found a few lovely books on Amazon…