Nursing Mother

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Breastfeeding Exclusively

"I am pregnant with twins and would like to breastfeed them exclusively (no formula). Is this realistic?"

My daughters will be 9 months old next week. I am still nursing them. They have never had formula. I started pumping at 4 weeks and my husband gave them expressed milk by bottle once per day beginning at 6 weeks. When they started daycare at 4 months, they got expressed milk all day. In the beginning, I nursed them separately. Since none of the three of us knew the ropes, it was too hard for me to get and keep them positioned. Since about 3 months, though, it became much easier to nurse simultaneously, and now I do it when they're hungry at the same time & I feel like it (sometimes I prefer to nurse them individually when my husband is available to distract the one who's waiting).

I am very proud that I'm nursing my daughters. I'm proof that it can be done, but it is hard and you have to really want to do it. In the early days when we didn't sleep much, I sometimes cried when my husband brought me a crying baby I had thought was finished eating. Also, some of the things I ate bothered them and I had to really restrict my diet for a while. But I know that wanting to do it isn't enough. I've been really lucky to have no problems with nursing or pumping.

The nurses started supplementing and actually sort of pressuring me to supplement because my milk wasn't coming in. I was really stressed out because they wanted me to nurse the boys every 2-3 hours and I had trouble waking them up! The first day home (3 days after they were born) was kind of rough because we hadn't really spent much time with them alone yet. So I advise spend lots of time with them at the hospital while there are nurses around you can ask questions! (Important if you, like me, have little experience with babies.) My pediatrician was great--he and his wife have twins. At our 1 week check up he told me that if I really want to breastfeed I should stop supplementing entirely and just let the boys nurse whenever they were hungry to "pump up" my milk supply. It worked great and I'm still breastfeeding!

I found breastfeeding to be much easier than bottles. The girls have never had formula.

I'm a single mom with no help and I managed to breastfeed my twin boys till 6 1/2 months! So, it can be done. I too found it easier than bottles, especially in the middle of the night. I'd bring the twins into bed with me and would lie on my side and at least rest while they were feeding. I'd grab the first hungry one and then the second one. Eventually, I'd end up with both boys in bed with me, one on either side. For the next round of feeding, instead of getting up, I'd just roll over onto my side to face the hungry baby. This is what worked for me and my situation.

Even though one of my twins had trouble nursing at first, I pumped my milk and never fed either one formula. It was very important to me that I be able to nourish my babies completely from my own body. I have philosophical/moral objections to formula companies and their reprehensible conduct in developing nations. Even if that hadn't been a consideration, we have allergies and eczema in the family, and breastfeeding offers a good defense against that. Most of all I wanted to give my children the best possible start.

Supplementing can be a slippery slope. The breasts need the stimulation of nursing babies to maintain & increase the production of milk. The more you supplement the less milk there is, and the result of this feedback loop is the end of nursing, for the reason of insufficient milk. I am not telling you what to do, only giving you an indication of what might happen if you supplement. It may not happen, it may happen anyway, it may be fine with you.

In order to be sure that breastfed babies are getting enough, you should check that they are producing enough wet diapers & poopy diapers, that they are gaining weight, that they appear satisfied. Make sure the mother gets enough rest, is eating well & drinking fluids, and nurses as much as possible. The mother can spend the day in bed, just nursing. Wet nurses used to nurse as many as six babies. All this is not based on any professional expertise, only on my research & experience as a nursing mother. My twins are still nursing at almost 18 months. They have never had formula.

Someone asked about nursing 7 week olds. I believe this is the time the babies would be going through a growth spurt, 6 weeks actually, so it's not abnormal for them to be hungry more often. They go through this several times and the best thing is to keep nursing or there won't be enough milk. Drink lots of liquids and eat well and rest when possible. There is a breastfeeding newsgroup that is really very helpful, if you get a chance post the question there and you'll receive a lot of responses. For the first 6 weeks of my girls lives I had to wake them up and force them to eat and they didn't want to, they were so tired because they were preemies but they had a lot of catching up to do. Once they reached their due date they were a bit more normal and ate about every 3 hours but at times it would be every 1 to 1 1/2 hours. I always assumed they were having a growth spurt and needed it. I also don't believe in scheduling feedings, I feel they know when they are hungry much more than I do. At 10 months they do eat every 3 hours still and will nurse between feedings when I am home. I just assumed it was normal. Good luck with nursing, it has worked out wonderfully for me and though it was rough in the beginning I have never regretted it.

(Note: There are links to breastfeeding newsgroups and bulletin boards in the WWW Resources section of this FAQ.)

I nursed exclusively until...well, they never got bottles and at 2.5 they're still nursing. Of course they eat as well. I nursed them separately to start out because they were so wobbly. Then I did end up nursing together, although I've never liked it as well. I didn't supplement at all. But, it did take them longer to start really gaining than with my singleton. I think this must be due to a longer to time to build up sufficient supply.

Nursing Multiples Table of Contents | Twins List FAQs

Giving Breastmilk in Bottles

"I am pumping my milk and giving it to my 6 week old twins in bottles because it is easier to see how much they are getting. Is this O.K.?"

Breastfeeding can feel very overwhelming at first because you DON'T know how much they are getting, and I found that nerve wracking for several weeks. As soon as they were able to (about 8 weeks) I nursed them together on demand (about every 2.5 hours). If pumping works better for all of you, then do it. However, by pumping you do not produce as much as the babies would by sucking so you may need to pump more often.

The thing that helped me the most was belonging to a monthly support group at my local hospital for nursing moms (not an LLL group). The lactation consultant let me bring my twins for a weight check every week for the first month after they were out of the NICU (spent 5 weeks there). They always gained more than the range of 3-7 ounces a week. I felt much better then about my body's ability to produce enough. Also, she told me that babies have a high need to suck in the evening. They are often so fussy not because they are hungry (which my dh would insist) but because they need to suck. Letting them nurse as much as they want in the eves for those first 3 months or so will go a long way in helping your body produce more milk and helping them calm down. They won't actually be getting a lot of milk then, like at morning nursing. Good luck!!

I am not a lactation consultant or anything like that, but I'm in my 22nd month of nursing my twin daughters. Even though I worked 3-5 days per week from when they were 4 months to 19 months, they never had formula. In my opinion, pumping milk and giving it in bottles when you are available to nurse is unwise.

First, even if it continues to work, you are missing out on many of the benefits of breastfeeding, such as the cheek and jaw development for the baby, the convenience of not having to use (or take along) any equipment, being able to respond to hunger immediately, the skin-to-skin closeness, the way the composition of the breastmilk changes during a feeding in response to the baby's sucking pattern, the way the baby can nurse for comfort without eating a lot more towards the end of a session.

Second, according to everything I've read it is unlikely to keep working for the long term. Decreased milk production is the obvious challenge. Even if milk production does not drop off, I can't see that production would increase the way that it needs to for growth spurts and the increased appetite of an older baby. What do you plan to do if they finish everything you've pumped and are still crying for more? In addition, nursing is a skill that babies can forget or fail to learn if they spend too much time drinking from bottles early on.

My twins are my first children, and I, too, was nervous about them eating enough at first, even though they were essentially full term (37.5 weeks) and good weights (5 lbs 6 oz & 6 lbs 4 oz). I kept a log of the number of diaper changes--the output will tell you if the input is sufficient. I also weighed them weekly on a kitchen scale. Gradually I began to trust that the system worked, that my body could produce enough milk and nourish the girls just the way it had when I was pregnant, and I discontinued the record-keeping.

As someone who did a *lot* of pumping, I think nursing is way easier than pumping. Anyone who pumps is really dedicated to providing breastmilk for her children. Then why not do it the easy way and the way that's much more likely to work in the long run: straight from the source!

On the whole I agree that it is better to breastfeed than to give breastmilk in bottles; however, if you bring home preemies I would disagree. With preemies I feel it's essential to know how much they're getting at a feeding, and this can be done with nursing by using the pump. I always made sure at least one of the triplets got a bottle at each feeding, usually pumped breastmilk if I had it available. That way I could see how much he was eating on an average. A friend of mine would feed one baby at one breast and pump the other breast at the same time. Her let down occurred more easily for the baby at the breast, plus she was expressing milk for the bottle for one of her other triplets.

Nursing Multiples Table of Contents | Twins List FAQs
Breast Pumps

Surviving the First Months: Tips from Breastfeeding Mothers

Drinking QUARTS of fluid (I chose water) helped my amount increase VERY quickly. A lactating mother's constant companion must be a glass (or jug!) of fluid. Extra pumping won't really help unless you are COMPLETELY, CONSTANTLY hydrated.

Soak tea bags (cheap black, orange pekoe) in warm water then place moist tea bag between nursing pad and nipple for sore, cracked or even blistered nipples. (Been there, done that...REALLY works).

1. Get PLENTY of rest. You obviously have to be the one to do the nighttime feedings (at least until your milk supply is established) but you may want to have someone bring the babies to you. My husband (bless him) used to get up & change the babies' diapers & bring them to me. I got used to hooking them up & dozing off while they ate. When the next one (or two) got hungry he would burp the fed baby, take it back to bed and swap it with the next one. It will take you a while for you & the babies to get comfortable enough nursing to do it in your sleep, but it does work!

2. If you have help, DON'T waste it by having them help with feedings. It sounds like a good idea to give you a break, but if you are going to nurse (and it does make life SOOO much easier) you need time to get good at it. You can't get that if someone else is feeding them. It seems like volunteers all want to come over & ooh & ahh & play with the multiples. True friends do your laundry and clean your bathroom! If you don't feel comfortable with this, ask volunteers to bring over a meal. You have to eat lots right now & probably won't have time to cook. DON'T be shy about asking people to scram if you are getting tired!

3. There's a good book on nursing written by Karen Pryor called (I think) _Nursing Your Baby_. She's very pro-breastfeeding, so be forewarned. But there is a nice section in the book on raising your milk supply and gradually decreasing reliance on formula. If someone is looking for a way to help, send them to the library or bookstore for you.

Whatever you do, or don't do, SLEEP WHENEVER YOU CAN!! This was my second pregnancy, and my second time nursing, and I didn't sleep as often as I did last time. I had a lot of trouble keeping enough milk, because I was sooooooooo tired. You need to get enough sleep, and you should have enough milk.

There's been some great advice about these early days of nursing, to all of which I say Amen! I'd just like to add: drink more water than you ever thought you could. I was downing at least a gallon from 10 pm to 5 am at nursing's height.
I also found the teas to stimulate milk production to be very helpful--they usually contain fennel, some mint, raspberry leaf, whatever. _Nursing Mother's Companion_by Kathleen Huggins was a book that helped me a lot, as did the La Leche League--selfless, helpful women with lots of solid tried & true commonsensical advice plus support & encouragement.

It does get better. Although things are rough, remember that "this too shall pass." Those words of wisdom were a godsend for me. The first two months were, in all honesty, hell. I'm a single mom of twins and I remember getting up every hour to nurse for 8 solid weeks! The most sleep I would get in a stretch was 20 minutes and receive a grand total of 1-2 hours sleep for the day.

Finally, a friend of mine would come over once or twice a week and watch the boys in the evening for an hour or so and give them a bottle of formula and put them down to sleep. This allowed me to get a jump on my sleep and I would get a good 2 hours of sleep time in before starting the night shift of nursing, changing, etc. Another thing that helped around this time, was that I would give them a bottle of formula for their evening feeding, then go straight to bed myself. When the first baby woke up, I brought him into bed with me to nurse. I found that by nursing on my side, I could actually doze off myself while the baby was still nursing (I don't know if this is good or not, but it's what I did). Then when the second baby woke up, I kept the first one in bed and brought the second one in bed for nursing. I'd end up with a baby on either side of me. For the next round of feeding, I simply rolled on to my side for whomever was hungry. This way I didn't have to get out of bed and could at least rest if not sleep. Of course, this was at an age were they could not roll over, and it sure helped me get through the night time feedings.

After the 8 week mark, I was getting 3-4 hours sleep per night, then more and more there after. It does get better and this too shall pass.

My hospital breastfeeding consultant (who also fed twins) advised me to dedicate the first few weeks to breastfeeding and rest. My consultant did this by having a mattress on the floor where she and her babies slept, napped, fed, etc. I stayed on the couch with a basket for each baby within easy reach and a stack of diapers. When the babies slept during the day so did I. My husband was with me the first week plus so he did the housework and fed me. The next few week I would get up to fix myself something to eat but let everything else go until he got home. I didn't leave the couch to sleep in bed until about the fourth week.

Stick it out the first month. The first month is difficult for many breastfeeding moms. If you feel sore or tired, or etc, an occasional bottle of water or formula can be used.

Make sure you are all set up before you sit down to nurse, big cup of water or juice, remote control, spit up cloths, extra pillows in reach, etc. Watch your posture and make sure that the babies are positioned just right to prevent discomfort and soreness.

Others have already mentioned the need to drink lots of fluids and to rest, particularly during the first months of nursing. There are two other points worth mentioning:

1. EAT. Eat lots, eat healthy. The start is so demanding, it is hard find time to do this, but do it nonetheless. Ask anyone who offers help to bring over a casserole or other food. The best gift I received was five frozen casseroles made by my next-door-neighbour. I also stocked the house with high quality European-style muesli (heath food stores often carry some dense muesli with lots of nuts and fruit), because it is nutritious and filling and fast. You need food to make milk.

2. FORGET HOUSEWORK. Who cares if your floor needs vacuming or there are dirty dishes in the sink?! The only important job is to make sure your babies are fed and changed. I don't think I washed a dish or cooked a meal until the girls were three months old. My husband would do that when he got home from work. He felt strongly that my job was to feed the babies and I needed enough rest to do that. I agree.

If you have to travel by car for any distance, remember to bring plenty of liquids. We brought a 2 1/2 gallon container of bottled water. Also you might experiment about where you can nurse both at the same time (bring your pillow). We found that the front passenger seat with the door closed and arm rest down works well if your other seats are filled with stuff.

To get that last little bit of breastmilk smell out of their clothes, and yours for that matter, add a cup of vinegar to the wash. You can also add a little liquid softener to the wash if your little one(s) aren't sensitive.

My advice would be to link up with a La Leche person long before you deliver. I know some of their members can be a little pushy, but I really think a support person who had breastfed (preferably multiples) would have kept me going. If nothing else, get involved with your local twins club before you deliver and ask if there are support women for breastfeeding. My club has several members who breastfed their twins for a long time and are happy to talk with anyone trying to do the same.

Nursing Multiples Table of Contents | Twins List FAQs
Coping with Multiple Infants FAQ

Building Your Milk Supply

  • For Newborns
  • For Older Babies

    For Newborns - "I don't think I have enough milk. My 1 week old babies nurse all the time and still seem hungry."

    I think it is too soon to get overly concerned. Are you into LLL much? (I only bring that in because they might be able to find you a local mom that went thru this too.)

    When you have a complicated pregnancy and/or a complicated delivery and neonatal period...nursing can be challenging! It's a lot harder...takes a lot more persistence...needs a lot more coaxing...requires a concentrated effort to relax (sounds like opposite terms) :) BUT if you can get thru can be sooooo wonderful! :) :)

    Tips: Really relax...think happy thoughts about your babies: not...wonder if I'll have enough milk ever? not...will they ever be able to suckle my breasts. Think like this: When my milk finally comes it will help my sons to be stronger. My milk will soon be enough to feed them both. My babies will come to like nursing from me real soon.

    Have you tried a hot shower? Seriously...I know dozens of women that thought they weren't going to be able to nurse, going into their second or third weeks of trying, who took a shower...going in tired and frustrated and needing to relax...really got into feeling the warmth and the streams of water soothing them...and suddenly had their milk *letdown*...some laughingly tell the story now of "when their milk shot out across the bathtub (bathroom, shower, etc) surprising them and then it just kept coming...non-stop flow" funny to talk about later...but often a revelation then!

    Sometimes...especially in the early days/weeks of nursing...we all resort to *warming up* the breast with a hot (as you can stand) washcloth. Put it on and just lean back with your eyes closed and shut your ears to crying babes for a minute or two.

    It's been sooo long since I've been nursing babies...If I think of some other ideas, I'll let you know. :) Hang in there! :) :)

    I had a similar problem with my milk supply coming in. I delivered my boy/girl twins at 36 weeks gestation after being induced. My milk did not come in until the 7th day after the birth of my babies. I too had to supplement with formula but nursed each baby for 20 minutes before allowing the nurses to gavage feed the babies with formula (both babies were in NICU). I rented an electric double breast pump from the hospital (less traumatic to the breasts than a manual pump and double the stimulation) and pumped for at least 20 minutes at a time, as often as I could in between visiting/nursing my babies in the hospital. I too felt frustrated at the tiny amount of colostrum and then milk that I was able to express and save for my babies but I felt a little bit was better than none.

    My sister-in-law then mentioned an old wives' remedy: that of drinking beer! Within a day of consuming a couple of beers (I tried Guiness as it contains iron and is good for you) my milk came in and then I had the problem of being engorged which was painful! Now whether this was sheer coincidence or not I do not know. There is supposed to be something to do with beer making, the use of hops or yeast that helps the production of milk rather than the relaxing effect of the alcohol consumed. Apparently a glass of wine, gin & tonic etc. does not have the same effect. If you do not like the taste of beer, you might try taking brewers yeast tablets and drinking lots of water. If you are concerned about the small amount of alcohol that will be present in breastmilk you can always express and waste that first milk. My concern was in getting the milk supply established.

    To this day I do not know why my milk supply was so slow in coming in. None of the books I read on having a baby/babies mentioned this problem, neither did any of the La Leche League literature that I read. I just put my problem down to the fact that I was ill prior to the delivery (hence the need to be induced so early) and that my body was not primed and ready to produce milk at that time. I am now nursing both babies but supplement with formula too.

    It took about 6 days for my milk to come in when I had my twins (not preemies--39 weeks). Everyone else has given lots of good hints that I don't need to repeat, but something I will mention is that you only make a small amount of colostrum (or milk) when babies are newborn because that's all their little tummies can hold! I read somewhere (and the pediatrician confirmed, I believe, that a newborn's stomach capacity is only about 1/2 to 1 ounce at a feeding.

    It seems obvious to me now, but at the time we were new parents and didn't know any better, had no experience. We figured if the boys were eating they must be hungry right? I was convinced I wasn't making enough milk and they were starving. Well, apparently some newborns haven't yet figured out when their tummies are full they need to stop nursing. My guys would eat and eat and then throw up because they had eaten more than their stomachs could hold.

    The spring 1996 issue of Mothering magazine has suggestions for increasing milk production. One of their suggestions is to drink hops tea or a good quality nonalcoholic beer (hops stimulates milk production). They also suggest fennel seed tea, vitex (chaste berry) capsules, and teas made of blessed thistle, aniseeds, nettles, raspberry leaves and fenugreek (whatever those things are!). The article also mentions that "foods such as carrots, brown rice, sweet potatoes, pecans, apricots, green beans and all dark, leafy greens are quite helpful in boosting breastmilk production and providing the proper supply of nutrients to both mother and baby." They also mention that "taken in a tea form by a breastfeeding mother, catnip gently encourages the cramps in a baby's intestines to subside." Hey, it might be worth a try?

    The best way to let your milk down is to nurse away from distractions or stressors. Go to a quiet place, and when your baby latches on, think of nothing but the baby and that all-encompassing love you feel for him/her. Take a deep cleansing breath, relax, and focus on that love!

    Drink warm DARK beer: usually only 1/2 to 1 cup is needed. This treatment is actually PRESCRIBED in European countries for new moms. When this small amount is consumed, only minute trace amounts of "alcohol" are found in the breastmilk. This has NOT been shown to adverse effects on the baby. Now the benefits to mom & baby are enormous. First the mom when she consumes the beer will have a relaxing effect that will allow the milk to "come down" easier. This will allow the baby to relax and the feeding will go much better. Beer actually has natural milk enhancers in it!! The hops, barley, malt all help to produce a richer milk. Other things a nursing mom can do to is get the Carnation malted milk mix in milk and drink that one time a day. Oatmeal or any whole grain cereals are good also.

    For twins, feeding them both at the same time is the best way to increase the milk supply. With any baby if you feel that the baby is not getting enough milk, DO NOT SUPPLEMENT!!!!!! This will in fact DECREASE your milk supply. Instead, when the baby stops feeding use a manual or electric breast pump to express any milk left in breast. Pump for about 5-10 minutes on each side. The extra stimulation will cause your breasts to increase the milk supply at the next feeding. This is especially helpful for growth spurts.

    For Older Babies - "I am breastfeeding our 11 week old girls exclusively and would like to continue past 6 months and hopefully to a year. Will my milk production keep up with their needs? They seem to eat a lot and `drain' me."

    Congratulations on continuing to breastfeed your twins! At eleven weeks you have made it through the roughest spots--it's practically down hill from here. Your will body will continue to keep up with you babies. I breastfed my twins for a little over a year and it was a wonderful experience. Just remember to eat right, drink plenty of fluids and put your feet up and relax while you are nursing. Also it is important to remember that if you feel that your production is not meeting your twins needs don't offer a supplement right away--that will only cut down your production more! Sometimes if the babies are having a growth spurt it may take a little time for your body to adjust--but it will. Breastfeeding is a miracle, the more your babies drink, the more your milk your body will make. It also helps to nurse the babies at the same time--it is also easier on you to have them on the same schedule. I nursed my twins by holding one twin in a "normal" position and the other twin going in the same direction with his head in her lap. It worked out great. I always tried to change which twin was on "top" at every feeding and which direction they were going so that they didn't always have the same view. Also remember that around 6 months they will start eating solids so they will have to depend less on mother's milk.

    Nursing Multiples Table of Contents | Twins List FAQs

    Supplementing with Formula

    "I am supplementing with formula but would like to keep breastfeeding as well. Is this possible?"

    My twins are almost 6 months old and are fed 90% breastmilk and 10% formula. Their last feeding of the night is always formula. I have heard that babies who are allergy prone could be upset by even this small amount of formula. So far we haven't had any problems. However, I have noticed that the formula is harder for them to digest (we've found one that seems easier on their systems (Soy-A-Lac) than Enfamil or Similac). I've heard that the only reason to never give them formula is if food allergies run in your family. Otherwise, it would seem that they'd get all the immunological benefits of breastmilk plus some extra "filler."

    From the beginning we supplemented. This had a lot to do with the hospital I was in. I didn't get to try to nurse until almost 24 hours after my C-section, and they locked the nursery and gave bottles at night. So once we got home my supply was nowhere close to enough (especially for my daughter, who was particularly hungry baby). By 6 weeks, after lots of pumping for extra stimulation, we reached the point where most days my daughter got one formula bottle a day, and my son, who had more trouble with the formula, was essentially completely breastfed. I still gave an extra bottle here and there when I was feeling completely drained (especially in the 4th month. They hit growth spurts at different times, so I felt like I always had someone on!).

    I had difficulty trying to nurse all three babies when they came home so I gave up nursing when they were a little over 2 months--they were never able to take enough (supply was not the problem--they simply got too tired after getting used to being fed through a tube for weeks) so I always had to supplement. I pumped (it was an endless task--my supply of milk was plentiful) and supplemented with breastmilk. When I decided that I could no longer keep up pumping, feeding and surviving, we switched to formula.

    However, I pumped long enough to mix formula and breastmilk (half and half) for over a month. Our babies had no problems adjusting to or digesting the formula--just a thought for someone who may be in the same position.

    Between two babies, I had a break of an hour between feedings. Now I breastfeed them at the same time, but I've also gone to a few bottles to get a break.

    Be open to supplementing the breastfeeding with bottles. Eventually, I gave my boys a bottle at night. This works well because milk production tends to be lower, the formula is harder to digest and they seem to sleep for a longer interval, and you can get a longer stretch between feedings to allow someone else (like your husband or friend) to feed them and give you more time to snatch some sleep. Yet, they (and you) get the benefits of breastfeeding!

    A friend of mine, also a MOT, advised me to breastfeed one baby, while giving the other baby formula (alternate at each feeding). It worked out great for all of us. During the feeding I could relax and enjoy the babies, not worrying about do they get enough or should I give them supplement. I could give each baby, esp. the one I was breastfeeding, all my special attention. When my husband was at home he could help me with giving the other baby formula, a wonderful opportunity for him to get bonded with each baby. For me they had the best of both, the good things of breastfeeding and no worry about do they get enough.

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