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How to Succeed in Nursing Multiples

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by Sharon Withers

There it was again–another look of disbelief. Melinda’s confidence dipped a little lower with each look or thoughtless remark: “You’re not going to nurse twins, are you?” or “You’ll have your hands full enough without nursing.” Already exhausted from a lack of sleep–it was hard to get comfortable at night–Melinda was especially vulnerable to negative remarks. Melinda’s concerns–sleep and milk–are not unlike those of thousands of other mothers who eventually find nursing twins one of the most rewarding experiences of their lives. In the beginning, however, the reality–sleep, milk production, emotions and a dramatic change in lifestyle–can be overwhelming.

“When I was breastfeeding my twins, I felt like I had my shirt off 24 hours a day,” recalled Jean Dosdos, a breastfeeding support volunteer through the West Palm Beach Mothers of Twins Club in West Palm Beach, Fla. “I know how frustrating it can be for new moms of twins, and that’s why I volunteer. I know it’s a tremendous help to have that support and encouragement. Otherwise, new moms would quit trying after two or three weeks.”

Find support
The first steps to successfully nursing twins are to seek out supportive family, friends and an encouraging pediatrician; get accurate information; and turn a deaf ear to negative remarks. Talk to other mothers who are nursing twins a couple of months older than yours. Join a Mothers of Twins club and attend La Leche League meetings before your delivery. A lactation consultant can administer a healthy dose of facts and the wisdom of experience.

Carol Huotari, accredited La Leche League leader and an international board certified lactation consultant, said that commitment is essential to successfully breastfeeding twins. “A migratory field worker pumped her milk three times a day in the bus and the other workers laughed at her, but her commitment was strong and her twins were the healthy ones who didn’t have ear infections.”

Set goals

Knowing your goals is part of commitment. “Are you going to nurse exclusively for six months? A working mother may supplement with bottles. Think it through and decide what will work in your life,” Huotari advised. Success is defined differently for every mother.

It takes time to learn
While still in the hospital, talk to your lactation consultant about your goals, concerns and lifestyle. Ask that she be there when you first nurse and ask for a home visit if you have preemies. She will guide you through the first sessions; they are the learning times for you and your babies. Your newborns are trying to latch on and you are establishing your milk supply. “With twins in the football hold position, you can really watch what they are doing with their mouth,” Huotari explained. As they grow you may find more comfortable positions.

Preemies may take a little longer to latch on since their sucking instinct may not be fully developed. In that case, you may need to pump your breasts to get the milk flowing.

You will have milk
When your twins latch on well and nurse effectively, your milk supply will quickly build. It is a case of demand and supply. The greater the demand, the more milk you supply. Expect to nurse your newborn twins about 10 to 12 times in a 24-hour period.

Until your twins learn to latch on, it may be a good idea to nurse them one at a time. “It really helps mothers to individualize their twins and see who’s who. Each baby has a different nursing style,” Huotari said.

Know who nurses when and where
Whether you continue to nurse them individually or simultaneously, you do it you need to be organized about it. Keeping track of who nursed first and at which breast helps you know how they are feeding.

“I breastfed my 30-month-old triplets, Sammy, Hope and Emma. One of the three is still breastfeeding, one weaned at 13 months, the other at 24 months,” said Sheri Ingalls of Port St. Lucie, Fla. “To keep my milk supply up, I nursed the babies on demand through the night. It also alleviated some of my concern over the babies getting enough to eat. During the day, the babies had to be on a schedule so that I could ensure that each one had the opportunity to be first–which was the easiest let-down–and last, which was the longest time on Mommy. If I allowed them to nurse on demand all the time, Hope would have nursed all day and left the smaller ones with nothing.”

Sleep when your twins sleep
Allison Berryhill of Atlantic, Iowa, found nighttime nursing to be a way of life during her twin boys’ most milk-dependent months. “With newborns, I reclined in a pillow-piled Lay-Z-Boy, each boy to a breast, attached for the night. I did not get long, uninterrupted hours of slumber, but I was no more sleep-deprived than during the final months of pregnancy when few positions were comfortable.”

Sleep becomes the top priority–after establishing your milk supply and feeding your twins. The rule for mothers of twins is sleep when your twins sleep.

You’ll get more rest if you can learn to nurse lying down in bed and if you set up a comfortable “nursing station” for the days. Whether it is a Lay-Z-Boy or a comfortable sofa, you need room to prop plenty of pillows and a footstool for your feet. On a table within easy reach have a telephone, diapers, a notepad for jotting down who nursed first and where, and a snack and a beverage. A well-arranged nursing station means you won’t have to hop up once you’re settled and you will be more rested.

Nurture yourself
If you become fatigued your ability to keep a positive outlook while coping with the ups and downs of nursing twins diminishes. You must take care of yourself. That means sleeping as much as possible, eating right and drinking quarts of fluids each day.

The number one piece of advice new mothers of twins offer expectant mothers is to get help with the household chores and cooking.

But housework may have to wait. Cooking is something others do for you. Only you can nurse your twins.

Sleep deprivation and neglecting your basic care just opens the door to depression. About 10% of women have postpartum depression the first year, but with mothers of twins the figure jumps to 25%, according to Huotari. When you are home and alone with your babies, you can quickly feel isolated and overwhelmed. Be sure you have a friend to talk with, one who understands the special demands of multiples.

Don’t give up
Regardless of how much support you have and how well you prepare mentally, the reality of your new job can be an emotional seesaw and the adjustment definitely takes time. Huotari offered some sage advice: If you feel like giving up, stick with what you’re doing for three days and then see how you feel. Remember, tens of thousands of nursing mothers say joy does come out of the early chaos.

Sheri summed up: “Don’t listen to other people, not even doctors, when they tell you it can’t be done. You can make enough milk. You can get some sleep. You can have a life! Don’t give up if it’s tough at first, because after your babies are bigger and getting more milk in a shorter period of time, it’s a breeze.”

BREASTFEEDING FAQs
How can I tell if my twins are nursing effectively?
Most newborns breastfeed 10 to 12 times per 24-hour period. They nurse for 15 to 30 minutes at a feeding and swallow after every one or two sucks. A baby who is having difficulty getting enough to eat will not latch on properly, may want to nurse inordinately long and will not swallow often.

How do I know if my babies are getting enough to eat?
After the first couple of days, they saturate six to eight diapers per day and have from three to five bowel movements. With multiples, it is helpful to keep notes on who nursed at which breast, for how long, and the number of wet and soiled diapers. An electronic scale help your confidence. Once your milk and their weight gain are established, tracking the nursing schedules and diapers is not essential.

Why are my twins suddenly starving all day and night?
Growth spurts occur periodically; the first may come as early as 10 to 14 days after birth. The next one may surface around four to six weeks and another one around three months. Prop your feet up and nurse, nurse, nurse on demand. Your milk supply will quickly catch up with your twins’ needs. If, however, you respond with supplemental bottles, your milk supply may not increase to meet the rising demand.

Can I nurse my preemies in the NICU?
Babies develop the ability to swallow when they are 11 to 16 weeks in utero. The ability to suck follows a few weeks later. The ability to coordinate both actions and breathing comes later still. If your babies are very low birth weight, you may have to express your breast. Expect to pump for a total of 100 to 120 minutes a day. The NICU will watch for signs that your preemies are ready for nutritive sucking.

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