Breastfeeding Twins: Insights from an IVCLC and Mother of Twins

Introduction

  • Milena, an IVCLC and mother of twins, shares her experiences and insights on breastfeeding twins.
  • Having prior knowledge from the International Breastfeeding Center was advantageous.

Milena's Experience

  • Twins were born prematurely at 27 weeks (six months gestational age).
  • Spent time in three different NICUs.
  • Latching began at 34 weeks gestational age.
  • Established milk supply early with hand expression and pumping.
  • Successfully used a lactation aid at the breast.

Managing Twin Feeding

  • Twins were on a similar schedule for eating, bowel movements, and naps, allowing for breaks.
  • Tandem feeding was used with a breastfeeding pillow.
  • Positioning was challenging; success was measured one feeding at a time.
  • Babies initially received NG tube feeds and bottles (donor milk).
  • Domperidone was used early on to help with milk supply due to prematurity.

Tips for Getting Twins on a Similar Pattern

  • Bed sharing facilitated breastfeeding, especially in the sideline position post-C-section.
  • Bed sharing provided easy access and facilitated breastfeeding.
  • Parents who prefer control and schedules may lean towards pumping, while those co-sleeping and following cues may breastfeed longer.

Breastfeeding Journey

  • Almost exclusively breastfed for six months.
  • Donor milk was used initially to boost milk supply.
  • After 34 weeks, donor milk was replaced with occasional formula supplementation.
  • Breastfeeding continued successfully with some formula supplementation.
  • Formula was given occasionally (a couple of bottles weekly).
  • Pacing bottles was not prioritized due to exhaustion.
  • Solids were introduced at six months corrected age (nine months chronologically).
  • Breastfeeding continued until 15 months chronologically (one year corrected).
  • Pumping continued until the twins were three years old, mixing breast milk with their food.

Pumping and Breast Milk Benefits

  • Breastfeeding might not always work, but pumping can extend breast milk benefits.
  • Even if unable to breastfeed, pumping and providing breast milk is still beneficial.

Lactation Consultant Tips for Twins

  • Every family is different, with varying breastfeeding goals.
  • Establish the mother's goals and work from there.
  • Consider the mother's physical comfort; offer tandem positioning but respect preferences for feeding one at a time.
  • Allow mothers time to get comfortable with holding, positioning, and recognizing milk transfer.
  • Breastfeeding is a learned skill, requiring practice, especially with twins.
  • Prioritize mom's goals and work toward them gradually.
  • Assess the practicality of using lactation aids.

Practical Advice for Lactation Consultants

  • Focus on individual assessment to help with latching effectively.
  • Recognize the importance of good latch, effective drinking, and pumping to stimulate milk supply.

Additional Tips

  • Any amount of breast milk is beneficial.
  • Triple feeding (breastfeeding, supplementing, pumping) is often unsustainable.
  • Having a fridge full of supplementary breast milk alongside exclusive breastfeeding is often unrealistic.
  • Set realistic goals and acknowledge that goals can change.
  • Take it one feeding at a time and do your best.

Setting Expectations

  • Acknowledge various scenarios and the possibility of changing goals.
  • Mental well-being is important, especially with multiples and other children.
  • Listen to the mother and treat her as an individual, not a cookie-cutter case. Tailor the approach to her unique needs and goals.
  • Build on progress gradually, one visit at a time, to avoid overwhelming the mother.
  • Provide a written plan to aid information retention, given sleep deprivation.