Saturday, June 26, 2010

The Breastfeeding Plan

So about 10 days ago I promised to tell you what the Lactation Consultant (LC) said.

And then I fell into a dark pit and disappeared for a while.

Ok, well actually I just was too tired and too busy to even think about blogging. I had a paper due (which I have another due now) and the babies were/are going through some kind of growth spurt that has me up all night feeding them constantly. And during the day I was awake to work on my paper and feed babies too, so was going with really no sleep other than the small catnaps I'd fall into every once in a while.

But yesterday a call came out over twitter to help answer a question for an expectant mom of twins about breastfeeding. I couldn't just let that go un-heeded since I'm still in the middle of that same issue, so I started answering and realized I had a whole post written.

So here you go.

Let me set the stage for you. I have a four year old who I really wanted to nurse, but had so much trouble with latching and supply that I ended up giving up after 3 weeks of pumping.

So with my second pregnancy I was determined to make breastfeeding work. I was thinking about this way back when we started trying for baby #2 in 2006 even. I was going to make sure to attend LLL meetings BEFORE giving birth. I knew I needed to establish a support network of people who I could ask for help before the babies came. Especially once we found out they were twins. I think this is REALLY important. I didn't even have to join to attend meetings at my local LLL group. They have an email group so I was able to ask questions even while still in the hospital.

I also worked a lot with the LC while the girls were in the NICU. That's a reality I was prepared for this time, while I hadn't expected it with Nicky. Luckily the twins were big, over 6lbs each at 36 weeks gestation, but still they were in the NICU for 12 days. While we were there I pumped like a fiend, and this time I was also able to board in the hospital with the girls to practice nursing. With Nicky I was sent home on day 4. I was able to nurse the twins with help from the LC (and with a nipple shield) but it was still really hard with twins. Not a lot of sleeping going on for me. Mostly they were getting formula as my supply wasn't enough for both of them yet.

Once home I pumped some with my new fancy Medela Pump In Style that I insisted we buy immediately, but between feeding the babies, taking care of Nicky, and trying to sleep and recover from the c-section, pumping was just too much. Getting either baby to latch on took lots of pillows and props and definitely two hands. Tandem nursing was just out of the question for us at this time.

My supply was dwindling away. At the high point I could get one ounce from each side. But now I was only pumping one ounce total from both sides. I could see this going the same way it had with Nicky where I basically just dwindled to nothing in 3 weeks.

So I came up with a plan.

Basically I'm not afraid to give my babies formula. I know for a fact it's good enough. They'd be perfectly healthy on it. To deal with the financial issue of formula feeding twins, I even went ahead and got on WIC which pays for the formula.

However, I DO want them to get the antibodies and good stuff in breast-milk as much as possible. With Nicky in preschool and me working at the university we're exposed to all sorts of germs and the babies need that extra protection. And I also very much want to experience breastfeeding myself. You know me, I'm all about experiencing the most out of pregnancy, birth and mothering because I thought for so long that I'd never have the chance.

But the girls were so small and my boobs so huge (and they would smother if I didn't use two hands due to my anatomy, contrary to all the things you read on breastfeeding) that I just couldn't tandem nurse to save any time right now. My supply also wasn't high enough to exclusively bf even if I did it one at a time, and so often they were both hungry at the same time. Bottle feeding two at a time was hard enough!

So my plan was to keep my supply existent, forget about trying to increase supply with pumping fiendishly. Just keep it in existence until the girls are old enough to have more head and hand control and they can better latch themselves and look out for their own breathing. Then we can try more tandem nursing and I can let them nurse on demand and see if it can increase my supply to meet their wants then. They'll have a stronger suck then too and hopefully be more efficient. If they still have to have formula too, well I'm ok with that. Nursing can be the fun bonding thing and bottles can be the main food source. No problem. We'll let the babies drive that bus.

I ran my plan by the LC during one of the postpartum luncheons they have on Tuesdays. She agreed that it was a great plan. She actually praised me for doing as much as I had already with the twins and said to throw any negative feelings I had out the window. That was so nice to hear! She suggested that I put a time limit on the girls because as it was they would nurse forever if I let them, and then still take a whole bottle, but that would wear them out and use up too many calories for them. So at each feeding, when possible, I latch at least one baby on for only 10 minutes. Both (one at a time) if they'll let me or if I have help to have someone else bottle feed one while I bf the other for 10 minutes. This should keep my supply existent and keep the babies practicing at latching.

So we've been doing this for almost two weeks now. The babies are so much better at latching. I haven't pumped at all and DO NOT feel guilty about it (other than having a really expensive pump we bought that I'm not using). Occasionally if one baby is awake while the other is sleeping I will let them nurse longer, but for the most part it's only 10 minutes. It's not every feeding, especially not at night when I'm trying to snatch every available second to sleep myself (and only getting about 3 non-consecutive hours if that). But it's at least 4x a day I'd say. I think my supply might be increasing too. I might even pump one day soon, just to see if I'm getting any more that way (I was only getting a total of one ounce for both breasts before).

But right now this is working for us. The girls are definitely getting some breast-milk and the pediatrician and the LC both think this plan is very good. They both said that every little bit they get is great. So basically, they're formula fed babies that are supplemented with breast-milk. I think of it as their "medicine" or their "vitamins".

Oh yes, I did run this by the pediatrician too. That visit will be the next post!


Big Ole Pregnant Lady said...

Hi Angela! I'm just catching up on hwo you've been doing. With the twins, reading blogs and keeping in touch has become a luxury!

Thank you SO so much for posting your BFing plan. It's great to see someone in the same situation as me but be so positive about it. I guess that I've been beating myself up about the whole thing. I thought that eventually I'd be able to build up my supply to exlusively BF them (in tandem nonetheless) but I too am lucky if I pump an ounce.

I'm to the point where I don't pump either and I don't always BF in the night so I could get some sleep. When I do pump, I get at least an once, which is great for me! You should give it a shot..perhaps in the morning afer some sleep when your supply is greatest.

Just today I was thinking that giving formula and supplementing with breastmilk isn't so least they're getting something.

Maybe I'll try the 10 minute limit. My limit is 20 minutes per boob per baby. My reason being that my hind milk may take a good 10 minutes to come in. Hmmm, no wonder I'm driving myself nuts.

Anyway, glad to hear that the girls are doing so well and that their diaper rash is gone. I love that Aquafor stuff even if it is can use it on any baby acne. Also, the J&J baby powder wtih cornstarch works well and it's less than $2 at Target!!