Throwing the Birth Plan Out the Window
I didn’t focus too much on making a birth plan because I knew that a C-section was inevitable. I wanted them to be placed on my chest after delivery since I was determined to breastfeed them. Besides the positive outcomes for both mother and babies, I was not sure that we could afford formula for two infants. The lactation consultant I met with before their birth proclaimed,
“Two boobs can feed two babies! One for each!”
The birth plan goes out the window when there are complications and the girls make a surprise early entrance under extenuating circumstances. Due to pain issues, I was made unconscious during my C-section and was then incapable of seeing the girls for about 36 hours after they were born. The girls came early, but there was no early bonding. They were in the NICU, and pumping breast milk to give to them seemed daunting. My husband and I started right away on the pumping every two hours, even when the first six pumping sessions produced nothing but sore nipples. When I finally got 5 mL of colostrum, my husband took it to the girls in the NICU. Their nurse questioned if there was anything in the oral syringe. This was not the sort of encouragement I needed. We were determined though, and I say we because my husband did everything he could to help support me, including washing all of the pumping parts after each session and running to the NICU with whatever liquid gold we were able to mine. It started out slowly, but eventually my supply started to increase. I drank dark beer and mother’s milk tea, took fenugreek and ate lactation cookies; I was adamant about breastfeeding my girls. In the meantime, though, the NICU team wasn’t comfortable waiting for my body to cooperate, so the girls were given formula by bottle and pacifiers to soothe them.
I continued to pump every two hours. With the NICU 45 minutes away from home (without traffic), I even pumped in the car. This was the beginning of not caring who saw my breasts, whether it was a trucker next to us in traffic, my mother-in-law, who has now seen more of my breasts than she ever wanted to, or the NICU nurses.
I was intimidated by the NICU nurses. They were with my girls all the time and I didn’t really feel like they were mine whilst they were still in the hospital. After such a physically and emotionally traumatizing birth, I was exhausted. By the time they were ready to come home, they were receiving half expressed breast milk, half formula. Whatever I pumped had to be split in two and fed to the girls, then I supplemented with formula. They ate every 3-4 hours. Only about once or twice a day would I actually be able to put them to my breast before we needed to go home so that I could continue trying to heal from the major abdominal surgery.
Transitioning From NICU to Home
I was told to keep them on the same feeding schedule that the NICU had established. However, I was unprepared and uneducated on what exactly I should do with them when we got home. Turning to Facebook pages about breastfeeding twins, I found more support there than the health care system offered me. I continued to feed them pumped breast milk and formula. At lightning speed, they went through whatever supply I had stored up in the refrigerator. I panicked. My sister asked me why I wasn’t breastfeeding them and I didn’t have a good answer, so I started putting them to breast more frequently and on demand.
This executive decision suddenly excluded my husband and mother-in-law from the feeding process. I was going to stop formula and bottles of breast milk (because there were no more to give) and just breastfeed. My mother-in-law had never breastfed and could offer no advice and my husband, who had demonstrated a natural ability to give a bottle in the NICU, now felt left out. This was what was best for the girls, though, if we were going to pursue breastfeeding long term.
There was some push back whenever the girls cried, but I don’t think it was ever malicious.
“Are they still hungry?”
“Did they eat enough?”
I found breastfeeding to be very stressful. Were my underweight babies eating enough? Was I making enough milk? Why did it feel like they were eating every 30 minutes?
I cracked under the pressures of breastfeeding and having newborn twins at home. I tried to schedule the feeds every two hours. A schedule would mean routine, something babies are supposed to respond to, right? I could envision breastfeeding on demand if I only had one baby to look after, but with two? I had to schedule for my own sanity, otherwise I may conceivably never sleep. If one baby was up and the other was asleep, I would break the cardinal rule of infants and frequently wake a sleeping baby. I would nurse them simultaneously and my husband and/or mother-in-law would help place them on the tandem nursing pillow. In the beginning, we would switch breasts every feed. Once I had finished nursing, the girls would then be taken away to have their diapers changed before sleeping. I felt like my only role was to be the milk machine, and then the girls would be passed on to the next stage of the production line. I didn’t have the opportunity to hold them or cuddle them. Just as in the NICU, they still didn’t feel like my girls.
At their two week post-NICU check-up, I was pressured to supplement. My husband and mother-in-law gave me knowing looks.
See? I told you they weren’t eating enough!
So we supplemented with formula for a couple more weeks before constipation started and I repeated the executive order. At about this time, they each got assigned a breast, too. One of the girls was less fussy on the right and protected her from thrush when I developed it on the left breast. We had a brief period of everything feeling easier until I started to overthink everything.
The Great Bottle Strike of February 2015
They gained half a pound a week until they hit three months old. In my desperate attempt for more sleep, I tried to stretch their eating to every three hours. My colicky girl would only nurse for five minutes at a time and I was worried that she wasn’t receiving any fatty hind milk, so I switched to bottle feeding and was back to pumping every two hours again. My mother-in-law had returned home at this point and for the first time, I was on my own during the day. I was finally starting to feel like my little girls’ mom.
I thought they would eat more if they had bottles of breast milk. I thought they would sleep longer at night if I gave them a bottle of formula before bed and did a dream feed. I assumed I had them figured out; they set out to prove me wrong. No doubt this will be a theme throughout their childhood.
During their fourth month, they started to take less and less from the bottles and soon there were days when they had half of the ounces they were expected to have. There were nights when my colicky girl would just scream and refuse to take a bottle altogether, and then her sister started to join in. Their weight gain slowed. If they had a union representative, I would have been informed they were on strike. While not identical, they seemed to be amazingly in sync with each other. With ever-increasing maternal concern, I took great pride in their obstinate teamwork.
I thought that I needed the schedule for my sanity; however, not paying attention to what the girls were trying to tell me ended up being insane. Finally, I came to my senses and put the breast pump back in the closet, put the bottles away and stopped using formula. Again. I tried a couple of days of doing the schedule again with breastfeeding and then threw my hands up in the air and conceded that we would breastfeed on demand. Should we have done that all along? Maybe. Hindsight is always 20/20. They were able to go longer periods of time between feedings so it made on demand easier. Looking back, I feel like each step lead me to the next one—there was some sort of rhyme and reason to the meandering path that we traveled.
Babies Know Best
Once I abandoned my need to control the situation, I let the girls start to do more of the managerial work and things went more smoothly for about 6 weeks. We continued tandem feeding on demand and they would sweetly hold hands, when they weren’t trying to gouge each other’s eyes out. Nevertheless, their weights had not rebounded from their month of diminished bottle feeding and the pediatrician had some concerns. While they were catching up on their developmental milestones and about as active as they could be, their weights were still lagging behind, even when adjusted for their 5-week early arrival. At this stage, we were encouraged to start solids at four and a half months old. Breastfeeding seemed much easier once we started purees and oatmeal. Five months of wondering if I was doing anything right in regards to breastfeeding and I finally hit my stride.
Well, That Certainly Takes the Guesswork Out of It…
No longer do I need to wonder if they are hungry because now the girls just crawl over to me and pull up my shirt. Their history of tandem feeding might explain why they hate to eat alone now but if I start to nurse one of the girls, the other one will come over and want to nurse as well. These days, there is a lot less hand holding between them and a lot more mixed martial arts.
Feeding twins seems to require more physical coordination than anything else. We didn’t have to deal with tongue ties or mastitis or other challenges commonly faced with breastfeeding; I just needed to have more confidence in what I was doing from the beginning. However, I don’t think I could gain that confidence without going through all of our ups and downs. Besides the added extra bonus of saving us $2500 in formula for two babies so far, they also weren’t sick for the first 8 months. We were lucky.
We are sharing stories this week about our triumphs and travails with breastfeeding in honor of World Breastfeeding Week (1-7 August 2015, coordinated by WABA).*
“This World Breastfeeding Week, WABA calls for concerted global action to support women to combine breastfeeding and work. Whether a woman is working in the formal, non-formal or home setting, it is necessary that she is empowered in claiming her and her baby’s right to breastfeed.”
For more information please visit http://worldbreastfeedingweek.org/.
*Disclaimer: Rainbows & Unicorns does not discriminate against how any parent chooses to feed their child. We honor that families always choose the best thing that works for them, whether that is formula feeding, breastfeeding, exclusively pumping, or a mixture of any of these.