Breastfeeding Twins: A Delicate Balance

Yesterday marked the first "official" day of spring.  Which also meant, as Scott pointed out, that yesterday was the spring equinox meaning the Earth's axis is "just so" and the suns rays are hitting the equator in such a way that you can easily balance an egg on a table...or something.  Of course we had to see this for ourselves and, whaddayaknow?  He was right.  Except he was not (which he admitted after the fact), the whole egg on the table thing is a myth - it's no easier to balance an egg on a table on the equinox as it is any other day - but still, it looks pretty cool to see an egg balancing on a table.

Speaking of balance, I have a baby for each boob.  How's that for balance?  All joking aside, I do have to say I am pretty proud of the fact that breastfeeding two little people is going so well (for now).  I'm not out of the woods yet, but my milk supply has met the demand and Haven and Mira are gaining weight as they should.  Don't get me wrong, breastfeeding two at once is not easy, is a colossal commitment and there have definitely been moments where I wondered "why am I doing this?" But then I focus on my goals and remember why I made this choice. (For mothers who choose to formula feed whether by choice or necessity,  fear not - here's a great account from one twin mom and her journey, for a different perspective).

I absolutely loved breastfeeding Isla and did so for sixteen months (stopping only when we discovered I was pregnant with twins).  In my experience, it's an amazing mother/baby bonding exercise and - let's be honest - you cannot beat the calorie burning factor (I have already shed 30 of the 50 pounds I gained) and, hey, it sure is nice to be able to fill out a top for a change.  Oh yeah, and it's really, really good for our babies.

So what does it take to establish breastfeeding for twins in the early weeks post delivery?  Well, I am no expert but have been successful thus far.  Aside from a lot of dedication and patience, here is what has worked for me and my girls:

1. Initiate breastfeeding as quickly after the birth as possible.  I began nursing Haven and Mira within an hour of their delivery.  Of course there are always situations that arise which might prevent this from happening, but if you can - try to nurse your babies within three hours of birth.  They say the most important time to establish breastfeeding and milk supply are the first seventy-two hours after delivery, so do what you can to set that off on the right foot (that includes pumping if your babies are in the NICU).
2. Room in with the baby at the hospital.  Again, this might not be possible for NICU babies (and that is okay, there are many, many success stories of women successfully breastfeeding NICU twins) but if you can, room in with the baby and do not opt to have the nurses take them to he nursery overnight.  As mentioned, the first seventy-two hours are critical to successful nursing and having your babies at your side, ready to nurse on demand (or every two hours at least) will help to establish that and greatly increase your chances for success.
3. Begin tandem breastfeeding right from the start.  I was very fortunate  to give birth in a very pro-breastfeeding hospital.  Unless you tell them otherwise, it is assumed you will breastfeed and they do not supplement with formula, give pacifiers and lactation consultants are available at your disposal.  My lactation consultant advised I start tandem nursing from the get-go and I am thankful for it.  Now, my girls feed at the same time almost every time.  If only one wakes up hungry, I wake the other and feed them together.  This is a humongous time and sanity saver.
4. Invest in a good twin nursing pillow.  I have the Double Blessing Nursing Pillow and it is, hands down, a lifesaver for me.  I brought it to the hospital with me as well and it makes positioning the babies and nursing two at once so much easier. (Side note: I nurse Haven and Mira with the football hold).
5. Start tracking feedings/diapers/sleep times.  I bought a journal similar to this one, but after a few weeks I found it suuuuper annoying and was told about the Baby Connect App (for a smart phone) by another twin mom.  It is SO fantastic, totally user friendly and is completely customizable.  I keep track of each individual baby's feedings, pees and poops and when they sleep and wake.  This has been so helpful for me, especially for charting which baby was on what boob, when (I switch them every feeding to ensure a balance in the milk supply) and tracking diaper output, which is the only real way for a nursing mom to know if her baby/ies are getting enough to eat.  When you are nursing two at once it is incredibly easy to get confused (remember, you are sleep deprived and there are two of them) so just keep track of it.  Trust me.
6. Feed every two hours, around the clock.  This is where things get tricky.  For the first few weeks, in order to establish milk supply, it was recommended to me to feed the girls every two hours no matter what.  Occasionally I have let them go three hours between feedings (mostly at night) - but the general schedule is to put them on the boobs every two hours.  It's a ton of work and doesn't leave a lot of "me" time in between, but hey, it's all for good reason, right?  In another week or two I will stretch this out a bit.
7. Be prepared for pain, and a lot of it.  The hospital lactation consultant told me to "accept no pain" and, if I did feel pain, to re-position the baby/ies to ensure a proper latch.  Well, that is way easier said than done when you have a babe on each boob.  I am convinced that, no matter what, the first week or two of breastfeeding involves some pain.  For me, it was the same with Isla and after a couple of weeks my nipples "broke in" and got used to the constant stimulation.  Like breaking in a new pair of shoes, the first couple wears might result in a blister or two, but before you know it - your feet (and the shoes) will adjust and you will walk pain-free.  Yes, I just compared my twins to a pair of new shoes.  
8. Have support.  This is incredibly important.  I would not be able to do this if not for Scott and my mom.  Because we have a toddler at home, the above schedule doesn't allow for too much time to tend to her.  Of course Isla and I have our special "us" times during the day, and story time at night is always reserved for her and I, but if you plan to nurse every two hours around the clock, you will NEED help on the home front to care for any other little ones. Luckily I almost always have my mom and Scott around to help divide and conquer.   It also helps to have someone be on call to get you water/food or the remote while you are nursing.  Not to mention when you start tandem breastfeeding, you will need help positioning the babies and ensuring proper latch, and it definitely helps if your partner can be on diaper duty so you can focus on feeding and getting into position (tandem nursing requires a tremendous amount of prep).
9. Stay hydrated.  I chug water, coconut water, and Mother's Milk Tea like they are going out of style.  I also take Motherlove More Milk Plus, a (horrible tasting) herbal supplement which is supposed to aid and boost milk supply.  Whether or not it has helped me with my milk supply is hard to say, but it can't hurt.  Hydration, on the other hand, does effect milk supply so drink up.
10. Co-sleep.  This is very controversial, I know - and many doctors and pediatricians do not advocate co-sleeping (of course, like anything, there are many advocates of this practice as well), but it is a personal decision and I went with my mommy instincts here and am glad for it.  It has worked for us, though my comfort is sacrificed (I dream about sleeping in the blessed supine position).  We do not plan on co-sleeping much longer, but for these first few weeks I have found it very beneficial.  I sleep more or less sitting up with our babies on their backs on the nursing pillow, ready to feed when the time arises.  It's much easier for all of us this way and we all get a little more sleep because of it.  
11. Stay focused and positive.  I mentioned that there are times when you will want to throw in the towel and give up.  At times, you will feel frustrated, discouraged and maybe even angry.  There will be times when it will seem so much easier to have someone bottle feed while you get a few more zzzzzz's.  When your nipples will hurt so much you will wince and grimace in pain upon latching.  It DOES get better and it DOES get easier.  Try to remember that this will one day be a distant memory and this time in the trenches will be a thing of the past in a few weeks. 

Any other tips I have missed?  Feel free to share in the comments.

Additional Resources: If you are interested in more information on successfully breastfeeding twins, I highly recommend reading the book Mothering Multiples: Breastfeeding and Caring for Twins or More by the La Leche League.