I apologize in advance for how lengthy this series on my twin breastfeeding journey is bound to be, but 15 months of breastfeeding twins did NOT come easy! And I feel like I have a lot to share...
So let's start at the beginning. If you are a first time mom of twins (or expecting twins), you likely have a lot of questions about breastfeeding in general. I know that many people say how natural of a thing it is, and that your baby and your body will know what to do. But honestly, that was not my experience with my singleton, and certainly not with my twins either. Even with the knowledge and experience I gained from nursing my first son 9 months, I was nervous for feeding two babies. The logistics alone seemed overwhelming.
I scoured the internet to try and prepare myself the best I could, and honestly there wasn't a lot out there. The best tips and information I found on nursing/pumping for twins, were from twin moms who shared their experience on Instagram. Two of my favorite accounts to follow were (and still are) @the_bernstein_brood (Becky) and @bemybreastfriend (Kristen).
This was a big part of why I chose to share so much of my breastfeeding journey online. I did my best to share as many videos, reels, story highlights and posts that I could on my page in the hopes they would be helpful to twin moms who were looking for support and encouragement, like I was.
So today I want to pass along some tips that helped me prepare for breastfeeding twins:
Do some research - find twin mom accounts to follow online, register for an online breastfeeding course, read up on the fundamentals of breastfeeding, and watch as many videos you can find.
Be prepared for babies arrival - set-up the nursery, stock up on supplies, create a birth plan, and discuss your options for delivery, feeding and care with your partner and medical team.
Start expressing breastmilk as soon possible (after delivery) - whether that is by latching baby(ies), hand expressing, pumping or otherwise. Doing so as soon as possible, and as frequently as possible will help establish your supply.
See a Lactation Consultant - request a visit from the hospital's LC to help work on your latch and provide advice and support before you head home. Request a referral to a lactation clinic that you can see once you leave the hospital, as well.
Arrange for help - if you can, having a second (third or fourth even) set of hands is so helpful those first few days and weeks from the hospital. Arranging for friends, family, spouse, doula or postpartum nurse to help with feeds until you get the hang of the logistics of feeding two babies, will take pressure off you and maximize your healing and rest.
Keep reading to hear about my personal experience, and how these tips impacted my journey!
Getting Prepared
I'm so grateful that my Instagram page opened up so many connections with other twin moms, especially those who shared their tips and tricks about breastfeeding. I am a visual learner, so seeing twin moms breastfeeding in action was incredibly helpful for me. Especially when those moms were in their living room, surrounded by other children, pets, etc. (like I soon would be). That's why I found Becky's page to be so helpful.
When I reached out to Becky about the struggles I had early on in my journey, and how grateful I was that she had shared so much information about nursing her twins on her Instagram, she shared with me that she had become an IBCLC and was launching an online twin breastfeeding course. She gave me access to her course and an affiliate link (which means I earn a small commission at no extra cost to you) that I am so excited to pass along to anyone who might be reading this post and looking for support. This is the course that I wish I had found when I was pregnant with twins! Not only does it have information on building/keeping supply, pumping & storing milk, bottle feeding, tandem nursing, combo feeding and everything else you could possibly think of, it ALSO gives you direct access to her. And she, is hands down one of the biggest reasons I am still nursing my twins today.
If an online course isn't something you are interested in, you can find resources through a local twins group, La Leche League and/or your medical team. And I hope this blog post and my Instagram page will also be helpful for you, as I share my breastfeeding journey and some of the tips I picked up along the way!
Preparing for Birth
I still can't believe that I made it all the way to my scheduled c-section (36 weeks on the dot) with my identical twins, especially given the number of scares we had along the way.
I'm not going to get into too much detail about my pregnancy and complications that we encountered in this post, but if you'd like to learn more about that, you can scroll back on my Instagram page where I shared a lot about my modi twin pregnancy.
Heading into the c-section, I was a ball of nerves. The unknown is really scary, and although I had given birth before, knowing the exact time, date and method of delivery was adding a whole new level of fear and anxiety to the mix for me. As was knowing that at 36 weeks, these babies would be premature and therefore might need to be taken to the NICU. This is something I wasn't as concerned about with my first son, since my water broke at 41 weeks.
I was as prepared as I could be leading up to the birth - I had the nursery set-up, clothes hung, enough diapers, wipes and formula for the first few weeks. Having had the experience of my first son, I knew what must have items I would need, and was confident I could get anything I might have missed quickly on Amazon (I've since created a newborn twin essentials checklist that you can check out here).
I also had my hospital bag packed, my parents arranged to stay with my son, and I had watched and read about as many other moms c-sections as I could. I also walked through the procedure in detail with my OB and discussed what options and preferences I could choose from (although limited). If you want to read my full birth story, find my list of hospital bag must haves, and my detailed birth plan, you can do so here: Twin Birth Story (What you need to know about a scheduled c-section)
Postpartum - Building Supply
After the surgery, I was so grateful that the babies were both healthy and able to come with us to recovery. I was hopeful that we would be able to get them latched right away and that I would produce enough colostrum to keep them from needing donor milk or formula.
Something to note, I was unaware that donor milk at the hospital we delivered at, was reserved for babies born before 32 weeks gestation. This is something you should definitely look into before hand, discuss with your medical provider, and note on your birth plan.
Once we were wheeled into recovery, the nurse helped me get into position for my first tandem feeding. It was very awkward with the IV and monitors that were on my arms and hands. Since I was still frozen from the chest down, I couldn't sit up or position myself or the babies very well, and as lovely as the nurse was, I didn't feel like she quite knew how to help with two babies either. So after only a few minutes of trying to get them both to latch, we opted to start hand expressions instead. Again, I was unable to do the expressions myself with all the cords and wires on my arms and hands. I was so grateful that the nurse took the time to do this for me. She collected 9mls of colostrum to feed to the babies via syringe.
I found this website really helpful to prepare me for hand expressions, building supply and learning to get a proper latch.
The nurse explained to me that the babies blood sugar levels needed to tested every hour, and if the levels were too low, they would need to supplement with formula to help elevate them. If after the babies took the formula their blood sugar levels remained low, they would need to be moved to the NICU to be monitored. I was really scared to have the babies be in the NICU without me, so we went ahead and offered them formula in bottles every 2-3 hours starting as soon as we got to the postpartum unit, only a couple hours after birth.
It was really devastating to me that the babies were being fed by syringe and bottles, and that they were getting formula instead of breastmilk (although I was also grateful that we were getting such care and attention without needing the NICU). With my first son, I had him on my chest within seconds of delivery, he was nursing within minutes of his birth, and I did not use bottles or formula for a least a few weeks after he was born. I worried that this start would impact my ability to build a good supply, and that starting on bottles so soon might lead to nipple confusion or bottle preference. So, I requested a pump, and started pumping right away in hopes I could at least have control over something.
I remember how defeated I felt seeing that those first few pumps were producing only a few mls of colostrum. The nurses were so kind in helping syringe out every last drop from the pump parts, to add to the bottles the babies were getting at each feed. They kept ensuring me that every drop was precious, and worth its weight in gold (they call colostrum liquid gold for a reason!). And I knew that the more often I pumped, the quicker my milk would come in and the better my supply would be. This was enough to motivate me to keep going, even though I was so exhausted and in a lot of pain and discomfort.
That first night, the babies blood sugar levels were tested every hour. And there were a few times that Hayden failed his checks, so early the next morning, he was taken to the NICU to be monitored. It was really hard to have him be separated from myself and his twin, Barrett, but I was grateful to know he was in such great care. Thankfully, he only needed to be monitored for a few hours, and there was no further intervention needed. Before we went home together on day 3, I was able to see a lactation consultant who helped me work on the latch with both babies separately. I was confident that I knew what I was doing in that regard, but unfortunately these babies were so small, and so sleepy, they just couldn't stay awake on the breast. We were released, but told that in order to leave, we would need to keep up with bottle feeding formula mixed with pumped milk, every 2-3 hours at home.
First few days at home
It was very overwhelming when we got home. I remember looking at my mom with pure panic in my eyes thinking how the heck was I going to manage feeding two babies by myself. But thankfully I had my husband home for 8 weeks (he took vacation), my mom and dad moved in to help for the first month, and so many friends, family members and twin mamas online, stepped in to support us..
The next day (day 4) we had a home visit from a public health nurse who checked the boys blood sugars, weights, temperatures and jaundice levels. Again, I was told that we needed to continue to give my milk mixed with formula to ensure the boys would keep up their sugar levels and gain the proper amount of weight. She told me it was most important that the boys ate at least 600mls in 24 hours, and that they should be gaining a minimum of 20-30 grams each day. Since they were so sleepy and it was so much work to get them to drink from a bottle, I was discouraged from spending more than a couple minutes with them on the breast at each feed, as it would tire them out and they might have a harder time consuming the amount of calories that they needed.
This news was really difficult to hear. I felt like my goal of breastfeeding the twins was becoming further and further away. That maybe it wasn't even possible. On top of that, trying to fit in even a few minutes on the breast for each baby in addition to pumping, bottle feeding, changing, comforting and getting them settled back to sleep every 2-3 hours, was nearly impossible (even with help!). I also needed to eat, sleep, recover, spend time with my first son (3 years old at the time), and take care of myself at the same time. It was A LOT. My milk coming in that day, and the rush of hormones that came with it, didn't help either. I broke down.
I remember my mom and husband stepping in and feeding the babies while I had a good long cry in their nursery. This was not the way I saw our first few days going, and I was really struggling.
Newborn Schedule & Lactation Consults
We worked on a three hour schedule, waking the babies to feed at 6am, 9am, 12pm, 3pm, 6pm and 12am. At first we would rotate having two people do the routine together, until we sorted out how to solo feed to give each other an extended rest. Since I was pumping, I would need to do so every three hours regardless, but on the times where my husband and mom took feeds I would pump and go back right to sleep.
The first couple days took about 1.5 hours start to finish (feed, burp, change, settle back to sleep, pump and go to sleep myself), meaning I would be lucky to get about 1hr worth of rest in between each feed. When there were two of us to do it, we would each take a baby and complete the full routine 1:1. Eventually we figured out how to lay them back to back on their sides which allowed us to pace feed them together and could each take one solo feed per day. We each had our own preference as to which way we liked to feed them on our own. My mom preferred her lap or the TwinZ pillow on the couch. Russ liked back to back in the pack n play or in the bouncy chairs, and I used a bed pillow on my lap or the TwinZ pillow on the floor. Once we had this process streamlined, it would take about 45 mins to feed and then an extra 20 for me to pump.
My supply was coming in great, and I was able to freeze a bunch of extra milk. We always had bottles in the fridge ready ahead of each feed, so anything I pumped went into the fridge or freezer. We also used the fridge/pitcher method for pumping to avoid cleaning and sterilizing my pump parts each time, this saved us so much time and effort and really helped streamline tasks between feeds. You can read more about the fridge method and decide if its something that would work for you, here.
Around 2 weeks postpartum I got the OK from my Dr to stop supplementing the bottles with formula. That was also when I had my first appointment with an IBCLC. Having the support of a Lactation professional was really great, however I wish I had known that there were those who specialized in twins off the bat. The Dr, while supportive, wasn't all that encouraging and made me feel like exclusively breastfeeding the twins was something I wouldn't be able to achieve without fulltime support. I left that appointment feeling defeated... the babies had latched for 15 minutes and only consumed 20mls of breastmilk before falling asleep (and that was with three of us prodding them, relatching, stroking with a cool cloth etc.).
I remember talking to my mom and husband about how much I hated pumping and that if I couldn't get the babies nursing, I wouldn't be able to continue giving them breastmilk much longer. That's when we decided to go day by day with the option to stop at any time, and re-evaluate at my second LC apt. In those next two weeks before the appointment, I practiced latching with one baby at a time, one feed per day. Slowly I saw small improvements with them staying latched and active a bit longer. And was pleased that at my next apt there was a small increase in what they consumed (50mls in 15 mins). That improvement helped me stay motivated to continue (the babies were 4 weeks at the time) and I started trying to tandem feed once per day (with help).
It was at my next appointment with the LC, when she told me she didn't think I'd be able to break their bottle preference. The babies were almost 6 weeks old (2 weeks adjusted) and still only getting about 50mls in 15 a minute feed. I told her how devastating that news was to hear and that I wasn't ready to give up. That's when she passed along the information for a twin specific IBCLC and postpartum doula. When I got home that night I had a long cry while pumping before bed. I looked at my husband with tears in my eyes and told him I was thinking about giving up pumping and just transitioning to formula while using up my freezer stash. Usually my husband is very supportive of whatever I want to do, so I was surprised when he told me "I think you'll regret it if you don't do everything possible to get there". And so we booked an at-home consultation with the twin IBCLC for later that week...
Part two - Transitioning from bottle to breast & tandem feeding - coming soon! Subscribe to be notified once its posted
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