Twins

by Cheri Kannarr

On November 30, 2001, my twins were born via Cesarean section. When I discovered that I was pregnant, I knew I would breastfeed my baby and this plan didn't change when I found out I was having twins. The babies were full-term and healthy.. My daughter Fiona was 7lb 12oz and my son Kieran was 6lb 4oz. I had been carrying 14 pounds of baby!

After the Cesarean, Fiona was brought to me immediately. My doula helped me to bring her to my breast, where she latched on like a pro. When my husband James brought Kieran a short time later, I brought him to the breast. He had a bit more difficulty, wanting to just take my nipple into his mouth. I knew this would be a quick path to sore nipples and coaxed him to open his mouth wide before latching on. For the next day and a half, everything seemed to be going well. The hospital welcomed fathers to stay and rooming in for babies was the norm. Fiona and Kieran slept next to me each night, so I could breastfeed whenever either baby demanded.

It was on the second night that I first felt like we were having problems. The babies were increasingly frantic and unwilling to latch on. I asked one of the nurses if she thought they were getting enough - she watched us for a few minutes and obviously thought everything was fine, because she left without giving any advice. The next morning, our doctor stopped in, very concerned because both babies had lost more than 10% of their birth weights. She seemed surprised that my milk hadn't come in yet and wanted us to start supplementing with formula. I knew that it was typical for it to take 3-5 days for your milk to come in. I also knew that introducing bottles at this point could lead to nipple confusion and difficulty in latching on and that if the babies were receiving bottles instead of nursing, my breasts wouldn't get the stimulation needed to produce enough milk. It was devastating - I felt like I was failing my babies. I was extremely committed to breastfeeding and thought I was well prepared. How could this be happening to us?

The nurse that day was wonderful. She brought us a Supplemental Nursing System (SNS) - a syringe to hold formula or expressed breast milk with a thin tube attached to deliver the milk to the baby. She showed me how to tape the tube to my breast so the baby could receive formula supplementation while still nursing to stimulate milk production. I also talked to a Lactation Consultant, Karen, who felt that using the SNS and giving formula until my milk came in would quickly put us on the right track. We both anticipated that my milk would come in that night or the next. We went home that afternoon, with the SNS, samples of formula, and two babies.

Imagine being a new mother, recovering from surgery, with newborn twins. The next few days were overwhelming and exhausting. I cried at least once a day - after visiting the doctor and finding that the babies were continuing to lose weight, after struggling to get an increasingly frantic baby to latch onto my breast, after getting both babies to sleep only to have them wake up hungry after less than an hour. This wasn't how I'd imagined motherhood and breastfeeding. I knew that the first few weeks of breastfeeding could be tough, but I wasn't prepared with how difficult it would be emotionally.

We had Karen come to our house to help. She was impressed that both babies were latching on quite well. She felt that once my milk came in, things would improve dramatically. One recommendation she made was to introduce bottles; she suggested that getting a large amount of calories into the babies would make them more awake and eager to nurse. After another doctor' s visit that afternoon and yet another discouraging weight check, we bought bottles. We didn't open the box, however; it sat on a table in the living room for several days. I thought opening that box would be the beginning of the end.

Finally, late on the sixth day, I discovered small drops of milk could be expressed from my breasts. The worst is over, I thought. Unfortunately, it wasn't. My milk supply still wasn't adequate for two babies. Things continued with the same pattern over the next week. I kept a detailed notebook of feeding times, if the baby received any supplemental formula, plus pees and poops. When you're taking care of two infants and facing sleep deprivation, it's impossible to remember when each baby ate or had a diaper change. This notebook became my bible - I was so concerned about their weight gain that those all-important numbers of wet and soiled diapers could make my day or send me into tears. At this point, I was unable to nurse both babies simultaneously, they were both sleepy, and feeding sessions would take 1 1/2 - 2 hours. We were waking the babies to eat every two hours during the day - this frequently involved completely undressing the baby, burping, diaper changes, and stimulation during nursing to keep the sleepy baby awake.

Karen was my lifeline throughout all this. She was available by phone to answer my questions - and I had a LOT of questions. Every time I talked to her, it helped. She was so calm and encouraging. She continually reassured me that we were doing incredibly well - that many moms breastfeeding twins have supply issues at first, and that we were several steps ahead since Fiona and Kieran continued to latch on well.

I found that afternoons, when milk production is low, were the worst time. Frequently, 5 pm would find all three of us crying - the babies because they were not getting enough and me because I felt so hopeless. It was on one of these horrible afternoons that we finally broke out the bottles. Karen reassured me that this would not end our breastfeeding relationship. I will always remember what she told me - she had never seen a mother who was committed to breastfeeding stop due to bottle use, but she had seen overwhelmed mothers stop breastfeeding due to frustration and exhaustion.

At their two week checkup, the goal was for each baby to have regained their birth weight. Success - Kieran was at his birth weight exactly, Fiona just a few ounces shy. We would still have difficulties, but the worst was over. Over the next few weeks, I discovered that the amount of formula each baby needed remained constant and finally started decreasing.

Fiona and Kieran are now two months old and exclusively breastfed. They haven't had a bottle since they were 5 weeks old, and my notebook is no longer updated. They've actually noticed each other and will stare at each other while nursing! There is nothing more special than seeing your babies fall asleep at the breast, with smiles on their faces and milk running down their cheeks. I look forward to having a long breastfeeding relationship with these two!