Breastfeeding update

I am a member of an online forum for people with twins who breastfeed, I rarely post, but I do read it all the time (thank goodness for my iphone when I'm nursing the boys!). I made a special point to actually pull out the computer to write out a response to a woman who was frustrated and confused about poor weight gain in her 4 month old twins who are breastfeeding after a LOT of work to get them exclusively breastfeeding...it was a VERY familiar problem for us. I realized that I never updated the blog with what has happened in the last few months with breastfeeding, so here is the post in response to that woman's question. Besides that, finding time to post to the blog is so hard that since I spent time to write to this woman I figured I would leverage the work!

Here is my response with some clarifying edits:
Oh I'm so sorry you are dealing with this! I was there about 1.5 months ago, my guys had fallen off the weight curve at their 4 month visit, particularly baby B [Odin]. My pediatrician didn't immediately suggest supplementing [with formula], but he did want us to try and get an additional feeding in [at the breast]. I, like you, was so confused because my guys always seemed so satisfied and happy, they slept 7-9 hours in a stretch at night, napped well, and all in all we were feeling like life was going really well, particularly after all of the problems we had with establishing exclusive breastfeeding. I decided to get data (I'm a chemist and DH [online forum speak for dear husband] is an oceanographer...we like data). I rented a breastfeeding scale and for 2 days fed as usual with trying to get an extra breastfeeding session per day in while weighing before and after each feeding. Baby B [Odin] was only getting 17 ounces and Baby A [Lars] was getting 20-22 ounces, Kelly mom [a fantastic online breastfeeding information site] says the average is 25 ounces for a breastfed baby and the range is 19-30. Looking at the data throughout the day, it was obvious that I had enough milk for them in the first 2 feedings of the day because they would take 5-6 ounces each from the breast, but then after that they were only getting 1-3 ounces in the subsquent feedings. It became obvious that I had a supply issue. Only after we had that data and I had talked to an LC [lactation consultant] did we start offering a bottle after feeding (at first it was EBM [expressed breast milk] from my small stash for going back to work) and they were obviously ravenous (the LC warned that they would probably be bottomless pits with the bottles afterwards for a few days, and she was right!). We used preemie flow nipples and held the bottles almost horizontal so that the bottle wasn't significantly easier than the breast in order to try and avoid them developing a bottle preference. I've done everything I can to increase my supply (domperidone, pumping after each feeding, oatmeal and lots of water) and through continued use of the scale, I saw no increase in what they were getting from the breast...and they are still very happy to eat at the breast, it's not like they were just waiting for the bottle. It took some time, but we have settled into a routine where they tandem feed at the breast for the two first feedings of the day, they alternate for each feeding since lefty just doesn't produce as much as righty, then for the next feedings I feed one from the breast and give him both breasts and the other baby I give a bottle (I do this in tandem using the EZ to nurse pillow, the baby with the bottle sits with his back against me and I give him the bottle). The boys both get about 10 ounces of formula a day and it works out that they get about 2/3 of their intake from the breast (or EBM if I'm at work, I work 3 days a week).

I still don't understand how they could have been so happy if they were not getting enough to eat, it completely baffles me. I struggled and struggled with giving my boys formula and still hate that I have to do it, but I do. It is really gratifying to see them growing and gaining weight before my eyes, it takes some of the sting out when I look at it from their point of view...not as a personal failing. I think I've mostly accepted that they aren't getting breastmilk exclusively, but it has been a process. They came at 34 weeks and I had to bring my milk in with a pump since I couldn't get them to the breast for about 3 weeks, and I think that my body just didn't get the message that there are 2 babies to feed. I keep telling myself that there were many things about their conception and birth that didn't happen as I wanted, but in the end I have the ultimate prize--2 healthy babies who I still do have that breastfeeding relationship with. I intend to do extended breastfeeding and I think my guys will do it...they like the boob. Their weight gain is right on track now, there is just a dip at 4 months.

I hope that you have a case of just needing to up your supply and that your body will respond...by no means do I think that you have the same issues as I do, but I wanted to share my story in case it helps. I've been there and it is SO hard, I can't tell you how many tears I shed. Since your babes are happy, I would suggest you take a couple of days to determine your plan of action so that you can act logically and not too emotionally, that was important for me. I wish you the best of luck and please PM [personal message] me if you want to talk more offline. Take care.
[end of forum post]

So you can see that things were pretty rocky, but we have figured out what works best for all 4 of us. The boys are gaining weight and growing like crazy! I weighed them this morning and Odin was 12 lbs 14.25 oz and Lars was 14 lbs 5 oz. I'm sure the pediatrician will be happy with what he sees at their 6 month appointment in 3 weeks! For reference, Odin weighed 10 lbs 1 oz and Lars weighed 11 lbs 2 oz at their 4 month visit 6 weeks ago.

Back to Front

Last Saturday, 10/16 (over a week ago already, gulp!) Lars rolled over from back to tummy for the first time! He got pretty frustrated about his arm being stuck that first time, but he has since learned the finer points of rolling, and now does it all the time with great finesse. Diaper and clothing changes are getting a little more challenging!

Here is crummy cell phone photographic proof of his first back to front roll:

Giggling!

Odin giggled for the first time this morning when Papa was playing with him. Too fun!

Over the last day or so he has also discovered just how loud his voice can be, he may put his cousin Soren's velociraptor screech to shame. Only time will tell. Is it too early for him to understand the concept of 'indoor voices?'

Happy Birthday Grandma Lynn!

We dressed up in our finest gear to wish you a happy birthday Grandma! We love you!

Odin Too!

Odin rolled over for the first time today!
Tiring of tummy time, he declared it over with a triumphant humph, and settled victoriously on his back.

Yay Odin!!!

Rollin' Rollin' Rollin'

This just in...
Lars rolled over from his tummy to his back for the first time today, and he did it 3 times in a row! Wowza!!

3 Months

Dear Lars and Odin-

The past month has been one of great accomplishment...both of you are exclusively breastfeeding! It has been a LONG road and a lot of work for all four of us, but we succeeded! If it weren't for the support of your Papa, sheer determination from your Mama, and you both being such good eaters, we wouldn't have made it happen. Now that you are both exclusively breastfeeding it makes for some real freedom since we don't have to wash bottles, keep milk cold when we leave the house, pump breast milk or wash pump parts. All we need to do is grab some diapers, the nursing pillow and away we go! I'm SO proud of you boys, we had a really poor breastfeeding start, but now there is no stopping us!

With all of the freedom afforded by breastfeeding, we took a sailing vacation to celebrate Mama and Papa's 10th (!) anniversary. We went sailing when you were six weeks old, but there were som rough parts to that trip since Mama and Papa weren't getting much sleep and we had to deal with the dreaded triple feedings (breastfeed, bottle feed, pump). This trip was MUCH different. There weren't any really rough parts since you are both sleeping well at night and breast feeding is established. We had a great time visiting Port Townsend where we got married 10 years ago. We ate Waterfront pizza and Elevated ice cream, walked around town and visited friends. It was a great trip. We also visited some anchorages we've never experienced like Port Ludlow...anchoring behind the twins, and Mats Mats. It was fun to experience them as a family. In a week we stopped twice for laundry so we could wash diapers. It all worked out Great!

Sailing on Yare! (actually motoring)

Lars steering

Lashed down tight for sailing

In the past month both of you are starting to smile. It warms our hearts. Papa laughs at me when I thank you for smiling at me, but I am very grateful every time you do it.

Beautiful smiles!

We started a PEPS group where we meet with other families who have twins. The meetings are fun. We get support from, and share laughs with other parents who are in the same place we are, and we get to see lots of babies. The meetings do get a little loud with all those babies!

You sleep beautifully at night. Typically we all go to bed around 9 o'clock and you wake up around 2 am or 3 am (sometimes 4 am) to eat and then we all go back to bed and you boys wake up around 8-9 am. It makes for a good night's sleep. Unfortunately, now that Papa is back to work, he doesn't get much sleep since he has to wake up at 4:45 am. By the end of the week, your Papa is very tired. I think the next step is getting you boys to bed earlier so that the whole schedule shifts earlier.

During the day you don't sleep very well, and when it is just me home with you, I feel like all I do is feed you and try to get you to sleep. It makes getting anything done difficult, but daytime sleep is important so that you don't get overtired and have a hard time falling asleep at night. We'll keep working on it and it will get better. We got some good tips on daytime sleep from a sleep doula at the last PEPS meeting. We'll try instituting her suggestions and hopefully things will be different by the time I write you a letter when you are four months old.

This past month we have done a lot of baby wearing. During your fussy time at night we like to each wear one of you and go for a walk around the neighborhood. It is a wonderful way to enjoy the summer and it's a good chance for Papa and me to talk. You boys take a snooze so when we come home you eat and go straight to bed. Its a wonderful way to be close as a family. When I'm home alone during the day, I've even worn both of you in the Moby wrap. It's pretty heavy, since you are both getting to be BIG boys, but I love feeling that close to you. It also alows me to have my hands free to do a couple of things around the house while you take a snooze. Baby wearing also allows Mama and Papa to be social on the weekends... we just wear you and go to parties.

Baby wearing to the extreme!

Bjorklund boy buns on a Daisy sandwich (we all went to a party to celebrate Daisy's arrival)

You are both getting really strong. You spend a fair amount of time each day doing tummy time so that you can develop muscles needed for rolling over and eventually crawling. At first you just laid there, but now you push your bodies up and kick your legs.

Before

After I went downstairs for a load of laundry...all locomotion provided by Odin

Lars says: 'On Guard!' (this is a reflex babies have when their heads are turned)

Lars and Odin, we are so proud of you and your development. Thank you for being such great babies.

We love you a little more each day,

Mama and Papa