While twins may be born vaginally at home with a midwife, most are delivered by cesarean section. At risk for prematurity, they may have to be awakened and encouraged to feed. Full term twins double the demand on nursing moms. Fortunately, there are ways to cope.
Establishing Milk Supply
Milk supplies are built on the principle of supply and demand. That means the more milk demanded by the baby, the more will be supplied by the breasts. Research shows frequency is even more important than length of feeding; that's why night nursings are so important. Sleeping skin-to-skin with babies and allowing them to suckle off and on (mostly on) all night provides plenty of nipple stimulation.
The herb fenugreek makes an earthy tea and the prescription medication reglan can both help to lay down progesterone receptors that establish a new mother's milk supply, normally in the first six weeks after delivery.(Birth control medication can interfere with that process--see a lactation consultant.)
Proper Ways of Pumping Milk
If babies are premature, separated from mother and unable to nurse, pumping is the next best thing. But a pump will not stimulate nipples in the same way that the tongue and gums of a newborn do. Also, pumping frequently enough and long enough is difficult for most women so over time milk supply dwindles.
That is not to say pumping can't help. It can. Pumping can increase milk supply if babies do not nurse enough. The time to pump is at the same time as the feed (if only one baby is nursing) or before the feed (as there will still be milk left for baby--they are much more efficient at extracting it). The breast continuously makes milk, so no matter how long a baby nurses there is still more milk for them.
Good Self Care is Key
Breastfeeding support groups offer understanding and good advice.
Drink as much fresh clean water as possible. Fluid is needed to make milk. Continue prenatal vitamins and eat well. A nursing diet should include dark leafy greens (cows eat grass and make milk)! The extra calories needed to lactate mean that weight loss and looking great! Mothers who are already thin should take in quality calories, not empty junk food ones. Nuts and avocados make nutritious snacks!
Mothers of twins support groups are a valuable resource for situations specific to raising multiples.
Nurse Often
Supplying milk for two should not be a problem if babies are allowed to nurse as often and for as long as they want. Since breastmilk is digested very quickly and a newborn's stomach is the size of a walnut, this will be quite often. Using any schedules or timing feedings is not recommended, but if a record must be kept:
Time a feeding from the beginning of one to the beginning of the next. If a baby starts to feed at 1 pm and nurses until 1:45 then sleeps 15 minutes until two and then starts to nurse again, those feedings are an hour apart! That is normal, especially for newborns. However, even newborns will sleep four hour stretches twice in a 24 hour period. Hopefully, one of those stretches is at night. Older babies with larger stomachs will go longer between feedings.
The consistency and content of breastmilk changes during feedings. When the baby starts nursing, the milk is watery. It quenches the baby's thirst. That's why a breastfed baby should never be given additional water; they get plenty from short frequent nursings. After the baby sucks for five or ten minutes, hind milk is released. This milk is rich with fat and calories, which helps the baby grow.
Mothers who don't sit still long enough and are constantly interrupting their babies' feedings might see slower weight gain in their little ones.
Avoid Things that Interfere with Milk Supply
Overuse of pacifiers, skipping feedings or feeding on pre-set schedules, and giving the babies formula will cause the mother's breasts to produce less milk
Feeding any formula at all can be devastating to breastmilk supplies. It is harder to digest so baby will not feed as often, depriving nipples of needed stimulation and breasts of the opportunity to make milk. Some doctors suggest that moms feed formula after they nurse. This can make a problem nursing situation worse.
If a baby has to be fed other than at the breast, try using a medicine cup or dropper. They can lap it up and not be confused by a rubber nipple. Hopefully it contains the mother's pumped milk.
Two-at-a-Time Positions
Breastfeeding pillows that encircle the waist are very helpful, the wider the better. Sit upright and put the pillow on your lap, then attach babies to the breast one at a time, their heads should meet in the center. Hold the back of each head in your hand, as close as possible. Your forearms support the babies backs.
Don't forget to put one foot up on a phone book or low stepstool. It will save your achin' back.
You can also use the double clutch position on the soft arms of an overstuffed chair. Hold each baby like a clutch purse or football with their feet going up the back of the chair (or wall, or headboard, if you are sitting with your back against one).
Finally, any amount of breastmilk is better than none. Exclusive breastfeeding reduces the rate of sudden infant death syndrome and many other illnesses. Breastfeeding is the best investment a mother can make in her babies health (and her own, including a lower risk of breast cancer and osteroporosis!)
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