breastfeeding | nursing.

Nursing.

I'm picking back up on my breastfeeding series.  You can find the first few posts here.

Because the breathe, suck, swallow concept is developed in the last few weeks before babies are born, the twins had a little catching up to do.  They were not able to develop this skill in utero so we had some work to do when they were born.  I was not actually able to nurse the boys until their last week in the NICU.  

We would do kangaroo care (skin to skin) every day because it has been proven to help preemies.  They don't have to work so hard to regulate their body temperature because they are against your warm skin, their breathing will sync to yours and regulate while they are laying on your chest and it's just good bonding time for mom and baby when nursing is not allowed yet and there isn't a lot of "hold time" allowed.  

Around the third week, the neonatologists and I talked about what the NICU world calls "lick-n-learn".  I would pump and then once I finished pumping, we would allow the boys to latch on to try and figure out what to do.  Because I pumped first, they were not going to actually be getting any milk.  So, they could work on the breathe and suck without having to add the swallow component yet.  We did this for a few times and then we got to try nursing.  The boys did great.  And the lactation consultants were super helpful.  Since the boys mouths were so small, we had to work on getting them to latch on correctly.  And we had to work to keep them awake.  Once they got all snuggled up to me, it was challenging to keep them awake and alert enough to actually nurse for any amount of time.  We were able to try for 20 minutes once a day at the beginning.  We had to limit our time so the boys wouldn't actually burn more calories trying to nurse than they would gain from the milk they got.  The Lactation Consultant would come in and weigh the boys, help me with nurse them and then weigh them again.  This allowed us to find out how many milliliters of milk they were getting.

When we took the twins home from the hospital, I was able to nurse them twice a day.  The other six feeds were pumped milk given by a bottle.  Each week I was able to increase the number of times I was able to nurse by one time per day.  

First, many people have asked me, do you nurse them both at the same time?  And the answer is yes.  For months it took too long to nurse the boys separately.  If I was to nurse them separately it would mean I would nurse one and then nurse the other and by the time they were both finished I would only have about an hour before it was time to start over again.  It typically would take 30-45 minutes from start to finish.  If I did them separately, that's 1-1.5 hours!

They sell a fabulous pillow called the Twins + Plus Brest Friend.  It is a necessity.  For real. It allows you to do a football hold with both babes and you can nurse, two babies, hands-free. 

There are some pictures below to show how it has worked for me:

A few notes about the picture above:  I just stuck a burp cloth in between their heads so you wouldn't have to see too much.  Which really, pretty much every woman in my life has seen everything I've got.  Except for the blogosphere.  So consider yourselves lucky :)  Secondly, Robin [the wonderful lactation consultant] suggested taking a blanket for each babe, folding it in half [hamburger fold - does that make sense?], then rolling it up and folding it into the shape of a candy cane.  Then, allow the babe's head to rest in the curve of the candy cane.  This helped immensely when the twins were so tiny.  It helped them latch on because they were higher and it helped my back because I didn't have to hunch over to try and get low enough for them.

When we would go out somewhere I would nurse the boys separately but it was stressful.  It almost made it not worth going out for long periods of time because I would spend so much of the time in the car.  But, over time the boys started taking less and less time to nurse.  This made it a lot easier to nurse when we were on the go.  It was definitely helpful to have someone around to hold one of the boys while I nursed the other.  Typically the other person (daddy, grandma, aunt, etc) would change a diaper while I nursed a baby and then we'd switch.  

Just in the past few months the boys have been able to start nursing together without the pillow.  I always use the pillow if we are at home but if we're out somewhere, we can make it work without the pillow.  They have gotten to the point where they realize what the other one is getting to do and they are super jealous that they aren't the one getting to nurse.  Plus, they are able to hold themselves up a little and they can definitely latch on just fine. 

But, even though I typically nurse them together, it is so sweet when I get to nurse them separately.  Any time I'm at my mom's house, I nurse them separately.  It is such a sweet time to just look into their little eyes and inspect their little toes and ears and hold their little hands.  I love it.  So, I definitely like having a mix of nursing them tandem and then individually as well.

So, I started working on this post back in March and I finally picked back up.  It is hard to believe how much has changed over the past eight months.  I am telling y'all now, this gets so much easier as you go on.  I promise.  I remember trying so hard to figure out a way to make nursing out in public easier.  But, it's just tough for some time.  But, it is just a season.  The super long, 30 minute nursing sessions will cut in half and then in half again before you know it.  The boys only take about 7-10 minutes to nurse now (sometimes even less)!  All that to say, stick with it mamas!  You can do this!  And you will be so glad you did!

breastfeeding | pumping.

Pumping.

Breastfeeding the twins has been quite an experience.  While they were in the NICU, I wasn't even allowed to attempt anything until they were about 3 weeks old.  The boys were so small  and nursing was so difficult that they would have burned more calories trying to nurse than they would have actually gained from eating.  

So...I pumped.

And pumped.

And pumped.

Then the boys would be fed the breast milk through their feeding tubes. 

I woke up every three hours during the night and pumped.  And I pumped every three hours during the day.  In order to give my supply a boost from the start, I pumped on a very strict three hour schedule and I pumped for the entire time milk was coming plus 2-5 minutes after I no longer had any milk left.  By pumping while empty, I was telling my body that I needed it to supply more than it was already supplying.  I definitely think this helped establish a healthy milk supply.  

For a while, my strict schedule was pretty limiting.  Both hands were tied up with holding the pump parts.  So pretty much, I just sat there.  I watched tv if I was at home.  But the majority of the times (other than the middle of the night), I was at the hospital.  

Thankfully, at both Duke and ARMC, I was allowed to pump beside the boys beds on most occasions.  At Duke the boys were never in the same room.  So I would pump beside Crews.  Then, three hours later, I would pump beside Tate.  They would pull the curtain around their isolette closed and I would sit and just stare at their sweet little bodies.  (At ARMC you had to manually set up these barriers - wheeling them through the NICU and locking multiple together to create a wall.  Thankfully, the boys were side-by-side at ARMC so we would just block off the whole corner and have quite a bit of room with the barriers up).  It was good to pump beside them because it has been proven to help your milk supply as a NICU mom.  When you aren't actually nursing your baby(ies) and you're hooked up to a pump every three hours, you start to feel like a machine.  You're not actually getting to enjoy the process so much.  Just getting the job done.  Which can often affect your milk supply.  Especially if you're sitting at home, without your babies.  Or if you're sitting in a pump room staring at a wall (I used the pump room only once at Duke and a few times at ARMC - only if family was visiting.  So they could stay with the boys instead of having to sit in the waiting room while I pumped.  I hated it every time.).  So, being around them and listening to them cry and watching them move and all of that, can help with your milk.  

Kinda like that episode of The Office when Pam has a baby and goes out to an office party and Kevin (the big, bald guy) keeps running up to her and going "Waaa-Waaa" really loud and in her face.  And she is confused about why he keeps doing that and what he is trying to accomplish.  So, he does that the whole time they're at the party.  Then, near the end of the party, Angela starts to cry and all of the sudden Pam looks at Jim, wide-eyed, and tells him they have to leave.  Right then.  Pam had started leaking.  (Kevin gets mad that he'd been trying it all night and it hadn't worked.  haha!)

The whole concept of how your body works with producing milk is amazing to me.  It's the craziest thing ever.  But, I just had to throw in The Office reference to relate to how it is seeing your babies and hearing them cry and your milk letting down.

Okay, so back to being tied up.  I would just sit there and look at the boys or watch tv.  But, if my phone rang or if I dropped something on the floor, or if I wanted to change the channel, I was in a bind.  I would have to stop pumping on one side  or somehow hold both sides with one hand so I could use my other hand to get the phone or the remote.   Over time I got better at holding both sides with one hand, but I would still end up in a bind.  

Thankfully my sister-in-law, Katie, was at the hospital one day while I was pumping and told me that I had to buy this hands-free pumping bra.  It changed.my.life.  I'm so serious!  I'm going to post a picture below, but I couldn't find one without a woman actually wearing it.  So, the picture does show it on a woman.  I actually tried to look for a brown-headed woman so you wouldn't think it was me at first glance.  Haha. So she does have blonde hair, but it's not me.  And, just so you know, my stomach looked JUST like that when the boys were a few weeks old and I was sitting by their bed pumping.  Riiiiighhhtt.

[via]

It's a Medela Easy Expression Bustier.  And it is the bomb-diggity.

Yes, I just used the term bomb-diggity.  Because it is THAT good.  Welcome to 1995.

I bought mine at Babies R Us and it was around $30, I think.  Best $30 I've spent.  Promise.  One of the best parts about it is that it's strapless and it zips in the front.  So, when you get ready to pump you just pull up your shirt, wrap this around you and zip it.  You don't have to pull it down over your head.  You don't have to worry with hooking it in the back.  And you only wear it when you actually pump, then take it right back off and throw it in the bag with your pump parts!  So, after I got that, I would set up to pump and sit by their beds and read them books.  Or at home, I would read, or get on the computer or stalk people on Facebook - ha.

The other thing that was limiting was that I had to be home or at the hospital every third hour so I could pump.  Untillll, we bought one of the adapters so you can plug a regular cord into the car.  It is fabulous.  I have since, pumped in the Target parking lot, sitting in the backseat while Jordan was driving, in the church parking lot in between services, and while driving myself down I-40.  Definitely worth it!  I'm all about some multi-tasking :)

Robin also helped a ton by telling me a few things before the boys arrived.  

First thing was that I would need to rent the hospital pump for a few months.   I have been renting the pump through Duke for the last four months.  It is about $80/month but it is a much more effective pump and with as much pumping as I have done, I needed a really good one.

Robin also told me to be prepared to supplement.  Many twin moms do not have enough milk to keep up with two babies.  So, she had already given me the talk about not being upset if I did not have enough milk.  That I might have to supplement and that it would be okay if that was necessary.

I am praising the Lord that this was not a problem.  After puking for four months straight, being on bed rest for two months, going in to labor three times, having the boys two months early AND having a month long NICU stay...my milk supply is one thing that worked correctly!  But, honestly, I realize that is not the case for many people and I do not take it for granted. 

My milk actually came in so well, and the boys needed so little (like 2 teaspoons every three hours!) that I had to figure out some way to store all this milk.  And quickly.  So we ended up buying a freezer to store it all. It only stores breast milk.  (Except for like three ziploc bags of corn in the door).

Again, Praise the Lord for milk.  But also...holy cow.  (Literally.)

Once they boys got to start nursing, I continued to pump after every time they ate.  Because I had worked up my milk supply, I needed to keep it up and not allow my body to readjust to only making what they needed as such small babies.  So, I would pump until I was dry after they boys were full.   Knowing that the boys only get one side apiece, means that each side has to produce enough to feed a baby.  So, I had to continue to keep my supply up so as they needed more, my body could keep up.  I know that this is all based on being a twin mom, but I would definitely recommend pumping after your baby or babies (it would work the same for a singleton mom) finish eating if you think you need to increase your milk supply.

And then, last thing, is that I am still pumping during the night.  The boys are now sleeping 8 1/2 - 10 hours per night.  But, I can't go longer than 6 hours without pumping.  I did not realize this.  And other moms forgot to mention this to me :) So, I typically pump once during the middle of the night.  I do allow myself one night a week where I sleep through the night without pumping but a lot of times it's not worth it because I wake up so uncomfortable.  Feeling like I have two cinder-blocks sitting on my chest.  Which is tons of fun. Let me tell you :)

Okay, I think I've dumped all my pumping knowledge here.  Maybe in a not-so-organized fashion.  But it's all I've got :)   My final thought is that pumping can definitely make a difference and has been worth every second!  

How about the rest of y'all?  Any pumping experiences?

breastfeeding | support.

Find support.

Breastfeeding is hard.

There, I said it.

It is this process that everyone thinks just comes about naturally.  Without work.  Without a fight. Without pain.

It is natural but, let me just tell you...

...it takes a ton of work.

...you have to fight for it.

...and, pain?  ummm...yes.  like toe-curling pain that I can't even begin to describe.  You can only understand when you've actually been through it. 

But, is it worth it?

ab.so.lutely!

There are so many benefits for you baby(ies).  To get lots of details, you can look here.

But, here is the quick list from their website:

1.  Protects against infection.

2.  Protects against illness.

3.  Protects from allergies.

4.  Enhances Development and Intelligence.

5.  Long term benefits (Dental Health, Toddler Health, Diabetes, Childhood Cancer, Chron's, etc.).

Okay, so we can all agree it's tough, right?

But we can also agree it's worth it, right?

So where does this leave us?

In need of help.  In need of support.  

And my advice? 

Find it any way you can.  

You will experience opposition.  Especially first-time moms.  And especially twin moms.  People will scoff at your "idealistic and naive" plan to exclusively breastfeed.  Many times it's the same reaction you will get if you tell people that you plan to cloth diaper.  And, I understand.  There is a reason many of these seasoned moms scoff, or just smirk while thinking, "I'll give her three weeks before she's out buying pampers and enfamil".  It's because motherhood is humbling.  You do things you said you never would.  And you eat your words.  And I get that - because three months in?  I've already done that.  

But for me?  Breastfeeding was a non-negotiable.   And it can be for you as well.  

Commit to it. 

And then get some support.

Thankfully, my family is pro-breastfeeding.  And, I married in to a family that is pro-breastfeeding.  So this made everything a lot easier.  My sister-in-laws are willing to answer any questions I have.  My family is willing to work around our schedule.  Sometimes it's inconvenient.  But, it's our "normal".  Giving up is not an option.  My family has never once suggested that I stop breastfeeding.  And I am so thankful for this.  I had my mind made up that we would do this.  We.  Yes, I am the one actually breastfeeding every three hours. But, Jordan and our families have had to support me in this.   

[Let me stop here and say, I had my mind made up that I would breastfeed as long as my milk supply would allow.  I know there are many women who have wanted to breastfeed so badly only to find out that their milk didn't come in.  I know this is a sensitive issue.  And while I was pregnant, I worried that I might struggle with this.  Thankfully - after puking for four months straight, being on bed-rest for two months, going in to labor at 25 weeks and then delivering at 32 weeks - my milk supply is one thing that actually went really well.  I am so incredibly thankful that this was not an issue for me and I would never want this series to make someone feel any kind of "mom-guilt" because they are unable to breastfeed.  This entire series is strongly encouraging the women who are physically able to breastfeed to commit to it even though there are many reasons you may find you want to quit.]

So, allllll of that to say....family support is super helpful.

And my secret weapon?

A fabulous lactation consultant.

Robin has been just that for me.  She is one of my mother-in-law's best friends.  She came to visit for a long weekend about a week after the boys came home from the hospital.  She stayed with my mother-in-law and came to help me during the days.  They even spent the night at our house one night to let me get a little rest!

Typically you have access to a lactation consultant while you are in the hospital.  They come and help you get started after you deliver.  Ask them questions!  Ask for them to come back and talk to you again before you get discharged if you still have questions.  Take advantage of having a professional who can answer your questions.  Who can show you how to get your baby(ies) to latch on.  Who can watch you nurse and give you tips on what would make it easier.

And, once you get home, if you start having problems or you're concerned that things aren't going well, or your becoming discouraged...find a lactation consultant.  Set up a home visit.  It is worth the money.  Or see if your pediatrician's office has a lactation consultant you can meet with.  Don't give up before you talk with them.  They will definitely be able to give you helpful tips!

Okay - so I might have painted a dreary picture to kick off the series.  And that was not my intent at all!  Breastfeeding is an incredible thing.  But it is difficult for many.  And you will have to commit to it.  And you will need support.  Just want you to be prepared :)

breastfeeding series.

I started my post about being "free" on Monday and I was just going to give a quick update on how breastfeeding has been going.  It started out as a general, quick breastfeeding post.  But, I then I realized that I've got a ridiculous amount of stuff to say.  And it was getting wordy.  And I wasn't even sure how to combine every aspect of this into one post, anyway. 


So, I thought how about I just write a pumping post?  Then I'll write a nursing post.  And then one about milk supply and storage and all of that.  And then...


I realized I typically don't follow through on these multiple post things.  I have to say what I want to say right then.  Because I often don't make the time to actually follow through.  But then I also realized, I will really write about this.  Because when I was pregnant with the twins I had so many questions about the actual process of nursing twins.  And I wanted to see, so badly, what someone's real life looked like while nursing twins.   I've become super passionate about it and I know that when I was pregnant with twins I searched and searched for a blog post that just showed what a real-life, twin mom was doing everyday with breastfeeding.  What it looked like for her.  I never found one that just kind of explained her process. 

So, I've decided to do a little mini series :)

This may be of interest to no one.  So, I'm sorry if I bore you with all these details.  But, if it helps one twin mom out there who's trying to decide whether she should attempt to breastfeed, or one twin mom who's going to go against all the people who attempt to tell her it will be too difficult and time consuming to do this with two babies, or one NICU mom who thinks that this would be too stressful under all the circumstances...then it will be worth it!  Plus, I've gotten questions from my friends and family about it so this will be a good place to just kinda get it all out there!

So, without further ado....I present:

I'm sure all of this will evolve as I actually write out the posts, but I'm thinking that these will be the general topics I'll talk about:

1.  Get help.

2. Pumping.

3.  Nursing.

4.  Breastfeeding while out and about.

5.  Milk supply and storage.

6.  Equipment you need.

I know that some of these will be individual posts.  But then others may morph into one post.  I'll throw a few funny stories in here and there from my experience so far.  And I may do a FAQ if people want to know something that I'm not covering.  

Are there other topics that you'd like to hear about?

i'm free, i'm free!

On Sunday night I talked with Robin.  She's a friend of my mother-in-law.  

Robin is a lactation consultant and she is so gifted.  She has been such a blessing to me since the boys have arrived.

So, I've been pumping after I feed the boys every time.  I nurse them and then I pump to make sure I keep my supply up.  I've been pumping essentially every three hours since October 25th.  

Let me say that again.

I have pumped every three hours since October 25th!

[Give or take the couple of times I accidentally slept through while the boys were in the NICU and the few times that the boys have slept longer during the night.]

This was something that Robin told me to do so I could make sure I had enough milk to feed both boys without having to supplement with formula.  

My pump has become my third child.  I'm not kidding.  When we get in the car to go anywhere I double check to make sure I have Crews, Tate and my pump.  

Well, when I talked to Robin on Sunday night she told me the the twins are finally big enough and my milk supply is established enough to stop pumping after every feed.  I only have to pump if I'm not able to nurse the boys for a feed (like you would normally do if you were breastfeeding).  

When Robin told me this, I yelled:

"I'm a free woman!" 

I'm down to only two kids!  Well, and Jordan :)

But the pump is no longer attached to me eight times a day!

It's won.der.ful.

[ps.  I know that pumping after every feed has made such an impact on establishing my milk supply so it has definitely been worth it.  But, that doesn't mean I can't celebrate that I don't have to do it anymore :)]