Breastfeeding Twins

Breastfeeding has many benefits for both mom and baby, and naturally the benefits double when nursing twins. As you know, breast milk is uniquely designed to meet the specific developmental needs of your baby, and the breastfeeding experience fosters a very special bond between the two of you. Nursing twins can be a challenge in the beginning, but it can also be a wonderful experience when moms are given the support and encouragement they need. Also, breastfeeding twins is more economical, more convenient, and less time-consuming than preparing bottles.
 
For moms of twins, it will be most important to establish an adequate milk supply early on and to maintain the supply to meet the growing demands of the babies. This can be facilitated by early and frequent breastfeedings – at least 8 times in 24 hours for each baby. As is the case with all newborn babies, do not let more than 3 hours go between the start of one feeding and the start of the next feeding. If the twins are born prematurely and have an immature suck, mom will need to pump frequently until they are able to nurse at the breast. This frequent stimulation is necessary to ensure that mothers will be able to produce enough milk.
 
There are a number of options for breastfeeding twins and it may take some experimenting to find what works best for you. The babies may breastfeed separately or simultaneously and this can be accomplished with various positions. When babies are fed separately, mom can breastfeed one infant and then the other, or one can be breastfed and the other bottle fed. You may have to wake the second baby to feed, but this will keep them on a consistent schedule. It will be important to nurse each of the babies on both breasts, especially in the early weeks, so that they are both evenly stimulated, particularly if one twin has a more vigorous suck than the other.
 
Some moms prefer to nurse their babies at the same time which saves time and ensures that both babies are eating on a similar schedule. Remember to alternate breasts with each baby for even stimulation and drainage. You should comfortably latch the less vigorous nurser first and then the other baby. In the beginning, you may need help getting comfortable with extra pillows, and of course good back support.  
 
There are 3 nursing positions you can try:

1- Both babies in the football hold or the double football: This position allows for better head control with smaller babies and moms can support their breasts better when latching and during the feeding. Mom also has good visualization of both babies in this position, and it is easier on a mom who has had a C-section.

2- Both babies in the cradle or cuddle hold with their legs crossed over or next to each other. This position may be more difficult in the beginning since mom can not support the babies’ heads as well.  However, as the babies gain more head and neck control, mom’s hands will be freer and she will have better eye contact with her babies in this position.

3- One baby in the cradle hold and one baby in the football hold.

As your babies mature and need less support, nursing will get easier and more comfortable. Hang in there!
 
Frequent feedings that drain the breasts will keep your supply up and will decrease the likelihood of developing sore nipples, plugged ducts, and breast infections. A breastfeeding log will help you to keep track of breastfeeding sessions in these first few hectic weeks. You can also keep track of the number of wet and soiled diapers in your log which is the best measure of breastfeeding success. You will also want to share this information with your Pediatrician and/or lactation professional.
 
I do not have personal experience nursing twins, but I have two very close friends (who happen to be twins themselves) who nursed their twin sons happily and successfully. They wanted to share some personal advice with you.

Dee – Mom of twin boys that nursed for 12 months:
 
“I remember going to La Leche League and buying a ‘twin pillow’ so I could nurse them both at the same time. It was the best investment because you are nursing so much. It gave me a little break in between. Nurse them on demand for the first couple of weeks to bring your milk supply in and remember, what seems like non-stop nursing will end. New moms have to hang in there for the first 4-6 weeks! Nursing gets so much easier after that (babies go longer and learn to nurse more efficiently so they are not on your breast as long), and it becomes so much more convenient than bottle feeding. Have someone leave snacks out for you to munch on during the day, such as graham crackers with peanut butter, because new moms forget to eat and drink…you’re so busy nursing, but you need the nutrition to build your milk supply! I had a doula for the first couple of months which helped me immensely, and she had twins so she knew what it was like.”
 
Deirdre – Mom of twin boys that nursed for 14 months:
 
“I agree with everything my twin sister said, but I would like to add a few things. In the first couple of weeks my nipples were a little sore when the babies first latched, but I hung in there and it passed and I’m so glad I did! I nursed each baby separately with soft music playing in the background. My husband would sometimes hold the second baby while I nursed the first one who was a more active, vigorous baby. In the middle of the night I would just roll over and nurse them. There was no need to get up and warm a bottle. It was so easy. Sometimes at night when the babies slept a little longer, I felt fuller, so I would pump a little milk off to keep my supply up and save it for when I had a chance to go out. I kept a breastfeeding ‘clip board’ to keep track of which baby was on which breast so I could alternate them. I sometimes wore two breast pads in my bra to help absorb leakage.  I would tell new moms to accept help from family and friends, eat well, and get rest when you can.  If I had an hour off, I wanted to be by myself, so I would take a bath with a glass of wine, or I would go out for an hour of shopping! Breastfeeding was the most rewarding experience of my life.  It is an incredible bond. Don’t quit!” 
 
The first year of life for parents of a new baby is an adjustment, and for the parents of twins it can be very hectic, and at times it may seem overwhelming. Accepting the help of family, friends, and professionals if needed, will be essential in the first several weeks to ensure adequate rest and nutrition for mom. It is also a wonderful idea to contact other moms who have nursed twins for their support and suggestions. We are happy to be offering our own support group for mom of multiples beginning on January 30th. Below is a list of some additional resources to turn to for support.
 
Resources for Breastfeeding Support with Twins:

Mothering Multiples: Breastfeeding and Caring for Twins or More! (La Leche League International Book)

By Karen Kerkhoff Gromada

Buy on Amazon

LaLeche League International - www.llli.org/FAQ/twins.html
 
TWINSTUFF.COM-www.twinstuff.com/breastfd1.htm
 
http://breastfeedingtwins.tripod.com/MainPages

Introducing the Bottle

Mothers frequently ask me “When is the best time to give a bottle and how do we do it?” For many women, it is source of anxiety, but a necessity at some point or another. Fortunately, it is fairly easy if you do it in a controlled and timely fashion, rather than at three in the morning when you are desperate!

Obviously, my goal is to help mothers breastfeed successfully, whatever that means for them. If mothers need to give a bottle, I hope to help them give a bottle of expressed breast milk instead of formula. The most important thing to know about being able to breast and bottle feed, which many women need/want to do, is that it can be done. However, it can’t be done in the hospital, right from the get go. If you want to nurse, you have to spend the time getting breastfeeding off to a good start. This process usually takes about 3 to 4 weeks of exclusive nursing. If you do that, and nurse exclusively through the three week growth spurt, your milk supply will be well established. In addition, your baby will have learned how to nurse correctly and giving a bottle at this time will not “undo” that!

Early bottle introduction causes a host of problems for the breastfeeding family. First, these babies are usually given formula and too much of it. Babies who are nursing get only a small amount of colostrum (mother’s early milk) at each feeding, which is exactly what they need. Bottle fed babies tend to get 2-3 ounces of formula, which is much harder to digest. It prevents the meconium (baby’s first waste) from being passed quickly, suppresses their appetite and keeps them from feeding frequently, which they need to do to bring their mother’s milk in. In addition, hospital bottles have a standard size nipple, which is much smaller than a mother’s breast. Babies learn immediately to position their mouth incorrectly for breastfeeding when they are given this bottle. When they replicate that on their mom, it hurts!

So, the first few weeks should be about getting a good latch and getting your supply established. If you want to give expressed breast milk in a bottle when the time comes, you can also use this time to collect some milk to give later. There may be several opportunities for this in the early weeks. If you get engorged, you can pump just enough to make yourself comfortable, which may mean only pumping a half ounce! You may also have times when the baby takes only one side, falls into a milk coma and doesn’t take the other. In that case, pump the side he doesn’t take and save that milk. You can mix the milk from several different pumping sessions to make one bottle. When you collect a total of 3 ounces, stick it in the freezer, and you have milk for your first bottle!

Develop a plan for the first time you give your baby a bottle and have someone other than you do it. I like moms to leave the house and do something for themselves. Arrange for dinner with a friend, a haircut, or shopping to get some clothes that you fit into! The reason for this is that first of all, you probably need a little alone time after three weeks of exclusive nursing. In addition, if the baby sees, hears, or smells you, the baby may protest and wonder why you are not feeding him/her. And if the baby protests at all, the person with the bottle may quickly give up and pass the baby back to you!

It is best to time it so that you leave the house right before your baby is due to eat, and pump just before heading out the door. This gives you a few hours to do what you want, and you can nurse right when you get back. This pumped milk can be used immediately, if necessary, or goes into the freezer for the next time your baby gets a bottle. When your baby gets a bottle, it should be a bottle with a wide base and nipple, not a standard size. Thaw your frozen milk, pour it in, and have it at room temperature or a little warmer for the baby.

When done this way, bottle introduction is usually pretty uneventful. Be prepared for a mix of emotions when you come home and find out everything went fine, which is after all, what you want! Then make sure that the bottle is offered every few days, especially if you will be going back to work. If you do that, though your baby will always prefer you, he will take a bottle without difficulty when he needs to!

Rhode Island is the First US State to Support Breastfeeding Mothers by Becoming Bag-Free!

Through the hard work and dedication of many hospital employees throughout the state, and the gentle insistence of our Health Department, Rhode Island became the first “Bag Free” state in the nation. I realize it is old news by now, but for those who don’t know, this means “women who give birth in Rhode Island will no longer receive infant formula marketing packs when they head home from the hospital.”(www.banthebags.org) In an event held at the State House on November 28, 2012 Rhode Island’s First Lady, Stephanie Chafee, Lieutenant Governor, Elizabeth Roberts, RI Department of Health Director, Michael Fine, and Marsha Walker from the Massachusetts Breastfeeding Coalition’s Ban the Bags campaign all celebrated this achievement and “spoke of their commitment to breastfeeding families and their support of the hospitals’ efforts in this giant step forward in removing the commercial barriers to breastfeeding.”(www.banthebags.org)

I think that most everyone who heard about this knew that it was a good thing for the health of babies in our state. Some weren’t happy about it, but I really don’t think they understood what it means. And let me be clear: it does not mean that mothers will not be able to receive formula in the hospital if they choose not to breastfeed. The hospitals will still have formula, and will still provide it for your child if you want it. What they will no longer do, is routinely give out discharge packs with free formula to mothers as they leave the hospital. Dr. Melissa Bartick, a Boston MD, wrote in a very public debate with MA Governor Mitt Romney that giving formula samples to new mothers was akin to giving Big Macs to patients on a cardiac floor. As Marsha Walker has said many times, “Hospitals should market health, and nothing else.” When nurses send new mothers home with a bag of free formula, it is an implied endorsement of that product. “State health officials noted that studies link these giveaways to decreased breastfeeding rates, which is not in keeping with their efforts to promote optimal health for mothers and infants in Rhode Island.”(www.banthebags.org)

We all know the benefits of breastfeeding. This information has been well promoted among the public health community for years. But “because breastfeeding is the gold standard infant nutrition that provides optimal healt
h for both mothers and infants, lactation experts have recently shifted to describing the risks of formula feeding rather than the benefits of breastfeeding. For mothers, not breastfeeding is associated with an increased risk of post-partum blood loss, post-partum depression, and ovarian and breast cancer when compared with women who do breastfeed. For children, risks of formula feeding include an increased incidence and severity of a wide range of infectious diseases as well as chronic diseases such as diabetes mellitus and obesity.” (MacNamara et al, 2012) When framed that way, doesn’t it make sense not to promote an unhealthy behavior? Especially in a hospital, where we really have the opportunity to help mothers get off to a great start establishing healthy habits with their baby!

So our tiny little state has really done a big thing for families who deliver their babies here. Next on our agenda: having Rhode Island become the first state in the nation with all birthing hospitals designated as Baby Friendly. “The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding. The BFHI assists hospitals in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies or feeding formula safely, and gives special recognition to hospitals that have done so.”(www.babyfriendlyusa.org) Currently in Rhode Island, Newport, South County and Westerly hospitals have all achieved this status. Throughout the world, the majority of hospitals are Baby Friendly. It is only here in the USA, which is so heavily influenced by the business of formula marketing, that Baby Friendly hospitals are in the minority. Interested in helping to make this happen? Contact your local hospital and ask that they do everything they can to achieve this designation and deliver only at a hospital that has it. Consider joining the Rhode Island Breastfeeding Coalition (RIBC) and joining our advocacy efforts. You can read more about this wonderful organization and ways to get involved at the following link: www.health.ri.gov/partners/coalitions/breastfeeding. We hope that you will join us!

{Guest Post} Tips & Ideas from Newborn Photographer Jean Monti

We are incredibly lucky to spend our day with such wonderful moms and their precious babies. There is no question – the newborn phase goes by fast! Cherish those sweet snuggles, enjoy this special time with your little one, and take lots of photos!

In our guest post today, we share with you some great tips and ideas for newborn portraits from Rhode Island & Massachusetts Photographer and Artist – Jean Monti. Enjoy!

NEWBORN PHOTOGRAPHY PORTRAITS

http://www.jeanmontiphotography.com

TOP QUALITY NEWBORN PHOTOS: HOW JEAN MONTI PUTS HER HEART INTO NEWBORN PHOTOGRAPHY PORTRAITS.
I love newborn photography and look forward to every newborn photography session with excitement and enthusiasm.  Imagine welcoming new babies into your family every month!  I have the honor of this experience every time I welcome a new family into my home studio. Can you image the joy and love I am surrounded with during every session? Newborns represent innocence, purity, goodness, and so much hope for our future. I always try and photograph them in a wide variety of poses to be sure I capture the present newness that will change so quickly with each and every passing day. I love how cozy they look swaddled in a soft wrap on a fur blanket, and how beautiful they are in a basket bathed in sunlight in a creative and natural setting, or how secure and loved they are when in the arms of their adoring parents.   The details of their rosebud lips, and their tiny little toes are important because we never want to forget how sweet and little they are.

Sunlight cascading through a window on a newborn is photographed by Jean Monti Photography in her Cumberland RI studio

It is best to photograph newborns during the first 14 days of their life. I understand how exhausted parents feel during this time, but I have never had a parent regret scheduling time to have professional photographs of their newborn. I highly recommend capturing this fleeting and special time in your life with a professional, but if you would like to try it on your own, here is what I suggest for ideas and tips.

Newborn Photographer, Jean Monti, photographs newborn at the Jean Monti Photography studio located in Cumberland, RI

Detail of a newborn’s head being held by the hands of her father and mother.

Detail image of a newborns tiny feet was captured in the photo studio of Jean Monti

Jean Monti loves to document the smallest details of a newborns lips during a newborn photography session

NEWBORN PHOTO IDEAS AND TIPS BY JEAN MONTI

PHOTOGRAPHING A NEWBORN BABY

Use a really good camera! I too think the mobile device cameras have come a long way for fun candid shots, but they are absolutely no substitute for a DSLR with a really good lens when capturing fine art portraits. You cannot control aperture, speed, or ISO with a mobile device.

Have a plan! I always go over color schemes, where the clients want to hang the finished portraits, do they want to fill an album, do they want 50% or 90% of the images to be just the newborn and the rest to be with the parents, etc.  It is best to photograph a newborn just after they eat and when they are asleep. Mom should avoid certain foods if nursing because the baby will be moved around more than usual and certain foods will make them more upset than usual. Within the first 15 minutes and while sound asleep, photograph them swaddled and wrapped lying down on a bed or a covered beanbag. This way you are guaranteed to have something great before moving on to more difficult poses where their body is exposed. Also, make sure the room and your hands are very warm. Babies love to be in constant contact, so I stay very close, hold their hands and legs close to their body, and always move them gently and slowly so as to not startle them. Whatever you do, don’t change them on a cold plastic changing pad! Imagine someone lifting you out of bed in the morning, undressing you, and then placing your warm body on a cold plastic pad!  Next, you can try to place them in a basket, but always have someone close by to make sure baby is safe and nothing in the basket is poking or hurting them in any way. Make the bed of the basket soft with blankets and/or fur and softly cushion their head.  At this time you can swap out hats, or headbands, and slowly try and remove the wrap.